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Contents

2019 - Questions .......................................................... 4

2020 - Questions ........................................................ 59
NEET PG 2013 - Questions ..................................... 121
NEET PG 2014 - Questions ..................................... 206
NEET PG 2015 - Questions ..................................... 292
NEET PG 2016 - Questions ..................................... 368

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 Subject: 2019 - Questions
1. Nutritional status Obese Overweight Moderately underweight Severely underweight
Moderate acute malnutrition Severe acute malnutrition Moderately stunted Age: birth to 5
years Weight-for-length/height or BMI-for-age >3 standard deviations (SD) of the median
Weight-for-length/height or BMI-for-age >2 SD and ?3 SD of the median Weight-for-age
Weight-for-age Weight-for-length/height or BMI-for-age ?–2 SD and ?–3 SD of the median, or
mid-upper arm circumference ?115 mm and Weight-for-length/height or BMI-for-age 190.
Severe acute malnutrition as per WHO criteria-
a) Weight for age less than median plus – 2 SD
b) Weight for height less than median plus 2 SD
c) Weight for age less than median plus 3 SD
d) Weight for height less than median minus -3SD

2. IV Mannitol is used for treatment of

a) Acute congestive glaucoma
b) Pulmonary edema
c) Acute renal failure
d) CHF

3. Most common type of gallstone is-

a) Mixed stones
b) Pure cholesterol stones
c) Pigment stones
d) Calcium bilirubinate

4. Coxsackievirus A16 causes

a) Yellow fever
b) Hand-foot-mouth disease
c) Rocky mountain spotted fever
d) Encephalomyocarditis

5. Which statement best describes mechanism of action of azole?

a) Synthesis of ergosterol
b) Thymidylate synthase
c) Targeting Beta-1,3 – glucan
d) Disruption of cell wall.

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6. Cross product ratio is determined by which study ?
a) Case control
b) Cohort
c) Cross sectional
d) RCT

7. What is the dose of ulipristal acetate?

a) 300mg
b) 30mg
c) 300?g
d) 30?g

8. What is the function of IL1?

a) Enhances hematopoiesis
b) Stimulates mast cells
c) Has antiviral properties
d) Endogenous pyrogen

9. Female with 41 wk gestation confirmed by radiological investigation, very sure of her

LMP, no uterine contractions, no effacement and no dilatation. What should not be done?
a) Intracervical foley’s
b) PGE1 tab
c) PGE2 gel
d) PGF2alpha

10. Osborn J waves is seen in-

a) Hypothermia
b) Hyperkalemia
c) Hypocalemia
d) Hypokalemia

11. Which method is used to study the following timeline?

a) Cohort Study
b) Cross sectional study
c) Randomized Control Trials
d) Interventional Studies

12. Identify the lesion of vocal cord in the image given below:
a) Reinke’s edema
b) Laryngeal Papilloma
c) Malignancy
d) Tracheomalacia

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13. Glanzmann thrombasthenia is due to
a) Decreased GpIb
b) Decreased GpIIb/IIIa
c) Anti-GpIIb/IIIa antibodies
d) Inhibition or deficiency of ADAMTS 13

14. Vertical transmission of HIV is highest with-

a) Elective caesarean section
b) High viral RNA load
c) Breast feeding
d) Term delivery

15. Not a personal protective equipment

a) Goggles
b) Badges for detecting radiation
c) Gloves
d) Lab coat

16. Premature ejaculation is a part of which phase of sexual disorders?

a) Excitement phase
b) Plateau phase
c) Orgasm phase
d) Refractory phase

17. MRP 2 associated with which of the following?

a) Rotor syndrome
b) Dubin-Johnson syndrome
c) Crigler-Najjar syndrome
d) Gilbert syndrome

18. Marked area in the given image is supplied by which dermatome?

a) T8
b) T9
c) T10
d) T11

19. Most common indication for liver transplant in children-

a) Biliary atresia
b) Cirrhosis
c) Hepatitis
d) Drug reactions

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20. Which of the following is false as physiological change in pregnancy?
a) Increase cardiac output
b) Increase total protein
c) Increase residual volume
d) Increase GFR

21. Parathyroid gland is implanted in which muscle?

a) Sartorius
b) Supinator
c) Deltoid
d) Brachioradialis

22. The major contribution of the amniotic fluid after 20 weeks of gestation :
a) Ultrafiltrate and maternal plasma
b) Fetal urine
c) Fetal lung fluid
d) Fetal skin

23. Which one of following is functions of PGI2?

a) Inhibits platelet aggregation
b) Is a vasodilator
c) Is pyrogenic like PGE2
d) All of the above

24. Two identical twins will not have same

a) Fingerprints
b) DNA copies
c) Iris color
d) Blood group

25. Anaesthetic gas with maximum respiratory irritation

a) Halothane
b) Enflurane
c) Desflurane
d) Sevoflurane

26. Identify the blood grouping process done here. Slide given with: AB no clumps,
Clumping in O & No clumps in control. Which group does this signify?
a) A-ve
b) B+ve
c) O+ve
d) Rh group

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27. Esotropiais usually associated with:
a) Myopia
b) Hypermetropia
c) Astigmatism
d) Presbyopia

28. Degloving skin involves removal of?

a) skin , subcutaneous fat, fascia, muscle
b) skin, subcutaneous fat, fascia
c) skin only
d) skin subcutaneous fat

29. Which is not related to HIV

a) Primary CNS lymphoma
b) Tertiary syphilis
c) Oesophageal candidasis
d) None

30. Which apolipoprotein is responsible for Alzeihmers disease

a) APOE4
b) APOE3
c) APOE2
d) APOE1

31. Achondroplasia shows which type inheritance-

a) XLR
b) XLD
c) Autosomal recessive
d) Autosomal dominant

32. Which of the following exocrine glandular ducts are not obstructed in cystic fibrosis:
a) Pancreas
b) Lung
c) Sweat gland
d) All of above

33. The significance of difference between proportions can also be tested by-
a) .‘t’ test
b) Chi square test
c) ANOVA
d) Correlation and regression

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34. years 3 years 4 years 5 years 187. Bidextrous grip is seen at what age?
a) 4 months
b) 5 months
c) 6 months
d) 7 months

35. Patient with recurrent abortion diagnosed to have antiphospholipid syndrome. What will
be the treatment?
a) Aspirin only
b) Aspirin + Low molecular weight Heparin
c) Aspirin + Low molecular weight Heparin + Prednisolone
d) No Treatment

36. MELD score includes

a) Serum creatinine
b) Transaminase
c) Albumin
d) Alkaline phosphatase

37. Contraception not desirable Progestogens Ethamsylate, NSAIDs Estrogen Tranexamic

for 3–4 months GnRH 3–4 months Combined OCPs Progestogens and other hormones
Mirena Effective Fails Minimal invasive Continuesurgery Normal uterus (DUB) Progestogens
and others ?No response Hysterectomy with removal of ovaries after 50 years Uterine
pathology Surgery for 6–9 months Hysterectomy with conservation of ovaries 221. 45 years
female with 3 months menorrhagia. USG showing 2 cm submucosal fibroid.Treatment
options.
a) Ocp for 3 months
b) Progesterone for 3 months
c) Endometrial sampling
d) Hysterectomy

38. Day 20 of menstrual cycle falls under which phase?

a) Menstrual phase
b) Follicular phase
c) Ovulation phase
d) Luteal phase

39. Following test is used to diagnose which ocular condition as shown in image:
a) Strabismus
b) Heterophoria
c) Both A & B
d) None of the above

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40. Viscera in toxicology stored in
a) Glycerine
b) Rectified spirit
c) Formalism
d) Saturated salt solution

41. In Retinitis pigmentosa decreased level of?

a) Arachidonic
b) Trielonic
c) Thromboxane
d) Docosa hexanoic acid

42. Rubella virus belongs to which family ?

a) Rheovirus
b) Togavirus
c) Picornavirus
d) Orthomyxo

43. What are Gitter cells:

a) Macroglia
b) Modified macrophages in CNS
c) Astrocytes
d) Oligodendrocytes

44. Right coronary artery arises from?

a) Right Aortic Sinus
b) Left Aortic Sinus
c) Posterior coronary sinus
d) Anterior coronary sinus

45. Chemotherapy agents for retinoblastoma:

a) vincristine ,carboplatin and etoposide
b) vinblastine, etoposide and bleomycin
c) vinblastine , vincristine and etoposide
d) vinblastine , vincristine and cisplatin

46. True about Tenosynovitis of finger ?

a) Fingers held in mild extension / Extension deformity at the involved fingers.
b) Tenosynovitis of little finger will spread to thumb rather than ring finger.
c) With involvement of little finger the infection can spread to the index finger.
d) Treatment is conservative.

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47. All of the following are examples of Dietary fibre except-
a) Pectin
b) Lignin
c) Cellulose
d) Gums

48. A child issuffering fromrecurrent chronic infections with encapsulated bacteria is due to
deficiency of subclass .
a) IgG1
b) IgG2
c) IgG3
d) IgG4

49. Flask shaped ulcers in intestine caused by

a) Giardia lamblia
b) Entamoeba histolytica
c) Helicobacter pylori (H. pylori)
d) E. vermicularis

50.
a) Cerebrum
b) Brain stem
c) Corpus callosum
d) Cerebellum

51. Identifythe instrument:

a) Maddox rod
b) Maddox wing
c) Maddox glass
d) Red glasses

52. DOC for chemotherapy induced vomiting is?

a) Graneseteron
b) Prazosin
c) Clonidine
d) Dimenhydrinate

53. Parotid mass mixed consistency

a) Pleomorphic adenoma
b) Sebaceous cyst
c) Dermoid cyst
d) All

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54. In a patient with lipoprotein lipase deficiency, which of the following is increased
following a fatty meal?
a) Chylomicron
b) LDL
c) HDL
d) Apo-A

55. Which of the following drug is alpha 2 agonist?

a) Apraclonidine
b) Timolol
c) PG analogues
d) Verampamil

56. What is the cause of death according to the below death certificate
a) Breast Cancer
b) Secondaries
c) Cerebral Hemorrhage
d) All of the Above

57. C-peptide seen in?

a) In Pre-proinsulin
b) In Proinsulin
c) As a combined entity with insulin after secretion
d) A gastrointestinal proactive molecul

58. Type of necrosis seen in blood vessels due to immune reactions-

a) Coagulation
b) Liquefaction
c) Fibrinoid
d) None

59. Nerve injured in Frey’s syndrome is:

a) Auriculotemporal Nerve
b) Great auricular nerve
c) Lingual Nerve
d) Inferior alveolar nerve

60. Most characteristic cardiovascular defect seen in Rubella-

a) Pulmonary artery stenosis
b) Coarctation of aorta
c) Ankylosis spondylitis
d) Rheumatic fever

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61. IL- 1 activated by-
a) Capsase 1
b) Capsase 3
c) Capsase 8
d) Capsase 5

62. Identify the structure marked by a red arrow in the given image:
a) Great vein of galen
b) Pineal gland
c) Fornix
d) Falx cerebri

63. Drug acting on K+ channels include which of the following?

a) Spironolacton
b) Amiloride.
c) Nicorandil
d) Methyldopa

64. Identify the condition given in the image?

a) Atrial fibrillar
b) Atrial flutter
c) Ventricular tachycardia
d) SVT

65. Vulvar atrophy and itching are treated by-

a) Estrogen ointment
b) Antihistamines
c) Tamoxifen
d) None

66. 2 year old boy of weight 12 kg with vitamin A deficiency what is oral dose of vitamin A
a) 50, 000 I.U
b) 1 lakh I.U.
c) 1.5 lakh I.U
d) 2 lakh I.U

67. Duct of Bellini are present in:

a) Pancreas
b) Liver
c) Kidney
d) Salivary gland

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68. Which of the following statement is correct about acute fatty liver of pregnancy?
a) Occurs in 1 in 1000 pregnancy
b) Mostly seen in last trimester
c) Common if female fetus is present
d) May be associated with decreased uric acid

69. Identify the condition shown in the image below.

a) Intertrigo
b) Heat rash
c) Eczema
d) Impetigo

70. Sexual perversions(Exhibitionism) is under section

a) Section 290
b) Section 294
c) Section 230
d) Section 291

71. Skin color Pulse rate Reflex irritability grimace Score of 1 blue at extremities body pink
(acrocyanosis) < 100 beats per minute grimace on suction or aggressive stimulation some
flexion weak, irregular, gasping Score of 2 no cyanosis body and extremities pink > 100
beats per minute cry on stimulation flexed arms and legs that resist extension strong, robust
cry Activity none Respiratory absent effort 189. APGAR score 3 at 1 minute indicates:
a) Mildly depressed
b) Further resuscitation not needed
c) Severely depressed
d) Normal

72. PGF2 alpha maximum dose in PPH is-

a) 2000 ?g
b) 200 ?g
c) 2 mg
d) 20 mg

73. First line of treatment of mastitis in a lactating mother is-

a) Dicloxacillin
b) Cefazolin
c) Ceftriaxone
d) Ampicillin

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74. DOC for smoking cessation?
a) Acamprosate
b) Varenicline
c) Thalidomide
d) Tryptophan

75. True about treatment of early breast carcinoma?

a) Aromatase inhibitors are replacing tamoxifen in premenopausal women
b) Post mastectomy radiation therapy is given when 4 or more lymph nodes are positive
c) Tamoxifen is not useful in post-menopausal women
d) In premenopausal women, multidrug chemotherapy is given in selected patients

76. Patient presents with purities of inter digits of left hand as shown in the image. Identify
the condition?
a) Sarcoptes scabis
b) Dermatitis herpetiformis
c) Xerotic dermatitis
d) Erythema multiforme

77. Zewellger syndrone is due to absence of

a) Lysosomal
b) Mitochondria
c) Peroxisome
d) Nucleus

78. Functional residual volume is?

a) After normal inspiration
b) After normal expiration
c) After forceful expiration
d) After forceful inspiration

79. A child with history of fever, photosensitivity, rash sparing nasolabial fold presents to
OP. Identify the condition?
a) SLE
b) Polymorphous light eruption
c) Discoid lupus
d) Skin tuberculosis

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80. With increase in age which of the following is true for lungs?
a) Pulmonary compliance increases
b) Residual volume decreases
c) Mucocillary clearance increases
d) Fibrous of interstitium dreaseses

81. Pharyngeal arch Muscular contributions Skeletal contributions Maxilla Zygomatic bone
Part of temporal and vomer, sphenoid, mandible Meckel’s cartilage:- Malleus,(V3). incus
Anteriorligament of malleus Sphenomandibular ligament Reichert’s cartilage, stapes
(except footplate) Ist (also Anterior belly of called “mandibulardigastric arch”) Tensor veli
palatini Tensortympani Stapedius Stylohyoid 10. Structure derived from first pharyngeal
arch:
a) Levator palatini
b) Buccinator
c) Stylohyoid
d) Anterior belly of digastric

82. Respiratory centres are stimulated by

a) Oxygen
b) Lactic acid
c) Carbon dioxide
d) Calcium

83. MgSO4 have no role in prevention of-

a) Seizures in severe pre-eclampsia
b) Recurrent seizures in eclampsia
c) RDS in premature baby
d) Bradycardia

84. Golgi tendon organ responsible for?

a) Tension
b) Length
c) Pressure
d) Proprioception

85. CEAP score indicates-

a) Atrial disorders
b) Venous disorder
c) Neurological disorde
d) Trauma disorder

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86. Menkes disease is associated with which enzyme deficiency.
a) lysyl oxidase
b) Methionine synthase
c) Glutamyl aminopeptidase
d) Lysyl hydroxylase

87. If a mother is donating kidney to her son is an example-

a) Isograft
b) Allograft
c) Autograft
d) Xenograft

88. Identify the image

a) Malaria
b) Plague
c) Japanese encephalitis
d) Paragonimus

89. Identify the condition of the given image:

a) Acquired cholesteatoma
b) Congenital cholesteatoma
c) Rupture of tympanic membrane
d) Keratosis obturans

90. Omphalocele is caused by?

a) Duplications of intestinal loops
b) Abnormal rotation of the intestinal loop
c) Failure of gut to return to the body cavity from its physiological herniation
d) Reversed rotation of the intestinal loop

91. Syndrome associated with posterior inferior cerebellar artery thrombosis:

a) Wallenberg syndrome
b) Medial medullary syndrome
c) Inferior alternating syndrome
d) Dejerine syndrome

92. In 34 weeks gestation the weight of baby was 3kg.The child shows following features
may indicate associated condition –
a) Anemia
b) Diabetes
c) APH
d) None

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93. Urea, creatinine, nitric oxide formed by which amino acid
a) Histidine
b) Glycine
c) Cysteine
d) Arginine

94. Krabbe’s disease is-

a) Deficiency of Beta- galactosylcermidase
b) Deficiency of aryl sulphatase
c) Alpha galactosidase
d) Acid lipase

95. Which of the following is not cardiodepressive?

a) Propofol
b) Thiopentone
c) Ketamine
d) Etomidate

96. Which of the following is water soluble contrast?

a) Barium
b) Iodine
c) Bromium
d) Calcium

97. In Wilson’s disease, there is less urinary excretion of-

a) Phosphorus
b) Methyl- Histidine
c) Phosphotyrosine
d) Serine

98. Chromosome number of partial hydatidiform mole is-

a) 46 XX
b) 45 XO
c) 46 XXY
d) 69 XXX

99. Identify the triangle in the image below-

a) Koch’s triangle
b) Gastrinoma triangle
c) Hesselbach’s triangle
d) Sherren’s triangle

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100. Identify the condition in the below image?
a) Lacunar infarct
b) Embolic infarct
c) Thrombotic infarct
d) Intracerebral hemorrhage

101. Apoptotic gene is-

a) Bax
b) Bcl2
c) Bclx
d) Mcl

102. Conversion of Norepinephrine to epinephrine is mainly by?

a) S-adenosyl methionine
b) Arginine
c) Phenylalanine
d) Dehydrogenease

103. Risk factors for alzheimer’s disease include-

a) Klinefelter syndrome
b) Low BP
c) Down’s syndrome
d) None

104. Which of the following is an absolute CONTRAINDI?CATION to OCP use:

a) Chronic renal disease
b) DVT
c) Diabetes mellitus
d) History of amenorrhea

105. Where to look for pre-ductal O2 saturation in PDA in a 3 minute born infant?
a) Fetal left Upper limb
b) Fetal left lower limb
c) Fetal right Upper limb
d) Fetal right lower limb

106. DOC for digitalis is induced centro-chilar tachycardia?

a) Lidocaine
b) Reducing dosage of digoxin itself, reverses the condition
c) Verapamil
d) Beta blockers

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107. Infarcts involving which portion of the myocardium cause aneurysm as a post- MI
complication-
a) Subendocardial
b) Anterior transmural
c) Posterior transmural
d) Inferior wall

108. True about type 1 diabetes mellitus

a) Decreased protein catabolism
b) Decreased hepatic Glucose output
c) Increased lipolysis
d) Increase glucose uptake

109. Healthy Human volunteers part of which clinical trial phase?

a) Phase 1
b) Phase 0
c) Phase 3
d) Phase 4

110. The most common site of the branchial cyst is:

a) Posterior border of sternocleidomastoid
b) Anterior border of sternocleidomastoid
c) Digastric muscle
d) Omohyoid muscle

111. Which is not a epidemiological indicator?

a) ABER
b) Annual parasite index
c) Annual falciparum incidence
d) None of the Above

112. MOA of Teduglutide in short bowel syndrome?

a) GLP-2 inhibitor
b) HT1a inhibitor
c) GLP-1 analogs
d) C-peptide analogs

113. Deep venous thrombosis which is incorrect –

a) Clinical assessment highly reliable
b) Mostly bilateral
c) Most common clinically presents as pain and tenderness in calf
d) Some cases may directly present as pulmonary thromboembolism

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114. Morbid fear of darkness known as:
a) Claustrophobia
b) Xenophobia
c) Mysophobia
d) Nyctophobia

115. Identify the infection from the chest X- ray of a patient with low-grade fever?
a) ILD
b) Bronchopneumonia
c) Miliary TB
d) Consolidation

116.
a) Duplication of Ureter
b) Congenital Megaureter
c) Ureterocele
d) Urinary Stones

117. Antiretroviral therapy is to be given in HIV infected patients irrespective of presence of

symptoms if CD4 count is less than?
a) 100
b) 150
c) 200
d) 350

118. Solitary lytic lesions seen in

a) Atherosclerosis
b) Multiple myeloma
c) Mitral stenosis
d) Osteoblast

119. Which among the following is most probable reason for preference of Cisatracurium
over atracurium?
a) Decreased histamine release
b) Increased histamine release
c) Due to elimination by Hofmann elimination
d) Increased CNS toxicity

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120. What is the nerve supply of Submandibular gland:
a) Auriculotemporal nerve
b) Lingual nerve
c) Glossopharyngeal nerve
d) Inferior alveolar nerve

121. Which wall of heart enlargement can be seen on barium swallow in patient with mitral
stenosis-
a) Left atrium
b) Right atrium
c) Left ventricle
d) Right ventricle

122. A 36 yrs old male patient c/,o cough cold fever/rusty sputum / sputum neg for tb ,h/o of
travel in china & eaten crab, Name the infection
a) Paragonimus westermani
b) Faciola hepatica
c) Fasciolopsis buski
d) Entamoeba histolytica

123. Identify the type of knot in the image-

a) Granny knot
b) Surgeon’s knot
c) Reef knot
d) None

124. Risk of genetic diseases in consanguineous marriage between first cousins?

a) 1-2%
b) 4-8%
c) 8-10%
d) 12-14%

125. 12 Identify the picture

a) Herpes zoster pic
b) Small pox
c) Chicken pox
d) Atopic dermatitis

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126. A 25 year old alcoholic presented with edema,hypertension, ocular disturbance,and
changes in mental state was observed, diagnosis of high output cardiac failure was made
with Wet Beri Beri, this is due to deficiency of?
a) Vit B3
b) Vit B6
c) Vit B9
d) Vit B1

127. Foot drop is caused by injury to which nerve involvement:

a) Femoral nerve
b) Tibial nerve
c) Common peroneal nerve
d) Sciatic nerve

128. Variation in sensitivity of response to different doses of a drug in different individual is

obtained from?
a) Dose response curve
b) Therapeutic index
c) Bioavailability
d) Phase 1 clinical trials

129. Drug used in acute congestive glaucoma are:

a) Atropine
b) Pilocarpine
c) Acetazolamide
d) Both B & C

130. Best representative of incidence of disease in different timeline-

a) Histogram
b) Line diagram
c) Scattered diagram
d) Bar diagram

131. In forceful expiration, which of the following neurons gets fired?

a) VRG
b) DRG
c) Pneumotaxic centre
d) Chemoreceptors

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132. A patient presented with the following picture of Tympanic Membrane. Most Probable
diagnosis (marked with arrow):
a) Tubercular Otitis Media
b) Syphilitic Otitis Media
c) Pseudomonas infection
d) Fungal Otitis Media

133. LCAT deficiency increases the following

a) HDL
b) LDL
c) VLDL
d) Chylomicron

134. Type of sensation lost on same side of Brown Sequard syndrome-

a) Pain
b) Touch
c) Proprioception
d) Temperature

135. Which nerve passes through the marked foramen in the given image:
a) Lingual nerve
b) Mandibular nerve
c) Chorda tympani nerve
d) Inferior alveolar nerve

136. Bell’s palsy is associated with the lesion in which of the nerve?
a) 11th cranial nerve
b) 7th cranial nerve
c) 9th cranial nerve
d) 3rd cranial nerve

137. Which one of the following is an autosomal recessive disorder?

a) Albinism
b) Huntington’s syndrome
c) Marfan’s syndrome
d) Neurofibromatosis-1

138. Identify the condition. This is child with asthmatic mother.

a) Atopic dermatitis
b) SLE
c) Erythema
d) TEN

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139. Polyuria is -
a) 70ml/kg
b) 60ml/kg
c) 50ml/kg
d) 40ml/kg

140. Identify the condition as shown:

a) Brodie abscess
b) Osteoid osteoma
c) Intracortical hemangioma
d) Chondromyxoid fibroma

141. DOC forCyclosporiasis?

a) Trimethoprim sulfamethoxazole combination
b) Paromomycin
c) Metronidazole
d) Cyclosporin

142. A patient came in emergency with severe abdominal pain pulse 112/ minute and systolic
BP 80 mm/Hg with the chest X- ray shown below. What will be the next appropriate step to
be taken for the patient?
a) Exploratory laprotomy
b) Saline Wash of stomach
c) Intercostal tube drainage
d) None

143. Parathyroid autoimplantation takes place in which of the muscle?

a) Biceps
b) Triceps
c) Brachioradialis
d) Sartorius

144. Identify the instrument-

a) Blade no. 15
b) Blade no. 10
c) Blade no. 11
d) Blade 12

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145. Calcitonin levels increased in
a) Hyperthyroidism
b) Hyperparathyroidism
c) Hypoparathyroidism
d) Cushing Syndrome

146. Which of the following drug is used in SIADH?

a) Tolvapatan
b) Desmopressin
c) Vwb factor
d) Terlipressin

147. Identify the image with the diagnosis?

a) VT
b) PSVT
c) AT
d) Ventricular fibrillation

148. Paradoxical carriers are-

a) A person who acquires the microorganism due to his contact with the patient.
b) A person who acquires the microorganism another carrier.
c) A person who is clinically recovered from an infectious disease but still capable of
transmitting the infectious agent to others.
d) None

149. Identify the type of the fibre marked in the image of internal capsule:
a) Projection fibres
b) Short association fibres
c) Long association fibres
d) Commissural fibres

150. Which statement is incorrect about the pathology shown in the image:
a) Tumor arise from epiphyseal to metaphyseal region
b) Tumor has distinct margin
c) Eccentric lesion
d) Chemotherapy is the treatment of choice

151. Diagnostic power of a test to correctly diagnose a disease is-

a) Negative predictive value
b) Positive predictive value
c) Sensitivity
d) Specificity

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152. Which is the following is orally active direct Xa inhibitor?
a) Rivaroxaban
b) Agrataban
c) Dabigatran
d) Bilverudin

153. Alpha one anti trypsin works by

a) inhibition of trypsin
b) inhibition of trypsinogen
c) inhibition of elastase
d) inhibition of chymotrypsin

154. Overt gestational diabetes is defined as blood glucose more than_?

a) >200 mg/dl
b) >126 mg/dl
c) >100 mg/dl
d) >180 mg/dl

155. D.O.C forisospora

a) Penicillin G
b) Benzathine penicillin
c) Co-trimoxazole
d) Albendazole

156. IV administration of which anesthetic drug is most painful among the following?
a) Methohexital
b) Ketamine
c) Propofol
d) Etomidate

157. Essential major blood culture criteria for infective endocarditis.

a) Single positive culture of hacek
b) Single positive culture of coxiella
c) Single positive culture of cornybacterium
d) Both a & b

158. Identify the condition in the image?

a) Leukoderma
b) Piebaldism
c) Vitiligo
d) DLE

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159. Scissor gait is seen in which of the following condition:
a) Polio
b) Cerebral palsy
c) Hyperbilirubinemia
d) Hyponatremia

160. Vasopressin acts through which channels in collecting duct?

a) Aquaporin 1
b) Aquaporin 2
c) GLUT –
d) GLUT – 4

161. Gastric lavage is not contraindicated after ingestion of which acid.

a) HCL
b) H2SO4
c) Carbolic acid
d) Nitric acid

162. Mechanism of action of buspirone is?

a) 5 HT1A partial agonism.
b) 5 HT1B antagonism.
c) 5 HT1B partial agonism.
d) 5 HT2C antagonism.

163.
a) DMARD with short course of Steroids
b) Only NSAID’S
c) DMARD after initial 3 months of NSAID’S
d) Monotherapy with TNF drugs

164. Bainbridge reflux causes?

a) Bradycardia
b) Increased cardiac output
c) Decreased venous return
d) Increased heart rate

165. A patient of RA is taking methotrexate, steroids and NSAIDs since 4 months but activity
of disease progression is same. What should be the next probable step?
a) Start monotherapy with anti TNF alpha drugs
b) Continue methotrexate and steroids
c) Stop oral methotrexate and start parenteral methotrexate
d) Add sulfasalazine

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166. For trench type of sanitary filling the amount of land required for 2 meter deep trench
for 10000 population is-
a) 1 acre
b) 2 acre
c) 3 acre
d) 4 acre

167. A child is having Battered baby syndrome how will you identify
a) Stab wound
b) Gunshot wound
c) Bruise of different ages
d) None of these

168. Paired T test is defined as-

a) Test used to assess quantitative observations before and after an intervention
b) Test that is used when the observation are in the form of proportions (for qualitative data)
c) Test applied when separate observations are made on individuals of two separate groups,
and these need to be compared
d) None

169. What is the Nerve Supply of marked structure in the given image:
a) Anterior interosseous nerve
b) Posterior interosseous nerve
c) Ulnar nerve
d) Median nerve

170. Mechanism of action of Oseltamivir?

a) Protein synthesis inhibitor
b) Thymidylate synthetase inhibitor
c) Neuraminidase inhibitor
d) Pyrimidine analogs.

171. Identify the condition in the ECG?

a) Atrial fibrillation
b) Arrhythmia
c) Atrial flutter
d) Cardiomyopathy

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172. Imipenem, a newer antibiotic with a broad antibacterial spectrum, is co administered
with cilastatin. Which of the following is the best reason for the same?
a) Combination of antibiotics is synergistic against Pseudomonas specie
b) Cilastatin aids gastrointestinal absorption of active moiety, imipenem
c) Cilastatin inhibits beta=lactamase enzyme destroying imipenem
d) Cilastatin inhibits an enzyme in kidney destroying imipenem

173. Tubuloglomerular feedback control is useful for which one of the following?
a) GFR
b) Plasma sodium
c) Plasma volume
d) Determining tubular secretion

174. Drug to differentiate Myasthenia gravis from cholinergic crisis?

a) Pyridostgmine
b) Edrophonium
c) Methacholine
d) Clonidine

175. Identify the condition shown in the image?

a) Sebaceous cyst
b) Alopecia areta
c) Trichotillomania
d) Tinea capitis

176. A child has ptosis and poor levator function. What surgery will you do?
a) Levator muscle resection
b) Mullerectomy
c) Fasanella Servat surgery
d) Frontalis suspension surgery

177. Double decidua sign is seen during-

a) 1St trimester
b) 2nd early trimester
c) 2nd late trimester
d) 3rd trimester

178. Which of the following structure is not derived from external oblique muscle:
a) Inguinal ligament
b) Lacunar ligament
c) Cooper ligament
d) Linea Semilunaris

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179. Pneumocystis jerovici is:
a) Associated with CMV
b) Diagnosis is by sputum microscopy
c) Seen only in immunocompromised patients
d) Always associated with pneumatocele

180. The causative organism for the condition depicted in image is?
a) Staphylococci
b) Candidal infection
c) Streptococcus
d) Actinomycetes

181. Last point where reproductive and child health programme are include :
a) Sub-centre
b) Anganwadi
c) District
d) Taluka

182. Contralateral loss of pain and temperature is due to injury to:

a) Anterior spinothalamic tract
b) Lateral spinothalamic tract
c) Fasciculus gracilis
d) Fasciculus cuneatus

183. Space of Disse is in:

a) Spleen
b) Lymph node
c) Liver
d) Bone

184. CT image of left maxilla with history of allergic rhinitis?

a) Ground glass appearance
b) Double densities
c) Honey comb
d) Onion Peel Appearance

185. Protein which is not synthesised In liver is

a) Phase protein
b) Immunoglobulins
c) Albumin
d) Plasma hormone

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186. Mechanism of action of curare like drugs?
a) Blocks ACh synthesis
b) Blocks ACh receptors
c) Persistent depolarization
d) Agonistic with Ach receptors

187. Disc diffusion method is also known as

a) Kirby Bauer
b) VDRL
c) Dark field microscopy
d) None of these

188. DOC for diphtheria carrier state is?

a) Penicillin
b) Antitoxin
c) Penicillin Or erythromycin
d) Ciprofloxacin

189. Joint involved in movement of head from left to right.

a) Atlanto axial
b) Atlanto occipital
c) C2- C3 Joint
d) C3- C4 Joint

190. True about Barrett’s esophagus are all of the following except:
a) Causes adenocarcinoma
b) Patient is usually asymptomatic
c) Histology of the lesion shows mucus secreting goblet cells
d) Chronic gastroesophageal reflux is a predisposing factor

191. Dose of diphtheria antitoxin is-

a) 1000 to 5000 IU
b) 10000 to 100000 IU
c) 1000 to 2000 IU
d) None

192. What type of culture media is used for Ligionella?

a) (BCYE) agar media
b) MacConkey agar
c) Baird–Parker agar
d) Sabouraud’s agar

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193.
a) Bilateral pneumonia
b) ARDS
c) Carcinogenic PE
d) Collapse 264. A patient is a known case of acute pancreatitis develops breathlessness,
bilateral basal crepitation on day 4 and chest radiography as shown in the image below.
What will be the diagnosis?

194. A female patient of 26 years, presents with oral ulcers, photosensitivity and skin malar
rash in face sparing the nasolabial folds of both side.
a) Sturge weber syndrome
b) SLE
c) Dermatitis
d) Psoriasis

195. Slow conduction velocity is seen with which of the following nerve fibers?
a) Preganglionic autonomic nerve fibers
b) Postganglionic autonomic nerve fibers
c) Motor nerves
d) Sympathetic nerve fibers

196. Inspiratory stridor is found in what kind of lesions:

a) Supraglottic
b) Subglottic
c) Tracheal
d) Bronchus

197. Alcoholic shows which type of cardiomyopathy-

a) Hyper cardiomyopathy
b) Dilated cardiomyopathy
c) Pericarditis
d) Myocarditis

198. When the values of Fev1=1.3 & FCV=3.9. Which of the following does this signify?
a) Normal lung function
b) Obstructive lung disease
c) Restrictive lung disease
d) Both

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 Subject: 2019 - Answer Key

Question 1: Correct Answer: D

Explanation: Ans. D.Weight for height less than median minus -3SD Severe acute malnutrition is defined by
a very low weight for height (below -3z scores of the median WHO growth standards), by visible severe
wasting, or by the presence of nutritional oedema. World Health Organization (WHO) classification of
nutritional status of infants and children:
Question 2: Correct Answer: A
Explanation: Ans. A. Acute congestive glaucoma. Mannitol may be used to reduce intraocular pressure when
given intravenously.
Question 3: Correct Answer: A
Explanation: Answer- A Mixed- Between 4% and 20% of stones are mixed. Pigment- Between 2% and 30%
of stones are bilirubin stones. Cholesterol- Between 35% and 90% of stones are cholesterol stones. The
most common type of gallstones was mixed cholesterol type gallstones with 67.5% followed by black
pigment and brown pigment types as 23.83% and 5.89%, respectively. Mixed stones are 90% common. It
contains cholesterol, calcium salts of phosphate carbonate, palmitate, proteins, and are multiple faceted.
Question 4: Correct Answer: B
Explanation: Answer: B. Hand-foot-mouth disease Hand, Foot and Mouth Disease (HFMD) is caused by
coxsackie A- 16 The viruses that cause HFMD are spread through close personal contact, through the air
from coughing and the feces of an infected person. Coxsackievirus A16 is the most common cause, and
enterovirus 71 is the second-most common cause. Other strains of coxsackievirus and enterovirus can also
be responsible. It typically begins with a fever and feeling generally unwell. This is followed a day or two later
by flat discolored spots or bumps that may blister, on the hands, feet and mouth and occasionally buttocks
and groin.
Question 5: Correct Answer: A
Explanation: Ans. A. Synthesis of ergosterol Inhibition of 14a-lanosterol demethylase, a key enzyme in
ergosterol biosynthesis ? resulting in depletion of ergosterol & accumulation of toxic 14a-methylated sterols
in membranes of susceptible yeast species ? Destruction of fungus.
Question 6: Correct Answer: A
Explanation: Ans.A. Case control study Cross product ratio : Risk in case control study is calculated by odds
ratio (cross product ratio).
Question 7: Correct Answer: B
Explanation: Ans. B. 30 mg Ulipristal (Ella) is a progesterone agonist/antagonist marketed for emergency
contraception. It is available by prescription only. Its mechanism of action varies based on time of
administration. When taken before ovulation, ulipristal delays or inhibits ovulation. Administration in the early
luteal phase may decrease endometrial thickness and affect implantation of a fertilized egg. Ulipristal is
labeled for use as an emergency contraceptive following unprotected sexual intercourse or contraceptive
failure. One tablet(30-mg tablet) taken as soon as possible, within 120 hours (five days) of unprotected
sexual intercourse or contraceptive failure.
Question 8: Correct Answer: D
Explanation: Answer- D (Endogenous pyrogen) was formerly known as lymphocyte-activating factor (LAF).
augments the activity of many cell types, especially T cells. is an endogenous pyrogen (EP). induces an

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increase in acute phase reactants. is a heat-stable and pH-stable peptide with a molecular weight of 17.5 kd.
occurs in two forms: IL-1I?± and IL-1I?2.
Question 9: Correct Answer: D
Explanation: Ans. D. PGF2alpha PgF2 alpha is a uterine relaxant so it can’t be used in induction of labour.
Question 10: Correct Answer: A
Explanation: Answer. A. Hypothermia Cause people suffering from hypothermia with a temperature of less
than 32°C (90°F).
Question 11: Correct Answer: A
Explanation: Ans. A.Cohort Study The image represents the Natural history of disease that refers to the
progression of a disease process in an individual over time, in the absence of treatment. The timeline shows
the state of susceptibility, exposure, the subclinical disease in which pathologic changes take place, the
onset of symptoms, followed by the usual time of diagnosis, clinical disease, followed by recovery, disability,
or death. Longitudinal studies are used to study the natural history of the disease.
Question 12: Correct Answer: B
Explanation: -Laryngeal papillomatosis, or recurrent respiratory papillomatosis (RRP), is the most frequent
benign tumor of the larynx. - It is caused by the human papillomavirus (HPV) types 6 and 11. It is also the
second most common cause of hoarseness in children. -Laryngeal papillomas are located primarily in the
larynx on the vocal cord margins and epiglottis. -Tumors are benign but present obstructive problems
because of their localization in the vocal cords or other sites - At presentation, papillomas are usually present
on one or both
Question 13: Correct Answer: B
Explanation: Ans. is. b. Decreased GpIIb/IIIa Glanzmann thrombasthenia is an autosomal recessive disorder.
There is a failure of primary platelet aggregation with ADP or collagen due to inherited deficiency of two
platelets membrane glycoproteins. It is caused due to deficiency of glycoprotein IIb- IIIa.
Question 14: Correct Answer: B
Explanation: Ans. B. High viral RNA load Vaginal and emergency caesarean section deliveries, prematurity,
and low CD4 cell count were most strongly associated with infant‚s infection status in univariate analyses .
Children delivered vaginally or by emergency caesarean section were more likely to be infected than those
delivered by elective caesarean section, with a reduction in risk of 79% associated with the latter (P<0.001).
Similarly, infants delivered before 37 weeks were more than twice as likely to be infected than infants who
were not premature. Caesarean section before onset of labour and rupture of membranes approximately
halves the risk of mother-to-child transmission. Transmission rate: During pregnancy: 5–10% During labour
and delivery:10–15% During breastfeeding:5–20% Overall without breastfeeding:15–25% Overall with
breastfeeding to six months:20–35% Overall with breastfeeding to 18–24 months:30–45%
Question 15: Correct Answer: B
Explanation: Ans. B.Badges for detecting radiation
Question 16: Correct Answer: C
Explanation: Ans. C. Orgasm phase The male sexual response is described as a sequence of phases
including 4 stages: sexual desire, arousal, orgasm (ejaculation) and resolution. The male sexual dysfunction
usually occurs in one or more of the three first stages of the sexual response cycle, including: Dysfunctions
of sexual desire (e.g. hypoactive sexual desire) Arousal (e.g. erectile dysfunction) Orgasm/ejaculation (e.g.
premature ejaculation, retarded ejaculation or inability to ejaculate). Premature ejaculation occurs due to the
rapid evolution of the two first stages of the sexual response cycle and is not necessarily related to strong

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sexual arousal or changes in erection. Premature Ejaculation seems to be a neurobiological problem that is
related to low serotonin levels in those regions of the central nervous system that regulate ejaculation (brain
and spinal cord).
Question 17: Correct Answer: B
Explanation: Ans:B. Dubin-Johnson syndrome. Dubin-Johnson syndrome: An autosomal recessive disorder.
Caused by gene mutation responsible for human canalicular multispecific organic anion transporter (cMOAT)
protein/ also referred “multidrug resistance protein 2 (MRP2)” or ABCC2.
Question 18: Correct Answer: C
Explanation: Answer C. T10 Important dermatome & anatomical landmarks Following is a list of spinal
nerves and points that are characteristically belonging to the dermatome of each nerve. * C2 – At least one
cm lateral to the occipital protuberance at the base of the skull. Alternately, a point at least 3 cm behind the
ear. * C3 – In the supraclavicular fossa, at the midclavicular line.
Question 19: Correct Answer: A
Explanation: Answer- A (Biliary atresia) Indications for liver transplantation in infants and children include
acute liver failure (ALF), chronic liver failure with pruritus, complications of cholestasis and failure to thrive. In
young children, the most common liver disease leading to transplantation is biliary atresia
Question 20: Correct Answer: C
Explanation: Ans. C. Increase residual volume The respiratory rate is essentially unchanged, but tidal volume
and resting minute ventilation increase significantly as pregnancy advances. The functional residual capacity
and the residual volume are decreased as a consequence of the elevated diaphragm.
Question 21: Correct Answer: D
Explanation: Answer D. Brachioradialis Parathyroid surgery: Autotransplantation The most common places
for auto-implantation of parathyroid glands are the brachioradialis muscle and the presternal region. Other
locations can also be used: the sternocleidomastoid, the subcutaneous tissue of upper limbs and abdominal
fat.
Question 22: Correct Answer: B
Explanation: Ans. B. Fetal urine There are two primary sources of amniotic fluid: fetal urine and the lung
liquid. After about 20 weeks, fetal urine makes up most of the fluid.
Question 23: Correct Answer: D
Explanation: Ans. D. All of the above. Functions of PGI2: Inhibits Inhibits platelet aggregation, vasodilator
plus bronchodilator & pyrogenic like PGE2.
Question 24: Correct Answer: A
Explanation: Answer: A. Fingerprints Identical twins have the same DNA, but their fingerprints
(dactylography) are still diferent and they do not change. These can be easily used to differentiate between
an identical set of twins. Identical twins have the same set of DNA, therefore DNA fingerprinting cannot
differentiate them.
Question 25: Correct Answer: C
Explanation: Ans:C. Desflurane Desflurane and isofurane when used for induction cause respiratory irritation
due to their pungent smell leading to breath holding and coughing. Halothane and sevoflurane do not cause
such effects.
Question 26: Correct Answer: D
Explanation: * D antigen – - Most important blood group antigen in routine blood banking. - Antibodies of Rh

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system do not occur naturally in serum. - Mostly as a result of antigen exposure during pregnancy or through
transfusion. * Presence or absence of D antigen determined by testing RBC’s with Anti-D.
Question 27: Correct Answer: B
Explanation: Ans.B.Hypermetropia Accommodative esotropia is one of the most common types of
strabismus in childhood. The incidence is estimated at 2% of the population. It is usually found in patients
with moderate amounts of hyperopia. As the patient accommodates or focuses the eyes, the eyes converge.
Question 28: Correct Answer: D
Explanation: Answer: D. skin subcutaneous fat The clinical entity of degloving injury means that the skin has
been lost, but the musculoskeletal unit is intact, and hence, the movements of the part have been preserved.
Degloving, also called avulsion, is a type of severe injury that happens when the top layers of your skin and
tissue are ripped from the underlying muscle, connective tissue, or bone. It can affect any body part, but it’s
more common in the legs Depending on the angle that the tire pullas across the extremity, the skin and
subcutaneous tissue may be pulled or sheared off on leading edge of extremity.
Question 29: Correct Answer: B
Explanation: Answer. B. Tertiary syphilis Tertiary Syphilis has no relation to HIV status and primarily based
on the duration of the infection and complications of Syphilis.
Question 30: Correct Answer: A
Explanation: ANSWER. A. APOE4 Three common polymorphisms in the APOE gene, e2, e3, and e4, result
in single amino changes in the ApoE protein. The e4 allele of apolipoprotein E (APOE) is the major genetic
risk factor for Alzheimer’s disease (AD). the differential effects of apoE isoforms on Aß aggregation and
clearance play the major role in AD pathogenesis. In particular, APOE e4 is associated with increased risk
for AD, whereas APOEe2 is associated with decreased risk.
Question 31: Correct Answer: D
Explanation: Answer. D. Autosomal dominant Achondroplasia is inherited in an autosomal dominant pattern,
which means one copy of the altered gene in each cell is sufficient to cause the disorder.
Question 32: Correct Answer: C
Explanation: Answer C. Sweat gland Most CF patients have 3 distinct abnormal characteristics: The ducts of
the mucus-secreting glands are obstructed due to an increase in viscosity of these secretions leading to
glandular dilatation and destruction. CF patients are prone to chronic bacterial colonization and infections.
The sweat glands are not obstructed in CF patients because in serous glands such as sweat glands there
are abnormal concentrations of inorganic ions, rather than glandular obstruction with thick mucus. The
quantitative pilocarpine iontophoresis sweat test is a uniformly accepted method for diagnosing CF. The
sweat gland ducts must be patent for this test. Obstruction of airways leads to bronchiectasis and
atelectasis; pancreatic duct obstruction leads to pancreatitis and malabsorption; and plugging of bile ducts
leads to obstructive jaundice.
Question 33: Correct Answer: B
Explanation: Ans. B. Chi square test Chi-Square test offers a method of testing the significance of difference
between the proportions. Its advantage lies in the fact that it can also be used when more than two groups
are to be compared. By using this test, we can find out if the difference between two proportions or ratios has
occurred by chance. The steps involved are- Testing the null hypothesis. Applying chi-square test.
Calculating the degree of freedom. Comparing with probability tables. 1. 2. 3. 4.
Question 34: Correct Answer: A
Explanation: Ans. A. 4 months FINE MOTOR MILESTONES: Age Milestone 4 months Bidextrous reach 6

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months Unidextrous reach 9 months Immature pincer grasp 12monthsMature pincer grasp 15monthsImitates
scribbling, tower of 2 blocks 18monthsScribbles, tower of 3 blocks Tower of 6 blocks, vertical & circular
stroke Tower of 9 blocks, copies circle Copies cross, bridge with blocks Copies triangle
Question 35: Correct Answer: B
Explanation: Ans. B. Aspirin + Low molecular weight Heparin The recommended treatment for women with
recurrent pregnancy loss associated with antiphospholipid syndrome includes combined Aspirin and Heparin
therapy. In pregnant SLE patients with Antiphospholipid antibodies and prior fetal loss, treatment with
heparin (standard or low –molecular- weight) plus low dose aspirin has been shown in prospective controlled
trials to increase significantly the proportion of live births. Combined aspirin and heparin therapy has proven
effectiveness and is the preferred treatment for women with recurrent pregnancy loss associated with
antiphospholipid syndrome.
Question 36: Correct Answer: A
Explanation: Answer. A. Serum creatinine The Model for End-stage Liver Disease (MELD) is a prospectively
developed and validated chronic liver disease severity scoring system that uses a patient’s laboratory
values for – Li Serum bilirubin Serum creatinine The international normalized ratio (INR) for prothrombin time
to predict three month survival. Patients with cirrhosis, and increasing MELD score is associated with
increasing severity of hepatic dysfunction and increased three- month mortality risk. Given its accuracy in
predicting short-term survival among patients with cirrhosis, MELD was adopted by the United network for
organ sharing (UNOS) in 2002 for prioritization or patients awaiting liver transplantation in the United states.
Question 37: Correct Answer: D
Explanation: YOUNG WOMEN Contraception desired OLDER WOMEN Rule out cancer &uterine pathology
Removal of an intrauterine contraceptive device if medical therapy fails. Myomectomy/hysterectomy for
uterine fibroids.
Question 38: Correct Answer: D
Explanation: Ans. D. Luteal phase The entire duration of a Menstrual cycle can be divided into four main
phases: 1. Menstrual phase (From day 1 to 5) 2. Follicular phase (From day 1 to 13) 3. Ovulation phase (Day
14) 4. Luteal phase (From day 15 to 28)
Question 39: Correct Answer: C
Explanation: Ans: C. Both A & B Given image is cover-uncover test The cover-uncover test to diagnose
various types of tropias, which is a medical term for strabismus. The single cover test is a test is used to
determine if there is a heterotropia or tropia, which is manifest strabismus or misalignment that is always
present. The first eye is covered for approximately 1-2 seconds. As this eye is covered, the uncovered eye is
observed for any shift in fixation.
Question 40: Correct Answer: D
Explanation: Answer-D. Saturated salt solution Toxicological viscera is preserved in a saturated solution of
common salt (sodium chloride). For toxicological analysis, viscera is never preserved in alcohol, formalin, or
bile salt. In fact, formalin denatures proteins and chemicai toxins and would interfere with the detection of
poisons during chemical analysis’
Question 41: Correct Answer: D
Explanation: Answer. D. Docosa hexanoic acid
Question 42: Correct Answer: B
Explanation: And. B. Togavirus Rubella virus (RuV) is the pathogenic agent of the disease rubella, and is the
cause of congenital rubella syndrome when infection occurs during the first weeks of pregnancy. Rubella

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virus is the only member of the genus Rubivirus and belongs to the family of Togaviridae, whose members
commonly have a genome of single-stranded RNA of positive polarity which is enclosed by an icosahedral
capsid.
Question 43: Correct Answer: B
Explanation: Answer B. Modified macrophages in CNS Gitter cells: These cells are macrophages and
because of their appearance they are called “Gitter cells”. They look this way because they are lipid-laden.
These macrophages are thought to be mainly derived from circulating blood monocytes, but some probably
originate from resident microglia. Any time there is parenchymal damage (e.g. inflammation, infarction,
parasite migration) these cells will phagocytose lipid from degenerated myelin and cellular debris. These lipid-
laden macrophages migrate to the perivascular spaces
Question 44: Correct Answer: A
Explanation: Answer A. Right Aortic Sinus RCA arises from anterior aortic sinus aka Right aortic sinus. LCA
arises from left posterior aortic sinus.
Question 45: Correct Answer: A
Explanation: Answer. A. Vincristine, carboplatin and etoposide Chemotherapy for Retinoblastoma
Chemotherapy (chemo) is the use of anti-cancer drugs to treat cancer. Chemo can be given in different ways
to treat retinoblastoma. Some of the chemo drugs used to treat retinoblastoma include: Carboplatin Cisplatin
Vincristine Etoposide Cyclophosphamide Topotecan Doxorubicin Most often, 2 or 3 drugs are given at the
same time. A standard combination is carboplatin, vincristine, and etoposide, although for very small tumors,
only carboplatin and vincristine may be enough. Other drugs might be used if these are not effective. 1. 2.
3. 4. 5. 6. 7.
Question 46: Correct Answer: B
Explanation: Ans. B. Tenosynovitis of little finger will spread to thumb rather than ring finger Infection of the
synovial sheath that surrounds the flexor tendon Infection from the flexor tendon sheath of the thumb can
also extend along the radial bursa to the space of Parona and then into the ulnar bursa and the flexor tendon
sheath of the little finger—and vice versa—leading to a “horseshoe” abscess. Horseshoe abscess: May
develop from spread pyogenic flexor tenosynovitis, of many individuals have a connection between the
sheaths of the thumb and little fingers at the level of the wrist
Question 47: Correct Answer: D
Explanation: Ans. D. Gums Dietary fibre consists of unabsorbable cell wall and other constituents of
vegetable food like cellulose, lignin, hemicellulose, gums, pectins, glycoproteins and other polysaccharides.
Dietary fibre absorbs water in the intestine, swells, increase bulk of stood by increasing water content of
faeces and soften it, decreases transit time by facilitating colonic transit. “The presence of fibre shortens the
transit times and increases the stool bulk” Dietary fibre is of two types: Soluble fibres: It absorbs upto 15
times its weight in water as it moves through GIT, producing softer stools. Its good sources are oat,
flaxseeds, peas, beans, apple, citrus fruits, carrots, barley and psyllium. Insoluble fibre: It promotes
movement of material through digestive system and increases stool bulk. It’s good sources are wheat flour,
wheat bran, nuts and vegetables. 1. 2.
Question 48: Correct Answer: B
Explanation: Answer: B. IgG2 IgG2 antibodies are predominantly against the polysaccharide (complex sugar)
coating (capsule) of certain disease-producing bacteria (such as, Streptococcus pneumoniaeand
Haemophilus influenzae). In young children, the ability to make IgG2 antibodies to the polysaccharide
coatings of bacteria develops more slowly than the ability to make antibodies to proteins.

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Question 49: Correct Answer: B
Explanation: Answer B. Entamoeba histolytica Disease occurs when amoeba comes in contact with the cells
lining the intestine. It then secretes the same substances it uses to digest bacteria, which include enzymes
that destroy cell membranes and proteins. This process can lead to penetration and digestion of human
tissues, resulting first in flask-shaped ulcerations in the intestine. Entamoeba histolytica ingests the
destroyed cells by phagocytosis and is often seen with red blood cells (a process known as
erythrophagocytosis) inside when viewed in stool samples
Question 50: Correct Answer: D
Explanation: 289. Identify the marked structure in the image:
Question 51: Correct Answer: A
Explanation: Answer A) Maddox rod The Maddox rod test can be used to subjectively detect and measure a
latent, manifest, horizontal or vertical strabismus for near and distance. The test is based on the principle of
diplopic projection The Maddox rod is a handheld instrument composed of red parallel plano-convex cylinder
lens, which refracts light rays so that a point source of light is seen as a line or streak of light. Due to the
optical properties, the streak of light is seen perpendicular to the axis of the cylinder.
Question 52: Correct Answer: A
Explanation: Ans. A. Granisetron. Granisetron: Serotonin 5-HT3 receptor antagonist. Used as an antiemetic
treating nausea & vomiting following chemotherapy & radiotherapy. Main effect: Reduces vagus nerve
activity (Vagus N. activates vomiting center in medulla oblongata).
Question 53: Correct Answer: A
Explanation: Answer- A (Pleomorphic adenoma) It is also known as “Mixed tumor, salivary gland type”,
which refers to its dual origin from epithelial and myoepithelial elements as opposed to its pleomorphic
appearance.
Question 54: Correct Answer: A
Explanation: Answer- A. Chylomicron Lipoprotein lipase deficiency (Type I hyperlipoproteinemia): is a rare,
autosomal recessive disorder caused by a deficiency of lipoprotein lipase.Resulting in fasting
chylomicronemia and hypertriglycerolemia.There is slow clearance of chylomicrons and VLDL. Low levels of
LDL and HDL. There is no increased risk of coronary disease.
Question 55: Correct Answer: A
Explanation: Ans. A. Apraclonidine Apraclonidine – Selective alpha 2 agonist. Useful in glaucoma. Alpha
agonists (Brimonidine and apraclonidine) are contraindicated in hypertensive crisis. Dipivefrin is a prodrug
which is converted into epinephrine inside ttre eyeUall, so can safely be used in hypertension.
Question 56: Correct Answer: D
Explanation: Ans. D. All of the Above All the Three are cause of death as they are in describing the
sequence of events in deaths .
Question 57: Correct Answer: B
Explanation: Ans: B. In proinsulin Synthesis of insulin: Synthesized as larger preprohormone (Pre-proinsulin)
entering ER. Removal of 23 amino-acid signal peptide takes place. Converted to “Prohormone -Proinsulin”.
Proinsulin structure: Made up A & B chain, connected by C-peptide/chain. C-peptide – Detached from
granules before secretion. 90% – 97% insulin from B cells. Along with equimolar amounts of C-peptide.
Question 58: Correct Answer: C
Explanation: Answer- C (Fibrinoid) In small vessel vasculitis, fibrin plugs frequently occur in the vessel

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lumen, but the term fibrinoid is usually used to refer to material outside the lumen of a vessel.Fibrinoid
necrosis also occurs in the walls of arterioles in malignant hypertension.
Question 59: Correct Answer: A
Explanation: Answer A. Auriculotemporal Nerve Frey’s syndrome (also known as Baillarger syndrome,
Dupuy’s syndrome, auriculotemporal syndrome, or Frey-Baillarger syndrome) is a rare neurological disorder
resulting from damage to or near the parotid glands responsible for making saliva, and from damage to the
auriculotemporal nerve often from surgery.
Question 60: Correct Answer: A
Explanation: Answer. A. Pulmonary artery stenosis The classic triad for congenital rubella syndrome is:
Sensorineural deafness (58% of patients) Eye abnormalities? especially retinopathy, cataract, and
microphthalmia Congenital heart disease? especially pulmonary artery stenosis and patent ductus
arteriosus.
Question 61: Correct Answer: A
Explanation: Answer- A (Capsase 1) The two inflammatory cytokines activated by Caspase-1 are excreted
from the cell to further induce the inflammatory response in neighboring cells.
Question 62: Correct Answer: C
Explanation: Answer C. Fornix The fornix is the main efferent system of the hippocampus and an important
part of the limbic system. It is one of the commissural fibers connecting the cerebral hemispheres. Gross
anatomy Roughly C-shaped, the fornix extends from the hippocampus to
Question 63: Correct Answer: C
Explanation: Ans. C. Nicorandil Nicorandil: Cardioprotective potassium channel opener. Causes ischemic
preconditioning & coronary dilation – By activating myocardial ATP sensitive K+ channels. Also possesses
NO-releasing property. Useful in angina.
Question 64: Correct Answer: C
Explanation: Answer- C (Ventricular tachycardia) Monomorphic VT Regular rhythm. Originates from a single
focus within the ventricles. Produces uniform QRS complexes within each lead — each QRS is identical
(except for fusion/capture beats).
Question 65: Correct Answer: A
Explanation: Ans. A. Estrogens ointment Atrophic vaginitis, the medical term for this condition, occurs as a
result of deterioration of the vaginal tissue. It’s a common condition in postmenopausal women because as
estrogen levels drop, the tissue that lines the vagina becomes thinner and more easily damaged. Women
with atrophic vaginitis may also experience vaginal itching, burning, frequent urination, or vaginal discharge.
Women can treat this condition topically with estrogen creams, tablets (Vagifem), or an estrogen-releasing
ring placed in the vagina (Estring). Oral estrogen, available with a doctor’s prescription, will also restore
vaginal tissue. Vaginal lubricants offer an alternative for women wary of using estrogen. Moisturizers such as
Replens, Astroglide, and Lubrin can reduce symptoms and make sexual intercourse more comfortable.
Question 66: Correct Answer: D
Explanation: Ans.D. 2 lakh I.U Treatment: Oral therapy: The oral regimen of vitamin A is 200,000 IU on day
of presentation, next day, and 2-4 weeks later. Children less than 1 year of age or less than 8 kg should
receive half the dose of the above dose. Repeat 200,000 IU every 6 months up to 6 years of age to prevent
recurrence. Parenteral therapy: If the patient has severe disease, is unable to take oral feeds, or has
malabsorption, the preferable dose is 100,000 IU of vitamin A given intramuscularly. Children with severe
measles should also receive vitamin A as they are very likely to be benefited from such therapy both in terms

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of saving sight and reducing case fatality. Prevention Prophylaxis consists of periodic administration of
Vitamin A supplements. WHO recommended schedule, which is universally recommended is as follows:
Infants 6–12 months old and any older children weighing less than 8 kg – 100,000 IU orally every 3–6
months
Question 67: Correct Answer: C
Explanation: Answer C. Kidney Papillary (collecting) ducts are anatomical structures of the kidneys,
previously known as the ducts of Bellini. Papillary ducts represent the most distal portion of the collecting
duct. They receive renal filtrate (precursor to urine) from several medullary collecting ducts and empty into a
minor calyx.
Question 68: Correct Answer: B
Explanation: Ans. B. Mostly seen in last trimester Acute fatty liver of pregnancy is usually seen in obese
woman. It is more commonly seen in woman carrying a male foetus. The neonate is at risk of fatty infiltration
of liver. It More commonly occurs in 3rd trimester. It May be associated with ?uric acid.
Question 69: Correct Answer: A
Explanation: Ans. A. Intertrigo Image shows Intertrigo rash on the back of a 4 month old baby’s neck.
Intertrigo is caused by warm moist folds of skin repeatedly rubbing together. The affected area may become
blistered or infected with bacteria or fungi. Intertrigo is a common condition in babies and is treated with
nappy
Question 70: Correct Answer: B
Explanation: Answer: B. Section 294 EXHIBITIONISM: sexual gratification by exposing one’s genitalia.
Punishable under sec 294 I.P.C.with imprisonment upto 3 months or fine
Question 71: Correct Answer: C
Explanation: Ans. C. Severely depressed APGAR CRITERIA: Score of 0 blue or pale all over absent no
response to stimulation Component of backronym Appearance Pulse Grimace Activity Respiration
Question 72: Correct Answer: C
Explanation: Ans. C. 2mg Drug doses for management of PPH: 15-Methyl prostaglandin F2a: Dose and
route:IM: 0.25 mg Continuing dose:0.25 mg every 15 minutes Maximum dose:8 doses (Total 2 mg)
Precautions/ contraindications:Asthma
Question 73: Correct Answer: A
Explanation: Ans. A. Dicloxacillin The beta lactamase-resistant penicillins have been recommended in the
treatment of mastitis. These include cloxacillin, dicloxacillin, or flucloxacillin. Because penicillins are acidic,
they are poorly concentrated in human milk, which is also acid. Therefore, cloxacillin and its congeners tend
to treat cellulitis well, but they are less effective in eradicating adenitis, the most likely precursor of breast
abscess. When patients are allergic to penicillins, cephalexin or clindamycin may be the alternative to
erythromycin. Combination like co-amoxiclav should be avoided because of fear of inducing MRSA
Question 74: Correct Answer: B
Explanation: Ans. B. Varenicline (If Bupropion is not an option) Anti-smoking drugs: Bupropion (along with
Varenicline & Nicotine replacement therapy) is a USFDA approved first-line agent for pharmacotherapy in
smoking cessation. Varenicline: Effective agents for smoking cessation. Synthetic drug with partial agonist
action at ?4 ß2 nicotinic receptors. Has antagonist properties persisting due to long half-life & high receptor
affinity. Hence, prevents stimulant effect of nicotine at presynaptic ?4 ß2 nicotinic receptors --> results in
dopamine release.

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Question 75: Correct Answer: B
Explanation: Ans. B. Post mastectomy radiation therapy is given when 4 or more lymph nodes are positive
Tamoxifen: Effective in both pre & postmenopausal women (if hormone receptor positive) DOC in
premenopausal women Aromatase inhibitors: Proven more beneficial than tamoxifen in postmenopausal
women. MOA: By lowering estrogen in post-menopausal women with hormone- receptor-positive breast
cancer. In post-menopausal women, most of body’s estrogen is from androgen. Aromatase inhibitors inhibits
aromatase enzyme a? blocking androgen into estrogena? lowering estrogen produced outside ovaries. Uses:
1st line therapy in postmenopausal women, adjuvant setting or
Question 76: Correct Answer: A
Explanation: Ans:A. Sarcoptes scabis Scabies is an intensely pruritic skin condition caused by infestation
with the microscopic mite Sarcoptes scabiei. Sarcoptes scabiei var hominis, and is transmitted from person
to person by skin-to-skin contact. Sarcoptes scabiei mite:
Question 77: Correct Answer: C
Explanation: Answer. C. Peroxisome Zellweger syndrome, also called cerebrohepatorenal syndrome, is a
rare congenital disorder characterized by the reduction or absence of functional peroxisomes in the cells of
an individual. Zellweger syndrome is associated with impaired neuronal migration, neuronal positioning, and
brain development. In addition, individuals with Zellweger syndrome can show a reduction in central nervous
system (CNS) myelin (particularly cerebral), which is referred to as hypomyelination.
Question 78: Correct Answer: A
Explanation: Ans:A. After normal inspiration Functional Residual Capacity (FRC) is the volume of air present
in the lungs at the end of passive expiration.
Question 79: Correct Answer: A
Explanation: Ans:A. SLE. Clinical presentation: Most common rash is photosensitive, raised erythematous
malar rash. 55-85% develop at some point in disease Discoid Lupus Erythematosus (DLE): 15-30% circular,
scaly hyperpigmented lesions with erythematous rim, atrophic center —can be disfiguring Mouth/vaginal/nasal
ulcers Alopecia: may be diffuse or patchy. Occurs 50%.
Question 80: Correct Answer: A
Explanation: Ans: A. Pulmonary compliance increases Anatomical and physiological changes of respiratory
system with aging: Anatomical: Air space size: Increased Compliance: Chest wall compliance: Decreased
Lung compliance: Increased to unchanged Total respiratory system compliance: Decreased Muscle strength:
Maximal inspiratory pressure (MIP): Decreased Trans diaphragmatic pressure (Pdi): Decreased Maximum
voluntary ventilation (MVV): Decreased Lung function: FEV1: Decreased FVC: Decreased TLC: Unchanged
Vital capacity: Decreased Functional residual capacity: Increased Residual volume: Increased DLCO/VA:
Decreased
Question 81: Correct Answer: D
Explanation: Answer D. Anterior belly of digastric MESODERMAL DERIVATIVES OF PHARYNGEAL
ARCHES Mylohyoid Muscles of mastication Mandibular division of Trigeminal Nerve Nerve
Question 82: Correct Answer: C
Explanation: Answer. C. Carbon dioxide The body’s respiratory center in the medulla is normally stimulated
by an increased concentration of carbon dioxide, and to a lesser extent, by decreased levels of oxygen in
arterial blood. Stimulation of the respiratory center causes an increase in the rate and depth of breathing,
thus blowing off excess carbon dioxide and reducing blood acidity.
Question 83: Correct Answer: C

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Explanation: Ans. C. RDS in premature baby Indicated to prevent seizures associated with pre-eclampsia,
and for control of seizures with eclampsia. Magnesium sulfate (MgSO4) is commonly used as an
anticonvulsant for toxemia and as a tocolytic agent for premature labor during the last half of pregnancy.
Toxicity of I/V magnesium sulfate includes cardiac arrhythmias, muscular paralysis, respiratory depression
and CNS depression in mother as well as the neonate.
Question 84: Correct Answer: A
Explanation: Ans: A. Tension. Difference between functions of muscle spindle & golgi tendon organ: Muscle
spindle: Acts as “Muscle length detectors”. Also detects rate of change in muscle length. Golgi tendon
organ: Acts as “Muscle tension detectors”. Also detects rate of change in muscle tension. Because of
location of muscle spindle & golgi tendon organ. Muscle spindle are parallel to muscle fibers (extrafusal
fibers). Golgi tendon organ in series to muscle fibers (extrafusal fibers). Yet, Both are activated by muscle
stretch.
Question 85: Correct Answer: B
Explanation: Answer- B. ( Venous disorder) Comprehensive Classification System for Chronic Venous
Disorders (CEAP) CEAP classification of chronic venous disease C3 Edema C4a Pigmentation or eczema
C4b C5 Healed venous ulcer Clinical classification Lipodermatosclerosis or athrophie blanche
Question 86: Correct Answer: A
Explanation: Answers: A. lysyl oxidase One of the enzymes, lysyl oxidase, requires copper for proper
function. This enzyme cross-links tropocollagen into strong collagen fibrils. Menkes disease (MNK), also
known as Menkes syndrome, is an X- linked recessive disorder caused by mutations in genes coding for the
copper-transport protein ATP7A, leading to copper deficiency. The decreased supply of copper can reduce
the activity of numerous copper-containing enzymes. These are necessary for the structure and function of
bone, skin, hair, blood vessels and the nervous system such as lysyl oxidase.
Question 87: Correct Answer: B
Explanation: Answer- B (Allograft) Allograft – Grafting between two non-identical member of same species
but not same genotypes. It includes the transplantation of heart, kidney, lung etc, from a members who
donate their organs. Anti – rejection drugs or immunosuppressant need to be taken to prevent the body from
rejecting a transplanted organ. Most human tissue and organ transplants are allografts.
Question 88: Correct Answer: C
Explanation: Answer; C. Japanese encephalitis Japanese encephalitis (JE) is an infection of the brain
caused by the Japanese encephalitis virus (JEV). JEV is generally spread by mosquitoes, specifically those
of the Culex type.Pigs and wild birds serve as a reservoir for the virus. symptoms may include headache,
vomiting, fever, confusion, and seizures.
Question 89: Correct Answer: D
Explanation: Answer. D. Keratosis obturans Given image is Keratosis obturans, otoscope view. This is a rare
condition of the ear canal with a generalised failure of migration of the normal canal skin. The skin
accumulates and the underlying bone is resorbed. Here there is a deep widening of the ear canal with
exposure of the circular annulus at the edge of the tympanic membrane (eardrum, centre). The jugular vein
(purple) can be seen through the remaining tissue
Question 90: Correct Answer: C
Explanation: Answer- C (Failure of gut to return to the body cavity from its physiological herniation) Failure of
gut to return to the body cavity from its physiological herniation. Exomphalos(omphalocele) is herniation of
abdominal viscera through an enlarged umbilical ring. The viscera, which may include liver, small and large

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intestines, stomach, spleen, or bladder, are covered by amnion. The origin of omphalocele is a failure of the
bowel to return to the body cavity from its physiological herniation during the 6th to 10th weeks.
Question 91: Correct Answer: A
Explanation: Answer A. Wallenberg syndrome Wallenberg syndrome is also known as lateral medullary
syndrome or the posterior inferior cerebellar artery syndrome. Wallenberg described the first case in 1895.
This neurological disorder is associated with a variety of symptoms that occur as a result of damage to the
lateral segment of the medulla posterior to the inferior olivary nucleus. It is the most typical posterior
circulation ischemic stroke syndrome in clinical practice. Etiology: Wallenberg syndrome is caused most
commonly by atherothrombotic occlusion of the vertebral artery, followed most frequently by the posterior
inferior cerebellar artery, and least often, the medullary arteries. Hypertension is the commonest risk factor
followed by smoking and diabetes. Medial medullary syndrome, also known as inferior alternating syndrome,
hypoglossal alternating hemiplegia, lower alternating hemiplegia, or Dejerine syndrome, is a type of
alternating hemiplegia
Question 92: Correct Answer: B
Explanation: Ans. B. Diabetes Macrosomia is the term used to describe a large fetus. Macrosomia is
associated with Gestational diabetes and Maternal obesity The recommended definition is fetal (neonatal)
weight exceeding two standard deviations or above 90th centile for the appropriate normal population.
According to ACOG : birth weight of > 4500gm is called as macrosomia. In Indian context Birth weight of >
4000 gm is called as macrosomia.
Question 93: Correct Answer: D
Explanation: Answer: D. Arginine Arginine, a semiessential or conditionally essential amino acid in humans,
is one of the most metabolically versatile amino acids. It serves as a precursor for the synthesis of urea, nitric
oxide, polyamines, proline, glutamate, creatine, and agmatine.
Question 94: Correct Answer: A
Explanation: Answer- A (Deficiency of Beta- galactosylcermidase) Krabbe disease is caused by mutations in
the GALC gene located on chromosome 14 (14q31),which is inherited in an autosomal recessive manner.
Mutations in the GALC gene cause a deficiency of an enzyme called galactosylceramidase.
Question 95: Correct Answer: D
Explanation: Ans:D. Etomidate Major advantage of etomidate: Cardiovascular stability after induction. Effects
of etomidate induction dose: Negligible increase in heart rate. Little decrease in blood pressure/cardiac
output. Little effect on coronary perfusion pressure, while reducing myocardial O2 consumption.
Question 96: Correct Answer: B
Explanation: Answer-B. Iodine Radiocontrast agents are typically iodine, barium-sulphate or gadolinium
based compounds.
Question 97: Correct Answer: B
Explanation: Answer-B. Methyl- Histidine Essentials of Diagnosis & Typical Features of Wilson disease:
Acute or chronic liver disease Deteriorating neurologic status Kayser-Fleischer rings Elevated liver copper
Abnormalities in levels of ceruloplasmin and serum and urine copper.
Question 98: Correct Answer: D
Explanation: Ans. D. 69XX A partial hydatidiform mole is a triploid pregnancy with 69 instead of 46
chromosomes and another strange complication of the reproductive process. Partial hydatidiform mole can
be identified by ultrasound showing placenta tissue, some hygromatous cysts, some fetal oddities, but no
clear fetus structure. Ultrasound is strictly an indicator. After spontaneous abortion or dilation and curettage,

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tissue needs to be examined by pathology and cytogenetics needs to be determined. If a triploid karyotype is
determined as 69, XXX, 69XXY, or 69 XYY [6], then a partial mole can be confirmed.
Question 99: Correct Answer: B
Explanation: Answer- B (Gastrinoma triangle) Explanation- The gastrinoma triangle, also known as
Passaro’s triangle. The triangle is formed by joining the following three points: superiorly: confluence of the
cystic and common bile ducts inferiorly: junction of the second and third portions of the duodenum medially:
junction of the neck and body of the pancreas
Question 100: Correct Answer: A
Explanation: Answer-A. Lacunar infarct This image shows a CT scan of a lacunar infarct. Occlusion of a
larger perforating vessel causes a lacunar infarct. Acutely, lacunar infarcts are often rounded with a hazy
outline and may fluctuate in size in the subacute phase— most often enlarging. When mature, however, they
become sharply delineated, shrink in size—typically less than 1.5 cm diameter—and cavity-like. The gliotic
hyperintense rim of a mature lacune on FLAIR differentiates it from a perivascular space. IOC for Hyperacute
Infarct ? MRI[best sequence –DWI] Acute/hyperacute infarcts show restricted diffusion
Question 101: Correct Answer: B
Explanation: Answer-B. Bcl2 Regulation is primarily by the Bcl-2 family of genes located on chromosome 18.
Some members of this family like bak, bid, bin, Bcl-xs (to remember, S for stimulating apoptosis) stimulate
apoptosis whereas others like Bcl-2, Bcl-xl (to remember, L for lower apoptosis), etc inhibit apoptosis. Gene
families such as caspases, inhibitor of apoptosis proteins, B cell lymphoma (Bcl)-2 family of genes, tumor
necrosis factor (TNF) receptor gene superfamily, or p53 gene are involved, and/or collaborate in the process
of apoptosis.
Question 102: Correct Answer: A
Explanation: Ans. A. S-adenosyl methionine S-adenosyl methionine is required & enzyme is
phenylethanolamine N-methyl transferase. S-adenosylmethionine donates methyl group for conversion of NE
to E in presence of Phenylethanolamine N Methyltransferase enzyme
Question 103: Correct Answer: C
Explanation: Answer. C. Down’s syndrome People with Down syndrome are born with an extra copy of
chromosome 21, which carries the APP gene. This gene produces a specific protein called amyloid
precursor protein (APP) with age these get accumulated in the brain cell and affects the functioning of the
brain leading to alzheimer’s dementia.
Question 104: Correct Answer: B
Explanation: Ans. B. DVT Contraindications to combined oral contraceptives They are generally accepted to
be contraindicated in women with pre-existing cardiovascular disease, in women who have a familial
tendency to form blood clots/ thrombosis (such as familial factor V Leiden), women with severe obesity
and/or hypercholesterolemia (high cholesterol level), and in smokers over age 40. COCP are also
contraindicated for women with liver tumors, hepatic adenoma or severe cirrhosis of the liver, and for those
with known or suspected breast cancer.
Question 105: Correct Answer: C
Explanation: Ans. C. Fetal right Upper limb A simpler way to detect this right-to-left shunting is to use two
pulse oximeters and measure preductal and postductal SpO2. In one study it was found that arterial
saturation in the right arm (preductal) of at least 3%above the lower limb (postductal) is evidence of right- to-
left ductal shunting.
Question 106: Correct Answer: A

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Explanation: Ans. A. Lidocaine Digitalis toxicity: Features: Generally unwell & lethargy. Nausea & vomiting.
Confusion. Yellow-green vision. Arrhythmias (e.g. AV block, bradycardia) Dizziness. Precipitating factors:
Renal disease Hypokalaemia Hypomagnesemia Hypoalbuminemia Hypothermia Hypothyroidism
Hypercalcemia. Hypernatremia Acidosis. Myocardial ischaemia. Partial AV block.
Question 107: Correct Answer: D
Explanation: Answer. D. Inferior wall Left ventricular aneurysm formation: Left ventricular apical aneurysm
formation usually occurs following antero-apical myocardial infarction, after LAD occlusion. This weakening
of the apical wall results in an outpouching or “dyskinesis” of the apex of the heart during systole.
Question 108: Correct Answer: C
Explanation: Answer: C. Increased lipolysis Uncontrolled insulin-dependent diabetes mellitus (type I
diabetes) involves decreased glucose utilization, with hyperglycemia, and increased fatty acid oxidation.
Increased fatty acid oxidation leads to excessive production of acetoacetic and 3-hydroxybutyric acids and of
acetone, which are known as ketone bodies. 2. Acetoacetic and 3-hydroxybutyric acids dissociate at body
pH and release H leading to a metabolic acidosis. LCAT is the enzyme that esterifies the free cholesterol on
HDL to cholesterol ester and allows the maturation of HDL. LCAT deficiency does not allow for HDL
maturation resulting in its rapid catabolism of circulating apoA-1 and apoA-2. The remaining form of HDL
resembles nascent HDL.
Question 109: Correct Answer: A
Explanation: Ans: A, Phase 1. Phase I of clinical trial is human pharmacology and safety. Phase I involves
normal human volunteers.
Question 110: Correct Answer: B
Explanation: Answer. B. Anterior border of sternocleidomastoid A branchial cleft cyst (BCC) commonly
presents as a solitary, painless mass in the neck of a child or young adult. They are most commonly located
along the anterior border and the upper third of the sternocleidomastoid muscle in the anterior triangle of the
neck.
Question 111: Correct Answer: A
Explanation: Answer – A. ABER ABER or Annual Blood Examination Rate is not an epidemiological indicator
but an indicator of operational efficiency of Malaria Control Programme.
Question 112: Correct Answer: A
Explanation: Ans. A. GLP-2 inhibitor Glucagon-like peptide-2 (GLP-2) – Important intestinotrophic growth
factor & mediator of intestinal adaptation. FDA approved teduglutide (Gattex—NPS) to treat short bowel
syndrome in adult patients requiring additional nutrition from I.V. parenteral nutrition. Effectively improves
fluid absorption.
Question 113: Correct Answer: B
Explanation: Answer. B. Mostly bilateral Wells score or criteria: (possible score -2 to 9) Active cancer
(treatment within last 6 months or palliative): +1 point Calf swelling = 3 cm compared to asymptomatic calf
(measured 10 cm below tibial tuberosity): +1 point Swollen unilateral superficial veins (non-varicose, in
symptomatic leg): +1 point Unilateral pitting edema (in symptomatic leg): +1 point Previous documented
DVT: +1 point Swelling of entire leg: +1 point Localized tenderness along the deep venous system: +1 point
Paralysis, paresis, or recent cast immobilization of lower extremities: +1 point Recently bedridden = 3 days,
or major surgery requiring regional or general anesthetic in the past 12 weeks: +1 point Alternative diagnosis
at least as likely: -2 points
Question 114: Correct Answer: D

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Explanation: Answer. D. Nyctophobia Nyctophobia is an extreme fear of night or darkness that can cause
intense symptoms of anxiety and depression. A fear becomes a phobia when it’s excessive, irrational, or
impacts your day-to-day life. Claustrophobia is a form of anxiety disorder, in which an irrational fear of having
no escape or being closed-in can lead to a panic attack. xenophobia. : fear and hatred of strangers or
foreigners or of anything that is strange or foreign. Mysophobia, also known as verminophobia,
germophobia, germaphobia, bacillophobia and bacteriophobia, is a pathological fear of contamination and
germs.
Question 115: Correct Answer: C
Explanation: Answer-C. Military TB Miliary tuberculosis is due to hematogenous dissemination of tubercle
bacilli. This is due to the hematogenous spread of infection and may be seen in both primary and post-
primary disease. At first, the chest radiograph may be normal but then small, discrete nodules, 1-2 mm in
diameter, become apparent, evenly distributed throughout both lungs. These may enlarge and coalesce but
with
Question 116: Correct Answer: C
Explanation: 259. A female patient presented with recurrent Urinary tract infections. Imaging shows the
following picture. What can be the most probable diagnosis?
Question 117: Correct Answer: C
Explanation: Ans. C. 200 Offer ART to symptomatic patients if the CD4 count is 200–350 cells/mm3
Consider ART for asymptomatic patients with CD4 count between 200-350 cells/mm3 and monitor closely for
new symptoms. If the CD4 count is 200–250 cells/mm3, physicians can consider repeating the CD4 test in 4
weeks in asymptomatic patients. This is to rule out the possibility of a 20% margin of error in laboratory
results. Patients should start ART before the CD4 count drops below 200 cells/mm3 Ref:
http://naco.gov.in/upload/Policies%20&%20Guidelines/1.%20Antiretroviral%2
infected%20Adults%20and%20Adolescents%20Including%20Post- exposure.pdf 0
Question 118: Correct Answer: B
Explanation: Answer- B. Multiple myeloma F: fibrous dysplasia (FD) or fibrous cortical defect (FCD) O:
osteoblastoma G: giant cell tumor (GCT) M: metastasis(es)/myeloma A: aneurysmal bone cyst (ABC) C:
chondroblastoma or chondromyxoid fibroma H: hyperparathyroidism (brown tumor) I: infection (osteomyelitis)
N: non-ossifying fibroma (NOF) E: enchondroma or eosinophilic granuloma (EG) S: simple (unicameral)
bone cyst
Question 119: Correct Answer: A
Explanation: Ans. A. Decreased histamine release Cisatracurium: * Undergoes Hofmann elimination. * Does
not provoke histamine release – Hence, preferred over atracurium. * No effect on heart rate/BP/nil autonomic
effect. * Produces less laudanosine than atracurium – Hence, less CNS toxicity (seizures).
Question 120: Correct Answer: B
Explanation: Answer B. Lingual Nerve The submandibular glands receive autonomic innervation through
parasympathetic and sympathetic fibres, which directly and indirectly regulate salivary secretions
respectively. Parasympathetic Parasympathetic innervation originates from the superior salivatory nucleus
through pre-synaptic fibres, which travel via the chorda tympani branch of the facial nerve (CN VII). The
chorda tympani then unifies with the lingual branch of the mandibular nerve (CNVIII) before synapsing at the
submandibular ganglion and suspending it by two nerve filaments. Post-ganglionic innervation consists of
secretomotor fibres which directly induce the gland to produce secretions, and vasodilator fibres which
accompany arteries to increase blood supply to the gland. Increased parasympathetic drive promotes saliva
secretion.

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Question 121: Correct Answer: D
Explanation: Answer. D. Right ventricle Mitral stenosis is associated with right ventricular hypertrophy. Left
ventricular diastolic pressure is normal in isolated MS. Mitral stenosis : Features left atrial pressure is
increased pulmonary arterial pressure is increased Increased right ventricular afterload impedes the
emptying of this chamber and Right ventricular end diastolic pressure and volume increase. Right ventricular
hypertrophy occurs.
Question 122: Correct Answer: A
Explanation: Ans: A. Paragonimus westermani (lung fluke ). During invasion and migration of the flukes,
diarrhea, abdominal pain, fever, cough, urticaria, hepatosplenomegaly, pulmonary abnormalities, and
eosinophilia may develop. Un embryonated eggs are passed in the sputum of a human. During the chronic
phase, the lungs are damaged most, but other organs may be involved. The clinical picture resembles and is
often confused with TB. Praziquantel is the treatment of choice.
Question 123: Correct Answer: A
Explanation: Answer- A (Granny’s knot) The granny knot is a binding knot, used to secure a rope or line
around an object.
Question 124: Correct Answer: B
Explanation: Ans. B.4-8% Consanguinity is a marriage between relatives and has various degrees. Closely
related individuals have a higher chance of carrying the same alleles than those less closely related and
therefore children from consanguineous marriages are more frequently homozygous for various alleles than
those from non- consanguineous unions. Generally speaking, frequency of congenital malformations among
newborns of first cousin unions is about 2 times the frequency among the general population. In other words
instead of a rate of 2- 3% of birth defects in the general population, the risk to first cousin couples is around
4-6%.
Question 125: Correct Answer: A
Explanation: Answer: A. Herpes zoster pic Shingles, also known as herpes zoster, is a viral disease
characterized by a painful skin rash with blisters in a localized area. Shingles is due to a reactivation of
varicella zoster virus (VZV) within a person’s body. The disease chickenpox is caused by the initial infection
with VZV. Once chickenpox has resolved, the virus may remain inactive in nerve cells. When it reactivates, it
travels from the nerve body to the endings in the skin, producing blisters.Risk factors for reactivation include
old age, poor immune function.
Question 126: Correct Answer: D
Explanation: Answer: D. Vit B1 Wet beriberi is the term used for thiamine deficiency with cardiovascular
involvement. In the first stage, peripheral vasodilation occurs, leading to a high cardiac output state. This
leads to salt and water retention mediated through the renin-angiotensin-aldosterone system in the kidneys.
A more rapid form of wet beriberi is termed acute fulminant cardiovascular beriberi, or Shoshin beriberi. The
predominant injury is to the heart, and rapid deterioration follows the inability of the heart muscle to satisfy
the body’s demands because of its own injury. In this case, edema may not be present. Instead, cyanosis of
the hands and feet, tachycardia, distended neck veins, restlessness, and anxiety occur.
Question 127: Correct Answer: C
Explanation: Answer C) Common Peroneal Nerve Foot drop, sometimes called drop foot, is a general term
for difficulty lifting the front part of the foot. Causes Foot drop is caused by weakness or paralysis of the
muscles involved in lifting the front part of the foot. Causes of foot drop might include: 1. Nerve injury. The
most common cause of foot drop is compression of a nerve in your leg that controls the muscles involved in
lifting the foot (peroneal nerve). This nerve can also be injured during hip or knee replacement surgery,

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which may cause foot drop. 2. A nerve root injury — 'pinched nerve' — in the spine can also cause foot drop.
People who have diabetes are more susceptible to nerve disorders, which are associated with foot drop. 3.
Muscle or nerve disorders. Various forms of muscular dystrophy, an inherited disease that causes
progressive muscle weakness, can contribute to foot drop. So can other disorders, such as polio or Charcot-
Marie-Tooth disease. 4. Brain and spinal cord disorders. Disorders that affect the spinal cord or brain — such
as amyotrophic lateral sclerosis (ALS), multiple sclerosis or stroke — may cause foot drop.
Question 128: Correct Answer: A
Explanation: Ans. A. Dose response curve The dose–response relationship, or exposure–response
relationship, describes the change in effect on an organism caused by differing levels of exposure to a
stressor after a certain exposure time, or to a food. Applies to individuals, or to populations.
Question 129: Correct Answer: D
Explanation: Answer. D. Both Pilocarpine & Acetazolamide Management of angle closure glaucoma Acute
congestive glaucoma also is known as acute angle closure glaucoma. Immediate medical therapy in acute
AC consists of commencing IOP-lowering eye medications such as topical ß-blocker, a2-agonist and even
prostaglandin analogues as soon as possible. Once the IOP is sufficiently reduced to allow iris reperfusion,
pilocarpine is instilled to induce miosis in an attempt to widen the anterior chamber angles and reestablish
aqueous outflow. Mydriatic drugs such as atropine, cyclopentolate, tropicamide and phenylephrine are
precipitating factor for angle closure glaucoma, so not used (contraindicated) in its treatment.
Question 130: Correct Answer: B
Explanation: Ans. B. Line diagram Line diagrams are used to show the trend of events with passage of time.
It is used to show the trend of events with passage of time and shows how the frequency of a particular
event or variable vary over time.
Question 131: Correct Answer: A
Explanation: Ans: A. VRG Medullary respiratory group: Principal areas in medulla oblongata concerned with
respiratory regulation. Includes, Dorsal respiratory group (DRG). Ventral respiratory group (VRG). Pre-
Botzinger complex. Peripheral inputs. Dorsal respiratory group (DRG): DRG neurons – Mainly concerned
with inspiration. Descend & terminate on spinal motor neurons innervating primary inspiratory muscles. I.e.,
Diaphragm & External intercostal muscles. Ventral respiratory group (VRG): VRG neurons – Mainly
concerned with forceful expiration. Minimal activities w.r.t inspiration. Contributes to both expiration &
inspiration.
Question 132: Correct Answer: A
Explanation: Answer. A. Tubercular Otitis Media Tuberculous Otitis Media Where perforations are multiple
and are associated with otorrhea, a tuberculosis of the middle ear should be suspected. These perforations
result from breaking down of tubercles. In the given image, Tympanic membrane showing multiple
Question 133: Correct Answer: A
Explanation: Answer: A. HDL Lecithin cholesterol acyltransferase deficiency (LCAT deficiency) is a disorder
of lipoprotein metabolism. A deficiency of LCAT causes accumulation of unesterified cholesterol in certain
body tissues. Cholesterol effluxes from cells as free cholesterol and is transported in HDL as esterified
cholesterol. LCAT is the enzyme that esterifies the free cholesterol on HDL to cholesterol ester and allows
the maturation of HDL. LCAT is the enzyme that esterifies the free cholesterol on HDL to cholesterol ester
and allows the maturation of HDL. LCAT deficiency does not allow for HDL maturation resulting in its rapid
catabolism of circulating apoA-1 and apoA-2. The remaining form of HDL resembles nascent HDL.
Question 134: Correct Answer: C

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Explanation: Answer. C. Proprioception Damage to one half of the spinal cord, resulting in paralysis and loss
of proprioception on the same (or ipsilateral) side as the injury or lesion, and loss of pain and temperature
sensation on the opposite (or contralateral) side as the lesion.
Question 135: Correct Answer: D
Explanation: Answer D. Inferior alveolar nerve Marked area is Mandibular foramen, Mandibular foramen–
opening on the medial surface of the ramus; passageway for the inferior alveolar nerve and artery, which
supply the lower teeth.
Question 136: Correct Answer: B
Explanation: Answer- B (7th cranial nerve) Bell’s palsy occurs due to a malfunction of the facial nerve (VII
cranial nerve), which controls the muscles of the face. Facial palsyis typified by inability to control movement
in the muscles of facial expression.
Question 137: Correct Answer: A
Explanation: Answer-A. Albinism Explanation- Albinism is caused by mutations in one of several genes, and
most types are inherited in an autosomal recessive manner.
Question 138: Correct Answer: A
Explanation: Ans:A. Atopic dermatitis Atopic dermatitis (eczema) is a type of inflammation of the skin
(dermatitis) resulting in itchy, red, swollen, and cracked skin. Also known as “atopic eczema”. Long lasting
(chronic) & tends to flare periodically. Common in children (can occur at any age). Usually starts in infancy or
early childhood. Children with family history of atopic dermatitis, asthma or hay fever are more likely to
develop atopic dermatitis.
Question 139: Correct Answer: C
Explanation: Ans: C. 50ml/kg Considered polyuric if urine production is greater than 50 ml/kg/day.
Question 140: Correct Answer: A
Explanation: Answer. A. Brodie abscess Brodie abscess is an intraosseous abscess related to a focus of
subacute pyogenic osteomyelitis. Unfortunately, there is no reliable way radiographically to exclude a focus
of osteomyelitis. It has a protean radiographic appearance and can occur at any location and in a patient of
any age. It might or might not be expansile, have a sclerotic or nonsclerotic border, or have associated
periostitis.
Question 141: Correct Answer: A
Explanation: Ans. A. Trimethoprim and sulfamethoxazole combination. Combination of trimethoprim with
sulfamethoxazole is DOC for cyclosporiasis & Isosporiasis (Protozoal infection).
Question 142: Correct Answer: A
Explanation: Answer. A. Exploratory laparotomy Above X-ray shows air under left diaphragm
(pneumoperitoneum) which indicates hollow viscous perforation with partial intrathoracic
Question 143: Correct Answer: C
Explanation: Answer- C (Brachioradialis) A total parathyroidectomy with a forearm autograft involves removal
of all parathyroid tissue in the neck, with reimplantation of a small amount of morcellated tissue within a
pocket formed in the brachioradialis muscle.
Question 144: Correct Answer: C
Explanation: Answer- C (Surgical blade 11) Explanation- The No.11 is also used for other small incisions for
example when inserting a laparoscopic port, vein and artery central lines ,opening the aorta and removing
calcifications in the aortic or mitral valves.

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Question 145: Correct Answer: B
Explanation: Ans: B. Hyperparathyroidism The serum calcitonin level is strongly increased in this type of
cancer. After successful total thyroidectomy, calcitonin is no longer detectable. Increasing concentrations of
calcitonin after therapy indicate relapse or metastasis. Hyperparathyroidism is present in 20-30% of patients
with medullar thyroid carcinoma.
Question 146: Correct Answer: A
Explanation: Ans. A. Tolvaptan Tolvaptan: * Vasopressin antagonists. * Orally active nonpeptide selective V2
receptor antagonist. * Metabolized by CYP3A4 – Not given to patients receiving this isoenzyme inhibitor. *
Given once daily. * t1?2: 6–8 hours. Actions: * Increases free water clearance by kidney (aquaretic). *
Corrects lower plasma Na+ levels. Uses: * Useful for hyponatremia treatment. * Hyponatremia caused by
CHF, cirrhosis of liver or syndrome of inappropriate ADH secretion (SIADH). Side effect: * Thirst & dry mouth
(most frequent). * Fever, G.I. upset & hyperglycaemia.
Question 147: Correct Answer: B
Explanation: Answer. B. PSVT Supraventricular tachycardia (SVT). Supraventricular tachycardia is an
abnormally fast heartbeat that originates somewhere above the ventricles. It’s caused by abnormal circuitry
in the heart that is usually present at birth and creates a loop of overlapping signals.
Question 148: Correct Answer: B
Explanation: Ans. B.A person who acquires the microorganism another carrier. Paradoxical carrier are
defined as person who acquires the microorganism another carrier.
Question 149: Correct Answer: A
Explanation: Answer A. Projection fibres Internal capsule Area of white matter in the brain that separates the
caudate nucleus and the thalamus from the putamen and the globus pallidus. The internal capsule contains
both ascending and descending axons. It consists of axonal fibres that run between the cerebral cortex and
Question 150: Correct Answer: D
Explanation: Answer. D. Chemotherapy is the treatment of choice Given image is of Giant cell tumor Giant
cell tumors of bone, also known as osteoclastomas, are relatively common bone tumors and are usually
benign. They typically arise from the metaphysis of long bones, extend into the epiphysis adjacent to the joint
surface, and have a narrow zone of transition. Classic appearance
Question 151: Correct Answer: B
Explanation: Ans.B. Positive predictive value Positive predictive value is the ability of a test to correctly
diagnose the proportion of cases in which persons with a positive screening test result have the disease in
question. Negative predictive value is the proportion of cases in which people with negative test result do not
have the disease in question. Sensitivity is defined as the ability of the test to identify correctly all those who
have the disease, i.e. true positive. Specificity is defined as the ability of the test to identify correctly those
who do not have the disease, i.e. true negative.
Question 152: Correct Answer: A
Explanation: Ans. a. Rivaroxaban Rivaroxaban, apixaban & edoxaban are factor Xa inhibitors. Dabigatran
etexilate is direct thrombin inhibitor.
Question 153: Correct Answer: C
Explanation: Answer- C (inhibition of elastase) Explanation- Alpha-1 antitrypsin (A1AT) is produced in the
liver, and one of its functions is to protect the lungs from neutrophil elastase, an enzyme that can disrupt
connective tissue.

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Question 154: Correct Answer: B
Explanation: Ans. B. >126 mg/dl If fasting is 92-125 mg/dl it is diagnosed as GDM and if it is = 126 mg/dl it is
designated as overt Diabetes
Question 155: Correct Answer: C
Explanation: Answer: C. Co-trimoxazole The most common antibiotic that is prescribed is co-trimoxazole
(trimethoprimsulfamethoxazole), more commonly known as Bactrim, Septra, or Cotrim. For
Immunocompetent hosts Prefered regimen: Trimethoprim- sulfamethoxazole 160 mg/800 mg PO bid for 7-10
days..
Question 156: Correct Answer: C
Explanation: Ans: c. Propofol Propofol preparation: Oil-based preparation (soybean oil, egg lecithin &
glycerol). Hence, pain on injection & rarely thrombophlebitis.
Question 157: Correct Answer: A
Explanation: Answer. A. Single positive culture of HACEK
Question 158: Correct Answer: A
Explanation: Ans:A. Leukoderma Leukoderma is a skin disease that causes loss of skin pigmentation
(melanin) that leads to skin whitening. The white patches on the skin are termed as leukoderma. When the
condition gets severe, the spots cover almost all parts of the body including scalp, face and the genitals.
Question 159: Correct Answer: B
Explanation: Answer. B. Cerebral palsy Scissor gait is a form of gait abnormality primarily associated with
spastic cerebral palsy. That condition and others like it are associated with an upper motor neuron lesion.
Question 160: Correct Answer: B
Explanation: Ans:B. Aquaporin 2 Principal cells of collecting duct contain a regulated system of water
channels antidiuretic hormone (ADH, also called arginine vasopressin, AVP). ADH controls permeability of
these cells to water by regulating insertion of pre-formed water channels (aquaporin-2, AQP2) into apical
membrane.
Question 161: Correct Answer: C
Explanation: Answer-C. Carbolic Acid The only obsolute contraindication is corrosive poisoning i.e alkalis,
mineral acid, vegetable acid and organic acids (except carbolic acid). Carbolic acid is the only corrosive in
which gastric lavage can be used. Gastric lavage must be done (except when contraindicated) irrespective of
whether vomiting has occured or not, to prevent aspiration of content. Carbolic acid is the only corrosive in
which gastric lavage is not contraindicated.
Question 162: Correct Answer: A
Explanation: Ans. A. HT1A partial agonism 5 HT1A: * Presynaptic autoreceptor. * Modulates serotonin
release. Partial 5 HT1A agonists: * Buspirone, isapirone, gepirone. * Useful as anti-anxiety drug.
Question 163: Correct Answer: A
Explanation: Monotherapy with TNF drugs Answer A. DMARD with Steroids Given condition is Rheumatoid
Arthritis 255. 14 yr old child with Naive Rheumatoid Arthritis patient as shown in image . What should be the
correct treatment of given condition:
Question 164: Correct Answer: D
Explanation: Ans:D. Increases heart rate. Bainbridge Reflex: Positive feedback mechanism with
compensatory increase in heart rate – Due to rise in right atrial pressure. Commonly referred to as “atrial
reflex”. Resulting from increased blood pressure or increased distension of large systemic veins & right

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upper chamber of heart.
Question 165: Correct Answer: D
Explanation: Ans. D. Add sulfasalazine
Question 166: Correct Answer: A
Explanation: Ans. A. 1 acre General WHO Guidelines for Shallow Trenches is 3-5 Metre for 100 People . So
About 300-500 Meter of Shallow Trenches for 10,000 People. Also there should be a perimeter of 30 m
around the trench. Now 1 Acre = 4046 Sq Meter [200 m X 200 m ] Hence Answer is 1 Acre.
Question 167: Correct Answer: C
Explanation: Ans-C. Bruise of different ages A battered child is one who has received repetitive physical
injuries as a result of non-accidental violence produced by a parent or a guardian. multiple bruise present
over body, Laceration of the oral mucosa, Parents give vague history of accident to be the cause of the
injuries. It is also called Caffey syndrome, Caffey-Kempe syndrome, maltreatment syndrome or Parent-infant
traumatic stress syndrome The injuries may be caused by hand, foot, teeth, stick, belt, shoe, hot water,
lighted cigarette, hot frying pan or any household article Accidental injuries typically involve bony
prominences [head (forehead, occipital or parietal region), nose, chin, palm, elbows, knees and shin], match
the history given by the parents and are keeping with the development of the child
Question 168: Correct Answer: A
Explanation: Ans. A. Test used to assess quantitative observations before and after an intervention Paired t-
tests The paired t-test is used to compare the values of means from two related samples, for example in a
‘before and after’ scenario. The difference between the means of the samples is unlikely to be equal to zero
(due to sampling variation) and the hypothesis test is designed to answer the question “Is the observed
difference sufficiently large enough to indicate that the alternative hypothesis is true”. The answer comes in
the form of a probability – the p-value.
Question 169: Correct Answer: D
Explanation: Answer D. Median nerve The structure indicated is the first lumbrical muscle of the hand. * The
lumbricals belong to the intrinsic group of muscles which act on the hand. * The intrinsic muscles include the
following muscles/groups: - Thenar group (act on thumb) - Hypothenar group (act on little finger)
Question 170: Correct Answer: C
Explanation: Ans. C. Neuraminidase inhibitor Neuraminidase inhibitors: Analogs of sialic acid. Interferes with
release of progeny influenza A & B virus from infected host cells. Competitively & reversibly interact with
active enzyme site –> resulting in clumping of newly released influenza virions to each other & to membrane
of infected cell.
Question 171: Correct Answer: C
Explanation: Answer. C. Atrial flutter Atrial flutter (AFl) is a cardiac dysrhythmia characterized by rapid and
regular depolarization of the atria that appears as a sawtooth pattern on the electrocardiogram (ECG) and is
categorized into type I (typical) and type II (atypical) AFl.
Question 172: Correct Answer: D
Explanation: Ans. D. Cilastatin inhibits an enzyme in kidney destroying imipenem Imipenem-cilastatin 0.5 g
i.v. 6 hourly (max 4 g/day). Effective in serious hospital-acquired respiratory, urinary, abdominal, pelvic, skin
& soft tissue infections including neutropenic, cancer & AIDS patients. For Ps. aeruginosa infections, it
should be combined with gentamicin.
Question 173: Correct Answer: A

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Explanation: Ans: A. GFR. Tubuloglomerular feedback – Two components: * Afferent arteriole feedback
mechanism - Usually referred as “Tubuloglomerular feedback” * Efferent arteriole feedback mechanism.
Afferent arteriolar feedback mechanism: * Transmitter involved – Adenosine causing Ca2+ channel opening.
Efferent arteriolar feedback mechanism: * Activates renin-angiotensin system generating angiotensin II?
efferent arteriole constriction ? ?ed GFR. * Feedback depends on juxtaglomerular apparatus & its specialized
cells. - Macula densa – Specialized epithelium of distal tubule in close contact with afferent arteriole
Question 174: Correct Answer: B
Explanation: Ans. B. Edrophomium. Edrophonium – Used as a diagnostic test for myasthenia. Steps: 2 mg
dose injected intravenously. If no reaction occurs after 45 seconds, an additional 8 mg administered. If the
patient has myasthenia gravis, an improvement in muscle strength lasting for about 5 minutes usually
observed.
Question 175: Correct Answer: B
Explanation: Ans:B. Alopecia areta Alopecia areata is an autoimmune disorder characterized by transient,
non-scarring hair loss and preservation of the hair follicle. Hair loss can take many forms ranging from loss in
well-defined patches to diffuse or total hair loss, which can affect all hair bearing sites. Patchy alopecia
affecting the scalp is the most common type.
Question 176: Correct Answer: D
Explanation: Answer D. Frontalis suspension surgery Muller muscle resections are typically used for repair of
minimal ptosis (2 mm) and are generally considered superior to the Fasanella-Servat procedure
(tarsoconjunctival mullerectomy) in maintaining eyelid contour and preserving the tarsus. When levator
function is poor, the surgeon should consider utilizing the accessory elevators of the eyelid in ptosis repair.
This type of surgery is most commonly required in congenital ptosis with poor levator function or in various
forms of neurogenic ptosis with poor levator function. Frontalis suspension surgeryperformed when levator
function is poor or absent, the eyelid is suspended directly from the frontalis muscle so that movement of the
brow is efficiently transmitted to the eyelid. Thus, the patient is able to elevate the eyelid by using the
frontalis muscle to lift the brow. Frontalis suspension can be performed transcutaneously or
transconjunctivally.This surgery connects the eyelid to the brow with a sling material and utilizes the power of
the frontalis muscle to elevate the poorly functioning eyelid.
Question 177: Correct Answer: A
Explanation: Ans. A. 1st trimester The double decidual sac sign (DDSS) is a useful feature on early
pregnancy ultrasound to confirm an early intrauterine pregnancy (IUP) when the yolk sac or embryo is still
not visualized. The “Double Decidual Sign”, first described by Nyberg and co- workers consists of two
echogenic rings surrounding the hypoechoic gestational sac. The inner ring represents the chorion,
embryonic disc and decidua capsularis. The outer ring represents the decidua parietalis.
Question 178: Correct Answer: D
Explanation: Answer D. Linea Semilunaris The external oblique muscle (of the abdomen) (also external
abdominal oblique muscle) is the largest and the outermost of the three flat muscles of the lateral anterior
abdomen. Inguinal ligament (Poupart’s ligament) is the folded lower border of external oblique aponeurosis
Lacunar ligament (Gimbernat ligament) is the crescent shaped expansion from the medial end of inguinal
ligament attached to pectineal line of pubis. Pectineal ligament (Cooper’s ligament) is strong fibrous band
extending laterally from the lacunar ligament along pectineal line of pubis. Similar to lacunar ligament, it is
made of external oblique aponeurosis. Reflected part of inguinal ligament extends from the lateral crus of
superficial inguinal ring formed by inguinal ligament upwards to linea alba. It forms the posterior wall of
inguinal canal. The linea semilunaris (also semilunar line or Spigelian line) is a curved tendinous intersection

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found on either side of the rectus abdominis muscle.
Question 179: Correct Answer: B
Explanation: Answer: B. Diagnosis is by sputum microscopy Human isolate of. Pneumocystis which is
associated with severe pneumonia in immunocompromised state particularly AIDS. P. jerovici is an
extracellular pathogen. Growth in the lung is limited to surfactant layer above alveolar epithelium. Serologic
evidence suggest that most individuals are infected in early childhood (thus option “c” is wrong) but the
pneumonia is seen only in immunocompromised state. Diagnosis is made by detection of organism in proper
specimen Sputum: Quick and non invasive. Broncho-alaeolar laoage (BAL) fluid: Mainstay of pneumocystis
diagnosis. Transbronchial biopsy: If diagnosis cannot be made by BAL.
Question 180: Correct Answer: A
Explanation: Ans:A. Staphylococcus. Impetigo: Lesions of common or superficial impetigo may contain group
A ß- hemolytic streptococci, S aureus, or both. Most common skin infection in children. Highly contagious.
Lesions in bullous (staphylococcal) impetigo: Caused by S aureus. Are superficial, thin-walled & bullous. On
ruptures --> results in thin, transparent, varnish-like crust
Question 181: Correct Answer: C
Explanation: Ans.C. District The various activities of Reproductive and child Health Programme (RCH) arc
targeted at the district level. “The RCH programme is based on a di iThrential approach. Inputs in all the
districts have not been kept uniform. While the care component are the same for all districts, the weaker
districts will get more support and sophisticated facilities are proposed for relatively advanced districts. On
the basis of crude birth rate and female literacy rate – all the districts have been divided into three categories
‘A, B, & C’ All the districts will be covered in a phased manner over a period of three years.”
Question 182: Correct Answer: B
Explanation: Answer B. Lateral spinothalamic tract Damage to lateral spinothalamic tract leads to loss of pain
and temperature on the opposite side of the body below the level of lesion, since the neurons of this tract
crosses to the opposite side in the spinal cord. Anterior spinothalamic tract carries crude touch and pressure
sensations. Fasciculus gracilis and fasciculus cuneatus carries conscious proprioception, fine touch,
stereognosis and vibration sensations.
Question 183: Correct Answer: C
Explanation: Ans. C. Liver The perisinusoidal space (or space of Disse) is a location in the liver between a
hepatocyte and a sinusoid. It contains the blood plasma. Microvilli of hepatocytes extend into this space,
allowing proteins and other plasma components from the sinusoids to be absorbed by the hepatocytes.
Question 184: Correct Answer: B
Explanation: Answer:B. Double Densitises Allergic fungal sinusitis is the most common form of fungal
sinusitis and is common in warm and humid climates. On imaging, it usually presents as opacification and
expansion of multiple paranasal sinuses, unilaterally or bilaterally, with content that is centrally hyperdense
on CT
Question 185: Correct Answer: B
Explanation: Answer: B. Immunoglobulins The liver serves several metabolic functions within the body
including protein synthesis and metabolism. The liver is responsible for an array of proteins.
Immunoglobulins are synthesised in plasma cells which are believed to be end products of the differentiation
of cells called B- lymphocytes. The liver plays a crucial role in the production of nearly all plasma proteins
(albumin, alpha-1-acid glycoprotein, majority of coagulation cascade, and fibrinolytic pathways). Notable
exceptions include: globulins, factor III, IV, VIII. Proteins produced by the liver: protein S, protein C, protein

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Z, plasminogen activator inhibitor, antithrombin III. Vitamin K dependent proteins synthesized by the liver
include: Factors II, VII, IX, and X, protein S and C.
Question 186: Correct Answer: B
Explanation: Ans. B. Blocks ACh receptors Tubocurarine, Cisatracurium, Rocuronium: Competitive
antagonist at nACh receptors mainly at NM junction. d-tubocurarine: Obsolete clinical usage. Prototype NM
blocker. Longer acting isoquinoline derivative. MOA: Acts predominantly at nicotinic receptor site blocking
their receptors – By competing with acetylcholine (competitive antagonism).
Question 187: Correct Answer: A
Explanation: Answer: A. Kirby Bauer The disk diffusion test, or agar diffusion test, or Kirby–Bauer test (disc-
diffusion antibiotic susceptibility test, disc-diffusion antibiotic sensitivity test, KB test), is a test of the antibiotic
sensitivity of bacteria. It uses antibiotic discs to test the extent to which bacteria are affected by those
antibiotics. In this test, wafers containing antibiotics are placed on an agar plate where bacteria have been
placed, and the plate is left to incubate. If an antibiotic stops the bacteria from growing or kills the bacteria,
there will be an area around the wafer where the bacteria have not grown enough to be visible. This is called
a zone of inhibition
Question 188: Correct Answer: C
Explanation: Ans. C. Penicillin or erythromycin Contacts should receive antibiotics. Benzathine penicillin G
(600,000 units for persons younger than 6 years old and 1,200,000 units for those 6 years old and older)
Oral erythromycin (40 mg/kg/ day for children and 1 g/day for adults) for 7- to 10-day course. Identified
carriers in community also receive antibiotics. Maintain close surveillance and begin antitoxin at the first
signs of illness.
Question 189: Correct Answer: A
Explanation: Answer A. Atlanto axial Atlanto-occipital (between skull and C1) joint permits nodding of head (
as when indicating approval or YES) and Atlanto-axial joint permits the head to be turned from side to side
(as indicating disapproval or NO).
Question 190: Correct Answer: A
Explanation: Answer- Barrett esophagus is a premalignant condition that involves the distal esophagus and
appears to be related to chronic gastroesophageal reflux (GORD). There is metaplastic change in the lining
mucosa of esophagus. Patient is usually asymptomatic in a case of Barrett's Esophagus. Histology of the
lesion in a case of Barrett's esophagus shows mucus secreting goblet cells. Diagnosis of Barrett's
esophagus is made by demons?tration of columnar mucosa, which on histopathology shows Intestinal type
of metaplasia Chronic reflux is a casue of Barrett's Esophagus.
Question 191: Correct Answer: B
Explanation: Ans. B. 10000 to 100000 IU DAT manufactured by Instituto Butantan is a sterile, transparent
(clear) serum solution supplied in 10 mL ampoules containing 10,000 IU each. DAT must be stored in the
refrigerator at 2 – 8°C (36 – 46°F). DO NOT FREEZE. Once an ampoule is opened, the DAT serum solution
should be used immediately.
Question 192: Correct Answer: A
Explanation: Answer: A. (BCYE) agar media BCYE is selective for certain Gram-negative bacteria, especially
Legionella pneumophila. The organisms are nutritionally fastidious, non-spore forming, aerobic, gram-
negative, slender rods. Media containing cysteine, yeast extract, a-ketoglutarate, and iron (BCYE) are
required for isolation of Legionella. Selective BCYE (medium containing antibiotics), is recommended for
specimens likely to be contaminated with other bacteria.

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Question 193: Correct Answer: A
Explanation: c) Carcinogenic PE d) Collapse 264. A patient is a known case of acute pancreatitis develops
breathlessness, bilateral basal crepitation on day 4 and chest radiography as shown in the image below.
What will be the diagnosis?
Question 194: Correct Answer: B
Explanation: Answer- B (SLE) Common symptoms include painful and swollen joints, fever, chest pain, hair
loss, mouth ulcers, swollen lymph nodes, feeling tired, and a red rash which is most commonly on the face.
Question 195: Correct Answer: B
Explanation: Ans: B. Postganglionic autonomic nerve fibers Erlanger & Gasser classification: C fiber –
Characteristics: Diameter – 0.2-1.0 Myelination – Unmyelinated Conduction – 0.2-2 (minimum) Functions:
Pain – Slow pain (“Protopathic /Second pain) Temperature Pressure Postganglionic autonomic fibers. High
susceptibility to: Local anesthetics
Question 196: Correct Answer: A
Explanation: Answer A. Supraglottic Generally, an inspiratory stridor suggests airway obstruction above the
glottis. While an expiratory stridor is indicative of obstruction in the lower trachea. A biphasic stridor suggests
a glottic or subglottic lesion.
Question 197: Correct Answer: B
Explanation: Answer. B. Dilated cardiomyopathy Alcoholic cardiomyopathy is a disease in which the chronic
long- term abuse of alcohol (i.e., ethanol) leads to heart failure.Alcoholic cardiomyopathy is a type of dilated
cardiomyopathy.
Question 198: Correct Answer: B
Explanation: Ans: B. Obstructive lung disease Measurement of the bronchodilator response of forced
expiratory volume in 1 second (FEV1) is an important method in clinical respiratory medicine. This
measurement is used to predict the response to bronchodilator treatment and is part of the diagnosis of
COPD and asthma. The bronchodilator response of forced vital capacity (FVC) has less clinical use than the
bronchodilator response of FEV1 but may add important clinical physiological information Airway obstruction
was defined as FEV1/FVC ratio below lower limit of normal (LLN) before bronchodilation, and COPD was
defined as an FEV1/FVC ratio below LLN after bronchodilation.

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 Subject: 2020 - Questions
1. A researcher wanted to prove the relation between COPD and smoking. He collected
patients records from government hospitals and records of cigarette sales from the finance
and taxation department. This is an example of which study design:
a) Cross-sectional
b) Posological study
c) Ecological study
d) Operations research

2. MBBS student she was choking with dyspnea, chest tightness, anxiety and an impending
sense of doom on examination all systemic conditions were found normal, then she went to
psychiatry. What is the probable diagnosis of the condition?
a) Panic disorder
b) Depression
c) Epilepsy
d) Asthma

3. Which of the following vitamin at higher doses causes cystoid macular edema-
a) Vit A
b) Vit D
c) Vit E
d) Niacin

4. Occipitomental view of PNS X-ray called as

a) Caldwell view
b) Water view
c) Town view
d) Pine view

5. True statement regarding Huntington’s chorea is

a) There is a loss of function type of mutation
b) It is an autosomal recessive
c) It is a trinucleotide repeat expansion type of disorder
d) Increased number of CAA repeats

6.
a) Endometrial polyp
b) Ca endometrium
c) Submucosal fibroid
d) None

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7. Drug of choice for invasive aspergillosis is
a) Posaconazole
b) Voriconazole
c) Liposomal AMB
d) Caspofungin

8. Parents of the Child complains of assaulted by one of their relatives and anal pain in a
child, On investigation test shows yellow iodine crystals with picric acid - what is the name
of the test?
a) Florence test
b) Barberio’s test
c) Acid phosphatase test
d) Creatine Phosphokinase

9. Identify the device shown in the image.

a) Nasopharyngeal Airway
b) Endotracheal Tube(Cuffed)
c) Guedel Airway
d) Laryngeal Mask Airway

10. 30 years old came with complaints of easy fatigability, exertional dyspnea, and weight
loss. She also complains of frequent falls. physical examination revealed there was a
bilateral decrease in vibration sense. Her hemoglobin levels were 8.2g%. She was treated
with folate. Her anemia improved but neurological symptoms worsened. Which of the
following is the most probable reason for her condition?
a) Folate not absorbed
b) Unmasked pyridoxine deficiency
c) Deficiency of folate reductase in CNS
d) Folate therapy caused rapid use of Vit B12 stores aggravating symptoms

11. A 4-year-old boy of a first-degree consanguineous couple was noted by the parents to
have darkening of the urine to an almost black color when it was left standing. He has a
normal sibling, and there are no other medical problems. Growth and development to date
are normal. Which of the following is most likely to be elevated in this patient?
a) Methylmalonate
b) Homogentisate
c) Phenylpyruvate
d) ?-Ketoisovalerate

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12. Fluoroquinolone contraindicated in liver disease is
a) Levofloxacin
b) Pefloxacin
c) Ofloxacin
d) Lomefloxacin

13. A patient having multiple Gall stones and shows 8 mm dilation and 4 stones in CBD, best
treatment modalities are –
a) Cholecystectomy with choledocholithotomy at the same setting
b) ESWL
c) Cholecystectomy and wait for ERCP
d) All

14. Which interleukin responsible for producing IgE from B cells

a) IL 1
b) IL 3
c) IL 4
d) Both B & C

15. Which of the following is the basis for the intestine-specific expression of apoprotein
B-48?
a) DNA rearrangement and loss
b) DNA rearrangement and loss
c) RNA alternative splicing
d) RNA editing

16. A person was given a muscle relaxant that competitively blocks nicotinic receptors.
Which of the following drugs is used for reversal of muscle relaxation after surgery?
a) Neostigmine
b) Carbachol
c) Succinylcholine
d) Physostigmine

17. In, the primary survey which is not included-

a) CECT to look for bleeding
b) Exposure of the whole body
c) ABC
d) Recording BP

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18. Prerequisite for sympathetic ophthalmitis
a) Penetrating injury to the eye
b) Blunt ocular tumor
c) Chemical injury
d) Urinary tract infection

19. MBBS student she was choking with dyspnea, chest tightness, anxiety and an impending
sense of doom on examination all systemic conditions were found normal, then she went to
psychiatry. What is the probable diagnosis of the condition?
a) Panic disorder
b) Depression
c) Epilepsy
d) Asthma

20. DOC of prophylaxis for motion sickness?

a) Promethazine
b) Prochlorperazine
c) Metoclopramide
d) Itopride

21. Barium Swallow examination is shown. What can be the most probable diagnosis?
a) Esophageal Ca
b) Esophageal Ring
c) Esophageal Tear
d) Achalasia Cardia <img src='images/image.jpg' alt='Description of image'>

22. A patient after a heavy meal comes with epigastric pain. On examination tenderness and
rigidity in the upper abdomen. X-ray showing pneumomediastinum. What can be the cause-
a) Spontaneous esophageal rupture
b) Penetrating foreign body injury to esophagus
c) Perforated peptic ulcer
d) Rupture of emphysematous bulla

23. Postmenopausal women 1st line of drug for osteoporosis is-

a) OCP
b) Bisphosphonates
c) Raloxifene
d) Strontium

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24. The patient is presenting with the deformity of the finger as shown. The PIP is involved
but the DIP is spared
a) Osteoarthritis
b) Rheumatoid arthritis
c) Psoriatic Arthritis
d) Ankylosing spondylitis

25. A 30-year-old man is presented with cramping gluteal pain after walking 500m. Which is
the vessel involved during this?
a) Arterial disease with aortoiliac involvement
b) Arterial disease with femoral artery involvement
c) Femoral venous insufficiency
d) None

26. Werner syndrome associated with premature aging is caused due to a defect in which of
the following?
a) Telomerase
b) Caspase
c) DNA topoisomerase
d) DNA helicase

27. In the following X-ray of the wrist, what is the exact age-
a) 2 yrs
b) 8yrs
c) 6yrs
d) 9 yrs

28. Esophageal manometry was performed - it revealed panesophageal pressurization with

distal contractile integrity as >450mm Hg pressure in the body. What will be the diagnosis?
a) Type 1 achalasia
b) Type 2 achalasia
c) Type 3 achalasia
d) Jackhammer esophagus

29. A boy met with a motorbike accident. CT brain shows injury to the posterior end of the
superior temporal gyrus. He is likely to suffer from
a) Fluent aphasia
b) Non-fluent aphasia
c) Conduction aphasia
d) None of the above

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30. Which of the following dietary fiber is insoluble in water?
a) Pectin
b) Lignin
c) Hemicellulose
d) Cellulose

31. An elderly man with a long-standing mole over the face which is increasing in size and
showing irregular borders. What will be the diagnosis?
a) Superficial spreading melanoma
b) Lentigo maligna
c) Acral melanoma
d) Nodular melanoma

32. Proteoglycan present in the glomerular basement membrane is?

a) Keratan sulphate 1
b) Keratan sulphate 2
c) Heparan sulphate
d) Chondroitin sulphate

33. The patient presents with, fever, dysphagia. Image showing pushing tonsil. what is the
diagnosis?
a) Parapharyngeal abscess
b) Retropharyngeal abscess
c) Peritonsillar abscess
d) Ludwig's angina

34. A 30-year-old woman presents with thyroid swelling. On investigations, her TSH levels
are found to be elevated. Postoperative reports showed lymphocytic infiltration and hurthle
cells. A most probable diagnosis is?
a) Graves disease
b) Hashimoto's thyroiditis
c) Follicular carcinoma
d) Medullary carcinoma thyroid

35.
a) Peutz jeghers
b) Juvenile polyp
c) Villous adenoma
d) Hyperplastic polyp 272. Identify the condition given below in the image

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36. Which of the following dietary fiber is insoluble in water?
a) Pectin
b) Lignin
c) Hemicellulose
d) Cellulose

37. True About Noncompetitive antagonist -

a) Km remains same, Vmax decreases
b) Km remains same, Vmax decreases
c) Km decreases, Vmax increases
d) Km increases, Vmax increases

38. Nutcracker esophagus, the correct statement is

a) There is extremely forceful peristaltic activity leading to episodes of chest pain and
dysphagia
b) There is no medical t/t available
c) Type of oesophageal Malignancy
d) None

39. A 36-week old pregnant lady with previous twin delivery. What is the Ovarian score?
a) G2P1
b) G2P2
c) G3P2
d) G3P3

40. What is the T stage of a 2.5cm lung carcinoma, not involving the pleura?
a) T1a
b) T2
c) T1b
d) T1c

41. If a sample of DNA if adenine is 28% what will be the amount of Cytosine present
a) 23%
b) 25%
c) 46%
d) 22%

42. Name the sign seen in the given below image represents-
a) Mickey mouse sign
b) String sign
c) Tillaux sign
d) Stemmer's sign

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43. What is the main feature of chemotaxis as observed in white blood cells?
a) Increased random movement of neutrophils
b) Increased adhesiveness to intima
c) Increased phagocytosis
d) Unidirectional locomotion of neutrophils

44. The most common cause of death in SLE in children

a) Lupus nephritis
b) Lupus cerebritis
c) Libman sacks endocarditis
d) Anemia and infections

45. Which of the following drugs act by inhibiting DNA replication?

a) 6 Mercaptopurine
b) Actinomycin D
c) Mitomycin C
d) Asparaginase

46. True for King's Criteria with acute fulminant liver failure except-
a) Age
b) Jaundice <7days
c) Serum bilirubin >17.5 mg/dl
d) INR >3.5

47. Which of the following anticancer drugs are competitive inhibitors of tyrosine kinase –
a) Imatinib and sunitinib
b) Letrozole
c) Bicalutamide
d) Fulvestrant

48. The patient is present with fecal peritonitis and during laparotomy, a diverticular
perforation is seen. Which stage is classified according to Hinchey’s stage?
a) 1
b) 2
c) 3
d) 4

49. Magnan’s symptoms are related to

a) Cocaine poisoning
b) Cannabis
c) Cannabis
d) Alcohol

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50. MC location of gastrinoma in MEN-1 syndrome?
a) Duodenum
b) Jejunum
c) Pancreas
d) Ileum

51. The variation in data is compared with another data set by:
a) Variance
b) Coefficient of variation
c) The standard error of mean
d) Standard deviation

52. In Vision 2020, the target for Secondary Sevice center is for how much population –
a) 10000
b) 50000
c) 1 lac
d) 5 lac

53. Loss of pain/temperature sensation on ipsilateral face & C/L body due to thrombosis in
a) PICA
b) Posterior cerebellar artery
c) Superior cerebellar artery
d) None of the above

54. The movement is lost in:

a) Third nerve palsy
b) Trochlear palsy
c) Sixth nerve palsy
d) Facial nerve palsy

55. History of trauma with a stab injury to the right lower chest with low BP and low pulse
rate. It can be improved with IV fluids and after resuscitation in the trauma center patient’s
BP becomes normal. A chest X-ray showed clear lung fields. What will be the next step-
a) EFAST
b) Keep immediate chest tube
c) CECT abdomen
d) CECT chest

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56. Prospective screening is done in case of?
a) Neonate for thyroid diseases
b) Immigrant screening
c) Pap smear for 45-year female
d) Diabetes mellitus for 40-year male

57. Which of the following criteria is used to assess the prognosis of the liver condition as
represented in the picture below?
a) Child pugh score
b) Milan score
c) Meld score
d) Alvarado score

58. The most common site of origin of the diverticulum of the pharynx seen in the barium
swallow given below is
a) Between stylopharyngeus and palatopharyngeus
b) Between middle and inferior constrictor
c) Between inferior constrictor and esophagus
d) Between thyropharyngeus and cricopharyngeus

59. All of the following is/are having superantigen Property Except

a) Vibrio cholera
b) Streptococcal pyrogenic
c) Staphylococcal enterotoxins
d) None of these

60. In RDS in a child, which cells are found defective?

a) Type 1 pneumocytes
b) Type 2 pneumocytes
c) Bronchial epithelium
d) None

61. Identify the following Image

a) Neisseria meningitidis
b) Neisseria cinerea
c) Neisseria gonorrhoeae
d) Neisseria polysaccharea

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62. A chest radiograph obtained a male with hypertension. What will be the diagnosis?
a) Tetralogy of Fallot
b) Ebstein's Anomaly
c) TAPVC
d) Coarctation of Aorta

63. The most common cause of death in SLE in children

a) Lupus nephritis
b) Lupus cerebritis
c) Libman sacks endocarditis
d) Anemia and infections

64. Mouth to mouth respiration provides what percentage of oxygen ?

a) 10%
b) 16%
c) 21%
d) 100%

65. A person reports 4 hours after having a clean wound without laceration. He had taken TT
10 years before. the next step in management is:
a) Full course Tetanus vaccine to be given
b) Full dose TT with TIG
c) Single-dose TT
d) No need for any vaccine

66. 5-year male child present to the clinic with H/O recurrent infection On examination he
was found to have rashes shown below in the image. On routine blood investigation, low
platelet count was found what will be the diagnosis?
a) Wiskott Aldrich syndrome
b) Job's syndrome
c) Chediak Higashi syndrome
d) None

67. Which of the following is not seen in Pituitary apoplexy

a) Headache
b) Hypertension
c) Hypotension
d) Vomiting

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68. Which of the following cell components produced by Neisseria gonorrhoeae is
responsible for attachment to host cells?
a) Lipooligosaccharide
b) Pili (fimbriae)
c) IgA1 protease
d) Outer membrane porin protein

69. What will you do when 3 yrs old child parents come to phc with fever, cough since 5
days with chest indrawing present under mnci classification
a) Give antipyretics only
b) Give antibiotics and follow up
c) Refer urgently to tertiary care
d) Give antibiotics and refer to tertiary care

70. Hepcidin inhibits ?

a) Absorption of cobalamine
b) Transfer of iron into enterocytes
c) Folic acid synthesis
d) Respiratory oxidase

71. Nosocomial Infection occurs within?

a) A- 48
b) B. 72
c) C. 24
d) D. 50

72. A term baby on breastfeeding with bilirubin 14mg/dL which of the following is true?
a) Exchange transfusion
b) Continue to breastfeed
c) Phototherapy
d) None

73. Warming in Frost frostbite should be done at what temperature:

a) 37 degree
b) 42 degree
c) 44 degree
d) 46 degree

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74. Where will you put chemical liquid biomedical waste
a) White
b) Yellow
c) Blue
d) Red

75. A patient with depression was given Imipramine for 2 weeks. Relatives noticed increased
excitement, colourful clothes, increased talking. What is the next step in management?
a) Antipsychotic with Imipramine continued
b) Discontinue Imipramine and start Valproate
c) Continue Imipramine alone
d) Manage with Valproate alone

76. A 30-year-old man is presented with cramping gluteal pain after walking 500m. Which is
the vessel involved during this?
a) Arterial disease with aortoiliac involvement
b) Arterial disease with femoral artery involvement
c) Femoral venous insufficiency
d) None

77. According to NCEP-ATP III, which among the following have not been included in
metabolic syndrome?
a) High LDL
b) Hypertriglyceridemia
c) Central Obesity
d) Hypertension

78. Which of the following factors play a major role in the initiation of thrombus formation?
a) Vasoconstriction
b) Coagulation cascade activation
c) Platelets activation
d) Endothelial injury

79. Prospective screening is done in case of?

a) Neonate for thyroid diseases
b) Immigrant screening
c) Pap smear for 45-year female
d) Diabetes mellitus for 40-year male

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80. A Female patient was on lithium for bipolar disorder for 6 months.she fasted for some
days due to religious condition and later presented with seizures,tremors, confusion and
weakness. What investigations have to be done to diagnose her condition
a) serum electrolytes
b) serum lithium
c) ECG
d) MRI

81. Claudication due to popliteal femoral incompetence is primarily seen in

a) Thigh
b) Calf
c) Buttocks
d) Feet

82. The differentiating feature between IBS and organic GI disease is:
a) Diarrhea
b) Stool calprotectin
c) Pain abdomen
d) Mucus in stools

83. Mission Indradhanush is for:

a) Non-communicable diseases
b) Universal immunization
c) Family planning
d) Safe water and sanitation

84. Which of the following technique is used to study current flow across a single ion
channel?
a) Patch clamp
b) Voltage clamp
c) lontophoresis
d) Galvanometry

85. In which of the following methods of management is the benefit measured in natural
units?
a) Program budgeting system
b) Network analysis
c) Cost-effective analysis
d) Cost-benefit analysis

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86. A man under alcohol intoxication had fallen into a manhole and had a perineal injury with
swollen scrotum and upper thigh along with blood at meatus. The patient is having difficulty
passing urine as well. What will be the injury associated due to this trauma?
a) Bladder rupture
b) Penile fracture
c) Bulbar urethra
d) Membranous urethra

87. Theophylline by what mechanism causes diuresis?

a) PDE3 inhibition
b) PDE4 inhibition
c) Beta 2 agonist action
d) Adenosine A1 receptor antagonism

88. A lady on treatment for infertility developed ascites, abdominal pain & dyspnea. USG of
the patient was done shown below. What will be the diagnosis?
a) PCOS
b) OHSS
c) Theca lutein cyst
d) Mucinous cystadenomas

89. Postmenopausal women 1st line of drug for osteoporosis is-

a) OCP
b) Bisphosphonates
c) Raloxifene
d) Strontium

90. A young man met with a motorbike accident and had injuries to ileum and jejunum.
Therefore the entire ileum and partial jejunum were resected. Which of the following would
the patient suffer from
a) Vitamin B12 deficiency
b) Atrophic gastritis
c) Constipation
d) None

91. At a high altitude of 3000 m, a person complains of breathlessness. All of the following
can be used for the management of this person except?
a) Intravenous digoxin
b) Oxygen supplementation
c) Immediate descent
d) Acetazolamide

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92. Identify the condition in the X-ray given below-
a) TGA
b) TAPVC
c) TOF
d) Ebstein's anomaly

93. In Modern obstetrics, for sensitized Rh- negative mother what should be done to
evaluate the condition of the mother?
a) MCA doppler peak systolic volume
b) Fetal blood
c) Amniocentesis
d) Biophysical profile

94. All found in LVF except

a) Lung oligemia
b) Kerley b lines
c) Rales
d) Pedal edema

95. An Hiv positive patient with a CD4 COUNT OF 300/Cumm presents with mucosal lesions
in the mouth as shown in the figure. on microscopy budding yeasts and pseudohyphae are
seen. A most probable diagnosis is?
a) Candidiasis
b) Hairy leukoplakia
c) Lichen planus
d) Diphtheria

96. A 30-year-old male came with complaints of swelling around the knee joint.
Histopathological examination of the swelling demonstrated many giant cells interspersed
with mononuclear cells. What is the probable diagnosis
a) Osteosarcoma
b) Ewing's sarcoma
c) Giant cell tumour
d) Chondrosarcoma

97. A patient diagnosed with Rheumatoid arthritis was on medications. After 2 years, he
developed a blurring vision and was found to have corneal opacity. Which drug is most
likely to cause this?
a) Sulfasalazine
b) Chloroquine
c) Methotrexate
d) Leflunomide

Page 74 of 446
98. Pegloticase is used for the treatment of an Ankylosing spondylosis
a) Reactive Arthritis
b) CPPD
c) Chronic tophaceous gout
d) Refractory Rheumatoid arthritis

99. CA-125 is a marker for the screening of ovarian cancer. To characterize this test,
histopathological confirmation of ovarian cancer was done in a cohort of patients. 60/100
women who tested positive for this test had ovarian cancer and 20/100 women who tested
negative had ovarian cancer. What is the negative predictive value of this test?
a) 20/100
b) 40/100
c) 60/100
d) 80/100

100. A 36-week old pregnant lady with previous twin delivery. What is the Ovarian score?
a) G2P1
b) G2P2
c) G3P2
d) G3P3

101. Fungal Infection which is acquired by traumatic inoculation is?

a) Sporothrix
b) Blastomycosis
c) Coccidioides
d) Paracoccidioides

102. Zero-order kinetics is otherwise known as saturation kinetics. It is independent of:

a) Plasma concentration
b) Clearance
c) Volume of distribution
d) Half life

103. 12 yr old Child admitted to ICU with blunt trauma and femur fracture- Pao2 60% despite
100%o2 and rebreather mask, CXR shows lung fields clear but the patient remains confused.
What is most likely the diagnosis -
a) Pulmonary contusion.
b) Fat embolism syndrome.
c) Hypovolaemic shock.
d) Pulmonary embolism.

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104. Steeple sign is seen in which of the following condition?
a) Acute epiglottitis
b) Acute laryngotracheobronchitis
c) Laryngeal papillomatosis
d) Bilateral abductor paralysis

105. The characteristic finding of fungal ulcers?

a) Satellite lesions
b) Dendritic ulcer
c) Ring abscess
d) White hypopyon

106. What is the MONICA project?

a) Multinational monitoring of trends and determinants in Cardiovascular Disease
b) Multinational of trends and determinants in cerebrovascular disease
c) Multinational monitoring of trends and determinants in diabetes
d) Multinational monitoring of trends and determinants in congenital heart disease

107. A mother brought her 16-year-old daughter to Gynaecology OPD with a complaint of not
attending menarche. She gives H/O cyclic abdominal pain. On further examination midline,
abdominal swelling seen. Per rectal examination reveals a bulging mass in the vagina.
Which of the following can be most commonly seen?
a) Imperforate hymen
b) Transvaginal septum
c) Vaginal agenesis
d) MRKH

108. Fluoroquinolone contraindicated in liver disease is

a) Levofloxacin
b) Pefloxacin
c) Ofloxacin
d) Lomefloxacin

109. Water hammer pulse is seen in

a) Aortic regurgitation
b) Mitral stenosis
c) Aortic stenosis
d) Left ventricular failure

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110. The vaccine to be given after disaster
a) vaccination against typhoid
b) vaccination against cholera
c) vaccination against typhoid and cholera
d) vaccination against tetanus

111. V- Richest source of vitamin B12 ?

a) Meat
b) Green leafy vegetables
c) Corn oil
d) Sunflower oil

112. Vector for zika virus is -

a) Aedes
b) Culex
c) Anopheles
d) None of these

113. Steeple sign is seen in which of the following condition?

a) Acute epiglottitis
b) Acute laryngotracheobronchitis
c) Laryngeal papillomatosis
d) Bilateral abductor paralysis

114. Blood stored in citrate-phosphate-dextrose is better for hypoxic patients than acidic-
citrate-dextrose because?
a) It has less P50
b) It is less acidic
c) The fall in 2, 3 DPG is less
d) None of the above

115. Culture media used for E.coli 0157:H7 is

a) SMAC
b) Wilson and Blair medium
c) Potassium tellurite in Mcleod's medium
d) Deoxycholate citrate agar (DCA)

116. Which of the following anticancer drugs are competitive inhibitors of tyrosine kinase –
a) Imatinib and sunitinib
b) Letrozole
c) Bicalutamide
d) Fulvestrant

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117. All of the following is/are having superantigen Property Except
a) Vibrio cholera
b) Streptococcal pyrogenic
c) Staphylococcal enterotoxins
d) None of these

118. Which of the following clotting factor in a patient on Warfarin therapy, would have
decreased gamma carboxyglutamate residue?
a) Factor 2
b) Factor 11
c) Tissue factor
d) Factor 5

119. Identify the muscle. What is its nerve supply

a) Dorsal scapular nerve
b) Thoracodorsal nerve
c) Spinal accessory nerve
d) Suprascapular nerve

120. Addition of which Amino Acid will increase UV absorption

a) Tryptophan
b) Leucine
c) Proline
d) Arginine

121. According to NCEP-ATP III, which among the following have not been included in
metabolic syndrome?
a) High LDL
b) Hypertriglyceridemia
c) Central Obesity
d) Hypertension

122. Which of the following does the image of Capnograph below depicts?
a) During inspiration
b) Inspiration with cardiac oscillations
c) During expiration
d) spontaneous respiration

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123. What will be the appropriate management for Abdominal aortic aneurysm-
a) Monitor till size reaches 55mm
b) Immediate surgery
c) USG monitoring till >70mm asymptomatic
d) No treatment

124. Which of the following antihypertensive drug is avoided in patients with high serum uric
acid levels?
a) Hydrochlorothiazide
b) Enalapril
c) Prazosin
d) Atenolol

125. History of Arthritis involving 1st MCP joint, other PIP & DIP joints, spares wrist and
ankle. What could be the diagnosis
a) Osteoarthritis
b) Rheumatoid arthritis
c) Psoriatic arthritis
d) Gout

126. What will be the Hysteroscopic finding in the given image?

a) Bilateral Hydrosalpinx
b) Bilateral cornual block
c) Normal HSG
d) Bicornuate uterus

127. Which drug acts via the tyrosine kinase receptor?

a) Insulin
b) TSH
c) LH
d) MSH

128. True hermaphroditism karyotype:

a) 45 X0 streaked gonads
b) 46 XX Ovotestis
c) 47 XY+9
d) 47 XX

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129. Most common site for Fertilization is-
a) Ampulla
b) Isthmus
c) Intramural
d) Fimbriae

130. All are used for postcoital contraception except-

a) CuT
b) Ru 486
c) High dose estrogen
d) Danazol

131. Extended sickness benefit for tuberculosis under the ESI Act is:
a) 91 days
b) 1-year
c) 2 years
d) 4 years

132. A Patient falls down often with behavioral change and enuresis. What is the condition
associated with him?
a) Frontotemporal dementia
b) Normal pressure hydrocephalus
c) Parkinson's disease
d) Alzheimer's disease

133. A patient with depression was given Imipramine for 2 weeks. Relatives noticed
increased excitement, colourful clothes, increased talking. What is the next step in
management?
a) Antipsychotic with Imipramine continued
b) Discontinue Imipramine and start Valproate
c) Continue Imipramine alone
d) Manage with Valproate alone

134. The patient is presenting with pain around the base of the thumb, tendons involved -
a) APB & EBL
b) APL & EPB
c) APB & EPB
d) APL & EPL

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135. Lithium causes:
a) Hypokalemia
b) Hyperkalemia
c) Hypocalcemia
d) Hypercalcemia 1. 2. 3. 4. 5. 6. 7.

136. Most common site for Fertilization is-

a) Ampulla
b) Isthmus
c) Intramural
d) Fimbriae

137. A Child is born, covered with a thick membranous coat, what could be the possible
diagnosis?
a) Lamellar ichthyosis
b) X-linked ichthyosis
c) Ichthyosis Vulgaris
d) Ichthyosis acquista

138. Battle sign image Bluish Purple colour behind mastoid?

a) Battle sign
b) Bezold abscess
c) Both A and B
d) None of these

139. All trans retinoic acid is used in the treatment of tumour associated with
a) BCR-ABL
b) PML-RARA
c) CMYC
d) CEBPA

140. In early pregnancy clinical signs of feeling the cer?vix and the body of bulky uterus
separated be?cause of softened isthmus at 6 - 8 weeks of gestation :
a) Goodell's sign
b) Chadwick's sign
c) Piskacek's sign
d) Hegar's sign

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141. Relatives of a patient told during postmortem examination that the person had a tattoo -
which was now invisible. How to identify?
a) Examine the Lymph node
b) Spectrophotometer
c) Ordinary light
d) X-ray

142. Interpret the partogram.

a) CPD
b) Maternal exhaustion
c) Inadequate uterine contractions
d) Rupture uterus

143. In Modern obstetrics, for sensitized Rh- negative mother what should be done to
evaluate the condition of the mother?
a) MCA doppler peak systolic volume
b) Fetal blood
c) Amniocentesis
d) Biophysical profile

144. Patients have precancerous lesions with abdominal swelling and inguinal nodes are
seen. On examination, lymphadenopathy was found. The most probable carcinoma related
to this condition will be?
a) ca penis
b) CaTestis
c) ca prostate
d) ca bladder

145. Thoracoscore , what is not the component

a) ASA CLASSIFICATIONS
b) SURGERY PRIORITIES
c) Performance status
d) Expected complications post-surgery

146. Stimulation of the external auditory canal leads to cough due to which nerve
a) Auricular branch Vagus
b) Greater auricular nerve
c) Auriculotemporal nerve
d) Facial Nerve

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147. Warming in Frost frostbite should be done at what temperature:
a) 37 degree
b) 42 degree
c) 44 degree
d) 46 degree

148. All of the following show low glucose in pleural fluid, EXCEPT-
a) Empyema
b) Malignant pleural effusion
c) Rheumatoid arthritis
d) Dressler's syndrome

149. Occipitomental view of PNS X-ray called as

a) Caldwell view
b) Water view
c) Town view
d) Pine view

150. a given time. Prevalent cases ? All breast cancer patients who are alive during a given
time frame. These can lead to different results because the probability of finding a case in a
given time frame is related to mortality risk. Those patients who hay a mild form of the
disease and survive for a relatively long time have a good chance of being around on the
date of data collection. Those patients who die quickly are unlikely to be around on that
date. 3. Referral bias or volunteer bias Volunteer or referral bias occurs because people who
volunteer to participate in a study (or who are referred to it) are often different than non-
volunteers/non-referral. This bias usually favours the treatment group, as volunteers tend to
be more motivated and concerned about there health. 4. Response bias This occurs when
those who respond to a survey differ in important ways from those who do not respond.
This bias can work in either direction, i.e., if bias occurs, when those who do not respond to
a survey differ in important ways from those who respond, it is called nonrespondent bias.
5. Berkesonian bias Berkesonian bias results from the greater probability of hospital
admission for people with two or more diseases than for people with one disease. So, it is
also known as admission rate bias. For example, If breast cancer is the exposure of interest
(diseases are often treated as exposures in hospital-based case-control studies) and
meningioma is the case disease then people with both breast cancer and meningioma could
be hospitalized for either breast cancer or meningioma or both. However, people with only
breast cancer or with the only meningioma could be hospitalized because of one of these
diseases. Therefore, a greater proportion of people in the community with both breast
cancer and meningioma would be admitted to the hospital than people with meningioma
only. So, Berkesonian bias occurs when both exposure (e.g., breast
a) N/A
b) N/A

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c) N/A
d) N/A

151. Ph7.2, HCO3 - (10 or 12), pco2-35 , metabolic acidosis due to

a) K+ excretion by the kidney
b) Co2 expiration by lungs
c) H+excretion by the kidney
d) Hco3 loss by kidney

152. All found in LVF except

a) Lung oligemia
b) Kerley b lines
c) Rales
d) Pedal edema

153. Photostress test to differentiate

a) Lens and cornea
b) The macula and Optic nerve diseases
c) Cataract and glaucoma
d) Retinal and vitreous diseases

154. A 4 yr old child while playing suddenly spun around his elbow from her servant maid's
hand and now continuously crying not allowing anyone to touch his elbow. He is keeping
his elbow extended .what is most likely the diagnosis -
a) Radial head fracture
b) Pulled elbow
c) supra condylar fracture
d) Elbow dislocation

155. An elderly man with a long-standing mole over the face which is increasing in size and
showing irregular borders. What will be the diagnosis?
a) Superficial spreading melanoma
b) Lentigo maligna
c) Acral melanoma
d) Nodular melanoma

156. Which interleukin responsible for producing IgE from B cells

a) IL 1
b) IL 3
c) IL 4
d) Both B & C

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157. As per the sustainable development goals, The target for MMR is to achieve maternal
deaths of
a) < 70 / Lac live births
b) < 100 / lac live births
c) < 7 / 1000 live births
d) < 10 / 1000 live births

158. Identify the sleep wave marked in the EEG during the sleep-wake cycle?
a) Stage 1 sleep
b) REM sleep
c) Stage 2 sleep
d) Stage 3 sleep

159. Parents of the Child complains of assaulted by one of their relatives and anal pain in a
child, On investigation test shows yellow iodine crystals with picric acid - what is the name
of the test?
a) Florence test
b) Barberio’s test
c) Acid phosphatase test
d) Creatine Phosphokinase

160. Atient has fatigue. But not gaining weight. Body was warm. Investigation will show:
a) Low TSH with more t3 or t4
b) High TSH with normal t3 or t4
c) High TSH with euthyroid
d) Increased uptake of t3, but decrease t4

161. Theophylline by what mechanism causes diuresis?

a) PDE3 inhibition
b) PDE4 inhibition
c) Beta 2 agonist action
d) Adenosine A1 receptor antagonism

162. As per the sustainable development goals, The target for MMR is to achieve maternal
deaths of
a) < 70 / Lac live births
b) < 100 / lac live births
c) < 7 / 1000 live births
d) < 10 / 1000 live births

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163. Zero-order kinetics is otherwise known as saturation kinetics. It is independent of:
a) Plasma concentration
b) Clearance
c) Volume of distribution
d) Half life

164. Identify the imagebelow:

a) Female condom
b) Male condom
c) Chaaya
d) Today

165. Which is not seen in Asepsis score-

a) Erythema
b) Induration
c) Serous discharge
d) Purulent exudate

166. Which of the following drugs acts by inhibiting the transcription of DNA to RNA?
a) Rifampicin
b) Nitrofurantoin
c) Ciprofloxacin
d) Novobiocin

167. Werner syndrome associated with premature aging is caused due to a defect in which
of the following?
a) Telomerase
b) Caspase
c) DNA topoisomerase
d) DNA helicase

168. Most common DRUG causing dependence?

a) Cannabis
b) Cocaine
c) Heroin
d) Amphetamine

169. Which amino acid is used to synthesize Nitric oxide?

a) Glycine
b) Arginine
c) Tyrosine
d) Threonine

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170. Prolactin secreted maximum at-
a) 24 hrs after delivery
b) REM
c) 2 hrs running
d) 24 hour after Ovulation

171. A 65 old male with a history of hypertension and diabetes, presents to the OPD with
complaints of diplopia and squint. On examination, the secondary deviation is more than the
primary deviation. Which of the following is most likely diagnosis
a) concomitant squint
b) paralytic squint
c) Restrictive squint
d) Pseudo squint

172. A 45-year-old man who is a chronic smoker came to the clinic with a complaint of
cough. The physician examines the patient and takes a biopsy, the picture in the biopsy was
as the description below. Which of the following cellular changes has happened to this
patient?
a) Hyperplasia
b) Dysplasia
c) Metaplasia
d) CIN3

173. A middle-aged man with a swelling over the neck since childhood with the overlying
skin not intact which had a bag or worm-like appearance with a black spot in the middle.
What will be the diagnosis?
a) Cirsoid aneurysm
b) Varicocele
c) Plexiform neurofibroma
d) Lymphangioma

174. A researcher wanted to prove the relation between COPD and smoking. He collected
patients records from government hospitals and records of cigarette sales from the finance
and taxation department. This is an example of which study design:
a) Cross-sectional
b) Posological study
c) Ecological study
d) Operations research

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175. Identify the radiological image given below-
a) Intussusception
b) Carcinoma colon
c) Sigmoid volvulus
d) Sigmoid volvulus

176. Retrosternal goiter which is true?

a) All patients should undergo CT chest
b) All patients require a median sternotomy
c) it receives blood supply from thoracic vessels
d) Majority of retrosternal goitres should be operated immediately

177. Sudden onset headache with neck rigidity?

a) Intraparenchymal hemorrhage
b) Sah
c) Meningitis
d) None of the above

178. What is the T stage of a 2.5cm lung carcinoma, not involving the pleura?
a) T1a
b) T2
c) T1b
d) T1c

179. If one variable is given then you can find another variable by
a) Coefficient of variation
b) Coefficient of correlation
c) Coefficient of regression
d) Coefficient of determination

180. Esotropia is common in

a) Myopia
b) Hypermetropia
c) Emmetropia
d) Astigmatism

181. A 23-year-old male presented with a history of fatigue and tiredness. On investigation,
he was found to have Hb values of 9gm%, MCV of 101 FL. peripheral smear examination
showed microcytic RBC and hypersegmented neutrophils. Which is most probable etiology
a) Lead poisoning
b) Iron deficiency anemia
c) Chronic alcoholism

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d) Hemolytic anemia

182. A middle-aged man with a swelling over the neck since childhood with the overlying
skin not intact which had a bag or worm-like appearance with a black spot in the middle.
What will be the diagnosis?
a) Cirsoid aneurysm
b) Varicocele
c) Plexiform neurofibroma
d) Lymphangioma

183. The active disinfectant property of bleaching powder is due to:

a) Chlorine
b) Hypochloric acid
c) Hypochlorous acid
d) Chloramines

184. Best treatment option for septate uterus-

a) Tompkins Metroplasty
b) Jones metroplasty
c) Strassmann metroplasty
d) Transcervical hysteroscopic resection of the septum

185. A 46-year-old woman with HIV complains severe persistent diarrhea, Histological
Investigation was performed, Identify the organism causing diarrhea in HIV Patient.
a) Cryptosporidium
b) Staphylococcus aureus
c) Salmonella
d) Clostridium botulinum

186. Mother does not transmit what antibody to the baby –

a) Polio
b) Diphtheria
c) Diphtheria
d) Tetanus

187. What causes shifting fluid?

a) Exudative Retinal detachment
b) Tractional Retinal Detachment
c) Rhegmatogenous retinal detachment
d) Retinodialysis

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188. Bedridden for >3 days or surgery in the last 4 weeks 1 Ref- Bailey and Love, Short
practice of surgery, 27th edition published in 2018 Pg 988 Tenderness along the line of
femoral or popliteal veins 1 Entire limb swollen 1 Calf >3cm larger circumference than
the other side 1 10cm below the tibial tuberosity 1 Pitting edema 1 Dilated collateral
superficial veins (not varicose veins) 1 Previous DVT 1 Malignancy (including treatment
up to 6 months ago) 1 Intravenous drug abuse 3 Alternative diagnosis more likely than
DVT -2
a) N/A
b) N/A
c) N/A
d) N/A

189. A person reports 4 hours after having a clean wound without laceration. He had taken
TT 10 years before. the next step in management is:
a) Full course Tetanus vaccine to be given
b) Full dose TT with TIG
c) Single-dose TT
d) No need for any vaccine

190. Blood bags are disposed of in

a) Yellow bag
b) Black bag
c) Red bag
d) White bag

191. Photostress test to differentiate

a) Lens and cornea
b) The macula and Optic nerve diseases
c) Cataract and glaucoma
d) Retinal and vitreous diseases

192. 18-year-old girl presents with 6 months of amenorrhea with h/o low-grade fever, weight
loss, pain abdomen, generalized weaknesses. On PR examination, palpable left-sided pelvic
mass felt... Diagnosis is
a) Fibroid with degeneration
b) TB pelvis with Tubo ovarian mass
c) Ectopic pregnancy
d) Granulosa cell tumour

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193. Which muscle is paralyzed if there is hyperextension of metacarpophalangeal joint and
flexion of the interphalangeal joint?
a) Extensor digitorum
b) Interossei and lumbricals
c) Adductor pollicis
d) Pronator quadratus muscle

194. Identify the device shown in the image.

a) Nasopharyngeal Airway
b) Endotracheal Tube(Cuffed)
c) Guedel Airway
d) Laryngeal Mask Airway

195. Punishment of perjury comes under IPC section?

a) IPC 191
b) IPC 192
c) IPC 193
d) IPC 197

196. A mother brought her 16-year-old daughter to Gynaecology OPD with a complaint of not
attending menarche. She gives H/O cyclic abdominal pain. On further examination midline,
abdominal swelling seen. Per rectal examination reveals a bulging mass in the vagina.
Which of the following can be most commonly seen?
a) Imperforate hymen
b) Transvaginal septum
c) Vaginal agenesis
d) MRKH

197. 30 years old came with complaints of easy fatigability, exertional dyspnea, and weight
loss. She also complains of frequent falls. physical examination revealed there was a
bilateral decrease in vibration sense. Her hemoglobin levels were 8.2g%. She was treated
with folate. Her anemia improved but neurological symptoms worsened. Which of the
following is the most probable reason for her condition?
a) Folate not absorbed
b) Unmasked pyridoxine deficiency
c) Deficiency of folate reductase in CNS
d) Folate therapy caused rapid use of Vit B12 stores aggravating symptoms

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 Subject: 2020 - Answer Key

Question 1: Correct Answer: C

Explanation: Ans. C. Ecological study design This is an example of an ecological study. An ecological study
is a type of Observational study where information is collected on a group (or population) rather than on
individual members and then analyzed. Here the association between a summary measure of sale of
cigarettes (risk factor) and a summary measure of the number of cases of COPD(outcome) is studied.
Question 2: Correct Answer: A
Explanation: ANS - A. Panic disorder Panic disorder-severe anxiety with choking, chest pain and
palpitations. Depression- low mood and lost interest in activities Epilepsy-neurological disorder with whole-
body fatigue and muscle spasms An asthma-respiratory disorder associated with symptoms of cough,
wheezing, etc Ref: ARVIND ARORA review of psychiatry p:131
Question 3: Correct Answer: D
Explanation: Ans: D. Niacin Cystoid macular edema (CME) is a condition that involves the macula, causing
painless vision loss. Niacin (nicotinic acid, vitamin B3, vitamin PP), one component of the dietary supplement
taken by the patient, is a vitamin preparation usually used for the treatment of lipid disorders Fraunfelder et
al. reported that 3 g or more per day of nicotinic acid could cause many ocular side effects such as blurred
vision, eyelid edema, toxic amblyopia, proptosis, loss of eyelashes or eyebrow, superficial punctate keratitis,
and cystoid macular edema, which represents the most serious ocular complications. All these adverse
effects are reversible with discontinuation of niacin therapy Ref- Case Reports in Ophthalmological Medicine,
Volume 2013, Article ID 713061, 5 page
Question 4: Correct Answer: B
Explanation: Answer:b. Water view Occipitomental view of PNS X-ray called as Water view
Question 5: Correct Answer: C
Explanation: Ans: C. It is a trinucleotide repeat expansion type of disorder Huntington’s chorea is an
autosomal dominant disorder with an increased number of CAG repeats. Clinically manifested as involuntary
jerky movements, mood disturbances and finally severe dementia. Ref- Lange biochemistry and genetics
flash cards, Huntington’s disease, pg 161
Question 6: Correct Answer: A
Explanation: Ans A. Endometrial polyp 280. 60 yr female with a history of intermittent bleeding with USG pic
shown below. What is thediagnosis? The 3D image gives a better picture of a large vessel passing into a
Question 7: Correct Answer: B
Explanation: Ans: B. Voriconazole The preferred treatment of primary IA is voriconazole, which has been
found to be superior to amphotericin B. Azoles interfere with the synthesis of ergosterol found in the fungal
cell membrane, whereas polyenes -- such as amphotericin B -- interfere with ergosterol function. An
echinocandin that disrupts fungal cell wall synthesis – caspofungin -- and itraconazole have been approved
for salvage therapy of IA. Ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4200583/
Question 8: Correct Answer: B
Explanation: Answer: B. Barberio’s test It detects spermin (secreted by the prostate) and uses an aqueous
or alcoholic solution of picric acid. A saturated aqueous or alcoholic solution of picric acid, when added to the
spermatic fluid, produces yellow needle-shaped rhombic crystals of spermine picrate. The reaction probably
depends on the presence of prostatic secretion. The Acid Phosphatase Test: The prostatic secretion element

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of seminal fluid contains 500 to 1000 times greater acid phosphatase than any other body fluid. Human red
cells, semen of higher apes, and juice of cauliflower have acid phosphatase level similar to that of human
semen THE ESSENTIALS OF FORENSIC MEDICINE AND TOXICOLOGY By Dr. K.S. NARAYAN REDDY
33/e- pg-434
Question 9: Correct Answer: D
Explanation: Ans:D.)Laryngeal Mask Airway Laryngeal mask airway A type of supraglottic airway. It is also
referred to as Brain mask as it was invented by Dr. Archies Brain. LMA provides an airway intermediate
between the face mask and tracheal tube It is a medical device that keeps a patient's airway open during
anaesthesia or unconsciousness. The principle of LMA is that it provides an effective gas-tight seal around
the laryngeal inlet without anything having to pass through the vocal cord. LMA is very effective in
maintaining a patent airway in the spontaneously breathing patient.
Question 10: Correct Answer: D
Explanation: Ans: D. Folate therapy caused rapid use of Vit B12 stores aggravating symptoms Vitamin B12
is required for the recycling of tetrahydrofolate, the form of folate that is needed for DNA synthesis. In
keeping with this relationship, the anemia of vitamin B12 deficiency is reversed with the administration of
folate. By contrast, folate administration does not prevent and may, in fact, worsen the
Question 11: Correct Answer: B
Explanation: Ans: B. Homogentisate. * Alkaptonuria is a rare metabolic disease involving a deficiency in
homogentisic acid oxidase, and the subsequent accumulation of homogentisic acid in the urine, which turns
dark upon standing. * The elevation of ? methylmalonate (due to methylmalonyl CoA mutase deficiency), ?
Phenylpyruvate (due to phenylalanine hydroxylase deficiency), ? ?-ketoisovalerate (due to branched-chain ?-
keto acid dehydrogenase deficiency), ? Homocysteine (due to cystathionine ?-synthase deficiency) * All of
these are inconsistent with a healthy child with a darkening of
Question 12: Correct Answer: B
Explanation: Ans: B. Pefloxacin Pefloxacin has longer t1?2: accumulates on repeated dosing achieving
plasma concentrations twice as high as after a single dose. Because of this, it is effective in many systemic
infections as well. The dose of pefloxacin needs to be reduced in liver disease, but not in renal insufficiency.
Ref: K. D. Tripathi 7th Edition. Page. 713
Question 13: Correct Answer: A
Explanation: Ans: A. Cholecystectomy with choledocholithotomy done at the same sitting Management of
suspected or proven CBD stones associated with gall bladder stones For gallstones - laparoscopic
cholecystectomy is the procedure of choice. For CBD stones two things can be done: 1) If the surgeon is
experienced in laparoscopic techniques of CBD stone removal then both cholecystectomy and
choledocholithotomy are done in the same sitting. CBD stones are first confirmed by an intraoperative
cholangiogram then the stones are removed laparoscopically via the cystic duct or by choledochotomy. 2) If
the surgeon is not experienced with laparoscopic methods of CBD stone removal, preoperative endoscopic
sphincterotomy with stone removal and later laparoscopic cholecystectomy is done. Laparoscopic
cholecystectomy with choledocholithotomy in the same sitting is the preferred technique (provided the
surgeon is experienced)
Question 14: Correct Answer: C
Explanation: Answer- C, IL 4 IgE is produced by plasma cells located in lymph nodes draining the site of
antigen entry or locally, at the sites of allergic reactions, by plasma cells derived from germinal centers
developing within the inflamed tissue. IgEantibody production requires TH2 cells that produce interleukin-4
(IL-4) and IL-13 and it can be inhibited by TH1 cells that produce interferon-? (IFN-?).

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https://www.ncbi.nlm.nih.gov/books/NBK27117/
Question 15: Correct Answer: D
Explanation: Ans: D. RNA editing. The production of apoB-48 in the intestine and apoB-100 in liver is the
result of RNA editing in the intestine, where a sense codon is changed to a nonsense codon by post-
transcriptional deamination of C to U.DNA rearrangement and transposition, as well as RNA interference and
alternate splicing, do alter gene expression, but are not the basis of apoB-48 tissue-specific production.
Reference- Lippincott’s Illustrated Reviews: Biochemistry, 5th edition, Regulation of Gene Expression, Pg
464.
Question 16: Correct Answer: A
Explanation: Ans: A. Neostigmine Neostigmine has been traditionally used as the agent of choice to reverse
Neuromuscular Blockade (NMB) after muscle paralysis during general anesthesia. Anticholinesterases
(neostigmine) are generally used to reverse the effects of neuromuscular blocking agents. Ref:
https://www.hindawi.com/journals/cria/2017/8197035/
Question 17: Correct Answer: A
Explanation: Answer – A. CECT to look for bleeding The primary survey aims to identify and manage the
most immediately life-threatening pathologies first and follows cABCDE. 1. c- Exsanguinating external
hemorrhage 2. A- airway with cervical spine control 3. B- Breathing & ventilation 4. C- Circulation &
hemorrhage 5. D- Disability 6. E- Exposure An assessment of the hemodynamic status should be made to
identify shocked patients: the skin may be pale, cool and sweaty, the pulse rate raised to over 100 per
minute and the blood pressure low. Ref- Bailey and Love, Short practice of surgery, 27th edition published in
2018 Pg 323
Question 18: Correct Answer: A
Explanation: Ans: a. Penetrating injury to the eye. >Sympathetic ophthalmia is a rare type of uveitis that
causes small abnormal clumps of cells (granulomas) to form. >This disorder occurs in the uninjured eye after
a penetrating injury (such as when a pencil, pen, or stick punctures the eye) or surgery to the other (injured)
eye. Ref:https://www.msdmanuals.com/en-in/home/eye-disorders/uveitis- and-related-disorders/sympathetic-
ophthalmia.
Question 19: Correct Answer: A
Explanation: ANS - A. Panic disorder Panic disorder-severe anxiety with choking, chest pain and
palpitations. Depression- low mood and lost interest in activities Epilepsy-neurological disorder with whole-
body fatigue and muscle spasms An asthma-respiratory disorder associated with symptoms of cough,
wheezing, etc Ref: ARVIND ARORA review of psychiatry p:131
Question 20: Correct Answer: A
Explanation: Ans: A. Promethazine Motion sickness: Antiemetics with the anticholinergic-antihistamine
property are the first choice drugs for motion sickness. Antidopaminergic and anti-HT 3 drugs are less
effective. All anti-motion sickness drugs act better when taken 1?2–1 hour before commencing the journey.
Once sickness has started, it is more difficult to control; higher doses/parenteral administration may be
needed. Drugs Included: Promethazine, diphenhydramine, dimenhydrinate: These drugs afford protection of
motion sickness for 4–6 hours. Promethazine theoclate: This salt of promethazine has been specially
promoted as an antiemetic, but the action does not appear to be significantly different from promethazine
HCl.
Question 21: Correct Answer: A
Explanation: Answer- A. Esophageal Ca The image is Esophageal carcinoma Squamous cell cancer and

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adenocarcinoma are the most common types. The classic appearance of a mid oesophageal proliferative
squamous cell carcinoma. Squamous cell carcinoma of the esophagus producing an irregular stricture with
shouldered margins. Ref- Bailey and Love, Short practice of surgery, 27th edition
Question 22: Correct Answer: A
Explanation: Answer- A. Spontaneous esophageal rupture This is a clinical case of spontaneous esophageal
rupture/ Boerhaave’s syndrome The clinical history is usually of severe pain in the chest or upper abdomen
after a meal or a bout of drinking. Mackler's triad, which consists of (1) vomiting followed by (2) chest pain
and (3) subcutaneous emphysema due to an esophageal rupture. A chest radiograph is often confirmed with
air in the mediastinum, pleura or peritoneum. InvestigationsChest X-ray—shows pneumomdiastinum (‘V’
sign of Naclerio). MRI/CT chest. Total count. Ref- Bailey and Love, Short practice of surgery, 27th edition
Question 23: Correct Answer: B
Explanation: Ans. is. B. Bisphosphonates First line of management of osteoporosis – Bisphosphonates
females. Alendronate, etidronate, pamidronate, and Ibandronate are bisphosphonates which inhibit bone
resorption, and are very effective for both osteoporosis prevention and treatment. Uses: First line drugs for
treating postmenopausal osteoporosis Paget’s disease Osteolytic bone metastasis. Raloxifene: It is a
selective estrogen receptor modulator which is also useful in management of osteoporosis but it is a
hormonal preparation.
Question 24: Correct Answer: B
Explanation: Ans: b.Rheumatoid arthritis >Swan-neck deformity of the finger describes hyperextension at the
PIP joint with flexion of the DIP joint >Rheumatoid Arthritis Clinical Presentation
Ref:https://www.medscape.com/answers/331715-5365/what-is- a-swan-neck-deformity-of-the-finger-in-
rheumatoid-arthritis-ra
Question 25: Correct Answer: A
Explanation: Answer- A. Arterial disease with aortoiliac involvement The muscle group affected by
claudication is classically one anatomical level below the level of arterial disease and is usually felt in the calf
because the superficial femoral artery is the most commonly affected artery (70% of cases). Aorto-iliac
disease (30% of cases) may cause thigh or buttock claudication. Buttock claudication in association with
sexual impotence resulting from arterial insufficiency is eponymously called Leriche's syndrome. It is very
rare. Ref- Bailey and Love, Short practice of surgery, 27th edition published in 2018 Pg 943
Question 26: Correct Answer: D
Explanation: Ans: D. DNA helicase Werner syndrome is a human autosomal recessive disorder that displays
symptoms of premature aging, including early graying and thinning of hair, wrinkling and ulceration of skin,
atherosclerosis, osteoporosis, and cataracts. In addition, Werner syndrome patients exhibit an increased
incidence of diabetes mellitus type 2, hypertension, and are highly disposed to the emergence of benign and
malignant neoplasms. Werner syndrome caused by mutation of the WRN gene, a member of the RecQ DNA
helicase family. Ref- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3237395/
Question 27: Correct Answer: C
Explanation: Answer- C- 6 yrs Assessments of skeletal maturity in pre-pubertal children are primarily based
on the epiphyseal size of the phalanges as they relate to the adjacent metaphyses. During this stage of
development, the ossification centers for the epiphysis increase in width and thickness, and eventually
assume a transverse diameter as wide as the metaphysis More weight is given to the size of the epiphysis in
the distal
Question 28: Correct Answer: C

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Explanation: Ans: C. Type 3 achalasia Type I achalasia (classic achalasia)- Elevated median IRP (>15
mmHg), 100% failed peristalsis (DCl <100 mmHg.s.cm) Premature contractions with DCI values <450
mmHg.s.cm satisfy criteria for failed peristalsis Type II achalasia (with esophageal compression)- Elevated
median IRP (>15 mmHg), 100% failed peristalsis, panesophageal pressurisation with >20% of swallows.
Contractions may be masked by oesophageal pressurization and DCI should not be calculated. Type lll
achalasia (spastic achalasia) Elevated median IRP (>15 mmHg), no normal peristalsis, premature (spastic)
contractions with DCI >450 mmHg.s.cm with >20% of swallows
Question 29: Correct Answer: A
Explanation: Ans: A. Fluent aphasia Fluent aphasia Lesions in the posterior portion of the left STG were
associated with the loss of the ability to comprehend and produce spoken words which are called as “fluent
aphasia” BDC 7th edition, volume 4, page no 129.
Question 30: Correct Answer: B
Explanation: Ans: B. Lignin The unavailable or indigestible carbohydrates in the diet are called dietary fiber.
Dietary fiber is necessary to maintain the normal motility of the gastrointestinal tract. They are chiefly-
Cellulose- Retains water in feces, promotes peristalsis, increases bowel action Lignin- Antioxidant, increases
bile acid excretion, hypocholesterolemic. Pectins- Partially Absorb water, slows esterified gastric emptying,
binds bile acids, increases their excretion Hemi-cellulose- Retains water in feces, cellulose, increases bile
acid and uronic acid excretion. Ref- DM Vasudevan- Textbook of biochemistry for medical students, 6th edn ,
Energy Metabolism and Nutrition. Pg 435.
Question 31: Correct Answer: A
Explanation: Answer- A. Superficial spreading melanoma Superficial spreading melanoma This is the most
common presentation (70%) usually arising in a pre- existent naevus after several years of slow change,
followed by rapid growth in the preceding months before presentation. Nodular melanoma (NM) Nodular
melanoma accounts for l5% ol all MM. Typically appear as blue/black papules, l-2 cm in diameter, and
because they lack the horizontal growth phase. Lentigo maligna melanoma- Presents as a slow-growing,
variegated brown macule on the face, neck or hands of the elderly. Acral lentiginous melanoma (ALM)ALM
affects the soles of feet and palms of hands. It usually presents as a flat, irregular macule in later life. Ref-
Bailey and Love, Short practice of surgery, 27th edition published in 2018 Pg 610
Question 32: Correct Answer: C
Explanation: Ans: c. Heparan sulphate The glomerular membrane (or the filtration barrier) is the filtration
surface through which the fluid is filtered out from the blood. The glomerular membrane (filtration barrier)
comprises: * The glomerular capillary endothelium. * The basement membrane (basal lamina). * The
Bowman's visceral epithelium (podocytes). * Important constituents of glomerular membrane include, -
Laminin - Type 4 collagen - Nidogen - Proteoglycans - (Heparan sulphate) Ref: Arvind Arora review book of
physiology (p. 371 - 372)
Question 33: Correct Answer: C
Explanation: Ans. C. Peritonsillar abscess Peritonsillar abscess, also known as quinsy, is the localized
collection of pus in peritonsillar space between the tonsillar capsule and superior constrictor muscle. >The
tonsil is found pushed downward and medially. >The uvula is swollen and edematous and pushed to the
opposite side. >There is a bulge on the soft palate and anterior tonsillar pillar. >Mucous may be seen
overlying the tonsillar region.
Question 34: Correct Answer: B
Explanation: Ans: B. Hashimoto's thyroiditis Hashimoto thyroiditis is the most common cause of
hypothyroidism which is characterized by gradual thyroid failure secondary to the autoimmune destruction of

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the thyroid gland. It is most prevalent between the ages of 45 and 65 years and is more common in women
than in men, ultimately leading to a varying degree of fibrosis and thyroid enlargement. The thyroid usually is
diffusely and symmetrically enlarged The cut surface is pale and gray-tan in appearance, and the tissue is
firm and somewhat friable. Microscopic examination reveals the widespread infiltration of the parenchyma by
a mononuclear inflammatory infiltrate containing small lymphocytes, plasma cells, and well-developed
germinal centers. The thyroid follicles are atrophic and are lined in many areas by
Question 35: Correct Answer: B
Explanation: Answer- B. Juvenile polyp The image shown here is Juvenile polyp. This is a bright red,
glistening pedunculated sphere (cherry tumour), which is found in infants and children. It can cause bleeding,
or pain if it prolapses during defecation. Ref- Bailey and Love, Short practice of surgery, 27th edition
published in 2018 Pg 1327
Question 36: Correct Answer: B
Explanation: Ans: B. Lignin The unavailable or indigestible carbohydrates in the diet are called dietary fiber.
Dietary fiber is necessary to maintain the normal motility of the gastrointestinal tract. They are chiefly-
Cellulose- Retains water in feces, promotes peristalsis, increases bowel action Lignin- Antioxidant, increases
bile acid excretion, hypocholesterolemic. Pectins- Partially Absorb water, slows esterified gastric emptying,
binds bile acids, increases their excretion Hemi-cellulose- Retains water in feces, cellulose, increases bile
acid and uronic acid excretion. Ref- DM Vasudevan- Textbook of biochemistry for medical students, 6th edn ,
Energy Metabolism and Nutrition. Pg 435.
Question 37: Correct Answer: A
Explanation: Ans: A. Km remains same, Vmax decreases Noncompetitive inhibition occurs when the inhibitor
and substrate bind at different sites on the enzyme. The noncompetitive inhibitor can bind either the free
enzyme or the ES complex, thereby preventing the reaction from occurring. Effect on Vmax: Noncompetitive
inhibition cannot be overcome by increasing the concentration of the substrate. Thus, noncompetitive
inhibitors decrease the apparent Vmax of the reaction. Effect on Km: Noncompetitive inhibitors do not
interfere with the binding of substrate to enzyme. Thus, the enzyme shows the same Km in the presence or
absence of the non-competitive inhibitor. Effect on Lineweaver-Burk plot: Noncompetitive inhibition is readily
differentiated from competitive inhibition by plotting 1/vo versus 1/[S] and noting that the apparent Vmax
decreases in the presence of a non-competitive inhibitor, whereas Km is unchanged Ref- lippincott’s
Illustrated reviews,5th edition,Inhibition of Enzyme Activity, pg 61.
Question 38: Correct Answer: A
Explanation: Ans: A. There is extremely forceful peristaltic activity leading to episodes of chest pain and
dysphagia NutCracker Oesophagus is a hypermotility disorder with high amplitude peristalsis. It is a
condition in which extremely forceful peristaltic activity leads to episodic chest pain and dysphagia.
Treatment is with nitrates or nifedipine. Ref. davidsons principles and practice 23rd edition page no.795
Question 39: Correct Answer: A
Explanation: ANS. A.G2P1 Gravida includes all confirmed pregnancies. Each pregnancy is only counted one
time, even if the pregnancy was multiple gestations, such as twins or triplets Parity reflects the total number
of births after 20 weeks, not the total number of infants born. Ref.OBS Dutta 8th ed Page no. 107
Question 40: Correct Answer: D
Explanation: Ref- Bailey and Love, Short practice of surgery, 27th edition
Question 41: Correct Answer: D
Explanation: Ans: D. 22% The bases of one strand of DNA are paired with the bases of the second strand so

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that adenine is always paired with thymine and cytosine is always paired with guanine. Therefore, one
polynucleotide chain of the DNA double helix is always the complement of the other. Given the sequence of
bases on one chain, the sequence of bases on the complementary chain can be determined. Note: The
specific base pairing in DNA leads to the Chargaff Rule: In any sample of dsDNA, the amount of adenine
equals the amount of thymine, the amount of guanine equals the amount of cytosine, and the total amount of
purines equals the total amount of pyrimidines. The base pairs are held together by hydrogen bonds: two
between A and T and three between G and C (Figure 29.5). These hydrogen bonds, plus the hydrophobic
interactions between the stacked bases, stabilize the structure of the double helix. Ref- lippincott’s
Illustrated reviews,5th edition, the structure of DNA, pg 397
Question 42: Correct Answer: A
Explanation: Answer- A- Mickey mouse sign The Mickey Mouse sign is said to represent the normal anatomy
of the common femoral artery, common femoral vein and great saphenous vein on ultrasound at the level
just inferior to the inguinal crease. Reference- Coleridge-Smith P, Labropoulos N, Partsch H, Myers K,
Nicolaides A, Cavezzi A. Duplex ultrasound investigation of
Question 43: Correct Answer: D
Explanation: Ans: D. Unidirectional locomotion of neutrophils Chemotaxis is defined as a unidirectional
movement of leukocytes up to a concentration gradient of chemotactic molecules. All granulocytes,
monocytes and to a lesser extent lymphocytes respond to chemotactic stimuli with varying rates of speed.
Chemoattractants are exogenous or endogenous. Exogenous agents are bacterial products. Endogenous
mediators are: Components of complement pathway C5a Products of lipoxygenase pathway LTB4 Cytokines
particularly those of chemokine families.
Question 44: Correct Answer: A
Explanation: Ans: A. Lupus nephritis Major causes of death in pediatric SLE include : 1. Renal disease
(lupus nephritis) 2. Severe disease flare 3. Infections
Question 45: Correct Answer: A
Explanation: Ans: A. 6 Mercaptopurine 6-Mercaptopurine acts by inhibiting DNA replication. Antimetabolites:
These are analogues related to the normal components of DNA or of coenzymes involved in the nucleic acid
synthesis. They competitively inhibit the utilization of the normal substrate or get themselves incorporated
forming dysfunctional macromolecules. Includes: Folate antagonist - Methotrexate (Mtx) Purine antagonist -
6-Mercaptopurine (6-MP) Pyrimidine antagonist - 5-Fluorouracil (5-FU) Purine antagonists Mercaptopurine
(6-MP) and thioguanine (6-TG). These are highly effective antineoplastic drugs. After synthesis in the body to
the corresponding mono ribonucleotides, they inhibit the conversion of inosine monophosphate to adenine
and guanine nucleotides that are the building blocks for RNA and DNA. There is also feedback inhibition of
de novo purine synthesis. They also get incorporated into RNA and DNA which are dysfunctional.
Question 46: Correct Answer: B
Explanation: Answer- B. Jaundice <7days King's College criteria for liver transplantation in AHF. APAP-
associated AHF- pH?<?7.3 or INR?>?6.5, serum creatinine >3.4 mg/dl, and grade III-IV encephalopathy All
other causes of AHF INR >6.5 Or Three of the following variables: 1. Age40 years 2. The cause is nonA,
nonB hepatitis or idiosyncratic drug reaction 3. Duration of jaundice before encephalopathy >7 days 4.
INR?>?3.5 5. Serum bilirubin >17.5 mg/dl APAP, acetaminophen; INR, international normalized ratio.
Question 47: Correct Answer: A
Explanation: Ans. is 'a' i.e., Imatinib and sunitinib Molecular targeted agents Tyrosine kinase inhibitors
Competitive inhibitors ? Imatinib, Nilotinib, Sunitinib, Dasatinib, Erlotinib, Gefitinib, Lapatinib, Sorafenib
(Remember all end with ' nib'). Monoclonal antibodies ? Cetuximab, panitumumab. HER2/neu (ERB B2)

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inhibitors Monoclonal antibody - Trastuzumab. Targeted antibody ? Gemtuzumab (anti CD-33), Rituximab
(anti - CD20), Alemtuzumab (anti CD-52). Vascular endothelial growth factor (VEGF) inhibitor ? Monoclonal
antibody - Bevacizumab. Proteosome inhibitors ? Bortezomib. Histone deacetylase inhibitor ? Vorinostat
DNA - methyltransferase inhibitor ? 5-azacytidine, 2-deoxy-5 azacytidine All - trans-retinoic acid. Biological
response modifier - Recombinant IL-2 (aldesleukin, denileukin)
Question 48: Correct Answer: D
Explanation: Answer- D. 4 Hinchey classification of complicated diverticulitis. 1. Grade I Mesenteric or
pericolic abscess 2. Grade ll Pelvic abscess 3. Grade lll Purulent peritonitis 4. Grade lV Faecal peritonitis
Ref- Bailey and Love, Short practice of surgery, 27th edition published in 2018 Pg 1274
Question 49: Correct Answer: A
Explanation: Answer:A. Cocaine poisoning Magnan's sign or Symptom is a clinical sign in which people with
cocaine addiction experience paraesthesia which feels like a constantly moving foreign bodies, (cocaine
bugs) such as fine sand or powder, under the skin. It is the most tactile hallucination. Degeneration of the
central nervous system occurs, and the patient may suffer from hallucinations, convulsions, delirium, and
insanity. Magnan's symptom or cocaine bugs is characteristic, in which there is a feeling as if grains of sand
are lying under the skin or some small insects are creeping on the skin giving rise to itching sensation
(formication, tactile hallucination) with resultant excoriation, leading to irregular scratches and ulcers. THE
ESSENTIALS OF FORENSIC MEDICINE AND TOXICOLOGY By Dr. K.S. NARAYAN REDDY 33/e- pg-603
Question 50: Correct Answer: A
Explanation: Answer- A. Duodenum PETs occur in around 50-60Vo of MEN 1 patients. The most common
functional tumour is gastrinoma in duodenum followed by insulinoma. Ref- Bailey and Love, Short practice of
surgery, 27th edition published in 2018 Pg 856
Question 51: Correct Answer: B
Explanation: Ans. B. Coefficient of variation Variance: Is the square of SD which tells about the standard
deviation Coefficient of variation: It may help by comparing the variations in the data set The standard error
of the mean: It is to compare the means of the data sets which have a different sample size, central
tendency, and standard deviations Standard deviation: It is the deviation of values from the mean Ref.
Fundamentals of Biostatistics - 7th Edition (Pg 20, 21)
Question 52: Correct Answer: D
Explanation: Ans is 'd' i.e. 5 lac Vision 2020: The Right to Sight, is a global initiative launched by WHO in
1999 in a broad coalition with a 'Task Force of International Non-Governmental Organisations (NGOs)' to
combat the gigantic problem of blindness in the world. The objective is to eliminate avoidable blindness by
the year 2020 and to reduce the global burden of blindness. The government of India has adopted 'Vision
2020: Right to Sight' under the National Programme for Control of Blindness. Based on the
recommendations of WHO, there is a need to develop the infrastructure pyramid which includes I. Primary
level Vision Centres There is a need to develop 20000 vision centers, An Each with one Ophthalmic
Assistant or equivalent (Community- based MLOP), Covering a population of 50000. 2. Service Centres.
There is a need to develop 2000 service centers at the secondary level. Each with two ophthalmologists and
8 paramedics (Hospital-based
Question 53: Correct Answer: A
Explanation: Ans: A. PICA .Most cases result from ipsilateral vertebral artery occlusion; occlusion of the
posterior inferior cerebellar artery is responsible for it. Vessel occlusion that results in Lateral Medullary
syndrome: Vertebral (most common) Posterior inferior cerebellar (2nd most common) Superior, middle or
Inferior lateral medullary arteries Lateral medullary syndrome (Wallenberg syndrome): Vertigo Numbness of

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ipsilateral face and contralateral limbs Diplopia Dysphagia Dysarthria Ataxia Hoarseness
Question 54: Correct Answer: B
Explanation: Ans:b.Trochlear palsy >The trochlear nerve is the fourth cranial nerve (CN IV) and one of the
ocular motor nerves that control eye movement. > The trochlear nerve, while the smallest of the cranial
nerves, has the longest intracranial course as it is the only nerve to have a dorsal exit from the brainstem. >It
originates in the midbrain and extends laterally and anteriorly to the superior oblique muscle.
Ref:https://www.ncbi.nlm.nih.gov/books/NBK537244/
Question 55: Correct Answer: A
Explanation: Answer- A. EFAST Investigations are driven by the cardiovascular status of the patient. In torso
trauma, the best and most sensitive modality is a CT scan with intravenous contrast for blunt injury if the
patient is stable. Routine investigation in the emergency department of injury to the chest is based on clinical
examination, supplemented by chest radiography. Ultrasound can be used to differentiate between contusion
and the actual presence of blood. Extended focused assessment with sonar for trauma (eFAST) is becoming
the most common investigation. Ref- Bailey and Love, Short practice of surgery, 27th edition published in
2018 Pg 366, 372
Question 56: Correct Answer: B
Explanation: Ans. B. Immigrant Screening Screening of immigrants to a country is an example of prospective
screening. Prospective screening: People screened for others benefit The essential purpose is case
detection Requested for screening for disease control; specific request from the authority
Question 57: Correct Answer: A
Explanation: Ans: A. Child pugh score the liver condition as represented in the picture above demonstrates
liver cirrhosis. Child-Pugh score (or the Child–Turcotte–Pugh score or Child Criteria) is used to assess the
prognosis of chronic liver disease, mainly cirrhosis. It is now used to determine the prognosis, as well as the
required strength of treatment and the necessity of liver transplantation. Hepatic None Grade I-II (or
suppressed Grade III-IV (or Factor 1 2 points 3 points point Total bilirubin <34 34-50 >50
(?mol/L) Serum albumin >35 28-35 <28 (g/L) PTINR <1.7 1.71-2.30 >2.30 Ascites None Mild
Moderate to Severe
Question 58: Correct Answer: D
Explanation: Ans:(d) Between thyropharyngeus and cricopharyngeus The given picture is the barium swallow
showing Zenker's diverticulum. >Zenker diverticulum, a pulsion diverticulum of the hypopharynx, is a rare
lesion that occurs in elderly populations. >The condition results in a classic presentation of symptoms, with
complications that include aspiration and pneumonia, and is managed by endoscopic and surgical repair.
Ref. Scott BroTon, Vol 3;746
Question 59: Correct Answer: A
Explanation: Answer-A- Vibrio Cholera SAgs are produced by some pathogenic viruses and bacteria most
likely as a defense mechanism against the immune system. Toxic shock syndrome toxin (TSST-1),
epidermolytic toxin and other staphylococcal enterotoxin are superantigens. These superantigens can bind
MHC molecules outside the peptide- binding cleft. Consequently, superantigen can activate up to 10% of T-
cells in a nonspecific manner which in turn leads to the release of large quantities of cytokines. Jawetz 27/e-
pg-135
Question 60: Correct Answer: B
Explanation: Ans. B. Type 2 pneumocytes Type I cells form the alveolar wall while the Type II cells
synthesize and secrete surfactant DPCC. The defect in the biosynthesis of Dipalmitoylphosphatidylcholine

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(DPPC), also known as dipalmitoyl lecithin leads to Respiratory distress syndrome. Ref.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2880575/
Question 61: Correct Answer: A
Explanation: Answer-A- Neisseria meningitides Neisseria meningitides often referred to as meningococcus,
is a Gram-negative bacterium that can cause meningitis and other forms of meningococcal disease such as
meningococcemia, life- threatening sepsis. N.meningitidis is a gram-negative ? proteobacterium and member
of the bacterial family of Neisseriaceae. N. meningitidis is a fastidious bacteria, dying within hours on
inanimate surfaces, and is either an encapsulated or unencapsulated, aerobic diplococcus with a “kidney” or
“coffee- bean” shape. Jawetz 27/e-pg-287;
Question 62: Correct Answer: D
Explanation: Answer- D- Coarctation of Aorta The chest radiograph classically demonstrates rib-notching
because of dilated posterior intercostal vessels. The heart is usually of normal size in the older child and
shows a classical 'three sign” replacing the typical aortic knuckle. Ref- Bailey and Love, Short practice of
surgery, 27th edition published in 2018 Pg 906
Question 63: Correct Answer: A
Explanation: Ans: A. Lupus nephritis Major causes of death in pediatric SLE include : 1. Renal disease
(lupus nephritis) 2. Severe disease flare 3. Infections
Question 64: Correct Answer: B
Explanation: Ans. B. 16% Mouth to mouth breathing provides 0.8 to 1.2 liters of exhaled air per breath and
16% of oxygen which is enough to sustain life. The use of Ambu bag and room air provides 21% O2. The
American Heart Association recommends tidal volumes of 700 to 1000 mL during mouth-to-mouth
ventilation, but smaller tidal volumes of 500 mL may be of advantage to decrease the likelihood of stomach
inflation, as mouth-to-mouth ventilation gas contains only 17% oxygen, but 4% carbon dioxide.
Question 65: Correct Answer: C
Explanation: Ans. C. Single-dose TT A patient with wound less than 6 hours old if clean, non-penetrating and
with negligible tissue damage if had a complete course of toxoid or a booster dose more than 10 years
ago(category C) should be treated with Toxoid 1 dose. Park’s PSM 24th ed. Page no. 331
Question 66: Correct Answer: A
Explanation: Ans. A. Wiskott Aldrich syndrome Wiskott Aldrich syndrome: There is a mutation in the gene
encoding Wiskott-Aldrich syndrome protein (WASP), which is located on Xp11.23. The X-linked disease is
characterized by thrombocytopenia, eczema, and a marked vulnerability to recurrent
Question 67: Correct Answer: C
Explanation: Ans: C. Hypotension Following are seen in Pituitary apoplexy Severe hypoglycemia Severe
headache (usually retro-orbital) Impaired consciousness Fever Visual disturbances (visual field defect, visual
acuity) Ophthalmoplegia (ocular paresis) ? Causing diplopia Hypotension & shock Nausea/vomiting
Meningeal sign
Question 68: Correct Answer: B
Explanation: Answer- B- Pili (fimbriae) Pili are hair-like appendages that extend up to several micrometers
from the gonococcal surface. They enhance attachment to host cells and resistance to phagocytosis. They
are made up of stacked pilin proteins. The amino terminal of the pilin molecule, which contains a high
percentage of hydrophobic amino acids, is conserved. The amino acid sequence near the midportion of the
molecule also is conserved; this portion of the molecule serves in an attachment to host cells and is less
prominent in the immune response. The amino acid sequence near the carboxyl-terminal is highly variable;

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this portion of the molecule is most prominent in the immune response. The pilins of almost all strains of N.
gonorrhea are antigenically different, and a single strain can make many antigenically distinct forms of pilin
Jawetz 27/e-pg-282
Question 69: Correct Answer: D
Explanation: Ans: D. Give antibiotics and refer to tertiary care
Question 70: Correct Answer: B
Explanation: Ans. is 'b' i.e., Transfer of iron into enterocytes Hepcidin is an iron metabolism regulatory
hormone that inhibits iron absorption (transfer of iron into enterocytes). Ascorbic acid (vitamin C) forms
soluble complexes with iron and reduces iron from the ferric to the ferrous state, thereby enhancing iron
absorption. Tannins, present in tea, form insoluble complexes with iron and lower its absorption.
Question 71: Correct Answer: A
Explanation: Answer- A- 48 hours A hospital-acquired infection (HAI), also known as a nosocomial infection,
is an infection that is acquired in a hospital or other health care facility. Nosocomial infections can be defined
as those occurring within 48 hours of hospital admission or within 3 days of discharge or 30 days of
operation. Some well known nosocomial infections include: ventilator-associated pneumonia, Methicillin-
resistant Staphylococcus aureus, Candida albicans, Acinetobacter baumannii, Clostridium difficile,
Tuberculosis, Urinary tract infection, Vancomycin-resistant Enterococcus, and Legionnaires' disease.
https://www.ncbi.nlm.nih.gov/books/NBK441857/
Question 72: Correct Answer: B
Explanation: Ans. B. Continue to breastfeed Compared with formula-fed newborns, breastfed infants are
three to six times more likely to experience moderate jaundice (total serum bilirubin level above 12 mg per
dL) or severe jaundice (total serum bilirubin level above 15 mg per dL. In a breastfed newborn with early-
onset hyperbilirubinemia, the frequency of feedings needs to be increased to more than 10 per day. If the
infant has a decline in weight gain, delayed stooling, and continued poor caloric intake, formula
supplementation may be necessary, but breastfeeding should be continued to maintain breast milk
production. Phototherapy usually not recommended when the total serum bilirubin level is below 15 mg per
dL. Ref: https://www.aafp.org/afp/2002/0215/p599.html
Question 73: Correct Answer: A
Explanation: Ans: A. 37 degree At temperature below freezing (dry-cold condition) frostbite occurs the tissue
freeze & ice crystals form in between the cells Affected part should be warmed using water at 44 °is under
Criticism, Warming should last about 20 minutes at a time, Intake of hot fluids promotes general rewarming
Question 74: Correct Answer: B
Explanation: Ans. B yellow Chemical waste is categorized into the yellow category. the hazardous chemical
and cytotoxic waste is a yellow category with a special sign of “CYTOTOXIC” waste. Another liquid waste as
body secretions is categorized into the yellow category of biomedical waste guidelines, 2016 Park’s PSM
24th ed. Page no. 831
Question 75: Correct Answer: A
Explanation: ANS-A. Antipsychotic with Imipramine continued The condition from which the patient above is
suffering is a bipolar disorder which includes both depression and mania. So in order to treat both
antidepressant i.e imipramine is continued along with an antipsychotic such as phenothiazines,
thioxanthenes, etc. Antipsychotic or valproate alone cannot reduce the depression and Imipramine alone
cannot reduce the mania. Ref: ARVIND ARORA review of psychiatry p.no:111
Question 76: Correct Answer: A

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Explanation: Answer- A. Arterial disease with aortoiliac involvement The muscle group affected by
claudication is classically one anatomical level below the level of arterial disease and is usually felt in the calf
because the superficial femoral artery is the most commonly affected artery (70% of cases). Aorto-iliac
disease (30% of cases) may cause thigh or buttock claudication. Buttock claudication in association with
sexual impotence resulting from arterial insufficiency is eponymously called Leriche's syndrome. It is very
rare. Ref- Bailey and Love, Short practice of surgery, 27th edition published in 2018 Pg 943
Question 77: Correct Answer: A
Explanation: Answer- A. High LDL Metabolic syndrome refers to the co-occurrence of several known
cardiovascular risk factors, including insulin resistance, obesity, atherogenic dyslipidemia, and hypertension.
These conditions are interrelated and share underlying mediators, mechanisms, and pathways. Criteria for
the Diagnosis of Metabolic Syndrome Elevated waist circumference: (For men >90 cm and for women, >80
cm). Elevated triglycerides: >150 mg/dL Reduced HDL (“good”) cholesterol: For men, <40 mg/dL; for
women, < 50 mg/dL Elevated blood pressure: >130/85 mm Hg Elevated fasting glucose: >100 mg/dL Insulin
resistance (hyperinsulinemia) Additional parameters include: coagulation abnormalities, hyperuricemia,
microalbuminuria non-alcoholic steatohepatitis (NASH) and increased CRP. Diagnosis is made, if any 3 out
of the 5 criteria given above.
Question 78: Correct Answer: D
Explanation: Ans: D. Endothelial injury The three primary abnormalities that lead to thrombus formation
(called Virchow's triad) are (1) endothelial injury, (2) stasis or turbulent blood flow, and (3) hypercoagulability
of the blood. Ref: robbins 9th edition chapter 4
Question 79: Correct Answer: B
Explanation: Ans. B. Immigrant Screening Screening of immigrants to a country is an example of prospective
screening. Prospective screening: People screened for others benefit The essential purpose is case
detection Requested for screening for disease control; specific request from the authority
Question 80: Correct Answer: B
Explanation: Ans: B. serum lithium Because of its effects on multiple body systems, including but not limited
to renal, hematologic, and thyroid systems, appropriate baseline studies must precede the start of lithium
therapy. The minimal tests to be done include serum creatinine, electrolytes, thyroid function tests, and a
complete blood count with differential. Additionally, because of its cardiac effect, an ECG is indicated. Any
woman thought to be pregnant should have a pregnancy test. Ref: Nurcombe B. (2008). Chapter 12.
Diagnostic Formulation, Treatment Planning, and Modes of Treatment in Children and Adolescents. In M.H.
Ebert, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds), CURRENT Diagnosis & Treatment: Psychiatry, 2e.
Question 81: Correct Answer: B
Explanation: Ans: B. Calf Calf Aorta and Common Iliac- Buttocks Femoral Artery- Thigh Superficial femoral
artery- Calf and popliteal artery Posterior tibial Artery- Feet BDC 7th edition, volume 2, page no 137.
Question 82: Correct Answer: B
Explanation: Ans: B. Stool calprotectin Both organic IBD and non-organic functional disorders like IBS exhibit
very similar symptoms researchers have identified several stool-based biomarkers to differentiate between
IBD and IBS. These become especially crucial when taking the next step towards deciding how to manage
the disease (e.g. therapeutic intervention, etc.). Those biomarkers include the following: Calprotectin Alpha-1
Antitrypsin Lysozyme Secretory IgA Albumin
Question 83: Correct Answer: B
Explanation: Ans. B. Universal immunization The Ministry of Health & Family Welfare has launched ' Mission

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Indra Dhanush', depicting seven colours of the rainbow in December 2014, to fully immunize more than 89
lakh children who are either unvaccinated or partially vaccinated; those that have not been covered during
the rounds of routine immunization for various reasons. They will be fully immunized against seven life-
threatening vaccine- preventable diseases which include diphtheria, whooping cough, tetanus, polio,
tuberculosis, measles, and hepatitis-B. In addition, vaccination against Japanese Encephalitis and
Haemophilus influenza type B will be provided in selected districts/states of the country. Pregnant women will
also be immunized against tetanus. Ref. Park’s PSM 24th ed. Page 462
Question 84: Correct Answer: A
Explanation: Ans. a. Patch-clamp Patch-clamp is a technique to record ion current flow through a single
protein channel. The patch-clamp technique is a laboratory technique in electrophysiology, that allows the
study of single or multiple ions channels in cells. The technique can be applied to a wide variety of cells but
is especially useful in the study of excitable cells such as neurons, cardiomyocytes, muscle fibers, and
pancreatic beta cells. It can also be applied to the study of bacterial ion channels especially prepared giant
spheroplasts. In the patch-clamp experiment, a small pipette is carefully maneuvered to seal off a portion of
a cell membrane. The pipette has an electrode bathed in an appropriate solution that allows for the recording
of electrical changes through any pore in the membrane.
Question 85: Correct Answer: C
Explanation: Ans. C. Cost-effective Analysis In cost-effective analysis (CEA), benefits are measured in
natural units of the outcomes of the programs (life-years gained, cases prevented, etc.) and the costs are
measured in monetary units. The most comprehensive indicator of CEA is Quality-Adjusted Life Years
(QALYs). Park’s PSM 24th ed. Page no. 908
Question 86: Correct Answer: C
Explanation: Answer- C. Bulbar urethra There is a history of a blow to the perineum, usually due to a fall
astride injury. The bulbar urethra is crushed upwards onto the pubic bone, typically with significant bruising.
Cycling accidents, loose manhole covers and gymnasium accidents astride the beam account for a number
of cases.C/F The signs of a ruptured bulbar urethra are perineal bruising and hematoma, typically with a
butterfly distribution. There is usually bleeding from the urethral meatus and retention of urine is also typically
present. Ref- Bailey and Love, Short practice of surgery, 27th edition published in 2018 Pg 1479, 1480
Question 87: Correct Answer: D
Explanation: Ans: D. Adenosine A1 receptor antagonism The mildly diuretic actions of both methylxanthines
are mainly the result of inhibition of tubular fluid reabsorption along the renal proximal tubule. Based upon
the use of specific adenosine receptor antagonists and the observation of a complete loss of diuresis in mice
with targeted deletion of the A1AR gene, transport inhibition by methylxanthines is mediated mainly by
antagonism of adenosine A1 receptors (A1AR) in the proximal tubule. Methylxanthines are weak renal
vasodilators, and they act as competitive antagonists against adenosine-induced preglomerular
vasoconstriction. Caffeine and theophylline stimulate the secretion of renin by inhibition of adenosine
receptors and removal of the general inhibitory brake function of endogenous adenosine. Since enhanced
intrarenal adenosine levels lead to reduced glomerular filtration rate in several pathological conditions
theophylline has been tested for its therapeutic potential in the renal impairment following the administration
of nephrotoxic substances such as radiocontrast media, cisplatin, calcineurin inhibitors or following ischemia-
reperfusion injury.
Question 88: Correct Answer: B
Explanation: ANS. B. OHSS Ovarian hyperstimulation syndrome (OHSS): It is a clinical symptom complex
associated with ovarian enlargement resulting from exogenous gonadotropin therapy. Symptoms may

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include abdominal pain and distension, ascites, gastrointestinal problems, respiratory compromise, oliguria,
hemoconcentration, and thromboembolism. These symptoms may develop during ovulation induction or in
early
Question 89: Correct Answer: B
Explanation: Ans. is. B. Bisphosphonates First line of management of osteoporosis – Bisphosphonates
females. Alendronate, etidronate, pamidronate, and Ibandronate are bisphosphonates which inhibit bone
resorption, and are very effective for both osteoporosis prevention and treatment. Uses: First line drugs for
treating postmenopausal osteoporosis Paget’s disease Osteolytic bone metastasis. Raloxifene: It is a
selective estrogen receptor modulator which is also useful in management of osteoporosis but it is a
hormonal preparation.
Question 90: Correct Answer: A
Explanation: Answer- A. Vitamin B12 deficiency The ileum is the only site of absorption of vitamin B12 and
bile salts. Bile salts are essential for the absorption of fats and fat-soluble vitamins. Following resection of the
ileum, the loss of bile salts increases and is not met by an increase in synthesis. The jejunum is the principal
site for digestion and absorption of fluid, electrolytes, iron, folate, fat, protein and carbohydrate, but the
absorption of bile salts and vitamin B12 only occurs in the terminal ileum, where there are specific
transporters. Ref- Bailey and Love, Short practice of surgery, 27th edition published in 2018 Pg 283, 1241
Question 91: Correct Answer: A
Explanation: Ans: A. Intravenous digoxin Management of AMS follows three axioms: a) further ascent should
be avoided until the symptoms have resolved, b)patients with no response to medical treatment should
descend to a lower altitude and c) if and when HACO is suspected, patients should urgently descend to a
lower altitude. Descent and supplementary oxygen are the treatments of choice and for severe illness, the
combination provides optimal therapy. Remarkably, a descent of only 500 to 1000 m usually leads to
resolution of acute mountain sickness while high-altitude cerebral edema(HACO) may require further
descent. Simulated descent with portable hyperbaric chambers, now commonly available in remote
locations, are also effective. Medical therapy becomes crucial when the descent is not immediately possible.
Ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923381/#!po=31.2500
Question 92: Correct Answer: C
Explanation: Answer- C - TOF The image shown above is of Tetralogy of Fallot condition. Classically the
chest radiograph demonstrates a 'boot-shaped' heart with poorly developed lung vasculature. The diagnosis
is confirmed with echocardiography. Surgery to correct the tetralogy is the mainstay of treatment and is
usually carried out at 4-6 months of age, when possible. Ref- Bailey and Love, Short practice of surgery,
27th edition published in 2018 Pg 905
Question 93: Correct Answer: A
Explanation: Ans. A. MCA doppler peak systolic volume Doppler ultrasound: Serial Doppler study of the
middle cerebral artery (MCA)-peak systolic velocity (PSV) is the mainstay to assess fetal anemia. A value
>1.5 multiples of the median (MOMs) for the corresponding gestational age, predicts moderate to severe
fetal anemia. This value (between 24 weeks and 35 weeks of gestation), is an indication for cordocentesis
and fetal transfusion Most centers have replaced serial amniocentesis with serial MCA Doppler studies. Ref.
OBstetrics Dutta ed. 8th pg. 391
Question 94: Correct Answer: A
Explanation: Ans: A. Lung oligemia Chest X-ray Features of Left ventricular failure: Cardiomegaly Kerley
lines Prominent upper lobe veins Bat’s wings shadow Pleural effusion Kerley B line is due to interstitial
edema. Prominent right descending pulmonary artery is seen in acute pulmonary embolism.

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Question 95: Correct Answer: A
Explanation: Correct Ans: A. Candidiasis Most common opportunistic infection in HIV is candidiasis
Candidiasis is a fungal infection due to any type of Candida. When it affects the mouth, it is commonly called
thrush. Signs and symptoms include white patches on the tongue or other
Question 96: Correct Answer: C
Explanation: Correct ans: C GCTs are large and red-brown and often show cystic degeneration. They are
composed of uniform oval mononuclear cells and scattered osteoclast-type giant cells containing 100 or
more nuclei. Mitotic figures are typically frequent. Necrosis, hemorrhage, and reactive bone formation also
are commonly present. Ref Robbin’s basics of pathology 9th edition page no.781
Question 97: Correct Answer: B
Explanation: Ans: B. Chloroquine In long-term chloroquine therapy Ocular complications were observed
>This therapy is usually used in patients with rheumatoid arthritis, lupus erythematosus, sarcoidosis, discoid
lupus, and other chronic 'collagen disease'. >Retinal changes, corneal opacifications, blurring of vision are
some complications seen in long term use of Chloroquine.
Ref:https://www.ncbi.nlm.nih.gov/pubmed/1427503
Question 98: Correct Answer: C
Explanation: Ans: C. Chronic tophaceous gout Pegloticase: Pegloticase is a medication for the treatment of
the severe, treatment of refractory chronic gout. It is a third-line treatment in those in whom other treatments
are not tolerated. Ref Gout and other crystal arthropathies by Robert Terkettaud ]
Question 99: Correct Answer: D
Explanation: Ans: D. 80/100 Negative predictive value (NPV): Ability of a screening test to identify correctly
all those who don't have the disease, out of all those who test negative on a screening test.
Question 100: Correct Answer: A
Explanation: ANS. A.G2P1 Gravida includes all confirmed pregnancies. Each pregnancy is only counted one
time, even if the pregnancy was multiple gestations, such as twins or triplets Parity reflects the total number
of births after 20 weeks, not the total number of infants born. Ref.OBS Dutta 8th ed Page no. 107
Question 101: Correct Answer: A
Explanation: Answer-A- Sporothrix Sporothrix schenckii is a thermally dimorphic fungus that lives on
vegetation. It is associated with a variety of plants, grasses, trees, sphagnum moss, rose bushes, and other
horticultural plants. The conidia or hyphal fragments of S.schenckii are introduced into the skin by trauma.
Following a traumatic introduction into the skin, S.schenckii causes sporotrichosis, a chronic granulomatous
infection. This manifestation mimics chronic cavitary tuberculosis and tends to occur in patients with impaired
cell-mediated immunity. Jawetz 27/e-pg-670
Question 102: Correct Answer: A
Explanation: Ans. A. Plasma concentration In zero-order kinetics or saturation kinetics, elimination
mechanisms become saturated and unable to process more drugs when drug concentrations rise.
Consequently, for drugs that are eliminated by zero-order kinetics, a constant amount of drug is eliminated
per unit time regardless of drug plasma concentration.
Question 103: Correct Answer: B
Explanation: Ans: b. Fat embolism. In this patient, based on the case presentation there is Respiratory
System involved as pao2 is 60, and CNS involvement as he is in a confused state. >So, the diagnosis here
is Fat embolism syndrome. >Embolized fat within capillary beds cause direct tissue damage as well as
induce a systemic inflammatory response resulting in pulmonary, cutaneous, neurological, and retinal

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symptoms. >Gurd's clinical description of the FES renewed interest in studying this syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665122/
Question 104: Correct Answer: B
Explanation: Answer- B- Acute laryngotracheobronchitis The image below indicates Acute
laryngotracheobronchitis. Croup is usually of slower onset than acute epiglottitis and occurs most commonly
in children under 2 years of age. The children have biphasic stridor and are often hoarse with a typical
barking cough. Ref- Bailey and Love, Short practice of surgery, 27th edition published in 2018 Pg 743
Question 105: Correct Answer: A
Explanation: And.a.Satellite lesions >Fungal keratitis or keratomycosis refers to an infective process of the
cornea caused by any of the multiple pathologic fungi capable of invading the ocular surface. >when the
epithelial integrity is broken either due to trauma or ocular surface disease and the organism gains access
into the tissue and proliferates. >Multifocal stromal infiltrates or 'satellite lesions' have been considered a
characteristic feature of fungal keratitis. Ref: https://eyewiki.aao.org/Fungal_Keratitis
Question 106: Correct Answer: A
Explanation: Ans: A. Multinational monitoring of trends and determinants in Cardiovascular Disease The
WHO has completed a project known as MONICA ' (multinational monitoring of trends and determinants in
cardiovascular diseases)' to elucidate this issue. Forty-one centers in 26 countries were participating in this
project, which was planned to continue for a 10 year period ending in 1994. Park’s PSM 24th ed. Page no.
385
Question 107: Correct Answer: A
Explanation: Ans. A. Imperforate hymen According to the clinical case, patients suffer from primary
amenorrhea and cryptomenorrhea(cyclic abdominal pain). The girl is aged about 14–16 years. The chief
complaints are periodic lower abdominal pain, which may be continuous, primary amenorrhea and urinary
symptoms, such as frequency, dysuria or even retention of urine. In fact, in significant cases, the presenting
feature may be the retention of urine. The cause of retention is due to the elongation of the urethra. An
abdominal examination reveals a suprapubic swelling, which may
Question 108: Correct Answer: B
Explanation: Ans: B. Pefloxacin Pefloxacin has longer t1?2: accumulates on repeated dosing achieving
plasma concentrations twice as high as after a single dose. Because of this, it is effective in many systemic
infections as well. The dose of pefloxacin needs to be reduced in liver disease, but not in renal insufficiency.
Ref: K. D. Tripathi 7th Edition. Page. 713
Question 109: Correct Answer: A
Explanation: Ans: A. Aortic regurgitation Water hammer pulse It is a large bounding pulse, associated with
an increased stroke volume of the left ventricle and a decrease in the peripheral resistance, leading to wide
pulse pressure. The pulse strikes the palpating finger with a rapid, forced jerk and quickly disappears. It is
best felt in the radial artery with the patient's arm elevated. It is seen in aortic regurgitation.
Question 110: Correct Answer: D
Explanation: Ans. D. vaccination against tetanus. The major concern for anyone exposed to unsanitary
conditions is that they should be up to date with the tetanus-containing vaccine because if they are injured
(as is common in disaster settings) the injury is likely to be contaminated. Routinely recommended vaccines
are recommended for evacuees, just like they are for everyone else. Cholera and typhoid vaccine do not
have any evidence for mass vaccination due to the low level of exposure and prevention Tetanus and HepB
vaccine is required.

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Question 111: Correct Answer: A
Explanation: Ans: A. Meat * Vitamin B12 is naturally found in animal products, including fish, meat, poultry,
eggs, milk, and milk products. * Synonyms are cobalamin, extrinsic factor (EF) of Castle and anti pernicious
anemia factor. Vitamin B12 is water-soluble, heat stable and red in color. It is satisfied by any of the following
groups: cyanide, hydroxyl, adenosyl or methyl. * Cyanocobalamin- Oral preparations are in this form. *
Hydroxy cobalamin- Injectable preparations are in this form. * Adenosylcobalamin- This is the major storage
form, seen in the liver. * Methylcobalamin-This is the major form seen in blood circulation as well as in the
cytoplasm of cells. * Vitamin B12 is generally not present in plant foods, but fortified breakfast cereals are a
readily available source of vitamin B12 with high bioavailability for vegetarians. * Rich source of vitamin B12?
- Beef, liver, and chicken. - Fish and shellfish such as trout, salmon, tuna fish, and clams. - Fortified
breakfast cereal. - Low-fat milk, yogurt, and cheese. - Eggs.
Question 112: Correct Answer: A
Explanation: Ans: A. Aedes Zika virus disease is caused by the Zika virus, which is spread to people
primarily through the bite of an infected mosquito (Aedes aegypti and Aedes albopictus). The virus can also
be transmitted through sex. These are the same mosquitoes that spread dengue and chikungunya viruses. A
mosquito gets infected with a virus when it bites an infected person during the period of time when the virus
can be found in the person’s blood, typically only through the first week of infection. Medical Microbiology
and Immunology 14/e-pg;395
Question 113: Correct Answer: B
Explanation: Answer- B- Acute laryngotracheobronchitis The image below indicates Acute
laryngotracheobronchitis. Croup is usually of slower onset than acute epiglottitis and occurs most commonly
in children under 2 years of age. The children have biphasic stridor and are often hoarse with a typical
barking cough. Ref- Bailey and Love, Short practice of surgery, 27th edition published in 2018 Pg 743
Question 114: Correct Answer: C
Explanation: Ans: C. The fall in 2, 3 DPG is less The infusion of ACD blood caused P50 and 2,3-DPG
concentration to decrease significantly. The infusion of blood stored in citrate phosphate dextrose (CPD) did
not significantly increase the oxygen affinity. To compensate for the increased oxygen affinity, there must be
a rise in cardiac output or more likely a decrease in venous PO2. The transfusion of CPD blood, therefore, is
more favorable in terms of oxygen supply, particularly in patients who have had cardiac surgery.
Question 115: Correct Answer: A
Explanation: Answer- A- SMAC An enterohemorrhagic bacterial strain, E. coli O157: H7 infects the
alimentary tract and induces abdominal cramps with hemorrhagic diarrhea. Transmission of E. coli O157: H7
occurs via the fecal-oral route after consumption of contaminated, undercooked liquids and foods. Mac
Conkey-Sorbitol ChromoSelect Agar (SMAC) is recommended for selective isolation of Escherichia coli
0157:H7 from food and animal feeding stuffs. MacConkey Sorbitol Agar is based on the formulation
described by Rappaport and Henigh. The medium contains sorbitol instead of lactose and it is recommended
for the detection of enteropathogenic strains of E. coli 0157:H7 which ferments lactose but does not ferment
sorbitol and hence produce colorless colonies. Sorbitol fermenting strains of E. coli produce pink-red
colonies. The red color is due to the production of acid from sorbitol, absorption of neutral red and a
subsequent colour change of the dye when the pH of the medium falls below 6.8.
https://www.sigmaaldrich.com/analytical- chromatography/microbiology/microbiology-products.html?
TablePage=18297647
Question 116: Correct Answer: A
Explanation: Ans. is 'a' i.e., Imatinib and sunitinib Molecular targeted agents Tyrosine kinase inhibitors

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Competitive inhibitors ? Imatinib, Nilotinib, Sunitinib, Dasatinib, Erlotinib, Gefitinib, Lapatinib, Sorafenib
(Remember all end with ' nib'). Monoclonal antibodies ? Cetuximab, panitumumab. HER2/neu (ERB B2)
inhibitors Monoclonal antibody - Trastuzumab. Targeted antibody ? Gemtuzumab (anti CD-33), Rituximab
(anti - CD20), Alemtuzumab (anti CD-52). Vascular endothelial growth factor (VEGF) inhibitor ? Monoclonal
antibody - Bevacizumab. Proteosome inhibitors ? Bortezomib. Histone deacetylase inhibitor ? Vorinostat
DNA - methyltransferase inhibitor ? 5-azacytidine, 2-deoxy-5 azacytidine. All - trans-retinoic acid. Biological
response modifier - Recombinant IL-2 (aldesleukin, denileukin).
Question 117: Correct Answer: A
Explanation: Answer-A- Vibrio Cholera SAgs are produced by some pathogenic viruses and bacteria most
likely as a defense mechanism against the immune system. Toxic shock syndrome toxin (TSST-1),
epidermolytic toxin and other staphylococcal enterotoxin are superantigens. These superantigens can bind
MHC molecules outside the peptide- binding cleft. Consequently, superantigen can activate up to 10% of T-
cells in a nonspecific manner which in turn leads to the release of large quantities of cytokines. Jawetz 27/e-
pg-135
Question 118: Correct Answer: A
Explanation: Ans: A. Factor 2 Vitamin K is a cofactor for the enzymatic conversion of glutamic acid (Glu)
residues to gamma-carboxyglutamic acid (GLA) in vitamin K- dependent proteins, via the endoplasmic
reticulum resident vitamin K-dependent gamma-glutamyl carboxylase. This carboxylase activity is found in
essentially all mammalian tissues, and its reaction product, Gla, has been observed in both vertebrates and
invertebrates; both play an important biological role in protein function. Vitamin K–dependent clotting factor
deficiency (VKCFD) is a rare autosomal recessive bleeding disorder that often presents with severe
hemorrhage during infancy. A rare inherited form of defective ?-carboxylation resulting in the early onset of
bleeding was first described by McMillan and Roberts in 1966 and subsequently has been termed vitamin
K–dependent clotting factor deficiency (VKCFD). Combined deficiency of vitamin K–dependent clotting
factors II, VII, IX, and X (and proteins C, S, and Z) is usually an acquired clinical problem, often resulting
from liver disease, malabsorption, or warfarin overdose.
Question 119: Correct Answer: A
Explanation: Ans: A. Dorsal scapular nerve Marked muscle is levator scapulae. It is supplied by C3, C4, and
C5 ( dorsal scapular nerve)
Question 120: Correct Answer: A
Explanation: Ans: A. Tryptophan Amino Acid Absorb UV Light Amino Acids that absorb 250-290 nm
(Maximum at 280 nm) UV light are tryptophan, phenylalanine, tyrosine. The maximum absorption of UV light
is by tryptophan. As it absorbs ultraviolet light about ten times more efficiently than phenylalanine or tyrosine,
tryptophan makes the major contribution to the ability of most proteins to absorb light in the region of 280
nm. Tryptophan and tyrosine absorb UV at approximately 280 nrn. UV absorption spectroscopy is utilized to
measure protein concentration. The absorption spectrum of a protein in the UV wavelength range is the
result of absorption of light by the aromatic amino acids (250-320 nm), the disulfide bonds (250-300 nm) and
the carbonyl group of the peptide bond (190-210). Remember Aromatic Amino Acids absorb UV Lights
Amino acids are colourless because they do not absorb visible light. Ref-Rebecca james-self assessment
and review of biochemistry, 3rd edn, Chemistry, and Metabolism of Amino Acids, Pg 7
Question 121: Correct Answer: A
Explanation: Answer- A. High LDL Metabolic syndrome refers to the co-occurrence of several known
cardiovascular risk factors, including insulin resistance, obesity, atherogenic dyslipidemia, and hypertension.
These conditions are interrelated and share underlying mediators, mechanisms, and pathways. Criteria for

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the Diagnosis of Metabolic Syndrome Elevated waist circumference: (For men >90 cm and for women, >80
cm). Elevated triglycerides: >150 mg/dL Reduced HDL (“good”) cholesterol: For men, <40 mg/dL; for
women, < 50 mg/dL Elevated blood pressure: >130/85 mm Hg Elevated fasting glucose: >100 mg/dL Insulin
resistance (hyperinsulinemia) Additional parameters include: coagulation abnormalities, hyperuricemia,
microalbuminuria non-alcoholic steatohepatitis (NASH) and increased CRP. Diagnosis is made, if any 3 out
of the 5 criteria given above.
Question 122: Correct Answer: D
Explanation: Ans. D. spontaneous respiration The image in the given question shows a capnograph with
clefts during phase III which indicates spontaneous breathing efforts by the patient during controlled
mechanical ventilation. Also known as curare notch or cleft. Ref:
https://www.ncbi.nlm.nih.gov/pubmed/24132805 Miller's Anesthesia 8th edition (Page no. 1554)
Question 123: Correct Answer: A
Explanation: Answer- A. Monitor till size reaches 55mm An asymptomatic abdominal aortic aneurysm in an
otherwise fit patient should be considered for repair if >55mm in diameter (measured by ultrasonography).
Regular ultrasonographic assessment is indicated for asymptomatic aneurysms <55 mm in diameter. 75% of
aneurysms are suitable for endovascular (minimally invasive) repair, usually via the femoral arteries in the
groin. Ruptured abdominal aortic aneurysm is a surgical emergency. Symptomatic AAA- An operation is
usually indicated in patients who are otherwise reasonably fit. Pain may be a warning sign of stretching of
the aneurysm sac and imminent rupture; surgery should be performed as soon as possible (usually on the
next available operating list). Ref- Bailey and Love, Short practice of surgery, 27th edition published in 2018
Pg 961
Question 124: Correct Answer: A
Explanation: Ans: A. Hydrochlorothiazide Long-term use of higher dose thiazides in hypertension has caused
a rise in blood urate levels. Ref: K. D. Tripathi 7th Edition. Page. 585
Question 125: Correct Answer: A
Explanation: Ans: a.Osteoarthritis >The distal interphalangeal (DIP) joint is actually the most common
location on the body for osteoarthritis (OA). >The frequency of hand arthritis, OA at the DIP joint occurs in
approximately 58% of individuals. >The symptoms of OA at the DIP joint commonly include pain and
changes to the size and shape of the joint. https://www.3pointproducts.com/blog/health-arthritis-finger- and-
toe-conditions/dip-joint-osteoarthritis-how-to-treat-this- common-form-of-arthritis
Question 126: Correct Answer: A
Explanation: Ans. A. Bilateral Hydrosalpinx The image is Hysterosalpingogram showing bilateral
hydrosalpinx (fimbrial block). Hysterosalpingogram showing radio-opaque shadow filling the uterine cavity.
The tubes of both sides are distended with the radio- opaque dye. There is no evidence of peritoneal
spillage.
Question 127: Correct Answer: A
Explanation: Ans: A. Insulin Insulin acts on specific receptors located on the cell membrane of practically
every cell, but their density depends on the cell type: liver and fat cells are very rich. The insulin receptor is a
receptor tyrosine kinase (RTK) which is a heterotetrameric glycoprotein consisting of 2 extracellular ? and 2
transmembrane ? subunits linked together by disulfide bonds. Ref: K. D. Tripathi 7th Edition. Page. 261
Question 128: Correct Answer: B
Explanation: Ans. B.46XX Ovotestis True hermaphrodite or ovotesticular disorder of sexual differentiation
(OVO-DSD) is one of the rarest variety of all inter sex anomalies. In about 90% of cases, patients have 46

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XX karyotype. Rarely, 46 XY/46 XX mosaicism may occur.
Question 129: Correct Answer: A
Explanation: Ans. A. Ampulla Fertilization is the process of fusion of the spermatozoon with the mature
ovum. It begins with sperm egg collision and ends with the production of a mononucleated single cell called
the zygote. Its objectives are: To initiate the embryonic development of the egg and To restore the
chromosome number of the species. Almost always, fertilization occurs in the ampullary part of the uterine
tube. Reference: Dutta Obstetrics ed. 8th Page no 23
Question 130: Correct Answer: D
Explanation: Ans. D. Danazol EMERGENCY CONTRACEPTIVES: Drug Levonorgestrel
Ethinylestradiol50?g+ norgestrel 0.25 mg Ethinyl estradiol Mifepristone Dose 0.75 mg stat and after 12 hours
2tabstatand2after 12 hours 2.5 mg Bd × 5 days 100 mg single dose PREGNANCY RATE 0–1 0–2 0–0.6
0–0.6 Ref:DUTTA GYNAECOLOGY ED. 6TH PAGE NO. 492 Copper Iuds (Gold
standard) Insertion within 5 0–0.1 days (RU 486Mifepristone) 30 mg PO 0–1 (ulipristal acetate)
Question 131: Correct Answer: C
Explanation: Ans. C. 2 years EXTENDED SICKNESS BENEFIT: In addition to 91 days of sickness benefit
insured persons suffering from certain long-term diseases are entitled to Extended Sickness Benefit as
shown below, for a maximum period of two years. Extended Sickness Benefit with effect from 1.1.2000 is
payable, in the case where the insured person has been in continuous employment for 2 years Tuberculosis
Park’s PSM 24th ed. Page no. 854
Question 132: Correct Answer: B
Explanation: Ans- B. Normal pressure hydrocephalus Frontotemporal dementia - Associated with poor
behavioral control, decision making, and language. Normal-pressure hydrocephalus - Associated with gait
disturbance, behavioural change, enuresis, and dementia. Parkinson’s disease - Associated with tremor and
muscular stiffness Alzheimer’s disease-Associated mainly with memory loss and confusion Ref: Normal
Pressure Hydrocephalus By Michael J. Fritsch, Uwe Kehler, Ullrich Meier P .16; Oxford textbook of
neurological surgery by Adel Helmy P.94
Question 133: Correct Answer: A
Explanation: ANS-A. Antipsychotic with Imipramine continued The condition from which the patient above is
suffering is a bipolar disorder which includes both depression and mania. So in order to treat both
antidepressant i.e imipramine is continued along with an antipsychotic such as phenothiazines,
thioxanthenes, etc. Antipsychotic or valproate alone cannot reduce the depression and Imipramine alone
cannot reduce the mania. Ref: ARVIND ARORA review of psychiatry p.no:111
Question 134: Correct Answer: B
Explanation: Ans: b. APL & EPB >The condition explained in the patient is De Quervain's Tenosynovitis >De
Quervain's Tenosynovitis is a painful inflammation of tendons on the side of the wrist at the base of the
thumb. >These tendons include the extensor pollicis brevis (EPB) and the abductor pollicis longus (APL).
>These muscles are located on the dorsal side of the forearm and go to the lateral side of the thumb through
a fibrous-osseous tunnel made of the processus styloideus radii and the extensor retinaculum.
Question 135: Correct Answer: A
Explanation: Ans: A. Hypokalemia Side effects of lithium Neurological: - Tremor is the commonest side effect
of lithium. Other CNS side effects are giddiness, ataxia, motor incoordination, hyperreflexia, mental
confusion, nystagmus. Renal: - Nephrogenic diabetes insipidus with polyuria & polydipsia. Amiloride is the
DOC for Lithium induced nephrogenic DI. Cardiovascular: - Effects are similar to hypokalemia. The most

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common ECG change is T wave depression. Endocrine: - Goitre, hypothyroidism GIT: - Nausea, vomiting,
diarrhea, metallic test, abdominal pain. Dermatological : - Acneiform eruptions, papular eruption,
exacerbation of psoriasis. Teratogenicity: - Ebstein's anomaly in the fetus.
Question 136: Correct Answer: A
Explanation: Ans. A. Ampulla Fertilization is the process of fusion of the spermatozoon with the mature
ovum. It begins with sperm egg collision and ends with the production of a mononucleated single cell called
the zygote. Its objectives are: To initiate the embryonic development of the egg and To restore the
chromosome number of the species. Almost always, fertilization occurs in the ampullary part of the uterine
tube. Reference: Dutta Obstetrics ed. 8th Page no 23
Question 137: Correct Answer: A
Explanation: Answer- a. Lamellar ichthyosis Explanation- Ichthyosis is one of the most common
genodermatoses. It is characterized by dry (xerotic) scaly skin all over the body. Scales are dull-brown-black.
The basic defect is an impairment in the barrier function of skin and inability to maintain moisture. Collodion
baby is the term used to denote the newborn baby with ichthyosis; the newborn baby is encased in a thick,
shiny membrane coat called collodion and is seen in Lamellar ichthyosis Ref- Arvind Arora skin, 6th edition,
page no 203
Question 138: Correct Answer: A
Explanation: Ans. (a)Battle sign. > Battle Sign (also called Battle's Sign) is defined as bruising over the
mastoid process. It is retroauricular or mastoid ecchymosis that is typically the result of head trauma.
ref:https://www.statpearls.com/kb/viewarticle/18169? utm_source=pubmed
Question 139: Correct Answer: B
Explanation: Ans: B. PML-RARA All-trans retinoic acid (ATRA) is an active metabolite of vitamin A under the
family retinoid. Retinoids, through their cognate nuclear receptors, exert potent effects on cell growth,
differentiation and apoptosis, and have significant promise for cancer therapy and chemoprevention.
Differentiation therapy with ATRA has marked a major advance and become the first choice drug in the
treatment of acute promyelocytic leukemia (APL). All-trans retinoic Acid is used in the treatment for Acute
Promyelocytic Leukemia (PML)
Question 140: Correct Answer: D
Explanation: Correct Ans: D. Hegar's sign At 6 to 8 weeks menstrual age, the firm cervix contrasts with the
now softer fundus and the compressible interposed softened isthmus —Hegar sign
Question 141: Correct Answer: A
Explanation: Answer- A-Examine the Lymph node Tattoo marks are permanent when dye penetrates the
dermis. Infrared photography makes old tattoos readily visible. A faded tattoo mark becomes visible by the
use of ultraviolet lamp 4 or rubbing the part and examining with a magnifying lens. Marks are recognized
even in decomposed bodies(Aret) when the epidermis is removed. Lymph nodes near the tattoo mark show
pigment deposition.
Question 142: Correct Answer: A
Explanation: Ans. A. CPD Patient admitted at 7 AM Cervical dilatation 4 cm Head: 5/5th palpable After 2 hrs
Cervical dilatation: 5 cm
Question 143: Correct Answer: A
Explanation: Ans. A. MCA doppler peak systolic volume Doppler ultrasound: Serial Doppler study of the
middle cerebral artery (MCA)-peak systolic velocity (PSV) is the mainstay to assess fetal anemia. A value
>1.5 multiples of the median (MOMs) for the corresponding gestational age, predicts moderate to severe

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fetal anemia. This value (between 24 weeks and 35 weeks of gestation), is an indication for cordocentesis
and fetal transfusion Most centers have replaced serial amniocentesis with serial MCA Doppler studies. Ref.
OBstetrics Dutta ed. 8th pg. 391
Question 144: Correct Answer: A
Explanation: Answer- A. ca penis Cancer penis spreads to inguinal nodes. A mass, pruritus or discharge is
common. Advanced tumours may cause fecal incontinence by the invasion of the sphincters. Anal canal
tumours are palpable and irregular indurated tender ulceration. Sphincter involvement may be evident. Ref-
Bailey and Love, Short practice of surgery, 27th edition published in 2018 Pg 1371
Question 145: Correct Answer: B
Explanation: Answer- B. SURGERY PRIORITIES The Thoracoscore is the most widely used model to
assess the risk of operative mortality in thoracic patients
Question 146: Correct Answer: A
Explanation: Ans: A. Auricular branch Vagus nerve. >Auricular branch of Vagus (Arnold's nerve) and Facial
nerve continues inwards to supply the posterior wall and floor of the EAC. > The cough response caused
while stimulating the ear canal is mediated by the vagus which also supplies the larynx. (Re/. Shambaugh,
6th ed., page 45)
Question 147: Correct Answer: A
Explanation: Ans: A. 37 degree At temperature below freezing (dry-cold condition) frostbite occurs the tissue
freeze & ice crystals form in between the cells Affected part should be warmed using water at 44 °is under
Criticism, Warming should last about 20 minutes at a time, Intake of hot fluids promotes general rewarming
Question 148: Correct Answer: D
Explanation: Answer is D (Dressler's Syndrome): Dressler syndrome is a secondary form of pericarditis that
occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart). It consists of fever,
pleuritic pain, pericarditis and/or pericardial effusion. The disease consists of persistent low-grade fever,
chest pain (usually pleuritic), pericarditis and/or pericardial effusion. The symptoms tend to occur 2–3 weeks
after myocardial infarction but can also be delayed a few months. It tends to subside in a few days, and very
rarely leads to pericardial tamponade. Elevated ESR is an objective but nonspecific laboratory finding.
Dressler's Syndrome is not associated with low glucose in pleural fluid. Rheumatoid Arthritis, Malignancy and
Empyema (Bacterial infections) are all established causes of pleural effusion with low glucose. Pleural
effusion with low glucose (< 60 mg/c11) Malignancy Bacterial infections Rheumatoid pleuritis 1. 2. 3.
Question 149: Correct Answer: B
Explanation: Answer:b. Water view Occipitomental view of PNS X-ray called as Water view
Question 150: Correct Answer: A
Explanation: Prevalent cases ? All breast cancer patients who are alive during a given time frame. These can
lead to different results because the probability of finding a case in a given time frame is related to mortality
risk. Those patients who hay a mild form of the disease and survive for a relatively long time have a good
chance of being around on the date of data collection. Those patients who die quickly are unlikely to be
around on that date. 3. Referral bias or volunteer bias Volunteer or referral bias occurs because people who
volunteer to participate in a study (or who are referred to it) are often different than non-volunteers/non-
referral. This bias usually favours the treatment group, as volunteers tend to be more motivated and
concerned about there health. 4. Response bias This occurs when those who respond to a survey differ in
important ways from those who do not respond. This bias can work in either direction, i.e., if bias occurs,
when those who do not respond to a survey differ in important ways from those who respond, it is called

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nonrespondent bias. 5. Berkesonian bias Berkesonian bias results from the greater probability of hospital
admission for people with two or more diseases than for people with one disease. So, it is also known as
admission rate bias. For example, If breast cancer is the exposure of interest (diseases are often treated as
exposures in hospital-based case-control studies) and meningioma is the case disease then people with
both breast cancer and meningioma could be hospitalized for either breast cancer or meningioma or both.
However, people with only breast cancer or with the only meningioma could be hospitalized because of one
of these diseases. Therefore, a greater proportion of people in the community with both breast cancer and
meningioma would be admitted to the hospital than people with meningioma only. So, Berkesonian bias
occurs when both exposure (e.g., breast
Question 151: Correct Answer: D
Explanation: Ans: D. Hco3 loss by kidney In the question, pH is decreased (acidosis) & pCO2 is decreased
(Normal= 40-45 mm Hg). A decreased pCO2 will try to increase pH, hence it must be a secondary
compensating mechanism. So, the primary mechanism causing the acid-base imbalance must be a
decrease in serum bicarbonate concentration i.e. metabolic acidosis.
Question 152: Correct Answer: A
Explanation: Ans: A. Lung oligemia Chest X-ray Features of Left ventricular failure: Cardiomegaly Kerley
lines Prominent upper lobe veins Bat’s wings shadow Pleural effusion Kerley B line is due to interstitial
edema. Prominent right descending pulmonary artery is seen in acute pulmonary embolism.
Question 153: Correct Answer: B
Explanation: Ans:b.The macula and Optic nerve diseases. >To distinguish optic nerve conduction defects
from the macular disease in patients with otherwise unexplained loss of central vision we first determined the
best visual acuity with correction at distance in unilateral defects. > The normal eye was tested first and
photo stressed for ten seconds by looking at an ordinary penlight held 2 to 3 cm from the eye. >The time
required to read three letters on three Snellen test lines just larger than the best acuity was used as the
endpoint. >Recovery time will be prolonged with maculopathy. >Prolonged recovery time will not be
observed in patients who have optic nerve disease. https://www.ncbi.nlm.nih.gov/pubmed/836667
Question 154: Correct Answer: B
Explanation: >Pulled elbow, also called nursemaid’s elbow, is a radial head subluxation caused by axial
traction or a sudden pull of the extended pronated arm, and it is a very common phenomenon. >In this case
of pulled elbow, the child usually avoids moving the affected arm, holding it close to his or her body, without
considerable pain, and no obvious swelling or deformity can be seen. >While a fracture should be excluded,
the pulled elbow can usually be identified based on this presentation.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5999240/
Question 155: Correct Answer: A
Explanation: Answer- A. Superficial spreading melanoma Superficial spreading melanoma This is the most
common presentation (70%) usually arising in a pre- existent naevus after several years of slow change,
followed by rapid growth in the preceding months before presentation. Nodular melanoma (NM) Nodular
melanoma accounts for l5% ol all MM. Typically appear as blue/black papules, l-2 cm in diameter, and
because they lack the horizontal growth phase. Lentigo maligna melanoma- Presents as a slow-growing,
variegated brown macule on the face, neck or hands of the elderly. Acral lentiginous melanoma (ALM)ALM
affects the soles of feet and palms of hands. It usually presents as a flat, irregular macule in later life. Ref-
Bailey and Love, Short practice of surgery, 27th edition published in 2018 Pg 610
Question 156: Correct Answer: C
Explanation: Answer- C, IL 4 IgE is produced by plasma cells located in lymph nodes draining the site of

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antigen entry or locally, at the sites of allergic reactions, by plasma cells derived from germinal centers
developing within the inflamed tissue. IgEantibody production requires TH2 cells that produce interleukin-4
(IL-4) and IL-13 and it can be inhibited by TH1 cells that produce interferon-? (IFN-?).
https://www.ncbi.nlm.nih.gov/books/NBK27117/
Question 157: Correct Answer: A
Explanation: Ans: A. < 70 / Lac live births By 2030, reduce the global maternal mortality ratio to less than 70
per 100,000 live births. Park’s PSM 24th ed. Page no. 28 Table: 4
Question 158: Correct Answer: B
Explanation: Ans: B. REM sleep Explanation: REM/Paradoxical Sleep: Due to the “presence of rapid eye
movement' recorded on electrooculogram. Has paradoxical elevation of brain activity, metabolism &
physiological activity. 'High-amplitude slow waves' replaced by 'rapid, low voltage activity & beta wave' -
During stage 3 & 4 REM sleep. Features of REM sleep:
Question 159: Correct Answer: B
Explanation: Answer: B. Barberio’s test It detects spermin (secreted by the prostate) and uses an aqueous
or alcoholic solution of picric acid. A saturated aqueous or alcoholic solution of picric acid, when added to the
spermatic fluid, produces yellow needle-shaped rhombic crystals of spermine picrate. The reaction probably
depends on the presence of prostatic secretion. The Acid Phosphatase Test: The prostatic secretion element
of seminal fluid contains 500 to 1000 times greater acid phosphatase than any other body fluid. Human red
cells, semen of higher apes, and juice of cauliflower have acid phosphatase level similar to that of human
semen THE ESSENTIALS OF FORENSIC MEDICINE AND TOXICOLOGY By Dr. K.S. NARAYAN REDDY
33/e- pg-434
Question 160: Correct Answer: A
Explanation: Ans: A. Low TSH with more t3 or t4
Question 161: Correct Answer: D
Explanation: Ans: D. Adenosine A1 receptor antagonism The mildly diuretic actions of both methylxanthines
are mainly the result of inhibition of tubular fluid reabsorption along the renal proximal tubule. Based upon
the use of specific adenosine receptor antagonists and the observation of a complete loss of diuresis in mice
with targeted deletion of the A1AR gene, transport inhibition by methylxanthines is mediated mainly by
antagonism of adenosine A1 receptors (A1AR) in the proximal tubule. Methylxanthines are weak renal
vasodilators, and they act as competitive antagonists against adenosine-induced preglomerular
vasoconstriction. Caffeine and theophylline stimulate the secretion of renin by inhibition of adenosine
receptors and removal of the general inhibitory brake function of endogenous adenosine. Since enhanced
intrarenal adenosine levels lead to reduced glomerular filtration rate in several pathological conditions
theophylline has been tested for its therapeutic potential in the renal impairment following the administration
of nephrotoxic substances such as radiocontrast media, cisplatin, calcineurin inhibitors or following ischemia-
reperfusion injury.
Question 162: Correct Answer: A
Explanation: Ans: A. < 70 / Lac live births By 2030, reduce the global maternal mortality ratio to less than 70
per 100,000 live births. Park’s PSM 24th ed. Page no. 28 Table: 4
Question 163: Correct Answer: A
Explanation: Ans. A. Plasma concentration In zero-order kinetics or saturation kinetics, elimination
mechanisms become saturated and unable to process more drugs when drug concentrations rise.
Consequently, for drugs that are eliminated by zero-order kinetics, a constant amount of drug is eliminated

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per unit time regardless of drug plasma concentration.
Question 164: Correct Answer: A
Explanation: Ans. A. Female condom The female condom (Femidom) : It is a pouch made of polyurethane
that lines the vagina and also the external genitalia. It is 17 cm in length with one flexible polyurethane ring at
each end. The inner ring at the closed end is smaller compared to the outer ring. Ref. Dutta gynaecology 6th
ed. Page no. 476
Question 165: Correct Answer: B
Explanation: Criterion Additional treatment Antibiotics for wound infection Drainage of pus under local
anaesthesia Debridement of wound under general anaesthesia Serous discharge Erythema Purulent
exudate Separation of deep tissues Isolation of bacteria from wound Stay as inpatient prolonged over 14
days as result of ound infection Points 0 10 5 10 Daily 0-5 Daily 0-5 Daily 0-10 Daily 0-10 10 5 Ref- Bailey
and Love, Short practice of surgery, 27th edition published in 2018 Pg 48
Question 166: Correct Answer: A
Explanation: Ans: A. Rifampicin Overall inhibition of RNA synthesis by rifampicin is caused by a destabilizing
effect on the binding of the intermediate oligonucleotides to the active enzyme-DNA complex. Rifampicin
itself can only interact specifically with RNA polymerase if the enzyme is free or in a binary complex with
DNA. Ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC327649/
Question 167: Correct Answer: D
Explanation: Ans: D. DNA helicase Werner syndrome is a human autosomal recessive disorder that displays
symptoms of premature aging, including early graying and thinning of hair, wrinkling and ulceration of skin,
atherosclerosis, osteoporosis, and cataracts. In addition, Werner syndrome patients exhibit an increased
incidence of diabetes mellitus type 2, hypertension, and are highly disposed to the emergence of benign and
malignant neoplasms. Werner syndrome caused by mutation of the WRN gene, a member of the RecQ DNA
helicase family. Ref- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3237395/
Question 168: Correct Answer: A
Explanation: ANS - A.Cannabis Cannabis- 9 million users,192 million users(Acc. To WHO Drug report 2018)
Heroin (opioid derivative) -2.5 lakh users It is estimated that 275 million people used illicit drugs, such as
cannabis, amphetamines, opioids, and cocaine, in 2016 which translates into an annual prevalence of illicit
drug use of 5.6%. Cannabis is most used with 192 million users. Some 31 million people who use drugs
suffer from drug use disorders.-(WHO Drug report 2018) Ref: ARVIND ARORA review of psychiatry p:64,
WHO Drug report(2018)
Question 169: Correct Answer: B
Explanation: Ans: B. Arginine Nitric oxide is formed from arginine by the enzyme nitric oxide synthase (NOS).
It contains heme, FAD, FMN, NADPH, and tetrahydrobiopterin. Nitric oxide has a very short half-life (3-4
seconds). NO combines with oxygen to form NO2. These nitrites are excreted through urine. Reacting with
hemoglobin, NO is converted to NO3; and nitrates are also excreted in the urine. The very low quantity of NO
is expelled through the lung. Arginine is a highly basic, semi-essential amino acid. It is glucogenic in nature.
Question 170: Correct Answer: A
Explanation: Ans. A.24 hrs after delivery Prolactin is maximum 24 hrs after delivery. Prolactin secretion also
increases during strenuous exercise and sleep(NREM). 24 hrs after ovulation estrogen has a negative
feedback effect on prolactin which decreases the level of prolactin.
Question 171: Correct Answer: B
Explanation: Ans:b.paralytic squint. >Paralytic or incomitant squint occurs when there is an acquired defect

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of the movement of an eye. > The squint (and double vision) is maximally demonstrated by looking in the
direction of action of the weakened muscle. >Paralytic squints occur due to disease of the III, IV and VI
cranial nerves. Ref:https://www.gponline.com/basics- strabismus/ophthalmology/article/1055827
Question 172: Correct Answer: B
Explanation: Ans: C. Metaplasia Metaplasia is a reversible change in which one adult cell type (epithelial or
mesenchymal) is replaced by another adult cell type.
Question 173: Correct Answer: C
Explanation: Answer- C- Plexiform neurofibroma Plexiform neurofibromas represent an uncommon variant of
NF-1 in which neurofibromas arise from multiple nerves as bulging and deforming masses involving also
connective tissue and skin folds— hence the clinical description of lesions as “bags of worms.”
Question 174: Correct Answer: C
Explanation: Ans. C. Ecological study design This is an example of an ecological study. An ecological study
is a type of Observational study where information is collected on a group (or population) rather than on
individual members and then analyzed. Here the association between a summary measure of sale of
cigarettes (risk factor) and a summary measure of the number of cases of COPD(outcome) is studied.
Question 175: Correct Answer: A
Explanation: Answer- A- Intussusception This image shows intussusception. The classic presentation is with
episodic abdominal pain and screaming episodes associated with the passage of blood and mucus ('red
current jelly'). The abdominal radiograph may demonstrate an absence of bowel gas in the right iliac fossa
with a rounded soft-tissue mass a
Question 176: Correct Answer: A
Explanation: Answer- A. All patients should undergo CT chest Retro sternal goitre tends to arise from the
slow growth of a multinodular gland down into the mediastinum. It gets its blood supply from the mediastinum
itself, not from the neck. Investigations A chest X-ray shows a soft tissue shadow under the sternum. A
radioactive iodine study is diagnostic. CT scan/ MRI is useful and all patients should undergo it. Surgical
removal of retrosternal thyroid is done. (TOC) Commonly it can be removed through an incision in the neck.
Ref- Bailey and Love, Short practice of surgery, 27th edition published in 2018 Pg 810 Sriram Bhat M, SRB's
Manual of Surgery, 4th edition published in 2013, Pg 498
Question 177: Correct Answer: B
Explanation: Ans: b. Sah sudden onset of a severe headache (often described as 'the worst headache of my
life') nausea and vomiting stiff neck sensitivity to light (photophobia) blurred or double vision loss of
consciousness seizures
Question 178: Correct Answer: D
Explanation: Ref- Bailey and Love, Short practice of surgery, 27th edition
Question 179: Correct Answer: C
Explanation: Ans. C. Coefficient of regression The coefficient of correlation tells about the strength of
association but not about quantity. On the other hand, the coefficient of regression is used for quantification.
If we wish to know in an individual case the value of one variable, knowing the value of the other, we
calculate what is known as the regression coefficient of one measurement to the other. It is customary to
denote the independent variable by x and the dependent variable by y.
Question 180: Correct Answer: B
Explanation: And: B. Hypermetropia >Patients with refractive esotropia are typically farsighted (hyperopic). >

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This means that the eyes must work harder to see clearly, particularly when the object of regard is up close.
https://aapos.org/glossary/accommodative-esotropia
Question 181: Correct Answer: A
Explanation: Ans: A. Lead poisoning Findings Microcytic Anemia - Iron Deficiency Hypersegmented
Neutrophils - B12 and Folic Acid Deficiency Young & No H/o Of Alcohol Consumption [Patient came with a
history of Fatigue and Tiredness] - Chronic Alcoholism can be ruled out Hemolytic Anemia - may
demonstrate red blood cell fragments called schistocytes, red blood cells that look like spheres
(spherocytes), and/or red blood cells missing small pieces (bite cells). An increased number of newly made
red blood cells (reticulocytes) may also be a sign of bone marrow compensation for anemia.
Question 182: Correct Answer: C
Explanation: Answer- C- Plexiform neurofibroma Plexiform neurofibromas represent an uncommon variant of
NF-1 in which neurofibromas arise from multiple nerves as bulging and deforming masses involving also
connective tissue and skin folds— hence the clinical description of lesions as “bags of worms.”
Question 183: Correct Answer: C
Explanation: Ans. C. Hypochlorous acid Hypochlorous acid is the most effective form of chlorine for water
disinfection. The active component of bleaching powder, CaOCl2, is hypochlorous acid. The disinfecting
action of chlorine is mainly due to hypochlorous acid, and to a small extent due to the hypochlorite ions.
Park’s PSM 24th ed. Page no. 138
Question 184: Correct Answer: D
Explanation: Ans. D. Transcervical hysteroscopic resection of the septum Hysteroscopic metroplasty is more
commonly done. Resection of the septum can be done either by a resectoscope or by laser. Advantages are:
High success rate (80–89%), Short hospital stay Reduced postoperative morbidity (infection or adhesions)
Subsequent chance of vaginal delivery is high compared to abdominal metroplasty where the cesarean
section is mandatory. Other methods: Abdominal metroplasty could be done either by excising the septum
(Strassman, Jones, and Jones) or by incising the septum (Tompkins). Ref. Dutta Gynaecology ed. 6th page
no. 47 1. 2. 3. 4.
Question 185: Correct Answer: A
Explanation: Answer-A- Cryptosporidium * The origin of infectious diarrhea in patients with AIDS can be
divided into 2 general categories: that caused by common pathogens and that caused by opportunistic
pathogens. * The most common infectious organisms causing AIDS-related diarrhea include -
Cytomegalovirus (CMV) - The parasites Cryptosporidium, - Microsporidia - Giardia lamblia * And the
bacterium Mycobacterium avium-intracellulare (MAC). * Other bacteria and parasites that cause diarrheal
symptoms in otherwise healthy people may cause more severe, prolonged or recurrent diarrhea in people
with HIV or AIDS https://aidsinfo.nih.gov/news/175/aids-related-diarrhea
Question 186: Correct Answer: A
Explanation: Ans. A. Polio When given during pregnancy, the Tdap vaccine boosts antibodies in the mother,
which are transferred to her developing baby. Early third-trimester administration optimizes neonatal
antibody levels. Ref. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168293/pdf/ciu327.pdf 1)
Question 187: Correct Answer: A
Explanation: Ans.a.Exudative Retinal detachment. >In exudative retinal detachment, the subretinal fluid may
be confined to a localized area, usually the posterior pole, or may extend to the periphery, even forming
bullous retinal detachment. >The characteristic feature of a significant exudative retinal detachment is the
presence of shifting subretinal fluid. >The fluid shifts to the most dependent location when patients change

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body position. https://clinicalgate.com/nonrhegmatogenous-retinal-detachment/
Question 188: Correct Answer: B
Explanation: Ref- Bailey and Love, Short practice of surgery, 27th edition published in 2018 Pg 988
Tenderness along the line of femoral or popliteal veins 1 Entire limb swollen 1 Calf >3cm larger
circumference than the other side 1 10cm below the tibial tuberosity 1 Pitting edema 1 Dilated
collateral superficial veins (not varicose veins) 1 Previous DVT 1 Malignancy (including treatment up to
6 months ago) 1 Intravenous drug abuse 3 Alternative diagnosis more likely than DVT -2
Question 189: Correct Answer: C
Explanation: Ans. C. Single-dose TT A patient with wound less than 6 hours old if clean, non-penetrating and
with negligible tissue damage if had a complete course of toxoid or a booster dose more than 10 years
ago(category C) should be treated with Toxoid 1 dose. Park’s PSM 24th ed. Page no. 331
Question 190: Correct Answer: C
Explanation: Ans : C. Red bag The black bag is used for collecting dry waste material which is not infectious.
Materials like paper, plastics, cardboard boxes, and other dry waste generated in the hospital office or in the
wards are disposed of in this bag. This is not biomedical waste. The red bag is used for the disposal of
plastics collected from operation theaters, ICUs and wards. The yellow bag is used for highly infectious items
like a pathological waste, human anatomical waste such as body parts, amputated parts/organs, tumors,
placentas, aborted or dead fetuses, blood- soaked cotton bandages, animal tissues, organs, carcasses, etc.
Blue or White opaque bag is used for collecting the segregated metal sharps such as needles, blades, saws,
scalpels, and glass pieces. Ref Park 23'/e p. 793-794]
Question 191: Correct Answer: B
Explanation: Ans:b.The macula and Optic nerve diseases. >To distinguish optic nerve conduction defects
from the macular disease in patients with otherwise unexplained loss of central vision we first determined the
best visual acuity with correction at distance in unilateral defects. > The normal eye was tested first and
photo stressed for ten seconds by looking at an ordinary penlight held 2 to 3 cm from the eye. >The time
required to read three letters on three Snellen test lines just larger than the best acuity was used as the
endpoint. >Recovery time will be prolonged with maculopathy. >Prolonged recovery time will not be
observed in patients who have optic nerve disease. https://www.ncbi.nlm.nih.gov/pubmed/836667
Question 192: Correct Answer: B
Explanation: Ans.B.TB pelvis with Tubo ovarian mass The tubercles burst to pour the caseous material
inside the lumen producing tubercular pyosalpinx, which may adhere to the ovaries and the surrounding
structures. Often the infection spreads outwards producing peri salpingitis with exudation, causing dense
adhesions with the surrounding structures tubercular tubo-ovarian mass. Clinical diagnostic features:
Weakness, low-grade fever, anorexia, anemia or night sweats may be present. Infertility: It may be primary
or secondary Chronic pelvic pain Vaginal discharge— postcoital bleeding or a blood-stained discharge.
Constitutional symptoms such as loss of weight, malaise, anorexia,
Question 193: Correct Answer: B
Explanation: Ans: B. Interossei and lumbricals Hyperextension of metacarpophalangeal joint and flexion of
the interphalangeal joint is due to palsy of lumbricals and interossei muscles. The action of Lumbricals:
Flexion of MCP, Extension of IP joint The action of Palmar interossei: Adduction of fingers The action of
Dorsal interossei: Abduction of fingers Ref: BDC, 7th edition, volume 1, pg no. 163.
Question 194: Correct Answer: D
Explanation: Ans:D.)Laryngeal Mask Airway Laryngeal mask airway A type of supraglottic airway. It is also

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referred to as Brain mask as it was invented by Dr. Archies Brain. LMA provides an airway intermediate
between the face mask and tracheal tube It is a medical device that keeps a patient's airway open during
anaesthesia or unconsciousness. The principle of LMA is that it provides an effective gas-tight seal around
the laryngeal inlet without anything having to pass through the vocal cord. LMA is very effective in
maintaining a patent airway in the spontaneously breathing patient.
Question 195: Correct Answer: C
Explanation: Ans: C. IPC 193 Defines punishment for fabricating false evidence The witness is liable to be
prosecuted for perjury, and the imprisonment may extend up to seven years. 193 IPC: punishment for false
evidence, (punishment for perjury): imprisonment up to 7 years and also liable for fine I91 IPC: Giving false
evidence (perjury) under oath. I92 IPC: Fabricating false evidence (perjury) THE ESSENTIALS OF
FORENSIC MEDICINE AND TOXICOLOGY -Dr. K.S. NARAYAN REDDY 33rd edition-pg-13
Question 196: Correct Answer: A
Explanation: Ans. A. Imperforate hymen According to the clinical case, patients suffer from primary
amenorrhea and cryptomenorrhea(cyclic abdominal pain). The girl is aged about 14–16 years. The chief
complaints are periodic lower abdominal pain, which may be continuous, primary amenorrhea and urinary
symptoms, such as frequency, dysuria or even retention of urine. In fact, in significant cases, the presenting
feature may be the retention of urine. The cause of retention is due to the elongation of the urethra. An
abdominal examination reveals a suprapubic swelling, which may
Question 197: Correct Answer: D
Explanation: Ans: D. Folate therapy caused rapid use of Vit B12 stores aggravating symptoms Vitamin B12
is required for the recycling of tetrahydrofolate, the form of folate that is needed for DNA synthesis. In
keeping with this relationship, the anemia of vitamin B12 deficiency is reversed with the administration of
folate. By contrast, folate administration does not prevent and may, in fact, worsen the

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 Subject: NEET PG 2013 - Questions
1. which level the somites initially form ?
a) Thoracic level
b) Cervical level
c) Lumbar level
d) Sacral level

2. Saccharolytic species of clostridia ?

a) C. tetani
b) Cl. cochlearum
c) Cl. septicum
d) None

3. All of the following are features of

Obstructive jaundice except:
September 2007
a) Normal alkaline phosphatase
b) Mildly elevated serum aminotransferases level
c) Clay colour stools
d) Pruritis

4. Schiller- Duval bodies is seen in

a) Choriocarcinoma
b) Embryonal cell Ca
c) Endodermal sinus tumour
d) Immature teratoma

5. Significant value of `p is ?
a) 0.01
b) 0.02
c) 0.04
d) 0.05

6. Most common cause of pleural effusion

in AIDS patients
a) Kaposi sarcoma
b) TB
c) Pneumocystis Jiroveci
d) Mycoplasma

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7. Maximum first pass metaboilsm is seen
by which route ?
a) Intravenous
b) Interaarterial
c) Rectal
d) Oral

8. The energy for glycogenesis is provided

by -
a) GTP
b) GDP
c) UTP
d) AMP

9. All statements are true about trachoma

except
a) Trachoma is caused by bedsonian organism of psittacosis -
lymphogranuloma - trachoma (PLT) group.
b) Strains mainly responsible are A, B, Ba and C
c) Marked papillary hyperplasia with limbal follicles are seen in
stage III
d) Corneal ulcerstion is a complication

10. Eutectic mixture of local anaesthetic

(EML
a) cream is
a) Bupivacaine 2.0% + Prilocaine 2.5%
b) Lidocaine 2.5% + Prilocaine 2.5%
c) Lidocaine 2.5% + Prilocaine 5%
d) Bupivacaine 0.5% + Lidocaine 2.5%

11. An adolescent male developed vomiting

and diarrhea 1 hour after having food
from a restaurant. The most likely
pathogen is?
a) Clostridium perfringens
b) Vibrio parahaemolyticus
c) Staphylococcus aureus
d) Salmonella

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12. Pelvic pain is mediated by ?
a) Pudendal nerve
b) Sciatic nerve
c) Autonomic nerves
d) None of the above

13. Botulinum toxin mimics -

a) Cholinergics
b) Anticholinergics
c) Adrenergics
d) Antiadrenergic

14. In senile nuclear cataract what type of

myopia is seen?
a) Curvature myopia
b) Index myopia
c) Axial myopia
d) Positional myopia

15. Hearing loss of 65dB, what is the grade

of deafness?
a) Mild
b) Moderate
c) Severe
d) Moderately severe

16. The procedure of choice for the

evaluation of aortic aneurysm is -
a) Ultasonography
b) Computed tomography
c) Magnetic resonance imaging
d) Arteriography

17. Arcuate field defect akin to glaucoma is

seen in?
a) Pituitary tumor
b) Occipital lobe infarct
c) Optic nerve lesion
d) None of the above

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18. Nail pitting is caused by all except ?
a) Lichen planus
b) Hyperthyroidism
c) Fungal infection
d) Pityriasis Rosacea

19. Which is not a DNA virus ?

a) Parvovirus
b) Papovavirus
c) Poxvirus
d) Rhabdovirus

20. Saddle nose is ?

a) Depressed nose
b) Crooked nose
c) Deviated nose
d) C-shaped

21. In which one of the following conditions

is gas under diaphragm not seen-
a) Perforated duodenal ulcer
b) Typhoid perforation
c) After laparotomy
d) Spontaneous rupture of oesophagus

22. Brown macular pigmentation in malar

area in a pregnant female is due to ?
a) Acne rosacea
b) Cholasma
c) Acanthosis nigricans
d) Urticaric pigmentosa
1. 2.

23. Milk ring test is done to detect which

organism present in milk?
a) Bordetella
b) Brucellosis
c) Bartonella
d) Salmonella

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24. Enhancement in CT contrast is due to -
a) Iodine
b) Gadolinium
c) Silver
d) Mercury

25. Inhibition of myenteric plexus results in

a) Hyperacidity
b) Diarrhea
c) Decreased gut motility
d) Increased secretions

26. Amoebic liver abscess can be diagnosed

by demonstrating-
a) Cysts in the sterile pus
b) Trophozoites in the pus
c) Cysts in the intestine
d) Trophozoites in the feces

27. High spinal anaesthesia is associated

with?
a) Decreased BP & decreased heart rate
b) Increased BP & decreased heart rate
c) Decreased BP & increased heart rate
d) Increased BP & increased heart rate

28. Most common location of gastrinoma is:

September 2007
a) Pancreas
b) Duodenum
c) Jejunum
d) Gall bladder

29. All insects have developed resistance to

DDT except?
a) Mosquito
b) Flea
c) Tsetse flies
d) Ticks

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30. Which of the following is true of
Wilsons disease all except -
a) Autosomal recessive
b) Serum ceruloplasmin level < 20 mg/d1
c) Urinary coppor excretion < 100 microgram/c11
d) Zinc acetate is used as maintence therapy

31. Which of the following drug can casue

thyroid dysfunction?
a) Amiodarone
b) Ampicillin
c) Ibutilide
d) Acyclovir

32. Most common cause of post-measles

death ?
a) Diarrhea
b) RTI
c) SSPE
d) Myocarditis

33. 2. 276. Anaerobic glycolysis occurs in all places

except
a) Muscles
b) RBCs
c) Brain
d) Kidney

34. The sign of reversible injury in a case of

alcoholic liver disease -
a) Loss of cell membrane
b) Nuclear karyolysis
c) Cytoplasmic vacuole
d) Pyknosis

35. Lymphatic drainage of orpharynx is

mainly through?
a) Superficial cervical lymph nodes
b) Submandibular nodes
c) Jugulodigastric node
d) Jugulo-omohyoid nodes

Page 126 of 446

36. Urinary bladder spasmolytic having local
anaesthetic property-
a) Tamsulosin
b) Terazosin
c) Oxybutynin
d) Yohimbine

37. All of the sterilization methods are

properly matched except ?
a) Catgut suture - Radiation
b) Culture media - Autoclaving
c) Bronchoscope - Autoclaving
d) Glassware & syringes - Hot air ove

38. Cheilography is the study of ?

a) Finger prints
b) Lip prints
c) Breath analysis
d) Foot prints

39. Nocturnal enuresis may be considered

normal upto:
March 2005
a) 3 years
b) 4 years
c) 5 years
d) 6 years

40. Cepacia syndrome fulminant illness

seen in
a) Sarcoidosis
b) Cystic fibrosis
c) Tuberculosis
d) Immotile cilia sydrome

41. DOC of GTCS in pregnancy

a) Lamotrigine
b) CBZ
c) Levetiracetam
d) Valproate

Page 127 of 446

42. Sweaty feet odor in urine is seen in ?
a) Phenylketonuria
b) Maple syrup urine
c) Isovaleric acidemia
d) Alkaptonuria

43. The international quarantine period for

yellow fever as approved by the
Government of India is ?
a) 6 days
b) 9 days
c) 10 days
d) 12 days

44. Classical triad of global confusion,

ataxia and ophthalmoplegia is seen in ?
a) Alzheimers disease
b) Delerium tremors
c) Wernickes encephalopathy
d) Korsakoff psychosis

45. All of the following are features of

interstitial lung disease except
a) Exertional dyspnea
b) Early productive cough
c) Digital clubbing
d) Coarse crepitation during clubbing

46. Abdominojugular reflex appears after

compressing abdomen for
a) 5 sec
b) 10 sec
c) 15 sec
d) 30 sec

47. What is seen in withdrawal reflex ?

a) Extension
b) Flexion
c) Extension followed by flexion
d) None of the above

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48. 2. 1. 1284. Which is not a stroke
a) TIA
b) Hemiplegia
c) SAH
d) Intracerebral hemorrhage

49. Fever increase water losses by mUday

per degree Celsius
a) 100
b) 200
c) 400
d) 800

50. Pavlovs experiment is an example of which of the following learning

theory?
a) Modeling
b) Classical conditioning
c) Operant conditioning
d) Learned helplessness

51. Intracorpuscular hemolytic anemia is

seen in ?
a) Autoimmune hemolytic anemia
b) TIP
c) Thalassemia
d) Infection

52. Result of liquorice ingestion

a) Hyperkalemic alkalosis
b) Hypokalemic alkalosis
c) Hypokalemic acidosis
d) Hypermalemic acidosis

53. Precentral gyrus & corticospinal tract are

essential for?
a) Vision
b) Olfaction
c) Auditory
d) Voluntary movement

Page 129 of 446

54. Drug of choice for familial
hypercholesterolemia ?
a) Gemfibrogil
b) Nicotinic acid
c) Lovastatin
d) Ceholestgramin

55. Half life of T3 ?

a) 10 hours
b) 1 day
c) 6 days
d) 10 days

56. The difference between contamination

and infection is that in infection-
a) Infectious agent is on body surface or on non human objects
b) Infectious agent is in the body of human
c) Arthropods on the body surface
d) None

57. The term "balanced anaesthesia" has

been given by?
a) Simpson
b) Fischer
c) Lundy
d) Mortan

58. Cerebellar damage causes all except ?

a) Dysmetria
b) Hypertonia
c) Ataxia
d) Past-pointing

59. Oedipus complex is related to which

phase of psychosexual development ?
a) Oral
b) Anal
c) Genital
d) Phallic

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60. Inclusion body containing glycogen is
seen in ?
a) Chlamydia trachomatis
b) Chlamydia pneumoniae
c) Chlamydia psittaci
d) All of the above

61. Investigation with least radiation dose

in the diagnosis Meckels diverticulum
is -
a) CT
b) MRI
c) Contrast radiography
d) Technetium -99m scanning

62. HMP shunt occurs in all organs except ?

a) Liver
b) Adipose tissue
c) RBC
d) Brain

63. Scissor reflex is seen in ?

a) Open angle glaucoma
b) Phlyctenular conjunctivitis
c) Keratoconus
d) Interstitial keratitis

64. ECT is contraindicated in -

a) Very ill patients
b) Raised ICT
c) Heart disease
d) Pregnancy

65. Arch of Aorta develops from which aortic

arch artery ?
a) Right Pt
b) Right 3rd
c) Left 4th
d) Left 3rd

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66. Calcified pulmonary metastasis is seen
in which carcinoma -
a) Pancreatic carcinoma
b) Thyroid carcinoma
c) Endometrial carcinoma
d) None

67. Most common infection in contact lens

users is?
a) Streptococcus
b) Pseudomonas
c) Staphylococcus
d) Neisseria

68. Glomerulonephritis in streptococcal

infection is diagnosed by -
a) Blood culture
b) Throat culture
c) ASO Titre
d) PCR

69. Fibrinoid necorsis with neutrophilic

infiltration is seen in ?
a) PAN
b) Giant cell arteritis
c) Takayasu arteritis
d) Wegeners granulomatosis

70. The treatment of choice for squamous cell anal cancer?

a) Laser fulgaration
b) Chemoradiotherapy
c) Abdominoperennial resection
d) Platinum-based chemotherapy

71. Tonsillar fossa is bounded anteriorly by

?
a) Pharyngobasilar fascia
b) Palatopharyngeal fold
c) Buccopharyngeal fascia
d) Palatoglossal fold

Page 132 of 446

72. People are separated into groups, from
each group people are selected
randomly. What type of sampling is this -
a) Simple random
b) Stratified random
c) Systemic random
d) Cluster

73. Sugars are primarily absorbed in ?

a) Duodenum
b) Jejunum
c) Ileus
d) Ascending colon

74. At mu receptor, buphrenorphine is?

a) Partial agonist
b) Partial antagonist
c) Complete agonist
d) Complete antagonist

75. Hexokinase is inhibited by ?

a) Glucose-6-phosphate
b) Glucagon
c) Glucose
d) Insulin

76. Term Psychiatry was coined by ?

a) Moral
b) Johann reil
c) Bleuler
d) Pinel

77. Hyoid bone fracture does not occur

in:
NEET 14
a) Hanging
b) Strangulation
c) Throttling
d) Choking

Page 133 of 446

78. All are true about chaperones except ?
a) Cause folding of proteins
b) Are lipid in nature
c) May have ATPase activity
d) Include heat shock proteins

79. All are intracranial complications of

otitis media except?
a) Lateral sinus thrombophlebitis
b) Facial nerve palsy
c) Brain abscess
d) Hydrocephalus

80. Glutathione requires which vitamin to act

as antioxidant ?
a) Vitamin E
b) Niacin
c) Vitamin C
d) Vitamin A

81. Blood transfusion should be completed

within hours of initiation
a) 1- 4 hours
b) 3- 6 hours
c) 4- 8 hours
d) 8- 12 hours

82. All sections of IPC are related to

grievous hurt, except
a) Sec. 320
b) Sec. 331
c) Sec. 326
d) Sec. 319

83. Elimination after 4 half lives in first order

Kinetics is
a) 84%
b) 93%
c) 80.5%
d) 4.75%

Page 134 of 446

84. Unmet needs of contraception to met
according to NFH S-3
a) Women < 20 years
b) Women after puperium
c) Women after 1 week delivery
d) After illegal abortion

85. Type of necrosis in pancreatitis ?

a) Fibrinoid
b) Coagulative
c) Fat
d) Caseous

86. 2. 3. 4. 5. 6. 7. 870. Screening for condition recommended

when ?
a) Low case fatality rate
b) Diagnostic tools not available
c) No effective treatment available
d) Early diagnosis can change disease course because of
effective treatment

87. All are obstructive lung disease except -

a) Emphysema
b) Interstitial fibrosis
c) Asthma
d) Bronchitis

88. Primary hormone for secretion of milk ?

a) Oxytocin
b) Prolactin
c) Glucocorticoids
d) Relaxin

89. 2. 3. 4. 5. 6. 7. 8. 1. 2. 1524. Cause of Coxa vera ?

a) Congenital
b) Perthes disease
c) SCFE
d) All of the above

Page 135 of 446

90. Ossicles of middle ear are responsible
for which of the following ?
a) Amplification of sound intensity
b) Reduction of sound intensity
c) Protecting the inner ear
d) Reduction of impedance to sound transmission

91. Reis-Buckler dystrophy affects which

layer of cornea
a) Epithelium
b) Stroma
c) Bowmans membrane
d) Endothelium

92. In which disease, symptoms improve

with crying -
a) Tetralogy of fallot
b) Choanal atresia
c) Bronchial asthma
d) All of above

93. Child wakes up at night sweating and

terrified does not remember the
episode-diagnosis?
a) Narcolepsy
b) Nightmares
c) Night terrors
d) Somnambulism

94. Etiology of bloody discharge from

nipple
a) Duct papiloma
b) Breast abscess
c) Fibroadenoma
d) Cyst

95. Cardiac conduction defect seen with

Tricyclic an tidepressants are due to ?
a) NE & serotonin uptake inhibitor
b) Antimuscarinic action on heart
c) Only NE uptake inhibition
d) Both NE uptake inhibition and antimuscarinic action on heart

Page 136 of 446

96. Chances of uterine rupture are least in -
a) LSCS
b) Classic
c) Inverted
d) Low vertical

97. Frequency of woods lamp is ?

a) 365 nm
b) 400 nm
c) 320 nm
d) 200 nm

98. Bilateral recurrent laryngeal nerve palsy

is seen in all except ?
a) Thyroid carcinoma
b) Lymphadenopathy
c) Thyroid surgery
d) Aortic aneurysm

99. Which thalamic nuclei can produce basal

ganglia symptoms ?
a) Lateral dorsal
b) Pulvinar
c) Ventral anterior
d) Intralaminar

100. High priority in triage is for -

a) Red color
b) Yellow color
c) Green color
d) Black color

101. Water shed infarct in brain

a) Occurs in the proximal portion of main arteries
b) Occurs in the central portion of main arteries
c) Occurs in the terminal portion of main arteries
d) Any of the above

Page 137 of 446

102. Quantum of punishment in dowry death
is ?
a) 7years
b) 5 years
c) Death
d) 10 years

103. Which of the following has only 1

serotype -
a) C psittaci
b) C pneumoniae
c) C trachomatis
d) None

104. Chronic atrophy of adrenal gland will

result in which hormone deficiency ?
a) CRH
b) ACTH
c) Cortisol
d) MSH

105. Tattooing around the entry wound is

seen in ?
a) Close shot
b) Contact shot
c) Distant shot
d) All of the above

106. During functional endoscopic sinus

surgery the position of patient is
a) Trendelenberg
b) Lateral
c) Reverse trendelenberg
d) Lithotomy

107. 2. 317. Keratin is a ?

a) Globular protein
b) Cylindrical protein
c) Fibrous protein
d) None of the above

Page 138 of 446

108. Amyloidosis occurs in all except
a) Tuberculosis
b) Chronic bronchitis
c) Osteomyelitis
d) Bronchiectasis

109. The tensile strength of wound reaches

that of tissue by ?
a) 6 weeks
b) 2 months
c) 4 months
d) None

110. 2. 97. Deep injury of neck always involves

a) Platysma
b) Tropezius
c) Sternocleidomastoid
d) Longus colli

111. HLA is located on ?

a) Short arm of chr-6
b) Long arm of chr-6
c) Short arm of chr-3
d) Long arm of chr-3

112. All are features of haemolytic uremic

syndrome, except-
a) Hyperkalemia
b) Anaemia
c) Renal microthrombi
d) Neuro psychiatric disturbances

113. Gyromagnetic property of proton is

seen in -
a) MRI
b) CT
c) PET scan
d) USG

Page 139 of 446

114. Chief artery of lateral surface of cerebral
hemisphere ?
a) Anterior cerebral artery
b) Posterior cerebral artery
c) Middle cerebral artery
d) Posterior inferior cerebellar artery

115. Upper Lid Retractors include

a) Muller muscle and superior rectus
b) Levator palpabrae superioris and superior oblique
c) Superior oblique and superior rectus
d) Levator palpabrae superioris & muller muscle

116. Spot map is used for ?

a) Local distribution of disease
b) Rural-urban variation
c) National variation
d) None

117. Kehrs sign seen in splenic rupture is -

a) Pain over left shoulder
b) Pain over right scapula
c) Periumbilical pain
d) Pain over renal angle

118. Riboflavin deficiency is assessed by ?

a) Transketolase
b) Glutathione reductase
c) PDH
d) None

119. Duanne syndrome involves?

a) Superior oblique
b) Inferior oblique
c) Lateral rectus
d) Superior rectus

120. Polar amino acids are all except ?

a) Glutamic acid
b) Histidine
c) Glutamine
d) Methionine

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121. Ratio of connective tissue : smooth
muscle in cervix is ?
a) 2:1
b) 5:1
c) 8:1
d) None

122. Torsades de pointes is seen in all

except
a) Hyponatremia
b) Hypocalcemia
c) Hypomagnesemia
d) Hypokalemia

123. Pencil in cup deformity is seen in ?

a) Rheumatoid arthritis
b) Ankylosing spondylitis
c) AVN
d) Psoriatic arthritis

124. Not a hepatotoxic drug ?

a) Chlorpropamide
b) Allopurinol
c) Streptomycin
d) Halothane

125. All are true regarding interleukin-1

except ?
a) Primary source is monocyte-macrophage system
b) Endogenous pyrogens
c) Inhibit IL-2 production by T-cells
d) All are true

126. Jelly formed around the heart tube during

early development, contributes to the
formation of:
a) Pericardium
b) Mesocardium
c) Myocardium
d) Endocardium

Page 141 of 446

127. 2. 3. 4. 771. Consumption of uncooked pork is likely
to cause which of the following
helminthic disease -
a) Taenia saginata
b) Taenia solium
c) Trichuris trichiura
d) None of these

128. Vallecula sign is seen in ?

a) TB laryngitis
b) Vocal nodule
c) Inverted papilloma
d) Acute epiglottitis

129. Cryoprecipitate is useful in?

a) Hemophilia A
b) Thrombosthenia
c) A fibrogenemi a
d) Warfarin reversal

130. 2. 3. 4. 5. 6. 7. 8. 846. According to MDG child mortality has to

be reduced by how, much by 2015 ?
a) One third
b) Half
c) Two third
d) One fourth

131. Major apolipoprotein of chylomicrons ?

a) B-100
b) D
c) B-48
d) None

132. The following are suitable for simple

mastectomy except-
a) Pagets disease
b) Fibroadenoma
c) Cystosarcoma phyllodes
d) None

Page 142 of 446

133. Which of the following is best for
transport of the newborn with
maintainance of warm temperature ?
a) Kangaroo Mother Care (KMC)
b) Transport incubator
c) Thermacol box
d) Hot bottle

134. Rosens incision is used for ?

a) Septoplasty
b) SMR
c) Stapedectomy
d) Tonsillectomy

135. False about wound healing ?

a) Inhibited by infection
b) Inhibited by DM
c) Inhibited by hematoma
d) Inhibited by foreign body

136. Which hormone is responsible for acne

?
a) Estrogen
b) Thyroid
c) Testosterone
d) Gonadotropins

137. Most common congenital anomaly of

kidney
a) Ectopic kidney
b) Renal duplication
c) Horse shoe kidney
d) Renal agenesis

138. Patterns of Inter-relationships between

persons in a society is ?
a) Social structure
b) Social psychology
c) Herd structure
d) Social science

Page 143 of 446

139. Peritonsillar abscess is caused most
commonly by ?
a) Streptococcus pneumoniae
b) Staphylococcus aureus
c) Beta hemolytic streptococcus
d) H. influenzae

140. Pyridoxine is used in treatment of ?

a) Galactosemia
b) Phenylketonuria
c) Propionic acidemia
d) Homocystinuria

141. A 55 year male has history of dysphagia

with vomiting of undigested food
throughout the day, weight loss,
emaciated & dehydrated. No mass
palpable per abdomen. The modality of
treatment is
a) IV total parenteral nutrition
b) Endoscopic dilation
c) IV normal saline
d) pH monitoring

142. Which lymph nodes drain upper vagina &

cervix?
a) Para aortic
b) External iliac
c) Superior inguinal
d) Deep inguinal

143. X-ray Artifact is -

a) A radiolucent area
b) Any abnormal opacity in the radiograph
c) Produced when patient moves while taking the shoot
d) All the above

144. Resolution of inflammation caused by ?

a) TNF Alfa, IL-1 and CRP
b) TNF beta, IL-6 and CRP
c) TNF Alfa, IL 10 and IL 1 receptor antagonist
d) TNF gamma

Page 144 of 446

145. Treatment of choice for lichen planus ?
a) Topical corticosteroids
b) Systemic corticosteroids
c) Antihistaminics
d) Acitretin

146. Thumb print appearance in culture film

smear is seen -
a) Bacillus anthracis
b) Brucella, species
c) Bordetella pertussis
d) Clostridium Welchii

147. Which thalamic nuclei connects with

neocortex?
a) Palvinar
b) Intralaminar
c) Anterior
d) All

148. Young male with history of trauma

having left sided testis swollen &
erythematous. Other side normal
diagnosis
a) Torsion
b) Carcinoma
c) Hematoma
d) Hernia

149. Cryoprecipitate is useful in?

a) Hemophilia A
b) Thrombosthenia
c) A fibrogenemi a
d) Warfarin reversal

150. Lithotomy position increases vaginal

opening by how many cm -
a) 1cm
b) 2cm
c) 3cm
d) 4cm

Page 145 of 446

151. 2. 3. 1538. Moth eaten bone is ?
a) Osteoid osteoma
b) Multiple myeloma
c) Eosinophilic granuloma
d) Chondromyxoid fibroma

152. Standard in perimetry ?

a) Goldman type I
b) Goldman type II
c) Goldman type III
d) Goldman type IV

153. Which is not used in status epilepticus?

a) Lorazepam
b) Phenytoin
c) Phenobarbitone
d) Valproate

154. Systemic sclerosis shows all except

a) Acroosteolysis
b) Tufting
c) Calcinosis cutis
d) Digital ulcers

155. 2. 3. 1110. A child has got a congenital cataract

involving the visual axis which was
detected by the parents right at birth.
This child should be operated:
a) Immediately
b) At 2 months of age
c) At 1 year of age when the globe becomes normal sized
d) After 4 years when entire ocular and orbital growth becomes
normal

156. Dacron vascular graft is a:

a) Textile biologic
b) Textile synthetic
c) Nontextile biologic
d) Nontextile synthetic

Page 146 of 446

157. Good prognostic factor for
schizophrenia is ?
a) Blunted affect
b) Early onset
c) Presence of depression
d) Male sex

158. Jobs syndrome is the following type of

immuno nodeficiency disease
a) Humoral immunodeficiency
b) Cellular immunodeficiency
c) Disorder of complement
d) Disorder of phagocytosis

159. Thurston Holland sign is seen in ?

a) Type I
b) Type II
c) Type III
d) Type IV

160. A temporary, provisional view held by the people on a point of view is:
a) Opinion
b) Belief
c) Practice
d) Attitude

161. Non-sterile hypopyon is seen in ?

a) Pneumococcus infection
b) Pseudomonas infection
c) Fungal infection
d) Gonococcal infection

162. Abdominal surgery under LA, patient

suddenly felt pain due to
a) Liver
b) Gut
c) Parietal peritoneum
d) Visceral peritoneum

Page 147 of 446

163. Mechanism of action of cholecystokinin
?
a) Activation of adenylyl cyclase
b) Opening of ion channels
c) Through IP3- DAG system
d) Transcription facters

164. A:G maintained in

a) Nephritic syndrome
b) Cirrhosis
c) Protein losing enteropathy
d) Multiple myeloma

165. Mugging is compression of neck by ?

a) Wooden sticks
b) Rope
c) Forearm
d) Hand

166. Incest is defined as sexual intercourse

between ?
a) Man and animals
b) Man and closely related women
c) Man and women other than wife
d) Man and man

167. Weber ferguson approach is used for?

a) Mastoidectomy
b) Maxillectomy
c) Myringoplasty
d) Mandibulectomy

168. Myelodysplastic syndrome is common

in which age group
a) 2-10yrs
b) 15-20yrs
c) 25-40 yrs
d) > 50yrs

Page 148 of 446

169. Which of the following stage of Breast Ca corresponds with following
feature?
Breast mass of 6 x 3 cm. size
Ipsilateral supraclavicular lymph node
Distant metastasis cannot be assessed
a) T4 N3 MX
b) T4 N1 M1
c) T4 N0 M0
d) T3 N3c MX

170. All are true about Polycythemia vera

except
a) Increased vit B12
b) Decrease LAP score
c) Leucocytosis
d) Increased platelets

171. Lowest pH is seen in which of the

gastrointestinal secretion?
a) Gastric juice
b) Bile juice
c) Saliva
d) Pancreatic juice

172. Hyoid lies at the level of ?

a) C3
b) C,
c) C7
d) T2

173. Freys syndrome is caused by ?

a) Post traumatic nerve fibres of facial nerve with parasympathetic
of auriculotemporal nerve
b) Greater auricular with auriculotemporal nerve
c) Facial nerve with greater auricular nerve
d) None

174. All are major complications of massive

transfusion except
a) Hypokalemia
b) Hypothermia
c) Hypomagnesemia

Page 149 of 446

d) Hypocalcemia

175. CT Scan finding in carotid cavernous

sinus fistula is -
a) Enlarged superior ophthalmic vein
b) Enlarged inferior ophthalmic vein
c) Enlarged superior ophthalmic artery
d) Enlarged inferior ophthalmic artery

176. Angiotensin II causes all of the following, EXCEPT:

a) Stimulation of thirst
b) Aldosterone secretion
c) Increased ADH secretion
d) Vasodilation

177. Daily salivary secretion is

a) 250-500 ml
b) 1000-1500 ml
c) 2000-2500 ml
d) 3000 ml

178. Delta-sign is seen in ?

a) Petrositis
b) Acute mastoiditis
c) Sigmoid sinus thrombosis
d) Glomus tumor

179. Not true about hereditary spherocytosis

a) Defect in ankyrin
b) Decreased MCV
c) Decreased MCHC
d) Reticulocytosis

180. Neurovascular bundle of anterior

compartment of leg passes between the
tendons of ?
a) EHL and EDL
b) EDL and peroneus tertius
c) Tibialis anterior and EHL
d) None of the above

Page 150 of 446

181. All of the following are adverse effects of
nicotinic acid except ?
a) Vasodilation
b) Pancreatitis
c) Liver dysfunction
d) Hyperpigmentation

182. Muscle causing flexion of hip ?

a) Biceps femoris
b) Psoas major
c) Gluteus maximus
d) TFL

183. Pathognonomic of maniac episode is ?

a) Elevated mood
b) Grandiosity
c) Decreased appetite
d) Increased sleep

184. Which of the following is high energy

compound?
a) ADP
b) Glucose-6-phosphate
c) Creatine phosphate
d) Fructose-6-phosphate

185. Antibiotic sensitivity testing can be done

using all except
a) E test
b) Kirby-Bauer method
c) Culture agar method
d) Broth dilution method

186. Eye of a newborn is ?

a) Emmetropic
b) Hypermetropic
c) Myopic
d) Astigmatism

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187. Erlotinib is used in ?
a) Colon cancer
b) Pancreatic cancer
c) Gall bladder cancer
d) GIST

188. Seen in SIADH

a) Generalized edema
b) Ascites
c) Normal BP
d) Dry mucous membrane

189. Maximum correction of myopia can be

done by ?
a) Radial keratotomy
b) LASIK
c) Photorefractive keratotomy
d) Orthokeratology

190. Acute retropharyngeal abscess, not

true ?
a) Due to lymphadenitis
b) Common in adults
c) Swelling on one side of midline
d) Incision & drainage

191. Kochs postulate is fullfilled by all

except
a) M.tuburculosis
b) E.coli
c) T. pallidum
d) None

192. All are true about antemortem contusion

except?
a) Sequential color change
b) No inflammation
c) Raized enzyme levels
d) Blood cells in surrounding tissueAccidendal

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193. All are absolute indications of
tonsillectomy except
a) Suspicious malignancy
b) Peritonsillar abscess
c) Chronic tonsillits
d) Tonsils causing obstructive sleep apnea

194. The Fc piece of which immunoglobulin

fixes C1
a) IgA
b) IgG
c) IgM
d) c and b

195. Band test is done in ?

a) RA
b) SLE
c) Scleroderma
d) PAN

196. Transovarian transmission is seen in-

a) Rickettesial diseases
b) Malaria
c) Filaria
d) None

197. Which of the following anesthetic

agents have analgesic property:
a) Ketamine
b) Nitrous oxide
c) Thiopentone
d) a and b

198. Thalassemia gives protection against ?

a) Filaria
b) Kala-azar
c) Malaria
d) Leptospirosis

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199. Best test for lung fibrosis
a) Chest x-ray
b) MRI
c) HRCT
d) Biopsy

200. 2. 3. 1822. Ganser syndrome is a feature of ?

a) OCD
b) Conversion disorder
c) Dissociative disorder
d) Schizoid personality disorder

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 Subject: NEET PG 2013 - Answer Key

Question 1: Correct Answer: B

Explanation: - B
Ans. is b i.e., Cervical level
The first pair of somites develop a short distance posterior to the
cranial end of the notochord, and the rest of the somites from
caudally.
"By the 20" day, the first pair of somites have formed in neck region."
Textbook of embryology
Paraxial mesoderm differentiates into somites. By the end of 20th
day, the first pair of somites have formed in neck region. After this,
about 3 pairs of somites are formed per day and by the end of 5"
week about 42-44 somite pairs are formed (4-occipital, 8-cervical,
12-thoracic, 5-lumbar, 5-sacral and 8-10 cooccygeal). Somites are
further differentiated into :-
Dermatomyotome :- Give rise to skeletal muscles and dermis.
Sclerotomes :- Give rise to vertebral column.
Question 2: Correct Answer: C
Explanation: - C
Ans. is c i.e., Cl. septicum
Clostridia may break down carbohydrate for energy (saccharolytic)
or break down protein for energy Proteolytic) or both.
Different clostridia have a different pattern:-
A) Both proteolytic and saccharolytic
Pre-dominating proteolytic- Cl. sporogenes, Cl botulinum A.B.F.,
Cl. bifermentans, Cl. histolyticum.
Pre-Dominating Saccharolytic - Cl. perfringens, Cl. noyyi, Cl.
septicum, Cl. difficile.
B) Only proteolytic (not saccharolytic) - Cl. tetani
C) Only Saccharolytic (not proteolytic) - Cl. botulinum C.D.E.
D) Neither proteolytic nor saccharolytic - Cl. cochlear
Question 3: Correct Answer: A
Explanation: - A
Ans. A: Normal alkaline phosphatase
Obstruction to the flow of bile in common bile duct may result from
choledocholithiasis, malignancy od head of pancreas, bile ducts or
ampulla of Vater.
Charcots triad of intermittent fever, pain and jaundice is
characteristic of ascending cholangitis and indicates biliary
obstruction.
Hepatomegaly is present in most cases of obstructive jaundice and
is due to congestion and stretching out of intrahepatic biliary spaces.
A palpable gall bladder usually indicates obstruction of the distal

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CBD, due to other causes like underlying malignancy, than stone
(Courvoisiers law).
Hepatic bile flow suppression leads to jaundice accompanied by
dark urine (bilirubinuria) and light coloured (alcoholic) stools.
Bile salts and pigments in urine and absent urobilinogen also favour
the diagnosis of obstructive jaundice.
Serum albumin and prothrombin time are good indicators of liver
function derangement. Serum bilirubin levels indicate severity of
jaundice and high direct bilirubin rules out hemolytic jaundice.
Mild elevation of SGPT levels are also seen in obstructive jaundice
Question 4: Correct Answer: C
Explanation: - C
Ans. is c i.e., Endodermal sinus tumor
Yolk sac tumor (endodermal sinus tumor or infantile embryonal
carcinoma) —> Schiller - Duval bodies.
Leydig (interstitial) cell tumor -3 Reinke crystalloids.
Note : - Rienke crystals are also seen in the hilus cell tumor of ovary.
Question 5: Correct Answer: D
Explanation: - D
Ans. is d i.e., 0.05
P is the probability that the difference seen between 2 samples
occurs due to chance".
If p . .05 it is considered statistically significant.
It means that
There is 5% probability that the result could have been obtained by
chance. or
The investigator can be 95% sure that the result was not obtained by
chance.
Question 6: Correct Answer: A
Explanation: - A
Ans. is a i.e., Kaposi sarcoma
Ophthalmological diseases
The most common abnormal findings on fundoscopic examination
are cotton wool spots.
CMV retinitis is the most severe ocular complication and occurs
when CD4 T-cells count is less than 50/ml. It typical presents as
perivascular hemorrhage and exudae with Cottage-Cheese
appearance.
Acute retinal necrosis syndrome, also called progressive outer
retinal necrosis (PORN) is caused by HSV and VZV
Other manifestations are chorioretinitis by toxoplasma and P carinii,
kaposi sarcoma of eyelid, and lymphoma.
Question 7: Correct Answer: D
Explanation: - D

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Ans. is d i.e., Oral
First pass metabolism is seen with oral and rectal routes.
Maximum first pass metabolism is seen with oral route.
In rectal route, drug absorbed into external hemorrhoidal veins
bypasses liver, but not that absorbed into internal haemorrhoidal
veins ?First pass metabolism occurs, but less than oral route
(avoids first pass metabolism to 50%).
Most rapid onset of action is seen with I. route.
Bioavailability by I. V route is 100%.
Question 8: Correct Answer: C
Explanation: - C
Ans. is c i.e., UTP
Question 9: Correct Answer: C
Explanation: - C
C. i.e. Marked papillary hyperplasia with limbal follicles are seen in
stage III
>Trachoma is caused by a Bedsonian organism, the Chlamydia
trachomatis belonging to the Psittacosis-lymphogranulomatrachoma
(PLT) group.
>Serotypes A, B, Ba and C are associated with hyperendemic
(blinding) trachoma, while serotypes D-K are associated with
paratrachoma (oculogenital chlamydial disease).
>Congestion of upper tarsal and forniceal conjunctiva. 2.
Conjunctival follicles. Follicles look like boiled sagograins and are
commonly seen on upper tarsal conjunctiva and fornix; but may also
be present in the lower fornix, plica semilunaris and caruncle.
Sometimes, (follicles may be seen on the bulbar conjunctiva
(pathognomic of trachoma).
>Pannus i.e., infiltration of the cornea associated with
vascularization is seen in upper part
>Grading of trachoma McCallans classification McCallan in 1908,
divided the clinical course of the trachoma into following four stages:
Stage I (Incipient trachoma or stage of infiltration). It is characterized
by hyperaemia of palpebral conjunctiva and immature follicles.
Question 10: Correct Answer: B
Explanation: - B
Ans. is b i.e., Lidocaine 2.5% + Prilocaine 2.5%
Eutectic mixture of local anaesthetic (EMLA)
This is unique topical preparation which can anaesthetise intact skin.
It is a mixture of 2.5% lidocaine and 2.5 prilocaine.
It acts slowly and the cream must held in contact with skin for at
least 1 hour.
EMLA is used : to make venepuncture painless especially in
children, and for procedure like skin grafting & circumcision.
As systemic absorption of prilocaine can cause methemoglobinemia,

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EMLA should not be used on mucocutaneous membrane or in very
small child.
Question 11: Correct Answer: C
Explanation: - C
Ans. is c i.e., Staphylococcus aureus
. Among the given options, only staphylococcus can cause
gasteroenteritis within 6 hours.
Question 12: Correct Answer: C
Explanation: - C
Ans. is c i.e., Autonomic nerves
Visceral afferent fibers of pelvis travel with autonomic nerve fibers.
Visceral afferent fibers conducting reflexive sensations (information
that does not reach consciousness) travel with parasympathetic
fibers to spinal sensory ganglia of S2- S4.
The route taken by visceral afferent fibers conducting pain sensation
differs in relation to an imaginary line, the pelvic pain line, that
corresponds to the inferior limit of peritoneum, except in case of
large intestine, where pain line occurs midway along length of
sigmoid colon.
Visceral afferent fibers that transmit pain sensations from the viscera
inferior to pelvic pain line travel in parasympathetic fibers of the
spinal ganglia S, - S4 (via pelvic splanchnic nerve or nerve
erigentes).
Visceral afferent fiber conducting pain from the viscera superior to
pelvic pain line follow the sympatheitc fibers reterogradely to inferior
thoracic and superior lumbar (Ti - Li 0,2 )spinal ganglia.
Question 13: Correct Answer: B
Explanation: - B
Ans. is b i.e., Anticholinergics
Question 14: Correct Answer: B
Explanation: - B
Ans. is b i.e., Index myopia
Nuclear changes of aging induce a modification of refractive index of
lens and produce an index myopia.
"Nuclear cataracts cause a general decrease in the transperancy of
the lens nucleus.They are associated
withindexmyopia" —
Ophthalmic study guide
Causes of errors of refraction
Possible causes of ametropia are : ?
1) Axial
It is the commonest form of ametropia (both myopia and
hypermetropia). In hypermetropia, there is an axial shortening of
eyeball. So, image is formed behind the retina. In myopia, there is

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an axial lengthening of eyeball. So, image is formed in front of the
retina. 1 mm change in axial length leads to ametropia of 3D. For
example 1 mm shortening in axial length causes hypermetropia of
3D.
2) Curvature
Change in the curvature of cornea or lens will cause ametropia. In
hypermetropia, the curvature of cornea or lens is lesser than normal.
In myopia, there is increase in curvature of cornea or lens./ mm
Question 15: Correct Answer: D
Explanation: - D
Ans. is d i.e., Moderately severe
Question 16: Correct Answer: B
Explanation: - B
Ans. is b i.e. Computed tomography
"CT is the most precise test for imaging aortic aneurysm" - Sabiston
As a preoperative scanning tool, CT scan is the gold standard.
Angiography has largely been replaced by contrast CT scanning" -
Schwartz
Question 17: Correct Answer: C
Explanation: - C
Ans. is c i.e., Optic nerve lesion
An arcuate visual field defect usually results from damage to retinal
nerve fibers or ganglion cells in the superior or
inferior arcuate nerve fiber bundles.
In such cases there is a central field defect that is not circular but
instead is limited above or below by the horizontal meridian.
This visual field defect may occur in patients with occlusion of blood
supply of the superior or inferior portion of macula or in patients with
glaucoma.
In both settings, the scotoma is associated with normal visual acuity,
since it does not completely affect the macula.
Virtually any lesion, whether ischemic, infiltrative or compressive,
can cause arcute field defect, and may be located in either the retina
or optic nerve.
Important causes of arcuate scotoma are :-
1. Glaucoma
2. Optic neuritis
3. Anterior ischemic optic neuropathy (AION)
4. Branch retinal vascular occlusion (artery or vein)
5. Optic nerve drusen
Question 18: Correct Answer: D
Explanation: - D
Ans. is d i.e., Pityriasis Rosacea
Question 19: Correct Answer: D

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Explanation: - D
Ans. is d i.e., Rhabdovirus
Question 20: Correct Answer: A
Explanation: - A
Ans. is a i.e., Depressed nose
Saddle nose (Depressed nose)
Nasal dorsum is depressed (sagging of the bridge of nose).
Depressed nasal dorsum may involve either bony, cartilaginous or
both bony and cartilaginous components. Most common etiology :
Nasal trauma
Causes are hematoma, excessive surgical removal, trauma, syphilis,
abscess, Leprosy, and tuberculosis.
Crooked or deviated nose
Crooked nose is the external deviation of nose due to deviation of
the dorsal border of septal cartilage, forming a `C or S shaped
curve.
In crooked nose, the midline dorsum is curved in C or S shaped
manner from the frontonasal angle to the tip of nose.
In a deviated nose, the midline is straight but deviated to one side,
midline is not curved as in crooked nose.
Question 21: Correct Answer: D
Explanation: - D
Ans. is d i.e., Spontaneous rupture of oesophagus
Chilaiditis syndrome : Condition characterised by inter position of
small or large bowel between liver and right diaphragm.
Radiologically it gives gas under diaphragm.
Iatrogenic pneumoperitoneum : Certain procedure like peritoneal
dialysis, Iatrogenically air pushed before putting PD cannula to avoid
injury of viscera in such case gas under diaphragm can be seen.
All cases when intestine or viscera preforat we can get gas under
diaphragm.
Question 22: Correct Answer: B
Explanation: - B
Ans. is `b i.e., Cholasma
Chloasma (Melasma)
Melasma (Chlosma) is the most common cause for facial
pigmentation in Indian patients. There is Brown macular
pigmentation on the molar area of face, forehead and sometimes
chin. It usually affects young and middle aged women. When
melasma results from pregnancy it is referred as chloasma.
Two major etiological factors are : -
Hormonal (estrogen) --> Appears in pregnancy or in person on
OCPs.
Sun exposure ---> Especially UVB.
For treatment Combination of topical hydroquinone (2-4%), retinoic

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acid and a topical corticosteroids. Other drugs are --> Glycolic acid
(4-10%), Azelic acid, topical vitamin C.
Question 23: Correct Answer: B
Explanation: - B
correct answer- B--> Brucellosis
For the detection of Brucella in infected animals, pooled milk
samples may be tested for bacilli by culture and for antibodies by
several techniques.
In the milk ring test, a sample of whole milk is mixed well with a drop
of stained brucella antigen and incubated in a water bath at 70
degrees for 40-50 min.
If antibodies are present in the milk, the bacilli are agglutinated and
rise with the cream to form a blue ring at the top, leaving the milk
unstained.
If antibodies are absent, no colour ring is formed and the milk
remains uniformly blue.
Also Know:
Bordetella is detected using the cough plate method, post nasal
swab, and the pernasal swab method.
Bartonella bacilliformis causes Oroya fever.
Bartonella quintana causes trench fever.
Bartonella henselae causes cat scratch disease.
Salmonella is detected using a widal reaction.
Question 24: Correct Answer: A
Explanation: - A
Answer- A. Iodine
Iodinated contrasts are the most commonly used radiocontrast
media in radiography and CT.
Gadolinium is the most commonly used MR contrast agent.
Question 25: Correct Answer: C
Explanation: - C
Ans. C. Decreased gut motility
Myenteric plexus or Auerbachs plexus : - It is an outer plexus lying
between the longitudinal and circular muscle layer.
The myenteric plexus controls mainly gastrointestinal motility
therefore, perisalsis requires an active myenteric plexus
Question 26: Correct Answer: B
Explanation: - B
Ans. is b i.e., Trophozoites in the pus
Question 27: Correct Answer: A
Explanation: - A
Ans. is a i.e., Decreased BP & decreased heart rate
Spinal anesthesia ascending into the cervical levels (high spinal
anesthesia) causes severe hypotension, bradycardia and respiratory

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insufficiency.Complications of spinal anaesthesia
Intraoperative Postoperative
Haedache
(post dural
puncture
headach) -
most
common
Hypotension
Cranial nerve
(mostcommon)
palsies (any
Bradycardia10th
cranial nerve
Respiratorydepression
except the
Cardiac arrest
1st,9th & most
Hypothermia in elderly
commonly 6th
nerve is
involved)
Cauda
equina
Question 28: Correct Answer: B
Explanation: - B
Ans. B: Duodenum
Zollinger-Ellison syndrome is a disorder where increased levels of
the hormone gastrin are produced, causing the stomach to produce
excess hydrochloric acid.
Often the cause is a tumor (gastrinoma) of the duodenum or
pancreas producing the hormone gastrin. Gastrin then causes an
excessive production of acid which can lead to peptic ulcers in
almost 95% of patients.
Gastrinomas may occur as single tumors or as multiple, small
tumors. About one-half to two-thirds of single gastrinomas are
malignant tumors that most commonly spread to the liver and lymph
nodes near the pancreas and small bowel. Nearly 25 percent of
patients with gastrinomas have multiple tumors as part of a condition
called multiple endocrine
neoplasia type I (MEN I). MEN I patients have tumors in their
pituitary gland and parathyroid glands in addition to tumors of the
pancreas.
Question 29: Correct Answer: C
Explanation: - C

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Ans. is c i.e., Tsetse flies
Arthropods showing resistance to DDT ? Arthropods showing no
resistance to DDT
Houseflies (e.g., Musca
domestica)
Moquito (Culex,
Anopheles, Aedes)
Sandlies
(Phlebotomus)
Tsetse flies
(Gluossianae)Flea (rat flea, Sand flea)
Lice (Pediculus
capitis/corporis, Phthirus
pubis)
Ticks & Mites
Question 30: Correct Answer: C
Explanation: - C
Urinary copper excretion <100 microgram/di [Ref: Harrison 17"/e p.
2450, 2449]
Symptomatic pts. of Wilson disease invariably have urine copper
levels > 100 pg per day.
Wilson disease is an autosomal recessive disorder caused by
mutation in the ATP 7B gene (a copper transporting ATPase)
Diagnosis - The gold standard for diagnosis is Liver biopsy with
quantitative copper assayQ.
Other diagnostic tests used are ?
- Serum ceruloplasmin levelQ
- KF rings(2
- Urine copper excretiono
- DNA Helpful-ye analysisQ
Serum copper values have no diagnostic value, since they may be
low, normal or elevated depending upon the stage of evolution of
disease.
Table : Useful Diagnostic Tests for Wilson
Disease
Test
Normal
180-350
Value Wilson Disease
Question 31: Correct Answer: A
Explanation: - A
Ans. is a i.e., Amiodarone
Drugs causing hypothyroidism
Lithium Sulfonamide Phenobarbitone Phenytoin
Amiodarone Paraminosalycylic acid (PAS) Rifampicin

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Carbamazepine
Question 32: Correct Answer: B
Explanation: - B
Ans. is b i.e., RTI
Respiratory tract infection (RTI) is the most common cause of death.
"Pneumonia is the most common life-threatening
complication"_______________________ Park
Question 33: Correct Answer: C
Explanation: - C
Ans. is c i.e., Brain
There are two types of glycolysis : -
Aerobic glycolysis : - It occurs when oxygen is plentiful and the final
product is pyruvate, i.e., final step is catalyzed by pyruvate kinase
(see the cycle above). Which is later converted to acetyl CoA by
oxidative decarboxylation. There is net gain of 7 ATPs. Acetyl CoA
enters TCA cycle.
Anaerobic glycolysis : - It occurs in the absence of oxygen. The
pyruvate is fermented (reduced) to lactate in single stage. The
reoxidation of NADH (formed in the glyceraldehyde-3-phosphate
dehydrogenase step) by respiratory chain is prevented as same
NADH is utilized at lactate dehydrogenase step. So, there is no net
production of NADH. Thus, there is net gain of 2 ATP only. Unlike
pyruvate which is converted to acetyl CoA to enter into krebs cycle,
lactate cannot be further utilized by further metabolic pathways.
Thus, lactate can be regareded as dead end in glycolysis. Anaerobic
glycolysis occurs in exercising skeletal muscle, RBCs, lens, some
region of retina, renal medulla, testis and leucocytes.
Question 34: Correct Answer: C
Explanation: - C
Ans. is c i.e., Cytoplasmic vacuole
o Fatty changes occur in alcoholic steatosis (fatty liver). It is
manifested by appearence of lipid vacuole in the cytoplasm, which is
a sign of reversible injury.
o Other three options (loss of cell membrane, nuclear karyolysis and
pyknosis) are signs of irreversible injury
Question 35: Correct Answer: C
Explanation: - C
Ans. is c i.e., Jugulodigastric nodes
Deep cervical lymph nodes are divided into two groups :- (i)
jugulodigastric, and (ii) jugulo-omohyoid.
Lymphatics from oropharynx drain into jugulodigastric nodes.
Lymphatic drainage of pharynx
Lymphatic drainage of pharynx may be :?
1. Nasopharynx

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Nasopharynx drains into upper deep cervical nodes either directly or
indirectly through retropharyngeal or parapharyngeal nodes.
Nasopharynx also drains into spinal accessory chain of nodes in the
posterior triangle of the neck.
2. Oropharynx
Lymphatics from the oropharynx drain into upper jugular particularly
the jugulodigastric (tonsillar) nodes.
The soft palate, lateral and posterior pharyngeal walls and the base
of tongue also drain into retropharyngeal and parapharyngeal nodes
and from there to the jugulodigastric and posterior cervical group.
3. Hyphopharynx
Pyriform sinus drains into upper jugular chain & then to deep
cervical group of lymph nodes.
Postcricoid region drains into parapharyngeal and paratracheal
Question 36: Correct Answer: C
Explanation: - C
Ans. is c i.e., Oxybutynin
o Oxybutynin, a newer antimuscarinic, has high affinity for receptors
in urinary bladder and salivary glands alongwith additional smooth
muscle relaxant and local anaesthetic properties.
Question 37: Correct Answer: C
Explanation: - C
Ans. is c i.e., Bronchoscope - Autoclaving
Question 38: Correct Answer: B
Explanation: - B
Ans. is b i.e., Lip prints
Cheiloscopy or queiloscopy is the study of lip prints.
Podogram is the study of foot prints which are due to ridge on the
sole and toes of the foot.
Palato prints (rugoscopy) is the study of anterior part of palate.
DactylographyDermatoglyphics/Galton system- is the study of Finger
prints. Finger print pattern is absolutely individual i.e. no two hands
are entirely alike, not even identical twins. Thats why, it is best
(most sensitive and most specific) and most reliable method of
identification (Quetelets rule of biological variation).
Question 39: Correct Answer: D
Explanation: - D
Ans. D: 6 years
Nocturnal enuresis is normal upto 6 years while its normal upto the
age of 4 years for daytime.
Question 40: Correct Answer: B
Explanation: - B
Answer- B. Cystic fibrosis
Capacea syndrome is a rapid clinical deterioration in patients with

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cystic fibrosis due to new acquisition of or chronic colonization with
Burkholderia cepacia complex and carries a very high mortality.
In chronically colonized patients the deterioration is often triggered
by an intercurrent illness.
Question 41: Correct Answer: A
Explanation: - A
Ans. is a i.e., Lamotrigine
Lamotrigine is often better tolerated and is less teratogenic than
valproate.
Lamotrigine has been increasingly prescribed in pregnancy over
older antiepileptic drugs such as carbamazepine and sodium
valproate.
Question 42: Correct Answer: C
Explanation: - C
Ans. is c i.e., Isovaleric acidemia
"Sweaty Feet" odour is seen in isovaleric acidemia & glutaric
aciduria
"Mousy or Musty Odour" of skin, hair and urine is seen in PKU.
Burnt sugar like odour is seen in MSU disease (Branched chain
ketonuria).
Boiled cabbage like urinary odour is seen in - Tyrosinemia &
hypermethioninemia.
Swimming pool urine odour is seen in - Hawkinsinuria
Question 43: Correct Answer: A
Explanation: - A
Ans. is a i.e., 6 days
o Quarantine period an infected area.
o Validity of certificate vaccination.
--> —> 6 days from the date of leaving
Starts 10 days after the date of
Question 44: Correct Answer: C
Explanation: - C
Ans. is c i.e., Wernickes encephalopathy
Question 45: Correct Answer: B
Explanation: - B
Answer- B. Early productive cough
Cough is usually nonproductive, a productive cough is unusual
Hemoptysis
Wheezing
Chest pain
Clubbing can occur with interstitial lung disease.
Question 46: Correct Answer: C
Explanation: - C
Answer- C. 15 sec

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This is done by applying firm pressure with the palm of the hand to
the right upper quadrant of the abdomen for 10-15 seconds with the
patients breathing quietly while the jugular vein is observed.
A positive abdominojugular reflux sign is defined by an increase in
the jugular venous pressure of greater than 3 cm, sustained for
greater than 15 seconds.
Question 47: Correct Answer: B
Explanation: - B
Ans. B. Flexion
Question 48: Correct Answer: A
Explanation: - A
Answer- A. TIA
Stroke occurs when poor blood flow to brain results in death of brain
cells.
Stroke is of two types :-
Ischemic stroke: It is the most common type and occurs due to
thrombosis of cerebral blood vessels.
Hemorrhagic stroke: It occurs due to hemorrhage either in brain
tissue (Intracerebral hemorrhage) or in subarachnoid space
(subarachnoid hemorrhage).
Symptoms of stroke are :-
Sudden onset of hemiparesis / hemiplagia
Question 49: Correct Answer: B
Explanation: - B
Ans. is `b i.e., 200 ml/day per degree Celsius
Question 50: Correct Answer: B
Explanation: - B
Pavlov’s experiment is an example of Classical conditioning.
Classical conditioning is a process of learning, by which a previously neutral stimulus elicit
an identical or similar response to one originally elicited by another stimulus as a result of
pairing of the two stimuli.
Ref: Kaplan & Sadocks Comprehensive Textbook of Psychiatry, 9th edition, page 647.
Beginning Psychology By Malcolm Hardy, 5th edition page 54 ; Universal Principles of
Design By William Lidwell, page 174 ; Psychology: Concepts and Applications By Jeffrey
S. Nevid, 3rd edition page 176.
Question 51: Correct Answer: C
Explanation: - C
Ans. is `c i.e., Thalassemia
Intracorpuscular hemolysis : Hereditary sphlerocytosis, G6PD
deficiency, thalassemia, sickle cell anemia, PNH.
Extracorpuscular hemolysis : Microangiopathic hemolytic anemia
(TTP, HUS, DIC), infection (malaria), prosthetic valve,
immunohemolytic anemia and hyperplenism.
Question 52: Correct Answer: B

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Explanation: - B
Answer- B. Hypokalemic alkalosis
Liquorice (Licorice) ingestion causes apparent mineralocorticoid
excess (pseudohyperaldosteronism) due to inhibition of enzyme 11-
13-HSD.
This causes metabolic alkalosis, hypokalemia and volume overload.
Question 53: Correct Answer: D
Explanation: - D
Ans. D. Voluntary movement
Precentral gyrus is the primary motor cortex (Brodmanns Area 4)
where the impulse for voluntary activity originates.
Question 54: Correct Answer: C
Explanation: - C
Ans. is c i.e., Lovastatin
Question 55: Correct Answer: B
Explanation: - B
Ans. B. 1 day
Question 56: Correct Answer: B
Explanation: - B
Ans. is b i.e., Infectious agent is in the body of human
o Infection --> Infectious agent in the body.
o Contamination ---> Infectious agent on body surface or on objects.
o Infestation --> Arthropods on body surface.
Question 57: Correct Answer: C
Explanation: - C
Ans. is c i.e., Lundy
Term balanced anaesthesia was introduced by Lundy in 1926.
Balanced anaesthesia
The cardinal feature of general anaesthetics are : ?
1. Loss of all sensations, especially pain
2. Sleep (unconciousness) and amnesia
3. Immobility and muscle relaxation
4. Abolition of reflexes
In modern practice of balanced anaesthesia these modalities are
achieved by using combination of inhaled and iv.drugs.
Question 58: Correct Answer: B
Explanation: - B
Ans. B. Hypertonia
Damage to the cerebellum leads to several characteristic
abnormalities, including :
Ataxia
Hypotonia
Dysmetria
Rebound phenomenon

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Decomposition of movement
Question 59: Correct Answer: D
Explanation: - D
Ans. is `d i.e., Phallic
Question 60: Correct Answer: A
Explanation: - A
Ans. is a i.e., Chlamydia trachomatis
Characteristics of the chlamydia
Inclusion
morphology
C trachomatis C pneumoniae C psittaci
Round,
vacuolar Round, dense Large, variable
shape, dense
Glycogen in
inclusions Yes No No
Elementary body
morphology Round Pear-shaped,
round Round
Susceptible to
sulfonamides Yes No No
DNA homology
to C pneumoniae < 10% 100% < 10%
Plasmid Yes No Yes
Serovars 15 1 > 4
Natural host Humans Humans Birds
Mode of
Person to
Airborne
Airborne bird
transmission
person, mother
person to
excreta to
to infant person humans
Major diseases Trachoma,
Question 61: Correct Answer: C
Explanation: - C
Answer- C. Contrast radiography
It is a general rule that the ascending order of the radiation dose is
MRI < X- ray < CT - Scan. Technetium - 99m has the radiation
exposure more than X - ray but less than CT - Scan. So contrast
radiography will have the minimum radiation exposure as it involves
taking a radiograph after small bowel enema for diagnosis of
meckels diverticulum.

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Question 62: Correct Answer: D
Explanation: - D
Ans. is d i.e., Brain
HMP is an alternative route for the oxidation of glucose (beside
glycolysis).
It is also called as "pentose phosphate pathway", "Dickens -
Horecker pathway", "Shunt pathway" or "phosphogluconate
oxidative pathway".
HMP shunt is required for provision of reduced NADPH and fiver-
carbon sugars (Pentose phosphates) for nucleic acid synthesis.
Normally, 90% of glucose is oxidized by glycolysis and 10% is
oxidized by HMP shunt.
However, in liver and RBCs HMP shunt accounts for oxidation of
30% glucose.
HMP shunt occurs in the cytosol.
It is highly active in liver, adipose tissue, adrenal cortex, lens,
cornea, lactating (but not the nonlactating) mammag gland, Gonads
(testis, ovary) and erythrocytes.
Activity of this pathway is minimal in muscle and brain, where almost
all of the glucose is degraded by glycolysis.
Question 63: Correct Answer: C
Explanation: - C
Ans. is c i.e., Keratoconus
Keratoconus is a progressive, noninflammatory, bilateral ectatic
corneal disease, characterizedparaxiastromal thinning and
weakening that leads to corneal surface distortion.
Essential pathological changes are thinning and ectasia which occur
as a result of defective synthesis of mucopolysaccharide and
collagen tissue.
It usually starts at puberty and progresses slowly.
Symptoms usually begins as blurred vision with shadowing around
images.
Vision becomes progressively more blurred and distorted with
associated glare, halos around lights, light sensitivity and ocular
irritation.
Visual loss occurs primarily from irregular astigmatism and myopia.
and secondarily from corneal scarring
The hallmark of keratoconus is central or paracentral stromal
thinning, apical protrusion of anterior corneaand irregular
astigmatism.
The cornea thins near the centre and progressively bulges forwards,
with the apex of cone always being slightly below the centre of the
cornea.
Important findings an examination are -
Question 64: Correct Answer: B

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Explanation: - B
Ans. is b i.e., Raised ICT
Question 65: Correct Answer: C
Explanation: - C
Ans. is c i.e., Left 4th
Question 66: Correct Answer: B
Explanation: - B
Answer- B. Thyroid carcinoma
Differential diagnosis of calcified pulmonary metastasis :-
1. Osteosarcoma
2. Colon carcinoma
3. Chondrosarcoma
4. Giant cell tumor of bone
5. Thyroid carcinoma
6. Ovarian cancer
7. Synovial sarcoma
8. Breast carcinoma
Question 67: Correct Answer: B
Explanation: - B
Ans. is b i.e., Pseudomonas
Complications of contact lens wear
Complications of contact lens wearing are : ?
Intolerance :- Some people find wearing contact lenses intolerable.
Corneal complications :- Corneal abrasion, Corneal edema, Corneal
vascularization, Microbial keratitis (Pseudomonas, acanthamoeba),
Sterile corneal infiltrate.
Giant papillary conjunctivitis
Hypoxia :- Cornea is deprived of oxygen from the tear film by the
presence of the contact lens. The cornea becomes edematous and
new vessels may develop in the limbal area.
Sensitivity :- This may develop in response to the preservative
(thiomersal) in the cleaning and soaking solution. This results in
allergic conjunctivitis.
Question 68: Correct Answer: C
Explanation: - C
Ans. is c i.e., ASO Titre
In rheumatic fever and glomerulonephritis, retrospective
diagnosis of streptococcal infection may
be established by demonstrating high levels of antibodies to
streptococcal toxins.
The usual test done is antistreptolysin O titration.
ASO titres higher than 200 units are considered significant
and suggests either recent or recurrent infection with streptococci.
ASO titres > 200 units do not mean rheumatic fever, it only indicates

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recent or recurrent infection.
Question 69: Correct Answer: A
Explanation: - A
Ans. is a i.e., PAN
Among the given options, PAN is predominantly necrotizing
vasculitis, characterized by fibrinoid necrosis.
During acute phase of PAN, there is transmural inflammation with
mixed infiltrate of neutrophils, eosinophils and mononuclear cells
with accompanied fibrinoid necrosis.
Other three options are predominantly granulomatous vasculitis.
Question 70: Correct Answer: B
Explanation: - B
Squamous cell anal cancer is rare but associated with Human papilloma virus infection
(HPV), Anal intra-epithelial neoplasia (AIN) and immunosuppression.
The current treatment of anal canal carcinoma is chemoradiotherapy (combined modality
therapy).
Chemotherapy include a combination of 5-FU with mitomycin C or Cisplatin.
Ref: Bailey and Love Short Practice of Surgery, 25th Edition, Page 1269; The MD
Anderson Manual of Medical Oncology, 2nd Edition, Chapter 22.
Question 71: Correct Answer: D
Explanation: - D
Ans. is d i.e., Palatoglossal fold
Palatine tonsils are masses of lymphoid tissue that can be seen on
the left and right sides at the back of the throat.
There are two palatine tonsils, and each palatine tonsil (right or left)
lies in the tonsilar sinus (tonsilar fossa) on the lateral wall of
oropharynx.
Tonsillar fossa bounded by the palatoglossal fold in front and the
palatopharyngeal fold behind.
Tonsils are lined by non - keratinized stratified squamous epithelium.
Medial surface of each tonsil has 15-20 crypts, the largest of which
is called Intratonsillar cleft or crypta magna (which represents
persistence of the ventral portion of the second pharyngeal pouch).
Tonsillar bed is formed from within - outwards by :-
Li Pharyngobasilar fascia
Superior constrictor (above) and palatopharyngeus muscle
Styloglossus (below)
Buccopharyngeal fascia
Question 72: Correct Answer: B
Explanation: - B
Ans. is b i.e., Stratified random
o Separation of people in groups followed by random sampling from
those groups is stratified random sampling.
Question 73: Correct Answer: B

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Explanation: - B
Ans. B. Jejunum
Absorption of glucose, galactose and fructose occurs mainly in small
intestine, especially in the proximal part of jejunum.
Question 74: Correct Answer: A
Explanation: - A
Ans. is a i.e., Partial agonist
Question 75: Correct Answer: A
Explanation: - A
Ans. is a i.e., Glucose-6-phosphate [Ref: Harper 29"/e p. 171,
190]
Question 76: Correct Answer: B
Explanation: - B
Ans. is b i.e., Johann reil
IMPORTANT CONTRIBUTORS IN PSYCHIATRY
Term Coined by
Moral
Emil
Kraepelin
Demence precoce
Dementia precox
Catatonia, cyclotymia
Hebephrenia
Schizophrenia
Ambivalence
Free association
Psychoanalysis,
Psychodynamics
Id, ego, Superego
Psychiatry
Kahlbaum
Hecker
Eugen
Bleuler
Eugen
Bleuler
Sigmund
Freud
Sigmunnd
Freud
Sigmund
Freud
Johann
christion Reil

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Question 77: Correct Answer: D
Explanation: - D
Ans. Choking
[Ref Parikh 61Ve p. 3.24]
It is very simple question. Hyoid fracture will occur only when there
is pressure on hyoid (neck) from outside.
In choking, there is no pressure on hyoid.
Fracture of hyoid : Throttling (manual strangulation) > ligature
strangulation > Hanging.
Question 78: Correct Answer: B
Explanation: - B
Ans. is b i.e., Are lipid in nature
Chaperones are proteins (not lipid).
Chaperones
Certain proteins play a role in the assembly or proper folding of other
proteins without themselves being components of the latter.
Such proteins are called molecular chaperones.
Most chaperones exhibit ATPase activity and bind ADP and ATP.
This activity is important for their effect on folding.
Some Properties of Chaperone Proteins
Present in a wide range of species from bacteria to humans
Many are so-called heat shock proteins (Hsp)
Some are inducible by conditions that cause unfolding of newly
synthesized proteins (eg, elevated temperature and various
chemicals)
They blind to predominantly hydrophobic regions of infolded proteins
and prevent their aggregation
They act in part as a quality control or editing mechanism for
detecting misfolded or otherwise defective proteins
Most chapersones show associated ATPase activity, with ATP or
ADP being involved in the protein-chaperone interaction
Found in various cellular compartments such as cytosol,
mitochondria, and the lumen of the endoplasmic reticulum
Question 79: Correct Answer: B
Explanation: - B
Ans. is b i.e., Facial nerve palsy
Question 80: Correct Answer: B
Explanation: - B
Ans. is b i.e., Niacin
Question 81: Correct Answer: A
Explanation: - A
Ans. is a i.e., 1-4 hours
From starting the infusion (puncturing the blood with the infusion set)
to completion, infusion pack should take a maximum of 4 hours.

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Question 82: Correct Answer: D
Explanation: - D
Ans. d. Sec. 319
319. Hurt.—Whoever causes bodily pain, disease or infirmity to any
person is said to cause hurt.
It is of two types: i. Simple and ii. Grievous
Sec-319 --> Defines Hurt.—Whoever causes bodily pain, disease or
infirmity to any person is said to cause hurt.
Sec- 320--> Defines the grievous hurt and comprises of 8 clauses
Sec-326 --> Voluntarily causing grievous hurt by dangerous
weapons/means, fine/punishment up to 10 years.
Sec 331 --> Voluntarily causing grievous hurt to extort confession, or
to compel restoration of the property. shall be punished with
imprisonment of either description for a term which may extend to
ten years, and shall also be liable to fine.
Question 83: Correct Answer: B
Explanation: - B
Ans. is b i.e., 93%
Half life Elimination
1t%2 50%
2t/2 75%
3 0/2 87.5%
41 93.75%
5 t/ 96.875
Question 84: Correct Answer: A
Explanation: - A
Ans. is a i.e., Women < 20 years
Many women who are sexually active would prefer to avoid
pregnancy, but nevertheless are not using any method of
contraception.
These women are considered to have unmet need for family
planning.
The concept is usually applied to married women.
According to the National Family Health Survey-3, Unmet need for
family planning is highest (27.1%) among women below 20 years
age and is almost entirely for spacing the births rather than for
limiting the births.
It is also relatively high for women in age group 20-24 years (21.1%)
with 75% need for spacing and 25% for limiting the birth.
Unmet need for contraception among women aged 30 years and
above are mostly for limiting birth.
Age group Unmet need of contraception for
< 20 years For spacing the birth
20-24 years For spacing (75%) and for limiting birth (25%)
30 years For limiting birth

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Question 85: Correct Answer: C
Explanation: - C
Ans. is c i.e., Fat
Fat necrosis is seen most frequently in acute pancreatitis due to
leakage of lipase.
Fat necrosis
Fat necrosis may be of two types : ?
1. Enzymatic fat necrosis
This is due to action of lipase on adipose tissue.
It occurs most frequently in acute pancreatitis due to leakage of
lipase.
Depending on the severity of acute pancreatitis, fat necrosis may
occur in : - a Adipose tissue contiguous to pancrease,
retroperitoneal fat.
Adipose tissue in anterior mediastinum.
Bone marrow
Omental and abdominal fat
2. Nonenzymatic or Traumatic fat necrosis
Occurs due to trauma
Is seen in subcutaneous tissue of breast, thigh, and abdomen.
Question 86: Correct Answer: D
Explanation: - D
Ans. is d i.e., Early diagnosis can change disease course because
of effective treatment
Criteria for screening
o The criteria for screening are based on two consideration.
i) Disease to be screened
ii) Screening test to be applied
o Disease to be screened
The disease to be screened should fulfil the following criteria before
it is considered suitable for screening.
The condition sougth should be an important health problem (in
general, prevalence should be high).
There should be a recognizable latent or early asymptomatic stage.
The natural history of the contition, including development from
latent to declared disease, should be adequately understood (so that
we can know at what stage the process ceases to be reversible).
There is a test that can detect the disease prior to the onset of signs
and symptoms.
facilities should be available for confirmation of the diagnosis.
There is an effective treatment.
There should be an agreed-on policy concerning whom to treat as
Question 87: Correct Answer: B
Explanation: - B
Ans. is b i.e., Interstitial fibrosis

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Diffuse pulmonary diseases are divided into two categories -
Obstructive disease (airway disease)
Obstructive disease is characterized by an increase in resistance to
airflow owing to partial or complete obstruction at any level, from the
trachea to the respiratory bronchioles.
Examples are chronic obstructive lung disease (COPD -
Emphysema, bronchitis), bronchiectasis, and asthma.
Restrictive disease
Restrictive disease is characterized by reduced expansion of lung
parenchyma, with decreased total lung capacity. o It may occur due
to two types of disorders -
Chest wall disorders in the presence of Normal lungs
Neuromuscular disorders, e.g.polio, severe obesity, pleural disease,
kyphoscoliosis.
Interstitial and infiltrative diseases of lung Pneumoconiosis,
interstitial fibrosis.
Question 88: Correct Answer: B
Explanation: - B
Ans. B. Prolactin
Lactogenesis is the synthesis and secretion of milk from breast
alveoli.
This requires primarily prolactin
Question 89: Correct Answer: A
Explanation: - A
Ans. is d i.e., All of the above
Coxa vera
Coxa vera refers to reduced angle between the neck and shaft of the
femur.
Coxa vera may be congenital or acquired.
1. Congenital (developmental / Infantile) coxa vera
This is coxa vara resulting from some unknown growth anomaly at
the upper femoral epiphysis.
It is noticed as a painless limp in a child who has just started
walking.
In severe cases, shortening of the leg may be obvious.
On examination, abduction and internal rotation of the hip are limited
and the leg is short.
X - rays will show a reduction in neck - shaft angle.
The epiphyseal plate may be too vertical.
There may be a separate triangle of bone in the inferior portion of
the metaphysis, called Fairbanks triangle.
Treatment is by a subtrochanteric corrective osteotomy.
2. Aquired coxa - vera
Aquired coxa-vera is seen in :-
SCFE (slipped capital femoral epiphysis)

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Sequelae of avascular necrosis of femoral epiphysis
Question 90: Correct Answer: D
Explanation: - D
Ans. is d i.e., Reduction of impedance to sound transmission
The ear canal (auditory canal) acts as a resonator, i.e. it resonates
(amplifies frequencies) between 2000 and 5000 (average 3000)
cycles per second and therefore most energy will be transmitted to
the cochlea in these frequencies.
However, if this sound energy hits the inner ear fluid directly most of
the energy would be reflected, resulting in hearing loss (as all the
sound wave is reflected and nothing is a transmitted as electrical
impulse).
Therefore, there is a need for a transformer mechanism, a need that
is fullfilled by middle ear ? middle ear converts sound of greater
amplitude but lesser force to that of lesser amplitude but greater
force.
This function of the middle ear is called impedence matching
mechanism or the transformer action.
Question 91: Correct Answer: C
Explanation: - C
Ans. is c i.e., Bowmans membrane
Question 92: Correct Answer: B
Explanation: - B
Ans. is b i.e., Choanal atresia
o Bilateral choanal atresia is a very serious life-threatening condition
because the baby is unable to breath directly after birth as neonates
are obligate nasal breathers.
o In some cases, this may present as cyanosis while the baby is
feeding because the oral air passages are blocked by the tongue.
o The cyanosis may improve when the baby cries, as the oral airway
is used at this time.
o These babies may require airway resuscitation soon after birth.
Question 93: Correct Answer: C
Explanation: - C
Ans. is c i.e., Night terrors
Sleep terror or night terrors (pavor nocturnus) : - The patient
suddenly gets up screaming, with autonomic arousal (tachycardia,
sweating). Sleep terrors are rarely remembered in the morning (in
contrast to night mares). No treatment is required only reassurance
is required. However, in severe cases benzodiazepine can be used.
Question 94: Correct Answer: A
Explanation: - A
Answer- A. Duct papiloma
Table 1: Causes of nipple discharge

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Physiologic
Duct abnormalities
Intraductal papilloma
Duct ectasia
Periductal mastitis
Carcinoma
Galactorrhea
Hyperprolactinemia
Hypothyroidism
Medications: oral contraceptives, cimetidine, verapamil,
phenothiazine, metoclopramide, alpha-methyldopa
Conditions that may mimc nipple discharge
Eczema with drainage
Pagets disease of the breast
Nipple adenoma
Question 95: Correct Answer: D
Explanation: - D
Ans. is d i.e., Both NE uptake inhibition and antimuscarinic action
on heart
The commonest cardiovascular effect of tricyclic antidepressant
overdose is sinus tachycardia.
Due to inhibition of norepincphrine reuptake and the anticholinergic
action.
However, the most important toxic effect of tricyclics is the slowing of
depolarisation of the cardiac action potential by inhibition of the
sodium current and this delays propagation of depolarisation through
both myocardium and conducting tissue.
This results in prolongation of the QRS complex and the PR/QT
intervals with a predisposition to cardiac arrhythmias.
This inhibition of sodium flux into myocardial cells can occur to such
an extent that depressed contractility can result and this, coupled
with the reduction in peripheral resistance, contributes to
hypotension.
Question 96: Correct Answer: A
Explanation: - A
Ans. A. LSCS
Question 97: Correct Answer: A
Explanation: - A
Ans. is `a i.e., 360 nm
Woods lamp
Woods lamp has an ultraviolet light lamp (365 nm) with a filter
containing nickle oxide and barium silicate. The UV light, when
absorbed by certain substances, fluorescences in dark and the color
of fluorescence is useful in diagnosis of the condition.
Condition

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Fluorescent colours
Tinea capitis
Bright yellow green
Erythrasma
Coral red or pink
Vitiligo
Milky white
Albinism
Blue white
Leprosy
Blue white
Tuberous sclerosis
Blue white
Pseudomonas infection
Question 98: Correct Answer: D
Explanation: - D
Ans. is d i.e., Aortic aneurysm
Question 99: Correct Answer: C
Explanation: - C
Ans. C. Ventral anterior
Motor nuclei (ventral anterior and ventral lateral) of thalamus relay
and process messages from basal ganglia (especially globus
pallidus) and cerebellum to motor and premotor cortex
Question 100: Correct Answer: A
Explanation: - A
Ans. is a i.e., Red colour
Question 101: Correct Answer: C
Explanation: - C
Answer- C. Occurs in the terminal portion of main arteries
Border zone or watershed infarcts are ischemic lesion that occurs in
characteristic location at the junction between two main arterial
territories.
Watershed strokes are named that way because they affect the
watershed areas of the brain.
These areas are thin strips of brain which are sandwiched in
between the farthest end branches of two adjacent vascular
territories.
Question 102: Correct Answer: D
Explanation: - D
Ans. is d i.e., 10 years
304-B IPC: Dowry death : 10 years of imprisonment which can
extend to life.
498-A IPC : Punishment for cruelty by husband or his relatives.
Dowry death

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In some cases newly married girls are abused, harassed, cruelly
treated and tortured by the husband, in-laws and their relatives for or
in connection with any demand for dowry. In extreme cases, the
woman is killed by burning or some other method. Law in relation to
dowry death are :
Low prescribing punishment and definition (section 304 B IPC)
Husband or (his any) relative will be tried under section 304B, IPC
and shall he deemed to have caused her death, if a woman dies due
to bodily injury or burns or otherwise in suspicious circumstances
with in 7 years of marriage and it is shown that soon before her
death she was subjected to harassment or cruelty by them, in
connection with, any demand for dowry. Such death shall be called
dowry death. Punishment includes imprisonment of not less than 10
years, but which may extend to life imprisonment.
Low prescribing punishment for causing cruelty to a married
women (Sec. 498A, IPC)
Husband or (his any) relative will be tried under section 498A, IPC
Question 103: Correct Answer: B
Explanation: - B
Ans. is b i.e., C pneumoniae
There are many serovars of chlamydiae :
C. trachomatis TRIC —p. 12 serotypes } Total 15
C. trachomatis LGV 3 serotypes
C. psittaci — Many serotyes
C. pneumoniae —10. Only one serotype
Question 104: Correct Answer: C
Explanation: - C
Ans. C. Cortisol
Cortisol (the major glucocorticoid) is released by adrenal cortex.
CRH is secreted by hypothalamus, and ACTH and MSH are
secreted by pituitary.
Question 105: Correct Answer: A
Explanation: - A
Ans. is a i.e., Close shot
Question 106: Correct Answer: C
Explanation: - C
Answer- C. Reverse trendelenberg
Using the reverse trendelenburg position during functional
endoscopic sinus surgery (FESS) is safe, simple, and cost-free
method that has been found to reduce intraoperative blood loss.
Question 107: Correct Answer: C
Explanation: - C
Ans. is c i.e., Fibrous protein
Based on their three-dimensional shape (i.e., conformation), the

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proteins are divided into two classes :
Fibrous proteins : - The polypeptide chains extend along a
longitudinal axis without showing any sharp bends, giving them rod
or needle like elongated shape. Most of the structural proteins are
fibrous proteins, e.g., collagen, elastin, and keratin. Fibrous proteins
centrifuge more rapidly because of their rod like shape.
Globular proteins : - The polypeptide chains are tightly folded and
packed into compact structure giving spherical or oval shape. Most
enzymes, tranport proteins (albumin, globulins), hemoglobin,
myoglobin, antibodies and hormones are globular proteins.
Question 108: Correct Answer: B
Explanation: - B
Answer- B. Chronic bronchitis
Secondory amyloidosis
It occurs secondary to an associated inflammatory conditions like
1. Rheumatoid arthritis (most common)
2. TB & Leprosy
3. Ankylosing spondylitis
4. Chronic osteomyelitis
5. IBD (crohn disease, ulcerative colitis)
6. Bronchiectasis
It may also occur in some tumors
1. Renal cell carcinoma (Hypernephroma)
2. Hodgkin lymphoma
Question 109: Correct Answer: D
Explanation: - D
Ans. is None
It never equals the tensile strength of unwounded skin.
Robbins writes- "How long does it take for a skin wound to achieve
its maximal strength? When sutures are removed from an incisional
surgical wound, usually at the end of the first week, wound strength
is approximately 10% that of unwounded skin. Wound strength
increases rapidly over the next 4 weeks, slows down at
approximately the third month after the original incision, and reaches
a plateau at about 70% to 80% of the tensile strength of unwounded
skin."
Question 110: Correct Answer: A
Explanation: - A
Ans. is a i.e., Platysma
The neck is invested by two major fascial layers :?
Superficial fascia : Platysma and its investing fascia.
Deep fasica : Invests the depper muscles, the thoracic duct, blood
vessels, nerves, glands, trachea and oesophagus.
Significant injury to deep strucutres of the neck is unlikely without
penetration of the platysma.

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Therefore, a stab wound that does not penetrate the platysma needs
no further evaluation.
Question 111: Correct Answer: A
Explanation: - A
Ans. is a i.e., Short arm of chr- 6
HLA complex (MHC) gene is located on the short arm of
chromosome 6.
The histocompatibility antigens (human leukocyte antigens - HLA)
are cell surface antigens that induce an immune response leading to
rejection of allografts.
The principal physiologic function of the cell surface
histocompatibility molecules is to bind peptide fragments of foreign
proteins for presentation to antigen specific T cells.
The histocompatibility antigens are encoded by a closely linked
multiallelic cluster of genes?Major histocompatibility complex
(MHC) or Human leukocyte antigens complex (HLA complex).
HLA complex of genes is located on the short arm of chromosome 6.
Question 112: Correct Answer: D
Explanation: - D
Ans. is d i.e., neuropsychiatric manifestations
Hyperkalemia is seen in hemolytic urenic syndrome as a result of
renal failure.
ABOUT NEUROPSYCHIATRIC MANIFESTATIONS
* Neurological manifestations are used to distinguish between
Hemolytic uremic syndrome and Thrombotic Throm bocytopenic
Purpura.
* H.U.S. is distinguished from T.T.P by the absence of neurological
symptoms and the prominence of acute renal failure.
* Recent studies, however have tended to blurr these clinical
distinctions. Many adult patients with "T. T.P. lack one or more of the
five criteria and patients with "HUS" have fever and neurological
dysfunction.
Question 113: Correct Answer: A
Explanation: - A
Answer- A. MRI
Ultrasonography is based on piezoelectric effect.
MRI is based on gyeromagnetic property of proton W9.
Question 114: Correct Answer: C
Explanation: - C
Ans. C. Middle cerebral artery
Question 115: Correct Answer: D
Explanation: - D
Ans. is d i.e., Levator palpabrae superioris & muller muscle
The levator palpebrae superioris is the important upper eye lid

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retractor. Injury or weakness to this muscle leads to ptosis.
This muscle is supplied by occulomotor (3) nerve.
Deep part of the elevator muscle is the Mullers muscle, which is
sympathetically innvervated.
In hyperthyroidism, sensitization of the Muller muscle leads to upper
eyelid retraction and pseudoproptosis.
On the other hand, in Horners syndrome loss of this muscle action
leads to ptosis.
The capsulopalpebral fascia assists in lower eyelid retraction and
coordinates with eyeball movement. It arises as an extension of the
inferior rectus and inserts into the lower edge of the lower tarsus and
the adjacent orbital septum.
Question 116: Correct Answer: A
Explanation: - A
Ans. is a i.e., Local distribution of disease
Inner and outer city variations in disease frequency are well known.
These variations are best studied with the aid of "spot maps" or
"shaded maps".
These maps show at a glance areas of high and low frequency, the
boundaries and distribution.
For example, if the map shows "clustering" of cases, it may suggest
a common source of infection or a common risk factor shared by all
the cases.
The classical example of use of spot maps was by John snow for
cholera epidemic in 1854.
Question 117: Correct Answer: A
Explanation: - A
Ans. is A i.e., Pain over left shoulder
In splenic rupture the pain may be referred to the tip of the left
shoulder.
This is known as Kehrs sign.
It occurs due to irritation of the undersurface of the diaphragm with
blood and the pain is referred to the shoulder through the affected
fibres of phrenic nerve (C4 and C5).
Kehrs sign can be elicited by bimaual compression of the left upper
quadrant after the patient has been in Trendelenburgs position for
about 10 minutes prior to the manoeuvre.
Question 118: Correct Answer: B
Explanation: - B
Ans. is b i.e., Glutathione reductase
Riboflavin (Vitamin B2)
Riboflavin is also called Warburg yellow enzyme.
Riboflavin provides the reactive moieties of the coenzymes flavin
mononucleotide (FMN) and flavin adenine dinucleotide (FAD).
Flavin coenzymes are involved in oxidoreduction reactions as

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electron carriers.
These reactions include the mitochondrial respiratory chain, key
enzymes in fatty acid and amino acid oxidation and the citric acid
cycle.
Flavin dependent (flavoprotein) enzymes are :
FMN dependent : L-amino acid oxidase, NADH dehydrogenase.
FAD dependent : Complex II of respiratory chain, microsomal
hydroxylase system, D-amino acid oxidase, xanthine oxidase,
succinate dehydrogenase, acyl-CoA dehydrogenase, glycerol-3-
phosphate dehydrognenase, pyruvate dehydrognenase, a-
ketoglutarate dehydrogenase.
Deficiency of riboflavin is charcterized by cheilosis, desquamation
and inflammation of tongue, and a seborrheic dermatitis.
Riboflavin nutritional status is assessed by measurement of
activation ofglutathione reductase by FAD added in vitro.
Question 119: Correct Answer: C
Explanation: - C
Ans. is c i.e., Lateral rectus
retraction syndrome represents the most frequent and most
prominent congenital cranial dysinnervation disorder (CCDD).
It is due to fibrosis of the lateral rectus or an innervational anomaly
withCo-contraction of the lateral and medial recti.
There is deficiency of abduction, associated with impaired
adduction, contraction of palpebral fissure and oblique movements
of the eye.
Question 120: Correct Answer: D
Explanation: - D
Ans. is d i.e., Methionine
Question 121: Correct Answer: C
Explanation: - C
Ans. is c i.e., 8:1
Question 122: Correct Answer: A
Explanation: - A
Answer- A. Hyponatremia
HypokalemiaQ
HypocalcemiaQ
Hypomagnesemia
Question 123: Correct Answer: D
Explanation: - D
Ans. is `D i.e., Psoriatic arthritis
Gulls wing appearance- Psoriatic arthritis
Opera glass deformity- Psoriatic arthritis
Cup and pencil deformity- Psoriatic arthritis
Question 124: Correct Answer: C

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Explanation: - C
Ans. is c i.e., Streptomycin
Question 125: Correct Answer: C
Explanation: - C
Ans. is c i.e., Inhibit IL-2 production by T-cells
Interleukin -1
Also known as leucocyte activating factor (LAF) or B cell activating
factor (BAF).
Principally secreted by macrophages and monocytes; and epithelial
cells.
Other sources are B lymphocytes, fibroblasts and endothelial cells.
Immunological effects-
Activation of T cells for the production of IL - 2.
B cell proliferation and antibody synthesis
Neutrophil chemotaxis and increased PMN release from bone
marrow.
Increases body temperature (important endogenous pyrogen).
Bone marrow cell proliferation
Induction of acute phase protein.
Question 126: Correct Answer: C
Explanation: - C
C i.e. Myocardium
Dorsal mesocardium forms transverse pericardial sinus;
somatopleuric mesoderm forms parietal pericardium;
splanchnopluric mesoderm forms myocardium & conduction system
of hearts (i.e. Purkinje fibers) ; neural creast cells form
subpulmonary infundibulum.
Cardiac jelly forms endocardial cushion and myocardium
Question 127: Correct Answer: B
Explanation: - B
Ans. is b i.e., Taenia solium
Humans acquire intestinal tapeworm infection by ingesting
undercooked pork containing cysticerci.
Mode of infection of tapeworms
T. saginata --> Under cooked beef contains cysticercus bovis.
T solium --> Undercooked pork containing cysticercus cellulosae &
rarely by ingestion of egg (autoinfection.)
Trichuris - trichiura caused by ingestion of infective egg via faeco-
oral route from contaminated soil.
Hydatid cyst is caused by ingestion of infectious egg via faeco-oral
route from contaminated soil.
Question 128: Correct Answer: D
Explanation: - D
Ans. is d i.e., Acute epiglottitis

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There are two important radiological signs in acute epiglottitis :?
1. Thumb sign
2. Vollecula sign
Question 129: Correct Answer: C
Explanation: - C
Ans. is c i.e., Afibrogenemia
Cryoprecipitate was originally developed for the treatment of
hemophilia A. It is no longer the treatment of choice for that disorder
because less infectious alternatives are available.
At the present time, Cryoprecipitate is most often used for correction
of hypofibrinogenemia in bleeding patients.
Question 130: Correct Answer: C
Explanation: - C
Ans. is c i.e., Two third [Ref Park 20th/e p. 834]
3 of 8 goals of MDG (Goal 4, 5, 6), 8 of 18 targets and 18 of 48
indicators are directly health related.
Goal 1: Eradicate extreme poverty and hunger.
Goal 2: Achieve universal primary education.
Goal 3: Promote gender equality and empower women.
Goal 4: Reduce child mortality (Reduce by two-thirds the under-five
mortality rate).
Goal 5: Improve maternal health (Reduce by three-quarters the
maternal mortality ratio.
Goal 6: Combat HIV/AIDS, malaria and other diseases.
Goal 7: Ensure environmental sustainability.
Goal 8: Develop a global partnership for development.
Question 131: Correct Answer: C
Explanation: - C
Ans. is c i.e., B-48
Question 132: Correct Answer: B
Explanation: - B
Answer- B. Fibroadenoma
Indications for simple mastectomy
A) Without an axillary procedure
1. Risk-reducing mastectomy
2. Local recurrence in a previously treated breast cancer iii)Malignant
phyllodes tumor (cystosarcoma phyllodes) b) With concomitant
axillary procedure
3. Locally advanced breast cancer (including paget disease)
4. Multifocal breast cancer
5. Extensive ductal carcinoma in situ (DCIC)
6. Patient is unsuitable for breast-conservative approach
Question 133: Correct Answer: A
Explanation: - A

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Ans is a i.e., Kangaroo Mother Care (KMC)
"Preferably mother should accompany and baby can be transported
in KMC position. Even father can provide KMC during transport if
mother can not acompany."
Question 134: Correct Answer: C
Explanation: - C
Ans. is c i.e., Stapedectomy
Rosens incision is the most commonly used for stapedectomy
through endomeatal or transcanal approach. Also know
Lemperts incision is used for endural approach.
Wildes incision is used for postaural approach.
Question 135: Correct Answer: C
Explanation: - C
Ans. is c i.e., Inhibited by hematoma
Factors causing impairment of wound healing
A. Systemic factors
Poor nutrition (protein deficiency, vitamin C deficiency).
Metabolic abnormalities (Diabetes mellitus).
Poor circulatory status (Inadequate blood supply).
Hormones, e.g. glucocorticoids.
B. Local factors
Infection is the single most important factor.
Mechanical factors, e.g. early mobilization.
Foreign bodies (unnecessary sutures, fragments of steel or glass).
Wound in poorly vacularized area, e.g. foot.
Question 136: Correct Answer: C
Explanation: - C
Ans. is c i.e., Testosterone
Predisposing factors for Acne vulgaris
Genetic factors
Hormones -4 Androgens, glucocorticoids.
Psychological stress and depression.
Environmental factors High temperature & humidity.
Cosmetics -3 Containing lenolin, petroleum, vegetable oils.
Infection --> Propionibacterium, Pityrosporum, Staph. epidermidis.
Menstural cycle -4 Premenstural aggravation.
Hyperkeratosis of pilosebaceous ostia.
Drugs Antepileptics (Carbamazepine, phenytoin, phenobarbitone),
antitubercular (INH, rifampin, ethionamide), antidepressants,
cyclosporine, Vitamin B12.Cough syrups containing halogens
(Iodides, bromides).
Question 137: Correct Answer: C
Explanation: - C
Ans. is c i.e., Horse shoe kidney

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Horse shoe kidney is the most common congenital renal anomaly,
with an incidence of 1 in 400 live births.
Fusion typically occurs at lower poles, with subsequent arrest of
ascend of kidney, due to restriction at the inferior mesenteric artery.
As a result, kidneys are lower in abdomen.
Question 138: Correct Answer: A
Explanation: - A
Ans. is a i.e., Social structure
Patterns of inter-relationships between persons in a society is called
social structure. Note - Study of human inter-relationship is called
sociology.
Question 139: Correct Answer: C
Explanation: - C
Ans. is c i.e., Beta hemolytic streptococcus
Peritonsillar abscess (Ouinsy)
Quinsy consists of suppuration outside the capsule in the area
around the capsule. There is collection of pus between the capsule
of tonsil and the superior constrictor muscle, i.e. in the peritonsillar
area.
Peritonsillar abscess is a complication of tonsillitis and is most
commonly caused by group A beta - hemolytic streptococcus.
Clinical features of Quinsy
Clinical features are divided into :?
General : They are due to septicaemia and resemble any acute
infection.
1. They include fever (up to 104°F), chills and rigors, general malaise,
body aches, headache, nausea and constipation.
2. Local :
3. 4. Severe pain in throat. Usually unilateral.
Odynophagia. It is so marked that the patient cannot even swallow
his own saliva which dribbles from the angle of his mouth. Patient is
usually dehydrated.
5. 6. Muffled and thick speech, often called "Hot potato voice".
Foul breath due to sepsis in the oral cavity and poor hygiene.
Question 140: Correct Answer: D
Explanation: - D
Ans. is d i.e., Homocystinuria
Inborn error of metabolism and Treatment
Alkaptonuria Vitamin C, Folic acid
Homocystinuria Pyridoxine + Folic acid
Cystinuria Alkalization of urine + d-Penicillamine,
Captopril
Hartnup disease Nicotinamide
Multiple carboxylase
eficiency Biotin

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Methyl malonic academia Vitamin B 12
Hyperoxaluria Pyridoxine
Tyrosinemia NTBC, Liver Transplantation
Question 141: Correct Answer: B
Explanation: - B
Answer- B. Endoscopic dilation
The symptom & sign complex indicates diagnosis of Achalasia.
One of the treatment modalities for achalasia cardia is endoscopic
dilation.
Question 142: Correct Answer: B
Explanation: - B
Ans. is b i.e., External iliac
The lymphatics from the cervix drain into the external iliac, internal
iliac and sacral nodes.
Lymphatic Drainage of uterus:
Fundus and upper body - aortic nodes and superficial inguinal nodes
Lower body - external iliac nodes
Cervix - external iliac, internal iliac and sacral nodes.
Lymphatic drainage of Vagina:
Upper 1/3 - external iliac nodes
Middle 1/3 - internal iliac nodes
Lower 1/3- superficial inguinal nodes
Question 143: Correct Answer: C
Explanation: - C
Answer- C. Produced when patient moves while taking the
shoot
Artifacts can present in a variety of ways including abnormal shadow
noted on a radiograph or degraded image quality and have been
produced by artificial means from hardware failure, operator error
and software (post-processing) artifacts.
Common causes :-
Improper handling of the films
Errors while processing the films
Patient movement while taking the shoot
Question 144: Correct Answer: C
Explanation: - C
Ans. is c i.e., TNF Alfa, IL-10 and IL 1 receptor antagonist
Actually no option is absolutely correct:
IL-10 is an anti-inflammatory cytokine Cause resolution of
inflammation
IL-1 is a pro-inflammatory cytokine ? IL-1 receptor antagonism will
cause resolution of inflammation
TNF-a is an pro-inflammatory cytokine ? causes inflammation
So, in option C, two mediators are correct and one is incorrect

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regarding resolution of inflammation. However, among the given
options only option C is the closest one.
Proinflammatory cytokines
Major :- IL-1, TNF- alpha, IL-6
Other :- IL-2, IL-4, IL-5, IL-6, IL-8, IL-11, IL-12, IL-15, IL-21, IL-23,
ITN- gamma, GM-CSF
Anti-inflammatory cytokines
IL-4, IL-10, IL-13
Here, you can consider IL-4 as pro-inflammatory cytokine ( as more
than one options can be correct in PGI chandigarh).
Question 145: Correct Answer: A
Explanation: - A
Ans. is a i.e., Topical corticosteroids
Treatment of Lichen planus
The first line treatment of lichen planus are topical corticosteroids.
Second choice would be systemic corticosteroids for symptom
control and possibly more rapid resolution.
Oral antihistaminics are given for pruritic.
PUVA can be used for extensive lesions.
Acitretin can be used for mucosal lesions.
Question 146: Correct Answer: C
Explanation: - C
Ans. is c i.e., Bordetella pertussis
In culture smears, the bacilli are arranged in loose clumps with clear
spaces in between giving a thumbprint appearance.
Culture Characteristics of Bordetella
Incorporation of diamine fluoride and penicillin (Laceys DFP
medium) makes it more selective.
It produces bisected pearl or mercury drops colonies.
Confluent growth is present with “aluminium paint” appearance.
In culture smears the bacilli are arranged in loose clumps with clear
spaces in between giving a thumbprint appearance.
Transport media used are modified by Stuarts medium and
Mischulo’s charcoal agar.
Question 147: Correct Answer: D
Explanation: - D
Ans. is d i.e., All
Question 148: Correct Answer: C
Explanation: - C
Answer- C. Hematoma
Blunt trauma to testis can cause hematoma.
There is associated tenderness, swelling and ecchymosis of the
hemiscrotum.
Question 149: Correct Answer: C

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Explanation: - C
Ans. is c i.e., Afibrogenemia
Cryoprecipitate was originally developed for the treatment of
hemophilia A. It is no longer the treatment of choice for that disorder
because less infectious alternatives are available.
At the present time, Cryoprecipitate is most often used for correction
of hypofibrinogenemia in bleeding patients.
Question 150: Correct Answer: B
Explanation: - B
Ans. B. 2cm
In dorsal lithotomy position, the antero-posterior diameter of the
outlet may be increased to 1.5-2 cm.
Furthermore, the coccyx is pushed back while the head ilescends
down to the perineum.
Question 151: Correct Answer: B
Explanation: - B
Ans. is b i.e., Multiple myeloma
Patterns of bone destruction present in a lytic lesion ?
Geographic : Sharp clearly defined margins. Less aggressive,
benign. Eg: non ossifying fibroma, chondromyxoid fibroma,
eosinophilic granuloma.
Moth eaten appearance : Holes in destroyed bone. Rapid growth,
malignant Eg: Myeloma, metastasis, lymphoma.
Permeative : Ill defined, diffuse, somewhat subtle destructive
process of bone. Eg: Lymphoma, leukemia, Ewings sarcoma,
osteomyelitis.
Question 152: Correct Answer: C
Explanation: - C
Ans. is c i.e., Goldman type III
Projected stimuli in perimetry are usually white and of variable size
and intensity.
There are five different sizes on Goldmann scale designated by
Roman numeral Ito V.
The standard used in both manual and automated perimetry is
Goldman III (0.05" and area of 4mm2). o Failure to recognize target
size III necessitates testing with stimulus V
Goldman scale Stimulus size (mm2)
I /4
II 1
III 4
IV 16
v 64
Question 153: Correct Answer: D
Explanation: - D

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Ans. is d i.e., Valproate
Question 154: Correct Answer: B
Explanation: - B
Answer- B. Tufting
Skin involvement in systemic sclerosis
Pruritus in the early stages
Edema in the early stages
Sclerodactyly
Digital ulcers
Pitting at the fingertips
Telangiectasia
Calcinosis cutis
Question 155: Correct Answer: A
Explanation: - A
Ans. A [Immediately]
Congenital cataract - Timing of surgery
Bilateral dense - cataract requires early surgery (i.e. by 6 weeks of
age ) to prevent the development of stimulus deprivation amblyopia
Bilateral partial- cataract may not require surgery until later if at all,
in cases of doubt, it may be prudent to defer surgery monitor lens
opacity, and visual function and intervene later if vision deteriorates.
Unilateral dense - cataract merits urgent surgery (within days )
followed by aggressive anti-amblyopia therapy the cataract is
detected after 16 weeks of age then surgery can be delayed little
because amblyopia is refractory
4. Partial unilateral - cataract can usually be observed or treated
non surgically with pupillary dilatation and possibly part-time
contralateral occlusion to prevent amblyopia "The critical period of
developing the fixation reflexes in both unilateral and bilateral visual
deprivation disorders is between 2 and 4 months of age, any
cataract dense enough to impair vision must be dealt with before this
Question 156: Correct Answer: B
Explanation: - B
Dacron graft is a type of textile synthetic graft. It is associated with increased risk of
thrombosis due to low flow rates.
They are pre coated with collagen, which eliminates the need for pre-clotting.
It is now reserved for aortic and high pressure, large diameter bypass grafts or used as
aortic endografts.
Ref: Diabetic Foot: Lower Extremity Arterial Disease and Limb Salvage, Anton N. Sidawy,
2006 Edition, Chapter 22, Page 234; Mastery of Vascular and Endovascular Surgery By
Gerald B. Zelenock, 2006 Edition, Chapter 50, Page 414; Vascular Access: Principles and
Practice By Samuel Eric Wilson, 5th Edition, Page 115; Vascular Surgery By Alun H.
Davies, Page 135.
Question 157: Correct Answer: C

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Explanation: - C
Ans. is c i.e., Presence of depression
Good prognostic factors :- Acute onset; late onset (onset after 35
years of age); Presence of precipitating stressor; Good premorbid
adjustment; catatonic (best prognosis) & Paranoid (2nd best); short
duration (< 6 months); Married; Positive symptoms; Presence of
depression; family history of mood disorder; first episode; pyknic
(fat) physique; female sex; good treatment compliance & good
response to treatment; good social support; presence of confusion
or perplexity; normal brain CT Scan; outpatient treatment.
Question 158: Correct Answer: D
Explanation: - D
Ans. is d i.e., Disorder of phagocytosis
Jobs syndrome is defect in phagocytic function.
It is characterized by cold staphylococcal abscess, atopic eczema,
otitis media; serum immunoglobulins are normal except IgE that is
elevated
Question 159: Correct Answer: B
Explanation: - B
Ans. is b i.e., Type II
Epiphyseal (Physeall Injuries
o The junction between the metaphysis and epiphysis, i.e. physeal
plate/growth plate, is the weakest point of a long bone in children
and is, therefore, most vulnerable to shearing forces.
o Salter and Harris have classified epiphyseal injuries into five types
?
Type I : Complete separation of epiphysis from the metaphysis
without fracture. Common in rickets, scurvy and osteomyelitis.
Type II: The fracture involves the physis and a triangle of
metaphyseal bone (Thurston Holland sign).This is the commonest
type of epiphyseal injury accounting for 73 percent of cases over 10
years of age.
Type III: The fracture is intra- articular and extends along the physis
and then along the growth plate. This injury is relatively uncommon.
Type IV: The fracture is intra- articular and extends through the
epiphysis, physis and metaphysis. Perfect reduction is necessary
and open reduction is more often necessary to prevent growth
arrest.
Type V : Crushing of epiphysis. Growth arrest usually follows.
Type VI (Rangs type) : There is a peripheral physis (perichondrial
ring) injury.
Question 160: Correct Answer: A
Explanation: - A
Opinion are views held by people on a point of dispute.
They are based on evidence available at the time.

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Opinions by definition are temporary, provisional.
They can be looked on as beliefs for the time being.
Ref: Park’s Textbook of Preventive and Social Medicine, 19th edition, Page 542.
Question 161: Correct Answer: C
Explanation: - C
Ans. is c i.e., Fungal infection
Hypopyon refers to accumulation ofpolymorphonuclear leucocytes in
the lower angle of anterior chamber. Many
pyogenic organisms (Staphylococcus, streptococci, gonococci,
Moraxella) and fungi may produce hypopyon but
by far the most dangerous are pseudomonas pyogenea and
pneumococcus.
Thus, any corneal ulcer may be associated with hypopyon, however,
it is customary to reserve the term hypopyon
corneal ulcer for the characteristic ulcer caused by pneumococcus
and the term corneal ulcer with hypopyon for
the ulcers associated with hypopyon due to other causes. The
characteristic hypopyon corneal ulcer caused by
pneumococcus is called "ulcus serpens" .
It is worth noting that the hypopyon in bacterial causes is sterile
since the outpouring of polymorphonuclear cells is due to toxin and
not due to actual invasion by bacteria. On the other hand, hypopyon
in fungal (mycotic) corneal ulcer is non-sterile as there is direct
invasion by fungi.
Question 162: Correct Answer: C
Explanation: - C
Answer- C. Parietal peritoneum
Embryologically parietal peritoneum is derived from the
somatopleural layer of the lateral plate mesoderm. Its blood supply
and nerve supply are the same as those of the overlying body wall.
Because of the somatic innervation, it is pain sensitive." — BDC
Anatomy
Question 163: Correct Answer: C
Explanation: - C
Ans. C. Through IP3- DAG system
Question 164: Correct Answer: A
Explanation: - A
Answer- A. Nephritic syndrome
Decreased albumin/Globulin ratio is seen :
Multiple myeloma or metastatics disease
AIDS
Renal disease
Liver disease (cirrhosis)
Intestinal disease (Protein losing enteropathy)

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Cachexic patient
CHF
A/G ratio is decreased in nephrotic syndrome.
Question 165: Correct Answer: C
Explanation: - C
Ans. is c i.e., Forearm
Mugging (choke hold) : It is compression of neck by forearm or in the
bend of elbow.
Bansdola : Compression of neck with one or two wooden sticks or
bamboo.
Garrotting : It is compression of neck by a rope thrown from behind.
Spanish windlass is a type of garrotting, which used to be the official
mode of execution in spain. In this, an iron collor around the neck
was tightened by a screw for strangulation.
Throttling (manual strangulation) : Neck is compressed by one or
both hands.
Question 166: Correct Answer: B
Explanation: - B
Ans. is b i.e., Man and closely related women
Question 167: Correct Answer: B
Explanation: - B
Ans. B. Maxillectomy
WEBER FERGUSON APPROACH:
This approach involves an extension of the lateral rhinotomy incision
that includes the splitting of upperlip.
Indications: Exenteration of maxilla for total or subtotal maxillectomy
(splitting the upper lip releases the facial flap for adequate lateral
retraction and adds transoral exposure of palate and teeth)
Question 168: Correct Answer: D
Explanation: - D
Answer- D. > 50yrs
Myelodysplastic syndrome occurs most commonly in older adults
with median age at diagnosis in most cases of 65 years and a male
preponderance. Onset of the disease earlier than age 50 is unusual.
Question 169: Correct Answer: D
Explanation: - D
According to TNM staging system for breast cancer,
T3: Tumor >5 cm in greatest dimension
N3c: Metastasis in ipsilateral supraclavicular lymph node(s)
MX: Distant metastasis cannot be assessed
Ref: Hunt K.K., Newman L.A., Copeland E.M., Bland K.I. (2010). Chapter 17. The Breast.
In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E.
Pollock (Eds), Schwartzs Principles of Surgery, 9e.
Question 170: Correct Answer: B

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Explanation: - B
Ans. is b i.e., Decrease LAP score
Polycythemia vera
Polycythemia vera is a neoplasm arising in a multipotent myeloid
sterm cell that is characterized by increased marrow production of
erythroid, granulocytic and megakaryocytic elements.
This leads to erythrocytosis (polycythemia), granulocytosis, and
thrombocytosis in the peripheral blood.
Polycythemia is responsible for most of the clinical symptoms of
polycythemia vera.
Polycythemia vera progenitor cells have markedly decreased
requirements for erythropoietin and other hematopoietic growth
factors. Accordingly serum erythropoietin levels in polvuthemia vera
are very low, whereas almost all other forms of absolute
polycythemia are caused by elevated ervthropoietin levels.
Clinical manifestations
1. Symptoms due to polycythemia
Most symptoms are related to the increased red cell mass and
hematocrit, i.e., Polycythemia.
The elevation of hematocrit is usually accompanied by increased
total blood volume, and together these two promote abnormal blood
Question 171: Correct Answer: A
Explanation: - A
Ans. A. Gastric juice
Question 172: Correct Answer: A
Explanation: - A
Ans. is a i.e., C3
Surface anatomy of larynx are :
C, Level of body of hyoid and its greater cornu.
C3 -C, Junction Level of upper border of thyroid cartilage and
bifurcation of common carotid artery. C4- C, Junction Level of thyroid
cartilage.
C6 Level of cricoid cartilage.
Question 173: Correct Answer: A
Explanation: - A
Ans. is a i.e., Post traumatic nerve fibres of facial nerve with
parasympathetic of auriculotemporal nerve
Freys syndrome (gustatory sweating)
Gustatory sweating or Freys syndrome involves post-parotidectomy
facial sweating and skin flushing while eating.
The symptoms usually occur several months or even years after
parotid surgery.
The likely pathophysiology is aberrant regeneration of postganglionic
secretomotor parasympathetic nerve fibres (originating from the otic
ganglion) misdirected through several axonal sheaths of post-

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ganglionic sympathetic fibres feeding the sweat glands. These
sympathetic fibres are to the sweat glands of the skin in the
dissected field.
The freys syndrome is likely due to injury to auriculotemporal nerve
with faulty regeneration, therefore Freys syndrome is also known as
Auriculotemporal syndrome.
A variant of Freys syndrome in which there is gustatory facial
flushing but not sweating, occurs following facial paralysis due to
faulty regeneration following injury to the facial nerve. So, Freys
syndrome is not limited to parotid surgery with injury to
auriculotemporal nerve.
Question 174: Correct Answer: A
Explanation: - A
Answer- A. Hypokalemia
Complications of Massive transfusion : -
Coagulopathy
Citrate toxicity
Hypothermia
Metabolic alkaptosis
Hyperkalemia
Acute respiratory distress syndrome
Coagulation factor depletion
Question 175: Correct Answer: A
Explanation: - A
Answer- A. Enlarged superior ophthalmic vein
Contrast-enhanced CT scan and MRI will demonstrate a dilated
superior ophthalmic vein and cavernous sinus.
Ultrasonography may also demonstrate superior ophthalmic vein
engorgement.
Magnetic resonance angiography (MRA) is also very useful in
identifying fistulas as well as particular vessel involvement.
Question 176: Correct Answer: D
Explanation: - D
"Angiotensin II is one of the most potent vasoconstrictors known, being four to eight
times as active as norepinephrine on a weight basis in normal individuals". It produces
arteriolar constriction and a rise in systolic and diastolic blood pressure. - Ganong
It also acts on the adrenal cortex to increase secretion of aldosterone.
It facilitates the release of norepinephrine by a direct action on postganglionic sympathetic
neurons, contraction of mesangial cells with a resultant decrease in GFR and a direct effect
on the renal tubules to increase Na+ reabsorption.
It acts on the brain to increase water intake (through subfornicial organ) and increase the
secretion of vasopressin and ACTH.
Question 177: Correct Answer: B
Explanation: - B

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Ans.B. 1000-1500 ml
Question 178: Correct Answer: C
Explanation: - C
Ans. is c i.e., Sigmoid sinus thrombosis
Contrast-enhanced CT scan can show sinus thrombosis by typical
delta-sign. It is a triangular area with rim enhancement, and central
low density area is seen in posterior cranial fossa on axial cuts.
Delta-sign may also be seen on contrast enhanced M RI.
Question 179: Correct Answer: C
Explanation: - C
Ans. is c i.e., Decreased MCHC
Laboratory findings
Spherocytosis 4 Peripheral smear shows microspherocytes which
are small RBCs without central pallor (Normally central 1/3 pallor is
present in red cells).
MCV • Reticulocytosis -) As seen
with any type of hemolytic anemia.
MCHC T • Hemoglobin
Increased unconjugate bilirubin • Serum Heptoglobin Normal to
decreased.
Urine urobilinogen T • Increased osmotic fragility.
Stool stercobilinogen T
Question 180: Correct Answer: A
Explanation: - A
Ans. is a i.e., EHL and EDL
Question 181: Correct Answer: B
Explanation: - B
Ans. is b i.e., Pancreatitis
Adverse effects of nicotine
Adverse effects ? 1) Marked flushing, itching (pruritis) and heat due
to cutaneous vasodilatation, 2) Dyspepsia, vomiting and diarrhoea,
3) Liver dysfunction, 4) Hyperpigmentation and dryness of skin, 5)
Hyperglycemia and hyperuricemia.
The cutaneous effects of nicotinic acid include flushing and pruritis
of face and upper trunk, skin rashes and acanthosis nigricans.
These symptoms are due to vasodilatory action of niacin through
release of PGs and can be prevented by pretreatment with aspirin.
Question 182: Correct Answer: B
Explanation: - B
Ans. is b i.e., Psoas major
Question 183: Correct Answer: B
Explanation: - B
Ans. is b i.e., Grandiosity
Option a is confusing one. Yes, elevated mood is one of the most

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classical symptom of mania. But it is not pathognomonic.
Pathognomonic means a symptom which can be used for diagnosis.
Elevated mood is not a symptom of diagnostic criteria of mania.
Diagnostic criteria for mania
Three or more of the following for at least 1 week :-
1. Inflated self esteem or grandiosity
2. Decreased need for sleep
3. Overtalkativeness
4. Flight of ideas
5. Distractibility
6. Psychomotor agitation or Increased goal directed activitie
7. Excessive involvement in pleasurable activities
Important symptoms of mania
1. Elevated mood :- Euphoria, elation, exatlation, ectasy, high self
esteem.
2. Thought & speech :- Pressure of speech (Talkativeness), flight of
ideas, delusion of grandeur, delusion of persecution, distractibility.
3. Increased psychomotor activity :- Overactiveness, restlessness,
increased energy.
4. Goal directed activity :- Patient is alert, trying to do many things at
Question 184: Correct Answer: C
Explanation: - C
Ans. is c i.e., Creatine phosphate
High energy compounds
The energy released during oxidation of monosaccharides, fatty
acids and amino acids may not be required immediately. Therefore,
there must be some way of storing energy. The energy released
during catabolism is captured in the form of a group of compounds
known as "high-energy phosphates". The most important member of
this groupis ATP.
A compound that liberates 7 Kcal/mol or more on hydrolysis is called
high energy compound, or a compound that on hydrolysis
undergoes a large ( 7 kcal/mol) decrease in free energy (AG) under
standard condition is called high energy compound, i.e., AG ?- 7
Kcal/mol. For example, ATP liberates 7.3 Kcal/mol on hydrolysis.
High energy compounds are : ?
Phosphate compounds : Nucleotides (ATP Q,GTP, UTP, UDP-
glucose), Creatinine phosphate, arginine phosphate, 1,3-
bisphosphoglycerate, Phosphoenol pyruvate, inorganic
pyrophosphate, Carbamoyl phosphatee,amino acyl adenylate (amino
acyl AMP).
Sulfur compounds : - CoA derivatives (acetyl CoAe, Succinyl CoA,
Question 185: Correct Answer: C
Explanation: - C
Ans. is c i.e., Culture agar method

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Tests used for antimicrobial sensitivity are :
1. Disc susceptibility test (most commonly used)
2. Broth dilution susceptibility test
3. Kirby-Bauer disc diffusion method
4. E-test (Epsilonieter test)
Question 186: Correct Answer: B
Explanation: - B
Ans. is b i.e., Hypermetropic
Eye at birth
Anteroposterior diameter of eye ball is about 16.5 mm (70% of adult
size). Adult size is attained by 7-8 years.
Corneal diameter is about 10 mm. Adult size (11.7 mm) is attained
by 2 years of age.
Anterior chamber is shallow and angle is narrow.
Lens is spherical at birth.
Retina : - Apart from macular area, the retina is fully differentiated.
Macula differentiates 4-6 months after birth.
Myelination of optic nerve fibres has reached the lamina cribrosa.
New born is usually hypermetropic by +2 to +3D.
Orbit is more divergent (50°) as compared to adult (450).
Lacrimal gland is still underdeveloped and tears are not secreted.
Question 187: Correct Answer: B
Explanation: - B
Ans. is b i.e., Pancreatic cancer
Question 188: Correct Answer: C
Explanation: - C
Answer- C. Normal BP
Hyponatremia (dilutional hyponatremia with Net < 135 mmol/L)
Decreased plasma osmolality (<280 m osm/kg) with inappropriately
increased urine osmolality > 150 m osm).
High urine sodium (over 20 meq/1)
Low blood urea nitrogen <10 mg/L
Hypouricemia (<4 mg/dL)
Clinical euvolemia
Question 189: Correct Answer: B
Explanation: - B
Ans. is b i.e., LASIK
Amongst the given options, maximum correction can be achieved by
LASIK.
Surgical ocedure Myopia orrection
Radial keratomy -2 to -6 D
Photorefractive keratotomy -2 to -6 D
LASIK Upto -12D
Extraction of lens -16 to -18 D

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Phakic IOL > -12 D
Interconaeal ring (ICR 1-6 D
Orthokeratology upto - 5D
Question 190: Correct Answer: B
Explanation: - B
Ans. is b i.e., Common in adults
Retropharyngeal abscess
Retropharyngeal space lies behind the pharynx, i.e. between
buccopharyngeal fascia covering pharyngeal constrictor muscles
(anteriorly) and prevertebral fascia covering the prevertebral
muscles (posteriorly).
So, retropharyngeal space lies behind the pharyngeal constrictor
muscles and anterior to prevertebral fascia covering the prevertebral
muscles.
Abscess in this space may present differently depending upon the
age :?
Abscess in infants (acute Retropharyngeal abscess)
It is commonly seen in infants and children below 3 years of
age. Most commonly it results from retropharyngeal
lymphadenitis due to an upper respiratory tract infection. The
presention is acute, i.e. child has high temperature and sore throat.
There is smooth swelling (bulge) in posterior pharyngeal wall
on one side of the midline. There is dysphagia, difficulty in
breathing, stridor, croupy cough and torticollis. Swelling can be
palpable per orally on the posterior pharyngeal wall. Treatment is
incision and drainage.
Question 191: Correct Answer: C
Explanation: - C
Ans. is c i.e., T. pallidum
Koch postulates
Robert Koch proposed a series of postulates that have been applied
broadly to link many specific bacterial species with particular
disease.
Kochs postulates are :
1. The microorganism should be found in all cases of the disease in
question and its distribution in the body should be in accordance
with the lesions observed.
2. The microorganism should be grown in pure culture in vitro (or
outside the body of the host) for several generations.
3. When such a pure culture is inoculated into susceptible animal
species, the typical disease must result.
4. The microorganism must again be isolated from the lesions of such
experimentally produced disease.
Microorganisms that do not meet the criteria of Kochs postulates
1. Mycobacterium leprae (leprosy) ? Can not be cultured in vitro

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2. Treponema pallidum (syphilis) ? Neisseria gonorrhoeae
3. No animal model for experimental infection
Microorganism that partially satisfy the postulates
E. coli induced diarrhea
Question 192: Correct Answer: B
Explanation: - B
Ans. is b i.e., No inflammation
Question 193: Correct Answer: C
Explanation: - C
Ans. is c i.e., Chronic tonsillits
Tonsillectomy
Tonsillectomy, as the name suggests, is the surgical procedure to
remove the tonsils.
Often, tonsillectomy is done at the same time as adenoidectomy.
Indications
Indications are divided into :?
A. Absolute
1. Recurrent infections of throat. This is the most common
indication.Recurrent infections are further defined as :
Seven or more episodes in one year, or
Five episodes per year for 2 years, or
Three episodes per year for 3 years, or
Two weeks or more of lost school or work in one year.
2. Peritonsillar abscess.
In children. tonsillectomy is done 4-6 weeks after abscess has been
treated. In adults, second attack of peritonsillar abscess forms the
absolute indication.
3. Tonsillitis causing febrile seizures.
4. Hypertrophy of tonsils causing
Airway obstruction (sleep apnoea)
Question 194: Correct Answer: D
Explanation: - D
Ans. is c > b i.e., IgM > IgG
Make it very clear in your mind that both IgM and IgG fix C 1.
" C2 of IgG and C114 of IgM bind to CIq portion of C1"--------
Ananthanarayan
"CIq portion of CI is an aggregate of 18 polypeptides that binds to
the Fc portion of IgM and igG."---LANGE microbiology
However, if you will have to choose one option, IgM is the best
because IgM is more effective than IgG for complement fixation.
Question 195: Correct Answer: B
Explanation: - B
Ans. is b i.e., SLE
Band test (Lupus band test)

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Lupus band test is done upon skin biopsy, with direct
immunofluorescence staining, in which, if positive, IgG and
complement depositions are found at the dermoepidermal junction.
This test can be helpful in distinguishing systemic lupus
erythematosus (SLE) from cutaneous lupus, because in SLE the
lupus band test will be positive in both involved and uninvolved skin,
whereas with cutaneous lupus only the involved skin will be positive.
The minimum criteria for positivity are:
In sun-exposed skin : Presence of a band of deposits of IgM along
the epidermal basement membrane in 50% of the biopsy,
intermediate (2+) intensity or more.
In sun protected skin : Presence of interrupted (i.e. less than 50%)
deposits of IgM along the epidermal basement membrane,
intermediate (2+) intensity or more.
The presence of other immunoglobulins (especially IgA) and/or
complement proteins (especially C4) increases the specificity of a
positive test.
Question 196: Correct Answer: A
Explanation: - A
Ans. is a i.e., Rickettesial diseases
o Transovarial transmission is seen in Rickettesial disease (scrub
typhus, Rickettsial pox, RMSF, ITT, Q fever).
Question 197: Correct Answer: D
Explanation: - D
A i.e. Ketamine; B i.e. Nitrous oxide
Question 198: Correct Answer: C
Explanation: - C
Ans. is c i.e., Malaria
Types of anemia that have protective effect against P. falciparum
malaria : -
G6PD deficiency, Sickle cell anemia, Thalassemia, HbC, Pyruvate
kinase deficiency
Question 199: Correct Answer: C
Explanation: - C
Ans. is c i.e., HRCT
Lung fibrosis is a diffuse parenchymal lung disease.
Idiopathic pulmonary fibrosis is the most common form of idiopathic
interstitial pneumonia.
We have already discussed that best investigation for interstitial lung
disease is HRCT
Estimated relative frequency of the interstitial lung disease
Diagnosis Relative frequency,
%
Idiopathic interstitial

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pneumonias 40
Idiopathic pulmonary fibrosis 55
Nonspecific interstitial
pneumonia 25
Respiratory bronchiolitis-ILD
and 15
Cryptogenic organizing
pneumonia 3
Acute interstitial pneumonia <1
Occupational and environmental 26
Sarcoidosis 10
Question 200: Correct Answer: C
Explanation: - C
Ans. is c i.e., Dissociative disorder
Dissociative disorder
The essential feature of the dissociative disorder is a disruption in
the usually integrated functions of consciousness, memory, identity
or perception of the environment. Dissociative disorder are :-
Dissociative (psychogenic) amnesia :- It is the most common type of
dissociative disorder. Dissociative amnesia is characterized by
retrograde amnesia (inability to retrieve stored memories and events
leading up to onset of amnesia) and absence of antegrade amnesia
(inability to form new long term memories).
Dissociative fugue :- A dissociative fugue may be present when a
person impulsively wanders or travels away from home and upon
arrival in the new location is unable to remember his/her past (i.e.,
amnesia for early life). There is loss of personal identity and the
person assumes a new identity. There is absence of awareness of
amnesia during fugue episode, i.e., Patient denies any memory loss
during fugue state. On recovery there is amnesia for fugue episodes
and recovery of memory of earlier life (i.e., before the episode of
fugue).
Dissociative identity disorder (multiple personality disorder) :- More
than one personality appears to possess the individuals, Showing
their characteristic behavior. At any instance behavior and memories

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 Subject: NEET PG 2014 - Questions
1. Hyoid bone fracture most common
occurs in ?
a) Manual strangulation
b) Hanging
c) Smothering
d) Traumatic asphyxia

2. When the patient fails to understand

normal speech, but can understand
shouted or amplified speech the
hearing loss, is termed ?
a) Mild hearing loss
b) Moderate hearing loss
c) Severe hearing loss
d) Profound hearing loss

3. Turban epiglottis is seen in ?

a) TB
b) Leprosy
c) Laryngeal papilloma
d) Epiglottitis

4. True about erythema

toxicumneonatorum is ?
a) It is present in 3 - 5 % of the newborns
b) It is mostly present at birth
c) It is called the flea bitten rash of newborn
d) Topical antibiotics is the treatment of choice

5. Development of Chondrosarcomas is
related with?
a) Maffucci syndrome
b) Felty syndrome
c) a and b both
d) None of the above

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6. Spalding sign is seen in ?
a) Drowning
b) Mummification
c) Maceration
d) Starvation

7. Large granular lymphocytes are ?

a) B cells
b) NK cells
c) T cell
d) Plasma cells

8. With regards to G6PD deficiency, which

of the following in false
a) Affects the pentose phosphate pathway
b) Associated with neonatal jaundice
c) Acute haemolysis can be precipitated by broad beans
d) X-linked recessive disorder that does not affect heterozygous
famales

9. Weil felix reaction is heterophile

antibodies reaction due sharing of
Rickettsial antigen with
a) Shigella
b) Proteus
c) Chlamydia
d) Mycoplasma

10. Biological value of protein is

a) Increase in weight per unit protein consumed
b) Percentage of ingested protein retained inside the body
c) Percentage of absorbed nitrogen retained
d) Percentage of energy provided by a protein of food

11. Z score measures the bone mineral

density compred to ?
a) Age, Race and sex matched individuals
b) Race and sex matched individuals
c) Sex matched individuals
d) None of the above

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12. Involvement of pyramidal tract leads to
all of the following except
a) Spasticity
b) Fasciculation
c) Hyper-reflexia
d) Positive Babinski sign

13. Following is false regarding the bullet

entry wound in skull ?
a) Punched in hole in outer table
b) Inner table shows bevelling surface
c) No pieces of bone are present in the bullet track
d) Wound is funnel shaped with the funnel opening in the direction
in which the bullet is travelling

14. Callaural fistula is an abnormality of ?

a) 1" branchial arch
b) Pt branchial cleft
c) 2nd branchial arch
d) 2nd branchial cleft

15. Hunters canal is seen in?

a) Cubital fossa
b) Popliteal fossa
c) Thigh
d) Calf

16. Which of the following endocrine tumors is most commonly seen in MEN
I?
a) Insulinoma
b) Gastrinoma
c) Glucagonoma
d) Somatostatmoma

17. Engagement of head in labour means ?

a) Smallest horizontal plane of the presenting part has crossed the
pelvic brim
b) Greatest horizontal plane of the presenting part has crossed the
pelvic brim
c) Smallest horizontal plane of the presenting part has crossed the
pelvic outlet
d) Greatest horizontal plane of the presenting part has crossed the

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pelvic outlet

18. Indian tick typhus is caused by:

a) R typhi
b) R conorii
c) R akari
d) C burnetii

19. Prophylactic dose of vitamin K given to

new born infants at delivery is ?
a) 1mg
b) 5mg
c) 10mg
d) 15mg

20. Recommended content of Iodine in salt

at production level ?
a) 10 ppm
b) 15 ppm
c) 20 ppm
d) 30 ppm

21. Subconjunctival cyst is seen in?

a) Toxoplasmosis
b) Cysticercosis
c) Leishmaniasis
d) Chagas disease

22. Most common finger print type is ?

a) Loops
b) Whorls
c) Composite
d) Arches

23. Mesothelioma is positive for which

intermediate filament
a) Vimentin
b) Cytokeratin
c) GFAP
d) Desmin

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24. Fever is produced by ?
a) PGF2?
b) PGE2
c) PGI2
d) PGD2

25. First line treatment of infertility in PCOS

is ?
a) Clomiphene
b) FSH
c) GnRH
d) Assisted reproductive techniques

26. Major sign for AIDS surveillance in WHO

case definition ?
a) > 10% weight loss
b) Cough > 1 month
c) Generalized lymphadenopathy
d) Disseminated Herpes

27. 2. 3. 1947. Dermatophyes affect ?

a) Keratin
b) Dermis of skin
c) Stratum basal
d) Stratum basal

28. XDR TB is resistance to ?

a) Isoniazid
b) Isoniazid + Rifampicin
c) Isoniazid + Rifampicin + Ethambutol
d) Isoniazid + Rifampicin + Kanamycin

29. Alveolar hypoventilation is present in

A/E:
a) Bulber poliomyelitis
b) COPD
c) Kyphoscoliosis
d) Lobar pneumonia

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30. Platelet adhesion is inhibited by ?
a) Nitric oxide
b) Substance P
c) Thrombin
d) IL 2

31. Condition where there is ingrowth of

the endometrium, both glandular and
stromal component in myometrium is ?
a) Adenomyosis
b) Courvelaire uterus
c) Placenta accreta
d) Uterine fibroid

32. Round pneumonia is seen with

a) Streptococcal pneumonia
b) Kerosene oil aspiration
c) Lung cancer
d) Mendelson syndrome

33. Thyroid nodule increased radioisotope

uptake IOC is
a) Biopsy
b) Thyroid scan
c) FNAC
d) None

34. Sensory perception involves Brodmanns

area ?
a) 3, 1, 2
b) 4, 6
c) 44, 45
d) 41, 42

35. Following is true about behcets

disease except ?
a) It shows presence of aphthous ulceration, genital ulceration and
uveitis
b) Uveitis is bilateral, acute recurrent iridocyclitis with hypopyon
c) It has good visual prognosis
d) Chlorambucil can be used to control the disease

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36. All of the following can precipitate
porphyria except ?
a) Steroids
b) Griesiofulvin
c) Penicillin
d) Estrogen

37. The most common type of Tracheo-

Oesophageal Fistula is -
a) Esophageal atresia without tracheoesophageal fistula
b) Esophageal atresia with proximal tracheoesophageal fistula
c) Esophageal atresia with distal tracheoesophageal fistula
d) Esophageal atresia with proximal and distal fistula

38. Puppes rule deals with?

a) Chemical injuries
b) Multiple impact injuries
c) Sexual assault
d) Percentage of burns

39. Grimace with APGAR score -

a) 0
b) 1
c) 2
d) 3

40. Following are the indications of barium

meal X-ray except -
a) Duodenal ulcer
b) Carcinoma stomach
c) Carcinoma head of pancreas
d) Ischemic Colitis

41. Dysthymia is ?
a) Chronic depression
b) Chronic mania
c) Bipolar disorder
d) Personality disorder

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42. Beta blockers mask all effects of
hypoglycemia except ?
a) Sweating
b) Palpitations
c) Dizziness
d) Tremors

43. In Takayasus arteritis there is

a) Intimal fibrosis
b) Renal hypertension
c) Coronary aneurysm
d) All of the above

44. Drug of choice for MRSA infection ?

a) Ciprofloxacin
b) Oxacillin
c) Vancomycin
d) Clindamycin

45. WPW syndrome is caused by

a) Bundle Branch Block
b) Right sided accessory pathway
c) Ectopic pacemaker in atrium
d) Left budle Branch block

46. Drugs for paralytic ileus for bowel resection

surgery are all except ?
a) Alvinopam
b) Dihydroergotamine
c) Naloxone
d) Methylnaltrexone

47. Not a cause of Gynaecomastia

a) Hypothyroidism
b) Kallman
c) obesity
d) Klinefelter syndrome

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48. Polyspermy is inhibited by which ion ?
a) Ca
b) Na
c) K
d) Cl

49. 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

50. Mania is characterized by:

a) Paranoid delusion
b) Loss of orientation
c) High self esteem
d) All

51. First rib is not related to ?

a) Sympathetic chain
b) Scalenus anterior
c) Suprapleural membrane
d) T2 Nerve

52. Most common cause of hypernatremia

a) Adipsic diabetes insipidus
b) Carcinoid syndrome
c) Renal losses
d) Sweating

53. Most common cause dementia in adult:

a) Alzheimers
b) Multiinfrct
c) Pick disease
d) Metabolic cause

54. Intra uterine hydronephrosis of 32-34

weeks-management?
a) Intrauterine drainage
b) Wait until 3 weeks
c) Immediate delivery

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d) Require serial USG and other associated anomalies

55. Lactose intolerance is due to ?

a) Deficiency of Galactokinase
b) Deficiency of Uridyl transferase
c) Deficiency of Lactase
d) Deficiency of Enteropeptidase

56. Maximum weight reduction is by which

surgery
a) BPD
b) Roux en Y gastric bypass
c) Sleeve gastrectomy
d) Gastric banding

57. Nonselective beta adrenergic antagonist

is
a) Nodalol
b) Atenolol
c) Bisoprolol
d) Esmolol

58. What is the pressure at which oxygen is

stored?
a) 75 psi
b) 1600 psi
c) 760 psi
d) 2200 psi

59. Febrile seizure most common - age

groups?
a) 1 month to 1 year
b) 6 month to 5 year
c) 6 month to 2 year
d) 2 month to 5 year

60. Goldenhar syndrome is associated with

which prominent ocular manifestation:
a) Microcornea
b) Megalocornea
c) Sclerocornea
d) Epibulbar dermoids

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61. Drugs used in ADHD are -
a) Atomoxetine
b) Methylphenidate
c) Dextro-amphetamine
d) All

62. Following statements about sarcoidosis

is false
a) Elevated level of angiotensin converting enzyme (ACE)
b) Bilateral parotid enlargement is the rule
c) Pleural effusion is common
d) Facial nerve palsy may be seen

63. Ketamine contraindicated in all except?

a) Head injury
b) Hypertension
c) Asthma
d) Glaucoma

64. 2. 1768. Ortolani test is positive when the

examiner hears the ?
a) Clunk of entry on abduction and flexion of hip
b) Clunk of entry on extension and adduction of hip
c) Click of exit on abduction and flexion of hip
d) Click of exit on extension and adduction of hip

65. Following are the side effects of

apraclonidine except ?
a) Lid dermatitis
b) Follicular conjunctivitis
c) Eye lid retraction
d) Watering of mouth

66. Relationship between positive predictive

value and prevalence ?
a) PPV ? Prevalence
b) PPV ? 1/Prevalence
c) PPV x Prevalence = 1
d) PPV = 1/Prevalence

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67. Blood is stored at what temperature in
blood bank?
a) -2 to -4 degrees Celsius
b) -2 to 0 degrees Celsius
c) 1 to 6 degrees Celsius
d) 6 to 12 degrees Celsius

68. Fomepizole acts as antidote for ?

a) Methanol poisoning
b) Cannabis poisoning
c) Lead poisoning
d) Cadmium Poisoning

69. Amslers grid is used to evaluate ?

a) Central 10 degress of vision
b) Central 20 degrees of vision
c) Peripheral vision
d) Lens opacity

70. Carcinoma due to inherited mutation of

p53 protooncogene
a) Li fraumeni syndrome
b) Familial adenomatous polyposis
c) Retinoblastoma
d) Osteosarcoma

71. Fundus in retinitis Pigmentosa is ?

a) White spots with red disc
b) Jet- black spots with pale-waxy disc
c) No pigmentation
d) Dilatation of arterioles

72. AST/ALT > 2 occurs in deficiency of

a) Glucose-6-phosphotase
b) Branching enzyme
c) Acid maltase
d) Liver phosphorylase

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73. Lumbar canal stenosis presents as ?
a) Claudication
b) Scoliotic deformity
c) Kyphotic deformity
d) Radiculopathy

74. Iron content of MALA-D ?

a) 10 mg
b) 19-5 mg
c) 29.5 mg
d) 40 mg

75. Which of the following enzyme does not

catalyzes irreversible step in glycolysis ?
a) Hexokinase
b) Phosphoglycerate kinase
c) Pyruvate kinase
d) Phosphofructokinase

76. Onset of post spinal headache is

usually at hours after spinal anesthesia
a) 0 - 6
b) 6-12
c) 12 - 72
d) 72 - 96

77. Which of the following has small

representation in somatosensory area of
cerebral cortex ?
a) Lips
b) Thumb/fingers
c) Tongue
d) Trunk

78. Basic laboratory service is not available

at PHC for which disease ?
a) TB
b) Malaria
c) Syphilis
d) Leprosy

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79. What of the following is seen in fresh
water drowning ?
a) Hypovolemia
b) Hemoconcentration
c) Hyperkalemia
d) Hypernatremia

80. True about Campylobacter jejuni ?

a) Obligate aerobe
b) Oxidase negative
c) Grows at 42°C
d) Non-motile

81. All of the following about thiopentone

are true except?
a) It decreases ICT
b) It has anticonvulsant action
c) IV injection is painless
d) It can cause reflex tachycardia

82. Pulsus Bigeminus is seen in therapy

with:
a) Digitalis
b) Beta Blockers
c) ACE Inhibitors
d) Calcium Channel Blockers

83. Xenobiotics are metabolized to ?

a) Increase water solubility
b) Increase lipid solubility
c) Make them nonpolar
d) None of the above

84. True about anorexia nervosa is all

except ?
a) Binge eating is common
b) Unknown in male
c) Ammenorrhoea starts before severe loss of weight
d) Self-induced vomiting

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85. Atopy in hypersensitivity is ?
a) Systemic type I hypersensitivity
b) Local type I hypersensitivity
c) Systemic type II hypersensitivity
d) Local type II hypersensitivity

86. Erbs Point in cardiology refers to:

a) Right 2nd intercostal space
b) Left 2nd intercostal space
c) Right 3rd intercostal space
d) Left 2nd intercostal space

87. Macintosh indicator is used for ?

a) To assess degree of NM blockade
b) Localization of extradural space
c) To assess level of GA
d) To monitor respiratory depression

88. Friedlander Pneumonia refers to

Pneumonia caused by:
a) Klebsiella
b) Pneumococcus
c) H. lnfluenzae
d) Staphylococcus

89. PDA true is all except ?

a) More common in preterm baby
b) Left to right shunt
c) Acyanotic congenital heart disease
d) More common in term baby

90. Virus most sensitive to inactivation by

biocides ?
a) Adenovirus
b) Herpes virus
c) Parvovirus
d) Poliovirus

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91. Hunterian perforators are seen in ?
a) Upper thigh
b) Lower thigh
c) Calf
d) Mid thigh

92. People are arranged alphabetically by

their names and then every 3rd person
is chosen for study. The type of
sampling is ?
a) Stratified random
b) Systematic random
c) Simple random
d) None of the above

93. Blunt trauma chest, first step in

management after initial resuscitation is
a) CT scan
b) Angiography
c) X-ray chest
d) USG

94. Not included in modified Jones criteria?

a) Polyarthalgia
b) Carditis
c) Chorea
d) Erythema marginatum

95. Most common germ cell tumor of ovary

is ?
a) Dysgerminoma
b) Serous cystadenoma
c) Yolk sac tumor
d) Dermoid cyst

96. Virus not sensitive to disinfection by

chlorination
a) Rotavirus
b) Norwalk virus
c) Poliovirus
d) None

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97. Boy power school preference no
spoken at school, normal speech at
other place, IQ assessment normal
diagnosis is?
a) Selective mutism
b) ADHD
c) Autism
d) Dyslexia

98. Under MCH programme, adult IFA tablet

contains ?
a) 100 mg elemental iron and 0.1 mg FA
b) 100 mg elemental iron and 0.5 mg FA
c) 20 mg elemental iron and 0.1 mg FA
d) 20 mg elemental iron and 0-5 mg FA

99. 2. 3. 4. 5. 693. Evidence not used in rape?

a) Semen in vagina
b) Semen on clothes
c) Presence of smega bacilli in vagina
d) Presence of smegma under prepuce

100. Specific inhibitor of succinate

dehydrogenase?
a) Fluoroacetate
b) Arsenite
c) Malonate
d) Fluoride

101. Most common infection in long term

IUCD use -
a) Actinomyosis
b) Mucormycosis
c) Aspergillosis
d) Candidiasis

102. Marker of angiosarcoma is

a) CD 31
b) Cytokeratin
c) Vimentin
d) CD 55

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103. Type VI glycogen storage disease is due
to the deficiency of –
a) Muscle phosphorylase
b) Glucose-6-phosphatase
c) Liver phosphorylase
d) Branching enzyme

104. Cecum forms the posterior wall of

which hernia
a) Sliding hernia
b) Rolling hernia
c) Incisional hernia
d) Hiatus hernia

105. Treatment of acute dacrocystitis in

stage of cellulitis is ?
a) Antibiotics
b) Abscess drainage
c) DCT
d) DCR

106. Needle shaped crystals negatively

birefringent on polarized microscopy is
characteristic of which crystal
associated arthropathy?
a) Gout
b) CPPD
c) Neuropathic arthropathy
d) Hemophilic arthropathy

107. Most common primary intraocular

neoplasm in a child is ?
a) Metastasis
b) Retinoblastoma
c) Basal cell carcinoma
d) Squamous cell carcinoma

108. Disscociated vertical deviation seen in

?
a) AV dissociation
b) Infantile esotropia
c) Congenital esotropia

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d) Superior oblique palsy

109. Chocolate Brown postmortem staining is

seen in ?
a) KCl poisoning
b) Opium poisoning
c) H2S poisoning
d) Cyanide poisoning

110. Organ of corti is situated in ?

a) Basilar membrane
b) Utricle
c) Saccule
d) None of the above

111. Hummingbird sign in brain MRI is seen

in ?
a) Multiple sclerosis
b) Progressive supranuclear palsy
c) Parkinsons disease
d) Alzheimer disease

112. Gene responsible for resistance to

rifampicin
a) Rpo B gene
b) Kat G gene
c) Rpm B gene
d) Emb B gene

113. Weight of an indian reference woman is

?
a) 45 kg
b) 50 kg
c) 55 kg
d) 60 kg

114. Type of collagen present in cornea ?

a) Type I
b) Type II
c) Type III
d) Type IV

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115. Most common GI malignancy of
childhood
a) Adenocarcinoma
b) Lymphoma
c) Sarcoma
d) carcinoid

116. Under Blood safety programme

compulsory tests done are all except ?
a) HIV
b) VDRL
c) Malaria
d) Hepatitis E

117. Large PDA leads to ?

a) Endocardial valvulitis
b) Eisenmenger syndrome
c) CHF
d) All of above

118. In scabies which skin layer is affected?

a) Stratum corneum
b) Stratum basale
c) Stratum lucidum
d) Stratum germinatum

119. Amino acid deficient in both Wheat and

Maize ?
a) Lysine
b) Threonine
c) Tryptophan
d) Methionine

120. 21-Hydroxylase deficiency - false is ?

a) Most common cause of congenital adrenal hyperlasia
b) Autosomal recessive
c) Femal pseudo hermaphroditism
d) Male pseudo hermephroditism

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121. Loose body in joint most common site
is -
a) Knee
b) Hip
c) Elbow
d) Ankle

122. Which of the following is not used for

investigation of fat malabsorption
a) 13C Trioctanoin
b) 13C Triolein
c) 13C Tripalmitin
d) 13C Triclosan

123. How many lactiferous ducts open in

nipple ?
a) 0 -10
b) 15 -20
c) 25 -50
d) 50 -75

124. Call Exner bodies seen in ?

a) Granulosa cell tumors
b) Serous cystadenomas
c) Dysgerminoma
d) Krukenberg tumor

125. Cerebral angiography was performed

by
a) Sir Walter Dandy
b) George Moore
c) Seldinger
d) Egas Moniz

126. Bilateral Painless parotid enlargement

is seen in all except
a) Mumps
b) Alcoholics
c) Sarcoidosis
d) Diabetes mellitus

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127. Hyperimmune IgE syndrome is also
called
a) Jobs syndrome
b) Wiscott Aldrich syndrome
c) Chediak-Higashi syndrome
d) Digeorge syndrome

128. Rb gene is located on which

chromosome?
a) 6
b) 9
c) 13
d) 21

129. Most common risk factor for rupture of

scarred uterus is
a) Use of oxytocin in labour
b) Grand multiparity
c) Forceps application
d) Obstructed labour

130. Metastatic calcification is characterized

by ?
a) Hypercalcemia
b) Hypocalcemia
c) Eucalcemia
d) None of the above

131. Carotid and aortic bodies are stimulated

when ?
a) Oxygen saturation decreases below 90%
b) Oxygen saturation decreases below 80%
c) Oxygen saturation decreases below 70%
d) Oxygen saturation decreases below 60%

132. Pepsinogen is activated by ?

a) Enterokinase
b) Enteropeptidase
c) H+
d) Trypsin

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133. First polar body is formed after ?
a) Mitosis
b) First meiosis
c) Second meiosis
d) Fertilization

134. Ostmann fat pad is related to ?

a) Ear lobule
b) Buccal mucosa
c) Eustachian tube
d) Tip of nose

135. All of the following are true about

pseudohalluci nations except ?
a) Arises in inner subjective self
b) Patient describes the sensations being perceived by mind eye
c) Are under voluntary control
d) Distressing flashback of PTSD is a n example

136. Macrophage activation syndrome

characterized by all except ?
a) Activation of CD 8 + T cells
b) Presence of cytokine storm
c) It is the other name for hemophagocytic lymphohistiocytosis
d) Low levels of plasma ferretin

137. Taurine is made from ?

a) Glycine
b) Tyrosine
c) Cysteine
d) Phenylalanine

138. RNA polymerase has which activity

a) Primase
b) Helicase
c) Ligase
d) Topoisomerase

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139. All the following are true regarding pseudocyesis, EXCEPT:
a) The patients usually have an intense desire to have children
b) Change in the breast may be present
c) There may be considerable increase in the size of the abdomen
d) The labour pain invariably continue to persist even if she is told
that she is not pregnant

140. Wide QRS complex is typically seen in

a) Bundle Branch block
b) Sick sinus syndrome
c) Mobitz type I block
d) Mobithz type II block

141. Lamina papyracea is between ?

a) Optic nerve and orbit
b) Maxillary sinus and orbit
c) Ethmoid sinus and orbit
d) Cranial cavity and orbit

142. Which is a safe muscle relaxant in renal

failure ?
a) Cisatracurium
b) Rocuronum
c) Vecuronium
d) Succinylcholine

143. False about transmission of Rubella ?

a) Droplet infection
b) Vertical transmission
c) Infection in early pregnancy causes milder disease
d) Fetus affected in late pregnancy may have only deafness

144. Myxedema madness includes ?

a) Auditory hallucinations and paranoia
b) Visual hallucinations and depression
c) Auditory hallucinations and depression
d) Paranoia and depression

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145. Which is correct about pneumonia
a) Bronchophonia
b) Decreased vocal fremitus
c) Shifting of trachea
d) Amphoric breathing

146. Exchange blood transfusion what is

used ?
a) Whole blood
b) EPP
c) Serum
d) Pack cell

147. "3 by 5" initiative in AIDS control

programme is ?
a) Providing 3 million people treatment by end of 2005
b) Providing treatment to 3 out of 5 patients
c) Reducing incidence of AIDS by 3% by 2005
d) All of the above
1. 2. 3. 4. 5.

148. A middle aged male complains of ache

and mumbness and sensated of fatigus
over his calf muscles that develops on
exercise and is relieved on rest; this
condition is not associated with
a) Smoking
b) Hypocalcemia
c) Peripheral arterial disease
d) Hypertension and diabetes

149. All are true about short saphenous vein

except?
a) Runs behind lateral malleolus
b) Runs on lateral side of leg
c) Accompanied by sural nerve
d) Achillis tendon is medial to vein

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150. Which of the following drugs is
contraindicated in liver dysfunction?
a) Pefloxacin
b) Vancomycin
c) Amikacin
d) Hydralazine

151. Satellitism is seen in cultures of?

a) Hemophilus
b) Streptococcus
c) Klebsiella
d) Proteus

152. Complement CI synthesized from -

a) Liver
b) Macrophage
c) Intestinal epithelium
d) Endothelium

153. Cause of death in diabetic ketoacidosis

in children
a) Cerebral edema
b) Hypokalemia
c) Infection
d) Acidosis

154. Attico antral disease is treated by ?

a) Modified radical mastoidectomy
b) Antibiotics
c) Grommet insertion
d) Synringing

155. Case control study is an example of ?

a) Prospective study
b) Retrospective study
c) Combined retrospective and prospective study
d) Study at one point of time

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156. In neonate, intra muscular injection
given at -
a) Deltoid
b) Gluteal
c) Thigh
d) Abdomen

157. False regarding papillae of tongue ?

a) Fungiform papillae at tip
b) Circumvallate papillae at base
c) Foliate papillae at back edge
d) Filiform papillae have taste buds at tip

158. RDA of vitamin A in an adolescent

female ?
a) 400 mcg
b) 350 mcg
c) 600 mcg
d) 800 mcg

159. M.C. site of CA oesophagus is -

a) Middle 1/3rd
b) Upper 1/3rd
c) Lower 1/3rd
d) Lower end of esophagus

160. Neostigmine is used in the following

except ?
a) Myasthenia gravis
b) Cobra bite
c) Atony of bladder
d) Glaucoma

161. A melanocytic naevus surrounded by a depigmented halo is called:

a) Suttons nevus
b) Meyerson’s naevus
c) Cockade naevus
d) Nevus anaemicus

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162. Which is not an extrapyramidal tract ?
a) Reticulospinal tract
b) Rubrospinal tract
c) Corticospinal tract
d) Tectospinal tract

163. Most common pulmonary manifestation

in AIDS
a) TB
b) Pneumonia
c) Bronchiectasis
d) Mycobacterial avium intracellular

164. True about foremilk & hind milk?

a) Foremilk has fat
b) Hind milk relieve hunger
c) Fore milk relieve hunger
d) Hind milk is rich in protein

165. Compensatory mechanism in acute

hemorrhage?
a) Decreased myocardial contractility
b) Decreased heart rate
c) Increased heart rate
d) Increased respiratory rate

166. Nullity of marriage is considered when ?

a) Adultery in first 7 years
b) Infertility of husband
c) Assault in first 7yrs
d) Age > 55years

167. Ujjwala scheme does not include ?

a) Rescue
b) Rehabilitation
c) Reintegration
d) Reward

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168. Under National Cancer control
Programme, oncology wings were
sanctioned to -
a) Regional Cancer institutes
b) District Hospitals
c) Medical college Hospitals
d) Voluntary Agenecies treating cancer patients

169. Anterior axillary fold is due to which

muscle ?
a) Pectoralis major
b) Pectoralis minor
c) Subscapularis
d) Teres major

170. Culture medium for campylobactor jejuni

?
a) BYCE medium
b) Skirrows medium
c) Thayer-Martin medium
d) TCBS medium

171. Herpes simplex infection can lead to?

a) Frontal lobe infarction
b) Parietal lobe infarction
c) Temporal lobe infarction
d) Occipital neuralgia

172. Constitution by which we can force

people on hunger strike to eat is ?
a) Article 21
b) Article 35
c) Article 48
d) Article 52

173. Radiological features of coarctation of

aorta is/ are -
a) Reverse figure of 3 sign
b) Dock sign
c) Double aortic knuckle
d) All of the above

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174. Most common complication of coeliac
plexus block ?
a) Hypotension
b) Parasthesias
c) Diarrhea
d) Pneumothorax

175. Which of the following is not seen in

Secondary Adrenal insufficiency
a) Pigmentation
b) Postural hypotension
c) Hypoglycemia
d) Lassitude

176. Type 5 Hypersensitivity mimics

a) Type 1
b) Type 2
c) Type 3
d) Type 4

177. Break bone fever is caused by ?

a) Yellow fever
b) Japanese encephlitis
c) Dengue fever
d) KFD
i. ii. iii. iv.

178. Multiple air fluid levels in X-ray of

abdomen is seen in
a) Hollow viscera perforation
b) Pyoperitoneum
c) Intestinal obstruction
d) None

179. Oxidation of very long chain fatty acids

takes place in ?
a) Cytosol
b) Mitochondria
c) Ribosomes
d) Peroxisomes

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180. True about blind loop syndrome, all
except
a) Syndrome of bacterial overgrowth
b) Steatorrhea, mayeloblastic anemia & deficiency of fat soluble
vitamins
c) Surgery is not indicated
d) 14C-xylose or 14C-cholyglycine breath tests are indirect tests
for bacterial overgrowth

181. Banana shaped left ventricle is seen in

a) HOCM
b) DCM
c) RCM
d) Takotsubo cardiomyopathy

182. Lower limit of sacro iliac joint lies upto

which level in females ?
a) 1 to 1 1/2
b) 2 to 2 1/2
c) 3 to 3 1/2
d) 4 to 4 1/2

183. Whitfields ointment consists of ?

a) 3% salicylic acid + 6% benzoic acid
b) 3% benzoic acid + 6% salicylic acid
c) 2% salicylic acid + 4% benzoic acid
d) 2% benzoic acid + 4% salicylic acid

184. Which of the following is not a sign of

upper motor neuron paralysis
a) Babinski sign
b) Spastic paralysis
c) Denervation potential in EMG
d) Exaggeration of tendon reflexes

185. MELD score includes

a) Serum creatinine
b) Transaminase
c) Albumin
d) Alkaline phosphatase

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186. Kangaroo mother care - False is?
a) Can also be given by father
b) Especially for low birth weight body
c) Effective thermal control
d) All of above

187. 2. 3. 4. 5. 580. Hypolipidemic drugs act on all except ?

a) HMG Co A reductase
b) Lipoprotein lipase
c) Acyl CoA, cholesterol acyl transferase 1
d) Peripheral decarboxylase

188. Gartners cyst are seen at ?

a) Antero lateral vaginal wall
b) Antero - lateral cervix
c) Posterolateral vaginal wall
d) Posterolateral cervix

189. Direct Coombs test detects:

a) Antibodies attached to RBC Surface
b) Antibodies in the serum
c) Antigens attached to RBC Surface
d) Antigens in the serum

190. Medical management of ectopic

pregnancy has decreased success if ?
a) Gestational sac < 3cm
b) Duration of gestation < 5 weeks
c) Cardiac activity present
d) Beta HCG < 8000 IU/L

191. Omalizumab is ?
a) Anti IgM antibody
b) AntilgG antibody
c) Anti IgE antibody
d) Anti IgD antibody

192. 2. 674. Presence of spiral grooves in the barrel

of weapon is referred to as ?
a) Rifling
b) Incendiary
c) Cocking

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d) None of the above

193. Systemic Millary TB spreads via

a) Artery
b) Vein
c) Bronchus
d) Lymphatic

194. Effect of infusion of hypotonic saline?

a) Increased ICF only
b) Increased ECF only
c) Increased in both ICF and ECF
d) Increased ICF and decreased ECF

195. Bullet which is left inside the body for

long is referred to as ?
a) Souvenir bullet
b) Tracer bullet
c) Tumbling bullet
d) Tandem bullet

196. Spread of chicken pox is maximum ?

a) After formation of scab
b) Just before and after onset of rash
c) One week before onset of rash
d) During convelescence

197. A 14 year old boy presents wit recurrent

episodes of hepatitis Opthalmoscopic
evalution reveals KF rings and serum
ceruloplasmin levels are < 20 mg/dl.
The treatment of choice for initial
therapy is
a) Zinc
b) Penicillamine
c) Tetrathromolybdate
d) Hepatic transplantation

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198. IgE binds to which cell ?
a) T cells
b) B cells
c) Mast cells
d) NK cells

199. Membrane attack complex (MAC) in

complement system is:
a) C3b
b) C13
c) C5_9
d) C24

200. Primary action of inferior oblique ?

a) Abduction
b) Adduction
c) Extorsion
d) Elevation

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 Subject: NEET PG 2014 - Answer Key

Question 1: Correct Answer: A

Explanation: - A
Ans. is a i.e., Manual strangulation
As manual strangulation (throttling) is among the most violent form
of asphyxia, hyoid fracture and other injury to neck structures is
more common.
Question 2: Correct Answer: C
Explanation: - C
Ans. is c i.e., Severe hearing loss
Severe hearing loss
What is severe hearing loss? On average, the most quiet sounds
heard by people with their better ear are between 70 and 95 dB.
People who suffer from severe hearing loss will benefit from
powerful hearing aids, but often they rely heavily on lip-reading even
when they are using hearing aids. Some also use sign language.
Question 3: Correct Answer: A
Explanation: - A
Ans. is a i.e., TB
Tubercular larvn_gitis
Tubercular laryngitis is almost always secondary to pulmonary
lesions, mostly affecting males in middle age (20-40 years). Disease
affects the posterior third of larynx more commonly than anterior
part.The parts affected in descending order of frequency are :- i)
Interarytenoid fold, ii) Ventricular band, iii) Vocal cords, iv) Epiglottis
Clinical features
Weakness of voice with periods of aphonia earliest symptoms. o
Hoarsness, cough, dysphagia (odynophagia)
Referred otalgia
Laryngeal examination in TB laryngitis
Hyperaemia of the vocal cord in its whole extent or confined to
posterior part with impairment of adduction is the first sign.
Swelling in the interarytenoid region giving a mammilated
appearance.
Ulceration of vocal cord giving mouse-nibbled appearance.
Superficial ragged ulceration on the arytenoids and interarytenoid
region.
Granulation tissue in interarytenoid region or vocal process of
arytenoid.
Pseudoedema of the epiglottis "turban epiglottis".
Question 4: Correct Answer: C
Explanation: - C
Ans. is c i.e., It is called the flea bitten rash of newborn

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Erythema ToxicumNeonatorum
It is the harmless, erythematous, short lived eruptions of the
newborn.
It is present in 30 - 50% of the newborns
It is considered a part of normal transition from the watery womb to
the dry external environment.
It appears most often in the first 2 days of life and is rarely present at
birth
It consists of widespread erythematous macules most present in the
trunk and the proximal parts of the extremities.
Hurwitz called it the flea bitten rash of new born.
No active therapy is needed for the treatment.
Question 5: Correct Answer: A
Explanation: - A
Ans. is a i.e., Maffucci syndrome
Chondrosarcomasdeveloping in patients with olliers and maffucci
syndrome is called secondary chondrosarcoma.
Secondary chondrosarcoma
It is the chondrosarcoma arising in benign precursor either
osteochondroma and enchondroma.
There are no reliable figures about the risk of developing secondary
chondrosarcoma in benign precursors.
The risk of chondrosarcoma in solitary osteochondroma is 2% and
that for osteochondromatosis is 5 - 25%.
Patients with olliers disease and maffucci syndrome have a 25 -
30% risk of developing chondrosarcoma.
Question 6: Correct Answer: C
Explanation: - C
Ans. is c i.e., Maceration
Dead born : A deadborn child is one which has died in utero and
shows one of the following signs after it is completely born :?
1) Rigor mortis : Rigor mortis may occur in dead fetus before birth or
at birth.
2) Maceration : Maceration is a process of aseptic autolysis. It
occurs when a dead fetus remains in the uterus for 3-4 days
surrounded by liquor amnii but with exclusion of air. Skin slippage is
the earliest sign (occurs within 12 hours). There is gas in the great
vessels and chambers of heart (Roberts sign). Except for lung and
uterus, which remain unchanged for a long time, all other organs
become soft, oedematous and loose there morphology. The one
important radiological sign suggestive of maceration is Spauldings
sign i.e. skull bones override each other. The smell is somewhat
rancid.
3) Putrefaction (decomposition) : If the membranes are ruptured
after death of fetus and air gains entry into liquor amnii, fetus

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undergoes putrefaction instead of maceration. Body is greenish, foul
smelling and bloated.
4) Mummification : It results when there is deficient blood supply,
scanty liquor and no air enters uterus. Body is thin, shrivelled dark
brown and emitting smell like rotten cheese.
Question 7: Correct Answer: B
Explanation: - B
Ans. is b NK cells
Null cells (Large granular lymphocytes)
Null cells are called so because they lack features of surface
markers of both B and T lymphocytes.
The account for 5 to 10% of peripheral blood lymphocytes.
They are also called "large granular lymphocytes (LGL)" as they
contain large azurophilic cytoplasmic granules.
Members of this group are:
a) Antibody dependent cytotoxic cells (ADCC)
b) Natural killer cells (NK Cells)
Question 8: Correct Answer: D
Explanation: - D
Ans. is d i.e., X-linked recessive disorder that does not affect
heterozygous famales
Glucose 6-phosphate dehydrogenase (G6PD) deficiency, an X-
linked disorder, is the most common enzymatic disorder of red blood
cells in humans, affecting 400 million people worldwide.
Clinical spectrum
The clinical expression of G6PD variants encompasses a spectrum
of hemolytic syndromes
The four forms of symptomatic G6PD deficiency :
Acute hemolytic anemia
Favism
Congenital nonspherocytic hemolytic anemia
Neonatal hyperbilirubinemia
G6PD deficiency is expressed in males carrying a variant gene that
results in sufficient enzyme deficiency to lead to symptoms.
Acute hemolytic anemia
Almost all individuals with the most prevalent G6PD variants, G6PD
A- and G6PD Mediterranean, are asymptomatic in the steady state.
They have neither anemia, evidence of increased red cell
destruction, nor an alteration in blood morphology,. o However
Question 9: Correct Answer: B
Explanation: - B
Ans. is b i.e., Proteus
Weil felix reaction
This reaction is an agglutination test in which sera are tested for
agglutinins to 0 antigens of certain nonmotile proteus strains OX -19,

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OX - 2 and OX - K.
The basis of the test is the sharing of an alkali - stable carbohydrate
antigen by some rickettsiae and by certain strains of proteus, P.
vulgaris OX - 19 and OX - 2 and P. mirabilis OX - K.
The test is usually done as a tube agglutination, though rapid slide
agglutination methods have been employed for screening
Question 10: Correct Answer: C
Explanation: - C
Ans. is c i.e., Percentage of absorbed nitrogen retained
Assessment of proteins
Protein can be assessed qualitatively or quantitatively:?
1) Protein quantity
It is assessed by the protein-energy ratio.
2) Protein quality
It is assessed by amino-acid score, biological value, net protein
utilization, protein efficiency ratio, and protein digestibility corrected
amino acid score.
Protein energy Ratio (Protein-energy percentage)
It is a quantitative measure for assessment of protein.
It measures the percentage of energy that is provided by the protein
in the food.
Question 11: Correct Answer: A
Explanation: - A
Ans. is a i.e., Age, Race and sex matched individuals
T Score and Z score are the measures of bone mineral density.
Z score : Measures the bone mineral density in terms standard
deviation from the mean bone mineral density of age, race and sex
matched individuals.
T score : Measures the bone mineral density in terms standard
deviation from the mean bone mineral density of race and sex
matched individuals of normal younger age group.
Question 12: Correct Answer: B
Explanation: - B
Answer is B (Fasciculation):
Fasciculations are a feature of Lower Motor Neuron Lesions.
Involvement of Pyramidal tract indicates an Upper Motor Neuron
Lesion. Hypertonia with Spasticity, Hyper-reflexia and a Positive
Babinski Sign with an Extensor Planter response are all features of
an upper motor neuron lesion (Pyramidal Tract Lesion).
Question 13: Correct Answer: C
Explanation: - C
Ans. is c i.e., No pieces of bone are present in the bullet track
Firearm/bullet wounds in the skull
Wound of entrance shows a punched in (clean) hole in the outer

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table. Cone shaped bone is detached from the inner table forming a
crater that is larger than the hole of the outer table and shows
beveling (sloping surface).
Fissured fractures are seen radiating from the defect.
Irregular lacerations may be seen involving the leptomeninges.
Pieces of bone from the wound of entry are often driven into the
cranial cavity and may establish the bullet track.
At the point of exit a punched out opening is produced in the inner
table and beveled opening in the outer table.
The wound is funnel shaped with the funnel opening in the direction
in which the bullet is travelling both in entrance and exit wound.
The exit wound is larger due to deformity and tumbling of the bullet
after entering the skull.
Question 14: Correct Answer: B
Explanation: - B
Ans. is b i.e., Pt branchial cleft
Collaural fistula is a 1" branchial cleft anomaly which arises from
failure of fusion of the ventral part of the Pt cleft.
Its upper part opens into floor of external auditary canal.
Its lower part opens in the neck between angle of mandible and
sternocleidomastoid muscle.
Question 15: Correct Answer: C
Explanation: - C
Ans. is c i.e., Thigh
Question 16: Correct Answer: B
Explanation: - B
Amongst the options provided, gastrinomas are the most common enteropancreatic tumors
associated with MEN I with insulinomas being the second most common.
Ref: Harrison’s Principles of Internal Medicine, 17th Edition, Page 2358 & 2359; 16th/
2232; Davidson’s principles and practice of Medicine, 20th Edition, Chapter 20, Page 803
Question 17: Correct Answer: B
Explanation: - B
Ans. B. Greatest horizontal plane of the presenting part has
crossed the pelvic brim
When the greatest horizontal plane of the presenting part has
passed the plane of pelvic brim the presenting part is said to be
engaged.
Question 18: Correct Answer: B
Explanation: - B
Ans. is. b i. e., R conorii
Question 19: Correct Answer: A
Explanation: - A
Ans. is a i.e., 1 mg
Vitamin K Deficiency in Newborns

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The symptoms of vitamin K deficiency are due to hemorrhage
Newborns are particularly susceptible to vitamin K deficiency
because of low fat stores, low breast milk levels of vitamin K, sterility
of the infantile intestinal tract, liver immaturity, and poor placental
transport.
Intracranial bleeding, as well as gastrointestinal and skin bleeding,
can occur in vitamin K-deficient infants 1 7 days after birth.
Thus, vitamin K (1 mg IM) is given prophylactically at the time of
delivery.
Question 20: Correct Answer: D
Explanation: - D
Ans. is d i.e., 30 ppm
Goitre control
There are following essential components of national goitre control
programme.
1. Iodized salt
The iodization of salt is now the most widely used prophylactic public
health measure against endemic goitre.
In India the level of iodization is fixed under the Prevention of food
adulteration (PFA) act and is not less than 30 ppm at the production
point and not less than 15 ppm of iodine at the consumer level.
Iodized salt is most economical, convenient and effective means of
mass prophylaxis in endemic areas.
Recently the National institure of Nutrition at Hyderabad has come
out with a new product, common salt fortified with iron and iodine —
> two in one salt (twin fortified salt or double fortified salt).
Iodized oil --> It is another effective method for controlling goitre. IM
injection of iodized oil (mostly poppy seed oil) is given. An average
dose of 1 ml will provide protection for 4 years.
2. Iodine monitoring
Neonatal hypothyroidism is a sensitive pointer to environmental
iodine deficiency and can thus be an effective indicator for
Question 21: Correct Answer: B
Explanation: - B
Ans. is b i.e., Cysticercosis
Parasitic cysts occurs in subconjunctival cysticercus, hydatid cyst
and filarial cyst.
Question 22: Correct Answer: A
Explanation: - A
Ans. is a i.e., Loops
Dactylography / DermatogIvphics / Calton system / Finger
prints
Finger prints are present from birth both on epidermis and dermis,
remain constant through out life and cant be altered without
destroying true skin.

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Finger print pattern is absolutely individual i.e. no two hands are
entirely alike, not even identical twins. Thats why, it is best (most
sensitive and most specific) and most reliable method of
identification (Quetelets rule of biological variation). DNA finger
printing may be same in monozygotic twins.
The pattern is neither inherited nor identical in any two persons. So
the paternity cannot be proved through finger print patterns.
However, paternity can be proved by DNA finger printing.
Loops (67% most common) > whorls (25%) > arches (7%) >
composite (2% least common) are four main types of pattern.
It is accepted that chances of 2 finger prints matching 16 ridge
characteristic are infinitely small (Parikhs). In practice 8 - 16 (Reddy)
/ 16 - 20 (Seth, Simpson) points of fine comparision are accepted as
proof of identity.
Locards poroscopy method is study of microscopic pores, formed by
mouths of ducts of subepidermal sweat gland present on ridges of
Question 23: Correct Answer: B
Explanation: - B
Answer- B. Cytokeratin
Cytokeratin- Carcinoma, mesothelioma, Non-seminoma GCT
Question 24: Correct Answer: B
Explanation: - B
Ans. is b i.e., PGE2
Fever is elevated body temperature due to resetting of hypothalamic
thermostat above the normal level.
IL-1 (most potent), TNF-? and IL-6 are pyrogens (fever producing
cytokines).
But they do not act directly.
They stimulate the release of PGE2, which resets the hypothalamic
thermostat at higher level.
Thus, PGE2 is the final effector in production of fever.
Question 25: Correct Answer: A
Explanation: - A
Ans. A. Clomiphene
Clomiphene citrate is the first line of treatment of infertility in a PCOS
woman.
Question 26: Correct Answer: A
Explanation: - A
Ans. is a i.e., > 10% weight loss
WHO case definition for AIDS surveillance
For the purpose of AIDS surveillance an adult or adolescent (six
years of age) is considered to have AIDS if at least 2 of the following
major signs are present in combination with one minor sign.
Major Signs

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Weight loss > 10 % of body weight
Chronic diarrhoea for more than 1 month
Prolonged fever for more than 1 month
Minor signs
Persistent cough for more than one month
Generalized pruritic dermatitis
History of herpes zoster
Chronic progressive or disseminated herpes simplex infection
Generalized lymphadenopathy
Oropharyngeal Candidiasis.
Expanded WHO case definition for AIDS surveillance
For the purpose of surveillance on adult or adolescent (>12 years of
age) is considered to have AIDS if a test for
HIV antibody gives a positive result and one or more of the following
conditions are present :
Question 27: Correct Answer: A
Explanation: - A
Ans. is a i.e., Keratin
Dermatophytes are keratinophillic fungi, living only on the superficial
dead keratin. That is why they infect skin, hair and nail. In skin they
infect most superficial layer of the epidermis i.e. stratum corneum.
They do not penetrate living tissues. Dermatophytes cause a variety
of clinical conditions, collectively known as dermatophytosis, tinea or
ringworm. Dermatophytes have been classified into 3 genera :-
trichophyton, microsporum, epidermophyton.
Trichophyton affects;- skin, hair, nails
Microsporum affects ;- skin, hair (nails are not affected)
Epidermophyton affects:- skin, nails (hair are not affected)
Deep fungal infections (eg:- maycetoma, chromoblastomycosis,
pheohyphomycosis, sporotrichosis, lobomycosis, rhinosporidiosis)
involve subcutaneous tissue.
Dermatophytosis is itchy and scaly
Question 28: Correct Answer: D
Explanation: - D
Ans.is d i.e., Isoniazid + Rifampicin + Kanamycin
Treatment of extensive drug resistance (XDR) TB
XDR-TB is defined as resistance to any fluoroquinolone and at least
one of the following three second-line drugs (capreomycin,
kanamycin, amikacin), in addition to multidrug resistance.
The Regimen for XDR-TB would be of 24-30 months duration, with
6-12 months Intensive Phase (IP) and 18 months Continuation
Phase (CP).
Regimen is :-
i) Intensive phase (6-12 months) : Seven drugs : Capreomycin, PAS,
moxifloxacin, high dose INH, clofazimine, Linezolid, amoxyclay.

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ii) Continuation phase (18 months) : Six drugs : PAS, moxifloxacin,
high dose INH, clofazimine, linezolid, amoxyclay.
Question 29: Correct Answer: D
Explanation: - D
D i.e Lobar Pneumonia
The important causes of hypoventilation :-
i) Obstruction in airways :- Foreign body, COPD (chronic
bronchitis, emphysema).
ii) Decrease in respiratory drive :- It is due to decrease in
stimulation of respiration from CNS e.g. brain injury, meningitis,
bulbar poliomyelitis, Drugs (morphine, sedative, anesthetics),
hypothyroidism.
iii) Decrease in functioning of respiratory muscles :- Mysthenia
gravis, poliomyelitis, kyphoscoliosis, myopathy, polymyositis, GB
syndrome, interstitial lung disorders, AML.
iv) Increased load on respiratory system :- It may be due to :?
a) Reduced chest wall compliance :- Pleural effusion,
pneumothorax, ascitis, rib cage disorder (kyphoscoliosis), ankylosing
spondylitis.
b) Reduced lung compliance :- Atelectasis, lung resection, alveolar
edema, PEEP.
Question 30: Correct Answer: A
Explanation: - A
Ans. is a i.e., Nitric Oxide
Question 31: Correct Answer: A
Explanation: - A
Ans, A. Adenomyosis
Adenomyosis is a condition where there is ingrowth of the
endometrium, both the glandular and stromal components, directly
into the myometrium.
Question 32: Correct Answer: A
Explanation: - A
Ans. is a i.e., Streptococcal pneumonia
Streptococcus Pneumoniae (pneumococcus) is the most common
organism responsible for round pneumonia.
Round Pneumonia is spherical pneumonia that is usually seen in
children due to the lack of collateral air drift.
Streptococcus Pneumoniae (pneumococcus) is the most common
organism responsible for round pneumonia.
Round pneumonia is important as they may simulate a tumor mass
from which they must be differentiated
Question 33: Correct Answer: C
Explanation: - C
Answer- C. FNAC

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isotope scanning a thyroid nodule can be hot, warm or cold.
FNAC is the investigation of choice for solitary thyroid nodule.
Question 34: Correct Answer: A
Explanation: - A
Ans.A. 3,1,2
Processing of general sensory inputs primarily occurs in primary
somatosensory area of parietal lobe.
Primary somatosensory area is Brodmanns area 3, 1, 2.
Question 35: Correct Answer: C
Explanation: - C
Ans. is c i.e., It has good visual prognosis
BEHCETS DISEASE
It is an idiopathic multisystem disease characterised by recurrent,
non-granulomatous uveitis, aphthous ulceration, genital ulcerations
and erythema multiforme.
Etiology
It is still unknown; the basic lesion is an obliterative vasculitis
probably caused by circulating immune complexes. The disease
typically affects the young men who are positive for HLA-B5 1.
Clinical features
Uveitis seen in Behcets disease is typically bilateral, acute recurrent
iridocyclitis associated with hypopyon. It may also be associated
with posterior uveitis, vitritis, periphlebitis retinae and retinitis in the
form of white necrotic infiltrates.
Treatment
No satisfactory treatment is available, and thus the disease has got
comparatively poor visual prognosis. Corticosteroids may by helpful
initially but ultimate response is poor. In some cases the disease
may be controlled by chlorambucil.
Question 36: Correct Answer: C
Explanation: - C
Ans. is c i.e., Penicillin
Penicillin is a safe drug in acute intermittent porphyria
Drugs precipitating acute intermittent porphyria
Barbiturates
Griseofulvin
Chlorpropramide
Rifampicin
Oral contraceptives
Estrogen
Phenytoin
Sulfonamides
Question 37: Correct Answer: C
Explanation: - C

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Ans. is c i.e., Esophageal atresia with distal
tracheoesophageal fistula
TEF is classified into five types based on presence of esophageal
atresia and location of fistula:?
1) Type A : There is esophageal atresia without TEF. There is no
gas in abdomen. It is 2d most common type.
2) Type B : There is proximal TEF. There is no gas in abdomen.
3) Type C : There is proximal esophageal atresia with distal TEF.
Gas in abdomen is present. It is most common.
4) Type D : Both proximal and distal fistula are present. Gas in
abdomen is present. It is least common.
5) Type E : Isolated TEF (H or N type) is there.
Question 38: Correct Answer: B
Explanation: - B
Ans. is `b i.e., Multiple impact injuries
Question 39: Correct Answer: B
Explanation: - B
Ans. is `b i.e., 1
Question 40: Correct Answer: D
Explanation: - D
Answer- D. Ischemic Colitis
Indications for Barium meal X-ray
Duodenal ulcer
Periampulary carcinoma
Psendocyst of pancreas
Carcinoma stomach
Chronic duodenal ileus
Carcinoma head of pancreas
Duodenal diverticula
Question 41: Correct Answer: A
Explanation: - A
Ans. A. Chronic depression
Persistent depressive disorder (Dysthymia)
Depression may run a chronic course over years with fluctuation of
mood interposed with symptom free intervals (less than 2 months).
If symptoms persist for more than 2 years, they are referred to as
persistent depressive disorder or dysthymia.
Question 42: Correct Answer: C
Explanation: - C
Ans. is c i.e., Dizziness
Symptoms of hypoglycemia are attributable to :-
i) Sympathetic stimulation : Sweating, tremor, tachycardia
palpitations and anxiety. These are the warning signs.
ii) Cerebral glucose deficiency : Decreased cognitive functions,

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dizziness and decreased concentration.
Use of beta-blockers, especially in diabetics who are taking
treatment, may mask typical sympathetic system mediated
symptoms of hypoglycemia such as sweating, tremor, tachycardia,
and palpitations.
Thus, dangerous severe hypoglycemia can occur without any
warning signs.
Question 43: Correct Answer: B
Explanation: - B
Ans. is `b i.e., Renal hypertension
Potential
Artery
clinical
manifestation
Arm
claudication,
Subclavian
Raynauds
phenomenon
Visual
changes,
syncope
Commoncarotid
transient,
ischaemic
attacks stroke
Abdominal
AbdominalAorta
pain, nausea
vomiting
Hypertension,
renal failure,
aortic
Renal
insufficiency,
congestive
heart failure
Question 44: Correct Answer: C
Explanation: - C
Ans. is c i.e., Vancomycin
Methicillin resistance staphylococcus aureus (MRSA)
MRSA is a bacterium responsible for several difficult-to-treat
infections in humans.
It may also be referred to as multi-drug resistant staphylococcus
aureus or oxacillin resistant staphylococcus aureus (ORSA).

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MRSA is by definition any strain of staphylococcus aureus that is
resistant to a 13-lactams including penicillin, methicillin, cloxacillin,
nafcillin, oxacillin and cephalosporins.
Resistance develops due to alteration in transpeptidase (penicillin
binding protein) on which all 13-lactam antibiotic act : so, MRSA is
resistant to all 0-lactam antibiotics.
MRSA (especially community acquired MRSA; CA-MRSA) display
enhanced virulence, spreading more rapidly and causing disease
much more severe than traditional staphylococcus aureus.
Question 45: Correct Answer: B
Explanation: - B
Ans. is b i.e., Right sided accessory pathway
Anatomy (Location ofAccessory pathway) in W.R W syndrome
Electrophysiological studies and mapping have shown that
accessory. Atrioventricular pathways may be located anywhere
along the A-V rign or groove in the septum.
The most frequent locations are : -
Left lateral (50%), posteroseptal (30%) right anteroseptal (10%).
Right lateral (10%).
Preexcitation resulting from left sided accessory is called type A
preexcitation.
Preexcitation resulting from right sided accessory pathway is called
type B preexcitation.
Question 46: Correct Answer: C
Explanation: - C
Ans. is c i.e., Naloxone
Pharmacologic Management of Post op paralytic ileus (P01):
Minimizing the sympathetic inhibition of gastrointestinal motility,
decreasing inflammation and stimulation of gastrointestinal 11-opioid
receptors are the ultimate goals of pharmacologic management.
A) Minimizing sympathetic inhibition
Both propranolol, a nonspecific 13-receptor antagonist, and
dihydroergotamine, an a-receptor antagonist, have been
investigated for treatment of POI.
Neostigmine is an acetylcholinsterase inhibitor that causes an
increase in cholinergic (parasympathetic) activity in the gut wall,
which is believed to thereby stimulate colonic motility.
Use of edrophonium chloride and bethanechol chloride, which
competitively inhibit acetylcholine on the binding site of
acetylcholinesterase, has been reported to show improvement of
POI.
Cisapride is a serotonin (5-HT)4 receptor antagonist that promotes
acetylcholine release from postganglionic nerve endings in the
myenteric plexus and is thought to indirectly improve gastrointestinal
motility.

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Metocloprimide is suspected to enhance gastrointestinal motility
Question 47: Correct Answer: A
Explanation: - A
. Ans. is a i.e., Hypothyroidism
Causes of Gynaecomastia
Puberty
During puberty, the serum oestradiol rises to adult levels before
testosterone, causing transient gynaecomastia. This normally
resolves within six months to two years.
Cirrhosis
Gynaecomastia occurs due to altered sex hormone metabolism, and
an increase in the oestradiol; free testosterone ratio.
Hypogonadism
Primary hypogonadism causes a compensatory rise in LH, in turn
causing increased peripheral aromatization of testosterone to
oestradiol.
Secondary hypogonadism, due to pituitary or hypothalamic disease
(e.g. prolactin excess, Kallmans syndrome haemachromatosis),
may also cause gynaecomastia despite LH deficiency, since the
adrenal cortex continues to produce oestrogen precursors, which
are converted to oestrogens in peripheral tissues.
Tumours
Testicular tumours:
Germ cell tumours account for over 95% testicular tumours.
Gynaecomatia occurs in 5% of patients, due to hCG secretion
Question 48: Correct Answer: A
Explanation: - A
Ans, A. Ca
The calcium wave amplifies the local signal at the site of sperm-
oocyte interaction and distributes it throughout the oocyte cytoplasm.
The increase in calcium concentration is the signal that causes the
oocyte to resume cell division, initiating the completion of meiosis II
and setting of the developmental programme that leads to
embryogenesis.
Question 49: Correct Answer: C
Explanation: - C
Isoleucine is one of the aminoacid with an aliphatic side chain.
Other aminoacids with an aliphatic side chain is glycine, alanine, valine and leucine.
Among the options provided, valine is the only aminoacid with an aliphatic side chain and
so it can be a homologous substitution for isoleucine in a protein sequence.
Ref: Harper’s Illustrated Biochemistry, 26th Edition, Chapter 3, Page 15; Human Gene
Evolution By David N. Cooper, 1999, Page 299.
Question 50: Correct Answer: C
Explanation: - C

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C i.e. High self esteem
Question 51: Correct Answer: D
Explanation: - D
Ans. is `d i.e., T2 Nerve
Anteriorly, the neck of the first rib is related to (from medial to
lateral) :- (1) Sympathetic chain, (ii) Ist posterior intercostal vein,
(iii) Supeior intercostal artery, and (iv) 1st thoracic nerve. These
structures are between neck of first rib (posteriorly) and apex of
lung (anteriorly).
Following are attached to first rib :- Scalenus anterior, scalenus
medius, subclavius, serratus anterior ( lst digitation), costo-clavicular
ligament and suprapleural membrane.
Question 52: Correct Answer: C
Explanation: - C
Ans. is `c i.e., Renal losses
Major causes of hypernatremia
Unreplaced water loss (which requires an impairment in either
thirst or access to water)
Insensible and sweat losses
Gastrointestinal losses
Central or nephrogenic diabetes insipidus o Osmotic diuresis
Glucose in uncontrolled diabetes mellitus
Urea in high-protein tube feedings
Mannitol
Hypothalamic lesions impairing thirst or osmoreceptor function
Primary hypodipsia
Reset osmostat in mineralocorticoid excess
Water loss into cells
Severe exercise or seizures
Sodioutn overload
Intake or administration of hypertonic sodium solutions
Question 53: Correct Answer: A
Explanation: - A
A i.e. Alzheimers
Question 54: Correct Answer: D
Explanation: - D
Ans. is `d i.e., Require serial USG and other associated anomalies
Antenatal hydronephrosis (ANH) is transient and resolves by the
third trimester in almost one-half cases.
The presence of oligohydramnios and additional renal or extrarenal
anomalies suggests significant pathology. o All patients with ANH
should undergo postnatal ultrasonography
The intensity of subsequent evaluation depends on anteroposterior
diameter (APD) of the renal pelvis and/or Society for Fetal Urology

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(SFU) grading.
Patients with postnatal APD exceeding 10 mm and/or SFU grade 3-
4 should be screened for upper or lower urinary tract obstruction and
vesicoureteric reflux.
Surgery is considered in patients with increasing renal pelvic APD
and/or an obstructed renogram with differential renal function <35-
40% or its subsequent decline.
Question 55: Correct Answer: C
Explanation: - C
Ans. is c i.e., Deficiency of Lactase
Lactose intolerance
It occurs due to deficiency of lactase, the most important member of
?-galactosidase enzymatic class.
Lactase hydrolyses lactose into glucose and galactose in the small
intestine.
Lactose is present in milk.
Therefore, deficiency of lactase, (?-galactosidase) results in
intolerance to milk and other dairy products.
Clinical features are bloating, diarrhea, failure to thrive, abdominal
distension and abdominal cramp.
Question 56: Correct Answer: A
Explanation: - A
Answer- A. BPD
Mixed procedures
1. 2. Gastric bypass (Roux en Y gastric bypass)
Sleeve gastrectrney with duodenal snitch
3. Implantable gastric stimulation
In general malabsorptive procedures lead to more weight loss than
restrictive procedures however morbidity risks are greater.
Studies have shown that it is maximum with Biliopancreatic diversion
(BPD).
Question 57: Correct Answer: A
Explanation: - A
Ans. is a i.e., Nodalol
Question 58: Correct Answer: D
Explanation: - D
Ans. is d i.e., 2200 psi
Question 59: Correct Answer: B
Explanation: - B
Ans. is b i.e., 6 month to 5 year
Febrile convulsion :-
Commonest provoked seizure
Between 6 months to 5 year
Neurologically normal child

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Occurs when temp rise abruptly
Simple benign febrile convulsion
Fits occur within 24 hour of onset of fever.
Duration less than 10 min.
Usually single per febrile episode
Generalised type of convulsion
Atypical febrile seizures
Presence of family history of epilepsy
Neurodevelopmental retardation
Focal neurological deficit.
Question 60: Correct Answer: D
Explanation: - D
Ans. Epibulbar dermoids
Goldenhar syndrome (oculoauriculovertebral dysplasia with
hemifacial microsomia) is a rare congenital developmental anomaly
involving the first and second branchial arches.
The classic features of this syndrome include ocular changes such
as microphthalmia, epibulbar dermoids, lipodermoids and coloboma;
aural features such as preauricular tragi, hearing loss and microtia;
and vertebral anomalies such as scoliosis, hemivertebrae and
cervical fusion.
Other ocular anomalies are rare but include microphthalmos,
microcornea, anophthalmos, eyelid colobomas, iris and choroid
colobomas, motility disorders, strabismus, blepharoptosis, palpebral
fissure, iris atrophy, polar cataract, anomalous lacrimal drainage
system, and retinal and optic nerve anomalies
Question 61: Correct Answer: D
Explanation: - D
Ans. is a i.e., Atomoxetine; b i.e., Methylphenidate; c i.e., Dextro-
amphetamine
Some common stimulants used to treat ADHD include:
Adderall (amphetamine)
Ritalin (methylphenidate)
Concerta (methylphenidate)
Focalin (dexmethylphenidate)
Daytrana (methylphenidate patch)
Metadate or Methylin (methylphenidate)
Dexedrine or Dextrostat (dextroamphetamine)
Vyvanse (lisdexamfetamine dimesylate)
Question 62: Correct Answer: C
Explanation: - C
Ans. is c i.e., Pleural effusion is common
Diffuse Effusion is an uncommon atypical manifestation in
Sarcoidosis reported in up to 5% of patients.
Parotid enlargement is a classic feature of sarcoidosis and bilateral

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involvement is the rule
Neurological disease is reported in 5-10% of patients with
sarcoidosis
Facial nerve palsy is the single most common neurological
manifestation of sarcoidosis seen in up to 50% of patients with
Neurosarcoidosis.
Angiotensin converting enzyme (ACE) levels are raised in
sarcoidosis
Lung involvement in sarcoidosis
Most common involved organ (90%).
Characterized by B/L hilar adenopathy.
Cavitations are rare
Pleural effusion are rare (1-2%)
Question 63: Correct Answer: C
Explanation: - C
Ans. is `c i.e., Asthma
Ketamine increases cerebral blood flow, metabolism, oxygen
consumption and intracranial tension, unlike thiopentone,
propofol&etomidate, which have cerebroprotectiveeffect, therefore
ketamine is contraindicated in head injury, intracranial space
occupying lesions and for neuroanaesthesia.
Cerebrovascular responsiveness to CO2 is preserved, and reducing
the arterial CO2 tension by hyperventilation attenuates the ketamine
induced rise in ICT.
Ketamine has direct myocardial depressant (negative ionotropic) &
vasodilator effect. However, ketamine also has
indirect sympathomimetic effect. Indirect sympathomimetic effect
predominates over direct myocardial depressant &vasodilator effect;
usual response is increased BP, cardiac output and heart rate-
Cardiac 02 demand is increased.
Ketamine is contraindicated in aortic aneurysm, hypertensive and
ischemic heart disease. Ketamine also sensitizes
the heart to adrenaline - arrhythmias may occur.
As ketamine cause sympathetic stimulation, it is the intravenous
anaesthetic of choice in patients with shock and hypovolemia.
Ketamine increases intra-ocular tension - Contraindicated in
glaucoma & open eye surgery.
Question 64: Correct Answer: A
Explanation: - A
Ans. is a i.e., Clunk of entry on abduction and flexion of hip
Clinical tests for CDH/DDH
In infancy two tests are used.
Barlows test
This test is done within 2-3 days of birth.
The test has two parts :?

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Part 1 :- Infant is in supine position with hip and knee in 90° of
flexion, The hip is slowly adducted & pushed to dislocate the hip and
one can hear a clunck of exit of femoral head out of the acetabulum.
Part 2 :- Now the hip is gentely abducted and pulled to reduce the
hip. This will cause clunk indicating reduction of hip.
It is quite obvious that part 1 can be done only dislocatable hip; but
not in already dislocated hip as the head is already out of the
acetabulum.
Ortolanis test
This test is similar to 2nd part of Barlows test, i.e. slow abduction of
hip in flexed position of hip & knee to reduce the hip.
Question 65: Correct Answer: D
Explanation: - D
Ans. is d i.e., Watering of mouth
Apraclonidine
Topical application lowers the intra ocular pressure by 25 %.
It decreases aqueous production by primary alphal and subsidiary
alpha 2 action in ciliary body.
Itching, lid dermatitis, follicular conjunctivitis, mydriasis, eyelid
retraction, dryness of mouth and nose are common side effects.
Its use is restricted to short term control of spikes of intraocular
tension after laser trabeculolasty or iridotomy.
Question 66: Correct Answer: A
Explanation: - A
Ans. is
a i.e., PPV ? Prevalence
Prevalence affects the PPV the most. PPV is directly
proportional to the prevalence of the disease in the population.
However, both sensitivity and specificity can change the
predictive value.
The prevalence of a disease in a population is high, the more
accurate will be the positive predictive value of a screening
test. If the prevalence declines, the PPV will be low.
NPV varies inversely with the prevalence
Question 67: Correct Answer: C
Explanation: - C
Ans. is c i.e., 1 to 6 degrees Celsius
Storage temperature of blood : 1-6°C
Storage temperature of packed RBCs : 40°C
Storage temperature of FFP : -20°C
Storage temperature of platelets: 20-24°C
Question 68: Correct Answer: A
Explanation: - A
Ans. is a i.e., Methanol poisoning

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Methanol is highly toxic alcohol. It is metabolized to formaldehyde
(by alcohol dehydrogenas) and formic acid (by acetaldehyde
dehydrogenase).
It is the accumulation of formic acid which causes toxic effects in
methanol poisoning. Accumulation of formic acid results in lactic
acidosis/high anion gap metabolic acidosis with low plasma
bicarbonates, blindness due to retinal damage, papilledema.
Methanol poisoning can be treated by supportive measures, gastric
lavage and sodium bicarbonate (to treat acidosis). Ethanol is useful
because it competitively inhibits the conversion of methanol to formic
acid. Fomepizole can also be used as it is a specific inhibitor of
alcohol dehydrogenase. Folic acid or folinic acid. Enhance the
metabolism formic acid to CO2. Hemodialysis may also be used.
Question 69: Correct Answer: A
Explanation: - A
Ans. is a i.e., Central 10 degress of vision
Metamorphopsia is a phenomenon wherein the patient perceives
objects to have an altered, irregular contour or shape. For example,
graph paper lines may be bent or obscured in areas.
This can be reviewed for any changes over time using an Amsler
grid, which tests the central 10° of vision.
It is associated with diseases affecting the macula such as central
serous choroidopathy, age- related macular degeneration, diabetic
macular oedema and macular hole.
Question 70: Correct Answer: A
Explanation: - A
Answer- A. Li fraumeni syndrome
Li-Fraumeni syndrome is due to mutation in p-53 gene.
Question 71: Correct Answer: B
Explanation: - B
Ans. is b i.e., Jet- black spots with pale-waxy disc
Examination findings in retinitis pigmentosa
Ophthalmoscopic findings are characteristic and include :-
i. Retinal pigmentary changes (Bone spicule intraneural retinal
pigmentation) : - Retina studded with small, jet-black spots
resembling bone corpuscles with a spidery outline. These
pigmentary changes are typically perivascular and retinal veins
(never arteries) have a sheath of pigment for part of their course.
These changes affect equatorial region initially sparing the posterior
pole and periphery. Later in the course of disease whole retina is
involved.
ii. iv. Attenuated and thread like retinal arterioles and veins.
iii. Pale and waxy optic disc (consecutive optic atrophy).
Thinning and atrophy of retinal pigment epithelium (RPE) in mid and
far peripheral retina with relative sparing of RPE at macula.

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Electroretinogram (ERG) and particularly the electro-oculogram
(EOG) are markedly subnormal.
Question 72: Correct Answer: C
Explanation: - C
Ans. is c i.e., Acid maltase [Ref Read below]
In liver diseases, ALT (alanine transaminase) is elevated more than
AST (aspartate transaminase). So, in liver diseases ALT/ AST ratio
is elevated.
But, when AST is higher than ALT, a muscle, source of these
enzymes should be considered.
Among the given options, only acid maltase deficiency (Pompes
disease) is myopathic form of glycogen storage disease (muscular
glycogenosis). Thus, AST/ALT ratio may be more than 2.
Other three options are liver glycogenoses (AST/ALT < 1, as ALT is
raised more than AST).
Question 73: Correct Answer: A
Explanation: - A
Ans. is a i.e., Claudication
The patient of lumbar canal stenosis is usually a man aged over 50,
complains of aching, heaviness, numbness and paraesthesia in the
thighs and legs; it comes on after standing upright or walking for 5-
10 minutes, and is consistently relieved by sitting, squatting or
leaning against a wall to flex the spine (hence the term spinal
claudication).
Question 74: Correct Answer: B
Explanation: - B
Ans. is b i.e., 19-5 mg
MALA-D contains -
i) 30 ug (0.03 mg) of ethinyl estradiol.
ii) 0.15 mg of desogestrel (D-norgestrel).
Each brown coloured film coated tablet contains 60 mg ferrous
fumarate equivalent to ferrous iron 19.5 mg.
Question 75: Correct Answer: B
Explanation: - B
Ans. is b i.e., Phosphoglycorate kinase
Glycolysis is regulated at 3 steps which are irreversible.
These reactions are catalyzed by following key enzymes :?
1) Hexokinase and glucokinase
2) Phosphofructokinase - I
3) Pyruvate kinase.
Question 76: Correct Answer: C
Explanation: - C
Ans. is c i.e., 12 - 72
Question 77: Correct Answer: D

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Explanation: - D
Ans. is d i.e., Trunk
A distinct topographic represention of the body can be demonstrated
in somatosensory area-I.
Each side of the cortex receives sensory information from the
opposite side of the body only (contralateral representation).
The body is represented upside down (vertical) in the postcentral
gyms, i.e. the face is represented at the foot of the gyrus whereas
the legs and feet are represented at the top extending on the medial
surface.
Some parts of body like face (especially lips, tongue) and fingers
have a proportionately large representation than the other areas like
the trunk. The cortical representation of the part of the body is
proportionate to its innervation density (number of sensory
receptors) rather than its size.
Question 78: Correct Answer: D
Explanation: - D
Ans. is d i.e., Leprosy
Basic laboratory services at PHC
i. Routine urine, stool and blood tests.
ii. Bleeding time, clotting time.
iii. Diagnosis of RT1/STDs with wet mounting, Grama stain, etc.
iv. Sputum testing for tuberculosis (if designated as a microscopy
center under RNTCP).
v. Blood smear examination for malarial parasite.
vi. Rapid tests for pregnancy.
vii. RPR test for Syphilis/YAWS surveillance.
viii. Rapid diagnostic tests for typhoid (Typhi Dot) and malaria.
ix. Raid test kit for faecal contamination of water.
x. Estimation of chlorine level of water using orthotoludine reagent.
Question 79: Correct Answer: C
Explanation: - C
Ans. is c i.e. Hyperkalemia
Question 80: Correct Answer: C
Explanation: - C
Ans. is C i.e., Grows at 42°C
Campylobacter jejuni
Morphology
Gram negative
Comma shaped
Motile with a single polar flagellum ? Darting or tumbling motility
Non capsulated
Non Sporing
Culture
Growth occurs under microaerophilic conditions (5% O2, 10%

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CO2 and 85% N2).
Thermophilic, growing at 42°C (Can grow at 37°C, but incubation at
higher temperatures suppresses normal fecal flora.)
Biochemical reactions
Do not ferment carbohydrate
Catalase and oxidase-positive
Nitrate reduction positive
Question 81: Correct Answer: C
Explanation: - C
Ans. is c i.e., IV injection is painless
Question 82: Correct Answer: A
Explanation: - A
Answer is A (Digitalis)
Pulsus Bigeminus is recognized as a cause of digitalis toxicity.
Pulsus Bigeminus is a disorder of rhythm (Irregular rhythm;
arrhythmia) most commonly caused by Premature Ventricular
Contractions that results in a pulse with irregular rhythm that
alternates in amplitude (pressure) from beat to beat. The most
common cause of Pulsus Bigeminus is Digitalis and Pulsus
Bigeminus is recognized as a cause of digitalis toxicity.
Question 83: Correct Answer: A
Explanation: - A
Ans. is a i.e., Increase water solubility
BIOTRANSFORMATION (METABOLISM)
Most of the drugs are treated by the body as foreign substances
(xenobiotics).
Like other foreign substances (xenobiotics), body tries to eliminate
drugs by various mechanisms for ridding itself of chemical intruders.
Biotransformation means chemical alteration of the drug in the body.
Why drug transformation is necessary ?
Kidney plays a pivotal role in terminating the activity of drugs.
For renal excretion the drug tends to be polar (lipid insoluble/water
soluble) so that it can not diffuse back from tubular lumen and can
be excreted.
But pharmacologically active organic molecules (drugs) tend to be
lipophlic (nonpolar) and remains unionized or only partially ionized at
physiological pH.
Biotransformation is needed to render nonpolar (lipid soluble)
compounds polar (water soluble) so that they are not reabsorbed in
the renal tubules and are excreted.
Sites and processes of biotransformation
Primary site of drug metabolism is liver, others are - kidney,
intestine, lung and plasma.
Biotransformation of drugs may lead to :-

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Question 84: Correct Answer: B
Explanation: - B
Ans. is b i.e., Unknown in male
Anorexia nervosa is less common in male, but can be seen.
There is binge eating and self induced vomiting.
"Amenorrhea often precedes severe weight loss" – Essentials of
psychiatry
ANOREXIA NERVOSA
The term `anorexia nervosa" is a misnomer as loss of appetite is a
rare symptom. This disorder is characterized by self imposed dietary
restrictions leading to malnutrition and severe weight loss.
Clinical features
Females are far more commonly affected than males. Onset usually
occurs between the age of 10-30 years, usually in mid adolescence.
A deliberate and persistent restriction of food is usually the earliest
presenting symptom. There is intense fear of becoming of obese,
even if body becomes very thin and underweight.
There is a body-image disturbance. The person is unable to
perceive the body size accurately.
Some patients cannot continuously control their voluntary restriction
of food intake and So have eating binges. These binges usually
occur secretly and often at night and are frequently followed by self-
induced vomiting. Patients abuse laxatives and even diuretics to
Question 85: Correct Answer: B
Explanation: - B
Ans. is `b i.e., Local type I hypersensitivity
Anaphylaxis -3 Acute, potentially fatal, systemic.
Atopy -›Chronic, Nonfatal, Localized.
Question 86: Correct Answer: C
Explanation: - C
Answer is C (Right 3rd intercostal space)
In cardiology, Erbs point refers to the third intercostal space on the
left sternal border where both components of S2 (A2 and P2) can be
well appreciated.
Both components of S2 (A2 and P2) are usually well transmitted to
the Erbs point. The physiological splitting of S2 into A2 and P2 is
believed to be appreciated best at the Erbs point or in the pulmonic
area.
A2 is best heard over the aortic area in the right second intercostal
space
P2 is best heard over the pulmonic area in the left second intercostal
space
Second heart sound (S2) is best heard over the pulmonic area
(Since both A2 and P2 can be heard at the pulmonic area) and at
the Erbs Point. Note that even at the pulmonic area A2 is louder

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than P2
1. Aortic area 2. Pulmonic
area
3. Erbs point Second intercostal space to the right of the
sternum (along right upper sternal border)
Second intercostal space to the left of the sternum
(along left upper sternal border)
Third intercostal to the left of the sternum(along left
sternal border)
Question 87: Correct Answer: B
Explanation: - B
Ans. is b i.e., Localization of extradural space
Various methods have been used to locate the epidural (extra dural
space), most of which rely on subatmospheric pressure.
These are :-
Loss of resistance to air or saline (most common technique).
Gutierrezs method : A hanging drop of saline on the hub of needle is
drawn in as the epidural space is entered (more reliable in thorocic
than lumbar region).
Odom s indicator : A fine-bore glass tube filled with saline and a
bubble that moves in response to a drop in pressure.
Macintoshs indicator : A small rubber balloon filled with air
connected to an adaptor causing it to deflate on entering the
epidural space.
Macintoshs spring-loaded needle.
Ultrasonic localization.
Oxford epidular space detector.
Question 88: Correct Answer: A
Explanation: - A
Answer is A (Klebsiella):
Klebsiella Pneumonia is also known as Friedlander Pneumonia.
Klebsiella initially described in 1882 by Friedlander was also known
as Friedlanders bacillus. Community acquired Pneumonia caused
by Friedlanders bacillus (Klebsiella) was termed as Friedlander
Pneumonia.
Question 89: Correct Answer: D
Explanation: - D
Ans. is d i.e., More common in term baby
During fetal life, most of the pulmonary arterial blood is shunted
through the ductus arteriosus into the aorta .
Functional closure of the ductus normally occurs soon after birth, but
if the ductus remains patent when pulmonary vascular resistance
falls, aortic blood is shunted into the pulmonary artery.
The aortic end of the ductus is just distal to the origin of the left
subclavian artery, and the ductus enters the pulmonary artery at its

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bifurcation
Female patients with PDA outnumber males 2 : 1.
PDA is also associated with maternal rubella infection during early
pregnancy.
It is a common problem in premature infants, where it can cause
severe hemodynamic derangements and several major sequelae
Question 90: Correct Answer: B
Explanation: - B
Ans. is b i.e., Herpes virus
Enveloped viruses are most sensitive to inactivation by biocides.
Among the given options only Herpesvirus is enveloped virus.
Adenovirus, parvovirus and poliovirus (picornavirus) are non-
enveloped viruses.
Question 91: Correct Answer: D
Explanation: - D
Ans. is d i.e., Mid thigh
Mid-thigh (Mid-hunter) - Adductor canal- Great saphenous with
femoral
Hunter perforator (Hunterian perforator or adductor canal perforator)
is seen in mid thigh.
Question 92: Correct Answer: B
Explanation: - B
Ans. is b i.e., Systematic random
Simple random sampling
Simple random sampling, also, known as unrestricted random
sampling; is applicable for small, homogenous, readily available
population and is used in clinical trials.
In simple random sampling each individual is chosen randomly and
entirely by chance.
So, each individual has the same probability of being chosen at any
stage during the sampling process. For example
Let us assume you had a school with 1000 students, divided equally
into boys and girls, and you wanted to select 100 of them for further
study.
You might put all their names in a bucket and then pull 100 names
out.
Not only does each person have an equal chance of being selected,
we can also easily calculate the probaility of
Question 93: Correct Answer: C
Explanation: - C
Answer- C. X-ray chest
First investigation of choice in any type of chest injury is chest X-ray.
Question 94: Correct Answer: A
Explanation: - A

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Ans. is a i.e., Polyarthalgia
All the given options are included in modified Jones criteria. Carditis,
chorea and erythema marginatum are major criteria. Only
polyarthralgia (arthralgia) is minor criterian.
Question 95: Correct Answer: D
Explanation: - D
Ans. D. Dermoid cyst
Question 96: Correct Answer: C
Explanation: - C
Ans. is c i.e., Poliovirus
Chlorination
Chlorination is one of the greatest advances in water purification.
Chlorine kills pathogenic bacteria, but has no effect on spores,
certain viruses (e.g., polio, viral hepatitis) and cyst of E.histolytica, in
usual doses.
Mechanism of action
When chlorine is added to water, there is the formation of
hypochloric and hypochlorous acid
The hypochloric acid is neutralized by the alkalinity of the water.
The hypochlorous acid ionizes to form hydrogen ions and
hypochlorite ions.
The disinfecting action of chlorine is mainly due to the hypochlorous
acid and to a small extent due to the hypochlorite ions.
The hypochlorous acid is the most effective form of chlorine for
water disinfection, it is 70-80 times more effective than hypochlorite
ion.
Question 97: Correct Answer: A
Explanation: - A
Ans. is a i.e., Selective mutism
Autism typically diagnosed before 36 month of age.
Autism is a neurodevelopmental disorder of unknown etiology, but
with a strong genetic basis.
It develops and is typically diagnosed before 36 mo of age.
It is characterized by a behavioral phenotype that includes
qualitative impairment in the areas of language development or
communication skills, social interactions and reciprocity, and
imagination and play.
Selective mutism is defined as a failure to speak in specific social
situations, despite speaking in other situations; it is typically a
symptom of an underlying anxiety disorder. Children with selective
mutism can speak normally in certain settings, such as within their
home or when they are alone with their parents, but do not speak in
other social settings, such as at school or at other places outside
their home.
Attention-deficit/hyperactivity disorder (ADHD) is the most common

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neurobehavioral disorder of childhood, 1 of the most prevalent
Question 98: Correct Answer: B
Explanation: - B
Ans. is b i.e., 100 mg elemental iron and 0.5 mg FA
Iron and Folic Acid content per IFA tablet:
Adult tablet: 100 mg elemental iron and 500 mcg folic acid
Pediatric tablet: 20 mg elemental iron and 100 mcg folic acid
For preterm infants, recommended Iron and Folic Acid content per
IFA tablet:
Pediatric tablet: 10 — 15 mg elemental iron and 100 mcg folic acid.
Question 99: Correct Answer: D
Explanation: - D
Ans. is d i.e., Presence of smegma under prepuce
Examination in a case of rape
A. Examination of victim
Victim cannot be examined without written informed consent.
Informed written consent should be obtained if the age of victim is
above 12 years. If she is less than 12 years of age or if she is
mentally unsound, the written consent of parent/guardian should be
taken (Sec. 90 IPC). Victim (female) should be examined by or
under supervision of a female RMP (Sec. 53(2) CrPC).
Finding which are suggestive of rape are :-
Signs of struggle on clothes (tear, blood, semen, mud etc), body and
genitals (abrasion, contusion, bites or nail marks etc).
Presence of the semen in the vagina (proof of sexual intercourse).
Presence of spermatozoa in the vagina.
Locards principal of exchange states that whenever two bodies
come in contact with each other, there is exchange of material
between the two and so a criminal can be linked to crime. In case of
rape, piece of cloth, button, hair, blood, saliva, semen or smegma
from the accused may be found on the body of victim and conversly
materials of victim may be found on the body of accused.
Presence of smegma bacilli in vagina is suggestive of coitus.
B.Examination of accused
Question 100: Correct Answer: C
Explanation: - C
Ans. C. Malonate
Inhibition of the enzyme succinate dehydrogenase by malonate
illustrates competitive inhibition by a substrate analog.
Succinate dehydrogenase catalyzes the removal of one hydrogen
atom from each of the two methylene carbons of succinate.
Question 101: Correct Answer: A
Explanation: - A
Ans. A. Actinomyosis

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Actinomycosis is an infection common in patients sing inert IUCDs.
Question 102: Correct Answer: A
Explanation: - A
Answer- A. CD 31
The endothelial origin of these tumors can be demonstrated by
immunohistochemical staining for CD31 or von Willebrand factor.
Question 103: Correct Answer: C
Explanation: - C
Type VI glycogen is also called Her’s disease and it is caused by
enzyme defect liver phosphorylase.
Clinical features are hepatomegaly, accumulation of glycogen in the
liver and mild hypoglycemia.
Question 104: Correct Answer: A
Explanation: - A
Answer- A. Sliding hernia
Sliding hernia is defined as any hernia in which part of the sac
(usually the posterior) is formed by the wall of a viscus.
Cecum is involved on the right side and sigmoid colon is involved on
left side.
It should be clearly understood that the caecum, appendix or part of
colon wholly within a hernial sac does not constitute a sliding hernia
(The viscera must form a wall of the sac to be termed as sliding
hernia).
[Ref: Bailey & Love 26th/e p. 956]
Question 105: Correct Answer: A
Explanation: - A
Ans. A. Antibiotics
Treatment of acute dacyrocystitis
During cellulitis stage
It consists of systemic and topical antibiotics to control infection; and
systemic anti-inflammatory analgesic drugs and hot fomentation to
relieve pain and swelling.
Question 106: Correct Answer: A
Explanation: - A
Ans. is a i.e., Gout
Crystal of Pseudogout
Made up of calcium pyrophosphate
Weakly positive birefringent, rhomboid
Crystal of gout :-
Made up of uric acid (monosodium urate)
Strongly negative birefringent, needle shaped
Question 107: Correct Answer: B
Explanation: - B
Ans. is b i.e., Retinoblastoma

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Question 108: Correct Answer: C
Explanation: - C
Ans. is c i.e., Congenital esotropia
The usual age of presentation of congenital (infantile) esotropia is
between 2-4 months of age. Presentation at birth is very rare.
Infantile esotropia has been classically described as large angle
constant esotropia (not variable).
The classicle triad of associated motor abnormalies in congenital
esotropia is inferior oblique overaction, dissociated vertical deviation
(DVD) and latent nystagmus.
"It seems, from a review of literature, that infants with esotropia
have, on average, refractive errors similar to the normal age
matched population". — Handbook
Question 109: Correct Answer: A
Explanation: - A
Ans. is a i.e., KCl Poisoning
Question 110: Correct Answer: A
Explanation: - A
Scala media (cochlear duct or membranous labyrinth) has 3
walls : -
The basilar membrane, which supports the organ of corti.
The Reissners membrane which separates it from the scala
vestibuli.
The stria vascularis which contains vascular epithelium and is
concerned with secretion of endolymph.
Question 111: Correct Answer: B
Explanation: - B
Ans. is b i.e., Progressive supranuclear palsy
[Ref Clinical neurology - 113]
Hummingbird sign on brain MRI is a radiological sign of progressive
supranuclear palsy.
Question 112: Correct Answer: A
Explanation: - A
Ans. is a i.e., Rpo B gene
Gene
ATT Drug
responsible for
drug resistance
INH inhA and Kat G
gene
Ethambutol emb B gene
Rifampicin rpoB gene
Pyrazinamide pncA gene
Question 113: Correct Answer: C

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Explanation: - C
Ans. is c i.e., 55 kg
Question 114: Correct Answer: A
Explanation: - A
Ans. is a i.e., Type I
Question 115: Correct Answer: B
Explanation: - B
Ans. is b i.e., Lymphoma
Over all hemangioma is most common Tumor in infant.
Hemangioma is usually benign in Nature.
Leukemia is most common malignancy in pediatric age gyp.
2" most common is CNS Tumor = Lymphoma is the most common
malignancy of the gastrointestinal tract in children. About 30% of
children with non-Hodgkin lymphoma present with abdominal
tumors.
Question 116: Correct Answer: D
Explanation: - D
Ans. is d i.e., Hepatitis E
Blood safety :?
Under Blood Safety Programme all the blood banks have to ensure
that before transfusion of blood to the patient the mandatory tests for
HIV, VDRL, Hepatitis B, Hepatitis C and Malaria are done.
Question 117: Correct Answer: D
Explanation: - D
Ans. is d i.e., All of above
Patent ductus arteriosus (PDA)
Small PDA may not cause any complication but large defect if
untread may leads to :
Pulmonary hypertension Left to Right shunt leads to too much
circulation of blood in lung which leads to pulmonary hypertension.
Eisenmengers syndrome - Large standing pulmonary hypertension
leads to permanent lung damage and causes Right to Left shunt.
Endocarditis.
Arrhythmia Enlargement of heart due to PDA increase risk of
arrhythmias
Question 118: Correct Answer: A
Explanation: - A
Ans. is a i.e., Stratum corneum
After copulation, the male mite dies and the female mite burrows into
the superficial skin layer (stratum cornuem) at the rate of 2 mm/day.
Female mite lays eggs which hatch into larva, which moulds and
mature into adult mites.
The mite then burrows into stratum corneum.
These burrow is visible clinically as an irregular gray-brown line.

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Burrow is a pathognomic sign for scabies.
Question 119: Correct Answer: A
Explanation: - A
Ans. is a i.e., Lysine
Wheat
Next to rice, wheat is the most important cereal.
The limiting amino acids in wheat proteins are lysine and threonine.
Question 120: Correct Answer: D
Explanation: - D
Ans. is d i.e., Male pseudo hermephroditism
Congenital adrenal hvperplasia (CAH)
Group of AR disorder
MC adrenal disorder in childhood
Most common 21-hydroxylase deficiency =There is elevated level of
pregenolone, 17 -OH pergenelone DHEA and decreas level of
progesterone, deoxycortisol,and estradiol so 21 hydroxylase
deficiency causes female pseudoher maphroditism.
Question 121: Correct Answer: A
Explanation: - A
Ans. is a i.e., Knee
Loose body in joint
A loose body is a free-floating piece of bone, cartilage or foreign
object in a joint.
The knee is the most common joint where one would find a loose
body.
Causes of loose bodies include :-
i) Osteoarthritis
ii) Osteochondritisdessicans
iii) Osteochondral fracture(injury)
iv) Charcots disease
v) Synovial chondromatosis
Question 122: Correct Answer: D
Explanation: - D
Answer- D. 13C Triclosan
Tests used for fat malabsorption
1. "C Triolene breath test
2. 3C Tripalmitin breath test
3. 3C Mixed-Triglyceride breath test
4. "C-Trioctanoin breath test
Question 123: Correct Answer: B
Explanation: - B
The nipple is pierced by 15-20 lectiferous ducts.
Question 124: Correct Answer: A
Explanation: - A

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Ans. A. Granulosa cell tumors
The formation of Call - Exner bodies is a distinct feature of granulosa
cells and can be readilyrecognized in certain types of granulosa cell
tumours.
Question 125: Correct Answer: D
Explanation: - D
Ans. is d i.e., Egas Moniz
Egas Moniz first performed cerebral Angiography in 1927. n He
received the Nobel Prize for developing for developing frontal
leucotomy as a treatment for psychiatric diseases.
Question 126: Correct Answer: A
Explanation: - A
Ans. is a i.e., Mumps
Bilateral parotid enlargement is seen in
Viral
infectionQ Metabolic causes Endocrinal Sarcoidosis
Mumps Diabetes mcuitus Gonadal Amyloidosis
Influenza Hyperlipoproteinemia hypofunction Sjogrens
syndrome
Epstein
barr virus Chronic pancreatitis Acromegaly
Coxackie
virus A Hepatic cirrhosis
CMV
HIV
Question 127: Correct Answer: A
Explanation: - A
Answer- A. Jobs syndrome
Jobs syndrome, also called Hyper-IgE syndrome or
Hyperimmunoglobulin E syndrome, is an autosomal dominant
disorder due to mutations in Signal Transducer and Activator of
Transcription-3 (STAT-3).
There is defect in phagocytosis. IgE levels are elevated. Other
immunoglobulins are normal.
Question 128: Correct Answer: C
Explanation: - C
Ans. is
c i.e.,13 [Ref Robbins 9tVe p. 290]
Retinoblastoma gene (RB gene) is located on 14 band on the long
arm of chromosome 13 (13q14). RB gene is a tumor supressor
gene.
Retinoblastoma develops when both the normal alleles of the RB
genes are inactive or altered. It is typical example of Knudsons two
hit hypothesis.

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Question 129: Correct Answer: A
Explanation: - A
Ans, A. Use of oxytocin in labour
The most common cause of rupture of scarred uterus k use of high
doses of oxytocin for the augmuntation of labour.
Question 130: Correct Answer: A
Explanation: - A
Ans. is a i.e., Hypercalcemia
Pathologic calcifications
Dystrophic calcification: Deposition of calcium at sites of cell injury
and necrosis.
Metastatic calcification: Deposition of calcium in normal tissues,
caused by hypercalcemia (usually a consequence of parathyroid
hormone excess)
Question 131: Correct Answer: A
Explanation: - A
Ans. is a i.e., Oxygen saturation decreases below 90%
Peripheral chemoreceptors (carotid and aortic bodies) are stimulated
if arterial PO2 is below 60 mmHg.
At PO2 of 60 mmHg, O2 saturation is about 90% (89%).
Question 132: Correct Answer: C
Explanation: - C
Ans. is c i.e.,H+
Pepsin is secreted by chief cells of stomach in an inactive
(zymogen) form called pepsinogen.
Acid (IF) in lumen of stomach converts pepsinogen to active pepsin.
Pepsin once formed also attacks pepsinogen producing more pepsin
molecules by autocatalysis.
Question 133: Correct Answer: B
Explanation: - B
Ans. is b i.e., First meiosis
Oogenesis
Oogenesis refers to the process of formation of ova from the
primitive germ cells. Unlike fetal testis (in which spermatogenesis
beings at puberty), the fetal ovary begins oogenesis by 10 weeks of
gestation. o The sequence of events in oogenesis are :
i) The primitive germ cells undergo mitotic divisions to form oogonia
(diploid Oogonium is unique in that it is the only female cell in which
both X chromosomes are active.
ii) The oogonia proliferate by mitosis to form primary oocytes (diploid
cells).
iii) Primary oocytes formed from the oogonia enter a prolonged
prophase (diplotene stage) of the first meiotic division and remain in
this stage until ovulation occurs after puberty.

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iv) Primary oocytes completes the first meiotic division at puberty
just before ovulation to form secondary oocyte (haploid cell) and 1st
polor body.
v) Secondary oocyte immediately begins second meiotic division but
this division stops at metaphase and is completed only if the mature
ovum (ootid) is fertilized with sperm. At that time second polor body
(polocyte) is extruded and the fertilized ovum proceeds to form a
new individual. Fertilization normally occurs in the ampulla of
Question 134: Correct Answer: C
Explanation: - C
Ans. is c i.e., Eustachian tube
There are small fat bodies located infermedial to Eustachian tube.
These are called Ostmann fat pads.
They are important in normal closure of eustachian tube and
preventing transmission of nasopharyngeal pressure to middle ear.
These fat pads are absent in Patulous tube syndrome.
Question 135: Correct Answer: C
Explanation: - C
Ans.C. Are under voluntary control
Pseudohallucination
Pseudohallucination is a perceptual experience, which differs from a
hallucination in that it appears to arise in the inner subjective space,
not through one of the external sensory organs.
Patients tend to describe these sensations as being perceived with
the inner eye or mind eye (or ear).
However, like true hallucinations pseudohallucinations are not under
voluntary control.
Example include: Distressing flashbacks in post-traumatic stress
disorder or the recently bereaved widow waking up to briefly see
her husband sitting at the foot of the bed,
Question 136: Correct Answer: D
Explanation: - D
Ans. is d i.e., Low levels of plasma ferretin
Hemophagocytic Lymphohistiocytosis
Hemophagocytic lymphohistiocytosis (HLH) is a reactive condition
marked by cytopenias and signs and symp toms of systemic
inflammation related to macrophage activation. For this reason, it is
also sometimes referred to as macrophage activation syndrome.
Pathogenesis
The common feature of all forms of HLH is systemic activation of
macrophages and CD8+ cytotoxic T cells.
The activated macrophages phagocytose blood cell progenitors in
the marrow and formed elements in the periph eral tissues, while the
"stew"of mediators released from macrophages and lymphocytes
suppress hematopoiesis and produce symptoms of systemic

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inflammation.
These effects lead to cytopenias and a shock-like picture,
sometimes referred to as "cytokine storm" or the systemic
inflammatory response syndrome.
Familial forms of HLH are associated with several different
mutations, all of which impact the ability of cytotoxic T cells and NK
to properly form or deploy cytotoxic granules.
The most common trigger for HLH is infection, particularly with
Question 137: Correct Answer: C
Explanation: - C
Ans. is c i.e., Cysteine
Taurine is synthesized from cysteine.
Question 138: Correct Answer: A
Explanation: - A
DNA synthesis cannot commence with deoxyribonucleotides
because DNA polymerase cannot add a mononucleotide to another
mononucleotide.
Thus, DNA polymerase cannot initiate synthesis of complementary
DNA synthesis strand of DNA on a totally single stranded template.
For this, they require RNA primer, which is a short piece of RNA
formed by enzyme primase (RNA polymerase) using DNA as a
template.
RNA primer is then extended by addition of deoxyribonucleotides.
Later on, the ribonucleotides of the primer are replaced by
deoxyribonucleotides.
Primase is actually a DNA primase which has RNA polymerase
activity. This DNA primase is also called DNA polymerase.
Question 139: Correct Answer: D
Explanation: - D
Pseudocyesis or phantom pregnancy is usually seen in patients nearing menopause or in
young women who intensely desire children.
Most of them suffer from some forms of psychic or hormonal disorder.
The abdomen may distend due to deposition of fat.
The pregnancy may progress to full term and the labour pain may stop abruptly when
informed that she is not pregnant.
Ref: Textbook of Forensic Medicine and Toxicology by Narayan Reddy, Edition 21, Page -
333
Question 140: Correct Answer: A
Explanation: - A
Ans. is a i.e., Bundle Branch block
Repeat from previous session.
Intrinsic intraventricular conduction delays such as left bundle block
and right bundle branch block are associated with wide QRS
complex.

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Question 141: Correct Answer: C
Explanation: - C
The thinnest portion of medial wall of orbit is the lamina papyracea
which separates ethmoid sinuses from orbit. o Infection from
ethmoidal sinus can easily breach this paper thin bone and affect the
orbital contents.
Question 142: Correct Answer: A
Explanation: - A
Ans. is a i.e., Cisatracurium
The unique feature of atracurium and cisatracurium is inactivation in
plasma by spontaneous nonenzymatic degradation (Hofman
elimination) in addition to that by alkaline ester hydrolysis.
Therefore both of these do not require hepatic or renal routes for
elimination therefore can be used safely in hepatic and renal failure.
Moreover, cisatracurium does not provoke histamine release,
therefore it is preferred over atracurium.
Question 143: Correct Answer: C
Explanation: - C
Ans. is c i.e., Infection in early pregnancy causes milder disease
Question 144: Correct Answer: A
Explanation: - A
Ans. A. Auditory hallucinations and paranoia
Psychiatric disorders in hypothyroidism
These include depressed mood, apathy, impaired memory and other
cognitive defects.
Hypothyroidism can contribute to the development of treatment
refractory depression.
Myxedema madness consisting of auditory hallucinations and
paranoia is seen in some Patients.
Question 145: Correct Answer: A
Explanation: - A
Ans. is a i.e., Bronchophonia
Physical examination findings of Common pulmonary
conditions
Pleural effusion Pneumonia Endobronchial
tumor Pneumothorax
Tracheal
Shifted or
position
midline Midline Shifted or
midline Shifted or midline
Chest wall Reduced or
Reduced or
Reduced or

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normal
normal
normal Reduced
Fremitus Decreased Increased Normal or
decreased None
Percussion Dull Dull Normal or Dull Hyperresonant
Breath
sounds Decreased Increased Normal or
Decreased Decreased/absent
Crackles None None None None
Wheeze None None Possible None
Egophony Band above
effusion(skodiac) Present None None
Tracheal
position
Question 146: Correct Answer: A
Explanation: - A
Ans. is a i.e., Whole blood
Exchange transfusion is the process of slowly removing patient
blood and replacing with fresh donor whole blood.
Question 147: Correct Answer: A
Explanation: - A
Ans. is a i.e., Providing 3 million people treatment by end of
2005
3 by 5 target
On 1st December 2003, WHO and UNAIDS announced a detailed
plan to reach the "3 by 5 target" of providing antiretroviral treatment
(ART) to three million people living with HIV/AIDS in the developing
countries by the end of 2005.
Ultimate goal of this strategy is to provide universal access to ART
to anyone who needs it.
It has five Pillars (focus areas of concerns) :?
Simplified standard tools to deliver ART
A new service to ensure effective, reliable supply of medicines and
diagnostics
Dissemination and application of new knowledge and successful
strategy
Urgent, sustained support to countries
Global leadership, backed by strong partnership
Question 148: Correct Answer: B
Explanation: - B
Answer- B. Hypocalcemia
Hyperlipidemia
Diabetes
Hypertension

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Cigarette smoking
Alcohol, lipoprotein (a)
Chlamydia pneumonae
Physcial inactivity
Herpes virus
CMV infection
Question 149: Correct Answer: B
Explanation: - B
Short saphanous vein runs in the back (posteriorly) of leg (not
laterally).
It enters the back of leg by passing behind the lateral malleolus and
is accompanied by sural nerve.
In leg it ascends lateral to tendocalcaneous (tendoachillis). Thus
tendoachillis is medial to vein.
Question 150: Correct Answer: A
Explanation: - A
Ans. is a i.e., Pefloxacin
Question 151: Correct Answer: A
Explanation: - A
Ans. is a i.e., Haemophilus
Satellitism
The growth of Haemophilus influenzae is scanty on blood agar, as
the factor V is not freely available, being imprisoned inside the red
blood cells. Growth is, therefore, better if the source of the V factor is
also provided.
When Staph aureus is streaked across a plate of blood agar on
which a specimen containing H. influenzae has been inoculated,
after overnight incubation, the colonies of H. influenzae will be large
and well developed alongside the streak of staphylococcus, and
smaller further away. This phenomenon is called satellitism.
Satellitism is due to a high concentration of factor V in staph aureus
which is released into medium and is used by H. influenzae.
Question 152: Correct Answer: C
Explanation: - C
Answer- C. Intestinal epithelium
CI is synthesized in intestine; C2 and C4 are synthesized by
macrophages; C5 and C8 are synthesized in spleen; and C3, C6
and C9 are synthesized in liver.
[Ref: Short textbook of medical microbiology by Satish Gupte p. 92]
Question 153: Correct Answer: A
Explanation: - A
Ans. is a i.e., Cerebral edema
High blood sugar will cross the blood-brain barrier and
simultaneously will draw water inside leading to cerebral edema.

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Cerebral edema accounts for 60-90% of all DKA related deaths in
children.
Infection is a precipitator for the development of DKA.
Other precipitating factors can be tissue ischemia, inadequate
insulin administration, drugs (cocaine) and pregnancy.
Question 154: Correct Answer: A
Explanation: - A
Ans. is a i.e., Modified radical mastoidectomy
Treatment of atticoantral disease
Since cholesteatoma is going to expand and destroy bone and
mucous membrane, it has to be removed. Therefore, surgery is the
mainstay of treatment. Primary aim is removal of disease by
mastoidectomy to make ear safe followed by reconstruction of
hearing at a later stage. Modified radical mastoidectomy is the
surgery of choice.
Two types of surgical procedures (mastoidectomy) are done to deal
with cholesteatoma.
1) Canal wall down procedures
These leave the mastoid cavity open into the external auditory canal
so that the diseased area is fully exteriorized.
The commonly used procedures for atticoantral disease are
atticotomy, modified radical mastoidectomy and rarely radical
mastoidectomy.
Modified radical mastoidectomy is the procedure of choice.
2) Canal wall up procedures (cortical mastoidectomy)
Here disease is removed by combined approach through the meatus
and mastoid but retaining the posterior bony meatus wall, thereby
avoiding an open mastoid cavity.
For reconstruction of hearing mechanism myringoplasty or
Question 155: Correct Answer: B
Explanation: - B
Ans. is b i.e., Retrospective study
Question 156: Correct Answer: C
Explanation: - C
Answer- C. Thigh
Anterolateral aspect of thigh because of lack of important blood
vessel & nerve is preferred site upto 12 month of age.
Question 157: Correct Answer: D
Explanation: - D
Ans. is d i.e., Filiform papillae have taste buds at tip
In tongue, taste buds are grouped in structures called papillae. Taste
buds are located in the walls of papillae. There are three types of
papillae :-
i) Fungiform papillae :- Are especially numerous near the tip and the

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margins of the tongue.
ii) Circumvallate (Vallate) papillae :- These are the largest papillae
and are distributed to a V-shaped region near the base of tongue.
iii) Foliate papillae :- Confined to the back edge of the tongue.
Besides these three types of papillae, there is also a fourth type, the
filiform papillae but these have no taste buds.
Question 158: Correct Answer: C
Explanation: - C
Ans. is c i.e., 600 mcg
Question 159: Correct Answer: A
Explanation: - A
Ans is (a) ie Middle 1/3rd
Well, I am not quite sure of the answer.
Esophageal Carcinoma is of two common histological types
i) Squamous cell Ca - the MC type in world (-95% according to
Sabiston)
ii) Adenocarcinoma - where incidence is increasing at a rapid
rate and is now the MC type in USA (Ref. Harrison, Schwartz)
Distribution of Squamous Cell Ca.
Upper 1/3 10%
Middle 113 60%
Lower 1/3 30%
Adenocarcinoma is mainly located in lower 1/3.
Nowhere, I could get the MC site of esophageal carcinoma overall
(including both squamous and adeno variety). [Harrison writes the
MC site to be lower 1/3, but it gives incidence for US population
only, not for the whole world]
But one thing is sure - squamous cell Ca is the MC type of
esophageal cancer in world [(Ref: Bailey & Love, 25/e p1026 (24/e
p1009); Robbins 8/e p772 (7/e p806); Sabiston I8/e p1090 (I7/e
p1118)]
So I presume that the overall MC site would be the MC site involved
by the MC type of esophageal cancer i.e. -* Middle 1/3
Question 160: Correct Answer: D
Explanation: - D
Ans. is d i.e., Glaucoma
Question 161: Correct Answer: A
Explanation: - A
Suttons nevus/halos nevus : a halo of depigmentation appears around a
preexisting melanocytic naevus.
Meyerson’s naevus is used to describe a melanocytic naevus that has developed an
associated inflammatory reaction, which looks like eczema.
Ref: Rooks textbook of dermatology, 8th edition Pg 54.20.
Question 162: Correct Answer: C

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Explanation: - C
Ans. is c i.e., Corticospinal tract
Question 163: Correct Answer: B
Explanation: - B
Ans. is b i.e., Pneumonia
Respiratory complications in AIDS
Respiratory diseases in AIDS include
A) Acute bronchitis and sinusitis
They are caused by S. pneumoniae and H influenzae and are very
common.
B) Pulmonary diseases
Pulmonary diseases are :-
1. Pneumonia
Most common pulmonary manifestation is pneumonia :
Bacterial pneumonia : It is caused most commonly by S pneumoniae
and pneumococcal infection is the earliest serious infection in AIDS.
H influenzae is also a common cause.
P canna pneumonia : It is the most common cause of pneumonia in
AIDS. Risk is greater when CD4 count less than 200/ml.
2. Tuberculosis
In developing countries like India, most important pathogen is M
tuberculosis. Other common pathogen causing TB is MAC (atypical
mycobacteria).
3. Other pulmonary diseases
These are fungal infections (cryptococcus, histoplasma, aspergillus),
Question 164: Correct Answer: B
Explanation: - B
Ans. is b i.e., Hind milk relive hunger
The foremilk (the milk "in front"); is produced at the beginning of
each feeding. It contains water, vitamins, and protein and relieve
thurst.
The hindmilk ; is pushed out latter, it is heavier, richer in lipid and
satisfy hunger.
Question 165: Correct Answer: C
Explanation: - C
Ans. is c i.e., Increased heart rate
Compensatory mechanisms in acute hemorrhage
In acute hemorrhage there is compensatory sympathetic stimulation
which causes :?
1) Generalized vasoconstriction with increased total peripheral
resistance (TFR).
2) Increased heart rate (tachycardia).
3) Increased cardiac contractility.
4) Increased renin release causing sodium and water retention
through RAA system.

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5) Shift of fluid from intracellular and interstitial space into
vascular space.
Question 166: Correct Answer: B
Explanation: - B
Ans. is b i.e., Infertility of husband
Under section 12 of Hindu Marriage Act 1955 or section 24 of
Special Marriage Act 1954, a wife may seek divorce on the ground
that her husband was impotent at the time of marriage and
continues to be impotent therefore he is incapable of fulfilling the
rights of consummation of marriage by an act of sexual intercourse.
Conditions for nullity of marriage
Any marriage can be declared null and void under following
conditions:?
1) Bigamy, i.e. one spouse has made one more marriage
2) Impotence
3) If either party is underage
4) If one spouse is having unsound mind at the time of marriage,
virulent form of leprosy or veneral disease in a communicable form.
5) If one spouse has not been heard of as being alive for a period of
7 years or undergoing a sentence of imprisonment for 7 years.
6) If the consent has been obtained by coercion or fraud.
7) If the woman already pregnant with some one elses child at the
time of marriage.
Question 167: Correct Answer: D
Explanation: - D
Ans. is `d i.e., Reward
Question 168: Correct Answer: C
Explanation: - C
Ans. is c i.e., Medical college Hospital
o Government hospital and government medical colleges are
provided with a grant of Rs 3.00 crores for the development of
oncology wing.
Question 169: Correct Answer: A
Explanation: - A
Anterior axillary fold is rounded in shaped and is formed by
pectoralis major (lower border). Posterior axillary fold is formed by
teres major and latisimus dorsi.
Question 170: Correct Answer: B
Explanation: - B
Ans. is b i.e., Skirrows medium
Question 171: Correct Answer: C
Explanation: - C
Answer- C. Temporal lobe infarction
Herpes simplex infection has a predilection for the involvement of

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Temporal lobe.
The lesions in HSV encephalitis are intense hemorrhagic necrosis of
the inferior and medial temporal lobe and the mediorbital part of
frontal lobes.
Question 172: Correct Answer: A
Explanation: - A
Ans. is a i.e., Article 21
Indian constitution (Article 21) ensures right to life; there is no
equivalent right to die. Since Indian constitution is supreme, force
feeding in hunger strikers is lawful in India.
Question 173: Correct Answer: D
Explanation: - D
Answer- D. All of the above
Radiological signs of COA are : i) Reverse figure of 3 sign (double
bulge sign or E sign), ii) Docks sign; iii) Double aortic knuckle.
Globular heart with oligemic lung fields
Reverse figure of 3 sign
Double aortic knuckle
Question 174: Correct Answer: A
Explanation: - A
Ans. is a i.e., Hypotension
Celiac plexus block
The celiac plexus is situated retroperitoneally in the upper abdomen.
It is at the level of T12 and L, vertebrae anterior to the crura of the
diaphragm. It contains visceral afferent and efferent fibers divided
from T5 to T1, by means of greater, lesser and least splanchnic
nerves. Celiac plexus innervates most of the abdominal viscera,
therefore this procedure blocks the nerves which come from the
pancreas, liver, gall bladder, stomach, intestine, spleen, kidney and
adrenal glands.
A celiac plexus block can be combined with an intercostal block to
provide anesthesia for intra-abdominal surgery.
Because celiac plexus block results in blockade of the autonomic
nervous system, this block may help to reduce stress and endocrine
responses to surgery. For the same reason, the most common
complication of celiac plexus block is postural hypotenstion because
of blockade of lumbar sympathetic chain leading to upper abdominal
vessel dilation and venous pooling.
Celiac plexus block can be done by following three approaches : -
Retrocrural (classic) approach, anterocrural approach and
Question 175: Correct Answer: A
Explanation: - A
Secondary adrenal insufficiency is adrenal hypofunction due to a
lack of adrenocorticotropic hormone (ACTH).

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Secondary adrenal insufficiency may occur in
Panhypopituitarism
Isolated failure of adrenocorticotropic hormone (ACTH) production
Patients receiving corticosteroids (by any route, including high doses
of inhaled, intra-articular, or topical corticosteroids)
Patients who have stopped taking corticosteroids
Symptoms are the same as for Addison disease and include fatigue,
weakness, weight loss, nausea, vomiting, and diarrhea, but there is
usually less hypovolemia.
Question 176: Correct Answer: B
Explanation: - B
Ans. is b i.e., Type 2
Type V hypersensitivity reactions were additionally added to the
scheme originally described by Coombs and Gell. Contrary to type
IV and in agreement with types I, 11 and III respectively, they are
mediated by antibodies too.
The type V reactions are sometimes considered as a subtype of
the type II hypersensitivity.
As its mechanisms do not destroy target cells, they are responsible
for induction of organ/tissue dysfunctions only most of authors prefer
it to be and independent, the 5 type of hypersensitivity reactions
Question 177: Correct Answer: C
Explanation: - C
Ans. is c i.e., Dengue fever
Break bone fever (Saddle back fever) is caused by dengue virus.
Dengue fever
Dengue fever is caused by arboviruses (at least 4 serotypes have
been recognized)
It is transmitted by Aedes (Aedes aegypti is the main vector).
The reservoir of infection is both man and mosquito.
The transmission cycle is Man-mosquito-man
Dengue fever occurs both epidemically and endemically. Epidemics
starts in rainy season and are usually explosive.
Aedes mosquito becomes infective by feeding on a patient from the
day before onset to the 5th day of illness.
Various manifestations of Dengue infection
A) Classical dengue fever –
Also known as break bone fever
Incubation period 2-7 days (3-10 days -4 Park)
Onset is sudden with chills and fever. Fever is usually between 39°c
and 40°c temperature returns to normal after 5-6 days or subside on
about the 3rd day and rise again after 5-8 days after onset (saddle
back fever).
Rashes appear in 80% of cases during remission or during second
febrile phase. The rash lasts for 2 hours to several days and may be

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Question 178: Correct Answer: C
Explanation: - C
Answer- C. Intestinal obstruction
The obstruction may be due to adhesion, hernia, neoplasm, foreign
body etc.
A normal person has on average 4 air fluid levels. Most of them are
seen in the colon.
For the diagnosis of small intestinal obstruction, we should see more
than 2 air fluid levels among the dilated loops of small bowel.
Question 179: Correct Answer: D
Explanation: - D
A modified form of ?-oxidation is found in peroxisomes and leads to
the breakdown of very-long-chain fatty acids (eg, C20, C22) with the
formation of acetyl-CoA and H2O2, which is broken down by
catalase.
This system is not linked directly to phosphorylation and the
generation of ATP, and also does not attack shorter-chain fatty
acids.
The peroxisomal enzymes are induced by high-fat diets and in some
species by hypolipidemic drugs such as clofibrate.
Another role of peroxisomal ?-oxidation is to shorten the side chain
of cholesterol in bile acid formation
Question 180: Correct Answer: C
Explanation: - C
Answer- C. Surgery is not indicated
Features
Diarrhea
Steatorrhea
Megaloblastic anemia (vit. B12 deficiency)
Weight loss
Abdominal pain
Fat soluble vitamin deficiency
Treatment
Parentral vit. B1, therapy
Broad spectrum antibiotics :
1. Tetracycline or co-amoxyclav
2. Cephalexin + metronidazole
3. Chloremphenical
Question 181: Correct Answer: A
Explanation: - A
Ans. is a i.e., HOCM
Spherical
Dilated
ventricle
cardiomyopathy

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Stress
Apical
ballooning
cardiomyopathy /
Tako-Tsubo
Spade-
shaped
ventricle
Distortion
of ventricle
Banana -
shaped
ventricle
Apical hypertrophic
cardiomyopathy
Myocardial
infarctions /
aneurysms /
remodeling
Hypertrophic
cardiomyopathy
Question 182: Correct Answer: B
Explanation: - B
, 2 to 2 1/2
Question 183: Correct Answer: A
Explanation: - A
Ans. is a i.e., 3% salicylic acid + 6% benzoic acid
Whitfields Ointment
Whitfields ointment is salicylic acid and benzoic acid in a suitable
base, such as lanolin or vaseline.
The original ointment contains 3% salicylic acid and 6% benzoic
acid, but other ratios are also used.
It is used for the treatment of fungal infections, such as athletes foot.
Its effectiveness is unclear.
It can have a slight burning effect that goes away after a few
minutes.
It is named for Arthur Whitfield (1868-1947), a British dermatologist
Question 184: Correct Answer: C
Explanation: - C
Ans. is c i.e., Denervation potential in EMG
Difference between upper and lower motor neuron paralysis
Upper motor
neuron
paralysis
Muscles

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affected in
groups never
individual
muscles
o Atrophy
slight and due
to disuse
Spasticity with
hyperactivity of
the tendon
reflexes and
Extensor
plantar reflex
(Babinski sign)
Lower motor neuron
paralysis
Individual muscles may
be affected
Atrophy pronounced up
to 70% of the total bulk
Flaccidity and hypotoniaQ
of affected muscles with
loss of tendon reflexes
Plantar reflex if present is
of normal flexor type
Question 185: Correct Answer: A
Explanation: - A
Answer. A. Serum creatinine
The Model for End-stage Liver Disease (MELD) is a prospectively
developed and validated chronic liver disease severity scoring
system that uses a patient’s laboratory values for –
Li Serum bilirubin
Serum creatinine
The international normalized ratio (INR) for prothrombin time to
predict three month survival.
Patients with cirrhosis, and increasing MELD score is associated
with increasing severity of hepatic dysfunction and increased three-
month mortality risk.
Given its accuracy in predicting short-term survival among patients
with cirrhosis, MELD was adopted by the United network for organ
sharing (UNOS) in 2002 for prioritization or patients awaiting liver
transplantation in the United states.
Question 186: Correct Answer: A
Explanation: - A
Ans.:A.)Can also be given by father

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KANGAROO MOTHER CARE
• KMC is care of preterm or LBW infants by placing skin-to-skin
contact with the mother
• Position: vertical position between the mothers breasts and under
her clothes
• The position is maintained until the infant no longer tolerates it
(indicated by sweating or baby refuses to stay in KMC position)
• Kangaroo nutrition: exclusive breast feeding
• Continuous KMC is an alternative to minimal care in an incubator
for infants who have already overcome major problems while
adapting to extra-uterine life
Able to suck and swallow properly
Thriving in neutral thermal environment
• Intermittent KMC (atleast 1-2 hour) when continuous KMC is not
possible
• All mothers can provide KMC irrespective of age, parity, education,
culture or religion
• Initiated in a facility and continued at home
Clinical benefits
• Significantly increases milk production in mothers
• Increases exclusive breast feeding rates
Question 187: Correct Answer: D
Explanation: - D
Ans. is d i.e., Peripheral decarboxylase
Hypolipidemic drugs
HMG-CoA reductase inhibitors (statins) - Lovastatin, Simvastatin,
Pravastatin, Atorvastatin, Rosuvastatin.
Bile acid sequestrants (Resins) - cholestyramine, colestipol.
Activate lipoprotein lipase (fibric acid derivatives) - clofibrate,
gemfibrozil, bezafibrate, fenofibrate.
Inhibit lipolysis and triglyceride synthesis - Nicotinic acid.
Other - Probucol, Gugulipid, Ezetimibe, Avasimibe, Torcetrapib.
Ezetimibe inhibits intestinal cholesterole absorption.
Avasimibe inhibits enzyme acyl Coenzyme A : cholesterol acyl
transferase-1 (ACAT-1) which causes esterification of cholesterol.
Torcetrapib inhibits cholesterol ester triglyceride transport protein ?
T HDL cholesterol.
Question 188: Correct Answer: A
Explanation: - A
Ans, A,’. Antero lateral vaginal wall
Gartners duct cyst arises from the remnants of the mesotephric duct
and lies in the anterolateral aspect of vaginal wall.
Question 189: Correct Answer: A
Explanation: - A
Answer is A (Antibodies attached to RBC Surface)

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Direct Coombs test detects IgG Antibodies (or complements)
attached to the surface of RBCs. Indirect Coombs test detects IgG
antibodies in the serum (e.g. Anti-D Antibodies).
Question 190: Correct Answer: C
Explanation: - C
Ans. C. Cardiac activity present
Medical management of an ectoPic Pregnancy is done when :
Patient is hemodynamically stable
No evidence of acute intra abdominal bleeding
Ready to comply with follow up care
Serum beta HCG < 10,000 IU/L
Absent embryonic heart activity
Diameter of ectopic gestational mass less than 4 cm.
Question 191: Correct Answer: C
Explanation: - C
Ans. is c i.e., Anti IgE antibody
Question 192: Correct Answer: A
Explanation: - A
Ans. is a i.e., Rifling
Type of firearm weapons
Bore (caliber) is the inner diameter of barrel. Based on inside of
barrel (i.e., bore), the firearm weapons are divided into:?
Smooth bore weapons : Barrel or bore is smooth inside, e.g., shot
gun, muskets, and muzzle loaders.
Rifled weapons : Barrel or bore is rifled from inside, i.e., has
longitudinally twised grooves. Example are : Pistals, rifles and
revolvers.
Pistals and revolvers are small, so referred to as hand guns.
Question 193: Correct Answer: A
Explanation: - A
. Ans. is a i.e., Artery
Systemic miliary ensues when infective foci in the lungs seed the
pulmonary venous return to the heart; the organisms subsequently
disseminate through the systemic arterial system.
Question 194: Correct Answer: C
Explanation: - C
Ans. is c i.e., Increased in both ICF and ECF
After infusion of hyptonic saline causes a decline in plasma
osmolality and a shift of water into interstial space (as water moves
from higher osmolarity to lower osmolarity), causing decrease in ICF
osmolality.
This results in shift of water from ECF to ICF.
Finally, both ECF and ICF compartments are increased (due to
increases water) and osmolality of both compartment are decreased.

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Question 195: Correct Answer: A
Explanation: - A
Ans. is a i.e., Souvenir bullet
Projectile is an object propelled by force of rapidly burning gases. In
shotgun these are lead shots and pellets (recently steel is also used
instead of lead) and in rifled weapons (pistal, rifle, revolver), these
are bullets.
Tip of the bullet is knwon as nose. Varieties of bullets are :-
i. Incendiary (igniting) bullet : The tip of bullet contains self igniting
material e.g. barium nitrate and powdered aluminium and
magnesium (in the past, phosphorus was used), so that it catches
fire on hitting the target. It is used to cause fire in usually
inflammable targets like fuel tanks (of air crafts etc).
ii. Explosive bullet : The tip contains a detonator or lead azide, so that
the bullet explodes on hitting the target.
iii. Dum-dum bullet (expanding bullet): It is a jacketed bullet with is nose
tip chiseled or cut off. It is designed to increase in diameter and
expand upon striking the target, thus producing larger diameter
wounds of limited penetration.
iv. Tandem bullet (Piggey tail bullet) : It is called one-behind-other bullet
because two bullets are ejected one after the other, when first bullet
failed to leave the burrel and is ejected by subsequently fired bullet.
Therefore, both enter body through same enterance wound (some
Question 196: Correct Answer: B
Explanation: - B
Ans. is b i.e., Just before and after onset of rash
Communicable period (period of maximum infectivity) in chicken pox
is 2 days before to 5 days after onset of rash.
Question 197: Correct Answer: A
Explanation: - A
Answer is A (Zinc)
Presence of KF rings and decreased ceruloplasmin levels suggest
the diagnosis of Wilson s disease.
The patient in question is presenting with intial hepatic disease
without any evidence of hepatic decompensation.
Zinc is the therapy of choice for patients with hepatitis or cirrhosis
without evidence of hepatic decompensation or neuropsychiatric
symptoms.
Question 198: Correct Answer: C
Explanation: - C
IgE binds to Mast cells and basophils, and mediate Type I
hypersensitivity.
Question 199: Correct Answer: C
Explanation: - C

Page 290 of 446

Ans. c. C5_9
Question 200: Correct Answer: C
Explanation: - C
Ans. is c i.e., Extorsion

Page 291 of 446

 Subject: NEET PG 2015 - Questions
1. ESWL is contraindicated in which of the
following stones -
a) Cysteine stones
b) Oxalate Stones
c) Urate stones
d) Phosphate stones

2. Following is true about oculocardiac

reflex except ?
a) It is also called aschner phenomenon
b) It is mediated by occulomotor and vagus nerve
c) It is characterized by bradycardia following traction on extra-
ocular muscles
d) Reflex is more sensitive in neonates

3. 1st mediator of inflammation to be

released is
a) Nitric oxide
b) PAF
c) Histamine
d) IL-1

4. Which of the following screening methods is used under RNTCP?

a) Active
b) Passive
c) Mass
d) All of the above

5. Pseudopapilitis with silk shot

appearance is seen in?
a) Hypermetropia
b) Myopia
c) Astigmatism
d) Presbyopia

6. Tributary of coronary sinus ?

a) Anterior cardiac vein
b) Thebesion vein
c) Smallest cardiac vein
d) Great cardiac vein

Page 292 of 446

7. ETHMOIDAL BULLAE are seen in?
a) Posterior ethmoidal air cells
b) Middle ethmoid air cells
c) Superior ethmoidal air cells
d) Inferior ethmoidal air cells

8. "Tree in bud appearance" on CT is seen

in
a) Pulmonary tuberculosis
b) Silicosis
c) Pulmonary hydatid cyst
d) Small cell carcinoma

9. What is the shape of caecum in the

newborn ?
a) Ovoid
b) Trapezoid
c) Globular
d) Conical

10. Consanguinous marriages increase risk

of diseases -
a) Autosomal dominant disease
b) Autosomal recessive disease
c) X linked dominant diseases
d) Environmental diseases

11. The zonules suspending the lens are

attached to the?
a) Root of iris
b) Ciliary body
c) Anterior vitreous
d) Limbus

12. Maternal mortality rate is defined as ?

a) Maternal death per 1000 total births
b) Maternal death per 1000 live births
c) Maternal death per 1000 women
d) Maternal death per 1000 women of reproductive age

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13. Sausage finger appearance is seen in -
a) Psoriatic arthritis
b) Rickets
c) Hyperthyroidism
d) Addisons disease

14. True about placental site trophoblastic

disease is
a) Highly Malignant behavior
b) Hysterectomy followed by chemoradiation is the treatment of
choice
c) Secretes human placental lactogen
d) Contains syncytiotrophoblasts mainly

15. Stroke volume increases in pregnancy

by
a) 20%
b) 25%
c) 40%
d) 45%

16. All of the following are principles of

negative pressure wound therapy
except
a) Stabilization of wound environment
b) Clearance of infection
c) Macrodeformation of the wound
d) Decreased edema

17. All are true about cross-matching of

blood except -
a) Mandatory in all cases except emergency
b) Recipient serum is tested against donor packed cells
c) Donor serum is tested against recipient packed cells
d) Involves visible agglutination

18. Smoking may be associated with all of

the following cancers, except:
a) Ca Larynx
b) Ca Nasopharynx
c) Ca Bladder
d) None

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19. Pulsatile proptosis is a feature of ?
a) Orbital varix
b) Retinoblastoma
c) Cortico-cavernous fistula
d) Covernous sinus thrombosis

20. Root value of thoracodorsal nerve ?

a) C5,C6,C7
b) C8,T1
c) C6,C7,C8
d) Ti T2

21. Homer rosette is seen in -

a) Neurobastoma
b) Nephroblastoma
c) Hepatoma
d) Ependymoma

22. Hansens bacillus is cultured in:

a) L J medium
b) Robertsons cooked meat medium
c) Foot pad of mice
d) Sabrauds agar

23. Most common mechanism of

arrhythmia
a) Re-entry
b) Early after depolarization
c) Late after depolarization
d) Automaticity

24. Three point bony relationship of the

elbow is disturbed in -
a) Supracondylar Fracture of the humerus
b) Fracture lateral condyle of the humerus
c) Monteggia Fracture dislocation
d) Fracture of Proximal Radius

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25. High volume of distribution depends on
?
a) High plasma protein binding
b) Lipid solubility
c) Elimination
d) Half life

26. Hypoxic Ischemic encephalopathy true

is ?
a) Lower limbs affected more than upper limbs
b) Prox. Muscles > distal muscles
c) Seizure
d) Trunk involved

27. MC cause of delirium ?

a) Infection
b) Liver failure
c) Belladonna poisoning
d) None of the above

28. Anemometer measures ?

a) Humidity
b) Air velocity
c) Room temperature
d) Radiant temperature

29. "Prosopagnosia" is characterized by :

a) Inability to read
b) Inability to identify faces
c) Inability to write
d) Inability to speak

30. Nosocomial infection is most commonly

caused by:
March 2004
a) Gram negative bacilli
b) Gram positive bacilli
c) Gram negative cocci
d) Mycoplasma

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31. Brazilian purpuric fever is caused by:
a) Bordetella pertussis
b) Haemophilus aegypticus
c) Haemophilus duceryi
d) Haemophilus parinfluenzae

32. True regarding cystic hygroma is -

a) Non transilluminant
b) Lined by columnar epithelium epithelium
c) Develops from jugular lymphatic sequestration
d) All

33. Which of the following is used as a

substitute for wrist extensors in radial
nerve PalsY?
a) Pronator Teres
b) Palmaris Longus
c) Flexor Digitorum SuPerficialis
d) Flexor Digitorum Profundus

34. Therepeutic phlebotomy is not done in

which of the following conditions ?
a) CML
b) Polycythemia vera
c) Hemochromatosis
d) Porphyria cutanea tarda

35. All of the following are false for Gall

Bladder carcinoma except:
March 2005
a) Carries a good prognosis
b) Gallstones may be a predisposing factor
c) Commonly squamous cell carcinoma
d) Jaundice is rare

36. Most common etiolopathogenetic cause

of glaucoma is:
March 2012
a) Raised pressure in episcleritic veins
b) Decreased outflow
c) Increased formation of aqueous humour
d) Increased scleral outflow

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37. Which of the following is true?
a) Glucocorticoids upregulate MHC expression
b) Glucocorticoids activate T-helper cells
c) Glucocorticoids activate cytotoxic T cells
d) None of the above

38. Hematological carcinoma is commonly

linked to
a) Nicotine
b) Benzene
c) Lithium
d) Alcohol

39. Hypertrophy is -
a) Increase in cell number
b) Increase in cell size
c) Decrease in cell number
d) Decrease in cell size

40. Maximum protein is found in ?

a) Egg
b) Soyabean
c) Rice
d) Wheat

41. 2. 1583. In which of the following phototherapy

is useful in treatment ?
a) Psoriasis
b) Tinea corporis
c) Pemphigus
d) PMLE

42. To examine the vaginal cells in of the

rape victim test used is -
a) Lugols iodine test
b) Takayama test
c) Florence test
d) Precipitin test

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43. Obliterative endarteritis in vasa vasorum
is seen in -
a) Hypertension
b) Tuberculosis
c) Syphilis
d) SLE

44. Capecitabine belongs to which class of

anticancer drug?
a) Antimetabolite
b) Alkylating agent
c) Nitrogen mustards
d) Vinca alkaloids

45. True about transdermal drug delivery

system are all except?
a) Applied to chest, abdomen and back
b) Drug is delivered at a constant rate
c) Good option in emergency situations
d) Fentanyl is used

46. Most common age related change in

vitreous ?
a) Anterior vitreous detachment
b) Posterior vitreous detachment
c) Vitreous hemorrhage
d) Vitritis

47. Lower limit of superior mediastinum is at

which level -
a) Ti
b) T1
c) T8
d) T10

48. Most common form of leptospirosis:

a) Weils disease
b) Icteric form
c) Hepatorenal form
d) Anicteric form

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49. Rademecker complex in EEG is seen in
-
a) SSPE
b) vCJD
c) cCJD
d) Kuru

50. Where is the auditory cortex located

inside the brain?
a) Superior temporal gyrus
b) Inferior temporal gyrus
c) Area 3,1,2
d) Cingulate gyrus

51. Sezary cells show which tlpe of nucleus -

a) Pleomorphic
b) Round
c) Eosinophillic
d) Cerebriform

52. External auditory canal is formed by:

a) 1st branchial groove
b) 1st visceral pouch
c) 2nd branchial groove
d) 2nd visceral pouch

53. Rolling of leucocytes on endothelial cells

is mediated by
a) ICAM-1
b) (3, integrin
c) IL-8
d) P- selectin

54. Maculae cerulea is seen in ?

a) Pediculosis hominis corporis
b) Pediculosis capitis
c) Scabies
d) Lupus erythematosus

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55. All of the following is true about
congenital hypertrophic pyloric
stenosis except
a) RamStedt Pyloromyotomy is the treatment of choice
b) Non Bilious vomiting is seen
c) Metabolic acidosis occurs
d) More common in males

56. Example of exopeptidase is ?

a) Trypsin
b) Chymotrypsin
c) Elastase
d) Carboxy peptidases

57. Which of the following is not an in vivo

test ?
a) Eleks gel precipitation test
b) Schick test
c) Lepromin test
d) Tuberculin test

58. A chronic alcoholic is presenting with

clinical features of meningitis. Most
likely organism which will grow on CSF
culture:
a) Streptococcus pneumoniae
b) N. meningitidis
c) Listeria monocytogenes
d) F. coli

59. Specific feature of simvastatin ?

a) Most potent statin
b) Longest acting statin
c) Lipophilic
d) Not metabolized

60. Smack is -
a) Cocaine
b) Heroine
c) Dhatura
d) Cannabis

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61. The posterior urethra is best visualized
by ?
a) Static cystogram
b) Retrograde urethrogram
c) Voiding cystogram
d) CT cystogram

62. Swajaldhara programme is associated with:

a) Provision of safe drinking water
b) Provision of food supplements for destitute women
c) Provision of relief for victim of sexual abuse
d) Provision of health care for sick tribals

63. Major central nucleus of sympathetic

system is
a) Nucleus ambiguus
b) Nucleus tractus solitarius
c) Edinger-Westphal nucleus
d) Hypothalamus

64. Unspecified pain pathway is for?

a) Neuropathic pain
b) Trauma
c) Visceral pain
d) Psychogenic pain

65. Following are the side effects of

thiazides except?
a) Hypokalemia
b) Hypocalcemia
c) Hepatic coma
d) Impotence

66. Lateral aberrant thyroid refers to -

a) Congenital thyroid abnormality
b) Metastatic focus in lymph nodes
c) Struma ovarii
d) Lingual thyroid

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67. Emphysema presents with all except
a) Cyanosis
b) Barrel shaped chest
c) Associated with smoking
d) Type I respiratory failure

68. Which of the following does not

predispose to leukemia?
a) Genetic disorder
b) Alcohol
c) Smoking
d) Chemical exposure

69. 2. 380. Programmed cell death is known as-

a) Cytolysis
b) Apoptosis
c) Necrosis
d) Proptosis

70. Most common renal sequel of lithium

toxicity is ?
a) Nephrogenic DM
b) Renal tubular acidosis
c) Glycosuria
d) MPGN

71. All of the following about MRI are

correct except:
a) MRI is contraindicated in patients with pacemakers
b) MRI is useful for evaluating bone marrow
c) MRI is better for calcified lesions
d) MRI is useful for localizing small lesione in the brain

72. Skeletal fluorosis occurs with fluoride

level in water?
a) < 1.5 mg/L
b) 1.5-3 mg/L
c) 3-6 mg/L
d) > 10 mg/L

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73. Recrudescences are commonly seen in
which malaria:
a) P vivax
b) P ovale
c) P malariae
d) P falciparum

74. A patient undergoing a minor surgical procedure is given lignocaine

injection.
Assertion: Local anaesthetics acts by blocking nerve conduction.
Reason: Small fibers and non myelinated fibers are blocked more easily
than large myelinated fibers.
a) Both Assertion and Reason are true, and Reason is the correct
explanation for Assertion
b) Both Assertion and Reason are true, and Reason is not the
correct explanation for Assertion
c) Assertion is true, but Reason is false
d) Assertion is false, but Reason is true

75. 45 year old female underwent modified

radical mastectomy with axillary
clearance for CA breast. After surgery
she could not lift her arm above head.
Which nerve is likely to be injured ?
a) Intercostobrachial nerve
b) Long thorasic nerve of Bell
c) Nerve to latissimus Dorsi
d) Lateral Pectoral nerve
1. 2.

76. Trigger Finger Involves Which joint ?

a) Proximal Interphalngeal joint
b) Distal Interphalngeal foint
c) Metacarpophalangeal joint
d) Carpometacarpal joint

77. Oncotic pressure is contributed by?

a) Sodium
b) Chloride
c) Chloride
d) Albumin

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78. Selective alpha 2 agoinst used in
glaucoma ?
a) Tirriolol
b) Epinephrine
c) Dipivefrine
d) Brimonidine

79. Eschar is seen in all the Rickettsial

diseases excent:
a) Scrub typhus
b) Rickettsial pox
c) Indian tick typhus
d) Endemic typhus

80. Shortest acting local anesthetic agent is

a) Procaine
b) Lidocaine
c) Tetracaine
d) Bupivacaine

81. Which of the following is false about

peripheral nerve injury?
a) Neuropraxia is irreversible
b) Epineurium is intact in axonotmesis
c) Neurotmesis is the most severe form of injury
d) Wellerian generation starts in axonotmesis

82. Thymus dependent area in spleen -

a) Mantel layer
b) Perifollicular region
c) Malphigian corpuscle
d) All of the above

83. A 25 year old male believes that his

penis is decreasing in size everyday
and one day it will disappear one day
and he will die. Diagnosis is ?
a) Obsession
b) Somatization
c) Hypochondriasis
d) Delusion disorder

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84. (?-oxidation of palmitic acid yields
a) 3 acetyl CoA
b) 129 ATP net
c) 131 ATP net
d) 16 Acetyl CoA

85. HIV RNA by PCR can detect as low as

a) 30 copies viral RNA/ml of blood
b) 40 copies viral RNA/ml of blood
c) 50 copies of viral RNA/ml of blood
d) 60 copies of viral RNA/ml of blood

86. All of the following are true regarding

Pagets Disease except -
a) Pelvis is the most common site
b) Cranial nerve involvement may be seen
c) High output cardiac failure is one of the complications
d) It may progress to a secondary chondrosarcoma

87. Vitamin D absorption is decreased by ?

a) Proteins
b) Acid
c) Lactose
d) Fat malabsorption

88. Selection bias occurs mainly in

a) Cohort study
b) Case-control study
c) RCT
d) All have equal chances

89. Submucosal resection is the treatment of

choice of?
a) DNS in adults
b) DNS in children
c) Sluders Neuralgia
d) Nasal polyp

Page 306 of 446

90. Hamilton Ruler test sign is positive in
which of the above mentioned
conditions ?
a) Anterior dislocation of shoulder
b) Acrornioclavivular joint dislocation
c) Posterior dislocation of shoulder
d) luxatio erecta

91. Heart tube is formed at -

a) 3 weeks
b) 6 weeks
c) 10 weeks
d) 12 weeks

92. 2. 3. 4. 1689. Capgras syndrome is ?

a) Sharing of delusion
b) Delusion of double
c) Erotomania
d) Hypochondriacal delusions

93. Most powerful refractory surface of eye

is -
a) Conjunctiva
b) Cornea
c) Vitreous
d) Lens

94. Volume of distribution of a drug is 500 ml

and target concentration of drug in blood
is 5 g/L. 20% of administered drug is
reached to systemic circulation. What
will be the loading dose of that drug -
a) 1 gm
b) 5 gm
c) 12.5 gm
d) 25 gm

95. Following delivery, tear involves

perineum, external anal spincter with
intact mucosa, grade of tear is -
a) First degree
b) Second degree

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c) Third degree
d) Fourth degree

96. Aetiology of Dressler Syndrome is

a) Viral
b) Autoimmune
c) Idiopathic
d) Toxin mediated

97. Von Magnus phenomenon -

a) Is a normal replicative cycle
b) Virus yield has low hemagglutination
c) Virus has high infectivity
d) Virus yields has high hemagglutination titre but low infectivity

98. Which is not true about alcoholic

hepatitis :
a) Gamma glutamyl transferase is raised
b) SGPT is raised > SGOT
c) SGOT is raised > SGPT
d) Alkaline phosphatase is raised

99. The artery which leads to bleeding in

Woodruffs area is?
a) Anterior ethmoidal artery
b) Sphenopalatine artery
c) Greater palatine artery
d) Superior labial artery

100. All of the following are treatments of

myopia except?
a) LASIK
b) Phakic intraocular lens
c) Radial Keratotomy
d) Holmium laser thermoplasty

101. Regarding efficacy and potency of a drug, all are true, EXCEPT:
a) In a clinical setup, efficacy is more important than potency
b) In the log dose response curve, the height of the curve
corresponds with efficacy
c) ED50 of the drug corresponds to efficacy
d) Drugs that produce a similar pharmacological effect can have

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different levels of efficacy

102. True about ENaC are all except ?

a) Epithelial channel
b) Composed of 2 homolous subunits
c) Present in kidney and GIT
d) Inhibited by amiloride

103. Which of the following organism has a

role to play in Seborrhic dermatitis ?
a) Pityrosporum ovale
b) Canida albicans
c) Propionibacterium
d) None of the above

104. EPSP is due to ?

a) K influx
b) Na* efflux
c) Na* influx
d) Ca** influx

105. True about influenza infectivity ?

a) Communicable period is 5 days before to 5 days after the onset
of symptoms
b) Source of infection is clinical case
c) There are no subclinical cases
d) All are correct

106. Granulomatosis infantiseptica is caused

by:
a) Pseudomonas
b) Chlamydia trachomatis
c) Group D streptococci
d) Listeria

107. Which of the following fractures of the

neck of femur are associated with
maximal compromise in blood supply ?
a) Intertrochantericfractures
b) Basicervical fracture
c) Trans cervical fracture
d) Sub Capital fractures

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108. Pruritus is a feature of which of the
following ?
a) Pemphigus foliaceous
b) Pemphigus vulgaris
c) Bullous Pemphigoid
d) All of the above

109. Dose of dexamethasone for fetal lung

maturity is -
a) 6 mg
b) 12 mg
c) 18 mg
d) 24 mg

110. Incorrect about LAMB syndrome -

a) Lentigines
b) Atrial Myxoma
c) Myaesthenic syndrome
d) Blue Nevi

111. Intercostal nerve is a branch of ?

a) Brachial plexus
b) Dorsal rami of thoracic spinal nerves
c) Ventral rami of thoracic spinal nerves
d) Ventral rami of cervical spinal nerves

112. Which of the following sites is

responsible for the amnestic defect in
Wernickes Korsakoff syndrome:
a) Mamillary body
b) Thalamus
c) Periventricular Grey matter
d) Hippocampus

113. Which of the following is true about

menetriers disease
a) It is premalignant condition
b) There is increased gastric acid secretion
c) Atrophied mucosal folds are seen
d) Affects the stomach and small intestines

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114. Parasitosis of extraocular eye muscles
is seen in?
a) Trichinosis
b) Cysticercosis
c) Amoebiasis
d) Ascariasis

115. Hydrocephalus is best detected

antenately by :
a) X-ray abdomen
b) Amniocentesis
c) Clinical examination
d) Ultrasonography

116. Which of the following is required in the

synthesis of acetylcholine -
a) Inositol
b) Carnitine
c) Glycine
d) Choline

117. Most important criterian in causal

relationship hypothesis ?
a) Temporal association
b) Coherence of association
c) Specificity of association
d) Strength of association

118. After load is decreased by ?

a) Exercise
b) Anemia
c) Thyrotoxicosis
d) All of the above

119. Risk factor for cervical carcinoma is -

a) Smoking
b) Human papilloma virus
c) Low socioeconomic status
d) All of the above

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120. Which antibiotic should not be given
after drinking milk?
a) Chloramphenical
b) Tetracycline
c) Erythromycin
d) Sulfonamide

121. Bone transport can be used in the

management of -
a) Gap non union
b) Deformity Correction
c) Communited shaft femur fracture
d) Avscular Necrosis of Femoral Head

122. Treatment of choice for acute panic

attacks is ?
a) Barbiturates
b) Benzodiazepines
c) TCAs
d) MAO inhibitors

123. At the end of anaesthesia after

discontinuation of nitrous oxide and
removal of endotracheal tube, 1000/0
oxygen is administered to the patient to
prevent:
a) Diffusion Hypoxia
b) Second gas effect
c) Hyperoxia
d) Bronchospasm

124. Thyroid nodule in a 65 year old male

who is clinically euthyroid is most likely
to be
a) Follicular adenoma
b) Follicular Carcinoma
c) Thyroid Cyst
d) Multinodular goiter

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125. Rockall score is used for prognosis of
patients of
a) Upper GI bleeding
b) Lower GI bleeding
c) Hepatic encephalopathy
d) IBD

126. Nigro Regimen is used for -

a) Anal Carcinoma
b) Rectal Carcinoma
c) Sigmoid Colon Carcinoma
d) Duodenal Carcinoma

127. Which antithyroid drug crosses placenta

?
a) Carbimazole
b) Propylthiouracil
c) Both
d) None

128. Eales disease is:

a) Recurrent optic neuritis
b) Recurrent pappilloedema
c) Recurrent periphelbitis retinae
d) None

129. In MRKH syndrome, which among the

following is absent?
a) Vagina
b) Breast development
c) Pubic hair development
d) Testes

130. Main function of sodium citrate in ORS ?

a) To increase absorption of glucose by cotransport
b) To correct electrolyte imbalance
c) To correct Acidosis
d) To correct dehydration

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131. Duodenal aspirate is used in diagnosis
of:
a) E histolytica
b) Giardia lamblia
c) Taenia solium
d) Leishmania

132. Broadmans area for motor speech?

a) Area 1,2,3
b) Area 4,6
c) Area 28,29
d) Area 44

133. Physiological antagonists are ?

a) Adrenaline and Isoprenaline
b) Histamine and adrenaline
c) Isoprenaline and propranolal
d) All of the above

134. Caloric requirement in an adult male for

heavy work?
a) 1800 k cal/d
b) 2300 k cal/d
c) 3000 k cal/d
d) 3500 k cal/d

135. Increased in plasma viscosity is

maximally caused by which plasma
protein?
a) Fibrinogen
b) Albumin
c) Globulin
d) All have equal effect

136. Spironolactone should NOT be given with the following pharmacological

agent:
a) Chlorothiazide
b) b-blocker
c) ACE inhibitors
d) Amlodipine

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137. Internal anal sphincter is a apart of:
a) Puborectalis muscle
b) Deep perineal muscles
c) Internal longitudinal fibers
d) Internal circular fibers

138. Intracranial pressure may be increased

by all of the following drugs except -
a) Hypervitaminosis A
b) Corticosteroids
c) Quinolones
d) Aminoglycosides

139. Village Health and Nutrition Day (VHND)

is observed ?
a) Every week
b) Every month
c) Every 6 month
d) Every year

140. In conversion of glucose to glucose-6-

phosphate in glycolysis true is
a) Glucokinase has low km
b) Hexokinase is found only in liver
c) Glucokinase is induced by insulin
d) Hexokinase is not specific for glucose

141. Bartonella quintana causes:

a) Trench fever
b) Scrub typhus
c) Endemic typhus
d) Epidemic typhus

142. Most common complication of modified

ECT
a) Intracerebellar Bleed
b) Fracture spine
c) Body ache
d) Amnesia

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143. Feature associated with mania is ?
a) Neologism
b) Perseveration
c) Echolalia
d) Flights of ideas

144. In an ECG the cardiac event corresponding to the ST segment is:

a) Atrial depolarisation
b) Ventricular depolarisation
c) Atrial repolarisation
d) Ventricular repolarisation

145. True about the anatomy of great

saphenous vein:
a) Starts as a continuation of medial marginal vein
b) Ends of femoral vein 2.5 cm below the inguinal ligament
c) There are 2 - 5 valves below the knee.
d) Ascends 2.5 - 3 cm behind tibial malleolus

146. IPC 304B is related to -

a) Punishment for cruelty by husband or his relatives
b) Dowry death
c) Death caused by negligence
d) Punishment of culpable homicide, not amounting to murder

147. Which of the following is not a feature of Juvenile Idiopathic Arthritis?

a) Rheumatoid nodules
b) Spikes of high fever
c) Uveitis
d) Raynauds phenomenon

148. All are resected in whipples operation

except ?
a) Duodenum
b) Head of pancreas
c) Neck of pancreas
d) Common bile duct

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149. Which of the following tests is not used
to differentiate between cochlear and
retrocochlear hearing loss?
a) SISI TEST
b) Evoked response audiometry
c) Threshold tone decay test
d) Recruitment

150. Which of the following agents is used to measure Glomerular Filtration

Rate (GFR)?
a) Iodohippurate
b) Tc99m-DTPA
c) Tc99m-MAG3
d) Tc99m-DMSA

151. Penile erection is mediated by?

a) Parasympathetic system via muscarinic receptors
b) Parasympathetic system via nicotinic receptors
c) Sympathetic system via a-receptors
d) Sympathetic system via (3-receptors

152. Commonest site of occurrence of

chondrosarcoma is -
a) Pelvis
b) Ribs
c) Femur
d) Proximal tibia

153. Which of the following is non-motile:

a) Pseudomonas aeruginosa
b) Burkholderia mallei
c) Burkholderia pseudomallei
d) None of the above

154. Chronic lung disease in a infancy is

defined as
a) Need for supplemental oxygen at 36 weeks after conception
b) Tachypnoea > 50 breaths/ min within 1 week of birth
c) Presence of bilateral infiltrates on chest Xray for 2 weeks
d) Reticulogranular pattern on chest Xray for 6 weeks

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155. Allantoin is the end product of
metabolism of ?
a) Glycogen
b) Purine
c) Pyrimidine
d) Histidine

156. All of the following are premalignant

conditions except -
a) Bowens Disease
b) Senile Keratosis
c) Xeroderma Pigmentosum
d) Pyoderma Gangrenosum

157. Skin fold thickness is measured in all of the following places, EXCEPT:
a) Mid triceps
b) Biceps
c) Supra pubic
d) Supra iliac

158. Dangerous area of scalp is -

a) Superficial facia
b) Aponeurosis
c) Subaponeurotic tissue
d) Pericranium

159. The weakest criterian in causal

relatianship hypothesis?
a) Temporal association
b) Coherence of association
c) Specificity of association
d) Strength of association

160. Best method of detection of retained

glass intraocular foreign body is:
a) CT scan
b) Radiography
c) Ultrasonography
d) Tonography

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161. Anterior part of interventricular septum is
supplied by -
a) Right coronary artery
b) Left coronary artery
c) Posterior descending coronary artery
d) None

162. Glycine is required in formation of all

except ?
a) Heme
b) Purines
c) Glutathione
d) Thyroxine

163. Anti-cholinesterase with central action ?

a) Neostigmine
b) Physostigmine
c) Pyridostigmine
d) Edrophonium

164. Statin having longest half life:

September 2012
a) Rosuvastatin
b) Pravastatin
c) Simvastatin
d) Lovastatin

165. Most common precipitant of Raynauds

phenomenon is
a) Exposure to cold
b) Exposure to heat
c) Psychosocial triggers
d) Exertion

166. Gametocidal antimalarial drug for all

species of plasmodium ?
a) Chloroquine
b) Quinine
c) Primaquine
d) Mefloquine

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167. All of the following are complications of
traumatic hyphema except?
a) Rebleeding
b) Pupillary Block
c) Corneal Ulcer
d) Posterior synechiae

168. Self mutilation is a feature of ?

a) Von-Gogh syndrome
b) Catatonic schizophrenia
c) Paranoid schizophrenia
d) None of the above

169. Cataract is caused by ?

a) Hypoparathyroidism
b) Cigrate smoking
c) Non-ionizing radiation
d) All of the above

170. Not a substrate for gluconeogenesis -

a) Glycerol
b) Leucine
c) Lactate
d) Propionate

171. Kaposi sarcoma is commonly seen in ?

a) Upper limbs
b) Lower limbs
c) Head and Neck
d) Trunk

172. Puff of smoke appearance on cerebral

angiography is seen in:
a) ACA aneurysm
b) Cavernous sinus thrombosis
c) Moyamoya disease
d) Vein of Galen malformation

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173. Contraindication to neruaxial block is ?
a) Hypertension
b) Renal disease
c) Clotting disorders
d) Diabetes

174. Central bronchiectasis is seen with

a) Cystic Adenomatoid Malformation
b) Cystic fibrosis
c) Broncho carcinoma
d) Tuberculosis

175. Under what guidelines is treatment

started for a patient presenting with
appendicular mass on CT Scan ?
a) Ochsner Sherren Regimen
b) Conservative management and discharge
c) Immediate Laprotomy
d) Kochers Regimen

176. Streptococcus bovis infection is

associated with -
a) CLL
b) Hairy cell leukemia
c) Colorectal cancer
d) Multiple myeloma

177. Eyelid papules and hoarse cry in a child

is suggestive of -
a) Congenital syphilis
b) Croup
c) Lipoid proteinosis
d) Acrodermatitis enterohepatica

178. Most common nephropathy associated

with malignaneN is:
a) Focal segmental glomerulosclerosis (FSGS)
b) Minimal change disease
c) IgA nephropathy
d) Membranous glomerulonephritis

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179. All are true for transplanted kidney
except
a) Humoral antibody responsible for rejection
b) CMI is responsible for rejection
c) Previous blood transfusion
d) HLA identity similarity seen in 1:100 people

180. PTH acts directly on which cells ?

a) Osteoclasts
b) Osteocytes
c) Osteoblasts
d) Macrophages

181. Malleus and incus are derived from ?

a) 1st Arch
b) 2nd Arch
c) 3rd Arch
d) 4th Arch

182. Not True about blood supply of kidney -

a) Renal vein drains into IVC
b) Renal artery is a branch of common iliac artery
c) Right renal artery passes behind IVC
d) Branches of renal artery are end arteries

183. Which of the following drug is not used in the treatment of akathisia?
a) Benzodiazepam
b) Propranolol
c) Trihexyphenidyl
d) Haloperidol

184. Drug NOT used in pulmonary

hypertension ?
a) Calcium channel blocker
b) Endothelin receptor antagonist
c) Alpha blocker
d) Prostacyclin

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185. Maximum potassium loss is caused by
which diuretics ?
a) Furosemide
b) Thiazide
c) Acetazolamide
d) Spironolactone

186. What is true about adductors of thigh –

a) Ischial head of adductor magnus is an adductor
b) Profunda femoris artery is the main blood supply
c) Ischial head of adductor magnus originates from adductor
tubercle
d) Adductor magnus is the largest muscle

187. Manifestations of vitamin E.deficiency

are all except -
a) Hemolytic anemia
b) Posterior column abnormalities
c) Cerebellar ataxia
d) Autonomic dysfunction

188. Prostate cancer that is limited to the

capsule and not the urethra would be
satged as -
a) Tx
b) T1
c) T2
d) T3

189. Cholesterol is not a precursor for

synthesis of -
a) Vitamin D
b) Progesterone
c) Bile acids
d) Lipocortin

190. In disaster management following are

practiced except
a) Triage
b) Rehabilitation
c) Mass vaccination
d) Disaster response

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191. Commonest infantile testicular tumour
is ?
a) Seminoma
b) Teratoma
c) Yolk sac tumor
d) Dysgerminoma

192. Pneumonic plague is spread by:

a) Bite of infected flae
b) Direct contact with infected tissue
c) Ingestion of contaminated food
d) Droplet infection

193. Increased aldosterone and ADH

secretiom following major trauma results
in all the following except ?
a) Decreased Na+ excretion is urine
b) Increased K excretion in urine
c) Increased osmolarity of urine
d) Increased water excretion

194. Converging point of both pathway in

coagulation is at:
a) Factor VIII
b) Stuart factor X
c) Factor IX
d) Factor VII

195. Number of barr bodies in klinfellters

syndrome is -
a) 0
b) 1
c) 2
d) 3

196. Post Prandial capillary glucose should

be mg/dl for adequate diabetes control
a) < 100mg / dl
b) < 140 mg / dl
c) < 180 mg/dl
d) < 200 mg/dl

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197. Pain is carried by which nerve fibers?
a) Act, A13
b) Act, Ay
c) AS, C
d) Ay, C

198. Most common cause of goiter in India

is
a) Diffuse Endemic Goitre
b) Papillary Carcinoma
c) Toxic Multinodular Goitre
d) Hashimotos Thyroiditis

199. Drug which is contraindicated before 2nd

stage of labor is:
March 2009
a) Mifepristone
b) Oxytocin
c) Misoprostol
d) Ergometrine

200. All of the following are are a part of medial

wall of the middle ear except?
a) Promontory
b) Fenestra vestibule
c) Pyramid
d) Subiculum

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 Subject: NEET PG 2015 - Answer Key

Question 1: Correct Answer: A

Explanation: - A
Answer- A. Cysteine stones
Contraindications for ESWL -
1. Uncorrected Bleeding disorder
2. Cysteine stones
3. Weight greater than 300 pounds
4. Pregnancy
5. Cardiac Pacemaker
6. Severe Orthpaedic deformity
7. UTI
8. Severe renal Failure
Question 2: Correct Answer: B
Explanation: - B
Ans. is b i.e., It is mediated by occulomotor and vagus nerve
Oculocardiac reflex
Oculocardiac reflex, is also known as Aschner phenomenon,
Aschner reflex, or Aschner-Dagnini reflex, o It is characterized by
decrease in pulse rate (bradycardia) associated with traction applied
to extraocular muscles and/or compression of the eyeball.
The reflex is mediated by nerve connections between the ophthalmic
branch of the trigeminal cranial nerve via the ciliary ganglion, and
the vagus nerve of the parasympathetic nervous system.
This reflex is especially sensitive in neonates and children,
particularly during strabismus correction surgery. However, this
reflex may also occur with adults.
Bradycardia, junctional rhythm and asystole, all of which may be life-
threatening,can be induced through this reflex.
Question 3: Correct Answer: C
Explanation: - C
Answer- C. Histamine
Vasoactive amines are present in preformed stores in cells and are
therefore among the first mediators to be released during
inflammation
The two amines are especially important. These are :- (i) Histamine
and (ii) Serotonin
Question 4: Correct Answer: B
Explanation: - B
Under RNTCP, active case finding is not pursued. Case finding is passive. Patients
presenting themselves with symptoms suggesting tuberculosis are screened with two
sputum smear examinations.
Ref: Park 21st edition, page 381.

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Question 5: Correct Answer: A
Explanation: - A
Ans.A. Hypermetropia
Clinical findings of hypermetropia
1. Small eyeball and cornea
2. Shallow anterior chamber
3. Fundus shows pseudopapillitis and shot silk appearance.
4. Degenerative retinoschisis
Question 6: Correct Answer: D
Explanation: - D
Ans. (D) Great cardiac vein
Coronary sinus
It opens in the posterior wall of right atrium, in the posterior part of
coronary sulcus.
Itopens in the right atrium between IVC and tricuspid orifices.
Coronary sinus is guarded by Thebesian valve (Thebesian valve
(incomplete semilunar valve) guards the orifice of coronary sinus.)
Tributaries of coronary sinus are :
Great cardiac vein :- Lies in the anterior interventricular groove. Left
marginal vein drains into it.
Middle cardiac vein :- Lies in the posterior interventricular groove.
Posterior vein of left ventricle.
Small cardiac vein :- It lies in the posterior part of coronary sulcus
with RCA. Right marginnal vein may sometimes open into small
cardiac vein, more often, however, right marginal vein opens
directly into right atrium.
Oblique vein of left atrium (vein of marshall) :- It is continuous above
with ligament of IVC. These two structures are embryological
remnants of left common cardinal vein (duct of cuvier).
Question 7: Correct Answer: B
Explanation: - B
Ans. is b i.e., Middle ethmoid air cells [Ref: Logan Turner 10th
le p. 379; Dhingra 5th/e p. 153, 154]
Question 8: Correct Answer: A
Explanation: - A
Answer- A. Pulmonary tuberculosis
It is usually visible on standard CT, however, it is best seen on HRCT chest.
Typically the centrilobular nodules are 2-4 mm in diameter and peripheral, within 5 mm of
the pleural surface.
The connection to opacified or thickened branching structures extends proximally
(representing the dilated and opacified bronchioles or inflamed arterioles)
Associated CT findings of bronchiolitis are seen in about 70% of patients with
bronchiectasis. Small centrilobular nodular and linear branching opacities (tree-in-bud sign)
express inflammatory and infectious bronchiolitis
Pathogenesis-

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The tree-in-bud sign occurs as a result of a number of processes, although often they co-
exist in the same condition:
a. bronchioles filled with pus or inflammatory exudate
e.g. pulmonary tuberculosis, aspiration bronchopneumonia
b. bronchiolitis: thickening of bronchiolar walls and bronchovascular bundle
e.g. cytomegalovirus pneumonitis, obliterative bronchiolitis
c. bronchiectasis with mucus plugging
e.g. cystic fibrosis
d. tumor emboli to centrilobular arteries (or carcinomatous endarteritis)
e.g. breast cancer, stomach cancer
Question 9: Correct Answer: D
Explanation: - D
Answer- D. Conical
The shape of the caecum in an infant is conical with the appendix
borne at the base of the cone.
Question 10: Correct Answer: B
Explanation: - B
Answer- B. Autosomal recessive disease
Increases risk of - autosomal recessive disease
No change in risk of - autosomal dominant, X linked recessive (if
neither parent affected)
Not Proven - complex late onset diseases like diabetes,
schizophrenia, cardiovascular diseases
Question 11: Correct Answer: B
Explanation: - B
Ans. B. Ciliary body
The ciliary zonules (Zonules of zinn or suspensory ligaments of lens)
hold the lens in position and enable the ciliary muscle to act on it.
These consist essentially of a series of fibres which run from the
ciliary body and fuse into the outer layer of the lens capsule around
the equatorial zone.
Question 12: Correct Answer: D
Explanation: - D
Ans. is d i.e., Maternal death per 1000 women of reproductive
age [Ref Park 23rd /e p.558-559]
Maternal mortality rate=Total no. of female death due to
complication of pregnancy childbirth or within 42 days of delivery /
Total no. of women of reproductive age x1000
Question 13: Correct Answer: A
Explanation: - A
Answer- A. Psoriatic arthritis
The common causes of sausage digit are :
Psoriatic arthropathy.
Ankylosing spondylitis

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Tuberculosis
Osteomyelitis.
Sickle cell disease
Leprosy
Question 14: Correct Answer: C
Explanation: - C
Answer- C. Secretes human placental lactogen
Placental Site Trophoblastic Tumour
Arises from the placental bed trophoblasts and invades the
myometrium.
Follows a full - term normal delivery.
Tumor contains mainly cytotrophoblasts with few or no
syncytiotrophoblasts.
Most of these tumors run a benign course, malignancy is rare.
[Ref Shaws Gynae le/e p. 313; Duttas Obs 8thie p. 231]
Question 15: Correct Answer: B
Explanation: - B
Answer- B. 25%
Hemodynamic changes during pregnancy
Non - pregnant Pregnancy near
term Change
Cardiac output
(lit/m1) 4.5 6.26 +40%
Stroke volume (ml) 65 75 +27%
Heart rate (per
minute) 70 85 + 17%
Blood pressure Unaffected or mid pregnancy drop of diastolic
pressure by 5 - 10 mmHg
Venous pressure 8 - 10 cm
(femoral) 20 cm +100%
Colloid oncotic
pressure (mmHg) 20 18 - 14%
Systemic vascular
resistance - 21%
Pulmonary vascular
rests - 34%
Question 16: Correct Answer: B
Explanation: - B
Answer- B. Clearance of infection
Four primary effects of NPWT on wound healing:
Macro-deformation - drawing the wound edges together leading to
contraction.
Stabilisation of the wound environment-ensuring it is protected from
outside microorganisms in a warm and moist environment.
Reduced oedema - with removal of soft tissue exudates.

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Micro-deformation- leading to cellular proliferation on the wound
surface.
Question 17: Correct Answer: C
Explanation: - C
Answer- C. Donor serum is tested against recipient packed
cells
Cross matching involves testing the patients serum with donor cells
to determine whether the patient has an antibody which may cause
a hemolytic transfusion reaction
Question 18: Correct Answer: D
Explanation: - D
Ans is None > Ca Nasopharynx
All the given options are mentioned by Harrison:
Harrison 17/e p2737 writes- "Tobacco smoking causes cancer of the
lung, oral cavity, naso-, oro-, and hypopharynx, nasal cavity and
paranasal sinuses, larynx, esophagus, stomach, pancreas, liver,
kidney (body and pelvis), ureter, urinary bladder, and uterine cervix
and also causes myeloid leukemia. There is evidence suggesting
that cigarette smoking may play a role in increasing the risk of
colorectal and possibly premenopausal breast cancer, but there is
no association with postmenopausal breast cancer. There does not
appear to be a causal link between cigarette smoking and cancer of
the endometrium, and there is a lower risk of uterine cancer among
postmenopausal women who smoke."
Thus the answer should be none, however Nasopharyngeal
carcinoma is found to be least associated with smoking. Head &
Neck Cancers by Enslow Jacobs 2003e p492 writes-"Association
between smoking and nasopharyngeal carcinoma has been shown
only by a few studies. If the association of tobacco and NPC is real,
the possible mechanism of tumor induction would be the
nitrosamines and its precursors in tobacco."
Question 19: Correct Answer: C
Explanation: - C
Ans. is c i.e., Cortico-cavernous fistula
Proptosis
Proptosis is bulging of the eyeball (forward bulging) beyond the
orbital margins. Though the word exophthalmos is synonymous with
proptosis; some source define xophthalmos as a protrusion of globe
greater than 18mm and proptosis as a protrusion equal to or less
than 18 mm. Proptosis may be classified as follows : ?
Unilateral Proptosis Proptosis of one eye.
Inflammatory lesions :- Orbital cellulitis, abscess, cavernous sinus
thrombosis, etc.
Vascular disturbances :- Haemorrhage, varicose orbital veins,
haemangioma, etc.

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Cysts and tumour :- Dermoid cyst, osteoma, lymphoma,
lymphosarcoma, glioma, meningioma of optic nerve, retinoblastoma
and metastatic deposits in orbit Neuroblastoma, breast, prostate,
lung, GIT, Kidney, Ewings tumor, melanoma, wilms tumor
(Nephroblastoma)].
Systemic diseases - Leukemias and endocrine disturbances such
as Graves disease and thyrotropic exophthalmos in initial stages.
Paralysis of extraocular muscles as in complete ophthalmoplegia.
Mucocele of PNS - Frontal (most common), ethmoid, maxillary.
Bilateral Proptosis Proptosis of both eyes.
Question 20: Correct Answer: C
Explanation: - C
Ans. is c i.e., C6C7C8
Branches of brachial plexus
Branches of brachial plexus arises from different anatomical
segments : -
1. Branches of the roots
Nerve to serratus anterior (long thoracic nerve) (C5,
C6, C7).
Nerve to rhomboideus (dorsal scapular nerve) (C5).
2. Branches of the trunks
These arise only from the upper trunk which gives two branches. I.
Suprascapular nerve (C5, C6)
Nerve to subclavius (C5, C6)
3. Branches of the cords
1. Branches of lateral cord
Lateral pectoral (C5-C7)
Musculocutaneous (C5-C7)
Lateral root of median (C5-C7)
2. Branches of medial cord
Medial pectoral (C8, T1)
Medial cutaneous nerve of arm (C8, TO
Medial cutaneous nerve of forearm (C8, Ti).
Question 21: Correct Answer: A
Explanation: - A
Answer- A. Neurobastoma
Homer Wright rosettes
Homer-Wright rosettes are characteristic of neuroblastomas and
medulloblastomas.
May also be seen in -4 Primitive neuroectodermal tumors (PNET),
Pineoblastomas, Retinoblastomas
Question 22: Correct Answer: C
Explanation: - C
Ans. is. c i. e., Foot pad of mice

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Question 23: Correct Answer: A
Explanation: - A
Ans. is a i.e., Re-entry
The most common arrhythmia mechanism is re-entry.
Fundamentally, re-entry is defined as the circulation of an activation
wave around an inexcitable obstacle.
Re-entry appears to be the basis for most abnormal sustained Supra
Ventricular Tachycardias (SVTs) and Ventricular tachycardia.
Examples of re-entry are:-
Polymorphic Ventricular tachycardia in patients with a genetically
determined ion channel abnormality such as the Brugada syndrome,
catecholaminergic polymorphic Ventricular tachycardia.
Question 24: Correct Answer: B
Explanation: - B
Answer- B. Fracture lateral condyle of the humerus
Three prominent bony points around elbow are medial epicondyle,
lateral epicondyle and tip of the olecranon.
In elbow injuries, following is seen in three bony relationship :
1. Maintained
2. Disturbed
Question 25: Correct Answer: B
Explanation: - B
Ans. B. Lipid solubility
[Ref: Clinical pharmacology 3d/e p. 31]
It a drug has high volume of distribution (> 42L), the drug is thought
to be distributed to all tissues of the body, especially fatty tissue.
A given drug will have high volume of distribution, if it has:
High lipid solubility (non-polar drug)
Low rate of ionization
Low plasma protein binding
Question 26: Correct Answer: C
Explanation: - C
Ans. is c i.e., Seizure
Clinical features of hvpoxic ischemic encephalopath
o Encephalopathy progress over time ?
1) Birth to 12 hours —> Decreased level of conciousness, poor
tone, decreased spontaneous movement, periodic breathing or
apnea, seizures.
2) 12-24 hours -4 More seizuers, Apneic spells, jitteriness,
weakness.
3) After 24 hours —> Hypotonia, conciousness, poor feeding,
brainstem signs (oculomotor) and pupillary disturbances.
Question 27: Correct Answer: A
Explanation: - A

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Ans. A. Infection
Infection is one of the most common causes of delirium.
Question 28: Correct Answer: B
Explanation: - B
Ans. is b i.e., Air velocity [Ref Park 23/e p. 749 & 22"d/e p. 695]
Question 29: Correct Answer: B
Explanation: - B
Ans. B. Inability to identify faces
Prosopagnosia is a recognition deficit in which the patient is unable
to recognize familiar faces.
Face and object recognition deficits are known as prosopagnosia
and visual object agnosia respectively.
The characteristic lesions in prosopagnosia and visual object
agnosia consists of a bilateral infarction in the territory of the
posterior cerebral arteries and involve lingual and fusiform gyri.
Question 30: Correct Answer: A
Explanation: - A
Ans. A i.e. Gram negative bacilli
Question 31: Correct Answer: B
Explanation: - B
Ans. is. b i. e., Haemophilus aegypticus
Question 32: Correct Answer: C
Explanation: - C
Ans. is c i.e., Develops from jugular lymphatic sequestration
Cystic hygroma
Cystic hygroma is a swelling usually occuring in the lower third of the
neck
It is most commonly seen in posterior triangle of the neck, but may
also occur in axilla, groin & mediastinum
It results due to sequestration of a portion of the jugular lymph sac
from the lymphatic system.
It usually manifests in the neonate or in early infancy (occasionally
present at birth)
The swelling is soft and partially compressible and invariably
increases in size when the child coughs or cries.
The characteristic that distinguishes it from all other neck swellings
is that it is brilliantly translucent.
The cysts are filled with clear lymph and are lined by endothelium.
Mostly these are multiple cysts but occasionally they can be
unilocular.
It may show spontaneous regression.
Treatment [Ref.: Sabiston 18/e p2053; Schwartz 9/e p1415]
There are two methods of treatment: Surgical excision &
Sclerotherapy

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Sabiston writes- "Complete surgical excision is the preferred
Question 33: Correct Answer: A
Explanation: - A
Answer- A. Pronator Teres
Pronator teres is a common muscle used as a substitute for wrist
extensors in case of wrist drop occurring as a result of radial nerve
palsy. Pronator teres is a pronator of the forearm supplied by
Median nerve.
Question 34: Correct Answer: A
Explanation: - A
Answer- A. CML
Indications for therepeutic phlebotomy-
Polycythemia vera
Hemochromatosis
Secondary polycythemia
Porphyria cutanea tarda
[Ref Current applications of therapeutic phlebotomy Tarek Bou Assi
and Elizabeth Baz. Blood Transfus. 2014 Jan; 12(Suppl 1): s75-s83]
Question 35: Correct Answer: B
Explanation: - B
Ans. B: Gallstones may be a predisposing factor
Primary carcinoma of the gallbladder is an uncommon, aggressive
malignancy that affects women more frequently than men.
Older age groups are most often affected, and coexisting gallstones
are present in the vast majority of cases.
The symptoms at presentation are vague and are most often related
to adjacent organ invasion. Imaging studies may reveal a mass
replacing the normal gallbladder, diffuse or focal thickening of the
gallbladder wall, or a polypoid mass within the gallbladder lumen.
Adjacent organ invasion, most commonly involving the liver, is
typically present at diagnosis, as is biliary obstruction. Periportal and
peripancreatic lymphadenopathy, hematogenous metastases, and
peritoneal metastases may also be seen. The vast majority of
gallbladder carcinomas are adenocarcinomas.
Because most patients present with advanced disease, the
prognosis is poor.
The radiologic differential diagnosis includes the more frequently
encountered inflammatory conditions of the gallbladder,
xanthogranulomatous cholecystitis, adenomyomatosis, other
hepatobiliary malignancies, and metastatic disease.
Question 36: Correct Answer: B
Explanation: - B
Ans: B i.e. Decreased outflow
A sustained increase in intraocular pressure may be due to

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increased formation of the aqueous humour, difficulty in its exit, or a
raised pressure in the episcleral veins of these, the first & last rarely
occur, and it follows that raised intraocular pressure is essentially
due to an increased resistance to the circulation of the aqueous at
the pupil and/ or its drainage through the angle of the anterior
chamber.
Question 37: Correct Answer: A
Explanation: - A
Ans. A. Glucocorticoids upregulate MHC expression
Glucocorticoids both inhibit as well as upregulate MHC expression
depending upon cells and species involved.
Dexamethasone increases MHC class 2 expression on human
endothelial cells and monocytes whereas it down regulates it on B-
cells.
Glucocorticoids have inhibitory effect on both T-Helper cells and
cytotoxic T cells.
Question 38: Correct Answer: B
Explanation: - B
Answer- B. Benzene
Benzene exposure is associated with leukemia.
Question 39: Correct Answer: B
Explanation: - B
Ans. is B i.e., Increase in cell size
Hypertrophy
* Hypertrophy refers to an increase in the size of cells without
increase in the number, resulting in an increase in the size of tissue.
* Hypertrophy involves cell enlargement without cell division.
* So, hypertrophied organ has just larger cells, but no new cells (by
contrast, in hyperplasia there is increase in number of new cells
without increase in size).
* Nuclei in hypertrophied cells have a higher DNA content than in
normal cells because the cells arrest in the cell cycle without
undergoing mitosis.
* Myocardium (heart muscle) and skeletal muscle undergo
hypertrophy.
* The most common stimulus for hypertrophy is increased workload.
Mechanism of hypertrophy
* The increase in cell size is due to synthesis of more structural
proteins.
* The genes that are induced during hypertrophy include those
encoding transcription factors (C-fos, C-jun), growth factors (TGF-(3,
TGF- 1, FGF); and vasoactive agents (a-agonists, endothelin-1,
angiotensin II).
* There may also be a switch of contractile proteins from adult to

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Question 40: Correct Answer: B
Explanation: - B
Ans. is b i.e., Soyabean
Question 41: Correct Answer: A
Explanation: - A
Ans. A. Psoriasis
lndications for PUVA and UVB
Established major indications :- Psoriasis, atopic dermatitis, vitiligo,
mycosisfungoides, Polymorphic light eruption, pompholyx.
Less frequently treated (less evidence of effectiveness) :- Pityriasis
rosea, morphea, chronic urticaria, Pityriasis lichenoid chronica,
Alopecia totalis & Universalis, Lichen planus, Pityriasis rubra pilaris,
Granuloma annulare, Generalized pruritis, Nacrobiosis lipoidics.
Question 42: Correct Answer: A
Explanation: - A
Ans is a i.e. Lugols iodine test [Ref G Rao p. 301]
Lugols iodine test
It is done on the washing of glans penis (or from a moist blotting
paper)of accused, which then exposed to iodine vapors or lugols
iodine solution. Brown color means the test is positive (on 4th day).
Brown color is due to glycogen present in vaginal epithelial cells of
the victim.
Question 43: Correct Answer: C
Explanation: - C
Answer- C. Syphilis
Obliterative endarteritis that involves vaso vasorum of aortais seen
in the tertiary stage of syphilis. It may lead to syphilitic aneursym
(leuetic aneurysm).
It usually affects the proximal ascending aorta, particularly the aortic
ring. Syphilitic aortitis may occasionaly involve the aortic arch or
descending aorta.
Question 44: Correct Answer: C
Explanation: - C
Ans. C. Nitrogen mustards
Antimetabolites
Purine antagonists -Mercaptopurine, Thioguanine, Azathioprine,
Fludarabine, Cladaribine
Pyrimidine antagonists - S-Fluorouracil, Cytosine arabinoside
(cytarabine), CaPecitabine, Gemcitabine.
Folate antagonist- Methotrexate, Pemetrexed.
Question 45: Correct Answer: C
Explanation: - C
Ans, C. Good option in emergency situations
The micropore membrane in transdermal patch is such that rate of

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drug delivery to skin surface is less than the slowest rate of
absorption from the skin.
This offsets any variation in the rate of absorption according to the
properties of different sites. As such, the drug is delivered at a
constant and predictable rate irrespective of site of application.
Usually chest, abdomen, upper arm, lowerback, buttock or mastoid
region arc utilized.
Transdermal patches of GTN, fentanyl, nicotine and estradiol are
available in India, while those of isosorbide dinitrate, hyoscine, and
clonidine are marketed elsewhere.
Question 46: Correct Answer: B
Explanation: - B
Ans. B. Posterior vitreous detachment
Yanoff Writes (Most common age related event in vitreous is
posterior vitreous detachment
Question 47: Correct Answer: B
Explanation: - B
Ans. is b i.e., T1 [Ref. BDC &/e vol.l p. 245]
Mediastinum is intrapleural space bounded on either side by
mediastinal pleura, anteriorly by sternum and posteriorly by
thoracic vertebral column.
It is divided into superior and inferior mediastinum by a line
passing through sternal angle and lower border ofTnvertebra.
Question 48: Correct Answer: D
Explanation: - D
Ans. (d) Anicteric form
It is most common (90%) and mild form. Most
commonfindingkfner with conjunctival suftrcion
Question 49: Correct Answer: A
Explanation: - A
Answer- A. SSPE
Characteristic periodic activity (Rademecker complex) is seen on
EEG showing widespread cortical dysfunction in SSPE.
It is characterised by high voltage spike occuning at higlr lrequency
of 0.5- 1.5 seconds.
Question 50: Correct Answer: A
Explanation: - A
Ans. is a i.e., Superior temporal gyrus [Ref Pickles,
James 0. (2012). An Introduction to the Physiology of Hearing (4th
ed.). Bingley, UK: Emerald Group Publishing Limited, pp. 215-217.]
Primary Auditory Cortex is located bilaterally, roughly at the upper
sides of the temporal lobes - in humans on the superior temporal
plane, within the lateral fissure and comprising parts of Heschls
gyrus and the superior temporal gyrus, including planum polare and

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planum temporale (roughly Brodmann areas 41, 42, and partially
22).
Question 51: Correct Answer: D
Explanation: - D
Answer- D. Cerebriform
Sezary cells are neoplastic T-cells found in sezary syndrome
(cutaneous T-cell lymphoma).
Question 52: Correct Answer: A
Explanation: - A
Ans. is. A. 1st branchial groove
Question 53: Correct Answer: D
Explanation: - D
Answer- D. P- selectin
Rolling & adhesion-
It is brought by- P selectin or CD 62
PECAM- 1 involved in leucocyte migration from endothelial surface.
Question 54: Correct Answer: A
Explanation: - A
Ans. A. Pediculosis hominis corporis
Maculae cerulea:
This is a latin name for blue-grey macula.
Pathognomic of lice infestation (Pediculosis corporis and
Pediculosispthiris)
They are hemosiderin-stained purpuric spots at the site of insect
bite.
Enzymes in insect salive breaks down human bilirubin to biliverdin,
causing the color change in the skin.
Question 55: Correct Answer: C
Explanation: - C
Answer- C. Metabolic acidosis occurs
Characterstically the first born male child is affected.
The conditon is most commonly seen at 4 weeks after birth ranging
from the 3rd week to on rare occasion
Non-bilious vomiting, becoming increasingly projectile, occurs over
several days to weeks
Infants develop a metabolic alkalosis with severe depletion of
potassium and chloride ions.
Treatment- Surgery : Fredet-Ramstedt pyloromyotomy. (In it the
pyloric mass is split without cutting the mucosa)
Question 56: Correct Answer: D
Explanation: - D
Ans. D. Carboxy peptidases
Question 57: Correct Answer: A

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Explanation: - A
Ans. is a i.e., Eleks gel precipitation test [Ref Read below]
Eleks gel precipitation is an in vitro test for toxigenicity of C
diphtheriae.
Other three options are skin tests (i.e. in vivo tests).
Question 58: Correct Answer: A
Explanation: - A
Streptococcus pneumoniae
Question 59: Correct Answer: C
Explanation: - C
Ans. C. Lipophilic
Statins are the most powerful LDL lowering drugs.
Statins are the most effective and best tolerated hypolipidemic
drugs.
Simvastatin and lovastatin are lipophilic and hence, their CNS
penetration is more than hydrophilic agents like pravastatin and
fluvastatin.
Question 60: Correct Answer: B
Explanation: - B
Ans is b i.e., Heroin
Heroin (smack or brown sugar) is the most commonly abused opioid
and 2" most commonly abused substance, after alcohol.
Question 61: Correct Answer: C
Explanation: - C
Ans. is c i.e., Voiding Cystogram
Voiding cystourethrography is the best method to visualize posterior
urethra.
Remember,
Urethra can be imaged radiographically in two ways.
Anterograde techniques —> Best for visualization of posterior
urethra. (This is done along with voiding cystourethrography or with
voiding following
excretory urography)
Retrograde technique —> Best for examining the
anterior (penile) urethra (Contrast is injected through tip of urethra).
Question 62: Correct Answer: A
Explanation: - A
Swajaldhara is a community lead participatory programme, which aims at provision of safe
drinking water in rural areas with the full ownership of the community.
Swajaldhara has 2 components:
Swajaldhara I – for a Grama Panjayath or a group of Panjayath
Swajaldhara II – for a district as such
Ref: Park, Edition 21, Page - 419
Question 63: Correct Answer: D

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Explanation: - D
Ans. isdi.e., Hypothalamus
The highest seat of regulation of autonomic nervous system (both
sympathetic & parasympathetic) is hypothalamus.
Question 64: Correct Answer: D
Explanation: - D
Ans. D. Psychogenic pain
Textbook of psychotherapy p.6
Idiopathic or unspecified pain: It is purely psychological in nature
and is therefore called psychogenic pain.
Question 65: Correct Answer: B
Explanation: - B
Ans. is b i.e., Hypocalcemia
Following are the side effects of thiazides:
Hypokalemia
Acute saline depletion, hemoconcentration and increased risk of
peripheral venous thrombosis
Dilutionsalhyponatremia
Nausea omitting diarrhea
Rarely headache, giddiness, weakness, parethesias, impotence
Hearing loss
Rashes, photosensitivity
Hyperuricemia
Hyperglycemia hyperlipidemia o Hypercalcemia
Magnesium depletion
Aggravated renal insufficiency
Brisk diuresis leading to mental disturbance and hepatic coma
Question 66: Correct Answer: B
Explanation: - B
Ans is "B" i.e. Metastatic focus in lymph nodes
Lateral aberrant thyroid refers to a metastatic focus in lymph
nodes.
Lateral aberrant thyroid is a misnomer and always refers to the
presence of metastatic thyroid carcinoma (papillary) in cervical
lymph nodes. It does not indicate the presence of ectopic thyroid
tissue as the name suggests.
Question 67: Correct Answer: A
Explanation: - A
Answer- A. Cyanosis
Dyspnoea
Cough or wheezing (some patient)
Weight loss
Barrel-Chest
FEVC and FEV1 are reduced. TLC, RC, and FRC are increased due

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to hyperinflation.
Cyanosis is rare (in contrast to chronic bronchitis)
Emphysema (COPD) causes type-1 respiratory failure
Question 68: Correct Answer: B
Explanation: - B
Answer- B. Alcohol
Etiological agents are radiation, chemicals (benzene, ethylene
oxide), smoking and drugs (alkylating agents, topoisomerase II
inhibitors).
Question 69: Correct Answer: B
Explanation: - B
Ans. is b i.e., Apoptosis
* Programmed cell death is apoptosis.
* But remember this important fact that not all apoptosis are
programmed cell death (read text below) Apoptosis
* Apoptosis is pathway of cell death that is induced by a tightly
regulated intracellular program in which cell destined to die activate
enzymes that degrade the cells own nuclear DNA, and nuclear &
cytoplasmic proteins.
* Apoptosis generally involves single cells in contrast to necrosis that
usually involve a group of cells. o Apoptosis may be of two types ?
A. Physiological (most of the time) Programmed cell
death.
B. Pathological Unprogrammed cell
death.
A.Physiological apoptosis
* Death by apoptosis is a normal phenomenon that serves to
eliminate cells that are no longer needed. o It is important in the
following physiologic situation :?
The programmed destruction of cells during embryogenesis,
including implantation, organogenesis, and metamorphosis.
Hormone dependent involution in adult, e.g., endometrial cell
breakdown during menstural cycle, ovarian follicular atresia in the
Question 70: Correct Answer: A
Explanation: - A
Ans. is a i.e., Nephrogenic DM
Lithium associated renal toxicity
The use of lithium salts for the treatment of manic-depressive illness
may have several renal sequelae, the most common of which is
nephrogenic diabetes insipidus manifesting as polyuria and
polydipsia.
Lithium accumulates in principal cells of the collecting duct by
entering through the epithelial sodium channel (ENaC), where it
inhibits glycogen synthase kinase 3 and down- regulates
vasopressin-regulated aquaporin water channels.

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Less frequently, chronic tubulointerstitial nephritis develops after
prolonged (greater than 10-20 years) lithium use and is most likely to
occur in patients that have experienced repeated episodes of toxic
lithium levels.
Question 71: Correct Answer: C
Explanation: - C
C i.e. MRI is better for calcified lesions
* MRI is very poor in detection of calcification. It is inferior to CT
scan, mammography and x-ray in detecting calcification. That is why
it lags behind mammography in early detection of noninvasive ductal
carcinoma in situ (DCIS)Q, which most commonly
has microcalcification as its only presenting feature. And similarly it
has a very limited role in detection of renal stones and gall
stonesQ. However, it is important to note that only upto 60% of gall
stones have enough calcium density (more than that of bile) to get
visualized on CT. Becaus of its superior calcification detection
abilities, MDCT is used in Agatston scoring (Coronary calcium
scoring) of calcified plaques of coronary artery using coronary
calcium as a surrogate marker to detect the presence and measure
the amount of coronary atherosclerosis. Because with exception of
patients with renal failure calcification of arteries occurs exclusively
in context of atherosclerosis.
Similarly nonenhanced helical CT is superior to all other imaging
modalities in diagnosis of urinary tract calculiQ but at the cost of
higher radiation exposure.
Now there is no need to say that MRI is better that CT for evaluation
of bone marrow, small brain lesions, meniscus/ ligament injuries,
soft tissue tumors and meningeal pathology. But MRI is very poor in
Question 72: Correct Answer: C
Explanation: - C
Ans. is C i.e., 3-6 mg/L
Dental fluorosis ? > 1.5 mg/L (PPM)
Skeletal fluorosis ? 3-6 mg/L (PPM)
Crippling fluorosis ? > 10 mg/L (PPM)
Question 73: Correct Answer: D
Explanation: - D
Ans. d. P falciparum
Question 74: Correct Answer: B
Explanation: - B
Local anaesthetics blocks nerve conduction by decreasing the entry of sodium ions during
upstroke of action potential.
Finally it blocks depolarization to reach threshold potential and conduction block occurs.
Small fibers are more sensitive to local anaesthetics than large fibers and non myelinated
fibers are blocked easily than myelinated fibers.

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Ref: Essentials of Medical Pharmacology by K D Tripathi, 5th Edition, Pages 321-3
Question 75: Correct Answer: B
Explanation: - B
Answer- B. Long thorasic nerve of Bell
Overhead abduction is caused by :-
Serratus anterior : supplied by long thoracic nerve.
Trapezius : supplied by spinal accessory nerve.
Question 76: Correct Answer: C
Explanation: - C
Answer- C. Metacarpophalangeal joint
The mouth of the fibrous digital sheath is at the level of metacarpo-
phalangeal joint.
Question 77: Correct Answer: D
Explanation: - D
Ans. D. Albumin
[Ref: Clinical physiology 3d/e p.336]
Oncotic pressure, also called colloid osmotic pressure, is a form of
osmotic pressure exerted by proteins in blood plasma that usually
tends to pull the water into the circulatory system.
The major contributing protein for plasma oncotic pressure is
albumin.
Question 78: Correct Answer: D
Explanation: - D
Ans. is d i.e., Brimonidine
Question 79: Correct Answer: D
Explanation: - D
Ans. is. d i. e., Endemic typhus
Question 80: Correct Answer: A
Explanation: - A
A i.e. Procaine
Question 81: Correct Answer: A
Explanation: - A
Ans. A. Neuropraxia is irreversible
Neuropraxia (Class l)
This is the least severe form of nerve injury, with complete recovery.
In this case, the axon remains intact, but there is myelin damage
causing an interruption in conduction of the impulse down the nerve
fiber.
Most commonly, this involves compression of the nerve or disruption
to the blood supply (ischemia).
No Wallerian degeneration is seen.
Question 82: Correct Answer: C
Explanation: - C

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Ans. is c i.e., Malphigian corpuscle
Thymus dependent (T-
cells collect)
1. Spleen
Periarterial lymphoid
collect
Malphigian corpuscle in
white pulp
2. Lymph node
Paracortical area
Thymus independent (B-
cells collection)
1. Spleen
Perifollicular region
Mantel layer
2. Lymph node
Cortical follicles
Germinal centres
Medullary cords
Question 83: Correct Answer: D
Explanation: - D
Ans. D. Delusion disorder
Description given in the question is of Koro syndrome, a delusional
disorder.
Koro syndrome
Koro is a culture-specific syndrome delusional disorder in which an
individual has an overpowering belief that one’s genitalia are
retracting and will disappear, despite the lack of any true
longstanding changes to the genitals.
Koro is also known as shrinking penis. The syndrome is commonly
known as genital retraction syndrome.
Question 84: Correct Answer: B
Explanation: - B
B i.e. 129 ATP net
Question 85: Correct Answer: B
Explanation: - B
Ans. is b i.e., 40 copies viral RNA/ml of blood
This assay generates data in the form of number of copies of HIV
RNA per milli litre of serum or plasma and can reliably detect as few
as 40 copies of HIV RNA per mili litre of plasma.
Research based assay can detect down to one copy/ml.
Question 86: Correct Answer: D
Explanation: - D
Answer- D. It may progress to a secondary chondrosarcoma

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Pagets disease may progress to a secondary osteosarcoma not
chondrosarcoma
Question 87: Correct Answer: D
Explanation: - D
Ans. D. Fat malabsorption
Absorption of all fat soluble vitamins is decreased in fat
malabsorption.
These fat soluble vitamins are A,D,E and K.
Question 88: Correct Answer: B
Explanation: - B
Ans. is b i.e., Case-control study
Case-control study > cross-sectional study > Retrospective cohort
study > Prospective cohort study > RCT
Selection bias: Cases and controls may not be representative of the
population or there may be systematic differences between both.
Question 89: Correct Answer: A
Explanation: - A
Ans. is a i.e., DNS in adults [Ref Dhingra 5th /e p. 423]
Submucous resection (SMR) is a surgical procedure to correct the
deformity of nasal septum.
The principle of this procedure is to remove deviated cartilage and
bone from beneath the mucosal lining of nasal septum, leaving a
corrected septum largely composed of scar tissue.
Submucous resection is not advocated in children upto 17 years of
age as it may interfere with development of the facial bones.
Question 90: Correct Answer: A
Explanation: - A
Answer- A. Anterior dislocation of shoulder
Hamilton ruler test : Because of flattening of shoulder, it is possible
to place a ruler on the lateral side of arm and it touches acromian &
lateral condyle of humerus simultaneously (in normal it would not
due to shoulder contour).
Question 91: Correct Answer: A
Explanation: - A
Ans. isai.e., 3 weeks [Ref: Embryology by Indu Khurana p.
209]
Tubular heart is formed at the end of 3d week"
Question 92: Correct Answer: B
Explanation: - B
Ans. is B i.e., Delusion of double
Capgras syndrome is a delusion of double.
The delusional misidentification syndrome (DSM)
DSM is characterized by misidentification delusions of others or self.
Four main syndromes are differentiated : ?

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Capgras syndrome (Delusion of double):- Patient falsely sees a
familiar person as a complete stranger who is imposing on him as a
familiar person.
Fregoli syndrome (illusion de fregola): - The patient falsely identifies
stranger as a familiar person.
Syndrome of subjective double: - The patients own self is perceived
as being replaced by a double.
Syndrome of intermetamorphosis: - A false belief that a person can
transform into another person.
These syndromes most commonly appear in schizophrenia. Other
causes are Alzheimer syndrome, head injuries, and delusional
disorders.
Question 93: Correct Answer: B
Explanation: - B
Ans. B. Cornea
The cornea, with the anterior chamber and lens, refracts light, with
the cornea accounting for approximately two-thirds of the eyes total
optical power.
In humans, the refractive power of the cornea is approximately 43
dioptres.
The diopteric power of reduced eye is + 5OD, of which + 44D is
contributed by cornea and + 16D by the crystalline lens.
Total diaopteric power of schematic eye is + 58D, of which cornea
contributes +43D and the lens +15D.
Question 94: Correct Answer: C
Explanation: - C
Ans. C. 12.5 gm
Loading dose = (Target Cp * Vd)/F
Target concentration (Cp) = 5 gm/L
Volume of distribution = 500 ml = 0.5L
F (Fraction of administered drug reaches systemic circulation) =
20Vo = 0.2 5x0.5
So, loading dose = r2.5 gm
Question 95: Correct Answer: C
Explanation: - C
Answer- C. Third degree
Third degree : Injury to perineum, involving the anal sphincter
complex (both the external and internal).
3a : if half thickness external anal sphincter involved.
3b : if full thickness external anal sphincter involved.
3c : if internal anal sphincter involoved.
Question 96: Correct Answer: B
Explanation: - B
Answer- B. Autoimmune

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Immunological factors are thoughts to be of primary importance.
The immune complexes hat are generated are deposited into the
pericardium, pleura and lungs.
Question 97: Correct Answer: D
Explanation: - D
Ans. is d i.e. virus yields has high hemagglutination titre but low
infectivity
Abnormal replicative cycles of viruses
. Von magnus phenomenon when cells are infected with a high dose
of influenza virus, there is defective assembly during replication and
the
produced virus has high hemagglutinin titre but low infectivity.
. Abortive infection Due to defective maturation or assembly, either
no release of virons occur or the progeny of virus is noninfectious.
. Defective viruses Some viruses are genetically defective and
require help of simultaneously infected helper virus for replication.
eg.
HDV, Rous sarcoma virus.
Question 98: Correct Answer: B
Explanation: - B
Answer is B
SGOT/SGPT ratio greater than 2 is highly suggestive of alcoholic
hepatitis and cirrhosis.
AST is synonymous with SGOT & ALT is synonymous with SGPT
In general AST and ALT levels rise parallel to each other. In
alcoholic liver disease the AST rises out of proportion to ALT such
that the ratio of AST and ALT may become greater than 2:
Stigmata of Alcoholic hepatitis / cirrhosis that aid in diagnosis :
1. Bilateral enlarged parotids Q.
2. GynaecomastiaQ
3. Testicular atrophy with loss of body hairQ
4. Wasting of muscle massQ
5. Duputyrens contractureQ
AST (SGOT) out of proportion to ALT (SGPT) seen in Q
1. Alcoholic hepatitis Q
2. Fatty liver in pregnancy Q
Gamma Glutamyl transferase levels correlate with levels of
Alkaline phosphatase and are a sensitive indicater of biliary tract
disease — obstructive jaundice. It is not an indicator of alcoholic
liver disease.
Question 99: Correct Answer: B
Explanation: - B
Ans. is b i.e., Sphenopalatine artery [Ref Scott Brown 7h/e Vol-
2p. 1597; Dhingra 5th/e p. 190]
Woodruffs area : ?

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It is situated under the posterior end of inferior turbinate.
Sphenopalatine artery anastomoses with posterior pharyngeal artery
here. Posterior epistaxis occurs in this area.
Question 100: Correct Answer: D
Explanation: - D
Ans. D. Holmium laser thermoplasty
Refractive surgeries for myopia
Radial keratotomy
Laser insitu keratomileusis (LASIK)
Phakic intraocular lens (IOL)
Orthokeratology
Photorefractive keratotomy (PRK)
Extraction oflens (Fucalas operation)
Intercorneal ring implantation
Question 101: Correct Answer: C
Explanation: - C
ED50 refers to Effective Dose of a drug needed to produce a particular response in 50%
of population. It is a quantitative measure of the potency of a drug. Smaller the ED50 value,
more potent is the drug.
Ref: Encyclopedia of Psychopharmacology By Ian P. Stolerman, Volume 2, Page 456
Question 102: Correct Answer: B
Explanation: - B
Ans. B. Composed of 2 homolous subunits
Epithelial Na+ channels (ENaC) is rate limiting step in Na+
reabsorption across several epithelial linings.
It is present in kidney (distal part), GIT (colon), salivary & sweat
glands, and respiratory tract.
ENaC is made of three homologous subunits > alpha, beta, and
gamma.
In late distal tubules and collecting ducts, ENaC is inhibited by
potassium sparing diuretics like amiloride and triameterene.
Question 103: Correct Answer: A
Explanation: - A
Ans. A. Pityrosporum ovale
Malasezia furfur or its yeast form Pityrosporum ovale plays an
etilogicalrole in Seborrhic dermatitis."
Question 104: Correct Answer: C
Explanation: - C
Ans. C. Na* influx
EPSP - Opening of ligand gated Na+ channel resulting in Na+ influx.
IPSP -
Opening of ligand gated Cl- channel resulting in Cl- influx.
Opening of ligand gated K+ channel resulting in K+ influx
Question 105: Correct Answer: B

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Explanation: - B
Ans. is b i.e., Source of infection is clinical case [Ref Park
23rdie p.154]
Influenza
Influenza virus a RNA virus, belongs to orthomyxovirus.
Source of infection of influenza is a clinical case or subclinical case.
Major reservoir of influenza virus exists in animal and birds.
Incubation period is 18-72 hours. Most of the infections are
subclinical. Clinical cases present with cough, fever, myalgia and
headache.
Complications include pneumonia, encephalitis, Reyes syndrome
(with type-B virus); GB syndrome and gastric flu/GIT symptoms (with
type-B virus).
Period of Communicability is 1-2 days before to 1-2 days after onset
of symptoms.
Question 106: Correct Answer: D
Explanation: - D
Granulomatosis infantiseptica is an intra-uterine infection of the
newborn caused by listeria.
The predominant feature of this condition is extensive focal necrosis
affecting especially the liver and, less often, the lungs.
The mortality rate is very high.
Occasionally meningitis may be associated with it.
The organisms can be isolated from the affected areas in the child
and frequently from the genital tract of the mother, who may or may
not manifest the disease.
Ref: Harrisons principles of internal medicine, 18th edition, Page:
1196.
Question 107: Correct Answer: D
Explanation: - D
Answer- D. Sub Capital fractures
The non-union and AVN will be most common in subcapital fracture
and least in basicervical fracture.
Question 108: Correct Answer: C
Explanation: - C
Ans. C. Bullous Pemphigoid
Diseases causing mild or no itching: Psonasis, Pityriasis rosea, SLE,
parapsoriasis, Secondary syphilis, Pemphigus.
Diseases causing moderate itching: Contact dermatitis, Dry skin,
Bullous pemphigoid, Photosensitivity (sunburn).
Diseases causing severe itching: Lichen planls, Lichen simplex
chronicus, Herpes gestationis, Mastocytosis, Dermatitis
herpetiformis, scabies, Prurigo nodularis.
Question 109: Correct Answer: A

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Explanation: - A
Answer- A. 6 mg
Betamethasone - 12 mg i.m. 24 hours apart for 2 doses
Dexamethasone - 6 mg i.m. 12 hours apart for 4 doses.
Betamethasone - Steroid of choice.
Question 110: Correct Answer: C
Explanation: - C
Answer- C. Myaesthenic syndrome
LAMB syndrome is characterized by presence of :-
Lentigines
Atrial Myxoma
Blue nevi.
Question 111: Correct Answer: C
Explanation: - C
Ans. is c i.e., Ventral rami of thoracic spinal nerves
Ventral rami of upper 11th thoracic spinal nerves are known as
intercostal nerves and ventral ramus of T12 is known as subcostal
nerve.
Upper six intercostal nerves supply thoracic wall whereas lower five
intercostal nerves and subcostal nerve supply thoracic and anterior
abdominal walls and hence known as thoracoabdominal nerves.
Upper two intercostal nerves also supply the upper limb.
Thus only 3rd to 6th are called typical intercostal nerves.
Question 112: Correct Answer: B
Explanation: - B
Answer is B (Thalamus):
The Amnestic effect in Wernickes Korsakoff Syndrome is related to
lesions in the dorso-medial nuclei of the thalamus.
`Lesions in the dorsomedial nucleus of the thalamus seem to be the
best correlate of the memory disturbance and confabulation -
Robbins
Question 113: Correct Answer: A
Explanation: - A
Answer- A. It is premalignant condition
Ménétrier disease is a rare, acquired, premalignant disease of the
stomach characterized by massive gastric folds, excessive mucous
production with resultant protein loss, and little or no acid production.
The disorder is associated with excessive secretion of transforming
growth factor alpha (TGF-?).
Question 114: Correct Answer: A
Explanation: - A
Ans, A. Trichinosis
Although many parasites can theoretically involve the extraocular
muscle the most frequent form of parasitic infestation of extraocular

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muscles is trichinosis
Question 115: Correct Answer: D
Explanation: - D
Ans. is d i.e. Ultrasonography
Hydrocephalus is a condition in which there is an abnormal increase
in cerebrospinal fluid within the ventricular and subarachnoid spaces
of brain.
"The prenatal diagnosis of hydrocephalus is usually made by
demonstration of a dilated ventricular system in an ultrasound
examination."
Earliest and most accurate sonographic sign of hydrocephalus –
Enlarged lateral ventricles.°
The lateral ventricle is measured at the level of atrium.
Normal transverse diameter of atrium is 7 mm ± 1 mm. (It remains
constant during the second and third trimester)
When diameter of atrium is >10 mm it is called as Ventriculomegaly /
Hydrocephalus.
Other signs of hydrocephalus on USG :
Dangling choroid plexuses.
Thinning out of cerebral cortex.
Extra Edge :
Friends, the terms ventriculomegaly and hydrocephalus are often
used interchangeably but have slightly different meanings.
* Ventriculomegaly : The condition in which lateral ventricles of the
Question 116: Correct Answer: D
Explanation: - D
Ans. is d i.e., Choline [Ref Principles of medical physiology p.
96]
Acetylcholine is synthesized in the cytosol of nerve terminal from
acetyl-CoA and choline, in the presence of choline-0-
acetyltransferase
Question 117: Correct Answer: A
Explanation: - A
Ans. is a i.e., Temporal association [Ref Park 23rd/e p.89]
Most important criteria ? temporal association
Weakest and most difficult criteria to establish ? specificity of
association
Question 118: Correct Answer: D
Explanation: - D
Ans. D. All of the above
After load (resistance offered to ventricular pumping action) :
Left ventricle has to pump out blood against aortic resistance.
Increased aortic resistance (e.g., high BP) tends to decrease stroke
volume.

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Decreased peripheral resistance increases cardiac output e.g., in
exercises, AV fistula or shunt, severe anemia (due to vasodilation by
anemic hypoxia), thyrotoxicosis (due to vasodilation caused by
increased O2 consumption),andwetberi-beri.
Question 119: Correct Answer: D
Explanation: - D
Answer- D. All of the above
HPV infection.
Coitus before 18 years.
Multiple sexual partners.
Delivery of the first baby before the age of 20 years.
Multiparity with poor birth spacing between pregnancies.
Poor personal hygiene.
Poor socioeconomic status.
Smoking.
Immunosupressive disease.
Question 120: Correct Answer: B
Explanation: - B
Ans. B. Tetracycline
Question 121: Correct Answer: A
Explanation: - A
Answer- A. Gap non union
Bone transport technique is primarily used in the management of
gap non unions.
An osteotomy is made in the normal bone and a segamnt of bone is
transported to the non union site
Question 122: Correct Answer: B
Explanation: - B
Ans. B. Benzodiazepines
DOC for Panic disorders - SSRI’s
DOC for acute panic attack - Benzodiazepines.
Question 123: Correct Answer: A
Explanation: - A
A i.e. Diffusion Hypoxia
(Ref : Willer 8/e p656, 3401)
On discontinuation of N2O administration, nitrous oxide gas can
diffuse from blood to the alveoli, diluting O2 in the lung.
Produce an effect called “Diffusional hypoxia”.
To avoid hypoxia, 100% O2, rather than air should be administered
when N2O discontinued.
Question 124: Correct Answer: A
Explanation: - A
Answer- A. Follicular adenoma
Most common solitary thyroid nodule is benign colloid nodule.

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2"d most common cause of solitary thyroid nodule is follicular
adenoma.
Question 125: Correct Answer: A
Explanation: - A
Answer- A. Upper GI bleeding
Question 126: Correct Answer: A
Explanation: - A
Answer- A. Anal Carcinoma
Nigro regimen refers to combined chemotherapy and radiotherapy
for primary treatment of malignant tumors of the anal canal.
Question 127: Correct Answer: C
Explanation: - C
Ans. C. Both
Both propylthiouracil and methimazole/carbimazole cross placenta.
But because of high protein binding capacity of propylthouracil is
transferred less across Placenta).
Therefore, it is preferred in pregnancy.
Question 128: Correct Answer: C
Explanation: - C
Ans. Recurrent periphelbitis retinae
Question 129: Correct Answer: D
Explanation: - D
Answer- D. Testes
MRKH syndrome is also known as MURCS syndrome (Mullerian
agenesis, Renal aplasia and cervicothoracic somite dysplasia).
MRKH (Mayer Rokitansky Kuster Hauser) syndrome has a
karyotype of 46, XX. So the gonads present are ovaries in contrast
to Androgen Insensitivity Syndrome where testes are present.
The MRKH syndrome is characterized by congenital aplasia of the
uterus and the upper part (2/3) of the vagina in women showing
normal development of secondary sexual characteristics and a
normal 46, XX karyotype.
Question 130: Correct Answer: C
Explanation: - C
Ans. is c i.e., To correct Acidosis
The main function of sodium citrate is to correct acidosis ?
"The citrate in ORS is needed for the treatment of acidosis, which
frequently occurs with dehydration" "Efficacy of sodium citrate
equals to sodium bicarbonate for correction of acidosis in diarrhea"
Question 131: Correct Answer: B
Explanation: - B
Ans. b. Giardia lamblia
Duodenal aspirate is used for G lambia, o sinesis, F heptica, and S

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stercoralis.
Question 132: Correct Answer: D
Explanation: - D
Ans. D. Area 44
[Ref Fullers 4 le p. 10; Ganong 24n le p. 293]
Motor speech is formed in Brocas area (area44).
Striate area of cortex is primary visual area (Brodmanns area 17 or
VI) and is located on the sides of calcarine fissure.
Question 133: Correct Answer: B
Explanation: - B
Ans. B. Histamine and adrenaline
Physiological antagonists are those that produce opposite action by
acting on different receptors.
Example
Histamine causes bronchoconstriction via H1 receptors and this
action is antagonized by adrenaline which causes bronchodilatation
through beta 2 receptors (option d).
Question 134: Correct Answer: D
Explanation: - D
Ans. is `d i.e., 3500 k cal/d [Ref Park 23rd le p.634]
Indian Reference Indian Reference
Energy requirements Man Woman
Light work 2320 kcal/day 1900 kcal/day
Moderate work 2730 kcal/day 2230 kcal/day
Heavy work 3490 kcal/day 2850 kcal/day
Question 135: Correct Answer: C
Explanation: - C
Ans. C. Globulin
[Ref: Clinical aspects of blood p.80]
The effect of a protein on plasma viscosity depends on its molecular
weight and structure.
The viscosity is higher if a protein has
1. Less spheroid shape
2. Higher molecular weight
3. Higher aggregation capacity
4. Higher temperature or pH sensitivity
The globulin causes maximum increase in plasma viscosity followed
by fibrinogen (2d after globnlin) and albumin (3rd in number).
Question 136: Correct Answer: C
Explanation: - C
Unlike most other diuretics, K+-sparing diuretics reduce urinary excretion of K+ and can
cause mild, moderate, or even life-threatening hyperkalemia.
The risk of this complication is greatly increased by renal disease (in which maximal K+
excretion may be reduced) or by the use of other drugs that reduce or inhibit renin (beta

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blockers, NSAIDs, aliskiren) or angiotensin II activity (angiotensin- converting enzyme
inhibitors, angiotensin receptor inhibitors).
Since most other diuretic agents lead to K+ losses, hyperkalemia is more common when
K+-sparing diuretics are used as the sole diuretic agent, especially in patients with renal
insufficiency.
Ref: Ives H.E. (2012). Chapter 15. Diuretic Agents. In B.G. Katzung, S.B. Masters, A.J.
Trevor (Eds), Basic & Clinical Pharmacology, 12e.
Question 137: Correct Answer: D
Explanation: - D
D. i.e. Internal circular fibres
Involuantry internal anal sphincter is formed by thickening of circular
muscle layer (i.e. circular layer of muscularis externa, a smooth
muscle) of upper end (2/3 or 3/4) of anal canal. This sphincter
remains in the state of tonic contraction most of the time to maintain
resting tone or pressures (-90 cm H20) & to prevent leakage of fluid
or flatus. Its contraction (tonus) is maintained by sympathetic fibers
from superior rectal (periarterial) and hypogastric plexuses; and
inhibited (i.e. sphincter relaxed) by parasympathetic pelvic
splanchnic nerves.
Question 138: Correct Answer: D
Explanation: - D
Ans. is d i.e., Aminoglycosides
Question 139: Correct Answer: B
Explanation: - B
Ans. is B i.e., Every month
The Village-Health and Nutrition day (VHND) is to be organized
once every month on a fixed day (such as the second Saturday).
The day can be decided by the VHWSC (village health and water
sanitation committee) in each village at anyone of the Anganwadi
centers (AWCs) in that village, preferably, all the AWCs should be
covered by rotation.
On that day, Anganwadi worker and other VHWSC members will
mobilize villagers to assemble in AWC.
Question 140: Correct Answer: C
Explanation: - C:D
Ans. is c i.e., Glucokinase is induced by insulin & d i.e.,
Hexokinase is not specific for glucose (Ref: Harper 29h/e p.
170-177; Vasudevan #/e p. 98)
Hexokinase is not specific for glucose metabolism. It is found
in most tissues except glucose.
Glucokinase has high KM. It is induced by insulin.
Question 141: Correct Answer: A
Explanation: - A
Ans. is. a i. e., Trench fever

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Question 142: Correct Answer: D
Explanation: - D
D i.e. Amnesia
* Electro convulsive therapy (seizure) increases production of brain
derived neurotrophic factor (BDNF)Q. Madsen proposed generation
of new neurons in the hippocampus may be an important
neurobiological element underlying the clinical effects of ECT.
* ECT is most commonly indicated (-85% of all ECT) and most
effective in treatment of major depression (with psychosis /
delusions /or suicidal tendency)Q. ECT is indicated in psychotic
(delusional) depressionQ because nihilistic delusions may induce
suicidal tendency, whereas ECT is not indicated in neurotic
depression (dysthynia), cyclothymiaQ. ECT may be useful in MDP
(bipolar) in decreasing duration of depressive episode.
ECT is not (or less) useful in chronic conditions like chronic
schizophrenia (with negativ symptoms esp)Q. Use of ECT is not the
first line (choice) of treatment in mania & schizophrenia (lithium &
anti psychotics are mainstay of treatment). Panic disorder is also
treated with drugs not ECT.
Indications of ECT
* ECT is most useful in acute and positive symptoms (eg suicidal
tendency, catatonia), whereas it is least effective in chronic
conditions and negative symptoms
Question 143: Correct Answer: D
Explanation: - D
Ans. D. Flights of ideas
Diagnostic criteria for mania
Three or more of the following for at least 1 week:-
1. Inflated selfvesteem or grandiosity
2. Decreased need for sleep
3. Overtalkativeness
4. Flightofvideas
5. Distractibility
6. Psychomotor agitation or Increased goal directed activities
7. Excessive involvement in pleasurable activities
Question 144: Correct Answer: D
Explanation: - D
PR – Interval corresponds with atrial depolarisation and conduction through AV node
QRS – corresponds with Ventricular depolarisation + atrial repolarisation
QT – corresponds with ventricular depolarisation + ventricular repolarisation
Ref: Review of Medical Physiology by Ganong, 20th Edition, Page 532.
Question 145: Correct Answer: A
Explanation: - A
A i.e. Starts as continuation- of medial marginal vein

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Question 146: Correct Answer: B
Explanation: - B
Ans. is b i.e. Dowry death
IPC 304 - Punishment of culpable homicide, not amounting to
murder
IPC 304 A - Death caused by negligence
IPC 304 B - Dowry death : 10 years of imprisonment which can
extend to life.
IPC 498 - Punishment for cruelty by husband or his relatives.
Question 147: Correct Answer: D
Explanation: - D
Raynauds Phenomenon is not mentioned in association with Juvenile Idiopathic Arthritis
(JIA).
Ref: Current Diagnosis and Treatment in Rheumatology, 2nd Edition, Pages 196-197;
Nelson’s Textbook of Pediatrics, 18th Edition, Page 1003; Primer on The Rheumatic
Diseases By John H. Klippel, Page 145
Question 148: Correct Answer: C
Explanation: - C
Ans is c
Whipples operation (Pancreaticoduodenectomy)
is the most commonly performed operation for carcinoma of head of
pancreas.
It includes resection of:
- distal stomach - duodenum
- gall bladder - proximal jejunum
- CBD - regional lymphatics
- head of pancreas
Restoration of gastrointestinal continuity requires -
pancreaticojejunostomy choledochojejunostomy &
- gastrojejunostomy
Question 149: Correct Answer: C
Explanation: - C
Ans. is c i.e., Threshold tone decay test [Ref Dhingra 5th/e p.
31; zr/e p. 28]
Question 150: Correct Answer: B
Explanation: - B
Tc99m-Diethylene Triamine Pentothenic Acid (DTPA) is an agent of choice widely used in
measuring GFR.
Ref: Renal Disease: Techniques and Protocols By Michael S Goligorsky, Page 87;
Paediatric Uroradiology By Richard Fotter, ALbert L Baert, Page 47
Question 151: Correct Answer: A
Explanation: - A
Ans. A.Parasympathetic system via muscarinic receptors
[Ref Ganong 24h/e p.339-342, Ganong 23d/e p.341]

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Erection of penis ? Muscarinic effect of parasympathetic system.
Ejaculation - alpha-receptor ofsympathetic system
Question 152: Correct Answer: A
Explanation: - A
Answer- A. Pelvis
A chondrosarcoma is a malignant tumor derived from cartilage cells
and it tends to maintain its cartilaginous character throughout its
evolution
Most commonly involved bones are pelvis (most common), femur
(2nd most common), humerus, ribs and shoulder girdles.
It may be at metaphysis or diaphysis.
Question 153: Correct Answer: B
Explanation: - B
Ans. is. b i. e., Burkholderia mallei
Question 154: Correct Answer: A
Explanation: - A
Answer- A. Need for supplemental oxygen at 36 weeks after
conception
Chronic lung disease of infancy was formerly called
bronchopulmonary dysplasia.
Bronchopulmonary dysplasia is usually defined as a need for
supplemental oxygen at 36 weeks after conception.
Bronchopulmonary dysplasia is usually defined as a need for
supplemental oxygen at 36 weeks after conception. BPD is usually
defined as a need for supplemental oxygen at 36 wk after
conception.
BPD is a result of lung injury in infants requiring mechanical
ventilation and supplemental oxygen.
Question 155: Correct Answer: B
Explanation: - B
In non-primate mammals, end product of purine metabolism is
allantoin due to presence of enzyme uricase. Uricase convertes uric
acid to allantoin.
Humans lack the enzyme uricase. Therefore, end product of purine
catabolism in humans is uric acid.
Question 156: Correct Answer: D
Explanation: - D
Answer- D. Pyoderma Gangrenosum
Bowens Disease Lupus vulgaris
Actinic Keratosis Long standing chronic ulcer (e.g. marjolins
ulcers)
Xeroderma
pigmentosum Senile Keratosis
Following burn, venous ulcer, old scar etc.

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Question 157: Correct Answer: C
Explanation: - C
Harpenden callipers are used to measure skin fold thickness.
Skin fold thickness is measured in mid triceps, biceps, supra iliac and sub scapular
areas.
The sum of these measurements should be less than 40 mm in boys and 50 mm in girls.
Ref: Park 21st edition, page 369.
Question 158: Correct Answer: C
Explanation: - C
Ans. isci.e., Subaponeurotic tissue
Loose subaponeurotic areolar tissue (4s layer) is called
dangerous area of scalp because it contains emissary veins
throughwhich infection in subaponeurotic space may spread
readily to intracranial venous sinuses
Question 159: Correct Answer: C
Explanation: - C
Ans. is c i.e., Specificity of association
Question 160: Correct Answer: A
Explanation: - A
Ans. CT scan
Question 161: Correct Answer: B
Explanation: - B
Anterior 2/3rd of septum is supplied by LCA and posterior 1/3rd is by
RCA
Question 162: Correct Answer: D
Explanation: - D
Ans. is d i.e., Thyroxine
Glycine
lycine is a nonessential amino acid which is synthesized from serine.
Glycine is metabolized by following three pathways -
It can be converted to serine, a reaction that require tetrahydrofolate
(derivative of folic acid and pyridoxal phosphate as coenzyme.
Further serine is metabolized by serine dehydratase into pyruvate
and NH 4+.
The major pathway of glycine degradation is oxidative cleavage into
CO, and NH: by glycine cleavage complex of liver. H4 folate is
required which is converted to N5, N10-methylene H4 folate. Thus
folic acid is required for glycine metabolism.
Glycine may be oxidatively deaminated by glycine oxidase to
glyoxylic acid.
Glycine is necessary for the formation of following products:- Heme,
purine ring, bile acids conjugation (formation of glycocholic acid, and
glyco-chenodeoxycholic acid), creatine, glutathione, glucose (by
gluconeogenesis).

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Question 163: Correct Answer: B
Explanation: - B
Ans. B. Physostigmine
Lipid soluble agents (organophosphates and physostigmine) have
more marked muscarinic and CNS effect; and stimulate ganglia but
action on skeletal muscle is less prominent.
Question 164: Correct Answer: A
Explanation: - A
Ans. A i.e. Rosuvastatin
Rosuvastatin
It is a competitive inhibitor of the enzyme HMG-CoA reductase,
having a mechanism of action similar to that of other statins.
Its approximate elimination half life is 19 h and its time to peak
plasma concentration is reached in 3-5 h following oral
administration.
Question 165: Correct Answer: A
Explanation: - A
Answer- A. Exposure to cold
Is ds of young women (F:M ratio is 5:1)
Commonly the upper limbs are affected specially the fingers (the
thumb is generally escaped)
Exposure to cold is main trigger
Question 166: Correct Answer: C
Explanation: - C
Ans. C. Primaquine
Gametocidal - Acts on gametocytes
For all species: Primaquine, artimisinins
For P. vivax: Chloroquine, quinine
Question 167: Correct Answer: C
Explanation: - C
Ans. C. Corneal Ulcer
Complications of traumatic hyphema
1. Obstruction of trabecular meshwork with associated intraocular
pressure elevation
2. Peripheral anterior synechiae (PAS)
3. Posterior synechiae
4. Cornealbloodstaining
5. Rebleeding: Can occur when the initial clot retracts and lyses
allowing for a second episode ofbleeding. Rebleeds are generally
more severe than the initial bleed, more likely to lead to glaucoma,
corneal blood staining, and synechiae formation. It has been
reported to occur 3.5% to 38% ofthe timeand probably 5-10%
overall.
6. Pupillaryblock

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7. Amblyopia (pediatric patients)
Question 168: Correct Answer: A
Explanation: - A
Ans. A. Von-Gogh syndrome
Dramatic self-mutilation occurring in schizophrenia has also been
called Von-Gogh syndrome
Question 169: Correct Answer: D
Explanation: - D
Ans. is d i.e., All of the above
Question 170: Correct Answer: B
Explanation: - B
Ans. is b i.e., Leucine
Substrates for gluconeognesis ?
1. Lactate
2. All amino acids except leucine and lysine
3. Pyruvate
4. Propionate
5. Glycerol
6. Intermediates of citric acid cycle
Alanine is the most important gluconeogenic amino acid.
Question 171: Correct Answer: B
Explanation: - B
Ans. is b i.e., Lower limbs
" It occurs predominantly on the skin and can involve virtually any
organ, perhaps except the brain. The initially described form, now
known as classic KS, predominantly involves the lower extremities of
elderly men. KS is now the most common tumor seen in HIV-
infected patients"- Devitas Oncology
Question 172: Correct Answer: C
Explanation: - C
Ans. c. Moyamoya disease
Moyamoya disease is an idiopathic, non inflammatory, non
atherosclerotic progressive vasculo-occlusive disease involving the
circle of Willis, typically the supraclinoid internal carotid arteries.
Small abnormal net-like vessels proliferate giving the
characteristic "puff of smoke" appearance on direct
angiography. CTA and MRA is not always able to demonstrate this
appearance on account of lower flow and spatial resolution.
Question 173: Correct Answer: C
Explanation: - C
Ans. C. Clotting disorders
Contraindications of central neuroaxial block:
Absolute :- Infection at the site of injection, patient refusal,
coagulopathyor other bleeding disorder, severe hypovolemia,

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increased ICT, severe aortic or mitral stenosis.
Relative :- Sepsis, unco-operative patient, pre-existing neurological
deficit, demyelinating lesions, severe spinal deformity, stenotic
valvular heart disease
Question 174: Correct Answer: B
Explanation: - B
Ans. isb i.e., Cystic fibrosis
The distribution ()I. bronchiectasis mar be important diagnostically
A central ? Perihilar
allergic bronchopulmonary aspergillosis.
Predominant upper lobe o Middle and lower lobe ? Cystic
fibrosis or one of its variants. Distribution is consistent with PCD
Lower lobe involvement is ? Middle lobe and lingular segment of
the LUL involvement is characteristic of non tuberculous
mycobacteria (NTM). Idiopathic bronchiectasis
Question 175: Correct Answer: A
Explanation: - A
Answer- A. Ochsner Sherren Regimen
Ochsner Sherren regimen is the expectant management giving to a
patient with an appendix mass. It is expectant because it is expected
that the symptoms and signs the patient presented with will improve
during the course of the management and the patient may later be
scheduled for elective/interval appendicectomy.
Question 176: Correct Answer: C
Explanation: - C
Answer- C. Colorectal cancer
Colon and rectal tumors Streptococcus bovis (bacteremia)
Question 177: Correct Answer: C
Explanation: - C
Answer- C. Lipoid proteinosis
Lipoid proteinosis also known as hyalinosis cutis et mucosa or
Urbach-Weithe disease is a rare autosomal recessive disorder.
characterized clinically by a myriad signs and symptoms that include
hoarseness of the voice, beaded eyelid papules (Moniliform
blepharosis), yellowish-white mucocutaneous infiltrates, and atrophic
pock-like scars.
Question 178: Correct Answer: D
Explanation: - D
Ans: D. Membranous glomerulonephritis
Most common nephropathy associated with malignancy -
Membranous glomerulonephritis.
In 25-30% - Associated with malignancy (solid tumors of breast,
lung, colon), infection (hepatitis B, malaria, Schistosomiasis), or
rheumatologic disorders like lupus or rarely rheumatoid arthritis.

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Histopathology:
Electron-dense deposits along the epithelial side of the basement
membrane with effacement of foot processes overlying deposits.
(Ref Robbins 9/e p917-918; Harrison 19/e p1843).
Question 179: Correct Answer: D
Explanation: - D
Answer- D. HLA identity similarity seen in 1:100 people
Within any particular family, siblings have a 7:4 chance of being
HLA identical. In contrast among unrelated
people, the probabilities of HLA identity in several thousand
depending upon phenotype involved It is due to the fact that
HLA complex is inherited intact as two haplotypes.
Question 180: Correct Answer: C
Explanation: - C
Answer- C. Osteoblasts
Parathormone activates osteoblasts which then secrete mediators of
osteoclastogenesis that stimulate osteoclasts for bone resorption.
Question 181: Correct Answer: A
Explanation: - A
Ans. is a i.e., 1st Arch
lst (mandibular arch):-
Muscular Contribution:-Muscles of mastication, Anterior belly of
the digastric, Mylohyoid, Tensor tympani, Tensor veli palatini.
Skeletal Contributions:- Maxilla, mandible (only as a model for
mandible ), Incus and malleus, Meckels cartilage, Ant. ligament of
malleus, Sphenomandibular ligament.
Nerve:- Trigeminal nerve (V2 and V3).
Artery:- Maxillary artery, external carotid artery.
Question 182: Correct Answer: B
Explanation: - B
Ans. is bi.e., Renal artery is a branch of common iliac
artery [Re/ BDC &/eVol.2 p. 313-3171
Each kidney is supplied by renal artery (branch of abdominal
aorta) and is drained by renal vein to IVC.
Renal artery:- Right renal artery is longer and passes behind
IVC.
Branches of the renal artery are end arteries.
Question 183: Correct Answer: D
Explanation: - D
Akathisia refers to somatic restlessness which occur in patients treated with first
generation antipsychotics.
Among the options given haloperidol is an old generation antipsychotic which causes a side
effect of akathisia.
Drugs commonly used to treat akathisia are propranolol, benzodiazepines and

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anticholinergics.
Ref: American Psychiatric Association Practice Guidelines for the treatment of Psychiatric
Disorders 2006, page 649
Question 184: Correct Answer: C
Explanation: - C
alpha blockers [Ref- Harrison 17th/e p 1577, 1578] Pulmonary
hypertension
General management
Diuretic therapy may be useful as it relieves pulmonary edema.
Anticoagulant therapy is advocated for all patients.
Specific management
Calcium channel blockers
Patients who have substantial reductions in pulmonary arterial
pressure in response to short acting vasodilators at the time of
cardiac catheterization should he initially treated with calcium
channel blockers.
Endothelin receptor antagonist
Bostenan is a non-selective endothelium receptor antagonist, is an
approved t/t ,for patients who are NYHA .functional classes III and
IV.
Phosphodiesterase-5 inhibitors
Slidenafil is used for patients who are NYHA functional classes II
and
Prostacyclins
Iloprost is a prostacyclin analogue used in PAH patients who are
Question 185: Correct Answer: C
Explanation: - C
Ans. C. Acetazolamide
For the same degree of natriuresis CAse inhibitors causes most
marked kaliuresis compared to other diuretics.
Question 186: Correct Answer: D
Explanation: - D
Ans. isdi.e., Adductor magnus is the largest muscle
Ischial head of adductor magnus is a hamstring muscle (not
adductor).
Ischial head of adductor magnus originates from inferolateral aspect
of Ischial tuberosity (not from adductor tubercle).
Main artery of adductor (medial) compartment of thigh is obturator
artery (not profunda femoris).
Adductor magnus is the largest muscle of the adductor
compartment.
Question 187: Correct Answer: D
Explanation: - D
Answer- D. Autonomic dysfunction

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The clinical manifestations are edema, hemolytic anemia (due to
fragile red cells membrane as a result of lipid peroxidation) and
thrombocytosis. Nerve and muscle membrane damage may occur.
Vitamin E deficiency causes axonal degeneration of the large
myelinated axons and results in posterior column and
spinocerebellar symptoms.
Question 188: Correct Answer: C
Explanation: - C
Answer- C. T2
Question 189: Correct Answer: D
Explanation: - D
Ans. is d i.e., Lipocortin
Cholesterol is an important precursor for the synthesis of :-
1. Steroid hormones:- Progesterone, estrogen„ androgens,
glucocorticoids, mineralocorticoids
2. Vitamin D
3. Bile acids
Question 190: Correct Answer: C
Explanation: - C
Ans. is c i.e., Mass vaccination
Disaster Management includes three aspects:
1. Disaster impact and response:
Search, rescue, and first-aid
• Field care
• Triage
• Tagging
• Identification of the dead
2. Rehabilitation or recovery:
• Water supply
• Basic sanitation and personal hygiene
• Food safety
• Vector control
3. Mitigation: Measures designed either to prevent hazards from
causing disaster or to reduce the effects of the disaster. This
also includes preparedness for any impending disasters or in
disaster-prone areas.
Question 191: Correct Answer: C
Explanation: - C
Ans. is c i.e., Yolk sac tumor
o Most common tumor of testis Seminoma.
o Most common tumor of testis in childhood ---> yolk sac tumor
(endodermal sinus tumor or infantile embryonal carcinoma).
Question 192: Correct Answer: D
Explanation: - D

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Ans. is. d i. e., Droplet infection
Question 193: Correct Answer: D
Explanation: - D
Ans. D. Increased water excretion
After major trauma, secretion of ADH and aldosterone increases.
ADH - Causes increased water reabsorption from collecting duct.
Aldosterone - Causes increase Na+&Cl- reabsorption and increase
K+ secretion/excretion.
Question 194: Correct Answer: B
Explanation: - B
Answer is B (Stuart factor X)
The extrinsic and Intrinsic pathways in coagulation converge at the
Stuart factor X.
Question 195: Correct Answer: B
Explanation: - B
Answer- B. 1
Found in female But -
Kleinefelter syndrome is male with one Barr body.
Turner syndrome is female without Barr body.
Question 196: Correct Answer: C
Explanation: - C
Answer- C. < 180 mg/dl
HbA IC- two
Preprandial capillary plasma glucose- 70-130 mg/d1 <
Peak post prandial capillary plasma glucose -180 mg/d1 <
Blood pressure- 130/80
Question 197: Correct Answer: A
Explanation: - A:C
Ans. A. Act, A13 & C. AS, C
[Rd Ganong 24n/e p. 92 & 23d/e p. 89; Principles of physiology p.
5121]
Fast fibers carrying pain -+ Ad (fast pain)
Slow fibers carrying pain -) C (slow pain)
Question 198: Correct Answer: A
Explanation: - A
Answer- A. Diffuse Endemic Goitre
The lack of the iodine leads to decreased synthesis of thyroid
hormones and a compensatory increase in TSH, which in turn leads
to follicular cell hypertrophy and hyperplasia and goitrous
enlargement - Diffuse hyperplastic goiter.
Mostly patients are euthyroid.
Question 199: Correct Answer: D
Explanation: - D

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Ans. D: Ergometrine
Drugs used for medical method of induction of labour are:
Mifepristone
Oxytocin
Misoprostol (Prostaglandins El)
Ergometrine is contraindicated in pregnancy, 1st stage of labour, 2nd
stage of labour before crowning of the head and in breech delivery
prior to crowning.
Question 200: Correct Answer: C
Explanation: - C
Ans. is
c i.e.,Pyramid [Ref Dhingra S
ave p. 6]
Medial or inner or labyrinthic wall (paries labyrinthica) of middle
ear
It is formed by labyrinth and separates the middle ear cavity from
internal ear. It has following features :- A bulge called as
promontory formed by basal turn of cochlea.
Fenestra vestibuli (oval window) lies posterosuperior (behind and
above) to the promontory and opens into scala vestibuli.
It is occupied by foot plate of stapes fixed by annular ligament.
Its, size on average is 3.25 mm long & 1.75 mm wide.
Fenestra cochleae (round window) lies posteroinferior to the
promontory and opens into scala tympani of cochlea. It is closed by
secondary tympanic membrane. The round window is closest to
ampulla of posterior semicircular canal. Round window is a
triangular opening. Its diameter is between 1.8 to 2.3 mm.

Page 367 of 446

 Subject: NEET PG 2016 - Questions
1. False about osteoarthritis is ?
a) Involves synovial joints
b) Progressive softening of the articular cartilage
c) It is an inflammatory arthritis
d) Marginal osteophytes are produced

2. Rhinolith can cause

a) Nasal obstruction
b) Epistaxis
c) Epiphora
d) All of the above

3. Tisse factor activates?

a) Preaccelerin
b) Hageman facter
c) Labile facter
d) Prothrombin

4. Patient with 45 XO , what HRT to be

given ?
a) Growth hormone + E+P
b) Estrogene
c) No HRT Needed
d) HRT only after 45 years

5. Longest cutaneous nerve in body ?

a) Lateral cutaneous nerve of thigh
b) Medial cutaneous nerve of thigh
c) Saphenous nerve
d) Sural nerve

6. Which of the following antiarrhythmic

drugs can develop Long QT syndrome?
a) Ibutilide
b) Dofetilide
c) Sotalol
d) All the above

Page 368 of 446

7. Infectivity of convalescent carrier of
cholera lasts for?
a) 1-5 days
b) 1-2 weeks
c) 2-3 weeks
d) 4-5 weeks

8. Pulmonary eosinophilia is found in

infection with ?
a) Babesia
b) Malaria
c) Strongyloides
d) Trypanosoma

9. Which of the following is not true about

SCFE?
a) Males are affected more frequently
b) Extension is restricted
c) Commonly occurs during adolescence
d) Varus, adduction and external rotation deformities are present

10. Ocular findings in diabetes are all

except -
a) Retinopathy
b) Early senile cataract
c) Neovascular glaucoma
d) Blepharophimosis

11. Aspergillus fumigatus is differentiated by

other fungi by ?
a) Showing septate hyphae
b) Grow at 45°C
c) Cause respiratory tract infection
d) Most common endemic mycosis

12. Folding defect is associated with which

disease
a) Parkinsons disease
b) Marfan syndrome
c) Acute intermittent porphyria
d) Wermer syndrome

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13. Amino acid metabolism is implicated in
which disease?
a) Maple syrup urine disease
b) Reyes syndrome
c) Von Gierkes disease
d) McArdles disease

14. Nerve supply to the angle of the

mandible is by ?
a) Posterior primary rami of C2, C3
b) Greater auricular nerve
c) Maxillary nerve
d) Mandibular nerve

15. All of the following are converted to

cr-ketoglutarate on catabolism except-
a) Glutamate
b) Histidine
c) Proline
d) Glycine

16. Temazepam is superior to diazepam in ?

a) Longer duration of action
b) Safely used in liver failure
c) No active metabolite required.
d) High hepatic metabolism

17. True about cephalhematoma is :

a) Crosses the suture lines
b) Always present at birth
c) Ventouse delivery is a risk factor
d) All of the above

18. Which of the following is true ?

a) Two live vaccines should not be given together
b) Live and killed vaccine should not be given together
c) Immunoglobolin should not be given for at least 6 weeks when
a live vaccine is administered
d) Live vaccine should not be given for 12 weeks if immunoglobin
has been given

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19. Nutrient agar heated at 80°C used for
a) Spore germination
b) To grow mesophilic bacteria
c) To grow thermophilic bacteria
d) For clostridium isolation

20. A person is declared dead if he/she is

not found for
a) 7 years
b) 10 years
c) 14 years
d) 21 years

21. Empyema necessitans is defined as so

when ?
a) Plural empyema is under pressure
b) Pleural empyema has ruptured into bronchus
c) Pleural empyema has ruptured into the pericardium
d) Pleural empyema is showing extension to the subcutaneous
tissue

22. All are true about thrombotic

thrombocytopenic purpura except?
a) Micro angiopathic hemolytic anemia
b) Thrombocytopenia
c) Normal complement level
d) Grossly abnormal coagulation tests

23. True about rhabdoviridae are all except ?

a) Includes vesculostomatitis virus
b) Rabies virus is inactivated by formalin
c) Rabies virus is negative sense double stranded RNA virus
d) All of the above correct

24. Which of the following interleukin is

secreted by T helper 2 cells?
a) IL 11
b) IL 7
c) IL 1
d) IL 13

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25. Pearl necklace appearance is
characteristic of ?
a) Ectopic pregnancy
b) PCOS
c) Endometriosis
d) PID

26. Which of the following inhalational

anesthetic agent most easily crosses
blood brain barrier?
a) Methoxyflurane
b) Sevoflurane
c) Desflurane
d) Nitrous oxide

27. Pantaloon hernia is also called as -

a) Dual hernia
b) Saddle bag hernia
c) Bochdaleks hernia
d) Retrosternal hernia

28. Definition of childhood is under what

age?
a) 8 years
b) 10 years
c) 12 years
d) 16 years

29. Type 4 hypersensitivity reaction to TB

antigen is similar to which of the
following?
a) Serum sickness
b) Asthma
c) Myasthenia gravis
d) Temporal arteritis

30. With reference to fetal heart rate, a

nonstress test is considered reactive
when?
a) Two fetal heart rate accelerations are noted in 20 minutes
b) One fetal heart rate acceleration is noted in 20 minutes
c) Two fetal heart rate accelerations are noted in 10 minutes

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d) Three fetal heart rate accelerations are noted in 30 minutes

31. Jumpers knee

a) Apophysitis of patellar tendon as it inserts in patella
b) Apophysitis of patellar tendon as it inserts in tibia
c) Apophysitis of quadriceps tendon as it inserts in patella
d) Apophysitis of hamstring tendon as it inserts in tibia

32. Compound used as primer in weapon is

a) Potassium chlorate
b) Sulphur
c) Potassium nitrate
d) Nitrocellulose

33. Live influenza vaccine is given by which

route ?
a) Intradermal
b) Subcutaneous
c) Intramuscular
d) Intra nasal

34. True about NPCDCS is all, EXCEPT:

a) Separate centre for stroke, DM
b) Implementation in some 5 states over 10 district
c) CHC has facilities for diagnosis and treatment of CVD, Diabetes
d) Day care facilities are available at subcentre

35. Elevated CA-125 are seen in -

a) Abdominal TB
b) Ca cervix
c) Endometriosis
d) All

36. All are true about cutaneous anthrax

except ?
a) Extremely painful
b) The whole area is congested and edematous
c) Central crustation with black eschar
d) Satellite nodule around inguinal region

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37. Violent abnormal flinging movements
which are irregular and affecting one
side are called as -
a) Chorea
b) Athetosis
c) Dystonia
d) Hemiballismus

38. Food particles mostly get obstructed in which

part of esophagus -
a) Cricopharyngeal sphincter
b) Crossing of arch of aorta
c) Cardiac end
d) None of the above

39. Complication of Benign Ovarian Cysts

is ?
a) Torsion
b) Intracystic hemorrhage
c) Pseudomyxoma perotonei
d) All of the above

40. True about RCC is?

a) Most common site is lower lobe of kidney
b) Most common variety is papillary type
c) Invasion of renal vein is more common than renal artery
d) Most common site of metastasis is lymph nodes

41. Least failure rate ?

a) CuT
b) MIRENA
c) DMPA
d) O.C. PILLS

42. Nucleus of basal ganglia

a) Dentate
b) Thalamus
c) Caudate
d) Red nucleus

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43. Drug/s used in management relapsed
multiple myeloma is
a) Bortezomib
b) Lenalidomide
c) Doxorubicin
d) All the above

44. Reconstituted measles vaccine should

be used with in -
a) 1 hour
b) 3 hour
c) 6 hour
d) 12 hour

45. All of the following can determine protein

structure except
a) Edmans Sequencing
b) X ray crystallography
c) Optical rotatory dispersion
d) Spectrophotometry

46. Pulp of the index finger is supplied by

a) Median nerve
b) Radial nerve
c) Ulnar nerve
d) Axillary nerve

47. Regarding FISH all are true except ?

a) Used to detect copy number variations
b) Used to detect balanced translocations
c) Requires oligonucleotides
d) Requires DNA polymerase

48. X-linked adrenoleukodystrophy is

a) Fatty acid disorder
b) Lysosomal storage disorder
c) Mucoplysaccharridoses
d) Glycogen defect disorder

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49. Azoospermic patient can be a father of
a child, by which of the following?
a) IUI
b) ZIFT
c) ICSI
d) Not possible & counsel regarding adoption

50. Range of flight of Aedes mosquito is ?

a) 1 km
b) Less than 100 m
c) 400 m
d) 10 kms

51. The number of Anganwadi workers

supervised by a Mukhyasevika is:
a) 10
b) 15
c) 25
d) 30

52. Penile carcinoma is usually?

a) Squamous cell carcinoma
b) Basal cell carcinoma
c) Adenocarcinoma
d) Small cell carcinoma

53. Grade 1 Ca endometrium, there is

presence of % non sqoumaous growth
?
a) <5
b) 6-25
c) 25-50
d) >50

54. Abetalipoproteinemia affects ?

a) Retinal pigment epithelium
b) Optic nerve
c) Occipital cortex
d) Bipolar neurons

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55. Normally squamo-columnar junction is
usually located at
a) Distal 2-3 cms of esophagus
b) Proximal 2-3 cms of stomach
c) In esophagus more than 3cms proximal to GEJ
d) None of the above

56. Preferred vein for central venous

catheter insertion is
a) Right internal jugular vein
b) Left internal jugular vein
c) Right subclavian vein
d) Right antecubital vein

57. True about MHC-class II -

a) Not involved in innate immunity
b) Cytotoxic T-cell involved
c) Present in nucleated cells
d) All

58. Normal epidermal turnover time is?

a) 1 week
b) 2 weeks
c) 3 weeks
d) 4 weeks

59. In positively skewed deviation ?

a) Mean = Median = Mode
b) Mean > Medians > Mode
c) Mode > Median > Mean
d) None of the above

60. Treatment of large omphalocele defect

can be done by
a) Primary closure
b) Staged closure using PTFE mesh
c) Painting intact sac daily with antiseptic solution
d) All the above

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61. Pars dorsalis is a part of ?
a) Cerebrum
b) Cerebellum
c) Pons
d) Thalamus

62. Features of marasmus are all except :

a) Absence of anasarca
b) Increased appetite
c) Excessive catabolism of adipose tissue and muscle protein
d) Uncompensated phase of PEM

63. Powder burnt lesion seen in ?

a) PID
b) PCOS
c) Endometriosis
d) All of the above

64. All of the following organs are in direct

contact with the spleen except?
a) Duodenum
b) Stomach
c) Left kidney
d) Colon

65. The most commonly used

myocutaneous pedicle graft for pelvis
surgeries contains muscle segments
from -
a) Rectus abdominis muscle
b) External oblique muscle
c) Internal oblique muscle
d) Transversus abdominis muscle

66. Attachment on posterior surface of

sacrum?
a) Multifidus Lumborum
b) Iliacus
c) Coccygeus
d) Piriformis

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67. Pontiac fever is caused by:
a) Legionella
b) Listeria
c) Scrub typhus
d) Leptospira
e) Rickettsia

68. What is the main hazard of ectopic

testis -
a) Impotence
b) Carcinoma development
c) Liable to injury
d) Hernia development

69. Leptotene and pachytene are stages

ofwhich phases of meiosis -
a) Prophase I
b) Metaphase I
c) Anaphase II
d) Telophase II

70. Enophthalmos is seen in ?

a) Blow out fracture of orbit wall
b) Hyperthyroidism
c) Radiation Injuries
d) Diabetes mellitus

71. Cardiotmdcity is the side effect of :?

a) Bleomycin
b) Topotecan
c) Rubidomycin
d) Procarbazine

72. Woman has 100 ml blood loss every 30

days. This is called as ?
a) Menorrhagia
b) Polymenorrhea
c) Hypomenorrhea
d) Normal menses

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73. Seat belt injury is
a) Tear drop fracture
b) Wedge fracture
c) Chance fracture
d) Whiplash injury

74. SI unit of radioactivity is:

March 2013 (c, f)
a) Rem
b) Rad
c) Becuerel
d) Curie
e) None

75. Volcano sign is seen in?

a) Leprosy
b) Leishmaniasis
c) Lupus vulgaris
d) DLE

76. Non - ionizing radiation among the

following is -
a) MRI
b) CT Scan
c) X-ray
d) Position emission scintigraphy

77. Most common cancer found in coal mine

workers
a) Anal canal
b) Testicular
c) Lung
d) Liver

78. If chronological age > skeletal age with

normal growth velocity, then the final
height that is expected to be achieved
is
a) Normal
b) Less because of small bones
c) More than expected
d) Less because of epiphyseal closure due to accelerated growth

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velocity

79. Which of the following is not seen after

nerve transection?
a) Morphologic pattern of wallerian degeneration
b) Myelin ovoids
c) Painful neuroma
d) Neuroma in continuity

80. Mid year population is estimated on ?

a) 1st March
b) 1st July
c) 1st April
d) 15th August

81. The most common reentrant

tachycardia associated with WPW
syndrome is
a) Orthodromic AV reentry
b) Antidromic AV reentry
c) Rapidly conducting AF
d) None

82. Cauliflower ear seen in:

a) Hematoma of the auricle
b) Carcinoma of the auricle
c) Fungal infection of the auricle
d) Congenital deformity

83. LNG content of Mirena is -

a) 20 gms
b) 20 mg
c) 52 gms
d) 52 mgs

84. Which of the following is the

respiratory centre of cell?
a) Mitochondria
b) Microsome
c) Lysosome
d) Nucleus

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85. 2. 3. 114. Chorda tympani is a branch of ?
a) Facial nerve
b) Trigeminal nerve
c) Greater auricular nerve
d) External laryngeal nerve

86. Which of the following is NOT a side

effect of amiodarone?
a) Pulmonary fibrosis
b) Corneal microdeposits
c) Photosensitivity
d) Tachycardia

87. Which of the following is teratogenic:

a) Folate
b) Cyanocobalamin
c) Vitamin A
d) Vitamin C

88. True about cohort study

a) Descriptive study
b) Incidence study
c) Proceeds from effect to cause
d) All are correct

89. Contraindication of bag and mask

ventilation are all of the following
except:
March 2009
a) Tracheo-esophageal fistula
b) Hiatus hernia
c) Pregnancy
d) Empty stomach

90. Chromosome for ABO gene is?

a) 9q
b) 10p
c) 11 q
d) 12p

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91. Hormone which affects IC* ion
concentration?
a) GH
b) Thyroxine
c) Insulin
d) Estrogen

92. Why adenosine has a short half life?

a) Spontaneous hydrolysis
b) Uptake in subcutaneous tissue
c) Uptake in RBC and endothelial cells
d) Renal excretion

93. Which muscle causes opening of the

upper end of esophagus?
a) Epiglottis
b) Thyropharungeus
c) Stylopharyngeus
d) Cricopharyngeus of inferior constrictor

94. Which of the following is derived from

the neural tube except?
a) Retina
b) Brain
c) Dorsal root ganglia
d) Pineal gland

95. Tibolone is a ?
a) Natural steroidal estrogen
b) Natural non-steroidal estrogen
c) Synthetic steroidal estrogen
d) Synthetic non-steroidal estrogen

96. Pure motor palsy seen in poisoning of

a) Lead poisoning
b) Arsenic poisoning
c) Cocaine poisoning
d) Cannabis poisoning

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97. Adverse effect of methysergide is ?
a) Metabolic syndrome
b) Endocardial fibrosis
c) Peyronies syndrome
d) Dry mouth

98. Nasally acting GnRH analogue is ?

a) Goserelin
b) Triptorelin
c) Nafarelin
d) Leuprolide

99. Generation time for M tuberculosis

a) 10-15 min
b) 10-15 hours
c) 10-15 days
d) 5-10 days

100. Thoracic duct opens into systemic

circulation at?
a) junction of SVC and left brachiocephalic vein
b) Junction of left internal jugular and left subclavian vein
c) Directly into coronary sinus
d) Into azygous vein

101. Maximum fat absorption in GI tract

occurs in?
a) Duodenum
b) Jejunum
c) Ileum
d) Calcium

102. Which of the following is not true for

scabies?
a) Wrist is common site in children
b) Burrows are intradermal lesions
c) Papules and pustules are due to hypersensitivity to mite
d) Itching generalized

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103. Dunlop traction is a type of traction
used in management of
a) Fracture humerus
b) Fracture radius
c) Fracture femur
d) Fracture Tibia

104. Which is a typical intercostal nerve?

a) First
b) Second
c) Third
d) Seventh

105. Increased Q angle predisposes to

a) Medial patellar subluxation
b) Lateral patellar subluxation
c) Superior patellar subluxation
d) Inferior patellar subluxation

106. cAMP activates?

a) Protein kinase A
b) Protein kinase C
c) Nuclear transcription
d) Phospholipare

107. Vitamin B12 deficiency causes all except

?
a) Homocysteinuria
b) Methylmalonic aciduria
c) Subacute combined degeneration
d) Epinephrine excess

108. HSV-2 causes latent infection in which

nerve plexus/ ganglia ?
a) Trigeminal ganglion
b) Otic ganglion
c) Sacral ganglion
d) Ciliary ganglion

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109. Investigation of choice for hepatic
metastasis form stomach cancer is
a) MRI
b) CECT
c) USG
d) HIDA

110. Generalized anxiety disorder is

diagnosed when anxiety and worry
continues for at least?
a) 2 months
b) 4 months
c) 6 months
d) 8 months

111. What is the age of a child who can

identify 4 colours and draw a triangle?
a) 21/2 years
b) 3 years
c) 4 years
d) 5 years

112. The globe is displaced to which side in

lacrimal gland tumour?
a) Inferotemporal
b) Inferonasal
c) Superotemoral
d) Nasal

113. The source of endogenous radiation is

a) Radon
b) Potassium
c) Thorium
d) Uranium

114. In cardiac muscles, T-tubules are present

at?
a) Z lines
b) A lines
c) I lines
d) A-I junction

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115. Post operative complications of cataract
are all except?
a) After cataract
b) Endophthalmitis
c) Glaucoma
d) Scleritis

116. Progesterone synthesis requires -

a) LDL
b) VLDL
c) HDL
d) Chylomicron

117. Psoriatic arthritis most commonly

involves which joint -
a) Distal interphalangeal joint
b) Proximal interphalangeal joint
c) Wrist joint
d) Metacarpophalangeal joint

118. In a case of Dysgerminoma of ovary one

of the following tumor markers is likely
to be raised :
a) Serum HCG
b) Serum alphafetoprotein
c) Serum lactic dehydrogenase
d) Serum inhibin

119. Which disease is diagnosed by jejunal

biopsy?
a) Celiac disease
b) Intestinal lymphoma
c) Argentaffinoma of intestine
d) Tropical sprue

120. Characteristic site for development of

venous leg ulcers is
a) Skin of gaiter region
b) Behind lateral malleolus
c) Shin of tibia
d) Medial aspect of knee

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121. Adherence of E. histolytica to colonic
mucosa is mediated by ?
a) Fibronectin
b) Lectin
c) Collagen
d) Fucose

122. LAHSAL code is used to represent

congenital malformation of -
a) Lip
b) Alveolus
c) Hard and soft palate
d) All the above

123. Fetal karyotyping can be done by all,

EXCEPT?
a) Cordocentesis
b) Amniocentesis
c) CVS
d) Fetal skin biopsy

124. Which of the following causes retinal

pigmentation?
a) Quinine
b) Chloroquine
c) Mefloquine
d) Atovaquone

125. First incisor to erupt is

a) Lower central
b) Upper central
c) Lower lateral
d) Upper lateral

126. Earliest age for doing BERA is?

a) In utero - before birth
b) At birth
c) 3 months
d) 6 months

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127. Which of the following epidermal layer
is dead layer?
a) Stratum basale
b) Stratum spinosum
c) Stratum corneum
d) Stratum granulosum

128. Which of the following is the test done to

confirm live born fetus after fetal death?
a) Mirror test
b) Breslaus test
c) Magnus test
d) Paraffin test

129. Multiple episodes of acute chest

syndrome are associated with
a) Asthma
b) Bronchieactasis
c) SLE
d) Sjogrens syndrome

130. Li-fraumani syndrome occurs due to

mutation in gene?
a) p53
b) p16
c) p41
d) p12

131. HALE is used to measure

a) Disability adjusted life expectancy
b) Healthy life expectancy
c) Quality adjusted life expectancy
d) Expectancy free of disability

132. Grasp reflex develops by -

a) 20 weeks
b) 24 weeks
c) 28 weeks
d) 32 weeks

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133. Specificity of antibody is dependent on ?
a) Fc portion
b) Fab region
c) Carboxy terminal
d) All of the above

134. Acculturation is?

a) Traige
b) Cultural changes due to socialisation
c) Attitude
d) Belief

135. Characteristic of histrionic personality

disorder is?
a) Violation of rules of society
b) Attention - seeking behavior
c) Unstable interpersonal relationship
d) Grandiose behavior

136. Fordyce spots involve?

a) Penis
b) Tongue
c) Fingers
d) Nails

137. Cardinal element of behavior therapy

is?
a) Modeling
b) Learning
c) Conditioning
d) Guidance

138. Mifepristone acts on which receptor?

a) Type A progesterone receptor
b) Estrogen receptor
c) LH receptor
d) Thyroid receptor

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139. Popliteal artery injury is commonly
seen in which type of traumatic knee
dislocation?
a) Anterior
b) Posterior
c) Medial
d) Lateral

140. UDP glucose is not used in ?

a) Uronic acid pathway
b) Glycogen synthesis
c) Galactose metabolism
d) HMP shunt

141. Acute salpingitis is most commonly

caused by ?
a) N. gonorrhoeae
b) Chlamydia trachomatis
c) Mycoplasma
d) Staphylococcus

142. DOC for medical management of

ectopic pegnancy ?
a) Actinomycin D
b) Intramuscular Methotrexate
c) Intramuscular Methotrexate
d) PGf2 alpha

143. Stalactite growth in ghee broth is due to

the following organism?
a) Y.pestis
b) T.palladium
c) H.influenzae
d) C.diphtheriae

144. Which cranial nerve is involved in

Weber syndrome?
a) II
b) III
c) IV
d) V

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145. Intermediate host is not required for
which parasite -
a) Toxoplasma
b) Schistosoma
c) Ancylostoma
d) Fish tapeworm

146. Blow out fracture of orbit leads to

fracture in
a) Floor
b) Posterior Medial wall
c) Lateral wall
d) Roof of the orbit

147. Following road traffic accident patient suffers

polytrauma and is evaluated in the
emergency section of the hospital. His pulse
rate is 116, respiratory rate is 24, blood
pressure of 122/78 mm of Hg and patient is
mildly anxious. What is the approximate
blood loss patient has following trauma?
a) <750 ml
b) 750 - 1500 ml
c) 1500 - 2000 ml
d) >2000 ml

148. The features of crohns disease are all

except ?
a) Lymphoid hyperplasia
b) Skin lesion
c) Transmural involvement
d) Crypt Abscess

149. Ricochet bullet is

a) Bullet producing a key hole entry wound
b) Bullet with nose tip chiseled off
c) Deviation in the direction or path of bullet
d) Bullet containing igniting material

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150. Acute myocarditis schintigraphy is
done with -
a) Thallium
b) Technetium
c) Gallium
d) None

151. What is Tiffeneau - Pinelli index?

a) FEV1/FVC ratio
b) Body mass index
c) Quetlet index
d) Ventilation/Perfusion ratio

152. Which of the following is true about the

management of venous ulcer of lower
limb?
a) Initial treatment is debridement and surgery
b) Compression dressings should ideally be applied on twice
weekly basis
c) Antibiotics do not speed up the ulcer healing
d) Biological dressings do not have potential to improve healing

153. Resorcinol is used in the treatment of?

a) Lichen planus
b) Acne
c) Vitiligo
d) Scabies

154. Activators of Acetyl CoA carboxylase

are all except
a) Acyl coA
b) Citrate
c) Glutamate
d) Dicarboxylic acid

155. What is a Rhinolith:

a) Foreign body in nose
b) Stone in nose
c) Deposition of calcium around foreign body in nose
d) Misnomer

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156. Inhibition of Na* ATPase leads to?
a) Decreased Na* in the cell
b) Increased Ca in the cell
c) Increased K* in the cell
d) Increased Cl- in the cell

157. For lower lip carcinoma of <1cm in size.

The treatment of choice will be-
a) Radiation
b) Chemotherapy
c) Excision
d) Radiation and chemotherapy

158. To create anaerobiosis which organism

is used
a) Micrococcus
b) Clostridium
c) B. anthracis
d) Corynebacterium

159. Styloid process is derived from ?

a) 1st arch
b) 2nd arch
c) 3rd arch
d) 4th arch

160. If the anal spincter is injured, it is which

degree of Perineal Tear ?
a) First
b) Second
c) Third
d) Fourth

161. Total colonic aganglionosis is a variant

of?
a) Crohns disease
b) Ulcerative colitis
c) Hirschsprungs disease
d) Tropical sprue

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162. Chronic bronchitis is said to be present
when patient has chronic cough
a) 3 consecutive months in at least two consecutive years
b) 2 consecutive months for 3 consecutive years
c) 3 consecutive months in one year
d) 1 month in a year for 2 consecutive years

163. Which of the following defines vital

capacity?
a) Air in lung after normal expiration
b) Maximum air that can be expirated after normal inspiration
c) Maximum air that can be expirated after maximum inspiration
d) Maximum air in lung after end of maximal inspiration

164. Sluders neuralgia is also called as

a) Anterior ethmoidal syndrome
b) Posterior ethmoidal syndrome
c) Trotter syndrome
d) Lermoyez syndrome

165. Carbamoyl phosphate synthetase I is:

a) Lysosolic enzyme
b) Cytosolic enzyme
c) Mitochondrial enzyme
d) All of the above

166. True about serous otitis media are all

except ?
a) Also called glue ear
b) Affect school going children
c) Type C tympanogram
d) Fluid in middle ear

167. What is maximum voluntary ventilation?

a) Amount of air expired in one munute at rest
b) Maximum amount of air that can be inspired and expired in one
minute
c) Maximum amount of air that can be inspired per breath
d) Maximum amount of air remaining in lung after forced expiration

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168. Total volume of CSF is?
a) 150 ml
b) 500 ml
c) 50 ml
d) 800 ml

169. Erection of penis occurs in which phase

of sexual cycle?
a) Excitement phase
b) Plateu phase
c) Orgasmic phase
d) Resolution

170. Pityriasis rosea clears with in?

a) 1-2 weeks
b) 2-4 weeks
c) 4-8 weeks
d) 6-12 weeks

171. Staging of rectal carcinoma is best

done by -
a) CT Scan
b) MRI
c) TRUS
d) All the above

172. Which of the following is the most

common anamoly in patients with
fanconis anemia?
a) Hyperpigmentation of the trunk, neck and intertriginous areas
b) Absent radii and thumb
c) Weak radial pulse
d) Presence of horse shoe kidneys

173. Kernahens striped Y classification,

Main reference point is -
a) Incisive foramen
b) Soft palate
c) Hard palate
d) Third molar

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174. Half life of tritium is -
a) 10.2 years
b) 12.3 years
c) 15.5 years
d) 20.7 years

175. Which of the following passes posterior to

the hilum of the lung?
a) Vagus
b) Phrenic nerve
c) SVC
d) Right atrium

176. Test used to detect genetic abnormality

in embryo,before transferring it to the
uterus in IVF is ?
a) Embryo cell biopsy
b) CVS
c) ICSI
d) All of the above

177. Breast surgery is considered under

what category of cardiac risk?
a) > 10 %
b) 5 - 10 %
c) 1 - 5 %
d) <1%

178. Conjunctival staining is done by all

except
a) Fluoroscein
b) India ink
c) Rose Bengal
d) Lissamine

179. Increase in the thickness of the prickle

cell layer of the epidermis is called?
a) Spongiosis
b) Acanthosis
c) Hypergranulosis
d) Hyperkeratosis

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180. Cubitus valgus develops as
complication of -
a) Jupitor fracture
b) Smiths fracture
c) Malgaigne fracture
d) Staddle fracture

181. Which of the following is the most

metabolically active part of long bone?
a) Epiphysis
b) Metaphysis
c) Diaphysis
d) Physis

182. Carcinoma associated most commonly

with upper one third of esophagus is
a) Adenocarcinoma
b) Squamous cell Carcinoma
c) Adeno-squamous Carcinoma
d) Leiomyosarcoma

183. Auerbachs plexus is present in the -

a) Colon
b) Esophagus
c) Stomach
d) All of the above

184. Placental hormone with highest

carbohydrate content is -
a) HCG
b) Human pregnancy specific beta glycoprotein
c) HPL
d) Relaxin

185. Immune thrombocytopenic puprpura

associated with
a) Hepatitis A infection
b) Hepatitis B infection
c) Hepatitis C infection
d) Hepatitis D infection

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186. How are chest compressions given in a
newborn?
a) Using palm on the lower third of sternum
b) Using two fingers on the middle third of sternum
c) Using the two thumbs on the lower third of sternum
d) Using three fingers on the lower third of sternum

187. Topical antifungal of choice for

aspergillus infection of eye is ?
a) Miconazole
b) Clotrimazole
c) Econazole
d) Fluconazole

188. Swimming pool conjunctivitis is caused

by
a) Chlamydia trachomatis
b) Adenovirus type 8
c) Adenovirus type 8
d) Gonococcus

189. Hypopigmented macules are found in?

a) Addisons disease
b) Porphyria
c) Cutaneous mastocytosis
d) Tuberous sclerosis

190. Which of the following pairs is correct?

a) Glibenclamide - Na ATP blocker
b) Biguanides - AMP Kinase activation
c) Vildagliptin - SGLT2 inhibitor
d) Voglibose - DPP4 inhibitor

191. Crossed eye fixation is positive in -

a) Esotropia
b) Exotropia
c) Hypertropia
d) Hypotropia

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192. The most common toxin causing
Dilated Cardiomyopathy is:
a) Alcohol
b) Chemotherapeutic agents
c) Heavy metal
d) Occupational exposure

193. Similarity between chlamydia and virus

is
a) Filterable through filter
b) Ability to grow in cell free media
c) Contains both DNA and RNA
d) All of the above

194. Early and late suspected instrumental

perforation of oesophagus should first
be assessed using
a) Water soluble contrast swallow
b) CT Scan
c) Dilute barium swallon
d) MRI

195. Size of LMA for a 15kg child is?

a) 1
b) 2
c) 3
d) 4

196. All of the following are true about

lactate utilisation in liver except -
a) Total net number of ATP formed because of coris cycle is
6
b) Coris cycle shifts the metabolic burden from muscle to liver
c) Coris cycle can not be sustained indefinitely because it is
energetically unfavourable
d) Coris cycle is linked to glycogen synthesis in muscle

197. True about aquaporins are all except ?

a) Protein
b) Aquaporin-1 in PCT
c) Aquaporin-2 in loop of Henle
d) Aquaporin-2 in CD

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198. Treatment of chronic phase of CML in
pregnant women is -
a) Imatinib
b) Leukapheresis
c) Spleenectomy
d) Interferon therapy

199. Trinucleotide sequence associated with

spino-cerebellar ataxia is?
a) CTG
b) CUG
c) GGG
d) CAG

200. All of the following are causes of acute

hyponatremia except
a) Glycine irrigation in TURP
b) Recent institution of thiazide therapy
c) MDMA ingestion
d) Liquorice ingestion

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 Subject: NEET PG 2016 - Answer Key

Question 1: Correct Answer: C

Explanation: - C
Ans. is c i.e., It is an inflammatory arthritis
Osteoarthritis (OA) is a chronic disorder of synovial joints in which
there is progressive softening and disintegration of articular cartilage
accompanied by new growth of cartilage and bone at the joint
margins (osteophytes), cyst formation and sclerosis in the
subchondral bone, mild synovitis and capsular fibrosis.
The term osteoarthritis is a misnomer as it is a non-inflammatory
condition.
The right term is osteoarthrosis or degenerative joint disorder
because it is a degenerative wear - and - tear process occuring in
joints.
Question 2: Correct Answer: D
Explanation: - D
A rhinolith is a calculus present in the nasal cavity.
The word is derived from the roots rhino- and -lith, literally meaning
"nose stone".
A rhinolith usually forms around the nucleus of a small exogenous
foreign body, blood clot or secretion by slow deposition of calcium
and magnesium salts.
Over a period of time, they grow into large irregular masses that fill
the nasal cavity.
They may cause pressure necrosis of the nasal septum or
lateral wall of nose leading to nasal obstruction, epistaxis,
headache, sinusitis and epiphora.
Question 3: Correct Answer: A
Explanation: - A
Ans. A. Preaccelerin
[Ref Ganong 23rd le p.531-535]
Preaccelerin (factor VII) is activated to factor Vila by tissue factor.
Tissue factor is the cofactor for both factor VII and Vila.
Question 4: Correct Answer: A
Explanation: - A
Ans. A. Growth hormone + E+P
Growth hormone (GH) therapy has become the standard of care for
girls with turner syndrome and should be considered as soon as
decreased linear growth velocity is apparent.
Initial hormone replacement involves low dose
estrogenmonotherapy.
Progestagenreplacement is generally added 1-2 yearsafter starting
estrogen or upon breakthrough bleeding.

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Question 5: Correct Answer: C
Explanation: - C
Ans, C. Saphenous nerve
The saphenous branch of the femoral nerve (saphenous nerve) is
the longest cutaneous nerve. It runs with the great saphenous vein
in front of medial malleolus and supplies the skin of anteromedial
aspect of the leg and medial border of the foot. The saphenous
nerve may be damaged in front of the medial malleolus during
venesection of the long saphenous vein.
Therefore, femoral nerve damage can cause sensory loss over the
area of the great saphenous vein in the leg.
Question 6: Correct Answer: D
Explanation: - D
Ans. D. All the above
Proarrhythmic Manifestations of Most Frequently Used
Antiarrhythmic Agents:
Amiodarrone
Digoxin
Disopyramide
Dofetilide
Dronedarone
Flecainides
Propafenone
Quinidine
Sotalol
Question 7: Correct Answer: C
Explanation: - C
Ans. is c i.e., 2-3 weeks
There are following types of carrier in cholera :
Incubatory : Shed vibrios only in the brief incubation period of 1-5
days.
Convalescent : Shed vibrios for 2-3 weeks.
Healthy or contact carrier : Has had subclinical infection and shed
vibrios for less than 10 days.
Chronic carriers : Can shed vibrios for months or years and may
have persistent infection in gall bladder
Question 8: Correct Answer: C
Explanation: - C
Ans. is c i.e., Strongyloides [Ref Harrison 18th/e p. 2120 & 17th/e
p. 1610]
Ascaris
Strongyloides stercoralis
Ancylostoma (hook worm)
Wuchereria bancrofti or W. malayi
Toxocara

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Question 9: Correct Answer: B
Explanation: - B
Answer- B. Extension is restricted
SCFE is the separation of proximal femoral capital epiphysis (head)
at growth plate.
SCFE occurs due to weakness of growth plate and occurs during
adolescent period (11-15 years) when the growth plate is weak due
to accelerated growth.
Males are affected more frequently than females.
Movements are restricted particularly abduction and internal rotation.
Flexion is also restricted and extension is increased. And this clinical
feature differentiates SCFE with all other hip pathologies because
most of the hip pathologies have opposite deformity, i.e. flexion
deformity with restricted extension.
Varus, adduction and external rotation deformities are present.
External rotation is increased along with extension.
When hip is flexed it goes into external rotation, i.e. obligatory
external rotation. It is a very important sign of SCFE.
Waddling gait is present.
Trendelenburgs test is positive.
Question 10: Correct Answer: D
Explanation: - D
Ans. is d i.e., Blepharophimosis [Ref Kanskis 8`Ve chapter 13,
p. 520]
Question 11: Correct Answer: B
Explanation: - B
Ans. is b i.e., Grow at 45°C [Ref Harrison 19thie p. 1346;
Ananthanarayan 8th/e p. 613]
Aspergillus is a mould with septate branching hyphae.
Ability of A. fumigatus to grow at 45° C helps to distinguish it from
other species.
Mode of transmission - Inhalation of Aspergillus spores (Conidia)
into lungs.
The commonest human disease caused by aspergillus is
otomycosis.
Aspergillus infection in neutropenic patient is characterized by
hyphal invasion of blood vessels, thrombosis, necrosis and
hemorrhagic infarction
Question 12: Correct Answer: A
Explanation: - A
Answer- A. Parkinsons disease
Defective protein folding disorders (DPFDs) are a group of diverse
neurological and systemic diseases in which the hallmark
pathological event is the misfolding, aggregation and accumulation
of a protein in different organs, inducing cellular apoptosis, tissue

Page 404 of 446

damage and organ dysfunction .
Includes Alzheimers disease, transmissible spongiform
encephalopathies, serpin-deficiency disorders, sickle cell anemia,
Huntingtons disease, diabetes type II, amyotrophic lateral sclerosis,
Parkinsons disease, dialysis-related amyloidosis, spinocerebellar
ataxias, secondary or reactive amyloidosis, cystic fibrosis and prion
diseases.
Question 13: Correct Answer: A
Explanation: - A
Answer- A. Maple syrup urine disease
It is due to deficiency of enzyme that catalyzes the second reaction
in these amino acids metabolism i.e. branched chain-a keto acid
dehydrogenase which catalyses decarboxylation of branched chain
amino acids.
Question 14: Correct Answer: B
Explanation: - B
Ans. is b i.e., Greater auricular nerve
The skin over the angle of the jaw (mandible) is supplied by the
anterior division of the greater auricular nerve.
Question 15: Correct Answer: D
Explanation: - D
Ans. is d i.e., Glycine [Ref Harper 30th/e p. 162, 250/e p. 166,
167]
Question 16: Correct Answer: B
Explanation: - B:C
Ans. B. Safely used in liver failure & C. No active metabolite
required.
[Ref KDT 7/e p. 405]
Temazepam
Intermediate acting benzodiazepine.
Its metabolism is independent of liver and hence, can be safely
given in patients with hepatic failure.
Temazepam does not have an active metabolite like diazepam
[Note: Diazepam is converted to an active metabolite `desmethyl
diazepam (oxazepam)].
Question 17: Correct Answer: C
Explanation: - C
Ans. C. Ventouse delivery is a risk factor
The usual causes of a cephalohematoma are a prolonged second
stage of labor or instrumental delivery,particularly ventouse.
Question 18: Correct Answer: D
Explanation: - D
Ans. is d i.e., Live vaccine should not be given for 12 weeks if
immunoglobin has been given.

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Two live vaccines can be given simultaneously, but they should be
given at different sites. Otherwise they should be given at an interval
of at least 3 weeks (if administered at same site).
Live and killed vaccine can be given together.
Live vaccines should not normally be given for 12 weeks after an
injection of normal human Ig and if a live vaccine has already been
given, Human Ig injection should be deferred for 2 weeks.
Question 19: Correct Answer: A
Explanation: - A:D
Ans. is a > d i.e., Spore germination > For clostridium
isolation
Heating for 20 minutes at 80 degrees centigrade destroys vegetative
cells and activates the spores for germination.
This method can be used to cultivate anaerobic spore-forming
organisms (e.g. clostridium)
About options a & c
Microorganisms can be grouped into broad (but not very precise)
categories, according to their temperature ranges for growth.
Psychrophiles (cold-loving) can grow at 0°C, and some even as low
as -10°C; their upper limit is often about 25°C.
Mesophlles grow in the moderate temperature range, from about
20°C (or lower) to 45°C.
Thermophiles are heat-loving, with an optimum growth temperature
of 50° or more, a maximum of up to 70°C or more, and a minimum of
about 20°C.
Hyperthermophiles have an optimum above 75°C and thus can grow
at the highest temperatures tolerated by any organism. An extreme
example is the genus Pyrodictium, found on geothermally heated
areas of the sea bed. It has a temperature minimum of 82°, an
optimum of 105° and a growth maximum of 110°C.
Question 20: Correct Answer: A
Explanation: - A
Ans. is
a i.e.,7 years [Ref Civil Law, Section 108 MA]
The Indian Evidence Act, under section 108 provides 7 years from
the date whence a person is declared to be missing and his
Question 21: Correct Answer: D
Explanation: - D
Ans. is d i.e., Pleural empyema is showing extension to the
subcutaneous tissue
Question 22: Correct Answer: D
Explanation: - D
Ans: D. Grossly abnormal coagulation test [Ref: Robbins 7m/e
p. 1010]

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* Thrombotic thrombocytopenic purpura (TTP) is characterized by
the presence of widespread thrombosisthroughout the
microcirculation.
* The unique characteristic of these thrombi is that they are primarily
composed of plateletso with very little.
fibrin in it.
* The consumption of platelet leads to thrombocytopenia and the
presence of intravascular thrombi causes microangiopathic
hemolytic anemiaQ and widespread organ dysfunction.
* You must have noticed that TTP and DIC share so many similar
features such as 4icrovascular occulsion and microangiopathic
hemolytic anemia,
But they are pathologically distinct. In TTP
* Activation of coagulation cascade is not of primary importance. The
thrombi present are essentially platelet thrombi, hence results of
laboratory tests of coagulation such as PT and PTT are usually
normal.
In D.I.C.
* The main defect is activation of coagulation system there fore PT
Question 23: Correct Answer: C
Explanation: - C
Ans. is c i.e., Rabies virus is negative sense double stranded
RNA virus
Rhabdoviridae contains two genera :?
1. Vesiculoviruses : Vesculostomatitis virus, chandipura virus.
2. Lyssavirus : Rabies virus.
Rabies virus
It is an eneveloped, RNA (negative sense ss RNA) virus.
It has RNA dependent RNA polymerase.
It is a bullet shaped virus.
Rabies virus is sensitive to ethanol, iodine preparations, soap,
quaternary ammonium compound, detergents and lipid solvents (like
ether, chloroform). It is inactivated by phenol, beta-propiolactone
(BPL), formalin, Sun light, UV irradiation, and by heat.
Rabies is primarily a zoonotic disease of warm-blooded animals,
particularly carnivorous such as dogs, Cats, Jackals and wolves.
It is transmitted to man usually by bites or licks of rabid animals.
It is the communicable disease which is always fatal.
It is dead end infection in man.
Question 24: Correct Answer: D
Explanation: - D
Ans. is d i.e., IL 13
A) T helper - 1 (TF,) secretes 4 IL-2 and interferon - y
B) T helper - 2 (T0
2) secretes -> IL-4, IL-5, IL-6, IL-13

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Question 25: Correct Answer: B
Explanation: - B
Ans. B. PCOS
USG features of polycystic ovarian syndrome (PCOS)
Greater than 12 follicles measuring between 2 mm and 9 mm in
diameter located peripherally, resulting in a pearl necklace
appearance.
Increased echogenicity of ovarianstroma and /or ovarian volume
greater than 10 ml.
Question 26: Correct Answer: A
Explanation: - A
Ans. A. Methoxyflurane
[Ref Ajay Yadav 4th/e p. 63]
Oil : gas partition coefficient measures the lipid solubility of the agent
and therefore solubility in the fat-rich tissues of the CNS (ability to
cross BBB).
Methoxyflurane has maximum oil : Gas partition coefficient —> Most
lipid soluble & most easily crosses BBB.
1120 has minimum oil : Gas partition coefficient -p Least lipid soluble
& therefore likely to cross BBB.
Question 27: Correct Answer: B
Explanation: - B
Answer- B. Saddle bag hernia
It is also called dual or saddle bag hernia.
This type of hernia consists of two sacs that straddle the inferior
epigastric artery, one sac being medial and the other lateral to this
vessel.
Question 28: Correct Answer: C
Explanation: - C
12 years REF: Nelson Textbook of Paediatrics 17th edition different
pages
Infancy 0-1 yr
Toddlerhood 1-3 yr
Early childhood (toddlerhood and some
time afterwards) 1-4 yr
Middle Childhood (School Age) 6-12 yr
Preschool 2-5 yr
Adolescence (onset of puberty to
maturity) 12-20 yr
Adulthood (full physical and intellectual
maturity)
20-21 yr
onwards
Question 29: Correct Answer: D

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Explanation: - D
Answer- D. Temporal arteritis
Type IV (T-Cell mediated)
Tuberculin test
Lepromin test
Sarcoidosis
Tuberculosis
Contact dermatitis
Granulomatous inflammation
Type I lepra reaction
Patch test
Temporal arteritis
Jones mote reaction (cutaneous basophilic HSN)
Graft rejection
Fairleys test
Fries test
Question 30: Correct Answer: A
Explanation: - A
Ans. A. Two fetal heart rate accelerations are noted in 20
minutes
Reactive (Reassuring) NST
Two or more accelerations of > 15 beats/minute above the baseline,
lasting for > 75 seconds arc present in 20-4O minutes observation
period.
Question 31: Correct Answer: A
Explanation: - A
Answer- A. Apophysitis of patellar tendon as it inserts in patella
It is also called Patellar tendinitis
This is an apophysitis (inflammation) of the patellar tendon as it
inserts into the patella.
It is associated with pain, swelling and crepitus.
Question 32: Correct Answer: A
Explanation: - A
Ans. is a i.e., Potassium chlorate [Ref Parikh 6th/e p.
4.29] Cartridge (round)
Cartridge is the ammunition used in firearms. Cartridge consists of
(i) Cartridge case, (ii) Propellant (gun powder), (iii) Projectile
(missile) and (iv) Wads (only in shot guns.).
1) Cartridge case
It is the outer shell or covering of the cartridge. In shotgun it is
cylinderical. Base is of brass and rest of it is of cardboard or plastic.
In rifled weapons, it is tapering and whole of it is made of brass or
steel.
Center of base has percussion cap (detonator cap) which has
sensitive composition, i.e. primer, consisting of potassium chlorate,

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antimony sulphide, mercury fulminate, barium nitrite, lead peroxide
or tetrazene.
In all weapons, after firing, the cartridge case remains in the barrel
and it is to be taken out manually (shotgun, revolvers, rifle) or it is
ejected out automatically, e.g. in pistals.
2) Propellent (gun powder)
It propels the projectile (missile) forward. It is composed of black
powder or smokeless powder in the form of grains, pellets, thin
cylindrical cords or flakes. Its ignition results in formation of
expanding hot gases under pressure which (gas pressure) propels
Question 33: Correct Answer: D
Explanation: - D
Ans. is d i.e., Intranasal [Ref Park 24thie p. 168]
The routes of important vaccines are :?
Subcutaneous : Measles, rubella, killed influenza, killed cholera,
IPV, yellow fever.
Intramuscular : Mumps, killed influenza, typhoid Vi-polysaccharide,
DPT (deep intramuscular), rabies, IPV. iii)Intradermal : BCG, rabies.
Nasal : Live influenza.
Oral : OPV, oral cholera, oral typhoid (typhoral).
Question 34: Correct Answer: C
Explanation: - C
The NPCDCS program has two components viz. (i) Cancer & (ii)
Diabetes, CVDs & stroke.
These two components have been integrated at different levels as
far as possible for optimal utilization of the resource.
The activities at State, District, CHC and Sub Centre level have
been planned under the programme and will be closely monitored
through NCD cell at different levels.
The strategies proposed will be implemented in 20,000 Sub Centres
and 700 Community Health Centre in 100 Districts across 21 States
during 2010-12
Early diagnosis of diabetes, CVDs, Stroke and Cancer is done
at District Hospital, not at CHC.
Ref: NPCDCS Operational Guidelines, DGHS, GOI, Page 6;
http:/health.bih.nic.in/Docs/Guidelines-NPCDCS.pdf.
Question 35: Correct Answer: D
Explanation: - D
Ans. is a i.e.,Abdominal TB; b i.e., Ca cervix; c i.e.,
Endometriosis
Elevated level of CA-125 is seen in
* Epithelial ovarian Cancer
* Non ovarian tumors :- Cancers of endometrium, cervix, fallopian
tubes, pancreas, breast, lung and colon.
* Non malignant conditions:- Pregnancy, mensturation, peritonitis,

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endometriosis, pelvic inflammatory disease (abdominal TB) and
uterine fibroids.
Question 36: Correct Answer: A
Explanation: - A
Ans. is a i.e., Extremely painful
Cutaneous anthrax is painless.
Question 37: Correct Answer: D
Explanation: - D
Answer- D. Hemiballismus
It is defined as the dysfunction in the implementation of appropriate
targeting and velocity of intended movements, dysfunction of
posture and abnormal involuntary movement, or the performance of
normal appearing movements at inappropriate or unintended times.
Question 38: Correct Answer: A
Explanation: - A
Ans. is a i.e, Cricopharyngeal sphincter [Ref: Dhingra 6thie p.
349]
By far the commonest site is at or just below the cricopharyngeal
sphincter. Flat objects like coins are held up at the sphincter while
others are held in the upper oesophagus just below the sphincter
due to poor peristalsis.
Question 39: Correct Answer: D
Explanation: - D
Ans. D. All of the above
Question 40: Correct Answer: C
Explanation: - C
Answer- C. Invasion of renal vein is more common than renal
artery
Renal cell carcinoma is the most common malignant tumor of
kidney. It occurs usually in 6th and 7th decade of life. There is male
preponderance.
Important risk factors for RCC are smoking (most significant),
obesity, hypertension, asbestos exposure, estrogen therapy, CRF,
tuberous sclerosis and familial conditions (Von Hippel-Lindau
syndrome).
RCC is an adenocarcinoma and most commonly arises from upper
pole.
The one of the striking characteristics of RCC is to invade renal vein
and is associated with poor prognosis.
Question 41: Correct Answer: B
Explanation: - B
Ans. B. MIRENA
Question 42: Correct Answer: C

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Explanation: - C
Ans: C i.e. Caudate nucleus
The basal ganglia have five nuclei on each side of the brain.
- Caudate nucleus
- Putamen
- Globus pallidus
- Subthalamic nucleus
- Substantia nigra
The caudate nucleus and putamen collectively form the striatum.
The putamen and globus pallidus collectively form the lentiform
nucleus.
The globus pallidus is divided into external and internal segments
Question 43: Correct Answer: D
Explanation: - D
Answer- D. All the above
The combination of bortezomib and liposomal doxorubicin is active
in relapsed myeloma.
Thalidomide, if not used as initial therapy, can achieve responses in
refractory cases.
High-dose melphalan and stem cell transplant, if not used earlier,
also have activity in patients with refractory disease.
Question 44: Correct Answer: A
Explanation: - A
Ans. is a i.e., 1 hour
"The reconstituted vaccine should be kept on ice and used within
one hour ". —Park Measles vaccine :
Type: Live attenuated, lyophilized (Freeze dried) vaccine,
Measles vaccine is live attenuated, lypholized (Freez dried) vaccine.
Strains of virus used to prepare vaccine are Edmonston Zagreb
strain (most common), Schwartz strain and Moraten strain.
It is given subcutaneously in to middle one-third of antero-lateral
aspect of thigh.
It is given at the age of 9 months (age can be lowerered to 6
months in epidemics & malnutrition) and is repeated at 16-24
months of age.
It has protective efficacy (sero-conversion) of 95%. Vaccination
provide life long immunity.
Incubation period of vaccine induced measles is 7 days.
In post-exposure prophylaxis, measles vaccine should be given
within 2-3 days of exposure. Incubation period of measles virus is 10
days. Incubation period of live attenuated measles virus of live
vaccine is 7 days. Thus, if the vaccine is given within 2-3 days of
exposure, the replication of vaccine virus takes preference over
replication of wild virus.
Question 45: Correct Answer: D

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Explanation: - D
Ans. is d i.e., Spectrophotometry
Methods used for studying primary structure :
A) Sangers sequencing
Sangers reagent is (1 fluro 2,4 Dinitrobenzene)
B) Edmans Sequencing
Edmans reagent is Phenylisothiocyanate
C) Reverse Sequencing
It has to be supplemented by Mass Spectrometry
Methods used for studying secondary structure:
1. Optical Rotatory Dispersion
2. Ocular Dichorism
Methods used for studying tertiary structure:
1. X-ray Crystallography
2. UV spectroscopy
3. NMR spectroscopy
Question 46: Correct Answer: A
Explanation: - A
Ans, A. Median nerve
Question 47: Correct Answer: D
Explanation: - D
Ans. is d i.e., Requires DNA polymerase
Fluoroscent in Situ Hybridisation is a cytogenetic technique used
to detect chromosomal abnormalities.
This technique uses fluorescently labelled oligonucleotides or DNA
probes. These probes bind to specific sequences of a chromosome.
Attached to the probes are reporter fluorescent dyes which under
fluorescence microscopy confirm the presence or absence of a
particular chromosomal aberration.
In FISH, the target is the nuclear DNA of either interphase cells or of
metaphase chromosomes affixed to a microscope slide. When a
specific probe is added, it anneals to its complementary sequence in
the affixed DNA. As the probe is labelled with a reporter molecule it
is visualized by fluorescence microscopy
Question 48: Correct Answer: A
Explanation: - A
Answer- A. Fatty acid disorder
X-linked adrenoleukodystrophy(ALD/X-ALD) is a disease is caused
by mutations in ABCD1, a gene located on the X chromosome, that
codes for ALD, a peroxisomal membrane transporter protein.
Question 49: Correct Answer: C
Explanation: - C
Ans. C. ICSI
PESA= percutaneous epididymalsperm aspiration

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MESA= microscopic epididymal sperm aspiration
TESA= testicular sperm asPiration
TESE= testicular sperm extraction (testicular biopsy)
Question 50: Correct Answer: B
Explanation: - B
Ans. is b i.e., Less than 100 m [Ref Park 23/e p. 771 &
22"d/e p. 715]
Aedes do not fly over long distances; usually less than 100 metres
(110 yards). Anopheles ? 3 - 5 Kms
Culex ? 11 Kms
Aedes ? 100 m
Question 51: Correct Answer: C
Explanation: - C
MukhyaSevika is a middle level supervisor. She supervises 20 to 25
Anganwadi workers. She is required to be a graduate in social work
or home science or a related field. She is trained for three months.
Ref: Health policies and programmes in India, D.K. Taneja 11th
edition page: 312
Question 52: Correct Answer: A
Explanation: - A
Answer- A. Squamous cell carcinoma
Most of penile cancers are squamous cell carcinoma and arise on
glans or inner surface of prepuce.
Question 53: Correct Answer: A
Explanation: - A
Ans. A. <5
FIGO Grading of Endometrial Carcinoma
Histopathologic degree of differentiation:
Gl: < 5% nonsquamous or nonmorular growth pattern.
Question 54: Correct Answer: A
Explanation: - A
Ans. is a i.e., Retinal pigment epithelium
Abetalipoproteinemia or Bassen-Kornzweig syndrome is caused by
a defect of Microsomal Triglyceride Transfer Protein (MTTP).
In abetalipoproteinemia, both chylomicron and VLDL formation get
affected.
As a result, fat absorption is affected and the affected child presents
with steatorrhea in the first few months of life.
All fat soluble vitamin absorption also get affected. Hence Vitamin A,
D, E and K deficiency is expected, however Vitamin E deficiency is
found to have profound effects.
Vitamin E deficiency presents as retinitis pigmentosa and subacute
combined degeneration.
Other features of abetalipoproteinemia are acanthocytes (star

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shaped RBCs in peripheral smear caused because the lipid
composition of RBC membrane gets affected), hypocholesterolemia.
Treatment involves vitamin E administration.
Question 55: Correct Answer: B
Explanation: - B
Answer- A. Distal 2-3 cms of esophagus
Proximal extension of the squamocolumnar junction beyond the
distal 2-3 cms of oesphagus is abnormal and is suggestive of
Barretts esophagus.
Question 56: Correct Answer: A
Explanation: - A
Answer- A. Right internal jugular vein
Placement of the central venous catheter is indicated for the
monitoring of the central venous pressure and for prolonged drug
administration for parenteral nutrition.
The preferred site for insertion of catheter into the superior venacava
is from internal jugular vein of the neck. Other used sites are from
the subclavian vein or from the peripheral vein in the antecubital
fossa.
Commonly used vein cannulation sites for central venous
access include:
Jugular vein
External jugular vein
Internal jugular vein (central, posterior, anterior approaches)
Subclavian vein (supraclavicular, infraclavicular, axillary
approaches)
Femoral vein
Basilic vein
Question 57: Correct Answer: A
Explanation: - A
Ans. is a i.e., NOT involved in innate immunity
o MHC I and II are part of adaptive immunity. A major function of the
MHC molecule is to present the antigen to T cell that is part of
adaptive immunity.
Cytotoxic T cells are MHC - class I restricted.
MHC class II complex is found only on cells of the immune system
(class I is found on all nucleated cells and platelets.)
The antigens binding with MHC II molecule are presented to CD4+ T
cells. As discussed earlier, helper T cells/CD4 T cells are MHC II-
restricted.
B cells have both MHC class I and II complexes.
Question 58: Correct Answer: C
Explanation: - C
Ans. C. 3 weeks

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[Ref: Neena Khanna 3rd le p. 297; Roxburghs 7th/e p. 62]
Treatment of scabies in children
Topical permethrin (5% cream) is a safe and effective scabicide in
children. It is recommended as a first-line therapy for patients older
than 2 months of age.
Because there are theoretical concerns regarding percutaneous
absorption of permethrin in infants younger than 2 months of age,
guidelines recommend 7% sulfur preparation instead of permethrin.
Question 59: Correct Answer: B
Explanation: - B
Ans. is b i.e., Mean > Medians > Mode
Question 60: Correct Answer: D
Explanation: - D
Answer- D. All the above
Large defects present a more substantial problem and four
techniques have been described: non-operative therapy, skin flap
closure, staged closure and primary closure
Question 61: Correct Answer: C
Explanation: - C
Ans. is c i.e., Pons [Ref Farlex Partner Medical Dictionary
Farlex 2012]
Pars Dorsalis
The part of the pons bounded laterally by the middle cerebellar
peduncles and anteriorly by the ventral part of pons; it is continuous
with the tegmentum of the mesencephalon and contains long tracts
such as the medialand lateral lemnisci, cranial nerve nuclei, and
reticular formatin.
Question 62: Correct Answer: D
Explanation: - D
Answer- D. Uncompensated phase of PEM
It is due to prolong deficiency of calories and proteins. Thus there is
exessive catabolism of adipose tissue and muscle protein.
It is characterized by gross wasting of muscle and subcutaneous
tissues resulting in emaciation and marked stunting.
Child may show voracious appetite.
Marasmus represents the compensated phase of PEM.
Question 63: Correct Answer: C
Explanation: - C
Ans. C. Endometriosis
Laparoscopy findings in endometriosis are:
Chocolate cysts
Blueberrylesion
Red/flame lesion
Powder burn sPots

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Red/purple raspberry lesion
Subovarian adhesions
Matchstick burnt sPots
White lesion.
Question 64: Correct Answer: A
Explanation: - A
Ans. is a i.e., Duodenum
Gross morphology of the spleen
Spleen has two ends (anterior or lateral and posterior or medial),
three borders (superior, inferior and intermediate), two surfaces
(visceral and diaphragmatic), two angles (anterobasal angle and
posterobasal angle) and hilum.
The anterior end is supported by the phrenicocolic ligament.
The superior border is characteristically notched near its anterior
end.
The visceral surface is related to the fundus of stomach (at gastric
impression), left kidney (at renal impression), splenic flexure of the
colon (at colic impression) and tail of the pancreas (at pancreatic
impression). Its lower end is related to the phrenicocolic
ligament. The diaphragmatic surface is related to the diaphragm.
Question 65: Correct Answer: A
Explanation: - A
Answer- A. Rectus abdominis muscle
The most frequently used myocutneous pedicle grafts contain,
muscle segments from the rectus abdominis muscle of the anterior
abdominal wall, gracialis muscle of the inner thigh, bulbocavernosus
muscle of the vulva, the tensor fascia lata muscle of the lateral thigh,
and gluteus maximus muscle.
Question 66: Correct Answer: A
Explanation: - A
Ans, A. Multifidus Lumborum
Attachements on sacrum
A) Posterior Surface
Multifidus lumborum –
The deepest muscle arising from the sacrum.
Some of its fibers cover the uPper two sacral foramina.
This muscle attaches to the transverse processes of the superior
vertebrae and is therefore able to help stabilize the spine.
Erector spinae –
Partly arises from the posterior sacrum and the sacrospinous
ligament.
It is essential in achieving extension and lateral bending of the head
and vertebral column
Question 67: Correct Answer: A

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Explanation: - A
Ans. (a) Legionella
Pontiac fever is a mild nonfatal influenza like illness caused by
Legionella pneumophila.
Pontiac fex c,
An acute self limiting flue like illness with IP of 24-48 hours
Malaise, fatigue and myalgia are the most frequent presenting
symptoms
Pneumonia doesnt develop.
Complete recovery takes place, without antibiotic therapy.
Diagnosis is established by antibody detection.
Question 68: Correct Answer: C
Explanation: - C
Answer- C. Liable to injury
The main hazard is liability to injury.
Question 69: Correct Answer: A
Explanation: - A
Ans. A. Prophase I
Meiosis 1 is divided into following phases :-
l) Prophase 1: It is further divided into following stages:-
1. Leptotene
2. zygotene
3. Pachytene
4. Diplotene
5. Diakinais
2) Metaphase 1
3) Anaphase 1
4) Telophase 1
Question 70: Correct Answer: A
Explanation: - A
Ans. is a i.e., Blow out fracture of orbit wall
Enophthalmos is seen in blow out fracture of orbit wall.
Question 71: Correct Answer: C
Explanation: - C
Ans. C. Rubidomycin
[Ref KDT 7th/e p. 826]
Anthracycline induced cardiotoxicity
Rubidomycin and doxorubicin are the anthracycline anti - tumor
antibiotics
They have cardiotoxicity as a adverse effect.
This can manifest either acutely with ECG changes, arrhythmias and
hypotension, which are reversible, or be delayed like CHF.
Question 72: Correct Answer: A
Explanation: - A

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Ans. A. Menorrhagia
Normal blood loss during menses is around 35 ml (20-80 ml)
Blood loss more than 80 ml is menorrhagia
Question 73: Correct Answer: C
Explanation: - C
C i.e. Chance fracture
A horizontal fracture of the vertebra extending from body to the
posterior element, caused by a strong distraction force
Question 74: Correct Answer: C
Explanation: - C
Ans. C i.e. Becquerel
Old unit of radioactivity is Curie and new unit (SI) is Becquerel.
Question 75: Correct Answer: B
Explanation: - B
Ans. B. Leishmaniasis
[Ref Indian Dermatol Online J. 2012 Sep-Dec; 3(3): 159-165.doi:
10.4103/2229-5178.101810]
Volcano sign:
Descriptive term for the morphologic feature of Old World cutaneous
leishmaniasis.
The lesion starts as a small nontender papule, which enlarges in
size and ulcerates in the centre.
The border of the crusted ulcer often has an erythematous rim and is
called as "Volcano sign".
Question 76: Correct Answer: A
Explanation: - A
Answer- A. MRI
Non- ionizing radiation-
USG
MRI
Thermography (infrared rays)
UV rays
Radiofrequency waves
Microwaves
Question 77: Correct Answer: C
Explanation: - C
Answer- C. Lung
Among coal worker pneumoconiosis patients standard incidence
ratio of various important carcinomas : ovary (2.0) > esophagus
(1.76) Lung > (1.45) > Stomach (1.42) > Liver (1.18) > kidney (1.06)
> prostate (1.02) > colorectal (1.00) > urinary bladder (0.91) > head
& neck (0.87)
Question 78: Correct Answer: A
Explanation: - A

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Answer- A. Normal
If the growth velocity is normal but the chronological age is more
than the bone age, then the diagnosis is Constitutional delay in
growth.
Constitutional delay in growth
It is the most common cause of short stature in mid childhood period
but the ultimate height is normal.
Their birth weight and height are normal. Strong family history of
parents having short stature in childhood with delay in onset of
puberty is usually present.
Question 79: Correct Answer: D
Explanation: - D
Answer- D. Neuroma in continuity
The morphologic hallmarks of axonal neuropathies produced by
cutting a peripheral nerve, results in a prototypical pattern of injury
described as Wallerian degeneration
Within a day of injury, the distal axons begin to fragment and the
associated myelin sheaths unravel and disintegrate into spherical
structures (myelin ovoids).
A failure of the outgrowing axons to find their distal target can
produce a "pseudotumor" termed traumatic neuroma— a
nonneoplastic haphazard whorled proliferation of axonal processes
and associated Schwann cells that results in a painful nodule.
Question 80: Correct Answer: B
Explanation: - B
Ans. is b i.e., 1St July [Ref Park 22"/e p. 58 & 21"/e p. 52]
Denominator in crude death rate is mid year population, which is
estimated on first of July of an year.
Question 81: Correct Answer: A
Explanation: - A
Answer is A (Orthodromic AV reentry)
123.The most common macro-reentrant tachycardia associated
WPW syndrome is orthodromic AV reentry.
The most common macro-reentrant tachycardia associated with
WPW syndrome is referred to as Orthodromic AV reentry
Question 82: Correct Answer: A
Explanation: - A
Cauliflower ear (boxers ear, wrestlers ear) is an acquired deformity
of the outer ear.
In this injury, the ear can shrivel up and fold in on itself and appear
pale, giving it a cauliflower-like appearance, hence the term
cauliflower ear.
Wrestlers, boxers and martial artists in particular are susceptible to
this type of injury. When the ear is struck and a blood clot develops

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under the skin, or the skin is sheared from the cartilage, the
connection of the skin to the cartilage is disrupted.
Question 83: Correct Answer: D
Explanation: - D
Ans. D. 52 mgs
Mirena/LNG IUD/LNG 2O/levonova/LNG IUS
Mirenacontainsatotalof52mglevonorgestrel(LNG).LNGisreleasedintotheuterinecavit
at a rate of approximtely20pg/day.
Question 84: Correct Answer: A
Explanation: - A
Ans. is a i.e., Mitochondria
As mitochondria harbours the electron transport chain. In electron
transport chain, the electrons from NADH and FADH2 are
transferred through the various complexes to finally Oxygen.
Oxygen is then converted to water. This way all fuels get oxidised to
Carbondioxide. In other words in miotochondria, Oxygen is utilised
and Carbon dioxide generation is supported. Hence it is called as
the respiratory centre of the cell.
Question 85: Correct Answer: A
Explanation: - A
Ans. is a i.e., Facial nerve [Ref: BDC 6th le Vol 3 p. 371]
Branches of facial nerve
In fallopian (facial canal) :- Greater petrosal (greater superficial
petrosal) nerve, nerve to stapedius, chorda tympani.
At its exit from stylomastoid foramen :- Posterior auricular, digastric
nerve, stylohyoid nerve.
Terminal branches :- Temporal, zygomatic, buccal, marginal
mandibular, and cervical.
Question 86: Correct Answer: D
Explanation: - D
Ans. D. Tachycardia
[Ref: KDT 7"Ve p. 534]
Amiodarone is a broad spectrum anti - arrhythmic drug which
belongs to class III of the anti - arrhythmic drugs.
Following are the adverse effects -
Fall in BP, bradycardia and myocardial depression occurs on i.v.
injection.
Question 87: Correct Answer: C
Explanation: - C
Ans. C: Vitamin A
Pharmacological doses of vitamin A are teratogenic and in
pregnancy the daily dose must not exceed 6000-8000 IU.
Synthetic analogues of vitamin A:
* Tretinoin

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* Isotretinoin
* Etretinate
* Acetretin
* Teratogenic drugs
Drugs and medications:
* Tobacco Caffeine
* Drinking alcohol (ethanol) (fetal alcohol spectrum disorder),
* Isotretinoin (13-cis-retinoic acid)
* Temazepam
* Nitrazepam
* Aminopterin or methotrexate
* Androgenic hormones Busulfan
* Captopril, enalapril
* Coumarin
* Cyclophosphamide
* Diethylstilbestrol
* Phenytoin (diphenylhydantoin)
Question 88: Correct Answer: B
Explanation: - B
A cohort study is a type of analytic observational study
Cohort study proceeds forward from cause to effect, i.e., the disease
has not occurred in subjects (In contrast to case-control study which
proceeds backward from effect to cause).
It is also known as Prospective study, longitudinal study, Incidence
study, forward-looking study.
The features of cohort studies are :
The cohorts are identified before the appearance of the disease
under investigation.
The study groups, so defined, are observed over some time to
determine the frequency of disease among them.
The study proceeds forward from cause to effect.
Question 89: Correct Answer: D
Explanation: - D
Ans. D: Empty Stomach
Bag-mask ventilation can produce gastric inflation with
complications, including regurgitation, aspiration, and pneumonia.
Conditions predisposing to aspiration are:
Full stomach patients
Hiatus hernia, pregnancy
Intestinal obstruction
Tracheo-esophageal fistula
Meconium aspiration syndrome
Gastric inflation can elevate the diaphragm, restrict lung movement,
and decrease respiratory system compliance
Question 90: Correct Answer: A

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Explanation: - A
Answer- A. 9q
The ABO gene (Histo-blood group ABO system transferase enzyme)
resides on chromosome 9 at the band 9q34.2.
Histo-blood group ABO system transferase is
an enzyme with glycosyltransferase activity, which is encoded by
the ABO gene in humans. It is ubiquitously expressed in many
tissues and cell types.
Question 91: Correct Answer: C
Explanation: - C
Ans. C. Insulin
[Ref Guyton Ilth/e p.710]
Insulin lowers serum IC concentration i.e., causes hypokalemia. The
hypokalemic action of insulin is due to stimulation of K+ intake by
the cells mainly in muscle and adipose tissue. Insulin increases the
activity of Na+ - K. ATPase in cell membrane, so that more K+ is
pumped into cells.
Question 92: Correct Answer: C
Explanation: - C
Ans. C. Uptake in RBC and endothelial cells
[Ref KDT 6thIe p. 518; Katzung 11thie p. 244]
Adenosine is the DOC for P.S.V.T.
Administered by rapid i.v. injection either as free base or as ATP.
Action is very rapid - terminates more than 90% episodes of PSVT
within 30 sec.
Adenosine is very short acting (t. in blood - 10 sec) due to uptake
into RBCs and endothelial cells.
Question 93: Correct Answer: D
Explanation: - D
Ans. is d i.e., Cricopharyngeus of inferior constrictor [Ref Hall,
Arthur C. Guyton, John E. (2005). Textbook of medical
physiology (11th ed.). Philadelphia: W.B. Saunders. p. 782-784.]
Upper esophageal sphinctor
The upper esophageal sphincter surrounds the upper part of the
esophagus.
It consists of skeletal muscle, but is not under voluntary control.
Opening of the upper esophageal sphincter is triggered by the
swallowing reflex.
The primary muscle of the upper esophageal sphincter is the
cricopharyngeal part of the inferior pharyngeal constrictor.
Question 94: Correct Answer: C
Explanation: - C
Ans. is
c i.e.,Dorsal root ganglia [Ref Textbook of human

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embryology -786]
Nervous system develops from ectoderm (neuroectoderm). Nervous
system develops from neural tube which in turn devtlops by process
of neurulation, i.e. formation of neural plate and its infolding into
neural tube.
Question 95: Correct Answer: C
Explanation: - C
Ans. C. Synthetic steroidal estrogen
[Ref KDT 7Ve p. 306, 311]
Synthetic estrogens
Steroidal ? Ethinylestradiol, mestranol, tibolone.
Nonsteroidal ? Diethylstilbestrol, hexestrol, dienestrol.
Question 96: Correct Answer: A
Explanation: - A
Ans. is A i.e., Lead poisoning
The peripheral neuropathy of lead toxicity is a pure motor
neuropathy affecting the upper limbs more than the lower limbs,
presenting as symmetric or asymmetric wrist drop. The weakness
may also involve other muscle groups of the distal upper extremities,
the involvement of lower extremities, including isolated foot drop,
also may occur.
Question 97: Correct Answer: B
Explanation: - B
Ans. B. Endocardial fibrosis
[Ref KDT 7th/e p. 174]
Methysergide
Chemically related to ergot alkaloids which antagonizes action of
5HT on smooth muscles including that of blood vessels.
Mechanism of action
Potent 5HT2A/2C antagonist with No a adrenergic or dopaminergic
action.
Uses:
Migraine prophylaxis, carcinoid syndrome and post gastrectomy
dumping syndrome.
Adverse effects
Abdominal, pulmonary or endocardial fibrosis is produced with
prolonged use.
Question 98: Correct Answer: C
Explanation: - C
Ans. C. Nafarelin
[Ref KDT 7thie p. 242]
GnRH analogues are used by SC route, however nafarilin and
busurelin can be used as intranasal spray.
GnRH analogues can cause hot flushes, loss of libido and

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osteoporosis.
Question 99: Correct Answer: B
Explanation: - B
Ans. is b i.e., 10-15 hours [Ref Ananthanarayan 8th/e p. 365]
Generation time of lepra bacillus ? 4 12-13 days
Generation time of tubercle bacillus ? 14 hours
Generation time of coliform bacilli ? 20 minutes
Question 100: Correct Answer: B
Explanation: - B
Ans. B. Junction of left internal jugular and left subclavian vein
Thoracic duct begins as a continuation of the upper end of the
cisternachy linear the lower border of T12 vertebra and enters the
thorax through the aortic opening of diaphragrn (at T12). It then
ascends through the posterior mediastinum and at T5 level crosses
from right side to the left side and ascends along left margin of
oesophagus to enter the neck. At the level of C7 vertebrae, arches
towards left side to open into left brachiocephalic vein at the angle of
union of left subclavian and left internal jugular veins.
Question 101: Correct Answer: B
Explanation: - B
Ans. B. Jejunum
After fat digestion, fatty acids and monoglycerides are absorbed in
small intestine especially in the jejunum and some amount also in
ileum.
In side the enterocyte, fatty acids and monoglycerides again form
triglycerides.
These triglycerides are incorporated into chylomicrons and
transported to lymphatics and from there to blood vessels.
Question 102: Correct Answer: B
Explanation: - B
Ans. B. Burrows are intradermal lesions
[Ref Behl 10th/e p. 179]
Burrow is the serpentine (S-shaped), thread like gray-brown line
which represent the intraepidermal tunnel created by the moving
female mite in stratum corneum.
Burrow is Pathognomic of scabies.
Burrows are difficult to demonstrate in infant.
Clinical features of scabies
1. Severe itching is the most prominent symptom, and has following
characteristic features :
Worse at night
Generalized
Affecting several family members
2. In Scabies, severe itching typically worsen at night, most notably

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along the web spaces of fingers, wrists, elbows, axillae and groin
area - Areas know as circle of Hebra.
3. Papules and papulovesicles due to hypersensitivity to mite.
4. Pustules can occur due to secondary infection.
5. Excoriation and scratch marks.
6. History of involvement of family member
Question 103: Correct Answer: A
Explanation: - A
Answer- A. Fracture humerus
It is used in management of fracture humerus.
It is a skin traction applied to the arm with the child supine.
Traction straps are applied to the forearm with the arm supinated.
A counterweight is hung from the upper part of the arm to help pull
the proximal fragment of the humerus posteriorly, to approximate the
distal fragment.
Longitudinal traction is then applied to the supinated forearm with
the elbow flexed to about 45 degrees
Question 104: Correct Answer: C
Explanation: - C
Third
"Typical intercostal nerves are the ones that are confined to their
own intercostal spaces in the thoracic wall. The third, fourth, fifth and
sixth intercostal nerves are the typical nerves"
Question 105: Correct Answer: B
Explanation: - B
Answer- B. Lateral patellar subluxation
Patellar alignment can be assessed by measuring the Q-angle
(quadriceps angle).
This is the angle subtended by a line drawn from the anterior
superior iliac spine to the centre of the patella and another from the
centre of the patella to the tibial tubercle.
It normally averages about 14 degrees in men and 17 degrees in
women.
Patellofemoral stability is maintained by a combination of the
articular surface geometry and soft tissue restraints.
Question 106: Correct Answer: A
Explanation: - A
Ans. A. Protein kinase A
Hormones acting through adenylyl cyclase (AC):
Corticotropin releasing hormone (CRH), FSH, LH, TSH, ACTH
(corticotropin), ADH, Vasopressin (V2 receptors), Parathormone,
Catecholamine) e.g., adrenaline (most actions), Glucagon, hCG,
Calcitonin, Somatostatin, acetylcholine (M2), Dopamine (1),
Angiotensin II (epithelial cells), GABA-B, Histamine (H2).

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Question 107: Correct Answer: D
Explanation: - D
Ans. is d i.e.,Epinephrine excess [Ref Dinesh Puri 3rd le p. 381]
Deficiency of vitamin B12 causes Pernicious anemia, megaloblastic
anemia (secondary to functional folate deficiency due to folate trap),
methylmalonic aciduria due to accumulation of methylmalonyl-CoA,
and neuropathy, like subacute combined degeneration (SACD) and
demyelination.
There may homocysteinuria as methionine synthase, a
methylcobalamine dependent enzyme, is defective.
Question 108: Correct Answer: C
Explanation: - C
Ans. is c i.e., Sacral ganglion [Ref Essentials of medical
microbiology 3/e p. 1215]
Site of latency
HSV-1? Trigeminal ganglion.
HSV-2 ? Sacral ganglion.
Question 109: Correct Answer: B
Explanation: - B
Answer- B. CECT
CT is the imaging modality of choice for evaluating liver metastases.
This preference is largely attributable to the effects of the dual blood
supply on the enhancement characteristics of metastases, as
compared with normal liver parenchyma.
Question 110: Correct Answer: C
Explanation: - C
Ans. C. 6 months
[Ref Harrison 17"/e p. 2712; Kaplan & Saddocks 10th/e p. 626]
GENERALIZED ANXIETY DISORDER
This is characterized by excessive anxiety and worry which are
persistent & generalized and not restricted to any specific situation
or object.
Excessive anxiety worry occur for at least 6 months.
Question 111: Correct Answer: D
Explanation: - D
Answer- D. 5 years
A child learns to draw a triangle at the age of 5 years.
Identification of four colours is attained at the age of 4 years.
Question 112: Correct Answer: B
Explanation: - B
Ans. is b i.e., Inferonasal [Ref Bernardini FP, Devoto MH,
Croxatto JO. Epithelial tumors of the lacrimal gland: an update.
Curr Opin Ophthalmol 2008;19:409-13]
All lacrimal gland tumors typically share the following symptoms:

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facial asymmetry due to displacement of the globe, diplopia, ptosis,
limited ocular motility, and enlargement of the lacrimal gland.
Epithelial lesions tend to develop mostly in the orbital lobe of the
lacrimal gland and are principally unilateral.
The initial sign is usually inferior and nasal displacement of the globe
and proptosis, due to the superotemporal location of the lacrimal
gland in the anterior aspect of the orbit.
Question 113: Correct Answer: B
Explanation: - B
Ans. is b i.e.. Potassium
o Radiation is part of mans environment.
Question 114: Correct Answer: A
Explanation: - A
Ans. A. “Z” lines.
[Ref Principles of medical physiology p.794]
The cardiac muscle cell contains actin, myosin the sarcotubular
system and other organelles seen in skeletal muscles.
However, the T system of cardiac muscle is located at Z lines rather
than at A-I junction, where it is located in skeletal muscles.
Question 115: Correct Answer: D
Explanation: - D
Ans. is d i.e., Scleritis [Ref Ophthalmology by Duker 2"d/e p.
484]
There are so many complications of cataract surgery, Here are
only important ones:?
After cataract (opacification of capsule)
Retinal detachment
Vitreous prolapse & loss
Neovascular glaucoma
Cystoid macular edema
Anterior uveitis (iridocyclitis)
Endophthalmitis
Iris prolapse
Aphakic glaucoma
Stria keratopathy & Pseudophakic bullous keratopathy
Fibrous & endothelial growth
Corneal endothelial damage
Question 116: Correct Answer: C
Explanation: - C
Ans. is
c i.e.,HDL
Granulosa cells use follicular fluid HDL as a source of cholesterol for
the synthesis of progesterone.
Under the influence of LH, corpus luteal cells take up cholesterol

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from follicular fluid HDL and convert cholesterol into progesterone.
Question 117: Correct Answer: A
Explanation: - A
Answer- A. Distal interphalangeal joint
These include :
1. 2. 3. 4. Arthritis of distal interphalangeal (DIP) joints
Assymetrical oligoarthritis : Most common pattern
Symmetrical polyarthritis similar to RA
Axial involvement (sacroiliac and spine) similar to ankylosing
spondylitis
5. Arthritis multilans
Question 118: Correct Answer: C
Explanation: - C
Ans. is c i.e. Serum lactic dehydrogenase
however placental alkaline phosphate and lactate
dehydrogenase are commonly produced by dysgerminomas
and may be useful in monitoring the disease."
Question 119: Correct Answer: B
Explanation: - B
Answer- B. Intestinal lymphoma
the jejunal biopsy is useful in the diagnosis of the following
disorders:
Intestinal lymphoma
Intestinal lymphangiectasia
Eosinophilic gastroenteritis
Amyloidosis
Crohns disease
Infection by one or more
microorganisms
Mastocytosis
Whipples disease
Question 120: Correct Answer: A
Explanation: - A
Answer- A. Skin of gaiter region
The venous ulcer of the leg characteristically develops in the skin of
the gaiter region, the area between the muscles of the calf and the
ankle. This is the region where many of the Cockett perforators join
the posterior tibial vein to the surface vein, known as the posterior
arch vein
The majority of ulcers develop on the medial side of the calf but
ulcers associated with lesser saphenous incompetence often
develop on the lateral side of the leg.
Ulcers can develop on any part of the calf skin in patients with post-
thrombotic legs; however, venous ulcers rarely extend on to the foot

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or into the upper calf and, if there is ulceration at these sites, other
diagnoses should be seriously considered.
Question 121: Correct Answer: B
Explanation: - B
Ans. is b i.e., Lectin [Ref www.pathologyoutlines.com]
Pathophysiology of E. histolytica infection
Cyst are ingested from fecally contaminated food or water, sexual
transmission also occurs.
Excystation to 8 motile trophozoites occurs in the small intestine
The cysts are resistant to gastric acid (and chlorine in water
supplies).
Trophozoites are potentially invasive and multiply by binary fission.
In an estimated 20% of infections invasion into the wall of the colon
with tissue destruction occurs.
Adherence to colonic mucosa is mediated by a lectin on E.
histolyticss surface.
The parasite then induces apoptosis of epithelial cells through a
channel forming pore protein
E. histolytica ingests remnant cells.
Some trophozoites undergo encystation through signalling pathways
completing the cycle.
Question 122: Correct Answer: D
Explanation: - D
Answer- D. All the above
Question 123: Correct Answer: D
Explanation: - D
Ans. D. Fetal skin biopsy
Percutaneous umbilical blood sampling (PUBS) is also known as
cordocentesisis performed after 16 weeks gestation under USG
guidance a needle is inserted into umbilical vein. This technique
apart from karyotyping is also useful for evaluating fetal metabolism
and hematologic abnormalities.
Question 124: Correct Answer: B
Explanation: - B
Ans. B. Chloroquine
[Ref KDT 7thie p. 823]
Chloroquine:
1st line anti malarial drug, which is an erythrocytic schizonticide.
However, its prolonged use of high doses (as in DLE, rheumatoid
arthritis) may cause loss of vision due to retinal damage in the form
of retinal pigmentation.
Cause corneal deposits and affect vision and are reversible on
discontinuation.
Loss of hearing, rashes, photoallergy, myopathy, graying of hair may

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occur.
Question 125: Correct Answer: A
Explanation: - A
Ans. is
a i.e.,Lower central [Ref Reddy 30thie p. 60]
First temporary tooth to upper (in primary dentition) is lower central
incisors and last temporary tooth to erupt is2nd molar. The
sequence of eruption is lower central incisor > upper central incisor
> upper lateral incisor >lower lateral incisor > I" molar > Canine >
molar. Therefore eurption of temporary teeth is completed by
eruption of 2"° molar at 25 months (2 years).
First permanent tooth to erupt (in secondary dentition) is 1" molar
and last to erupt is 3rd molar. The sequence of eruption is 1" molar >
central incisor > lateral incisor > 1" premolar > 2" premolar > canine
> 2" molar > 3rd molar. Eruption of permanent teeth is completed by
eruption of 3rd molar between 17-25 years.
Question 126: Correct Answer: B
Explanation: - B
Ans. is b i.e., At birth [Ref Logan Turner 10thle p. 254; PL
Dhingra 4th/e p. 28]
"Worldwide screening is largely performed in newborn nursery with
the first screening test performed from birth until 10 days of age"
Question 127: Correct Answer: C
Explanation: - C
Ans. C. Stratum corneum
Stratum corneum (Horny layer):
This is the most superficial layer of epidermis and skin.
Cells are fully keratinized and end up as anucleate dead cells.
Therefore, stratum corneum is dead layer.
Stratum corneum is last to develop 4 Therefore in premature
newborn it is absent.
Question 128: Correct Answer: B
Explanation: - B
Ans. is b i.e., Breslaus test [Ref SK Singhal 4th le p. 271]
Tests used in infanticide
Ploucquets test :
Weight of lung is measured in relation to body wieght. Before birth
weight of lung is 1/70 of body weight and after respiration it becomes
1/35 of body weight due to increased blood flow in lung beds.
Static test or Foderes test :
The average weight of both lungs before respiration is 30-40 gm and
after respiration is 60-70 cm.
Hydrostatic test (Raygats test, 1" life test) :
The gravity of a non-respired lung is 1040-1050 and of a respired

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lung is 940-950, so, after respiration lung floats on water (specific

gravity of water is 1000).

Breslaus second life test :
It assumes that a live born child would respire and therefore, would
also swallow some air into the stomach and bowel.
Hence they float on water. This test is falsely positive in putrefaction
(due to putrefied gases) or in cases of attempted artificial respiration.
Werdins test :
Before birth middle ear contains gelatinous embryonic tissue which
is replaced by air after respiration.
Question 129: Correct Answer: A
Explanation: - A
Answer- A. Asthma
Patient presents with recurrent episodes of acute chest syndrome.
The characteristic symptoms during an episode of asthma are
wheezing, dyspnea, and coughing, which are variable, both
spontaneously and with therapy.
Prodromal symptoms may precede an attack, with itching under the
chin, discomfort between the scapulae, or inexplicable fear
(impending doom).
Question 130: Correct Answer: A
Explanation: - A
Answer- A. p53
Li-Fraumeni syndrome is due to germ line mutation in p-53 gene.
Question 131: Correct Answer: B
Explanation: - B
Ans. is b i.e., Healthy life expectancy
Health-Adjusted life expectancy (HALE)
HALE is the indicator used to measure a healthy life expectancy.
HALE is based on the life expectancy at birth but includes an
adjustment for time spent in poor health.
It is the equivalent number of years in full health that a newborn can
expect to live based on current rates of ill health and mortality.
Question 132: Correct Answer: C
Explanation: - C
Ans. is c i.e., 28 weeks
Reflex- Age of appearance 32 - Age of disappearance (after birth)
Question 133: Correct Answer: B
Explanation: - B
Ans. is b i.e., Fab region [Ref: Harrison 19th/e p. 372;
Ananthanarayan 9thie p. 100]
The infinite range of the antibody specificity of immunoglobulins
depends on the variability of the aminoacid sequences at the

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variable units of H and L chains.
Variable region is present on Fab region.
Question 134: Correct Answer: B
Explanation: - B
Ans. is b i.e., Cultural changes due to socialisation
Acculturation is a process of social, psychological, and cultural
change that stems from the balancing of two cultures while
adapting to the prevailing culture of the society. Acculturation
is a process in which an individual adopts, acquires and
adjusts to a new cultural environment.
Question 135: Correct Answer: B
Explanation: - B
Ans. B. Attention - seeking behavior
[Ref Niraj Ahuja 6"/e p. 122]
Patients with histrionic personality disorder display excessive
emotionality and attention-seeking behavior. Other options
Violation of rules of society ? antisocial personality disorder
Unstable interpersonal relationship ? borderline personality disorder
Grandiose behavior ? narcissistic personality disorder
Question 136: Correct Answer: A
Explanation: - A
Ans. A. Penis
[Ref IADVL 3"1/e p. 1779]
Fordyce spots (Fordyce granules or Fordyce disease):
Fordyces spot represents ectopic sebaceous glands on lips (most
common site) and oral mucosa.
They may also appear on vulva and penis, where they are called
Tysons gland, i.e., ectopic sebaceous gland at penis (prepuce) and
vulva is called tysons gland.
These glands have histopathology similar to normal sebaceous
glands, despite their ectopic location.
Question 137: Correct Answer: B
Explanation: - B
Ans.B. Learning
[Ref Niraj Ahuja 61* p. 220]
Behavior therapy is based on the assumption that all behaviors
(normal or abnormal) are learning response. Normal and abnormal
behaviors are subject to the laws of learning and the same laws can
be used to change them. Behavior therapy is based on theories of
learning and aims at changing the maladaptive behavior and
substituting it with adaptive behavior.
Question 138: Correct Answer: A
Explanation: - A
Ans. A. Type A progesterone receptor

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[Ref KDT 7hle p. 319, 320]
Mifepristone
It is a potent, 19 - norsteroid.
It has anti - progestational, significant anti - glucocorticoid and anti -
androgenic activity.
Mifepristone is a partial agonist and competitive antagonist at both A
and B forms of progesterone receptor (PR) In the absence of
progesterone (anovulatory cycles after menopause) it exerts weak
progestional activity and induces predecidual changes.
Question 139: Correct Answer: B
Explanation: - B
Answer- B. Posterior
Popliteal artery injury is common with both anterior and posterior
dislocations.
Posterior dislocations more likely to result in direct injury and even
rupture of popliteal artery (isolated transection).
Anterior dislocations cause stretching of popliteal artery which may
lead to intimal disruption and thrombosis (damage is over a longer
segment of artery).
Question 140: Correct Answer: D
Explanation: - D
Ans. is d i.e., HMP shunt
UDP-glucose is derived from glucose-6-phosphate via glucose-l-
phosphate.
The major fate of UDP-glucose is the synthesis of glycogen.
Other uses of UDP-glucose are -
1. In uronic acid (glucoronic acid) cycle to generate UDP
glucuronate.
2. Galactose metabolism
3. Glycosylation of proteins, lipids and proteoglycans.
Question 141: Correct Answer: B
Explanation: - B
Ans, B. Chlamydia trachomatis
Option B is now a days slightly more commoner than option a) &
hence the best option to mark
If polymicrobial/mixed infection, is in the option, then that is the
answer.
Question 142: Correct Answer: B
Explanation: - B
Ans. B. Intramuscular Methotrexate
Question 143: Correct Answer: A
Explanation: - A
Cultural characteristics of Yersinia pestis:
1. When grown in a flask of broth with oil / ghee floated on top (ghee

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broth) a characteristic growth occurs which hangs down into the
broth from the surface, resembling stalactite.
2. On nutrient agar, colonies are small, delicate, transparent discs,
becoming opaque on continued incubation.
3. On blood agar colonies are dark brown due to absorption of the
hemin pigment.
4. On MacConkey agar colourless colonies are formed.
5. In broth a flocculent growth occurs at the bottom and along the
sides of the tube.
Ref: Textbook of Microbiology Ananthanarayanan, 8th edition
Question 144: Correct Answer: B
Explanation: - B
Answer- B. III
Webers syndrome- Midbrain- Oculomotor nerve- Ipsilateral third-
nerve palsy
Question 145: Correct Answer: C
Explanation: - C
Ans. is c i.e., Ancylostoma [Ref Rajesh Karykarte p. 7]
The sequential stages in growth, development and multiplication
constitute its life cycle
Question 146: Correct Answer: B
Explanation: - B
Ans:B
1. A blow out fracture of the orbital floor is typically caused by a
sudden increase in orbital pressure by a striking object which is
greater than 5 cm in diameter, greater than the orital sin diameter
such as a fist or tennis ball.
2. The fracture most frequently involves the floor of the orbit along
the thin bone covering the infra orbital canal.
3. The floor consists of three bones: Zygomatic, Maxillary and
Palatine.
4. The posteromedial portion of the maxillary bone is relatively
weak and may be involved in a ‘blowout’ fracture.
5. Fracture of the Roof of the orbit known as ‘blow in’ fractures.
6. Most medial wall orbital fractures are associated with floor fracture
Question 147: Correct Answer: B
Explanation: - B
Answer- B. 750 - 1500 ml
Question 148: Correct Answer: A
Explanation: - A
Ans. is a i.e., Lymphoid hyperplasia
Intermittent mild diarrhea, fever, abdominal pain (MC)
Right lower quadrant mass, weight loss, anemia
Sometimes mimics appendicitis or bowel perforation

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Anal complaints (fissure, fistula, abscess) – frequent
Fat/vitamin malabsorption present
Recurrence after surgery common
Malignancy (most common cause) + with colon involvement
String sign of Kantor is seen in Crohns Disease.
Creeping fat is a feature of Crohns Disease.
Question 149: Correct Answer: C
Explanation: - C
Ans. is c i.e., Deviation in the direction or path of bullet [Ref
Reddy 30th/e p. 211]
Ricochetting of bullet is defined as deviation in the direction or path
of bullet because of striking of bullet to an intermediary object.
Question 150: Correct Answer: C
Explanation: - C
Answer- C. Gallium
Gallium-67 uptake is increased in inflamed myocardium. Gallium-67
citrate injected intravenously binds to transferrin, and it is
incorporated into the transferrin receptor of inflammatory cells or
malignant tumor cells.
Gallium-67 scintigraphy is useful for examination of heart disease
including cardiac sarcoidosis and acute myocarditis
Question 151: Correct Answer: A
Explanation: - A
Answer- A. FEV1/FVC ratio
Question 152: Correct Answer: C
Explanation: - C
Answer- C. Antibiotics do not speed up the ulcer healing
Patients are initially treated by a compression bandaging regimen.
Alternative to these bandaging regimens is to apply a bland
absorbent leak-proof dressing beneath a graduated elastic
compression stocking (class II).
Biopsies are indicated if malignancy is suspected and it is important
to remember that a Marjolins type of ulcer (a squamous cell or basal
cell carcinoma) can develop in a chronic longstanding venous ulcer.
Consideration must be given to healing the ulcer by excision and
grafting.
Biological dressings have been developed, including fetal
keratinocytes and collagen meshes
Pinch grafts and ulcer excision with mesh grafting have been shown
to provide good early healing with moderate long-term results
Question 153: Correct Answer: B
Explanation: - B
Ans. B. Acne
[Ref Contact and occupational dermatology p. 195]

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Resorcinol is included in many antiseptic and keratolytic topical
medications.
Uses include psoriasis, hidradenitis suppurativa, eczema, acne,
seborrhea, corns, calluses, warts, and other skin disorders.
Question 154: Correct Answer: A
Explanation: - A
Ans. is a i.e., Acyl CoA [Ref Harper 29thle p. 217, 220]
Allosteric modulation of acetyl CoA carboxylase
1. Activaters : Citrate (tricarboxylic acid); glutamate (dicarboxylic amino
acid) & other dicarboxylic acids; ATP
2. Inhibitors : Acyl CoA
Question 155: Correct Answer: C
Explanation: - C
Rhinoliths are calcareous masses which result due to deposition of
salts-like calcium and magnesium carbonates and phosphates
around the nucleus of a foreign body.
Question 156: Correct Answer: B
Explanation: - B
Ans. B. Increased Ca in the cell
[Ref Principles of medical physiology 3rdle p. 786]
3Na+/1Ca+ exchanger (Sodium/Calcium exchange pump):
It moves 3Na+ into the cell in exchange one Ca+ going out
Question 157: Correct Answer: C
Explanation: - C
Answer- C. Excision
Small tumors (T1 & T2) (<2cm) - If 1/3rd or less than 1/3rd lip
involved- V or W-shaped excision + primary closure.
Excision of lower lip upto 1/3rd can be sutured primarily in 3 layers –
mucosa, muscle, and skin keeping vermillion border in proper
apposition.
Question 158: Correct Answer: A
Explanation: - A
Ans. is a i.e., Micrococcus
Obligate aerobic micrococcus is used to create anaerobic condition
(anaerobiosis).
The micrococcus and the anaerobic organism to be cultivated are
both inoculated into the same liquid medium.
During incubation the Micrococcus gradually utilizes the free oxygen
creating conditions favorable for the growth of anaerobe.
After anaerobiosis is achieved, the micrococcus dies (due to lack of
oxygen) leaving the anaerobe in pure culture.
Question 159: Correct Answer: B
Explanation: - B
Styloid process is derived from 2nd pharyngeal arch.

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Question 160: Correct Answer: C
Explanation: - C
Ans, C. Third
Perineal Tears are classified into four categories
First-degree tear: laceration is limited to the fourchette and
superficial perineal skin or vaginal mucosa.
Second-degree tear: laceration extends beyond fourchette,
perinealskin and vaginal mucosa to perineal muscles and fascia, but
not the anal sphincter.
Third-degree tear: fourchette, perineal skin, vaginal mucosa,
muscles, and anal sphincter are torn
Question 161: Correct Answer: C
Explanation: - C
Answer- C. Hirschsprungs disease
Hirschprung disease (Congenital aganglonic megacolon) is caused
by defective migration of neural crest into the mesodermal layer of
gut. There is aganglionosis (absence of ganglions) in a portion of
intestinal tract. Intestinal segment lacks both Meissner submucosal
and Auerbach myenteric plexuses.
Question 162: Correct Answer: A
Explanation: - A
Answer-A. 3 consecutive months in at least 2 consecutive
years.
Cigarette smoking is the most important risk factor; air pollutants
also contribute.
The dominant pathologic features are mucus hypersecre- tion and
persistent inflammation.
Histologic examination demonstrates enlargement of mucous-
secreting glands, goblet cell hyperplasia, chronic inflammation, and
bronchiolar wall fibrosis.
Question 163: Correct Answer: C
Explanation: - C
Ans. C. Maximum air that can be expirated after maximum
inspiration
Vital capacity (VC):
4700 ml.
Amount of air that can be exhaled with maximum effort after
maximum inspiration (ERV+TV+IRV).
Used to assess strength of thoracic muscles as well as pulmonary
function.
Question 164: Correct Answer: A
Explanation: - A
Ans. is a i.e., Anterior ethmoidal syndrome [Ref Dhingra 6th/e
p. 450]

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Sluders neuralgia
It is also called anterior ethmoidal syndrome.
It is said to originate from the middle turbinate pressing on the nasal
septum.
It is characterized by pain around the bridge of the nose radiating
into forehead.
Treatment Anatomical correction relieves the pain.
Question 165: Correct Answer: C
Explanation: - C
Mitochondrial carbamoyl phosphate synthetase I is an enzyme that
catalyzes a reaction that produces carbamoyl phosphate.
This enzyme catalyzes the reaction of ATP and bicarbonate to
produce carbonyl phosphate and ADP. Carbonyl phosphate reacts
with ammonia to give carbamate
Cytosolic carbamoyl phosphate synthetase II uses glutamine rather
than ammonia as the nitrogen donor and functions in pyrimidine
synthesis.
Question 166: Correct Answer: C
Explanation: - C
Ans. is `c i.e., Type C tympanogram
Serous otitis media
Serous otitis media (SOM) has many synonyms : Serous otitis
media, otitis media with effusion, glue ear, non-suppurative otitis
media, mucoid otitis media, silent otitis media. SOM is an insidious
condition in which there is thick or sticky non-purulent fluid behind
the eardrum in the middle ear, but there is no ear infection, i.e.,
effusion of middle ear without infection. Fluid in the middle ear is
sterile. SOM occurs most commonly in school going children and
SOM is the commonest cause of childhood hearing loss.
Etiopathogenesis
1. Eustachian tube dysfunction
Eustachian tube dysfunction, coupled with recurrent upper
respiratory tract infection is the most important factor in the
development of SOM. Normally eustachian tube helps to drain fluids
to prevent them from building up in the ear. In Eustachian tube
dysfunction, it is unable to drain the fluid. Following can cause
Eustachian tube block :-
1. 3. Respiratory tract infection :- Adenoid, rhinitis, tonsillitis, sinusitis.
2. Allergies
Benign and malignant tumor of nasopharynx.
Question 167: Correct Answer: B
Explanation: - B
Ans. B. Maximum amount of air that can be inspired and
expired in one minute
[Ref Guyton 12th/e p. 472, 473; Ganong 24th/e p. 633]

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Maximum voluntary ventilation (MVV):
It is the maximum amount of air that can be moved into and out of
the lungs in 1 minute by voluntary effort.
About 125-170 L/min.
Question 168: Correct Answer: A
Explanation: - A
Ans. is a i.e., 150ml
The major source of CSF is the choroidal plexus of all 4 ventricles,
mainly in two lateral ventricles. Other sources of CSF are ependymal
cells of the ventricles and the brain itself, via perivascular spaces.
The total volume of CSF in an adult is about 125-150 ml. The rate of
formation of CSF is about 500-550 ml/day. Thus the CSF is replaced
3-4 times every day.
The watery part of CSF is secreted by transduction but each of its
constitutions is actively transported. Na. is secreted into the CSF
with the help of Na+ ATPase. Glucose enters CSF through facilitated
diffusion mediated by GLUT-1. HCO3 is secreted with the help of
carbonic anhydrase.
Question 169: Correct Answer: A
Explanation: - A
Ans. A. Excitement phase
Ref Oxford textbook of psychiatry p.227]
Excitement phase
There is increased physiological excitement such as high BP and
heart rate.
There is erection of penis (in males) and swelling of clitoris & labia
minora (in females).
Testes swell, scrotum tightens
There is vaginal lubrication
Question 170: Correct Answer: B
Explanation: - B
Ans. B. 2-4 weeks
[Ref Behl 10th/e p. 406; Neena Khanna 3rd/e p. 50, 51]
Pityriasis rosea:
P. rosea is self limiting disease, subsides with 6-12 weeks.
P. rosea is a common scaly disorder, occuring usually in children
and young adults (10-35 years).
Characterized by round/oval pink brown patches with a superficial,
centrifugal scale, distributed over trunk in a Christmas tree pattern.
The exact etiology is not known, but it is considered to be a viral
disease; Human Herpes virus 6 (HHV 6) and Human Herpes virus 7
(HHV 7) may play a role.
Clinical manifestations of P. rosea:
The disease starts with an upper respiratory prodrome or a mild flu.
After 1-2 weeks, annular erythematous plaque appears on trunk that

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is referred to as mother patch or herald patch.
Over the next 1-2 weeks, fresh patch appear all over the trunk, in a
Christmas tree configuration or Fir tree Configuration.
Question 171: Correct Answer: B
Explanation: - B
Answer-B
90% of rectal growths can be felt by per-rectal examination
High-resolution phased array external MRI is the investigation of
choice for local issues in the primary staging of rectal
cancer (best investigation for staging) as well as for restaging
after NACT-RT. It provides the highest accuracy for issues in
pretreatment local staging
Investigation of choice – rigid sigmoidoscopy and biopsy
To assess local spread – TRUS (Endoluminal ultrasound)
For local staging and assessment of proposed circumferential
resection margin – MRI (CT is not accurate in local staging)
Question 172: Correct Answer: A
Explanation: - A
Answer- A. Hyperpigmentation of the trunk, neck and
intertriginous areas
Fanconi anemia (FA) is primarily inherited in an autosomal recessive
manner (one uncommon form is X-linked recessive).
The most common anomaly in FA is hyperpigmentation of the trunk,
neck, and intertriginous areas, as well as café-au-lait spots and
vitiligo, alone or in combination.
Anomalies of the feet, congenital hip dislocation, and leg
abnormalities are seen.
Question 173: Correct Answer: A
Explanation: - A
Answer- A. Incisive foramen
Kernahens striped Y classification
It is used to classify cleft lip and cleft palate
The incisive foramen is taken as reference point
Question 174: Correct Answer: B
Explanation: - B
Answer- B. 12.3 years
Tritium (hydrogen-3) is a radioactive isotope of hydrogen. The
nucleus of tritium (sometimes called a triton) contains one proton
and two neutrons.
Whereas the nucleus of protium contains one proton and no
neutrons.
Tritium has a half-life of 12.3 years
Question 175: Correct Answer: A
Explanation: - A

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Ans, A. Vagus
Question 176: Correct Answer: A
Explanation: - A
Ans, A. Embryo cell biopsy
PGD, involves removing a cell from an IVF embryo to test it for a
specific genetic condition (cystic fibrosis for example) before
transferring the embryo to the uterus.
Question 177: Correct Answer: D
Explanation: - D
Answer- D. <1%
Low (reported cardia risk < 1%)-
Endoscopic procedures
Superficial proccdure
Cataract surgery
Breast surgery
Ambulatory surgery
Question 178: Correct Answer: B
Explanation: - B
Ans. is b i.e., India ink [Ref Can J Ophthalmol. 2015
Aug;50(4):273-7. doi: 10.1016/j.jcjo.2015.05.007.]
Common dyes used for conjunctival staining : Rose Bengal,
Fluoroscein and Lissamine.
Question 179: Correct Answer: B
Explanation: - B
Ans. B. Acanthosis
[Ref Rooks 7th/e p. 7.36]
Important terminology related to epidermal layers
Separation of keratinocytes due to loss of intracellular bridges -
Acantholysis
Intracellular edema of keratinocytes Ballooning
Question 180: Correct Answer: A
Explanation: - A
Answer- A. Jupitor fracture
Fracture of lateral condyle of humerus (Jupitor fracture)
Question 181: Correct Answer: D
Explanation: - D
Answer- D. Physis
The growth plate (physis) and the adjacent terminal diaphysis
represent the most metabolically active segment of the long bone.
This part changes dramatically during development and hence it is
called the metaphysis
Question 182: Correct Answer: B
Explanation: - B

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Answer- B. Squamous cell Carcinoma
Squamous cell carcinoma is the most common type of esophageal
carcinoma worldwide and in India. It usually occurs in middle 1/3rd
(mot common) and upper 1/3 of esophagus. Some may also arise in
lower 1/3
Question 183: Correct Answer: D
Explanation: - D
All of the above
Question 184: Correct Answer: A
Explanation: - A
Ans, A. HCG
30%.
HCGhas the highest carbohydrate content of any human hormone-
Question 185: Correct Answer: C
Explanation: - C
Answer- C. Hepatitis C infection
Immune thrombocytopenic purpura (ITP; also termed idiopathic
thrombocytopenic purpura) is an acquired disorder in which there is
immune-mediated destruction of platelets and possibly inhibition of
platelet release from the megakaryocyte.
ITP is termed secondary if it is associated with an underlying
disorder; autoimmune disorders, particularly systemic lupus
erythematosus (SLE), and infections, such as HIV and hepatitis C,
are common causes.
Question 186: Correct Answer: C
Explanation: - C
Answer- C. Using the two thumbs on the lower third of sternum
Two - finger technique
The tips of the middle finger and either the index finger or ring finger
of one hand are used to compress the sternum.
The other hand is used to support the infants back, unless the infant
is on a very firm surface.
Question 187: Correct Answer: B
Explanation: - B
Ans. B. Clotrimazole
[Ref Khurana Ophthalmology 4th/e p. 422]
Clotrimazole:
Fungistatic and is effective against Candida, Aspergillus and many
others.
Its 1 percent suspension is effective topically and is the treatment of
choice in Aspergillus infections of the eye.
Question 188: Correct Answer: A
Explanation: - A
Ans., Chlamydia trachomatis

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Question 189: Correct Answer: D
Explanation: - D
Ans. D. Tuberous sclerosis
[Ref Rooks 7th/e p. 17.37-17, 39.58-39.59; Behl 10thie p. 154]
Causes of localized hypopigmentation (Macule/Patch):
Primary Cutaneous disorders:
Vitiligo
Pityriasis versicolor
Pityriasis alba
Postinflammatory
Nevus depigmentosus (achromicus)
Nevus anemicus
Piebaldism
Chemical leukoderma
Idiopathic guttate Hypomelanosis
Systemic diseases:
Scleroderma
Tuberous sclerosis
Sarcoidosis
Cutaneous T-cell lymphoma
Leprosy (tuberculoid & Indeterminate)
Onchocerciasis
Hypomelanosis of Ito
Incontinetia pigmenti (Stage IV)
Question 190: Correct Answer: B
Explanation: - B
Ans. B. Biguanides - AMP Kinase activation
[Ref Katzung 11th/e p. 741]
Biguanide acts as an AMP-activated protein kinase (AMPK)
activator.
Activation of AMPK has a high number of potentially
antiatherosclerotic effects, including reducing inflammatory cell
adhesion to blood vessel endothelium & reducing lipid accumulation.
Question 191: Correct Answer: A
Explanation: - A
Ans. is
a i.e.,Esotropia [Ref Internet]
Cross fixation is the use of the right eye to view the left visual field
and the use of the left eye to view the right visual field. This behavior
is very common in children with infantile esotropia. Cross fixation
often causes the appearance of not looking directly at a target and
parents often wonder if vision is reduced.
Question 192: Correct Answer: A
Explanation: - A
Answer is A (Alcohol)

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Chronic Alcohol Consumption is the most common cause of Toxic
Dilated Cardiomyopathy. Alcohol is the most common toxin
implicated in chronic dilated cardiomyopathy
Note :
Dilated cardiomyopathy is the most common type of cardiomyopathy
The most common cause of dilated cardiomyopathy is Idiopathic
(Two-Thirds) Alcohol Consumption is the most common cause of
Toxic Dilated Cardiomyopathy
Question 193: Correct Answer: A
Explanation: - A
Ans. is
a i.e.,Filterable through filter [Ref Textbook of
microbiology by Parija p. 418]
Chlamydiae were thought to be viruses because (like viruses)
they :
Pass through 0.45 ym filters.
Are obligate intracellular parasite - cannot be grown in cell free
media.
Question 194: Correct Answer: A
Explanation: - A
Answer- A. Water soluble contrast swallow
If this is negative, a dilute barium swallow should be considered.
A CT scan can be used to replace a contrast swallow or as an
adjunct to accurately delineate specific fluid collections.
Question 195: Correct Answer: B
Explanation: - B
Ans. B. 2
LMA according to patient’s weight and age:
10-20kgs, infants & children
Question 196: Correct Answer: A
Explanation: - A
Ans. is a i.e., Total net number of ATP formed because of coils
cycle is 6
CORIS CYCLE
Muscle uses a molecule of glucose through anaerobic glycolysis and
gets 2 ATPs. In this process, glucose becomes two molecules of
lactate. The 2 lactate molecules through circulation reach liver. In
liver, the two molecules of lactate are utilised through
gluconeogenesis to form a glucose molecule at the expense of 6
ATPs. The glucose formed in liver reaches muscle and is utilised for
again anaerobic glycolysis if the muscle is still exercising. In case
muscle is done with exercising, the glucose which reaches the
muscle from liver is used for glycogen synthesis.
Question 197: Correct Answer: C

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 Explanation: - C
Ans. C. Aquaporin-2 in loop of Henle
[Ref Ganong 24thie p.683-690]
Aquaporins are protein channels which help in rapid diffusion of
water
Proximal tubles and thin descending limb of loop of Henle ?
aquaporin - 1, which is independent of ADH.
Late distal tubule and collecting duct ? aquaporin - 2, dependent on
ADH.
Question 198: Correct Answer: B
Explanation: - B
Answer- B. Leukapheresis
Intensive leukapheresis may control the blood counts in chronic-
phase CML; however, it is expensive and cumbersome.
It is useful in emergencies where leukostasis-related complications
such as pulmonary failure or cerebrovascular accidents are likely.
Splenectomy was used in CML in the past because of the
suggestion that evolution to the acute phase might occur in the
spleen.
Splenic radiation is used rarely to reduce the size of the spleen.
Question 199: Correct Answer: D
Explanation: - D
Answer- D. CAG
Huntingtons disease (CAG repeat),
Spinocerebellar ataxia (CAG repeat),
Friedreich ataxia (GAA repeat),
Fragile-X-syndrome (GGG or GCC repeat),
Dystrophia myotonica (CTG/CUG repeat)
Question 200: Correct Answer: D
Explanation: - D
Answer- D. Liquorice ingestion
causes of hyponatremia
Iatrogenic
Postoperative: premenopausal women
Hypotonic fluids with causes of 1 vasopressin
Glycine irrigation: TURP, uterine surgery
Colonoscopy preparation
Recent institution of thiazides
Polydipsia MDMA ingestion
Exercise-induced
Multifactorial, e.g., thiazide and polydipsia

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