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However, we do not take any responsibility for any incorrect or wrong answers or typing mistake that might have crept in inadvertently, and for any contradiction in the given answers. Readers are requested to check the answers from their own sources. ALL INDIA PG MEDICAL ENTRANCE ENTRANCE EXAMINATION-2012

Anatomy 1. Dilator pupillae is supplie is supplied by 1. Post ganglionic parasympathetic fibres from Edinger Westphal nucleus 2. Post ganglionic sympathetic fibers from the cervical sympathic chain 3. III nerve 4. Sympathetic fibers from the fronto orbital branch of V nerve 2. All of the following cross the right ureter anteriorly except 1. Terminal ileum 2. Genitofemoral nerve 3. Right colic artery and iliocolic artery 4. Vas deferens In case of perforation of ulcer in the posterior wall of 1st part of duodenum, which of the following structure is likely to be involved ? 1. Inferior vena cava 2. Gastroduodenal artery 3. Bile duct 4. Portal vein All of the following are derivatives of the pharigeal arches except 1. Orbicularis oculi 2. Levator palpebrae superioris 3. Palatine tonsil 4. Tensor tympani Which of the following about the valves of Houston is true ? 1. The disappear after mobilization of the rectum 2. The middle valve folds towards the right side 3. The upper valve corresponds to the anterior peritoneal reflection 4. The valves contain all layers of the muscle wall A patient present with a penetrating chest wound associated with intrathoracic haemorrhage, A thoracotomy is done by taking an incision in the 4th/5th interacostals space starting 1 cm away from the lateral margin of the sternum. This is done to avoid injury to the 1. Pleura 2. Intercostal artery 3. Internal thoracic artery 4. Intercostal nerve All the following pass through the inguinal canal in females escept 1. Inferior epigastric artery 2. Round ligament of uterus 3. Ilioinguinal nerve 4. Lymphatics from the fundal part of the uterus All of the following are correct about spinal cord except

3.

4.

5.

6.

7.

8.

1. 2. 3. 4. 9.

The efferent nerve fibres originate from the anterior horn cells The central canal is situated in the white commisure It has grey matter core with white matter covering The ligament denticulatum anchors the lateral borders of the spinal cord to the meninges

The supraduodenal bile duct is chiefly supplied by 1. Vessels that run upwards from gastroduodenal and retroduodenal arteries 2. Vessels that run downwards from the cystic artery 3. Vessels that arise from the hepatic artery as it courses up along the common bile duct and supplies it in a non-axial fashion 4. Vessels that run downwards from the right hepatic artery

PHYSIOLOGY 1. Intrapleural pressure is negative because 1. Chest wall and lungs recoil in opposite directions to each other 2. Transpulmonary pressure is negative 3. Intrapulmonary pressure is always negative 4. Pulmonary collapse is prevented by surfactants 2. Cardiac output decreases during 1. Moderate increase in environmental temperature 2. Anxiety and excitement 3. Eating 4. Standing from lying down position 3. Glutamate as a neurotransmitter is synthesized mainly in which part of brain 1. Globus pallidus interna 2. Globus pallidus externa 3. Subthalamic nucleus 4. Putamen 4. Sex behavior is chiefly affected by lesions in which part of the hypothalamus 1. Preoptic area 2. Supraoptic area 3. Lateral hypothalamic area 4. Posterior hypothalamic area 5. 1. 2. 3. 4. 6. 1. 2. 3. 4. 7. Self stimulation could be induced experimentally most effectively from which part of brain Periacqueductal area (area around the aqueduct of Sylvius) Periventricular region of hypothalamus Medical forebrain bundle Mesencephalon The oxygen transported by 100 ml. of blood in a person breathing 100% oxygen at 4 atm is 9 ml 6 ml 3 ml 0.3 ml Discharge from Baroreceptors causes inhibition of 1. Caudal ventrolateral medulla 2. Rostral ventrolateral medulla 3. Nucleus ambiguous 4. Nucleus tractus solitaries

8.

Amyline is secreted by which cells of the islet of Langerhans ? 1. eta cells 2. Alfa cells 3. Delta cells 4. Gamma (pancreatic polypeptide cells) Electromechanical systole is the interval between 1. S wave and T wave 2. Q wave and T wave 3. R wave and first heart sound 4. Q1 wave and second heart sound

9.

10. Ventrolateral cordotomy is helpful in pain relief in the right leg as it interrupts 1. Right corticospinal tract 2. Left ventral spinothalamic tract 3. Left lateral spinothalamic tract 4. Right lateral spinothalamic tract 11. Clamping of carotid arteries above the level of carotid sinus would lead to 1. Rise in blood pressure along with tachycardia 2. Fall in blood pressure along with tachycardia 3. Rise in blood pressure along with Bradycardia 4. Fall in blood pressure along with Bradycardia 12. Reason of diurnal variation in eosinophil count 1. Variation in environmental temperature 2. Variation in cortisol levels 3. Bone marrow depression during sleep / night 4. Increased physical activity 1. 2. 3. 4. 13. An individual whose blood group is A , the possible genotype for him would be ? OO BO AO AB 14. True about experimental sham rage is 1. Occures in decorticate animals 2. Is caused by removal of hypothalamus 3. Is goal directed 4. Appears slowly and goes slowly 15. Without external cues, the sleep wake cycle in humans 1. Does not continue 2. Continues with cycle length of 24 hours 3. Continues with cycle length of < 24 hours 4. Continues with cycle length of 24 hours 16. The nerves impulse which leads to initiation of muscle contraction 1. Causes opening of the calcium channels which leads to increase in Ca++ concentration with the use of sarcomere 2. Causes both the plasma membrane and the T tubules to undergo hyperpolarization 3. Inhibits Na+ entry in sarcomere 4. Is initiated by binding of acetylcholine to receptors in the sarcoplasmic reticulum BIOCHEMISTRY

1.

The most correct method to confirm the function of a gene is 1. Production of transgenic animals 2. Production of knockout animals 3. Western blot method 4. Southern blot method Which of the following is not used for protein estimation ? 1. Biuret method 2. Bradford method 3. Lowrys method 4. Bromocresol green method Decreased glucose concentration in hepatic cells triggers all of the following except 1. Increased glucagon levels in blood 2. Activation of fructose -2,6 biphospatase 3. Inhibition of phoshofructose 2 4. Increased fructose -2,6 biphosphate levels

2.

3.

4. Which of the following does not undergo phosphorylation by protein kinases 1. Threonine 2. Thyrosine 3. Asparagine 4. Serine 5. All of the following types of porphyrias are autosomal dominant except 1. Acute intermittent porphyria 2. Porphyria cutanea tarda 3. CEP (Congenital erythropoietic porphyria) 4. Herediatary coproporphyria Mammalian mitochondrial are involved in all of the following except 1. Fatty acid synthesis 2. DNA synthesis 3. Fatty acid oxidation (-oxidation) 4. Protein synthesis Which of the following enzymes is involved in process of both cholesterol and ketone bodies synthesis ? 1. HMG CoA reductase 2. HMG CoA synthase 3. HMG CoA lyase 4. Thiolase True regarding cytoplasmic m RNA 1. It is chiefly translated from nuclear DNA 2. The sugar is deoxyribose 3. Thymine is present in place of uracil 4. Its MW is green than heterogenous RNA Restriction enzymes type II 1. Methylate specific DNA sequences 2. Cleave specific palindromic DNA sequences 3. Helps in protein digestion 4. Helps in keeping the nascent protein unfolded

6.

7.

8.

9.

10. Which amino acid in a protein acts a potential O-glycosylation site for attachment of an oligosaccharide unit ? 1. Glutamine 2. Cysteine 3. Serine 4. Asparagine 11. In immune complex formation , which structure of a protein is involved ? 1. Primary 2. Secondary 3. Tertiary 4. Quaternary 12. All are seen post 12-24 hours of starvation except 1. Increased ketone bodies 2. Increased plasma FFA 3. Decreaseed liver glycogen 4. Decreased serum protein PATHOLOGY 1. A young boy came with dyspnea and was found to have a mediastinal mass on CT scan. Histopathology is suggestive of lymphoma. Which of the following is the likely diagnosis ? 1. Diffuse large cell Lymphoma 2. T cell rich cell lymphoma 3. Primary mediastinal cell Lymphoma 4.T cell lymphoblastic lymphoma 2. A person with normal MCHC and high MCV may be suffering from\ 1. Cobalamine deficiency 2. Thalassemia 3. Bone marrow hypoplasia 4. Increased iron metabolism 3. An elderly hyperpensive male presents with microscopic haematuria and proteinuria of 2 g/day. He also shows increased serum creation (2.6 mg %) , anti- HCV anti bodies and decreases complement levels. What is the most likely diagnosis ? 1. Post infective GN 2. MPGN 3. Membranous nephropathy 4. Mixed essential cryoglobulinemia 4.A 12 yrs old girl suffering from fever , leucopenia and splenomegaly suddenly died due to rupture of the intestine. The most likely gross finding on post mortem Would be 1. Longitudinal ulcers of small intestine alongside of lymphoid tissues 2. Transverse ulcers of small intestine 3. Pin point ulcers of the colon 4. Ulcers of small intestine with pseudopolyps 5.Splenomegaly is least likely to be associated with 1. Chronic myeloid leukaimia 2. Primary thrombocythemia 3. Polycythemia vera 4. Primary myelofibrosis

6. Which of these is inherited aplastic anemia ? 1. Fanconis anemia 2. Eosinophilic fascilitis 3. PNH 4. Hypoimmunoguobulinemia 7.A 2 years old boy presents with skin rashes and bleeding. Investigations show very low platelet counts with decreased IgM. The most problem diagnosis is 1. Wiskott Aldrich syndrome 2. Ataxia telangiectasia 3. Chronic granulomatous disease 4. X linked agammaglobulinemia 8. The amyloid protein 1. A protein 2. SAA protein 3. 2 microglobulin 4. Amyloid light chains 9.Which of the following immunohistochemical markers is the most useful for establishing for the diagnosis of a poorly differented carcinoma ? 1. Alpha feto protein 2. Cystokeratin 3. Leukocyte common antigen 4. CD 99 (MIC- 2) 10.A young hypertensive male suddenly developed severe headache and vomiting . He became unconscious and expirerd within 24 hours. The most likely gross pathological finding on the kidneys would be 1. Petechial haemorrages on the surface 2. Large kidneys with a waxy appearance 3. Small kidneys with a granular surface 4. Small kidneys with an irregular surface 11.The most likely histopathological finding in adults with respiratory distress syndrome is 1. Diffuse interstitial pneumonia 2. Diffuse alveolar damage 3. Hypersensitivity pneumonitis 4. Resiretory bronchiolitis 12.The diagnostic method of choice for Hirschsprungs disease is 1. Rectal biopsy 2. Manometry 3. Contrast enema 4. MR Imaging 13. All are true about DIC except 1. Increased FDP, prolonged PT, reduce plated count 2. |Increased fibrogen , increased thrombin antithrombin complex, decreased antithrombin-III 3. Increased FDP , decreased PT , increased antithrombin-III 4. Increased FDP, prolonged PT , increased thrombin antithrombin complex 14. Which of the immune hypersensitivity reaction is responsible for myasthenia gravis ? 1. Type I hypersensitivity reaction 2. Type II hypersensitivity reaction 3. Type III hypersensitivity reaction

4. Type IV hypersensitivity reaction 15. All of the following are autosomal dominant except 1. Gardners syndrome 2. Neurofibromatosis (von Recklinghusen) 3. Peutz- Jeghers syndrome 4. Ataxia telangiectasia 16. A biopsy report shows inflammation of the airways with increased Reid index. The most probable diagnosis is 1. TB 2. Emphysema 3. Chronic bronchitis 4. Bronchiectasis 17. An acidified urinary sample contains protein that precipitates on heating at 40 50 C but redissolves on further heating. The protein is 1. Bence Jones proteins 2. Albumin 3. Globulin 4. IgE 18. A 9- year girl is diagnosed to have a primary small round cell tumour in tibia. Which of the following genetic abnormali ties is most likely? 1. 22q12 translocation 2. 13q14 deletion 3. 11p13 deletion 4. N-myc gene amplification 19. A 1- years old child p[resents with generalized skin rash. Skin biopsy is suggestive of Langerhans cell histiocytosis. Which of the following immunohistochemical stain is the best to confirm the diagnosis ? 1. CD 20 2. CD 68 3. CD 3 4. CD 1a 20. In normal healthy condition blood is prevented from clotting due to 1. Inhibition plasminogen activation 2. Inhibition protein C 3. Binding of thrombin to antithrombin III 4. Thrombodulin mediated activation of Factor IX 21. All of the following are bone marrow derived stem calls except 1. Endothelial progeny tor cells 2. Myeloblast 3. Mesenchymal stem cells 4. Haematopoetic stem cells 22. A 50 yrs old patient has been diagnosed with bronchiectasis 5-10 urs back. He now presents with pedal edema , albuminuria and hypoalbuminemia. The most likely histopathological finding seen on renal biopsy would be 1. Glomerulonephritis 2. Chronic tubuloiterstitial nephropathy 3. Minimal change disease 4. Amyloid nephropathy

23. B and T lymphocytes share all the feature except 1. Positive selection during development 2. Class I MHC expression 3. Antigen specific receptors 4. Dependence on cytokines secreted by other cells 24. A patient with renal tumor is diagnosed by exfoliative cytology. The most likely histological subtype would be 1. Transitional cell carcinoma 2. Adenocarcinoma 3. Well different carcinoma 4. All the three types can be easily deteted on exfoliative cytology 25. All of the following cytokines are pyrogenic except 1. 2. 3. 4. Interleukin (IL) 18 Interleukin -6 Tumour necrosis factor Interferon

PHARMACOLOGY 1. A patient Who underwent an abdominal surgery developed an infection at the wound site. A wound swab was sent for culture which revealed MRSA. All of the following antibiotics can be used for his treatment except 1. Ciprofloxacin 2. Cotrimoxazole 3. Cefaclor 4. Vancomycin Which of the following drugs is used for the treatment of constipation predominant IBS ? 1. Nipradilol 2. Ivabradine 3. Lubiprostone 4. Bromocriptine The drug used to treat cerebral vasospasm is 1. Nimodipine 2. Nifedipine 3. Lidoflazine 4. Losartan

2.

3.

4.Apixaban is 1. Uricosuric drug 2. Factor Xa inhibitor 3. TNF- antagonist 4. Vitamin K antagonist 5. 1. 2. 3. 4. The antineoplasmic agent temozolamide belongs to which of the following groups ? Hormonal agent Antimetabolite Antitumour antibiotic Alkylatin agent

6.Monitoring of the plasma levels is done for all of the following drug except

1. Lithium 2. Cyclosporine 3. Gentamicin 4. Warfarin 7.Drug induced osteomalacia is most commonly caused by 1. Steroids 2. Heparin 3. Phenytoin 4. Gmentamicin 8. A patient with multiple myeloma is suffering from severe hypercalcemia. All of the following drugs can decrease the serum calcium levels except 1. Prednisolone 2. Disodium etidronate 3. Frusemide 4. Hydrochlorthiazide 9.Which of the following fluoroquinolones has the longest half life ? 1. Levofloxacin 2. Ciprofloxacin 3. Lomefloxacine 4. Moxifloxacine 10. A patient suffering from HIV infection and is put on HAART therapy. He presents with lipodystrophy. Laboratory investigations show hypertriglyceridemia and hypercholesterolemia. Which of the following drugs is most likely responsible for these effects ? 1. Zidovudine 2. Ritonavir 3. Nevirapine 4. Lamivudine 11. A 20 yrs old female is suffering from diarrhea and is being treated by a drug that inhibits pyruvate ferredoxin oxidoreductase. The most likely diagnosis is 1. Cryptosporidiosis 2. Beef tape worm infection 3. Trypanosomiasis 4. Whipe worm infection 12. In slow acetylators on treatment for pulmonary tuberculosis with isoniazid, which of the following side effects is most likely to occur ? 1. Peripheral neuropathy 2. Thrombocytopenia 3. Hepatic toxicity 4. Nephrotic syndrome 13. Platelet therapy is udually given for patient with stroke, MI and peripheral vascular disease . PPIs are frequently administered along with these drug to prevent the risk of increased gastrointestinal erosions and bleeding . The interaction between clopidogrel and PPI has recently been given much attention due to its clinical significance. The metabolizing enzyme common to these two drug is 1. CYP2C10 2. CYPA2 3. CYPB2 4. CYP2C20 14. Cyanide toxicity can be caused due to overdose of which of the following drugs ? 1. Nitroglycerine

2. 3. 4.

Epinephrine Sodium nitroprusside Norepinephrine

15. Mobius syndrome can caused by antenatal intake of which of the following ? 1. Mifepristone 2. Misoprostal 3. Dinoprostone 4. Methotrexate 16. The material intake of which of the following drugs is associated with hypospadias in the male infant ? 1. Clomiphene citrate 2. Clobazam 3. Diethylstilbesteol 4. Tolbutamide 17. A 33yrs old pregnant female Gravida 4, para 3, attends the antenatal clinic. Her last mensural period was 8 weeks 4 days ago . She does not complain of any symptoms . On investigation, her rapid plasma regain test for syphilis (RPR) and her micro-heamagglutinin test for antibodies to Treponema pallidum (MHA-TP) are positive. The most appropriate treatment for her would be 1. Erythromycine 2. Levofloxacine 3. Penicillin 4. Metronidazole 18. All of the following drugs are bactericidal except 1. Isoniazid 2. Tigecycline 3. Moxifloxacin 4. Daptomycin

19. An old patient, who is on following medications is planned for surgery, Which of the following can be stopped ? 1. Steroids 2. Statins 3. ARB (Angiotensin II Receptor Blockers) 4. -blockers 20. All of the following are indications of thiazides except 1. Hypertension 2. Heart failure 3. Nephrolithiasis d/t idiopathic hypercalcemia 4. Hyperlipidemia 21. All of the following cause sinus tachycardia except 1. Theophyline 2. Clonidine 3. Nifedipine 4. Amphetamine 22. Nowadays the used method for drug designing is 1. 2. 3. Target-structure based Hit and trial method Molecular modeling way

4.

High throughput method

23. During detoxification of xenobiotics, which of the following is not a part of phase I reaction ? 1. Oxidation 2. Hydrolysis 3. Reduction 4. Conjugation 24. Cardiotoxicity is caused by which of the following ? 1. Rofecoxib 2. Nicorandil 3. Metoprolol 4. Losartan 25. The long term use of which antidiabetic drug is associated to vitamin B12 deficiency ? 1. Metaformin 2. Vildagliptin 3. Exenatide 4. Repaglinide 26. All of the following are side effects of thalidomide except 1. Sedation 2. Constipation 3. Cardiomyopathy 4. Neuropathy 27. A patient of leukemia was given chemotherapy with dactinomycin and Ara C. After 6 weeks , he present with persistent pancytopenia. All of the following cab be a cause for it except 1. Parvovirus infection 2. Folic acid deficiency and Vitamin B12 deficie 3. Persistent leukemia 4. Myelosuppression due to chemotherapy 28. Forced diuresis with acidification or alkalinization of urine is a common method for elimination of which of the following can be enhanced by alkaline diuresis ? 1. theophylline 2. Phenobarbitone 3. Doxepine 4. Amphetamine 29. A patient is receiving ketoconazole for the treatment of fungal infection . Now he has developed gastroesophageal reflux disease. Which one of the following drug should not be used in such case scenario ? 1. Metoclopramide 2. Cisapride 3. Itopride 4. Domperidone 30. After taking some drug for acute attack of migraine, a patient developed nausea and womiting . He also developed tingling and numbness in the tip of the finger that also turned blue. Which of the following is the most likely drug implicated in causing the above finding 1. Dihydroergotamine 2. Sumatriptan 3. Methysergide 4. - blocker

31. an eldery male suffering from allergic conjunctivitis, uses a drug that prevents the release of chemical mediators from masr cells. Which of the following drug has above action 1. Inhibition of 5- lipoxygenase 2. Blockade of muscarinic receptors 3. Activation of B receptors 4. Blockade of calcium influx MICROBIOLOGY 1. A series of ulcers in lower extremities in sub-Himalayan area is often caused by 1. Trichophyton rubrum 2. Psuedallescheria boydii 3. Cladosporium species 4. Sporothrix schenckii Vaccination is based on the principle of 1. Agglutination 2. Phagocytosis 3. Immunological memory 4. Clonal detection Epstein Barr virus causes autoimmunity by 1. Molecular mimicry 2. Including insppropriate expression of Class II MHC 3. Release of sequestered antigens 4. Polyclonal B cell activation The effect of cholera toxin is mediated via the stimulation of following second messenger 1. cAMP 2. cGMP 3. Calcium-calmodulin 4. Acetylcholine A characteristic infection of Nocardia asteroids is 1. Diarrhea 2. Secondary dissemination to liver 3. Brain abscess 4. Colonic diverticula The rheumatoid factor (RF) in the synovial fluid of patient with rheumatoid arthritis is most frequenly found to be 1. IgM reaction with IgG 2. Anti-IgM IgG 3. Antibody to collagen 4. IgG reacting with microbial cell wall polysaccharide All of the following are true about HUS except 1. Infection may be transmitted by food 2. HUS is caused by serotoxin-producing Escherichia coli 3. HUS is more common in children 4. HUS is rearly associated with heamorrhagic colitis In a 5- yrs old boy who has history of recurrent pyogenic infections by bacteria with polysacchariderich capsules, which of the following investigation should be done ? 1. IgA Deficiency 2. IgG IgA Deficiency

2.

3.

4.

5.

6.

7.

8.

3. 4. 9.

IgG2 IgA Deficiency IgA and IgG2 Deficiency

The endotoxin of the following Gram-negative bacteria has no role in the pathogenesis of disease 1. Escherichia coli 2. Klebsiella species 3. Vibrio cholerae 4. Pseudomonas aeruginosa

10. Salmonella typhi causes typhoid fever. The infection does of S. typhi is 1. One bacillus 2. 108 - 1010 bacilli 3. 102 105 bacilli 4. 1 to 10 bacilli 11. With reference to antibiotic resistance all of following statements are true except 1. The most common mechanism is production of neutralizing enzymes by bacteria 2. Plasmid mediated resistance is exclusively transferred vertically 3. Compelete elimination of target is the mechanism by which enterococci develop resistance to vancomycin 4. Alteration of target lesions leads to development of resistance to antibiotics in Streptococcus pneumoniae 12. Which of the following regarding the Interferon gamma release assays used for the diagnosis of tuberculosis is correct ? 1. 1st generation Quantiferon TB used ESAT 6 2. 2nd generation Quantiferon TB (gold) used ESAT 6 and CPF 10 3. These tests can distinguish between M. tuberculosis and M. bovis 4. None of the non tubercular mycobacteria give a positive reaction with this test 13. Which of the following is most resistant to the action of antiseptics and disinfectant ? 1. Spores 2. Coccidia 3. Prions 4. Mycobacteria 14. Bacteria resistance to antibiotics is a genetic event that is located in which part of the bacterial cell ? 1. Chromosome 2. Intron 3. Plasmid 4. Centromere 15. A person with AIDS related complex is most likely suffering from 1. Opportunistic infections 2. Cancers related to AIDS 3. Generalized lymphadenopathy 4. Herpes zoster 16. A 5 yrs old child presents with pustular lesions on the lower legs. The culture from the lesion showed hemolytic colonies on blood agar which were Gram-positive cocci. Provisional diagnosis of Group A streptococcal pyoderma can be done by ? 1. Catalase positivity 2. Optochin sensitivity 3. Bile solubility 4. Bacitracin sensitivity

FORENSIC MEDICINE AND TOXICOLOGY 1. The Japanese Detergent suicide technique involves mixing of household chemicals to produce : 1. H2S and other poisonous gases 2. Deadly foam 3. Deadly acidic compound 4. Deadly fluide in compound Degree of rupture of hymen and whether the rupture is recent or old in a case of rape can be determined by 1. Gaba rod 2. Glastair Keene rod 3. Gram rod 4. Cylinder rod For medical termination of pregnancy consent is taken from 1. Wife only 2. Husband only 3. Both husband and wife 4. Not required from any of them X on provocation hits Y with a wooden stick on the arm causing a bruise of size 3 x 3 cm. X will be punished by Simple imprisonment up to one year with a fine of Rs. 100 Rigorous imprisonment up to 6 months Simple imprisonment for 2 yrs. With a fine of Rs. 5000 None of the above Old blood stain can be demonstrated by 1. 2. 3. 4. 6. Magnifying lens Luminal Spray Ultraviolet light Infrared photography

2.

3.

4. 1. 2. 3. 4. 5.

The identity of rape victim is not disclosed under section 1. 226 of IPC 2. 227 of IPC 3. 228 of IPC 4. 229 of IPC An alleged accused of sodomy is brought to you, As a medical officer, when you enquired, he confesses that he is an active agent and is regularly practicing it. Which of the following is not to be seen ? 1. Presence of smegma 2. Faecal smell 3. Tear of frenulum 4. Relative constriction of the shaft of penis The antero-posterior diameter of the skull is minimum in 1. Brachycephaly 2. Doclicocephaly 3. Plagicephaly 4. Trigonocephaly

7.

8.

EAR, NOSE AND THROAT. 1. Which of the following Vibrio species is most often associated with ear infection ? 1. V. alginolyticus 2. V. parahaemophilus 3. V. mimicus 4. V. cholerae Which of the following nerves has no sensory supply to the auricle ? 1. Lesser occipital nerve 2. Greater auricular nerve 3. Auricular branch of vagus nerve 4. Tympanic branch of glossopharyngeal nerve Conductive hearing loss is seen in all of the following except 1. Otosclerosis 2. Otitis media with effusion 3. Endolymphatic hydrops 4. Suppurative otitis media Which of the following is not a rout of spread of infection from middle ear. 1. Directory through openings such as round window and oval windoe 2. By bony invasion 3. Osseothrombotic route 4. Lymphatics An elderly diabetic presents with painful ear discharge and edema of the external auditory canal with facial palsy, not responding to antibiotics. An increased uptake on technetium bone scan is noted. The most probable diagnosis is 1. Malignant otitis externa 2. Malignancy of the middle ear 3. Infective disease of the middle ear 4. Malignancy of nasopharynx with Eustachian tube obstruction Which of the following tatement is incorrect regarding the after-effects of cochlear implantation ? 1. Improved sound and speech perception 2. Tinnitus enhancement 3. Better chances of developing normal or almost normal auditory and verbal skills 4. Improved scholastic performance as compared to profoundly hearing impaired patiered patient without the use of a cochlear implant Which of the following nasal tumours originates from the olfactory mucosa ?\ 1. Neuoblastoma 2. Nasal glioma 3. Esthesioneuraroblastoma 4. Antrochonal polyp Which is not true about laryngomalacia ? 1. Omega shaped epiglottis 2. Stridor increases on crying, but decreases on placing the child in prone position 3. Most common congenital anomaly of the larynx 4. Surgical management of the airway by tracheostomy is the preferred initial treatment The following is not true about spasmodic dysphonia 1. Patients with the abductor type have strained and strained strangled voice

2.

3.

4.

5.

6.

7.

8.

9.

2. 3. 4.

Botulinum toxin is the standard treatment for SD Multiple sitting of botulinum toxin A is required for its treatment It affects the muscles of the larynx

10. Topical application of mitomycin- C is recommended for which of the following ? 1. 2. 3. 4. Endoscopic treatment of angiofibbroma Laryngotraccheal stenosis Skull base osteomyelitis Struge Weber syndrome

11. Spontaneous CSF leak is not seen in 1. Raised ICT 2. Pseudotumour cerebri 3. Empty sella syndrome 4. Low risk of encephalocele formation OPHTHALMOLOGY 1. A malnourished child from poor socioeconomic status, residing in overcrowded and dierty areas presents with a nodule around limbus with hyperemia of conjunctiva. Other significant findings were axillary and cervical lymphadenopathy 1. Phlyctenural conjunctivitis 2. Foreign body granuloma 3. Scleritis 4. Episcleritis A one year old child presents with lid lag and double round opacities on limbus with enlarged cornea (13 mm). What could be probable diagnosis ? 1. Thyroid opthalmopathy 2. Congenital glaucoma 3. Superficial keratitis 4. ----------------------CRAO may be seen in 1. Diabetes mellitus 2. CMV retinium 3. Panophthalmitis 4. Orbital mucormycosis Fundoscopy of a patient shows chalky white optic disc, the rest of the retina is absolutely normal. The most probable diagnosis is 1. Primary optic atrophy 2. Post-neuritic optic atrophy 3. Glaucomatous atrophy 4. Consecutive optic atrophy A 20 yrs old male presents with night blindness and tubular vision. His IOP was 18mmHg. Fundoscopy shows attenution of arterioles and waxy pallor of optic disc. Ring scotoma seen on perimetry. ERG is subnormal. The diagnosis is most likely to be 1. 2. 3. 4. Pigmentary retinal dystrophy POAG Lattice degeneration of retina Diabetic retinipathy

2.

3.

4.

5.

6.

The most common mode of spread of retinoblastoma is 1. Haematogenous 2. Lymphatic 3. Optic nerve 4. Trans scleral Three weeks following IOL implantation, a patient complains of diminished vision. On fundus fluorescein angiography, flower petal hyperfluoresence of macula is noted. The most likely diagnosis is 1. CME 2. Central serous retinopathy 3. Macular dystrophy 4. ARMD An elderly male on eye examination shows a limbal scar, deep anterior chamber, iridodonesis, dark papillary reflex and visual acuity 6/6 with 11D lens. The diagnosis is 1. Aphakia 2. Pseudophalia 3. Hypermetropia 4. Posterior dislocation of lens A patient presents with diplopia in one eye. On examination with oblique illumination ,golden cresents and on axial illumination black/dark crescents are seen. The likelydiagnosis would be 1. Ectopia lentis 2. Lenticonus 3. Colobona 4. Microspherophakia

7.

8.

9.

10. A child presents with bilateral white papillary reflex. On lip lamp examination there is zone of opacity around fetal nucleus with spokes of wheel like arrangement towards centre. The most probable diagnosis would be 1. Catarata pulverulenta 2. Lamellar cataract 3. Postirior polar cataract 4. Coronary cataract 11. Following 2 days of successful phacoemulsificantion and IOL placement, a diabetic patient presents with redness, pain and grey white papillary reflex. Patient also shows hypopyon, retrolental flare and posterior synecheae. The likely diagnosis is 1. Post-op endophthalmitis 2. Post-op glaucoma 3. Post-op keratitis 4. Post-op cyslitis 12. A 35 yrs old male on slit lamp shows keratic precipitates and aqueous flare in his right eye. No synecheae but a complicated cataract is seen. The probable diagnosis would be 1. Intermediate uveitis 2. Heerfordts syndrome 3. Subacute iridocyclitis 4. Heterochromic iridocyclitis of Fuchs 13. A 35 year female presents with recurrent chalazion of the upper eyelid. The curettage should be subjected to histopathological examination to rule out which of the following ? 1. Sebaceous cell carcinoma 2. Squamous cell carcinoma 3. basal cell carcinoma

4.

Malignant melanoma

14. An elderly diabetic patient presents with severe panophthalmiyis with orbital cellulites. A sample was collected from periorbital region, which on Gram staining shows irregularly branchingm, aseptate and broad hypae. The most likely etiological agent is 1. Penicillium 2. Aspergillus 3. Candida 4. Apophysomyces 15. A regular contact lens user presents with complains of redness, photophobia and blurring of vision in one eye for more than 2 weeks, which was not responding to normal treatment. On examination cornea shows ring shaped lesion along with some overlying epithelial defect. The most prabable diagnosis would be 1. Fungal keratitis 2. Viral keratitis 3. Acanthamoeba keratitis 4. Bacterial ulcer 16. Which of the following reflects wavelength (nanometers) of Laser used for shaping cornea in refractive surgery / 1. 193 2. 451 3. 532 4. 1064 PREVENTIVE AND SOCIAL MEDICINE 1. Which of the following intervention trials does not have individual as a randomization unit 1. Vaccine 2. Drug 3. Surgery 4. Health education 2. The sex ratio for age group 0-6 yrs as per 2011 cansus is 1. 914 2. 933 3. 940 4. 944 3. The concept of design effect is applied to 1. Stratified Sampling 2. Systematic Sampling 3. Simple random Sampling 4. Cluster Sampling 4. The Vision 2020, for India includes the following except 1. Vitamin A deficiency 2. Refractive errors 3. Cataract 4. Diabetic retinopathy 5. A state of desease andemicity where the disease transmission has been stopped but the agent is present in the environment is called 1. Eradication 2. Elimination

3. 4. 6. 1. 2. 3. 4. 7. 1. 2. 3. 4.

Control Holo-endemic You have diagnosed a patient clinically as SLE and ordered 6 tests, out of which 4 tests are positive and 2 tests are negative. To determine the probability at this point, you need to know Prior probability of SLE, sensitivity and specificity of each test. Incidence of SLE and predictive value of each test Incidence and prevalence of SLE Relative risk of SLE in this patient Efficacy of a new drug B with an existing drug A for treatment of particular disease in compared in Phase I trial Phase II trial Phase III trial Phase IV trial

8. If alternative of medicine is accepted as a modality of therapy, the yoga would be a form of 1. Physiotherapy 2. Emergency medicine 3. Preventive medicine 4. Caloric usurper 9. The amount of alcohol consumption by a group, pre-and post-intervention was recorded. To determine wheather there is a significant difference in alcohol consumption after intervention is seen or not, best test would be Paired t test Unpaired t test McNemar test Chi-squaretest

1. 2. 3. 4.

10. The p value stands for 1. The probability to achieve a correct result 2. The probability to achieve an incorrect result 3. The probability of concluding that a difference exists, while, in reality, such a difference does not exist 4. The probability of concluding that a difference does not exist, while,in reality, such a difference does exist 11. Median is not a good measure for central tandency of the followin 1. Blood pressure 2. Survival time 3. Incubation period 4. Health expenditure 12. Surveillance summaries are prepared 1. To document recent epidemiological studies 2. To provide information on disease patterns and trend 3. To provide reprints of reports and recommendations 4. To acknowledge the contributors 13. In natural history of the disease, all of the following are true about the pathogenesis phase except 1. Subclinical phase of an illness is included 2. Tertiary prevention is applicable 3. Screening has no effects on this phase 4. Start after entry agent into host body

14. Given three genera of mosquitoes (Culex, Anopheles and Aedes) are vectors for which of the following disease world wide ? 1. Malaria 2. Dengue 3. Lymphatic filariasis 4. Yellow fever 15. All are true about health related Millenium Development Goals except 1. Reduce by 3 / 4th, between 1990 and 2015, the maternal mortality ratio 2. Reduce by 3 / 3rd, between 1990 and 2015, the under- 5 mortality rate 3. Have halted by 2015 and reversed, the spread of HIV / AIDS 4. Have halted by 2015 and reversed, the incidence of tuberculosis 16. The blood sugar of diabetics is known to be normally distributed with a mean of 105 mg/ 100ml of blood with a standard deviation of 10 mg% . The blood glucose of 95 % of diabetics would lie between 1. 85 and 125 2. 103 and 107 3. 75 and 135 4. 95 and 115 17. Which of the following indices is adjusted to account for the age distribution in the population ? 1. Fertility rate 2. Crude mortality rate 3. Perinatal mortality rate 4. Life expectancy at birth 18. All the following vaccination are recommended for elderly population except 1. Tetnaus 2. Measles vaccine 3. Influenza vaccine 4. Pneumovax 19. The mean HB of a sample of 100 patients was found to be 10 g/dL and standard deviation is 1 g/dL. The standard error of mean of the sample would be 1. 0.001 2. 0.1 3. 1 4. 10 20. Not a larvicidal for malaria control 1. Malathion 2. pyrethrum 3. Copper acetoarsenite 4. Abate 21. The resource person / persons for training of ASHA under NRHM are 1. Medical officers and ANMs 2. AWWs and MPWs 3. AWWs and ANMs 4. ANMs and MPWs 22. A cohort study differs from a caseicontrol study as 1. Cohort studies requires longer time frame(may be years), while case control studies do not 2. Subjects are asked about the history of their exposure in cohort, but not so in case-control 3. Subjects are enrolled on basis of their exposure in cohirt studies, but so in case-control

4.

Cohorts studies are done for chronic diseases, while case-control are used for acute infectious disease

23. DALY expresses years of life lost to 1. Premature death and yrs lived with disability adjusted for disability 2. Premature death and yrs lived with disability adjusted for the severity of disability 3. Death and yrs lived with disability adjusted for disability 4. Death and yrs lived without disability adjusted for diability MEDICINE 1. Pituitary macroadenoma refers to size of tumour 1. > 1 cm 2. > 1.5 cm 3. > 2 cm 4. > 2.5 cm 2. 1. 2. 3. 4. A 5 yrs old child of severe nephritic syndrome on treatment with tacrolimus, frusemide and prednisolone development seizures. The investigations revealed Hypocalcemia Tacrolimus toxicity Uremia Hyponatremia

3. The least common presentation of multiple myeloma is 1. Infection 2. Hypervisosity 3. Anemia 4. Bone pains 4. 1. 2. 3. 4. 5. About fibromyalgia all are true except Associated with EEG abnormalities More common in males than females Associated with increased cortosole response Associated with decreased blood flow to brain The treatment of acute pulmonary oedema includes all of the following except ? 1. Morphine 2. Digoxin 3. Frusemide 4. Positive ventilation

6. RTA type I has all except 1. Nephrocalcinosis 2. Hypokalemia 3. Increased HCO3 excretion 4. Connot acidify urine to pH <5.5 7. .An athlete presents, with chest pain, which of the following tests would be sensitive and specific for diagnosis of myocardial infarction ? a. Troponin I and T b. Creatine kinase MB c. Leukocytosis d. C- reactive protein 8. . Which of the following is an example of small vessel vasculitis ? 5. Takayasu arteritis

6. 7. 8. 9.

Microscopic polyangitis Giant cell arteritis Polyarteritis nodosa

A young girl admitted with joint pains and butterfly rash and positive urine proteinuria. The best test for diagnosis is 1. Anti ds- DNA antibody 2. Anti centromere Antibody 3. Antibodies to RNP 4. Antibodies to tRNA synthetase

10. Which of the following disorders is least likely associated with progression to lymphoma ? 1. Sjogerns syndrome 2. Ataxia telasia 3. Severe combined immunodeficiency 4. Lynch II syndrome 11. All of the following are true about angioneurotic edema except 1. It is associated with pitting adema of the face, mucosa and lips 2. It is due to C1 esterase inhibitor deficiency 3. Occure in extremes of temperature. 4. It is due to angiotensin converting enzyme (ACE) inhibitor 12. Secondary haemochromatosis occurs in all of the following except 1. Sideroblastic anemia 2. - thalassemia 3. Paroxysmal nocturnal haemoglobinuria 4. Repeated blood transfusions 13. The occurance of hyperthyroidism following administration of supplemental iodine to subjects in endemic MNG 1. Wolf- Chaikoff effect 2. Jod-Basedow effect 3. Pembertion effect 4. Graves effect 14. All are true about Central hypothyroidism except 1. The most common cause is craniopharyngioma 2. Treatment is done according to YSH level in plasma 3. TSH level is not a good maker for diagnosis 4. Before starting treatment chechout for adrenal insufficiency 15. The third generation TSH detection tests can detect TSH at a minimum level of 1. 0.4 mU / L 2. 0.04 mU / L 3. 0.004 mU / L 4. 0.0004 mU / L 16. A person whose CSF grows Streptococcus pneumoniae on culture is most likely to show 1. Pleocytosis, high protein, reduced sugar 2. Pleocytosis, high protein, high sugar 3. Lymphocytosis, high protein, normal sugar 4. Lymphocytosis, low protein, normal sugar

17. A child presents with ambliguous genitalia without hyperpigmentation and normal blood pressure, 2.5 cm phallus with no opening at its tip, labia developed. Gonads are not seen in inguinal region and Mullerian structures are present on USG. The most probable diagnosis is ? 1. AIS 2. Meternal virilising tumour 3. CAH 4. 5- - Redutase deficiency 18. Neurofibrillary tangles are seen in case of Alzheimers disease. Which of the following areas of brain is resistant to neurofibrillary tangle formation ? 1. Area of visual assoctiation 2. Cuneal gyrus of area VI 3. Entorhinal cortex 4. Lateral geniculate nuleus 19. In a patient of Parkinsons disease with intractable tremors, the most preferred site of DBS (Deep Brain Stimulation) is 1. Globus Pallidus 2. Putamen 3. Subthalamic nuclei 4. Substantia nigra 20. Small fibre neuropathy is seen in 1. HIV 2. Vitamin B12 deficiency 3. AIP 4. Cisplatin toxicity 21. Episodic muscle weakness can be caused by all of the following except 1. Hypercalcemia 2. Channelopaties 3. Lambert-Eaton myasthenic syndrome 4. Hyper phosphatemia 22. The triad of strabismus, diplopia and ptosis due to damage of which nerves ? 1. Oculomotor 2. Trochlear 3. Abducent 4. Cervical sympathetic trunk 23. Which of the following is a sign of brainstem death ? 1. Dolls eye reflex 2. Fixed non-reactive pupil 3. Horners pupil 4. Positive vestibule-ocular reflex

24. A patient presents with ataxia. On examination ankle and knee jerks are absent. Plantars are extensor. The diagnosis would be 1. 2. 3. 4. Friedreichs ataxia SACD Vitamin B 12 deficiency Tabes Dorsalis

25. A 14 yrs old girl presents with quadriparesis, facial palsy, winging of scapula and ptosis. There is h/o similar illness in father and brother but less severe. Her CPK level is also raised (500IU/L). She is probably suffuring from 1. Emery-Dreifuss muscular dystrophy 2. Limb girdle dystrophy 1 3. Limb girdle dystrophy 4. Scapulofaciohumeral dystrophy 26. Conduction velocity of nerve is NOT affected in which of the following ? 1. Leprosy 2. Motor neuron disease 3. Hereditary neuropathy 4. AIDP 27. Prader- Will syndrome is associated with an increase in which of the following hormones ? 1. Ghrelin 2. GH 3. FSH 4. LH 28. Age related deterioration of cognitive function is due to increase in following ? 1. Homocystiene 2. Cysties 3. Taurine 4. Methionine 29. A patient presents with subarachnoid haemorrage. NCCT reveals blood in the fourth ventricle. The bleeding is most likely to occur from an aneurysm of which of the following arteries ? 1. Anterior communicating artery 2. Basilar top region 3. AICA 4. PICA 30. All of the following are true about von Hippel Lindau syndrome except 1. Multiple tumours are uncommon 2. Hemangiopericytomas are seen in the craniospinal axis 3. Supratentorial lesions are common 4. Tumors of Schwann cells are common

SURGERY 1. On the Glasgow Coma Scale, a patient speaking inappropriate words would be given a score of 1. 2 2. 3 3. 4 4. 5 The most common cause of pyogenic liver abscess is 1. Trauma 2. Appendicitis 3. Biliary tract disease 4. Diverticulitis An adult presents with rectal prolapse. Which of the following surgeries for rectal prolapse is associated with the least rate of recurrence ?

2.

3.

1. 2. 3. 4. 4.

Delormes operation Perineal rectosimoidectomy Rectopexy Thiersch wiring

Which of the following carcinoma has highest chances of metastasis to spleen ? 1. Pancrease 2. Stomach 3. Ovary 4. Cervix 5. 1. 2. 3. 4. 6. A 40 yrs male presents with hematemesis. On examination, his BP was 90/60 Hg and heart rate was 120 per min. Splenomegaly was also present. The most probable cause of his bleeding is Portal hypertension Gastric ulcer Duodenal ulcer Drug induced GI injury The absorption of which of the following is decreased / affected in case of short bowl syndrome ? 1. Vitamin K 2. Vitamin B23 3. Vitamin D 4. Caklcium A child presents with Wilms tumor stage 1 in one kidney with the contralateral kidney appears to be normal. First modality of treatment would be 1. Chemotherapy 2. Radiotherapy 3. Laparoscopic nephrectomy 4. Open nephroureterectomy An elderly male presents with complains of choking while sleeping. He gives a history of non progressive dysphagia and halitosis. The most likely diagnosis is 1. Schatzkis ring 2. Zenkers diverticulum 3. Plummer Vinson syndrome 4. Cork screw esophagus The expanded criteria for liver donation includes all of the following except 1. Can be taken from deceased individual 2. HBsag positive without any evidence of chronic disease progression 3. Age can be more than 70 years 4. Donor with mild hepatic steatosis

7.

8.

9.

10. Most common complication of TPN ? 1. Hypertriglyceridimia 2. Catheter infection 3. Increased liver enzyme 4. Increased bilirubin 11. False about non small cell CA lung is 1. Squamous cell CA is the most common type 2. C / L mediastinal lymphadenopathy is suggestive of inoperable disease 3. Geftnib is effective in adenocarcinoma history 4. Single agent chemotherapy can be used in elderly patients

12. Which of the following is true about small bowel carcinoids ? 1. It is the most common tumour of small intestine 2. Multiple tumour lead to increases risk of lung cancer 3. The most common site is duodenum 4. Endocardial fibrosis is not seen in case of carcinoid syndrome 13. A patient with (thorasic spine T3 injurd) presented with headache his blood pressure was 200/119 and heart rate 53. What would be management ? 1. Steroids 2. Oral nifedipine 3. Ringer lactate 4. LMW heparin 14. A 9 yrs old child presented with cervical lymphadenopathy. Needdle biopsy from the nodes revealed secondaries from papillary carcinoma thyroid. The child underwent near total thyroidectomy followed by radical neck dissection. Histopathology of the excised tissue further confirmed the diagnosis. The next step for the management of the child shoul be 1. Atart thyroxine suppression therapy 2. 131I whole body scan to assess the external of the disease 3. Bone scan to evaluate secondaries 4. CECT neck to detect any residual disease 15. The occurrence of left varicocele in an elderly male should arouse a suspicion of 1. Left testicular tumour 2. BPH 3. Left renal tumour 4. Acute injury

PEDIATRICS 1. a 1 yrs old girl presents with the fever since 24 hours and on and off coughing. She is passing foul smelling, bulky stool and had 4 attacks of bronchitis in past. The girl is suspected of having 1. Cystic fibrosis 2. Maple syrup urine disease 3. Phenylketonuria 4. Impaired glucoronidization A 2 yrs old boy keeps on looking at her own hands and does not respond on calling. Her motor development is otherwise normal. Probable diagnosis would be 1. Autism 2. Depression 3. ADHD 4. Schizophrenia Regarding parental nutrition of newborns, 20 % intralipid has all the following advantage over 10 % intralipid solution except 1. Reduced phospholipids 2. Increased EFA (Essential Fatty Acids) 3. Increased calorie density / mL of fluid 4. Better / improved triglycerisde clearance Most frequently identified fetal tumor ? 1. Neuroblastoma 2. Wilms tumor 3. Fibrosarcoma

2.

3.

4.

4. 5.

Sacrococcygeal teratoma

A case of meaningomyelocoele was posted for surgery. Till patient is waiting for surgery the covering of sac will be protected by a gauze piece soaked in 1. Narmal saline 2. Tincture iodine 3. Methylene blue 4. Mercurochrome Least chances of infective endocarditis is seen with 1. Small VSD 2. Amall ASD 3. Mild AS 4. Mild AR True about jaundice in neonates is 1. Can be seen after ventouse delivery 2. Physiological jaundice is seen within 48 hours of birth 3. Increased conjugated bilirubin leads to kernicterus 4. Breast milk jaundice is maximum in 7 days from birth A term infant born to a diabetic mother was lethargic few hours after birth and glucose was 30 mg % What should be done next ? 1. Give 10 % dextrose orally 2. 10 % dextrose IV 3. Give Expressed breast milk 4. Do exchange transfusion a mentally challenged child with dysphagia and ophisthotonic spasms is also having choreoathetoid movements and self multilating behaviour with positive family history. Which of the following investigations is suggested ? 1. Serum uric acid 2. Serum alkaline phosphatase 3. Serum lactate dehydrogenase 4. Lead levels in blood

6.

7.

8.

9.

OBSTETRICS AND GYNECOLOGY 1. Least likely to be seen in a normal pregnancy ? 1. Increased in blood volume 2. Increased in cardiac output 3. Increased in heart rate 4. Decrease in systolic pressure A female has just given birth to a normal baby. The most appropriate time for starting Kegels execises is 1. Immediately after delivery 2. 3-6 weeks after delivery 3. She should have started in 3rd trimester itself 4. After ceasarean section only IUCD that does not require to be changed after 3-5 yrs is 1. .Cu T 200 2. Cu T 375 3. Cu T 380 A 4. Multiload devices

2.

3.

4.

Not done in active management of 3rd stage of labour 1. Uterine massage 2. Early cord clamping 3. Inj.methergine 4. Inj. Oxytocin In an HBsAg +ve female, Which of the following statements is true ? 1. Transmission is mainly transplacental 2. HBsAg immunoglobulin should be given to baby within 12 hrs 3. Active immunization should be done within 48 hrs 4. Immunization can be delayed up to 96 hrs A young male presents with delayed puberty with decreased FSH, LH and testosterone. Which of the following is least likely possibility ? 1. Kallmans syndrome 2. Klinefelters syndrome 3. Constitutional delay 4. Dax-1 gene defect Mrs. A G3P1A1 is admitted in labour in a full-term pregnancy. On examination, she has uterine contractions 2 per 10 minutes, lasting 30-35 seconds, cervix is 4 cm dilated, membranes intact and 3/5ths of the head palpable per abdomen. On repeat examination 4 hrs later, cervix is 5 cm dilated, station is unchanged and the cervicograph remains o the right of alert line. Which of the following statements is true ? 1. The head was engaged at the time of presentation 2. Her cervicographical progress is satisfactory 3. Her cervicograph status suggests intervention 4. On repeat examination,her cervicograph should have touched the action line The LH surgr occurs due to 1. Markedly increased estrogen level 2. Increased level of prostaglandins 3. Increased in progesterone level 4. Decreased FSH levels All of the following are germ cell tumours of the ovary except 1. Choriocarcinoma 2. Dysgerminoma 3. Granulosa cell tumour 4. Endodermal sinus tumour

5.

6.

7.

8.

9.

10. A 55 yrs old female presents with abdominal pain, distension, ascites and dyspnea. Her CA 125 levels are elevated. The most likely diagnosis is 1. CA ovary 2. CA cervix 3. CA lung 4. Mucinous cystadenoma / lymphoma 11. All of the following are correct regarding mother-to-child transmission of HIV except 1. Risk of infection decreases if elective ceasarean section is done 2. Majority of the babies do not have any transmission even if no active intervention is done 3. HIV may be transmitted to fetus during gestation 4. Risk of infection in fetus increases as duration of infecton in mother increases

12. A pregnant female presents with fever. On lab investigation her HB was decreased (7 mg %), TLC was normal and platelet count was also decreased. Peripheral smear shows fragmented RBCs. Which is least probable diagnosis ? 1. DIC 2. TTP 3. HELLP syndrome 4. Evans syndrome 13. Not associated with gynaecomastia 1. Prolactinoma 2. TSH secreting adenoma 3. hCG secreting tumour 4. Estrogen secretig tumor 14. True about twin delivery is (in case of preterm labour) 1. First has more chance of asphyxia 2. Second has more chance of policythemia 3. Second will develop hyaline membrane disease 4. Increased mortality in first twin 15. True about GFR in pre-eclampsia ? 1. GFR decreases 2. GFR Increases 3. Remains same 4. None of the above ORTHOPEDICS 1. Little finger of the head corresponds to which dermatome ? 1. C6 dermatome 2. C7 dermatome 3. C8 dermatome 4. T1 dermatome After lifting something heavy from ground, a patient complaints of back pain, which is radiating to lateral leg and great toe of lower limb. Most probable diagnosis would be 1. L5 S1 disc prolapse 2. L4 L5 disc prolapse 3. L3 L4 disc prolapse 4. L5 fracture All of the following can occure as complications of fracture of the neck of femur except 1. Shortening 2. Non union 3. Mal union 4. Avascular necrosis Following an accident a person is not able to abduct his shoulder and flexion movement of elbow joint is also not possible. Rest all movements are normal. The most likely site of injury is 1. Upper trunk 2. Shoulder dislocation 3. Medial cord 4. Lateral cord 5. A patient presents with recurrent posterior dislocation of shoulder. The most probable site for Hill Sachs lesion on X-ray would be

2.

3.

4.

1. 2. 3. 4.

Anteromedial Anterior Posteromedial Posterior

6. Avascular necrosis in fractured proximal fragment of scaphoid bone is due to 1. Restrograde blood flow in scaphoid 2. The proximal fragment is articulating with radius 3. The proximal fragment is comminuted 4. Immobilization of proximal fragment is difficult 7. A young girl had a rapid increase in height for the last one year. She is having difficulty in sitting cross-legged and squatting and complains that the knee goes into axilla every time she try to squat. The most likely diagnosis is 1. Congenital coax vara 2. Slipped capital femoral epiphysis 3. Perthes disease 4. Synovitis of knee Following RTA, a patient presents with flexion and external rotation deformy of the left hip. Shortening of affected limb by 7 cm was also seen. A mass was noted in the left gluteal region which was moving with the movement of the femur. Most likely X-ray finding would be Pepkins Type IV dislocation Dislocated hip with lesser trochanter in full profile Posterior dislocation of the hip with neck in full profile Acetabular roof fracture with central dislocation A 30 yrs lady presents with pain and tenderness in index finger just under the nail. She was unable to wash her hands with cold water. Patient does not reveal any history of tranuma or injury. What could be a probable finding ? Sausage digits Ridging of nail, discolouration and pin head tenderness Stiffness of whole hand Hypersensitivity of finger

8.

1. 2. 3. 4. 9. 1. 2. 3. 4.

10. Tuberculosis osteomylitis is most likely 1. Paucibacillary and haematoganous 2. Multibacillary and haematoganous 3. Multibacillary and lymphatogenous 4. Paucibacillary and lymphatogenous 11. The most common cause cause of bone disease (specially in women) in India is 1. Steroid-induced osteoporosis 2. Nutritional deficiency 3. Pagets disease 4. Sarcoidosis 12. Which of the following is not included as a yellow flag sign for low back pain ? 1. Radicular impingement 2. Systemic steroids 3. Social isolation 4. High functional limitation at 4 weeks / after 4 weeks 13. Pain due to post ampulation neuroma is best treated by 1. Infrared therapy 2. Interference therapy

3. 4.

Ultrasound therapy Stump bandage

14. A 40 yrs old male presents with weakness and pain in his lower limb. Patient revealed a history of paralysis of both lower limbs during childhood. The probable diagnosis would be 1. Post polio syndrome 2. Polymysitis 3. Muscular dystrophy 4. Neuropathy 15. About SACH foot all are true except 1. It is stands for Solid Ancle Comfortable Heel 2. Shoes can be worm out 3. Central woodern keel is present 4. Base of lower limb prosthesis DERMATOLOGY 1. Total skin electron irradiation is used for the treatment of 1. Sezary syndrome 2. Mycoses fungoides 3. Psoriasis 4. Brain metastases One child presents with itchful vesicles and tens bullae. On DIF there is linear IgA deposition in basement membrane zone. The most likely diagnosis would be 1. Chronic bullous disease of childhood 2. Lichen planus 3. Phemphigus vulgaris 4. Dermatitis herpatiformis A newborn who is born out of non-consanguinous marriage shows eroded skin and formation of blisters while mother handle him for feeding and other purposes. There is history of one sibling died who had same presentation. The likely diagnosis is 1. Congenital syphilis 2. LCH (Langerhans cell histiocytosis) 3. Neonatal phemphigus 4. Epidermolysis bullosa A ypung boy presents with erythematous plaque and collarete of scale mainly on the trunk. The likely dianosis is 1. Pityriasis rosea 2. Pityriasis versicolor 3. Pityriasis rubra pilaris 4. Pityriasis alba A patient presents with erythematous scaly lesion on trunk with white plagues in oral mucosa or cavity. He also had same erosive lesion in perianal area. The likely diagnosis would be 1. Secondary syphilis 2. Psoriasis 3. Drug rash 4. P. rosacea

2.

3.

4.

5.

ANESTHESIA

1.

Total Cerebral Metabolic failure occurs at cerebral blood flow of 1. 10 ml / 100 mg /min 2. 20 ml / 100 mg /min 3. 30 ml / 100 mg /min 4. 40 ml / 100 mg /min During anaesthesia, which is least affected ? 1. Visual evoked response 2. Brainstem evoked response 3. Somatosensory evoked response from median nerve 4. Somatosensory evoked response from posterior tibial nerve Depth of anaesthesia is measured by 1. Bispectral index 2. Pulse oximetry 3. Jugular venous V 4. Microdialysis of brain Which is true about Total Intravenous Anaesthesia (TIVA) 1. It reduces CMR 2. Higher chances of nephrotoxicity than other agents 3. It deteriorates pulmonary vasoconstriction due to hypoxia 4. There have been reports of malignant hyperthermia with propofol Which of the following is contraineddicated in renal failure ? 1. Morphine 2. Pethidine 3. Fentany 1 4. Atracurium Which of the following agents causes pain on injection ? 1. Succinylcholine 2. Vecuronium bromide 3. Rocuronium 4. Cisatraccurium The primary mechanism by which thiopentone offers cerebroprotection is 1. Decreased brain metabolism 2. By acting a free radical scavenger 3. Calcium channel blocker 4. GABA agonist mechanism Following cannulation of right subclavian vein, patient developed respiratory distress. His blood pressure dropped to 100/55 and heart rate increased to 140 bpm. He also had diminished air entry towards right side of chest and hyperresonant note on percussion. Probable diagnosis would be 1. Tension Pneumothorax 2. Air embolism 3. Acute MI 4. Pulmonary edema The most potent cerebral vasodilator is 1. Beta blockers 2. Nitroglycerine 3. Sodium nitroprusside 4. Hypercarbia

2.

3.

4.

5.

6.

7.

8.

9.

10. A 45 yrs old male with history of smoking is scheduled for elective surgery. All are true except 1. Nicotine has effects on carotide and aortic bodies and can increase sympathetic tone 2. carbon monoxide shifts the oxyhaemoglobin dissociation curve to the right 3. Dose requirement of muscle relaxants are increased in smokers 4. Smoking cause decreased surfactant levels 11. Which is true about Anaesthetic machine1. Temprature for desflurane vaporizer chamber is 39C 2. Oxygen meter is attached to inspiratory limb 3. Rotameter is variable pressure flowmeter 4. .. RADIOLOGY 1. Basal exudates, infarcts and hydrocephalus on computed tomography are seen in 1. Tuberculosis meningitis 2. Viral meningitis 3. Herpes simplex encephalitis 4. Cerebral malaria A 16 yrs old child presents with recurrent headache and blurred vision. On CT scan, a well demarcated supraseller, calicified, cystic and enhancing mass is seen 1. Carniopharyngoma 2. Neurocysticercosis 3. Glioma 4. Central neurocytoma Wide neuralforamina is associated with 1. Neurofibromatosis 2. Sturge-Weber syndrome 3. Telangiectasia 4. The gold standard method for detection of renal scarring in patient with recurrent urinary tract infection is 1. 99 Tc-DMSA scan 2. 99 Tc-DTPA scan 3. 99 Tc-MIBG scan 4. 99 Tc-MDP scan A 45 yrs female presents with recurrent abdominal pain and jaundice. USG shows clausters of cysts, cysts are having lobulated margins, in the head of pancreas. MR reveals a multicystic mass with a bunch of grapes appearance and a grossly dialated pancreatic duct. The most probable diagnosis is 1. Serous cystadenoma 2. Mucinous cystadenoma 3. Intraductal papillary mucinous neoplasm (IPMN) 4. Solid pseudopapillary epithelial neoplasm Which of the following is the best view for detecting minimal pneumoperitoneum ? 1. Erect view of abdomen 2. AP view of abdomen 3. Right lateral decubitis with horizontal beam 4. Left lateral decubitus with horizontal beam Which of the following is used as a radio protector ? 1. Metronidazole

2.

3.

4.

5.

6.

7.

2. 3. 4. 8.

Amifostine Colony stimulating factors Cisplatin

A patient presented with a 4 cm tumour in the left parietal lobe for which he underwent surgery and radiotherapy. After 2 months, he presented with headache and vomotting. Which of the following would best characterize the lesion in this patient ? 1. Gd-enhanced MRI 2. 99 T-HMPAO SPECT brain 3. Digital subtraction angiography with dual source CT scan 4. 18FDG PET scan Hyperchoic hepatic metastases on USG are seen in which of the following malignancies 1. CA ovary 2. CA colon 3. Urinary bladder 4. Mucinous cystadenoma

9.

10. A patient presents with raised intracranial tension and ataxia. MRI findings are well demarcated cystic lesion with a mural nodule in the cerebellium. The most likely diagnosis is 1. Epidemoma 2. Hemangioblastoma 3. Lymphoma 4. ------------11. A 35 yrs old with a history of asbestos exposure presents with chest pain. X-ray shows a solitary pulmonary nodule in the right lower zone. CECT reveals an enhancing nodule adjoining the right lower costal pleura with comet tail sign and adjacent pleural thickening. The most likely diagnosis is 1. Mesothelioma 2. Round atelectasis 3. Pulmonary sequestration 4. Adenocarcinoma 12. The patho-physiological phenomenon that occurs during atheromatous plaque formation and is used for screening of asymptomatic coronary plaques on CT scan is 1. Increased outer diameter of coronary artery 2. Decreased inner diameter of coronary artery 3. Calcium deposition in the atheromatous plaque 4. Lipoid degeneration in the plaque 13. A 40 yrs. Female with recurrent headaches underwent a MRI which revealed an extra axial, durabased enhancing lesion. The most probable diagnosis is 1. Schwannoma 2. Pituitary adenoma 3. Glioma 4. Meningioma 14. Bone density can be best detected by which of the following techniques ? 1. CT 2. MRI 3. DEXA 4. Plain X-ray 15. All of the following about MRI are correct except 1. MRI is contraindicated in patients with pacemakers 2. MRI is useful for evaluating bone marrow

3. 4.

MRI is better for calcified lesions MRI is useful for localizing small lesione in the brain

16. Long-term effects of radiotherapy for cns tumor in children are all except 1. Reduced IQ and learning 2. Endocrinal dysfunctions 3. Musculoskelelat problems 4. The neuro-psychological effects are independent of the radiation dose

PSYCHIATRY 1. All of the following statement about clozapine are true except 1. When the WBC level is less than 3000 / mm3 , then clozapine should be diecontinued 2. Blood clozapine levels should be less than 350 ng /mL to prevent the risk of agranulocytosis 3. The action of clozapine is more on D1 receptors than D2 receptors 4. The combination of clozapine and carbamazepine should be better avoided 2. All of the following are criteria for substance dependence except 1. Repeated unsuccessful attempts to quit the substance 2. Recurrent substance related legal problems 3. Characteristic withdrawal symptoms; substance taken to relieve withdrawal 4. Substance taken in larger amount and for longer period than intended 3. All of the following is are serotonin-dopamine antagonist except 1. Zotepine 2. Loxapine 3. Sertindole 4. Amisulpride 4. Paranoid psychosis observed with cocaine abuse can be explained by 1. Tolerance 2. Intoxication 3. Reverse tolerance 4. Withdrawal A 35 yrs female has been diagnosed with obsessive compulsive disorder and she washes her hands many times a day. Which would be the best CBT technique for her treatment ? 1. Thought stopping 2. Response prevention 3. Relaxation 4. Exposure Poor scholastic performance is not associated with 1. SLD 2. ADHD 3. PICA 4. Anxiety Delusions are not likely to be seen in 1. Dementia 2. Depression 3. Schizophrenia 4. Conversion disorder

5.

6.

7.

8.

Repetitive transcranial magnetic stimulation (rTMS) which is approved by US FDA for the treatment of 1. Resistant schizophrenia 2. Obsessive compulsive disorder 3. Acute psychosis 4. Depressive disorder A 16 yrs old boy is suffering from drug abuse and his perception of sensory modailities has crossed over, i.e. he complains that sounds can be seen and sights can be heard. Which of the following agent is most likely responsible for this ? 1. Cocaine

9.

2. 3. 4. 5.

LSD Marijuana PCP

10. Which of the following statements regarding the NDPS act is true ? 1. It provides for severe punishment for drug users and peddlers alike 2. Farmers growing opium are permitted to grow and consume unlimited amounts of opium 3. Consumption of excessive alcohol is punishable under the act 4. The act recommends treatment of drug users rather than sending them to jail 11. Bizarre interpretation of an object is most appropriately known as 1. Illusion 2. Delusion 3. Dream 4. Hallucination 12. GAS (Genaral Adaptation Syndrome) is seen in 1. Panic attacks 2. Depression 3. Anxiety 4. Stressful situations

ANSWERS ALL INDIA PG MEDICAL ENTRANCE EXAMINATION 2012 ANATOMY 1. 2. 3. 4. 5. 6. 7. 8. 9. 2 2 2 2 1 3 1 2 1

PHYSIOLOGY 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 1 4 3 4 1 1 2 1 4 3 4 2 3 1 4 1

2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25.

1 2 1 2 1 1 2 2 1 2 1 3 2 4 3 1 1 4 3 2 4 2 4 1

28. 29. 30. 31.

2 2 1 1

MICROBOILOG Y 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 4 3 4 1 3 1 4 4 3 3 2 2 3 1 1 4

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17.

1 2 4 1 1 3 1 1 1 2 1 4 1 4 1 3 1

PREVENTIVE AND SOCIAL MEDICINE 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 4 1 4 1 2 1 3 3 9 3 1 2 3 3 4 1 2 2 2 2 3 1 2

PHARMACOLO GY 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 3 3 1 2 4 4 3 4 4 2 1 1 4 3 2 3 3 2 3 4 2 1 4 1 1 3 1

FORENSIC MEDICINE AND TOXICOLOGY 1. 2. 3. 4. 5. 6. 7. 8. 1 2 1 4 2 3 1 1

BIOCHEMISTRY 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 1 2 4 3 3 4 2 1 2 3 4 4

EAR, NOSE AND THROAT 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 1 1 3 4 1 2 3 4 1 2 4

MEDICINE 1. 2. 3. 4. 5. 6. 7. 8. 1 2 2 2 2 3 1 2

PATHOLOGY 1. 4

OPHTHAKMOL OGY

9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30.

1 3 1 3 2 2 2 1 2 4 3 1 1 1 2 1 4 2 1 1 4 1

PEDIATRICS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1 1 2 4 1 2 1 2 1 1

5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.

1 1 2 4 2 1 2 1 3 1 1

DERMATOLOG Y 1. 2. 3. 4. 5. 2 1 4 1 1

4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.

1 3 4 2 4 4 2 2 3 4 3 3 4

OBSTETRICS AND GYNECOLOGY 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 4 3 3 2 2 2 4 1 3 1 2 4 1 2 1

PSYCHIATRY 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 2 2 4 2 4 3 4 4 2 1 1 4

ANESTHESIA 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 1 2 1 1 2 3 1 1 4 2 1

SURGERY 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 2 3 3 3 1 2 4 2 1 2 1 2 2 1 3

ORTHOPEDICS RADIOLOGY 1. 2. 3. 4. 3 2 3 1 1. 2. 3. 1 1 1