NMCLE MBBS 2082-10-09 adapalene

23 Jan 2026, 9:49 p.m.

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1 180

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1. [Link] hernia of Bochdalek arises from

Your Answer: Correct

a. Posterior part of diaphragm

b. Postero-lateral part of diaphragm

c. Central part of diaphragm

d. Anterolateral part of diaphragm

Explanation:

ans:b posterolateral part of diaphragm

The large diaphramatic hernia that compromise lung growth are posterolateral in
position and are caused by defective closure of the pleuro-peritoneal canal. The
remnant of this canal in the normally developed diaphragm is the foramen of
Bochdalek.
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2. 2. Which of the following artery supplies blood to visual center?

Your Answer: Incorrect

[Link] cerebral artery and middle cerebral artery

b. Middle cerebral artery and posterior cerebral artery

C. Middle cerebral artery

d. Posterior cerebral artery

Explanation:

Ans: d. Posterior Cerebra artery

The greater part of supero-lateral surface of cerebral cortex is supplied by middle
cerebral
artery. The main artery supplying the medial surface is anterior cerebral artery.
The auditory area is supplied by middle cerebral artery and the visual area by
posterior cerebral artery.

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3. 3. Isthmus of thyroid gland lies opposite to which of the following tracheal
ring

Your Answer: Incorrect

a. 2,3

b. 5,6

C. 6,7

d. 8,9

Explanation:

ans : a 2,3
Isthmus of thyroid gland connects the lower parts of the two lobes of thyroid
gland. It has 2 surface and 2 borders with following relations:
• Anterior surface sternothyroids, omohyoids,anterior jugular veins, fascia and
skin
• Posterior surface - Related to 2nd and 3rd tracheal rings.
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4. [Link] lymphatic drainage of glans penis is into

Your Answer: ∅ Blank

[Link] iliac nodes

b. Obturator nodes

c. Deep inguinal lymph nodes

d. Superficial inguinal lymph nodes

Explanation:

ans:c Deep inguinal lymph nodes

Lymphatics from the glans drain into the deep inguinal nodes (gland of Cloquet/
Rosenmuller).
The rest of the lymphatics drain into the superficial inguinal lymph nodes

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5. 5. Foramen of Langer is associated with

Your Answer: Incorrect

a. Heart

b. Pancreas

[Link]

d. Skull

Explanation:

Ans: c Breast
The supero-lateral part of BREAST is prolonged upwards and laterally, pierces
deep fascia at the
anterior fold of axilla and lies in the axilla at the level of the 3rd rib. The process of
the gland is known
as axillary tail of Spencer. The opening in the deep fascia is known as foramen of
Langer.
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6. [Link] amount of blood volume of lungs in comparison to total blood
volume of entire circulatory system is:

Your Answer: ∅ Blank

a. 9%

b. 14%

c. 23%

d. 30 %

Explanation:

ans:a 9%
The blood volume of the lungs is about 450milliliters, about 9 per cent of the total
blood volume of the entire circulatory system. Approximately 70milliliters of this
pulmonary blood volume is in the pulmonary capillaries, and the remainder is
divided about equally between the pulmonary arteries and the veins.

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7. 7. Pulmonary circulation differs from systemic circulation:

Your Answer: ∅ Blank

a. Pulmonary vasodilatation in hypoxia

b. Pulmonary vasoconstriction in hypoxia

c. Decreased blood volume during systole

d. Increased basal vasoconstrictor tone

Explanation:

Ans:b. Pulmonary vasoconstriction in hypoxia.

Low oxygen concentration causes some yet undiscovered vasoconstrictor
substance to be released
from the lung tissue; this substance promotes constriction of the small arteries
and arterioles. This
causes the blood to flow through other areas of the lungs that are better aerated.
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8. 8. Which of the following statement regarding RBC is incorrect?

Your Answer: ∅ Blank

a. Diameter of RBC is 7.5 micrometer, thickness at periphery is 2.5 micrometer

b. RBC is shaped like a biconcave disc

c. Membrane skeleton of RBC is made of spectrin

d. Crenation of RBC takes place in Hypotonic solution

Explanation:

Ans:d. Creation of RBC takes place in hypotonic solution

RBC is biconcave disc, but can be deformed into any shape. Its diameter is 7.5
micrometer, thickness at periphery is 2.5 micrometer and thickness at centre is 1
micrometer. Shape of RBC is maintained by spectrin. Spectrin filaments are
attached to cell membrane by ankyrins. When RBC is placed in hypertonic
solution, it shrinks. This process is called Crenation. When RBC is placed in
hypotonic solution,it swells and bursts, releasing its Hb content, which is known
as hemolysis.
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9. 9. Almost all cells of reticuloendothelial system originates from:

Your Answer: ∅ Blank

a. Neutrophilic stem cells

b. Eosinophilic stem cells

c. Basophilic stem cells

d. Monocytic stem cells

Explanation:

Ans:d. Monocytic stem cells

The total combination of monocytes, mobile macrophages, tissue fixed
macrophages and a few
specialized endothelial cells in the bone marrow,spleen and lymph nodes is called
the
reticuloendothelial system. Almost all of these cells originate from monocytic stem
cells; therefore, the
reticuloendothelial system is almost synonymous with the monocytes-
macrophage system.
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10. [Link] of clot retraction is the indication for:

Your Answer: ∅ Blank

a. Anemia

b. Congenital deficiency of clotting factors

c. Deranged coagulation cascade

d. Low circulating platelets number

Explanation:

Ans:d. Low circulating platelets number

The clot is composed of a meshwork of fibrin fibers running in all directions and
entrapping blood
cells, platelets, and plasma. Within a few minutes after a clot is formed, it begins
to contract and usually
expresses most of the fluid (Serum) from the clot within 20 to 60 minutes.
Platelets are necessary for
clot retraction to occur. Therefore, failure of clot retraction is an indication that the
number of platelets
in the circulating blood might be low.
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11. 11. A single contraction of skeletal muscle is most likely to be terminated
by which of thefollowing actions?

Your Answer: ∅ Blank

a. Closure of the postsynaptic nicotinic acetylcholine receptor

b. Removal of acetylcholine from the neuromuscular junction

C. Removal of Cat from the terminal of the motor neuron

d. Removal of sarcoplasmic Ca++

Explanation:

Ans: d. Removal of sarcoplasmic Ca++

Skeletal muscle contraction is tightly regulated by the concentration of Cat in the
sarcoplasm. As
long as sarcoplasmic Cat is sufficiently high, none of the remaining events --
removal of acetylcholine from the neuromuscular junction, removal of Ca-from the
presynaptic terminal, closure of the acetylcholine receptor channel, and return of
the dihydropyridine receptor to its resting conformation -would have any effect on
the contractile state of the muscle.

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12. 12. For activity of antipsychotic, action is required at which receptor-

Your Answer: ∅ Blank

a. M1 muscarinic

b. D1 dopaminergic

c. D2 dopaminergic

d. 5HT4 serotonergic

Explanation:

Ans: c. D2 dopaminergic
• Typical antipsychotics acts by blocking D2 receptors →D2 antagonists
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13. 13. Metabolism of drugs is mostly done by which enzyme-

Your Answer: ∅ Blank

a. CYP3A4/5

b. CYP2D6

c. CYP2C8/9

d. CYP2C1.9

Explanation:

Ans: a. CYP3A4/5
• Depending upon the extent of amino acids sequence homology, the cytochrome
P-450 (CYP) isoenzymes are grouped into families designated by capital letters
(A, B, C….)
• Individual isoenzymes are again allotted numerals (1,2,3….)
• Examples are CYPIA2, 2A6, 2B6, 2C8, 3A/3A5)
• In human beings, only a few members of three isoenzyme families carry out
metabolism of most of the drugs
• Cyp 3A 4/5 carryout biotransformation of largest number (nearly 50%) of drugs
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14. 14. Alkaline diuresis in acidic drug poisoning is not done in-

Your Answer: ∅ Blank

a. Aspirin

b. Methotrexate

c. Morphine

d. Phenobarbitone

Explanation:

Ans: c. Morphine
• Acidic drugs (barbiturate, methotrexate, salicylate) are more ionized at alkaline
urine and are not absorbed from renal tubules if the urine is alkaline, and their
excretion in urine is increased. Therefore, alkalization of urine is done by
NaHCO3 in poisoning of acidic drugs. For the same reason, acidification of urine
is done by arginine hydrochloride and ammonium chloride (NH4CI) in poisoning
of basic drugs (morphine, amphetamines, quinine).

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15. 15. Of the following opioid is used by transdermal route in cases of
malignancy associated pain-

Your Answer: ∅ Blank

a. Fentanyl

b. Morphine

c. Codeine

d. Oxycodone

Explanation:

Ans: a. fentanyl
• Fentanyl is opioid analgesic used via transdermal delivery systems in case of
chronic pain
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16. 16. Benzodiazepine (BZN) receptor antagonist is-

Your Answer: ∅ Blank

a. Nalorphine

b. Carbamazepine

c. Naloxone

d. Flumazenil

Explanation:

Ans: d. flumazenil
• Flumazenil is a benzodiazepine analogue which competes with BZD agonists as
well as inverse agonists for the BZD receptor and reverses their depressant or
stimulant effects respectively
• It also antagonizes the action of Zolpidem, Zopiclone and zoleplon as these
drugs also act on BZD site

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17. 17. Half-life of Nicotine in blood-

Your Answer: ∅ Blank

a. 15 minutes

b. 2 hours

c. 5 hours

d. 24 hours

Explanation:

Ans: b. 2 hours
“Nicotine has a half-life of approximately 2 hours (range 1-2 hours)”
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18. [Link] of the following drug follows zero order kinetics?

Your Answer: ∅ Blank

a. Warfarin

b. Alcohol

c. Theophylline

d. Allof the above

Explanation:

Ans:d All of the above

Drugs that follows zero order kinetics are:@WATT Power
W=Warfarin
A=Alcohol
T=Theophylline
T=Tolbutamide
Power=phenytoin
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19. [Link] is not indicated in

Your Answer: ∅ Blank

a. Hypertension

b. Migrane

c. Varient Asthma

d. Thyrotoxicosis

Explanation:

Ans:c variant asthma

Indication of beta blocker are
• Angina pectoris
• Thyrotoxicosis
• Anxiety Glaucoma
• Hypertension
• Pheochromoctoma
• Migrane
• Essential tremors
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20. [Link] of the following drug doesnot cause gum hyperplasis?

Your Answer: ∅ Blank

a. Phenytoin

b. Cyclosporin

c. Verapamil

d. Phenobarbitone

Explanation:

Ans: d phenobarbitone
Drugs causing gum hyperplasia are
• CCB
• Cyclosporin
• Phenytoin
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21. 21. Action of metalloproteinase-

Your Answer: ∅ Blank

a. Degradation of collage

b. Polymerization of collagen

c. Oxidation of collagen

d. stimulation of collagen

Explanation:

Ans: ‘a’ i.e., Degradation of collagen

MMP is a family of enzymes that have in common a 180-residue zinc-protease
domain
Matrix metalloproteinases include:
i)Interstitial collagenase (MMP-1, 2, and 3): cleave the fibrillar collagen types I, II
and III
ii)Gelatinases (MMP-2 and 9): Degrade amorphous collagen and fibronectin
iii)Stromelysins (MMP-3, 10 and 11): Act on proteoglycans, laminin, fibronectin
and amorphous collagen
iv)Membrane-bound MMPs (ADAMs): Cleave membrane-bound precursor forms
of TNF and TGF-α, releasing the active molecule
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22. 22. Protein catabolism is increased in:

Your Answer: ∅ Blank

a. Starvation

b. Burns

c. surgery

d. all of the above

Explanation:

Ans: ‘d’ i.e., All of the above

Conditions causing increased protein catabolism:
o Multiple trauma
o Infection and sepsis
o Burns
o Fever
o Surgery
o Long bone fracture
o Prolonged starvation
o Prolonged corticosteroid therapy
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23. 23. which of the following phospholipid has antigenic activity:

Your Answer: ∅ Blank

a. Plasmalogen

b. Cardiolipin

c. Phosphatidylcholine

d. Sphingomyelin

Explanation:

ans: ‘b’ Cardiolipin

“Cardiolipin is the only human glycerophospholipid that possess antigenic
properties”
-Cardiolipin is the major lipid of inner mitochondrial membrane.

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24. 24. In cholesterol transport which is not needed:

Your Answer: ∅ Blank

a. Liver

b. Kidney

c. Intestine

d. Fat

Explanation:

. Ans: ‘b’ Kidney

• Dietary cholesterol is transported from intestine to liver by chylomicron-
chylomicron remnant system
• From liver cholesterol is in corporate into VLDL and is distributed to extrahepatic
tissues (like adipose tissue) through LDL (i.e. after conversion of VLDL into LDL)
• HDL transports cholesterol from extra-hepatic tissues (blood vessels, adipose
tissue)to liver
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25. [Link] contains which mineral:

Your Answer: ∅ Blank

a. Copper

b. Zinc

c. Iron

d. None

Explanation:

Ans: ‘b’ Zinc

Zinc containing enzymes are carboxypeptidase, carbonic anhydrase, alkaline
phosphatase, lactate dehydrogenase, alcohol dehydrogenase, glutamate
dehydrogenase, RNA polymerase and superoxide dismutase

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26. [Link] common biotype of S. aureus causing human infection-

Your Answer: ∅ Blank

a. A

b. B

c. C

d. D

Explanation:

Ans: a. A
• Staphylococcus aureus has been classified into six biotypes: A, B, C, D E and F
• Most human pathogenic strains belong to biotype A
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27. 27. HEPA filter is used to disinfect-

Your Answer: ∅ Blank

a. Water

b. Air

c. Culture

d. Blood

Explanation:

. Ans: b. Air
•HEPA (High-effciency particulate air) filter is used to remove microorganisms
from air
•HEPA filter traps airborne particles and microbes
•It can remove >95% of all particles including microorganisms with a diameter
>0.3µm

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28. 28. Complement components are-

Your Answer: ∅ Blank

a. Lipoproteins

b. Glycoproteins

c. Polysaccharides

d. Lipid

Explanation:

Ans: b. Glycoproteins
Most of the proteins and glycoproteins that constitute the complement system are
synthesized by hepatocytes
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29. [Link] reaction is seen in-

Your Answer: ∅ Blank

a. Group B streptococcus

b. Staphylococcus

c. Pneumococcus

d. Enterococcus

Explanation:

Ans: c. Pneumococcus
•A suspension of pneumococci is mixed on a slide with a drop of the type specific
antiserum and methylene blue. On the presence of homologous antiserum
capsule becomes apparently swollen, sharply delineated and refractile

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30. 30. Which myxovirus does not have hemagglutinin and neuraminidase
but have membrane fusion protein-

Your Answer: ∅ Blank

a. Measles

b. Parainfluenza

c. RSV

d. Influenza

Explanation:

ans: c. RSV
•RSV does not posses hemagglutinin or neuraminiase
•The viral envelope has two glycoproteins-
G protein → By which virus bring about fusion between viral and host cell
membranes. It is also
F-protein (Fusion protein) → which bring about fusion between viral and host cell
membranes. It is also responsible for cell to cell fusion, which leads to
characteristic syncytial formation
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31. 31. Laryngoscopes are sterilized by-

Your Answer: ∅ Blank

a. Glutaraldehyde

b. Formalin

c. Betadine

d. Boiling

Explanation:

Ans: a. Glutaraldehyde
•Laryngoscope should be cleaned before and after use with spirit
•Disinfection can be done once a day by removing the bulb and immersing the
bade in 2% cidex (glutaraldehyde) for 10 minutes
•They should be sterilized once a week by immersing in cidex for 10 hours or by
autoclaving

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32. [Link] of the following characterise early (Septic) shock rather than
hypovolemic or cardiogenic shock?

Your Answer: ∅ Blank

[Link] skin

b. Decreased cardiac output

[Link] total peripheral resistance

[Link] venous return to heart.

Explanation:

Ans: a. Warm skin

Warm skin -d/t decrease in TPR from vasodilation (histamine, bradykinin, nitric
oxide, relase of anaphylatoxins.)
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33. 33. Destruction of fat in acute pancreatitis is due to

Your Answer: ∅ Blank

a. Lipase and elastase

b. Lipase and phopholipase

c. Secretin

d. Cholecystokinin and Trypsin

Explanation:

Ans: b lipase and phospholipase

In acute pancreatictis, activated enzymes (Intracellular or extracellular) are
produced which
have different effects.
eg.
• Protease:- Proteolysis
• Elastase: Haemorrhage
• Lipase : fat necrosis
• Phospholipase: fat necrosis.
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34. [Link] histological examination, the intestinal villi swollen and
[Link] is accumulation of large granular Macrophages, containing
material which stains strongly with period acid schiff (PAS positive), in the lamina
propria. The most propable condition is

Your Answer: ∅ Blank

a Sprue

b. Chron's gap disease

[Link] disease

d. Whipple's disease

Explanation:

Ans: d Whipple disease

Whipple's disease is caused, most likely by Tropheryma whippelli

Approx. 90% of pt has h/o weight loss, 70% has h/o
diarrhoea or arthralgia & 30% has cardiac involvement
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35. 35. Which polyp has got the maximum risk of turning into malignancy.

Your Answer: ∅ Blank

a. Pseudopolyp

b. Hyperplastic polyp

C. Tubulo-villous adenoma (Multiple)

d. Adenomatous polyps

Explanation:

Ans: c Tubulovillous adenoma.

• FAP is an autosomal dominant disorder

• More than 100 adenomatous polyp is required to make diagnosis of FAP.
• Colorectal carcinoma develops
• Size is the most important characteristics that correlates with the risk of
malignancy.
• Prophylactic colectomy is the standard therapy for individual carrying APC
(Adenomatous polyposis coli) mutations.
• Hyperplastic polyp has the least malignant potential.
• Most common type of Gastric polyp is Hyperplastic polyp
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36. [Link] prognosis in hodgkin's lympohoma is with:

Your Answer: ∅ Blank

a. rich

b. Lymphocyte depletion

C. Nodular sclerosis

d. Lymphocyte mixed

Explanation:

Ans: a Lymphocyte rich.

Lymphocyte depletion has the worst prognosis

Most common variety is Nodular sclerosis
Incidence:
• Nodular sclerosis (70%)
• Mixed cellularity (25%)
• Lymphocyte predominant.(5%)
• Lymphocyte depletion (<1%)
Hodgkin's lymphoma has bimodal Age distribution.
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37. 37. In lead poisoning, the encephalopathy is directly attributed by

Your Answer: ∅ Blank

a. An increase RBC protoporphyrin

b. An increase in del-aminolevulenic acid

c. Pb deposition in the brain

d. tissue hypoxia secondary to anemia

Explanation:

Ans:b increase in del-aminolevulenic acid

Somehow; & aminolevulenic acid increases vessel permeability leading to
cerebral oedema.
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38. 38. In fresh water drowning, the death occurs within 4-5 minutes of
submersion due to ventricular fibrillation. Which of the following reason is
responsible?

Your Answer: ∅ Blank

a. Total asphyxia is produced due fresh water

b. Laryngospasm causing vagal inhibition

c. Hemoconcentration of blood caused the osmotic pressure effect

d. Hemodilution, overloading heart, hemolysis result in release of potassium

Explanation:

Ans: d
Death in fresh water drowning occurs within 4-5mins due to ventricular fibrillation
resulting from hemodilution and hemolysis causing release of potassium.

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39. 39. Patterned abrasion is variety of

Your Answer: ∅ Blank

a. Superficial bruise

b. Sliding abrasion

C. Linear abrasion

d. Pressure abrasion

Explanation:

Ans: d
Patterned abrasions are a result of perpendicular force on the epidermis, resulting
in an impression of the offending item. Patterned abrasions can be further sub-
classified as pressure abrasion and impact abrasion, depending on the duration
of contact with the offending object.
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40. 40. Whip lash injury is caused due to

Your Answer: ∅ Blank

a. Fall from height

b. A blow on top to the head

c. Acute hyperextension of the spine

[Link] hyper flexion of the spine

Explanation:

Ans:c
Whiplash injuries are hyperextension injuries of cervical spine due to violent
acceleration or deceleration force applied to front seat [Link] in head
on or tail on collisions. Fracture dislocation of cervical spine especially atlanto-
axial and atlanto-occipital joint with fatal contusion or lacerations.

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41. [Link] flash can cause injury by all the following except

Your Answer: ∅ Blank

a. Direct effect of electric current

b. Superheated air

[Link] and repelled air

[Link] air pushed in front of the current

Explanation:

ans : [Link] air pushed in front of the current

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42. [Link] are features of adipocere, except

Your Answer: ∅ Blank

a. It consists of fatty acids

b. Takes place in bodies buried in dry sandy soil

c. Takes about 3 weeks to form

d. Bacterial enzymes are necessary for its formation

Explanation:

Ans: b
Factors favorable to adipocere formation include mildly alkaline pH, warm
temperature, anaerobic conditions, and moisture. Cold temperature, lime, and
aerobic conditions are limiting factors.

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43. [Link] pearls or wax dripping is pathognomic of

Your Answer: ∅ Blank

[Link]

b. Lightening

c. Electrocution

[Link]

Explanation:

Ans:c Electrocution
Heat generated by current melts Ca phosphate = round dense foci on X-ray –
Bone pearls/ wax drippings,
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44. [Link] foot marks are associated with which type of injury?

Your Answer: ∅ Blank

a. Motor cyclist’s fracture

b. Under-running or tail gating

c. Steering wheel impact

d. Wind screen impact

Explanation:

Ans: d Wind screen impact.

Sparrow's foot marks are bizarre shaped lacerations that result when the face
coming in contact with shattered windshield glass

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45. [Link] in which weight of lung is compared to body weight:

Your Answer: ∅ Blank

a. Fodere’s test

b Cavett test

c. Ploucquet’s test

[Link] test

Explanation:

Ans: c Ploucquet test

This test compares weight of lungs to the body weight.
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46. [Link]’s stain is done for:

Your Answer: ∅ Blank

a. Air embolism [Link] embolism

[Link] embolism

[Link] fluid embolism

d. Pulmonary embolism

Explanation:

Ans:c. amniotic fluid embolism.

Fraser-lendrum stain : For fibrin, a multistaining procedure after Zenker's fixative
in which fibrin, keratin, and some cytoplasmic granules appear red, erythrocytes
appear orange, and collagen appears green.

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47. [Link] child is the one who

Your Answer: ∅ Blank

a. Does not belong to the women claiming to be its mother

b Has been abandoned by its parents

c. Is born after the death of its father

d. Is illegitimate

Explanation:

Ans: c born after death of its father.

Posthumous birth is the birth of a child after the death of a biological parent. A
person born in these circumstances is called a posthumous child or a
posthumously born person.
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48. [Link] from IMR other important indicator for socioeconomic health-

Your Answer: ∅ Blank

a. Maternal mortality rate

b. Perinatal mortality rate

c. Under-5 mortality rate

d. Neonatal mortality rate

Explanation:

Ans: C. Under-5 mortality rate

IMR is best indicator for:
• Health status of a community
• Level of living
• Effectiveness of MCH services
IMR is second best indicator of socioeconomic status of country (under 5
mortality rate is more refined indicator for socioeconomic status)
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49. 49. ASHA is not a depot holder of-

Your Answer: ∅ Blank

a. ORS

b. IFA

c. Contraceptives

d. OPV

Explanation:

Ans: d. OPV
ASHA are acting as a Depot Holder for essential provisions being made available
to every habitation like-
• Oral rehydration solution (ORS)
• Iron folic Acid (IFA) tablets
• Disposable Delivery Kits (DDK)
• Contraceptives (condom, OCP emergency pills)
• Cholorquine
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50. [Link] bias occurs during:

Your Answer: ∅ Blank

a. Recruitment

b. Treatment

c. Analysis

d. Observation

Explanation:

Ans: a. Recruitment
Selection biases are distortion that result from procedure used to select subjects
and from factors that influence study participation. Groups to be compared are
differentially susceptible to the outcome even before the experimental maneuver
is performed
Selection bias usually occurs at the Stage of recruitment of participants
Selection biases is less likely to occur in a cohort study compared to case-control
or cross-sectional study because study participant are selected before the
outcome occurs
Randomized control trials do not have selection bias as randomization eliminates
selection (investigator) bias.
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51. [Link] study is:

Your Answer: ∅ Blank

a. Case-control study

b. Cohort study

c. Cross-sectional study

d. RCT

Explanation:

Ans: a > b. Case-control study > cohort study

Case-control study is a retrospective study
Cohort study is mostly a prospective study. But retrospective cohort studies are
also there (has been explained in previous sessions)

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52. 52. False regarding polio vaccination:

Your Answer: ∅ Blank

a. Both killed and live vaccines are available

b. First OPV is given at 4 weeks

c. OPV induces both humoral and intestinal immunity

d. IPV is given intramuscularly

Explanation:

Ans: b. First OPV is given at 4 weeks

First OPV (zero dose) is given at birth
There are two polio vaccines: killed (IPV) and live attenuated (OPV)
OPV induces both humoral and intestinal immunity, whereas IPV induces only
humoral immunity
IPV is given intramuscularly (preferable) or subcutaneously.
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53. 53. After taking MMR live vaccine, conception should not occur within:

Your Answer: ∅ Blank

a. 2 weeks

b. 4 weeks

c. 8 weeks

d. 12 weeks

Explanation:

Ans: d. 12 weeks
Measles-mumps-rubella (MMR) vaccine and its component vaccines should not
be administered to women known to be pregnant. women should be counseled to
avoid becoming pregnant for 12 weeks after vaccination with MMR vaccine or its
component vaccines or varicella vaccine

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54. 54. The recommended content of Iodine in salt at the consumer level is:

Your Answer: ∅ Blank

a. 10 ppm

b. 15 ppm

c. 20 ppm

d. 30 ppm

Explanation:

Ans: b. 15ppm
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 15ppm of
iodine at the consumer level
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55. 55. Reservoir is defined as:

Your Answer: ∅ Blank

a. Person, animal or object from which infectious agent is transmitted to host

b. Person, animal or substance in which infectious agent lives and multiplies

c. Person, anima in which infectious agent causes a disease

d. none of the above

Explanation:

Ans: b. Person, animal or substance in which infectious agent lives and multiplies

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56. 56. Randomization is done to:

Your Answer: ∅ Blank

a. Facilitated double blinding

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

c. Ensure the groups are comparable on base line characteristics

d. Increase accuracy

Explanation:

Ans: c. Ensure the groups are comparable on base line characteristics

:
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57. 57. Vital statistics in a population are:

Your Answer: ∅ Blank

a. Sex ratio

b. Age composition

c. Birth rate

d. Dependency ratio

Explanation:

ans: c. Birth rate

Vital statistics are statistics concerning the important events in humon life, such
as birth, death, marriges and migration. These are:
• Birth rates
• Death rates
• Infant mortality rate
• Fertility rate
• Mortalility rates (perinatal mortality rate, MMR, CMR etc)
• Divorce rates
:
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58. 58. Rideal-walker coefficient for disinfectant used for cholera stool should
be:

Your Answer: ∅ Blank

a. 2

b. 4

c. 7

d. 10

Explanation:

Ans: d. 10
for cholera stool:-
“The most effective disinfectant for general use is a coal-tar disinfectant with a
Rideal-walker (RW) coefficient of 10 or more such as cresol”.

0 / 1 point
59. 59. Elemental iron and folic acid in adult IFA table is:

Your Answer: ∅ Blank

a. 100 mg iron & 200 µg FA

b. 200 mg iron & 100 µg FA

c. 20 mg iron & 100 µg FA

d. 100 mg iron & 500 µg FA

Explanation:

Ans: d. 100 mg iron & 500 mcg FA

Iron and folic Acid content per IFA tablet:-
Adult tabler: 100 mg elemental iron and 500 mcg folic acid
Pediatric tablet: 20 mg elemental iron and 100 mcg folic acid
:
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60. 60. Rule of Halves is related to:

Your Answer: ∅ Blank

a. Obesity

b. Burns

c. Blindness

d. Hypertension

Explanation:

Ans: d. Hypertension
Rule of Halves: Hypertension is an ‘Iceberg disease’. Only about half of
hypertensive subjects in general population of most of the developed countries
are aware of condition, only half of those aware of the problem were being treated
and only half of those treated were considered adequately treated

0 / 1 point
61. 61. Auenbrugger's sign is seen in

Your Answer: ∅ Blank

a. Pericardial effusion

b. Pericardial tamponade

c. Pericarditis

d. Pericardial tumors

Explanation:

Ans:a Pericardial effusion.

Auenbrugger's sign is a bulging of the epigastrium seen in cases of severe
pericardial effusion. It is often not spotted because pericardial effusion can be
caught on echocardiography before it progresses this far.
:
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62. 62.A young female presents with of history of dyspnoea on exertion. On
examination, she has wide, fixed split S2 with ejection systolic murmur (III/VI) in
left second intercostal space. Her EKG shows left axis [Link] most
probable diagnosis is:

Your Answer: ∅ Blank

a. Total anomalous pulmonary venous drainage.

b. Tricuspid atresia

. c. Ostium primum atrial septal defect.

d. Ventricular septal defect with pulmonary arterial hypertension

Explanation:

Ans: c
Wide and fixed splitting of S2 with no change difference between inspiration and
expiration is seen in ASD.

0 / 1 point
63. [Link] of the following statements about Atherosclerosis is true:

Your Answer: ∅ Blank

[Link] of Unsaturated Fatty Acids is associated with decreased risk

[Link] of lesions in veins is similar as that in arteries

c. Thoracic Aorta is more commonly involved than abdominal aorta

d. Hypercholesterolemia alone does not increase the risk of atherosclerosis

per se

Explanation:

Ans:a
Unsaturated Fatty Acids Improve Atherosclerosis Markers in Obese and
Overweight Non-diabetic Elderly Patients.
:
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64. 64.A patient suffered a transmural myocardial [Link] was started
on streptokinase and [Link] of the following finding on further
examination s an indication for stopping thrombolytics ?

Your Answer: ∅ Blank

[Link] type II block

b Pericardial Fluid collection on Echo

[Link] vein thrombosis in the leg

[Link] friction rub

Explanation:

Ans:b pericardial fluid collection in Echo.

0 / 1 point
65. [Link] of the following are correctly matched, except:

Your Answer: ∅ Blank

a.LKM1- Autoimmune Hepatitis

b.LKM2 - Drug Induced Hepatitis

c.LKM1- Chronic Hepatitis C

d.LKM2 - Chronic Hepatitis D

Explanation:

ans :d.LKM2 - Chronic Hepatitis D

:
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66. 66.A 55-year-old male patient was diagnosed to have chronic hepatitis C.
He responded to treatment with interferon. However, after one year of follow up
he showed a relapse of disease. Which of the following would be the next most
appropriate choice?

Your Answer: ∅ Blank

[Link] and pegylated interferon

b. Lamivudine and interferon

c. Nevirapine and lamivudine

d. Indinavir and ribavirin

Explanation:

Ans:a Ribavirin and pegylated interferon.

Pegylated interferon α (IFNα) in combination with ribavirin is currently
recommended as a standard-of-care treatment for chronic hepatitis C virus (HCV)
infection. This combination therapy has drastically improved the rate of sustained
virological response, specifically in difficult-to-treat patients

0 / 1 point
67. [Link] patients with acute liver failure, the best prognostic indicator is:

Your Answer: ∅ Blank

a. Serum albumin

[Link] alpha-fetoprotein

[Link] bilirubin

d. Factor V estimation

Explanation:

Ans:d factor V estimation

In acute liver failure, the Clichy criteria indicate poor prognosis and need for liver
transplantation, when factor V is below 20% in patients aged ≤ 30 or below 30%
associated with age ≥ 30[80]. Factor V has less prognostic value in
acetaminophen-induced fulminant hepatic failure
:
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68. [Link] of the following are true of Reye's syndrome except:

Your Answer: ∅ Blank

[Link] frequently complicates viral infections

[Link] time is prolonged

[Link] may by precipitated by salicylates

[Link] jaundice is present

Explanation:

Ans:d deep jaaundice is present.

The pathophysiology of Reye's syndrome is thought to involve mitochondrial
injury, which inhibits oxidative phosphorylation and fatty-acid beta-oxidation

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69. [Link] following features differentiate Rotor syndrome from Dubin
Johnson's syndrome except:

Your Answer: ∅ Blank

a. Liver patients with Rotor syndrome has no increased pigmentation and

appears normal

b. In Rotor syndrome Gall bladder is usually visualized on cholecystography

c. Total urinary coproporphyrin is substantially increased in Rotor syndrome

d. Fraction of corpophyrin Iin urine is elevated usually more than 80% of the
total in Rotor syndrome

Explanation:

Ans:d.
Dublin Johnson syndrome and rotor syndrome are conjugated hyperbilirubinemia.
:
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70. [Link]’s needle is used for:

Your Answer: ∅ Blank

[Link] aspiration

[Link] puncture

[Link] biopsy

d. Liver biopsy

Explanation:

Ans: d
Menghini needle:
A special needle used to obtain a sample of liver tissue

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71. [Link] gland enlargement isseen in all except:

Your Answer: ∅ Blank

[Link]'ssyndrome

b. Sarcoidosis

[Link] pancreatitis

d. SLE

Explanation:

Ans: d SLE
Causes of salivary gland swelling:
:
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72. 72.A 35 year old lady complains dysphagia, Raynaud's phenomenon,
sclerodactyly. Investigations show antinuclear antibody. The likely diagnosis is:

Your Answer: ∅ Blank

[Link] lupus erythematosis

[Link] sclerosis

[Link] connective tissue disorder

[Link] arthritis

Explanation:

Ans: b Systemic sclerosis

CREST (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly,
and telangiectasia).CREST syndrome are associated with the generalized form of
the disease Systemic sclerosis (scleroderma).

0 / 1 point
73. 73.A 20-year-old woman presents with bilateral conductive deafness,
palpable purpura on the leg and hemoptysis. Radiograph of the chest shows a
thin walled cavity in left lower zone. Investigations reveal total leukocyte count
12000/mm red cell casts in the urine and 12,000/mm serum creatinine 3
ing/[Link] is the most probable diagnosis?

Your Answer: ∅ Blank

[Link]-Schonlein purpura

[Link] nodosa

c. Wegener's granulomatosis

[Link] tuberculosis

Explanation:

ans :c. Wegener's granulomatosis

:
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74. [Link] of the following is recommended in a woman with
Antiphospholipid Antibodies and history of prior abortions /still birth.

Your Answer: ∅ Blank

[Link] only

b. Aspirin + Low molecular weight Heparin

c. Aspirin + Low molecular weight Heparin +Prednisolone.

d. No Treatment

Explanation:

ans : b. Aspirin + Low molecular weight Heparin

0 / 1 point
75. 75.A 40-year-old man underwent kidney trans-plantation for end-stage
renal disease. Two months after transplantation, he developed fever and features
suggestive of bilateral diffuse interstitial [Link] one of the following is
the most likely etiological agent?

Your Answer: ∅ Blank

[Link] simplex virusb.

[Link]

c. Epstein-Barr virus

d. Legionella

Explanation:

Ans: b CMV
Most common infection in post transplantation patient is CMV.
:
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76. 76. Most common carcinoma in pregnancy is-

Your Answer: ∅ Blank

a. Cervical

b. Ovary

c. Colon

d. oropharynx

Explanation:

Ans: a. Cervical
Cervical cancer is the most common malignancy diagnosed in pregnancy. This
may be related to the fact that it is the one type of cancer for which screening is
routinely performed on the first prenatal visit
Screening in pregnancy is recommended at the first prenatal visit and again at 6
weeks postpartum.

0 / 1 point
77. [Link] of the following ovarian tumors is most radiosensitive-

Your Answer: ∅ Blank

a. Carcinoid

b. Dysgerminoma

c. Serous Cystadenocarcinoma

d. Brenner tumor

Explanation:

Ans: b. Dysgerminoma
Dysgerminoma is the most radiosensitive among the ovarian tumors, but
radiotherapy is not the treatment of choice as dysgerminoma occurs in pre-
reproductive or reproductive age group and fertility is impaired with radiotherapy.
:
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78. 78. What is the blood flow in placenta in third trimester

Your Answer: ∅ Blank

a. 20 ml/min

b. 250 ml/min

c. 500 ml/min

d. 750 ml/min

Explanation:

Ans: d. 750 ml/min

Uterine blood flow is increased form 50 ml/minute in non-pregnant state to about
750 ml/minute near them
The increase is due to combined effect of uteroplacental and fetoplacental
vasodilatation
The vasodilatation is due to the smooth muscle relaxing effects of progesterone,
oestrogen, nitric oxide, prostaglandins, atrial natriuretic peptide (ANP). In a
normal pregnancy, vascular system becomes refractory to angiotensin II,
endothelin I and other pressor agents.
:
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79. 79. If the symphysiofundal height is 40 cm and the station of the head is
at -1, weight of the fetus is approximately-

Your Answer: ∅ Blank

a. 3kg

b. 3.3 kg

c. 4 kg

d. 4.3 kg

Explanation:

Ans: d. 4.3 kg
Johnson’s Formula for estimation of fetal weight:
Height of the uterus above the symphysis pubis in centimeters minus 12, if the
vertex is at or above the level of ischial spines or minus 11, if the vertex is below
the level of ischial spines-multiplied by 155 gives the weight in grams.
In this situation station of the head is at-1, so subtraction factor would be 12.
Solution: (40-12)x155=4340 gms

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80. [Link] index is-

Your Answer: ∅ Blank

a. BPD/OFD

b. BPD/HC

c. OFD/BPD

d. HC/FL

Explanation:

Ans: a. BPD/OFD
Cephalic index=BPD/OFD (Bipariental diameter divided by the occipito-frontal
diameter)
Normal , Cephalic index is approximately 70 to 88%
:
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81. 81. Which vaccine is not given in pregnancy-

Your Answer: ∅ Blank

a. OPVG

b. Rabies

c. Hepatitis B

d. Influenza

Explanation:

Ans: a. OPV
Immunization during Pregnancy:
Live virus vaccines-Contraindicated during pregnancy:
• MMR
• Varicella
• OPV
• Yellow fever
• Pnemococcal
• Vaccines safe during pregnancy:
• DT
• Hepatitis B
• Rabies
• Influenza
• TT
:
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82. 82. Maternal age is not associated with-

Your Answer: ∅ Blank

a. Preterm labour

b. Post maturity

c. Aneuploidy

d. Hydatidiform mole

Explanation:

Ans: a’ i.e., Preterm labour

Aneuploidy is associated with advanced maternal age. There is increased risk of
Down’s syndrome with advanced age at childbearing. Similarly elderly paternal
age is associated with Marfan’s syndrome
Hydatidiform mole is also highest in teenage pregnancies and in women over 35
years of age
Post maturity is more common in elderly primigravidae
Recent evidence however suggests lowest incidence of preterm labor between 18
and 35 years of age and higher risk in lower and higher age groups.
:
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83. 83. Torsion as a complication is seen with tumor-

Your Answer: ∅ Blank

a. Teratoma

b. Dysgerminoma

c. Granulose cell tumor

d. Servos cystadenoma

Explanation:

Ans: b. Teratoma
Teratomas are the most common germ cell tumors
Mature benign cystic teratomas are the most common benign tumor of ovary in
the reproductive age group
It is the most common benign neoplasm diagnosed during pregnancy
It is the most common tumor to undergo torsion

0 / 1 point
84. 84. Uterus is receptive for implantation for how many days after
fertilization-

Your Answer: ∅ Blank

a. 6 days

b. 12 days

c. 6 weeks

d. 12 weeks

Explanation:

Implantation usually begins about 6–7 days after fertilization, when the blastocyst
reaches the uterus and the endometrium is in its receptive phase (often called the
window of implantation).
:
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85. 85. Agent associated with carcinoma cervix-

Your Answer: ∅ Blank

a. Human Papilloma Virus

b. Trichomoniasis

c. herpes virus

d. Calymmatobacterium granulomatis

Explanation:

Ans: a. Human Papilloma Virus

Human papillomavirus is most commonly associated with cancer of cervix
Although herpes simplex virus 2 is also associated with ca cervix. But HPV is
believed to have a causal association with cancer cervix

0 / 1 point
86. 86. 40 yrs female with abnormal cervical cytology, pap smear suggestive
of CIN III, next step in management is-

Your Answer: ∅ Blank

a. Test for HPV and follow up after 3 months

b. Colposcopy and biopsy

c. Hysterectomy

d. Surgery with adjuvant chemoradiation

Explanation:

Ans: b. Colposcopy and biopsy

CIN III lesion needs colposcopy and biopsy to rule out invasive lesion
:
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87. 87.A female child has recently learned to eat with spoon without splling,
to dress and undress herself with supervision and to understand that she is a
[Link] skills are first mastered between the ages of:

Your Answer: ∅ Blank

a.2 and 3 years

b. 3 and 4 years

c.5 and 6 years

d.4 and 5 years

Explanation:

Ans. is a i.e., 2 and3 years

A child learns to feed herself with spoon without spilling its contents by the age of
15 months. A child can dress or undress herselfcompletelyby the age of3 years. A
child knows his gender by the age of 3 years.
So, the given milestones develop between the age of 15 months and 3 years.
Amongst the given options best answer is 'a' i.e., 2 and 3 years.
:
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88. 88.A two year old girl child is brocght to the out patient with features of
hand wringing stereotype movertents, impaired language and communication
development, breath holding spells, poor social skills and deceleration of head
growth after 6 month ofage. The most likely diagnosis is:

Your Answer: ∅ Blank

a) Aspergert syndrome

b) Rettt syndrome

c) Fragile x-syndrome

d)colarad syndrome

Explanation:

ans : b'i.e., Rett's syndrome

This 2 years child has following problems:_

1. Hand wringing movements. 2. Impaired language and communication
development. 3. Breath holding spells.
[Link] of hand growth after
All are the clinical features of Rett syndrome
:
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89. 89.A 2 year old boy has vitamin D refractory [Link] show
serum calcium 9 mg/dl. phosphate2.4mg dl, alkaline phosphate 1040 IU.
parathyroid hormone and bicarbonate levels are normal. the most probable
diagnosis is -

Your Answer: ∅ Blank

a) Distal renal tubular acidosis

b) Hlpophosphatemic rickets.

c) Vitamin D dependent rickets

d) Proximal renal tubular acidosis

Explanation:

Ans. is 'b, i.e., Hypophosphatemic rickets

In the patient :- There is normal calcium bicarbonate and parathermone level with
decrease in phosphate and increase in alkaline phosphate.
So it is a case of Hypophospheternic rickets. Proximal Renal tubular acidosis also
causes hypophosphetemic Rickets but the bicarbonate level will be reduced in a
case of proximal renal tubular and
Distal renal tubular acidosis causes vit D. dependent rickets so it is easily ruled
out.
:
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90. 90.A 3 yrs old boy is brought to the casualty by his mother with
progressive shortness of breath for 1 day. The child has h/o Bronchial
asthma.O/E, the child is blue, gasping and unresponsive. What will you like to do
first-

Your Answer: ∅ Blank

[Link]

b. Administer 100 % oxygen by mask

c. Ventillate with bag and mask

d. Administer nebulised salbutamol

Explanation:

Ans: b
It must be clear that the first step in cases of life threatening asthma is to
administer 100% oxygen
then medications (Salbutamol and Terbutaline).Mechanical Ventillation is
indicated only if these measures fail and the condition of the patient further
deteriorates.
:
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91. [Link] carey commb's murmur which is false

Your Answer: ∅ Blank

[Link] diastolic murmur

[Link] in Rheumatic fever

C. Can be associated with AR

d. Low pitched murmur

Explanation:

Ans:c associated with AR

Carey coombs murmur
-Heard in patient with acute rheumatic fever.
-Occurs due to inflammation of mitral valve cusps or excessive left atrial blood
flow as a consequence of MR.
-Soft systolic murmur usually follow [Link] diastole murmur

0 / 1 point
92. [Link] are true about Rheumatic fever except-

Your Answer: ∅ Blank

a. Common in poor socioeconomic group

b. Develops after Streptococcal pharyngitis

c Communicable disease

d. Seen in 5-15 yrs

Explanation:

Ans: c. Communicable disease.

Rheumatic fever is an acute immunologically mediated multisystem inflammatory

disease that
occurs few weeks after an episode of group A streptococcal pharyngitis.
The disease is immune mediated and not a communicable disease
:
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93. 93.A 50-hour-old full-term breastfed newborn boy weighing 3100 g
presents with clinically evident jaundice. Physical examination is otherwise
normal. The total bilirubin is 11.0 mg/dl with a direct bilirubin of 0.4 mg/dl. What
would be thecorrect treatment?

Your Answer: ∅ Blank

a. Continue breast feeds and review after 48hours

b. Continue breast feeds and start blue-light phototherapy

c. Stop breast feeding and review after 24 hours

d. Stop breast feeding and start blue-light phototherapy

Explanation:

Why:

This is a full-term, healthy newborn, 50 hours old

Total bilirubin = 11.0 mg/dL, direct = 0.4 mg/dL → unconjugated
hyperbilirubinemia
At ~48–72 hours of life, phototherapy is NOT indicated unless bilirubin is
much higher (≈15 mg/dL or more in term babies without risk factors)

This fits physiological neonatal jaundice, which is common in breastfed babies.

Do NOT stop breastfeeding — stopping feeds is not recommended and can

worsen jaundice due to dehydration.

So:
:
 0 / 1 point
94. 94.A premature neonate on top feeding develop abdominal destension
and bleeding per rectum. He recently recovered from acute upper respiratory tract
infection. What is the probable diagnosis -

Your Answer: ∅ Blank

a) Necrotizingenterocolitis

b) Vavulus

c) Meckels diverticulum

d) Intussusception

Explanation:

Ans. is 'a' i.e., Necrotizing enterocolitis

This child is -
i) Premature
ii) On artificial feeding (top feeding)
iii) Having abdominal distention and bleeding per rectum.
All these are suggestive of necrotizing enterocolitis :-
i) The greatest risk factor for necrotizing enterocolitis is prematurity.
ii) Almost all patients of neonatal enterocolitis are artificially fed prior to the onset
of illness.
iii) In stage I, there is abdominal distention and blood in stool.
So, the child in question is suffering from necrotizing enterocolitis.
:
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95. [Link] born at 30 weeks for 18 year old primi gravida of weight 2 kg
which died after 48 hours. Apgar scores were 5 and 8 at 1 and 5 minutes. On
autopsy ,bilateral enlarged kidney with multiple radially arranged cysts. Which of
the following findi g is expected to be associated with ?

Your Answer: ∅ Blank

a) Imperforate anus

b) Hepatic cyst and fibrosis

c) Absence ofureter

d) Holoprosencephaly

Explanation:

Ans. is 'b'i.e., Hepatic cyst and fibrosis

The, clinical findings suggest autosomal recessive polycystic kidney disease.
Both kidneys are mildly enlarged and grossly show innumerable cyst along the
cortex and medulla.
Liver involvement is characterized by bile duct proliferation and ectasia as well as
by hepaticfibrosis.
:
 0 / 1 point
96. 96.A patient who was on aspirin for long period was to undergo an
elective surgery. Now;

Your Answer: ∅ Blank

a. Stop aspirin for 7 days

b. Infusion of fresh frozen plasma

c. Infusion of platelet concentration

d. Go ahead with surgery maintaining adequate hemostasis.

Explanation:

Ans: a
MOA of aspirin:
Irreversibly inhibit TXA2 synthesis by platelets platelet aggregation is interfered &
bleeding time
prolonged nearly to twice.
Effect lasts for about 1 week (turn over time of platelet)

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97. [Link] agent with least blood gas partition coefficient is:

Your Answer: ∅ Blank

a. Desflurane

b. Nitrous oxide

c. Halothane

d. Ether

Explanation:

Ans: a Desflurane.
B/G partition coefficient of desflurane is least (0.42) amongst those used
nowadays (otherwise xenon has
least i.e. -0.14) and hence induction is fastest with desflurane.
:
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98. [Link] anesthetic modality is to be avoided in sickle cell disease?

Your Answer: ∅ Blank

a. General anaesthesia

b. Brachial plexus block

C. I.V. regional anaesthesia

d. Spinal anaesthesia

Explanation:

Ans: c. IV regional anaesthesia.

I.V. Regional anaesthesia is contraindicated in situations in which tourniquets are
contraindicated.
(E.g. Sickle cell anemia or Raynaud's disease)

0 / 1 point
99. [Link] of the following is contraindicated during endotracheal
intubation?

Your Answer: ∅ Blank

a. Head elevation

b. Pre-oxygenation with 100% oxygen

C. Neck flexion at atlanto-occipital joint

d. Introduction of blade towards the right side of oropharynx

Explanation:

Ans: c
During intubation, patient should be supine and there should be extension at the
Atlanto- occipital
joint and flexion at the cervical spine.
:
 0 / 1 point
100. [Link] are used for reversal of neuromuscular blockade
of all muscle relaxants below except.

Your Answer: ∅ Blank

a. Vecuronium

b. Decamethonium

C. d - tubocuranine

d. Rocuronium

Explanation:

Ans: b
Anticholinesterases are required for reversal of block by non- depolarizing
blockers only.

0 / 1 point
101. [Link] is of no use during the management of

Your Answer: ∅ Blank

a. Ventricular fibrillation

.b. Pulseless electrical activity

c Pulseless ventricular tachycardia

d. Polymorphic ventricular tachycardia

Explanation:

Ans:b

Asystole and pulseless electrical activity are non-shockable rhythms in which

there is no role of
defibrillator in ACLS.
:
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102. 102.. EMLA is combination of local anesthetics. What is it used for?

Your Answer: ∅ Blank

a. Spinal block

b. Bier's block

[Link] anaesthesia

d. Ring block in finger

Explanation:

Ans: c
EMLA (Eutectic mixture of Local Anesthetics) is a mixture of prilocaine 5% and
lignocaine 5% in
equal amount. It is used for topical or surface [Link] major limitation of
this cream is its slow onset.

0 / 1 point
103. [Link] giving pre-anesthetic medication, which anticholinergic will you
use antisialagouge effect only?

Your Answer: ∅ Blank

a. Glycopyrrolate

b. Atropine

[Link]

d. Any of the above

Explanation:

Ans: a
Atropine has mild antisialagouge property but more CNS toxicity, scopolamine
produce sedation and amnesia in addition. But glycopyrrolate has good
antisialagouge property without CNS toxicity and sedation.
:
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104. [Link] is a common feature of:

Your Answer: ∅ Blank

a. Alcohol withdrawal

b. Cocaine withdrawal

C. Cannabis withdrawal

d. Opioid withdrawal

Explanation:

Ans: d
The onset of opioid withdrawal symptoms occur typically within 12 - 24 hours and
subsides within 7- 10 days. The characteristic symptoms include lacrimation,
rhinorrhea, pupillary dilatation, sweating, diarrhea, yawning, tachycardia, mild
hypertension, insomnia, raised body temperature, muscle cramps, generalized
body ache, anxiety, piloerection, nausea, vomiting and anorexia.

0 / 1 point
105. 105. One of the following is reversible cause of dementia

Your Answer: ∅ Blank

a. Toxic dementia

b. Alzheimer's disease

d. Multi-infarct dementia

d. Pick's disease

Explanation:

Ans a
Reversible causes of dementia are: Toxic, deficiency (Vit B1, B12, nicotinic acid,
hypothyroidism etc), infective & traumatic (EDH, SDH, normal pressure
hydrocephalus)
:
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106. 106. 12 years old male presented with intensely itchy grouped vesicles
on buttock, trunk and scalp. On exposure to wheat they exaggerate. Diagnosis
is-

Your Answer: ∅ Blank

a. Herpes simplex

b. Dermatitis herpetiformis

c. Pemphigus vulgaris

d. Bullous impetigo

Explanation:

Ans: b. Dermatitis herpetiformis

Among given options only dermatitis herpetiformis is a gluten sensitivity disorder
and aggravates on eating gluten (wheat, rye, barley)
Other features in favour of diagnosis are
• Intense itching (characteristic feature)
• Distribution of lesion – buttock, trunk and scalp (extensor)
• Gender - Male
• Age group-DH is commonly seen in 2nd to 3rd decade
:
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107. 107. Positive Nikolsky’s sign is a feature of-

Your Answer: ∅ Blank

a. Pemphigoid

b. Dermatitis herpetiformis

c. Pemphigus

d. Rubella

Explanation:

Answe : c. Pemphigus
Positive Nikolsyky’s sign is seen in
• Pemphigus vulgaris
• Pemphigus foliaceus
• Bullous pemphigoid
• Epidermolysis bullosa
• Bullous lichen planus
• Bullous Lupus erythematosus
• Toxic epidermal necrolysis
• Steven Johnson syndrome
:
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108. 108. Which of the following is most serious type of psoriasis is-

Your Answer: ∅ Blank

a. Chronic plaque psoriasis

b. Generalized pustular psoriasis

c. Guttate psoriasis

d. Flexural psoriasis

Explanation:

Ans:b. Generalized pustular psoriasis

Erythrodermic and generalized pustular psoriasis (Von Zumbusch type) are can
become dermatological emergencies. They are the most severe forms
Chronic plaque psoriasis is the most common form (80%)

0 / 1 point
109. [Link] is done after ....... w eeks of an attack of quinsy.

Your Answer: ∅ Blank

a. 4

b. 6

C. 8.

d. 10

Explanation:

Ans: b 6 weeks
Tonsillectomy is done after 6 weeks of attack of quinsy.
:
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110. 110. A 50 years female comes with complain of bilateral hearing loss,
tinnitus and positive family history. The most likely diagnosis is:

Your Answer: ∅ Blank

a. Otospongiosis

b. Tympanosclerosis

[Link] ear

d. Chronis otitis media

Explanation:

Ans: a. Otospongiosis
Bilateral hearing loss, tinnitus,and positive family history points towards
otospongiosis.

0 / 1 point
111. 111. Which of the following arteries does not contribute to Kiesselbach's
plexus?

Your Answer: ∅ Blank

a. Posterior ethmoidal

b. Superior labial

[Link]

d. Greater palatine

Explanation:

Ans: a posterior ethmoidal

Blood supply of septum:- external carotid branches (sphenopalatine, greater
palatine, superior labial) and internal carotid (anterior and posterior ethmoidal
artery)
Posterior ethmoidal artery has no supply in the formation of Kiesselbach's plexus.
:
 0 / 1 point
112. [Link] of wound infection is done by all, except

Your Answer: ∅ Blank

a. Pre-op shaving

b. Pre-op antibiotic therapy

[Link] suture

d. Wound apposition

Explanation:

Ans: a
Prevention of the wound infection is done by prophylactic antibiotics, use of
proper suture material and type, proper wound apposition for healing by primary
intention.

0 / 1 point
113. 113. In acute tonsillitis, most common lymph node enlarged is

Your Answer: ∅ Blank

[Link]-mandibular

b. Post -cervical

c. Jugulo-digastric

d. Jugulo-omohyoid

Explanation:

Ans:c. Jugulo- diagastric

The jugulodigastric lymph nodes, also known as subdigastric lymph nodes, are
deep cervical nodes located below the posterior belly of the digastric muscle and
anterior to the internal jugular vein.
:
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114. [Link] having laryngo-tracheobronchitis presented with stridor. The
treatment of choice is

Your Answer: ∅ Blank

[Link] intubation

b. Antibiotics only

[Link] tracheostomy

d. Immediate tracheostomy

Explanation:

ans :[Link] intubation

0 / 1 point
115. 115. Acute tonsillitis in children is caused by

Your Answer: ∅ Blank

a. Staph. Aureus

b. Beta-hemolytic streptococci

C. S. pneumonia

d. H. influenzae

Explanation:

Ans: b Beta hemolytic streptococci.

:
 0 / 1 point
116. 116. A 15 year old boy presented with unilateral nasal obstruction,
epistaxis and swelling over cheek. Most likely diagnosis is

Your Answer: ∅ Blank

a. Foreign body

b. Nasopharyngeal carcinoma

c. Angifibroma

d. Nasal polyp

Explanation:

ans : c. Angifibroma

0 / 1 point
117. 117.A 72 year old male complains of gradual painless loss of vision with
cloudy papillary reflex. The most likely diagnosis is:

Your Answer: ∅ Blank

a. Cataract

b. Glaucoma

C. Retinal detachment

d. Hypertensive retinopathy

Explanation:

ans : a. Cataract
:
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118. 118.. In AIDS patient, the most common ocular manifestation is

Your Answer: ∅ Blank

a. Hemorrhage

b. Cottonwool spots

c. Hard exudates

d. Micro aneurysm

Explanation:

Ans: b. Cotton wool spots.

Multiple cotton wool spots are seen in 50% cases of retinopathy of AIDS.
Superficial and deep retinal hemorrhages occur
in 15-40% cases. Microaneurysms and telangiectasia may also be seen rarely

0 / 1 point
119. 119..Inert intraocular foreign body is

Your Answer: ∅ Blank

a. Iron

b. Copper

[Link]

d. Gold

Explanation:

Ans: d. Gold
Reactions to intraocular FB:
Organic FB: (wood, other vegetative materials) produce proliferative reactions.
Inorganic FB may be inert :(glass, plastic, porcelain, gold, silver, platinum), locally
irritating (lead and aluminum), suppurating (pure copper, zinc, nickel, mercury) or
specific reactions (iron siderosis bulbi, copper alloys chalcosis)
:
 0 / 1 point
120. [Link] mother of a one and half-year old child gives history of a white
reflex from one eye for the past 1 month. On CT scan of the orbit, there is
calcification seen within the globe. The most likely diagnosis is:

Your Answer: ∅ Blank

a. Congenital cataract

b. Retinoblastoma

C. Endophthalmitis

d. Coat's disease

Explanation:

Ans: b Retinoblastoma.
Retinoblastoma facts leading to the diagnosis:
The vast majority present within first 2 years of life.
White pupillary reflex or leukocoria is the commonest presentation.
Calcification occurs in 75% of the cases and is most pathognomic of
retinoblastoma.
:
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121. 121.A 55 year old female comes to the ophthalmology OPD with history
of severe eye pain, redness and diminution of vision. On examination the visual
acuity is 6/60, there is circumcorneal congestion, corneal edema and a shallow
anterior chamber. Which of the following is the best drug of choice?

Your Answer: ∅ Blank

a. Atropine ointment

b. I.V. Mannitol

c. Ciprofloxacin eye drops

d. Betamethasone eye drops

Explanation:

Ans: b. IV mannitol.
The case points towards Acute congestive glaucoma and among given options IV
mannitol will be the treatment.

0 / 1 point
122. 122.A 55 year old patient complains of decreased distance vision.
However, now he does not require his near glasses for near work. The most likely
cause is:

Your Answer: ∅ Blank

[Link] subcapsular cataract

[Link] subcapsular cataract

C. Nuclear sclerosis

d. Anterior subcapsular cantaract

Explanation:

Ans: c. Nuclear sclerosis.

This improvement of near vision in Nuclear sclerosis is called Second Sight.
:
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123. [Link] common benign bone tumor is:

Your Answer: ∅ Blank

a. Osteosarcoma

[Link] osteoma

c. Osteochondroma

d.. Chondrosarcoma

Explanation:

Ans: c. Osteochondroma
• Most common tumor of bone:Secondaries
• Most common primary bone malignancy: Multiple myeloma
• Most common benign tumor of bone: Osteochondroma
• Most common true benign tumor of bone: Osteoid osteoma
:
 0 / 1 point
124. 124 A 65-years-old female presented 6 weeks after a fracture of neck of
[Link] of choice in this patient will be:

Your Answer: ∅ Blank

[Link] hip replacement

b. Hemiarthroplasty

[Link]'s osteotomy

d. [Link]

Explanation:

Ans:a. Total hip replacement.

Closed reduction and internal fixation of fractures of neck of femur after 2-3
weeks of fracture is not possible due to uncertainty of vascularity of head of
femur. In patients of age < 60 years, on open reduction if the head is still vascular
hip reconstruction procedures (osteotomies) are done and if the head is
avascular, immediate excisions of the femoral head and its replacement by a
bipolar metal prosthesis is the treatment of choice (hemiarthroplasty). But if the
age is above 60 years, vascularity of head is always compromised and arthritic
changes are most likely and hence total hip replacement (THR) is the treatment
of choice.
:
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125. [Link]'s test is not positive in:

Your Answer: ∅ Blank

a. Tuberculosis of hip joint

b. Poliomyelitis

c. Posterior dislocation of hip

d. Fracture of neck of femur

Explanation:

Ans:b. Poliomyelitis
The body is prevented from falling to the other side; when a person stands on
one limb by the contraction of glutei medius and minimus of same side. If this
abductor mechanism is defective, the unsupported side of pelvis drops resulting
in positive Trendelenburg sign. This sign is positive in pain on weight bearing
(arthritis), weakness of glutei medius and minimus (poliomyelitis), shortening of
the femoral neck, and dislocation or subluxation of hip joint. This sign is positive
in late stage (stage 4) of TB hip only.

0 / 1 point
126. 126..In Volkmann's ischemia, the first sign is:

Your Answer: ∅ Blank

[Link] of radial pulse

b. Temperature

c. Pain

d. Pallor

Explanation:

Ans: c Pain
The high-risk injuries for Volkmann's ischemia are fractures of the elbow, forearm
bones, and proximal one-third of tibia. Classical features of ischemia are 5 Ps viz.
Pain, Paresthesia, Pallor, Paralysis and Pulselessness. The earliest of these
classical features to appear is pain .
:
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127. 127. Injury to the ulnar nerve at the wrist cause paralysis of

Your Answer: ∅ Blank

a. Apposition of the thumb

b. Abduction of the carpo-metacarpal joint of the thumb

c. Adduction of the thumb

d. Flexion of the MCP joint

Explanation:

Ans:.c. Adduction of the thumb

If ulnar nerve is paralysed, adductor pollicis will be paralysed and patient will not
be able to grasp a book between thumb and index finger. This test is called the
"Book test/ Forment's sign."

0 / 1 point
128. 128. True about CTEV is all except:

Your Answer: ∅ Blank

a. Equinus at the tibiotalar joint

b. Varus at talonavicular joint

c. Adduction at midtarsal joint

d. All of above are correct

Explanation:

Ans: .b. Varus at talonavicular joint

Varus in CTEV Occurs at the subtalar (talocalconeal joint)
:
 0 / 1 point
129. [Link] management of a patient with multiple fractures and fluid
loss includes the infusion of:

Your Answer: ∅ Blank

[Link]

b. Dextran

C. Ringer lactate

d. 5% dextrose

Explanation:

Ans: c Ringer lactate.

Resuscitation following blood loss from multiple fractures begins with
administration of 2 to 3 litres of isotonic crystalloid solution immediately to restore
blood pressure and peripheral circulation.

0 / 1 point
130. 130. Which of the following is better indicator of need for transfusion?

Your Answer: ∅ Blank

[Link] output

b. Hematocrit

C. Color of skin

d. Clinical examination

Explanation:

Ans:b Hematocrit.
Hematocrit is the volume percentage of the RBCs in blood. RBCs signifies the
ability of oxygen transport to
the tissues. Hematocrit levels are measured to help ensure the transfusion is
necessary and safe.
:
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131. 131.A 66 y/o nulliparous woman presents with abdominal distension
despite a poor [Link] had menopause 17 years ago. A rectal exam reveals
induration in the pouch ofDouglas. She has a fluid wave in theabdomen revealed
in USG and a left-sidedpleural effusion. A thoracocentesis shows clumps of
malignant cells in that stains positive for CA 125. Which of the following is the
most likely diagnosis?

Your Answer: ∅ Blank

a. Metastatic stomach cancer

b. Metastatic cervical cancer

c. Metastatic ovarian cancer

[Link] endometrial cancer

Explanation:

ans : c. Metastatic ovarian cancer

0 / 1 point
132. [Link] of the following is an INCORRECT statement about Krukenberg
tumor?

Your Answer: ∅ Blank

a. It is the spread of gastric cancer to both ovary.

b. It is the spread of ovarian cancer to the stomach.

c. It shows Signet ring cells on histology.

d. All of the above.

Explanation:

ans : b. It is the spread of ovarian cancer to the stomach.

:
 0 / 1 point
133. 133. In a suspected ovarian cancer, imaging work-up is required for all of
the following information, EXCEPT:

Your Answer: ∅ Blank

a. Detection of adnexal lesion.

b. Characterization of the lesion

[Link] the metastasis

d. none

Explanation:

ans : d. none

0 / 1 point
134. 134. In a case of Dysgerminoma of the Ovary, one of the following tumor
markers is likely to be raised:

Your Answer: ∅ Blank

a. Serum HCG

b. Serum a-fetoprotein

[Link] LDH

d. Serum Inhibin

Explanation:

ans : [Link] LDH

:
 0 / 1 point
135. 135. The most common pure germ cell tumor of ovary is

Your Answer: ∅ Blank

[Link]

[Link]

[Link] cell tumor

[Link] cell tumor

Explanation:

Ans:b
• Krukenberg tumor by definition represent carcinoma of stomach metastasised to
ovary. But the eponym is commonly used to denote any gastric cancer metastatic
to [Link] arise by retrograde lymphatic spread

Dysgerminoma: Commonest malignant germ cell tumour of ovary.

Primarily affect young [Link] unilateral, bilateral in 15-20% [Link] does
not secrete AFP and HCG is only rarely secreted, however it secretes LDH and
placental alkaline phosphate, which are used as tumour marker of dysgerminoma
:
 0 / 1 point
136. 136.A 40-year-old woman presents complaining of Heavy menstrual
periods that are very [Link], she has bleeding in between periods.
She also complains of pelvic pain and pressure. On exam, the uterus measures
16 weeks in size, irregular, and in the midline. The adnexa are not [Link]
is the most likely diagnosis?

Your Answer: ∅ Blank

a. Menorrhagia.

b. Fibroid

[Link]

d. Adenomyosis

Explanation:
ans : b. Fibroid

0 / 1 point
137. [Link] disease may present with all of the following EXCEPT:

Your Answer: ∅ Blank

a. Amenorrhoea

b. Pelvic mass

[Link]

d. Polymenorrhoea

Explanation:

ans : a. Amenorrhoea
:
 0 / 1 point
138. [Link] most common location for the lesion in this disease is:

Your Answer: ∅ Blank

a. Sub-mucosal

b. Sub-serosal

c. Intramural

d. Interligamentous

Explanation:

ans : c. Intramural

0 / 1 point
139. [Link] treatment for asymptomatic patient of this disease is:

Your Answer: ∅ Blank

a. Bed rest and narcotics

b. A course of GnRH agonist for 6 months

c. Myomectomy

d No treatment

Explanation:

ans : d No treatment

0 / 1 point
140. [Link] treatment of this disease is

Your Answer: ∅ Blank

[Link] rest and narcotics

b.A Couse of Gnrh agonist for 6 month

[Link]

[Link]

Explanation:
Ans:d
:
 FIBROID:
Fibroids are the most common benign solid tumors in females
Most common age group affected is 35–45 years
Fibroid is an estrogendependent tumor
Diseases commonly associated with leiomyomas— • Follicular cysts of ovary
• Endometrial hyperplasia
• Endometrial cancer • Endometriosis
Mostly fibroids are asymptomatic(M/C presentation)
• Most common symptom—Menstrual disturbances
• Most common menstrual disturbance: Progressive menorrhagia
• Dysmenorrhea – congestive as well as spasmodic type seen.
• Infertility
• Pain: A fibroid usually does not cause pain. Causes: Malignancy,Torsion of a
pedunculated fibroma, Degeneration
• Polycythemia,Hypoglycemia and hypokalemia.
• M/c investigation done in fibroids or IOC is USG.
Best investigation to detect a small submucous fibroid—hysteroscopy
According to the latest concept - Asymptomatic fibroids of any size can be
managed expectantly.
Definitive management of symptomatic fibroids is surgery.
Some Specific Indications for Hysterectomy:In patients > 40 years of age.,
Multiparous women,If fibroid is associated with malignancy,During myomectomy,
if their is uncontrolled hemorrhage or other surgical difficulty.
:
 0 / 1 point
141. 141.A 55-year-old post menopausal woman, on hormone replacement
therapy (HRT), presents with heaviness in both breasts. A screening
mammogram reveals a high density speculated mass with cluster of pleomorphic
microcalcification and ipsilateral large axillary lymph nodes. The mass described
here most likely represents:

Your Answer: ∅ Blank

a. Cystosarcoma phyllodes

b. Lymphoma

cFibroadenoma

d. Carcinoma Breast

Explanation:
ans : d. Carcinoma Breast

0 / 1 point
142. 142. On examination a 5cm lump was palpated in right breast with 3cm
node in the suprecoavicular [Link] of the following TNM stage she belongs
to as per the latest AJCC staging system?

Your Answer: ∅ Blank

a.T2N0M1

b.T1N0M1

c.T2N3M0

d.T2N2M0

Explanation:

ans : c.T2N3M0
:
 0 / 1 point
143. [Link] about treatment of early breast cancer:

Your Answer: ∅ Blank

a. Aromatase inhibitors are replacing tamoxifen in premenopausal women

b. Postmastectomy 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 chemo-therapy is given in selected

patients

Explanation:

ans : b. Postmastectomy radiation therapy is given when 4 or more lymph nodes

are positive

0 / 1 point
144. 144. All of the following are removed in radical mastectomy except:

Your Answer: ∅ Blank

a Pectoralis major

b. Pectoralis minor

c. Axillary lymph node

d. Supraclavicular lymph node

Explanation:

ans : d. Supraclavicular lymph node

0 / 1 point
145. 145.. In Patey's modified mastectomy, which of the following is
preserved?

Your Answer: ∅ Blank

[Link] nerve

b. Pectoralis major

[Link] minor
:
 d. Axillary fascia

Explanation:

Ans:b

CARCINOMA BREAST
• First investigation for tissue sampling is FNAC
• Best and diagnostic investigation is Biopsy
• Pattern of calcification in Breast disease
Carcinoma: Microcalcification, punctate, branching
Fibroadenoma: Popcorn (coarse ,granular ,crushed stone)
Fibrocystic disease:Powdery
Fat necrosis: Curvilinear
• Halstead's Radical Mastectomy
Structures Removed
• • Whole breast, skin and nipple-areola complex
• Subcutaneous fat, deep fascia vertically from lower border of the clavicle upto
the upper quarter of the sheath of the rectus abdominis and horizontally from
sternum to anterior border of lattissimus dorsi.
• Pectoralis major and minor muscle with clavipectoral fascia
• Level I, II and III axillary LNs
Structures preserved(ABC)
• Axillary vein and Cephalic vein
• Long thoracic nerve of Bell(Nerve to serratus anterior)
• Hormonal therapy in Carcinoma Breast:
-Tamoxifen is DOC in premenopausal women
-Aromatase inhibitors are DOC in post menopausal women
:
 0 / 1 point
146. 146.A patient gives a history of diarrhoea and blood in stool and presents
with multiple fistula in the perineum and multiple strictures in small [Link]
diagnosis is

Your Answer: ∅ Blank

a. Chrons disease

b. Ulcerative colitis

c. Radiation enteritis

d. Ischemic bowel disease

Explanation:

ans : a. Chrons disease

0 / 1 point
147. [Link] statement is regarding above disease is

Your Answer: ∅ Blank

a. Stomach not involved

b. No granulomatous +Transmucosal fissures

c. Continuous involvement

d. Through and through involvement of thickness of bowel wall.

Explanation:

ans : d. Through and through involvement of thickness of bowel wall.

:
 0 / 1 point
148. [Link] disease is associated with

Your Answer: ∅ Blank

a. NOD2/CARD-15 gene

b. P53 supressor gene

c. Philadelphia chromosomes

d. BRACA-1 gene

Explanation:

ans : a. NOD2/CARD-15 gene

0 / 1 point
149. [Link] difference between Ulcerative colitis and Chrons disease
is the presence of

Your Answer: ∅ Blank

a. Crypt abscess

b. Diffuse distribution of pseudopolyp

c. Mucosal edema

d. Lymphoid aggregates in the mucosa

Explanation:

ans : a. Crypt abscess

:
 0 / 1 point
150. [Link] patient underwent resection anastomosis. Now present on 7th
post-op day with anastomotic leak from a fistula. Every day leakage volume adds
up to 150–200ml. There is no intra-abdominal collection and the patient is stable
without any complaints. What will be next line of management?

Your Answer: ∅ Blank

[Link] treatment and leave him and hope for the spontaneous
resolution

b. Perform laparotomy and check for leakage site and healthy margins

[Link] laparotomy and completely exteriorize the fistula

d. Perform laparotomy and place drain and leave

Explanation:
Ans:a

INFLAMMATORY BOWEL DISEASE.

Identification of CARD 15/NOD 2 mutations ( on chromosome 16q) is relatively

specific for Crohn's disease.
Main intestinal complication of Crohn's disease includes obstruction and
[Link] occur in between the sites of perforation and adjacent
organs,usually at the site of previous laparotomy.
Treatment of post operative enterocutaneous fistula in Crohn's disease:
Conservative management allows those fistula to heal spontaneously and also
allyfor optimisation of nutritional status and control of wound and fistula
[Link] closure of the fistula after removing the fistula tract almost always
results in recurrence of the fistula.
:
 0 / 1 point
151. 151.A 48 years female has been admitted for [Link] has a serum
k+ level of 7.5 meq/[Link] is the fastest way to reduce hyperkalemia?

Your Answer: ∅ Blank

[Link] potassium bicarbonate

[Link] of insulin+glucose

[Link] gluconate

[Link] enema

Explanation:

ans : [Link] of insulin+glucose

0 / 1 point
152. [Link] of the following electrolyte abnormality is not seen in CRF?

Your Answer: ∅ Blank

a. Hypercalcemia

b. Hyperkalemia

c. Hyperphosphatemia

d. Hyperuricemia

Explanation:

ans : a. Hypercalcemia
:
 0 / 1 point
153. [Link] most common cause of death in patients on dialysis for CRF

Your Answer: ∅ Blank

[Link]

[Link] disease

[Link]

[Link]

Explanation:

ans : [Link] disease

0 / 1 point
154. [Link] patient later on underwent kidney transplant,but developed
lymphoproliferative [Link] most common virus implicated is

Your Answer: ∅ Blank

[Link]

[Link]

[Link]

[Link]

Explanation:

ans : [Link]
:
 0 / 1 point
155. [Link] common viral infection after kidney transplant is

Your Answer: ∅ Blank

a EBV

[Link]

[Link]

[Link]

Explanation:

Ans:c CMV

• The most common cause of death in patients on chronic dialysis in CRF is

cardiovascular disease .
Whereas Infection is the most common cause of death in patients dialyzed for
acute renal failure.
• Most common virus implicated in Post transplant Lymphoproliferative disorders
is EBV.
Whereas most common viral infection in post transplant cases is CMV

• Treatment of hyperkalemia:
:
 0 / 1 point
156. 156.A female has episodic, recurrent headache in left hemicranium with
nausea and parasthesia on right upper and lower limbs is most probably suffering
from:

Your Answer: ∅ Blank

a.. Migraine

b Glossopharyngeal neuralgia

c . Herpes zoster infection of trigeminal Nerve

d. Brain tumour

Explanation:

ans : a.. Migraine

0 / 1 point
157. [Link] of the following agents are used for prophylaxis of above
condition Except

Your Answer: ∅ Blank

[Link]

b Valproate

[Link]

d.. Ethosuxamide

Explanation:

ans : d.. Ethosuxamide

:
 0 / 1 point
158. [Link] is drug of choice for acute attack ?

Your Answer: ∅ Blank

a.. Methysergide

b. Caffeine

c. Amitryptiline

d. Sumatriptan

Explanation:

ans : d. Sumatriptan

0 / 1 point
159. [Link] of the following statements about treatmentare true, Except

Your Answer: ∅ Blank

a Narotriptan has slower onset and longer t1/2 than sumatriptan

b Rizatriptan is more efficacious than sumatriptan

c.. Sumatriptan is a selective 5-HT 1B/1D agonist

d. Sumatriptan is used for chronic migraine

Explanation:

ans : d. Sumatriptan is used for chronic migraine

:
 0 / 1 point
160. [Link] of the following is a varient of above condition?

Your Answer: ∅ Blank

a Basilar

[Link] hemiplegic

[Link]

d. All

Explanation:

Ans: d. all

MIGRANE
Variants:Focal,Basilar,opthalmoplegic, Hemiplegic, Episodic ataxia,Retinal
migraine,Migraine infarction ,etc.
Sumatriptan is DOC for acute migrane

0 / 1 point
161. 161.A 34 years old person falls on outstretched hand with hyperextension
and pronation anddeformity & swelling of forearm and injury to injured his
forearm. On examination, you found deformity and swelling of forearm and injury
to interosseous [Link] sent for X-ray of forearm. What is themost likely finding
you would be expecting?

Your Answer: ∅ Blank

a. Galeazzi fracture dislocation

b. Fracture of head of radius

C. Monteggia fracture dislocation

d. Terrible triad of elbow

Explanation:

ans : C. Monteggia fracture dislocation

:
 0 / 1 point
162. 162. What deformity is expected to follow due to this nerve injury?

Your Answer: ∅ Blank

a. Wrist drop

b. Thumb drop

C. Ape thumb deformity

d. Claw hand deformity

Explanation:

ans : b. Thumb drop

0 / 1 point
163. 163. Which one of the following is not a fracture of necessity?

Your Answer: ∅ Blank

a. Galeazzi # dislocation

b. Displaced # of olecranon and patella

C. Intertrochanteric # of femur

d. Monteggia # dislocation in adults

Explanation:

ans : C. Intertrochanteric # of femur

0 / 1 point
164. 164. What will be your plan for the management of fracture?

Your Answer: ∅ Blank

a. Closed reduction, immobilization in full arm plaster cast

b. ORIF with plate and screws

C. Immobilization in arm sling

d. Fixation with IM nailing

Explanation:
ans : b. ORIF with plate and screws
:
 0 / 1 point
165. 165. You found that the patient is having pain when you attempted to
stretch his fingers, his forearm is very tense and radial pulse was barely palpable.
Your next step will be all of the following except:

Your Answer: ∅ Blank

a. Limb elevation and active fingermovements

b. Remove casts, bandages and dressings

c. Advising to nurse the limb flat

d. Call the consultant immediately and plan for fasciotomy

Explanation:

ans : a. Limb elevation and active fingermovements

0 / 1 point
166. 166. A 40 y/o female patient presents with history of depressed mood,
loss of appetite, insomnia and no interest in surroundings for the last 1 year .
These symptoms followed soon after a business loss 1 year back,Which of the
following is true statement regarding the management of this patient?

Your Answer: ∅ Blank

a. No treatment is necessary as it is due to business loss,

b. SSRI is the most efficacious of the available drug for this patient.

c. Antidepressant treatment based on the side effect profile of the drugs.

d. Combination therapy of 2 anti-depressant drugs.

Explanation:

ans : c. Antidepressant treatment based on the side effect profile of the drugs.
:
 0 / 1 point
167. [Link] are the side effects of TCAS EXCEPT:

Your Answer: ∅ Blank

[Link]

b. Metallic taste

c. Dry mouth

d. Epigatric discomfort

Explanation:

ans :[Link]

0 / 1 point
168. [Link] of the following is anti-depressant with no anti-cholinergic
effects?

Your Answer: ∅ Blank

a. Imipramine

b. Fluvoxamine

C. Mainserine

d. Amitriptyline

Explanation:

ans : b. Fluvoxamine
:
 0 / 1 point
169. [Link] about TCA is:

Your Answer: ∅ Blank

a. May be useful in nocturnal enuresis.

b. Wide safety margin.

C. Low oral bio-availability.

d. Response time is short.

Explanation:

ans : a. May be useful in nocturnal enuresis.

0 / 1 point
170. [Link]-psychotic drug induced Parkinsonism is treated by:

Your Answer: ∅ Blank

a. Anti-cholinergics

b. Levo-dopa.

C. Selegiline.

d. Amantadine.

Explanation:

ans : a. Anti-cholinergics
:
 0 / 1 point
171. [Link] of 14 years old female are concerned about their daughter
not yet started menstruation .On examination you find delay in secondary sexual
characteristics,shielded chest and webbed [Link] is your probable
diagnosis?

Your Answer: ∅ Blank

[Link]'s syndrome

[Link] syndrome

[Link] syndrome

[Link] syndrome.

Explanation:

ans : [Link] syndrome

0 / 1 point
172. [Link] karyotype is

Your Answer: ∅ Blank

a.45 XO

b.47 XXY

c.48 XXYY

[Link]

Explanation:

ans : a.45 XO
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173. [Link] statement is

Your Answer: ∅ Blank

[Link] is present in Bonnevie- Ullrich syndrome

[Link] common cardiac defect is bicuspid aortic valve

[Link] be associated with horse shoe shaped kidney

[Link]

Explanation:

ans : [Link]

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174. 174 Single gene defect causing multiple unrelated problems is called

Your Answer: ∅ Blank

[Link]

[Link]

[Link]

[Link]

Explanation:

ans : [Link]
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175. [Link] are indications for genetic counseling EXCEPT

Your Answer: ∅ Blank

a paternal age>50 years

[Link]>45years

[Link] history of intellectual disability

[Link]

Explanation:

TURNER SYNDROME
Incidence : 1 in 2500 live birth
Karyotype: 45XO
Etiology: In 89% of the cases paternal X chromyis missing.
Features: Webbed neck,Low posterior hairline,Shield chest,Wide spaced nipples,
Coarctation of aorta, Lymphedema,Short stature, Coarctation of aorta, Bicuspid
aortic valve
Treatment: Multidisciplinary approach
Maternal age > 35 yrs is the indication for genetic counselling.
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176. 176. A 2 year old child presented in ER department.A/c to parents the
child while playing in the garden unattended, suddenly started to cough gaspingly
and the skin of the child turned blue. The cough lasted for 3 minutes and then
cyanosis ceased. At present the child is symptomless. Which of the following
response is important to you?

Your Answer: ∅ Blank

a. Parents' previous child died of valvular heart disease.

b. Child had pneumonia 2 weeks ago.

C. Child ate peanuts before the attack.

d. Child often drinks from a dug well.

Explanation:
ans : C. Child ate peanuts before the attack.

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177. 177. Which of the following diagnostic tests do you order?

Your Answer: ∅ Blank

a. ECG

b. Chest X-ray

c. USG chest

d. Observation only.

Explanation:

ans : b. Chest X-ray

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178. 178. Which of the following test do you additionally order?

Your Answer: ∅ Blank

a. Bronchoscopy

b. Bronchography

C. ECG

d. Swallowing test

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179. 179. Which of the following therapeutic interventions do you choose?

Your Answer: ∅ Blank

a. Administration of Methylene blue

b. Administration of N-acetyl cysteine

c. Bronchoscopy

d. Administration of Antibiotics

Explanation:

ans : c. Bronchoscopy
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180. [Link] view do you suggest for FB inesophagus?

Your Answer: ∅ Blank

a. AP view

b. Lateral view

c. Oblique view

d. Schullers view

Explanation:

Ans:a AP view.

AIRWAY FOREIGN BODY

Mostly seen in children of age 3-4 years
Most common foreign body is peanuts
Highly suggested if symptoms are acute choking,coughing, wheezing; often a
witnessed event
• Clinical presentation- depends on location
- Sudden onset of respiratory distress
- Cough, hoarseness, shortness of breath
-Wheezing (asymmetric) and decreased breath sounds (asymmetric))
• Complications-obstruction, erosion, infection (fever,cough, pneumonia,
hemoptysis, atelectasis)
• Diagnosis--Chest X-ray reveals airtrapping (ball-valve mechanism).
Bronchoscopy for definite diagnosis.
• Therapy-removal by rigid bronchoscopy

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