NEETPG Full Scale Mock Test 1832 Call 9000868356 Enroll www.onlinembbs.com

1. Peripheral blood smear showing classical forms of fever producing parasite are marked with arrow. Most likely cause is:
P. falciparum
L. donovani
P. vivax
P. malariae
2.True about infection caused by organism shown in the image is.
Only cyst is infective
Belongs to phyllum Apicomplexa
Resides in caecum
Only man to man transmission
3.Bone marrow aspiration reveals the following findings. Identify the findings:
Trypanosoma cruzi
Trypanosoma bruzi
Amastigote of L.donovani
Promastigote of L.donovani
4. Liver biopsy specimen showing refractile hooklets. Most likely cause is:-
Entameba histiolytica
Leishmania donovani
Strongyloides stercoralis
Echinococcus
5. Peripheral blood smear of a patient presenting with elephantiasis is given below. Blood sample taken in early adenolymphangitis stage. Most likely causative organism is :-
Ascaris lumbricoides
Wucheria bancrofti
Brugya malayii
Taenia solium
6. Identify the bile stained eggs as shown below:
Trichuris trichiura
Enterobius vermicularis
Latum
H.nana
7. Injection given in left forearm of a baby is showing which vaccination
HBV
BCG
DPT
Measles
8. 3 yr old child presents with history of cough and cold for 1 week and high grade fever for 4 days. Chest X-ray picture is shown below. Most likely diagnosis is :-
Right lung collapse
Lobar consolidation left lung
Left sided pleural effusion
Left sided collapse consolidation
9.Image of polio vaccine is given below.WM indicates.-
Vaccine can be used
Vaccine is not safe to use
Vaccine must be discarded
Inconclusive
10. A male child presents with repeated urinary infections and failure to gain weight. A MCU was carried out as shown in image, most probable diagnosis is?
Post urethral valve
Meatal stenosis
Bladder polyp
Bladder diverticula
11. All of the following are true regarding condition shown in photograph, except-
Transmitted as Autosomal recessive
Icthyosis can develop
Can cause fetal hydrops
Affected fetus is called Harlequin baby
12. Device shown in the photograph to secure airway is
Endotracheal tube
Oropharyngeal airway
Classic Laryngeal mask airway
Proseal LMA
13. Machine shown below is:-
Ventilator
Boyle's apparatus
Simulator
Modern anaesthesia workstation
14.Identify the airway tube depicted in the image?
Nasopliaryngeal tube
Laryngeal Mask Airway
Oropharyngeal tube
Endotracheal tube
15. Use of tube depicted in the image?
Facilitate feeding
For giving lavage
Prevent aspiration
Maintain patent airway
Chemotherapy is recommended in postevacuation phase of molar pregnancy in all, except:
Plateau of hCG for 6 weeks
Regression of uterine size
Persistent vaginal bleeding
Theca-lutein cysts >6 cm size
Incidence of choriocarcinoma is seen more after:
Ectopic pregnancy
Spontaneous abortion
Normal delivery
Cesarean section
Choriocarcinoma with lung metastasis is stage –
1
3
2
4
Dose of centchroman is -
Daily one tablet
Twice a week
Once a mont
Twice a month
Cervical stroma consists of –
Racemose glands
Tubular glands
Alveolar glands
Coiled tubular glands
Corpus luteum in the first 6 weeks of pregnancy is maintained by –
BetaHCG
Estrogen
Progesterone
Human placental lactogen
Human placenta is –
Discoid
Hemochorial
Deciduate
All the above
True about placenta is –
Majority of placenta is of maternal origin
Maternal pole is smaller than fetal pole
Placenta is hemicoroidal & discoid in shape
Both b & c
Presenting part most commonly encountered in longitudinal lie is –
Brow
Vertex
Face
Hand
Ovarian function test independent of ovarian cycle is-
Antimullerian hormone
Day 3 FSH
Inhibin B
Antral follicular count
Woman presents with 6 weeks amenorrhoea and bleeding per vaginum; which is the screening test for the above –
Urine Pregnancy Test
BetahCG
Ultrasonography
Laparotomy
Which of the following are not signs/symptoms indicating threatened abortion ?
Pain
Bleeding PV
External os open
Soft feel of cervix
In which type of abortion the gestational age corresponds to the uterine size?
Threatened
Inevitable
Complete
Mixed
Softening of the cervix during pregnancy is called as?
Goodell's sign
Jacquemier's sign
Chadwick's sign
Piskacek's sign
Method of choice for medical termination of pregnancy within 12 weeks of gestation is=select one-+Mifepristone and misoprostol=4
Dilation and evacuation
Menstrual regulation
Suction evacuation
Congestive dysmenorrhea is seen in patients with-
Fibroid
IUD wearers
PID
All the above
Intracytoplasmic injection of sperm is done when the infertile male has sperm count less than-
3 million/ml
4 million/ml
5 million/ml
6 million/ml
Hysteroscope procedure is done for –
Vagina
Cervix
Fallopian tubes
Uterus
Which method of Medical Termination of Pregnancy is not used in the first trimester of pregnancy?
Intrauterine instillation of hypertonic saline
Suction and evacuation
Mifepristone
Misoprostol
Pergnancy as a result of contraceptive failure can be terminated as per which indication of the MTP act ?
To save life of mother
Social indication
Eugenic indication
None of the above
Partial mole, not true is –
Fetus is present
RiskofGTD>10%
Theca lutein cysts uncommon?
Uterine size is less then date
Which of the following fibroids is most associated with inversion of uterus ?
Submucous fundal fibroid with sarcomatous change
Subserosal fibroid
Intramural fundal fibroid
None of the above
Which type of Degeneration of fibroid leads to formation of womb stone?
Fatty
Calcine
Red
Cystic
Process of carcinogenesis in carcinoma cervix begins at the-
Endocervix
Ectocervix
Transformation zone
None of the above
Transverse pericardial sinus lies between which structures –
Around large veins
Between arterial and venous tubes
Between SVC and IVC
Between heart and sternum
.Intercostal injection is given at –
Upper border of the rib
Lower order of the rib
n the center of the intercostal space
In anterior part of intercostal space
3rd esophageal constriction is –
At crossing of aortic arch
22-5 cm from incisor
Crossing of left bronchus
15 cm from incisor
2nd constriction of esophagus is caused by –
Left bronchus
Arch of aorta
Diaphragm
Lower sphincter
Angle of right principal bronchus from midline –
45°
25°
75°
15°
Subcostal nerve is –
Ventral rami of T 6
Dorsal rami of T6
Ventral rami of T6
Dorsal rami of T12
Direct tributary of superior vena cava –
Azygousvein
Internal jugular vein
External jugular vein
Hemiazygous vein
All are true about coronary sinus except –
Situated in anterior part of coronary sulcus
Directly opens into right atrium
Develops from left horn of sinus venosus
Opening is guarded by semilunar valve
Blood supply of diaphragm is through all, except –
Musculophrenic artery
Inferior phrenic artery
Middle phrenic artery
Pericardiophrenic artery
Medial branchopulmonary segment is a part of –
Upper lobe of right lung
Upper lobe of left lung
Lower lobe of left lung
Middle lobe of right lung
True about bronchopulmonary segment –
Supplied by respiratory bronchiole
Every segment has its own vein
Largest subdivision of a lobe
Surgically not resectable
Bronchial arteries supply the lung up to –
Major bronchi
Alveolar duct
Tertiary bronchi
Respiratory bronchioles
True about internal thoracic artery is-
Arises from 1st part of subclavian artery
Pericardiophrenic is a terminal branch
Divides in the 4th intercostal space
Descends at posterior end of intercostal space
Normal expiratory reserve volume of adult-
500 ml
3000 ml
1200 ml
4500 ml
239.Normal pulmonary artery pressure in mm Hg –
5
15
30
40
240.Chemoreceptors are located in which area-
Medulla
Arch of aorta
Bifurcation of carotid artery
All of the above
V/Q ratio at the base of lung-
1
3
0.6
1.8
Total dead space in healthy individuals –
50 ml
150 ml
500 ml
100 ml
Turbulent blood flow is due to –
Low density of blood
Large diameter of vessel
High viscocity of blood
All of the above
Pericytes are seen in-
Arteries
Veins
Capillaries
Alloftheaove
Most important factor determining the strength of a pulse-
MeanBP
TPR
Pulse pressure
None
Which muscarinic receptor causes dilatation of vessels-
M1
M2
M3
M4
C-Wave in JVP is due to –
Atrial contraction
Ventricular filling
Atrial filling
Bulging of tricuspid valve in right atrium
Most prominent action of angiotensin II-
Vasoconstriction
Induction of thirst
Increased secretion of aldosterone
Inerease'd Na+ reabsorption
Not true about gluconeogenesis –
Most important amino acid substrate is alanine
May occur in kidney
Fatty acid enters at succinyl CoA
Major site is cytosol
Pyruvate kinase is inhibited by –
Insulin
Fructose -1,6 bisphosphate
ATP
All of the above
SimUar step in gluconeogenesis and glycogenolysis is catalyzed by –
Glucose 1 phosphatase
Glucose-6-phosphatase
Phosphoglucomutare
Pyruvate kinase
Irreversible step in citric acid cycle is catalyzed by –
Aconitase
Succinate thiokinase
a-ketoglutarate dehydrogenase
Isocitrate dehydrogenase
Structure of triglyceride is-
2 molecules of FA + Glycerol
3 molecules of FA + Glycerol
2 molecules of FA + 2, 3 DPG
3 molecules of FA + 2, 3 DPG
Hydrogenation of fatty acid is –
Hydrolysis by Alkali
Auto-oxidation of PUFA
Addition of hydrogen to unsaturated fatty acid
Addition of hydrogen to saturated fatty acid
Which of the following reaction is due to Upid peroxidation –
Saponification
Rancidity
Hydrogenation
Soap formation
End point of fatty acid synthesis is formation of –
Palmitic acid
Stearic acid
Oleic acid
Linoleic acid
Familial hypercholesterolemia is characterized by-
Increased LDL
Decreased lipoprotein lipase
Increased VLDL
All of the above
Limiting amino acid in legumes –
Lysine
Methionine
Alanine
Tryptophan
Methionine is synthesized from –
Cysteine
Glycine
Histidine
Arginine
In human body, methionine is synthesized from –
Cysteine
Proline
Threonine
None
Most important amino acid which acts as methyl group donor –
Cysteine
Methionine
Tyrosine
Tryptophan
Which of following clostridia is non-invasive –
Clostridium novyi
Clostridium botulinum
Clostridium perfringens
Clostridium tetani
True about Cl perfringens are all except –
Invasive as well as toxigenic
Alpha toxin is detected by Naegler's reaction
Beta toxin is most important in gas gangrene
Theta toxin is perfringolysin
True about streptococcus pyogenes are all except –
Causes only localized infection
Rheumatic fever is non-supporative complications
Erythrogenic toxin causes scarlet fever
Glomerulonephritis is due to antigenic cross-reactivity
Causative agent of acute rheumatic fever –
Group 'A' p-hemolytic streptococcus
Group-B p-hemolytic streptococcus
Group-C p-hemolytic streptococcus
Group-D p-hemolytic streptococcus
Most common symptom of tetanus is –
Tonic-clonic seizures
Hemplegia
Lock-jaw
Opisthotonus
Culture medium used for streptococcus pneumoniae-
Human blood agar
Sheep blood agar
MacConkey's agar
Deoxycholate agar
Most dangerous type of diptheria-
Facial
Laryngeal
Nasal
Cutaneous
True about mycobacterium leprae –
Transmitted by droplet infection
Phenolic glycolipid (PGL) is virulence factor
Generation time 12-13 days
All are true
Capsule of pneumococcus is-
Polypeptide
Polysaccharide
Lipopolysaccharide
Virulence factor
Which of the following is late lactose fermenter –
Ecoli
Klebsiella
Salmonella
Shigella sonnei
Trachoma is caused by which serotype of chlamydia trachomatis –
D to K"
A,B,C
L,L2L3
All of the above
L1 L2 L3 serovar of chlamydia trachomatis cause –
Trachoma
Inclusion conjunctivitis
NGU
LGV
True about chlamydia is –
Replicative form is elementary body
Infective form to host cell is elementary body
Cell wall contains N-acetylmuramic acid and peptidoglycan
All of the above are correct
Chlamydia is associated with which bodies?
Torres bodies
Negri bodies
Reticulate bodies
Bollinger bodies
Temperature required for isolation of compylobacter-
20° C
25° C
37° C
42° C
Most salt retaining Glucocorticosteroid –
Hydrocortisone
Prednisolone
Betamethasone
Dexamethasone
Which of the following glucocorticoids has no mineralocorticoid activity –
Prednisolone
Cortisol
Hydrocortisone
Triamcinolone
Which is long acting glucocarticoid-
Hydrocartisone
Prednisolone
Cortisol
Dexamethasone
Maximum hypoglycemia is caused by which oral hypoglycomic –
Metformin
Sulfonylureas
Miglital
Pioglitazone
Venous thromboembolism is more common with which OCPs generation –
1st
2nd
3rd
Same with all
Bromocriptine is agonist of –
Dopamine
Serotonine
Acetylcholine
Epinephrine
Bromocriptine is agonist on –
5HT2A receptors
Di receptors
D2 receptors
Mi receptors
A PTT is required for monitoring of –
Streptokinase
Warfarin
Heparin
Tranexamic acid
Which drug is vassopressin V2 receptor selective agonist –
Lypressin
Desmopressin
Terlipressin
None
Darbopoetin is most useful in treatment of anemia caused by –
Chronic renal failure
Iron deficiency
Chemotherapy induced
Aplastic anemia
Statins are given at night because –
HMG-Co A reductase activity is maximum in midnight
Statins are maximally absorbed in night
Statins have more potency in night
Convenient for patient to remember
Rosuvastatin can be given in the morning because –
Long plasma half life
Better bioavailability
Lers drug interaction
All of the above
Rifampicin is never given again if patients develops following side effect of rifampicin-
Hepatitis
Visual loss
Thrombocytopenia
Peripheral neuropathy
Which class of antiretroviral drug is used for starting treatment for HIV infection –
Protease inhibitors
NRTIs
Fusion inhibitors
NNRITs
Cardinal signs of Inflammation are all except?
Rubor
Tumor
Color
Cyanosis
Stellate granuloma is seen in?
Crohn's disease
Cat scratch disease
Hodgkin's disease
Berrylliosis
Correct sequence of events in acute inflammation is –
Rolling, adhesion, margination, transmigration
Margination, rolling, adhesions, transmigration
Adhesion, rolling, transmigration, margination
Margination, adhesion, rolling, transmigration
Which of the following helps in movement and adhesion ?
MCP1
PGE2
LTB4
CD31
Slow mediators of inflammation are?
Leukotrienes
Prostaglandins
Interleukins
Vasoactive amines
Systemic inflammatory response syndrome, false is –
Hypoglycemia
Fever
Leukocytosis
Altered mental status
C3 compliment is cleared by –
CD 59
CD 55
Factor D
Factor E
Major basic proteins are produced by –
Lymphocyte
Neutrophil
Basophil
Eosinophil
HLA 2 is associated with –
Auto immune diseases
Graft rejection
Cell mediated cytolysis of viral infected cells
Mixed leukocyte reaction
Runt disease is associated with –
Acute rejection
Hyperacute rejection
Chronic rejection
Graft versus host disease
Acute graft rejection occurs within –
3 hours
3 days
3 months
3 years
Method of prevention of GVHD in bone marrow transplantation is -
T-cell removal
Prior immune suppression
Post procedure immune suppression
All of the above
No prior immune suppression is helpful in which type of graft rejection ?
Acute rejection
Hyperacute rejection
Chronic rejection
None of the above
Secondary allograft rejection is mediated by –
Memory cells
Antibodies
Immune complexes
None of the above
Complement proteins constitute what percentage of serum proteins ?
<1
1-5
5-10%
>10%
To rule out rheumatoid arthrirtis, most important among the followings is –
HLADR8
HLADR4
HLADQ1
HLAB27
A child with respiratory tract infection presents with gross hematuria within 2 days of the infection. The probable diagnosis is –
Post Streptococcal Glomerulonephritis
IgA Nephropathy
Nephrotic Syndrome
Urinary tract infection
A child with history of recurrent throat infrctions presents with hematuria and proteinuria with the last infection being 3 weeks back. The diagnosis is-
Berger's disease
Henoch Schonlein purpura
Membranoproliferative glomerulonephritis
Poststreptococcal glomerulonephritis
In morbus caeruleus foramen ovole closes after –
6 months
2 years
1 year
Never
Which is the most common congenital cardiac defect?
TAPVC
Transposition of great arteries
Ventricular septal defect
Atrial septal defect
All of the following are treatments of an infant with supraventricular tachycardia except?
Ice pack on face
Adenosine
DC Cardioversion
Verapamil
What is the treatment of a child with supraventricular tachycardia?
Adenosine
Digoxin
Sotalol
Flecainide
Long QT syndrome- All of the following may be a cause in children except –
Romano Ward syndrome
Jarvell and Lange Nielson Syndrome
Macrolide antibiotics
Holt Oram Syndrome
What is the mechanism of aortic regurgitation in a CaseofVSD-
Prolapse of right coronary leaflet
Changes in the pressure gradient due to left to right shunt
Eisenmengerization
Congenital defect
VACTERAL syndrome is associated with –
Blindness
Nerve deafness
Tracheo-esophageal fistula
Myoclonic epilepsy
Acute meningococcal meningitis is treated for how many days –
5-10 days
10-14 days
14-21 days
21-28 days
Craniopharyngioma arises from –
Pituitary stalk
Posterior pituitary
Pineal gland
Cerebellum
Abnormalities of copper metabolism are implicated in the pathogenesis of all the following except –
Wilson's disease
Monkes' Kinky-hair syndrome
Indian childhood cirrhosis
Keshan disease
Treatment of severe dehydration is –
Start Colloids immediately
Start Ringer's lactate immediately
Combination of 5% Dextrose with Ringer's lactate
Start DNS immediately
Most common endocrine abnormality in Down's syndrome is –
Hypothyroidism
Hypoparathyroidism
Congenital adrenal hyperplasia
Cushing's disease
Treatment of choice for fracture shaft femur in a child less than 2 years of age –
Gallow's traction
Hip spica
Russel traction
Intramedullary nail
A 23 year old profession footballer sufferd a twisting injury to his right ankle. On examination there is a lot of swelling around the medial malleolus but xray doesn't show any fracture. The structure injured could be-
Deltoid Ligament
Anterior talofibular ligament
Spring ligament
Tendo Achilles
MC complication of fracture talus is –
Avascular necrosis
Nonunion
Osteoarthritis of ankle joint
Osteoarthritis of subtalar joint
In Complete ACL rupture the tibia moves over the femur in which direction –
Forward
Backward
Lateral
Medial
Shenton's line is –
Line joining ASIS and ischeal tuberosity
Line joining ASIS and tip of GT
Line joining two ASIS [left & right]
Curve formed by neck of femur and obturator foramen
All of the following are red flag signs of back pain except –
Previous history of malignancy
Previous history of steroid use
Saddle anaesthsia
Age between 35-50
Irregular thigh folds are seen in –
Developmental dysplasia of hip
Perthe's disease
Slipped Capital femoral epiphysis
Congenital coxa vara
Pavlic harness is used to treat –
Deveopmental dysplasia of hip
Perthe's disease
Slipped Capital femoral epiphysis
Congenital coxa vara
A 63-year-old man with a long history of a duodenal ulcer was seen in the emergency department after vomiting blood-stained fluid and exhibiting all the signs and symptoms of severe hypovolemic shock. The following statements concerning duodenal ulcers could apply to the patient's condition except which?
The pyloric sphincter prevents most of the blood from the duodenal lumen from passing up into the stomach.
The gastroduodenal artery lies behind the first part of the duodenum and was probably eroded by the ulcer.
The gastroduodenal artery is a branch of the Superior Mesentric artery.
The duodenal ulcer was most likely to be situated on the posterior wall of the first part of the duodenum.
The following signs and symptoms consistent with the diagnosis of Meckel's diverticulum except which?
Tenderness of the anterior abdominal wall in the right iliac region
Anemia
Stools streaked with dark red blood
Pyrexia of 102°F
A 42-year-old woman presented because she experienced an agonizing pain in the rectum, which occurred on defecation. She had first noticed the pain a week before when she tried to defecate. The pain lasted for about an hour, then passed off, only to return with the next bowel movement. She said that she suffered from constipation and admitted that sometimes her stools were streaked with blood. After a careful examination, a diagnosis of anal fissure was made. . The following statements concerning this case are correct except which?
Gentle eversion of the anal margin under local anesthesia revealed the lower edge of a linear tear in the posterior wall of the anal canal; a small tag of skin projected from the lower end of the tear.
The forward edge of a hard fecal mass may have caught one of the anal valves and torn it downward as it descended.
Anal fissures tend to occur on the anterior and posterior walls of the anal canal because the mucous membrane is poorly supported in this region by the superficial external sphincter muscle.
The mucous membrane of the lower half of the anal canal is innervated by autonomic afferent nerves and is sensitive only to stretch.
A 45-year-old man complaining of a lump in the groin was seen by his physician. The lump, which caused him no pain or discomfort, was first recognized 3 months previously. On examination, a large discrete hard lump was found about 2 in. (5 cm) below and lateral to the pubic tubercle on the front of the right thigh. The following signs indicated that this patient had a melanoma of the right big toe with secondaries in the inguinal lymph nodes except which?
Two smaller hard swellings were found immediately below the large swelling.
On flexing the right knee joint, three small hard swellings could be palpated in the popliteal fossa.
The external genitalia were found to be normal.
Examination of the anal canal revealed nothing abnormal.
A 75-year-old woman was dusting the top of a high closet while balanced on a chair. She lost her balance and fell to the floor, catching her right lumbar region on the edge of the chair. The following statements about this patient are correct except which?
Examination of the back revealed a large bruised area in the right lumbar region, which was extremely tender to touch.
Anteroposterior and lateral radiographs exclude the presence of a fracture, especially of a transverse process.
A 24-hour specimen of urine should be examined for blood to exclude or confirm injury to the right kidney.
A lumbar puncture (spinal tap) should always be performed in back injuries to exclude damage to the spinal cord.
Which of the following hormones originates in the anterior pituitary?
Dopamine
Growth hormone-releasing hormone (GHRH)
Somatostatin
Thyroid-stimulating hormone (TSH)
Vibrio cholera causes diarrhea because it
Increases hco3- secretory channels in intestinal epithelial cells
Increases cl- secretory channels in crypt cells
Prevents the absorption of glucose and causes water to be retained in the intestinal lumen isosmotically
Inhibits cyclic adenosine monophosphate (camp) production in intestinal epithelial cells
To maintain normal H+ balance, total daily excretion of H+ should equal the daily
Fixed acid production plus fixed acid ingestion
Hco3- excretion
Hco3- filtered load
Titratable acid excretion
Which volume remains in the lungs after a tidal volume (TV) is expired?
Tidal volume (TV)
Vital capacity (VC)
Expiratory reserve volume (ERV)
Functional residual capacity (FRC)
In a capillary, Capillary Hydrostatic pressure(Pc ) is 30 mm Hg,Interstitial hydrostatic pressure( P1); is -2 mm Hg, Capillary oncotic pressure () c is 25 mm Hg, and ,Interstitial oncotic pressure( 1 )is 2 mm Hg. What is the direction of fluid movement and the net driving force?
Absorption; 6 mm Hg
Absorption; 9 mm Hg
Filtration; 6 mm Hg
Filtration; 9 mm Hg
Telomeres are complexes of DNA and protein that protect the ends of linear chromosomes. In the synthesis of telomeres:
Telomerase, a ribonucleoprotein, provides both the RNA and the polymerase needed for synthesis.
The RNA of telomerase serves as a primer.
The polymerase of telomerase is a DNA-directed DNA polymerase.
The shorter, 3′→5′ strand gets extended.
Dietary fat
Is usually present, although there is no specific need for it.
If present in excess, can be stored as either glycogen or adipose tissue triacylglycerol.
Should include linoleic and linolenic acids.
Should increase on an endurance training program to increase the body's energy stores.
The effects of vitamin A may include all of the following except
Prevention of anemia.
Serving as an antioxidant.
Cell differentiation.
Induction of certain cancers.
Porphyria cutanea tarda is due to deficiency of
Ala synthase
Ala dehydratase
Uroporphyrinogen III synthase
Uroporphyrinogen III decarboxylase
Which one of the following is the test with the highest sensitivity?
Identifies 80% of those with the disease and 95% of those without the disease
Identifies 90% of those with the disease and 80% of those without the disease
Identifies 95% of those with the disease and 70% of those without the disease
Identifies 99% of those with the disease and 60% of those without the disease
The normal flora of the large intestine consists mainly of
Bacteria
Fungi
Protozoa
Viruses
Thayer-Martin and Martin-Lewis media are used to isolate and identify
E. coli
Mycobacteria
Neisseria
Salmonella
What rapid test commonly used on Gram-negative rods, which, if positive, rules out Enterobacteriaceae?
Catalase
Coagulase
Oxidase
Chitinase
A patient presents with a brain abscess. The dominant organism is an anaerobe normally found as. part of the oral flora. Which of the following best fits that description?
Nocardia
Actinomyces
Mycobacterium
Pseudomonas aeruginosa
The eclipse period of a one-step viral multiplication curve is defined as the period of time between the
Uncoating and assembly of the virus
Start of the infection and the first appear­ance of extracellular virus
Start of the infection and the first appearance of intracellular virus
Start of the infection and uncoating of the virus
A 16-year-old boy presents at your office with a sore throat, fever, and enlarged lymph nodes. His tonsils are enlarged, the pharynx is inflamed, and splenomegaly is observed. He complains of severe fatigue. Confirmation of the causative agent is best done by observing
A positive Tzanck smear
IgM heterophile antibodies
Koilocytotic cells
RT-PCRforenterovirus
Drugs showing zero-order kinetics of elimination:
Are more common than those showing first-order kinetics.
Decrease in concentration exponentially with time.
Have a half-life independent of dose.
Show a plot of drug concentration versus time that is linear.
Which one of the following statements concerning COX-2 inhibitors is correct?
The COX-2 inhibitors show greater analgesic activity than traditional NSAIDs.
The COX-2 inhibitors decrease platelet function.
The COX-2 inhibitors do not affect the kidney.
The COX-2 inhibitors show anti-inflammatory activity similar to that of the traditional NSAIDs.
In which one of the following clinical situations is the prophylactic use of antibiotics not warranted?
Prevention of meningitis among individuals in close contact with infected patients.
Patient with a hip prosthesis who is having a tooth removed.
Presurgical treatment for implantation of a hip prosthesis.
Patient who complains of frequent respiratory illness.
We administer a highly lipid-soluble drug and monitor its elimination in vivo and in vitro. All the data indicate that it is transformed to a variety of more polar metabolites by a group of heme proteins that activate molecular oxygen to a form that is capable of interacting with organic substrates such as our test drug. Which of the following is the most likely enzyme or enzyme system involved in the initial metabolism of our test drug?
Cyclooxygenase
Cytochrome P450s
Monoamine oxidase (MAO)
Nicotinamide adenine dinucleotide phosphate (NADPH)
Which of the following statements accurately describes a "typical" postganglionic sympathetic nerve?
Atropine selectively blocks activation of receptors by the neurotransmitter released from nerve d
It causes bronchodilation (airway smooth muscle relaxation) when Beta 1 receptor is activated
It is adrenergic or noradrenergic
The primary neurotransmitter synthesized by postganglionic sympathetic nerve is epinephrine
Which of the following best identifies that rather unique effect of meperidine compared to other opioids?
Constipation leading to paralytic ileus
Heightened response to pain (paradoxical hyperalgesia)
Intense biliary tract spasm
Psychosis-like state, possibly seizures
Which of the following is most susceptible to radiation damage?
Bone
Gastrointestinal mucosa
Peripheral nervous tissue
Renal parenchyma
which of the following is side effect of methotrexate?
Defective osteoid matrix production
Hemorrhagic lesions of the mamillary bodies
Megaloblastic anemia
All of above
A 14-year-old boy is brought with a long history of recurrent epistaxis. His father also reports such a history. Of the following, which is the most likely condition consistent with these findings?
Cavernous hemangioma
Glomangioma
Hemangioendothelioma
Osier-Weber-Rendu syndrome
A 9-year-old girl is diagnosed with acute rheumatic fever. Instead of recovering as expected, her condition worsens, and she dies. Which of die following is the most likely cause of death?
Central nervous system involvement
Endocarditis
Myocarditis
Pericarditis
A 62-year-old man presents with pallor, fatigue, and dyspnea on exertion. A complete blood count reveals microcytic hypochromic anemia. The most likely cause of these findings is
Dietary deficiency of iron.
Gastrointestinal bleeding.
Hemodilution.
Hemolytic anemia.
A 3-year-old boy presents with epistaxis and fever. Multiple cutaneous petechiae are evident, and there is generalized enlargement of lymph nodes, as well as palpable splenomegaly. The hemoglobin and platelet count are markedly decreased, and the white blood cell count is elevated to 40,000 cells/uL, with a preponderance of lymphoblasts. Which of the following statements best characterizes this disorder?
It is the form of acute leukemia that is most responsive to therapy.
It occurs most often in adults but can occur in children.
Lymphoblastic cells cause damage to normal blood cells, resulting in low cell counts.
The presence of the CD10 marker is indicative of a poorer prognosis.
Which of the following deals with the, conventional laws of courtesy observed between members of the medical profession
Forensic pathology
Medical ethics
Medical jurisprudence
Medical etiquette
Throwing of which of the following acid on another individual is known as vitriolage
Nitric acid
Sulphuric acid
Hydrochloric acid
Any of above
False statement regarding SUBPOENA
Subpoena is a document compelling the attendance of a witness in a Court of law under penalty, on a particular day, time and place, for the purpose of giving evidence
Sections 61 to 69 of Cr.P.C. deal with summons
If a witness is summoned by two Courts on the same day , Criminal Courts have priority over civil Courts
In a civil case ,If the witness fails to attend the Court , the Court may issue bailable or non-bailable warrants to secure the presence of the witness
Law of criminal responsibility and is included in
Sec. 356, I.P.C
Sec. 84, I.P.C
Sec. 420, I.P.C
Sec. 34, I.P.C
False regarding Preservatives
Sodium floride should be used for preserving blood
Saturated sodium chloride solution in poisoning from corrosive acids
Rectified spirit, except in cases of alcohol
One ml of concentrated hydrochloric acid fluoride can be used for 10 ml urine as a preservative
A 12-year-old boy presents with pain over the tibial tubercle. His mother reports a recent growth spurt. The most likely diagnosis is
Legg-calve-perthes disease
Shin splints
Osgood-schlatter disease
Osteosarcoma
A 4-year-old boy is brought. The child has evidence of a stomatitis and a vesicular rash that affects his hands and feet. The most likely cause is
Coxsackievirus
Adenovirus
Syphilis
Varicella
The most common cause of metabolic pancreatitis in children is
Type i diabetes mellitus
Primary hyperparathyroidism
Primary hyperthyroidism
Diabetes insipidus
Anterior fontanel usually closes at
3 months
6 months
12 months
2 years
A 5-year-old boy is brought to the emergency room with inspiratory and expiratory stridor, high fever, and drooling. Initial treatment consists of
Oxygen therapy
Airway management by trained personnel
Inhaled bronchodilators
Lying the child in the supine position
Which of the following is a description of Prader-Willi syndrome?
Tall, large arm span, increased risk of aortic rupture
Obese, hypotonic, mental retardation,"hypogonadism
Short, obese, frontal bossing, precocious puberty
Normal size, mental retardation, precocious puberty
A 6 month old is brought to your office in mid january. The child's mother reports that the infant has had a low-grade fever, wheezing with coughing, and diminished appetite. The most likely diagnosis is
Bronchiolitis secondary to rsv
Pneumonia secondary to s. Pneumoniae
Asthma
Bronchitis secondary to h. Influenzae
Which of the following congenital heart defects is considered a cyanotic lesion?
Ventricular septal defect
Atrial septal defect
Patent ductus arteriosis
Tetralogy of Fallot
A child is found to have higher blood pressures in the arms than in the legs and pulses are bounding in the arms but decreased in the legs. The most likely condition is
Ventricular septal defect
Tetralogy of fallot
Transposition of the great arteries
Coarctation of the aorta
Which of the following statements regarding inhalant abuse is true?
Approximately 5% of children in middle school and high school have experimented with inhaled substances.
No associated fetal abnormalities have been associated with inhalant abuse during pregnancy.
Drug testing can help aid in the diagnosis of inhalant abuse.
Inhalant abuse can become addictive.
A 38-year-old woman with many neurotic features who volunteers she is thinking of killing herself should be
Taken seriously and referred for treatment.
Reassured that she will not do it.
Given some support, but need not be taken too seriously.
Considered a high suicide risk only if she is single.
Depersonalisation is associated with
Post-traumatic stress disorder.
Schizophrenia.
Agoraphobia.
All of the above conditions.
The most common pattern for seasonal affective disorder is
Onset in spring, recovery in summer.
Onset in summer, recovery in winter.
Onset in autumn, recovery in winter.
Onset in winter, recovery in spring.
In young women with an eating disorder, at what point would you expect her menstrual periods to resume?
75% of ideal body weight
80% of ideal body weight
90% of ideal body weight
100% of body weight
All of the following behaviors are associated with bulimia except?
Self-mutilation
Anxiety
Substance abuse
Anhedonia
A 3 5 -year-old patient with a history of endometriosis presents with a numberof clinical symptoms. Which of the following symptoms cannot be explained by the diagnosis of endometriosis?
Lump at site of previous surgical scar
Shortness of breath and pleuritic pain at onset of menses
Haematuria
Aching muscles
A nine-year-old boy is admitted to hospital 12 hours following the onset of acute scrotal pain and is referred for an ultrasound examination. Which of the following ultrasound appearances is incompatible with a diagnosis of testicular torsion?
Normal grey-scale appearance of both testes
Hydrocoele
Scrotal skin thickening
Diffusely hypoechoic echotexture of one testis
A 26-year-old male is involved in a motor vehicle accident and sustains a pelvic fracture. On ultrasound 'a bladder within a bladder' appearance is seen; that is, a bladder surrounded by a fluid collection. A diagnosis of extra-peritoneal bladder rupture is made. Where is the bladder most likely to have ruptured?
The dome of the bladder
The left ureteric orifice
The right ureteric orifice
Anterior aspect of the base of the bladder
A 15-year-old boy being investigated for recurrent urinary infection under­goes Tc-99m DTPA scintigraphy which demonstrates the presence of ahorseshoe kidney. What is likely to limit the isthmus?
Umbilical ligament
Coeliac axis
Superior mesenteric artery
Inferior mesenteric artery
A 5 5-year-old male is 18 months following right radical nephrectomy for an 8-cm renal cell carcinoma, which invaded the renal vein (T3b NO MO, Stage IIIA), and is undergoing a surveillance CT scan. Where is the most likely site for distant metastatic recurrence?
Brain
Contralateral kidney
Lung
Bowel
Subbamma , a 66-year-old woman undergoes a lysis of adhesions and bowel resection for small-bowel obstruction secondary to radiation enteritis after treatment for ovarian cancer. A jejunostomy is placed to facilitate nutritional repletion. Which of the following statements is true regarding postoperative nutrition?
Enteral nutrition has no advantages over parenteral nutrition in postoperative patients.
Institution of enteral feeding within 24 hours postoperatively is safe.
Institution of enteral feeding should be delayed until bowel function returns as evidenced by passage of flatus or a bowel movement.
Parenteral nutrition should be instituted immediately postoperatively and continued until enteral feeds have been initiated.
A 56-year-old woman has a life-threatening pulmonary embolus 5 days following removal of a uterine malignancy. She is immediately heparinized and maintained in good therapeutic range for the next 3 days, then passes gross blood from her vagina and develops tachycardia, hypotension, and oliguria. Following resuscitation, an abdominal CT scan reveals a major retroperitoneal hematoma. Which of the following is the best next step in management?
Immediately reverse heparin by a calculated dose of protamine and place a vena caval filter (eg, a Greenfield filter).
Reverse heparin with protamine, explore and evacuate the hematoma, and ligate the vena cava below the renal veins.
Switch to low-dose heparin.
Stop heparin, give fresh-frozen plasma (FFP), and begin warfarin therapy.
A 74 -year-old man develops dysphagia for both solids and liquids and weight loss of 30 KG over the past 6 months. He undergoes endoscopy, demonstrating a distal esophageal lesion, and biopsies are consistent with squamous cell carcinoma. He is scheduled for neoadjuvant chemoradiation followed by an esophagectomy and preoperatively is started on total parenteral nutrition, given his severe malnutrition reflected by an albumin of less than 1. Which of the following is most likely to be a concern initially in starting total parenteral nutrition in this patient?
Hyperkalemia
Hypermagnesemia
Hypoglycemia
Hypophosphatemia
A 58-year-old woman with multiple comorbidities and previous cardiac surgery is in a high-speed motor vehicle collision. Because of hemodynamic instability, a Swan-Ganz catheter is placed. However, the PCWP and left ventricular end-diastolic pressure (LVEDP) do not appear to be correlating. Which of the following conditions would best explain this lack of correlation?
Aortic stenosis
Aortic regurgitation
Coronary artery disease
Positive-pressure ventilation with positive end-expiratory pressure/continuous positive airway pressure (PEEP/CPAP)
An 18-year-old woman develops urticaria and wheezing after an injection of intravenous contrast for an abdominal CT scan. Her blood pressure is 120/60 mm Hg, heart rate is 155 beats per minute, and respiratory rate is 30 breaths per minute. Which of the following is the most appropriate immediate therapy?
Intubation
Epinephrine
Beta blockers
Iodine
A 42-year-old woman has a childhood history of a third-degree scald burn to her right lower extremity that did not require skin grafting. She states that she experienced trauma to the wound 1 year ago and since then she has had persistent non-healing of the area. A biopsy of the wound is performed. Which of the following is the most likely diagnosis?
Angiosarcoma
Malignant melanoma
Squamous cell carcinoma
Kaposi sarcoma
A 13-year-old male is in a motor vehicle collision in which the car caught fire. He sustained a circumferential burn but no fractures or other soft tissue trauma to his left lower extremity during extrication from the burning vehicle. Several hours after admission, he complains of numbness and severe pain in his left calf. On examination, he has a palpable, although weak, dorsalis pedis pulse. Which of the following is the most appropriate management?
Four-compartment fasciotomies
Medial and lateral escharotomies
Computed tomography (CT) scan of the left lower extremity
Magnetic resonance imaging (MRI) of the left lower extremity
During a brawl, a 19-year-old male sustains a 4-in laceration on his left arm from glass and presents to the emergency room the following morning, 10 hours later. He is neurovascularly intact and the wound is deep, extending down to fascia. Which of the following is the most appropriate management of the wound?
Closure of the skin only and administration of oral antibiotics for 1 week
Closure of the skin and subcutaneous tissue and administration of oral antibiotics for 1 week
single dose of intravenous antibiotics and closure of the skin and subcutaneous tissue
Local wound care without wound closure or antibiotics
A 75-year-old man with a history of coronary artery disease, hypertension, and diabetes mellitus undergoes a right hemicolectomy for colon cancer. On the second postoperative day, he complains of shortness of breath and chest pain. He becomes hypotensive with depressed mental status and is immediately transferred to the intensive care unit. After intubation and placement on mechanical ventilation, an echocardiogram confirms cardiogenic shock. A central venous catheter is placed that demonstrates a central venous pressure of 18 mm Hg. Which of the following is the most appropriate initial management strategy?
Additional liter fluid bolus
Inotropic support
Mechanical circulatory support with intra-aortic balloon pump (IABP)
Cardiac catheterization
A 22-year-old man is examined following a motor vehicle accident. His right leg is injured, as are his elbow and clavicle. Which of the following fractures or dislocations is most likely to result in an associated vascular injury?
Knee dislocation
Closed posterior elbow dislocation
Midclavicular fracture
Supracondylar femur fracture
A 23-year-old police constable from Assam BSF , previously healthy man presents to the ER after sustaining a single gunshot wound to the left chest. The entrance wound is 3 cm inferior to the nipple and the exit wound is just below the scapula. A chest tube is placed that drains 400 mL of blood and continues to drain 50 to 75 mL/h during the initial resuscitation. Initial blood pressure of 70/0 mm Hg has responded to 2 L crystalloid and is now 100/70 mm Hg. Abdominal examination is unremarkable. Chest x-ray reveals a reexpanded lung and no free air under the diaphragm. Which of the following is the best next step in his management?
Admission and observation
Peritoneal lavage
Exploratory thoracotomy
Exploratory celiotomy
A 37-year-old woman has developed a 6-cm mass on her anterior thigh over the past 10 months. The mass appears to be fixed to the underlying muscle, but the overlying skin is movable. Which of the following is the most appropriate next step in her management?
Above-knee amputation
Excisional biopsy
Incisional biopsy
Bone scan
A 50-year-old man is incidentally discovered to have non-Hodgkin lymphoma confined to the submucosa of the stomach during esophagogastroduodenoscopy for dyspepsia. Which of the following statements is true regarding his condition?
Surgery alone cannot be considered adequate treatment.
Combined chemotherapy and radiation therapy, without prior resection, are not effective.
Combined chemotherapy and radiation therapy, without prior resection, result in a high risk of severe hemorrhage and perforation.
The stomach is the most common site for non-Hodgkin lymphoma of the gastrointestinal tract.
Which of the following statements regarding malignant parotid tumors is correct?
Acinar carcinoma is a highly aggressive malignant tumor of the parotid gland.
Squamous carcinoma of the parotid gland exhibits only moderately malignant behavior.
Regional node dissection for occult metastases is not indicated for malignant parotid tumors because of their low incidence and the morbidity of lymphadenectomy
Facial nerve preservation should be attempted when the surgical margins of resection are free of tumor.
A newborn presents with signs and symptoms of distal intestinal obstruction. Abdominal x-rays reveal dilated loops of small bowel, absence of air-fluid levels, and a mass of meconium within the right side of the abdomen mixed with gas to give a ground-glass appearance. Which of the following is true regarding this condition?
It represents the earliest clinical manifestation of sickle cell disease.
Initial treatment is bowel rest with nasogastric tube decompression and IV antibiotics.
Initial treatment is a contrast enema.
Initial treatment is surgical evacuation of the luminal meconium.
A 4-week-old male infant presents with projectile, nonbilious emesis. Ultrasound of the abdomen reveals a pyloric muscle thickness of 8 mm (normal 3-4 mm). Which of the following is true regarding this condition?
Gastric outlet obstruction leads to hyperchloremic, metabolic alkalosis.
The highest incidence is found among African Americans and Chinese.
Males and females are equally affected.
Underlying metabolic alkalosis needs to be corrected prior to surgery.
A 1-month-old female infant presents with persistent jaundice. A serum direct bilirubin is 4.0 mg/dL and an ultrasound of the abdomen shows a shrunken gallbladder and inability to visualize the extrahepatic bile ducts. Which of the following is the most appropriate initial management of this patient?
NPO and total parenteral nutrition
Oral choleretic bile salts
Methylprednisolone
Exploratory laparotomy
A 2-year-old asymptomatic child is noted to have a systolic murmur, hypertension, and diminished femoral pulses. Which of the following is true about this child's disorder?
Atrial septal defects (ASDs) are frequently associated.
The child is unlikely to become normotensive even with surgical intervention.
Rib notching is often seen on x-ray.
Claudication is frequently noted.
A 35-week term infant presents with cyanosis shortly after birth. His arterial oxygen saturation is only 30%. Which of the following is the most likely diagnosis?
Patent ductus arteriosus
Atrial septal defect
Ventricular septal defect
Transposition of the great vessels
An elderly diabetic woman with chronic steroid-dependent bronchospasm has an ileocolectomy for a perforated cecum. She is taken to the 1CU intubated and is maintained on broad-spectrum antibiotics, renal dose dopamine, and a rapid steroid taper. On postoperative day 2, she develops a fever of 39.2CC (102.5°F), hypotension, lethargy, and laboratory values remarkable for hypoglycemia and hyperkalemia. Which of the following is the most likely explanation for her deterioration?
Sepsis
Hypovolemia
Adrenal insufficiency
Acute tubular necrosis
A patient develops a fever and tachycardia during a blood transfusion after a redo coronary artery bypass procedure. The nurse subsequently discovers that there was a mix-up in the cross-match because of a labeling error. Which of the following is diagnostic in a patient with an immediate hemolytic reaction secondary to a blood transfusion?
Serum haptoglobin above 50 mg/dL
Indirect bilirubin greater than 5 mg/dL
Direct bilirubin greater than 5 mg/dL
Positive Coombs test
A 52-year-old woman undergoes an exploratory laparotomy for peritonitis and is found to have perforated diverticulitis. She undergoes a sigmoid resection with an end colostomy. She is administered a third-generation cephalosporin within 1 hour prior to the incision and the antibiotic is continued postoperatively. One week later, she develops an intra-abdominal abscess, which is percutaneously drained. Bacteroidesfragilis is isolated from the cultures. Which of the following statements regarding her perioperative antibiotic regimen is most accurate?
The preoperative dose of antibiotics should have been given closer to the time of incision.
The patient should have received several doses of antibiotics prior to laparotomy.
The patient should have received a first-generation cephalosporin.
The patient did not have adequate anaerobic coverage.
A patient is brought to the ER after a motor vehicle accident. He is unconscious and has a deep scalp laceration and one dilated pupil. His heart rate is 120 beats per minute, blood pressure is 80/40 mm Hg, and respiratory rate is 35 breaths per minute. Despite rapid administration of 2 L normal saline, the patients vital signs do not change significantly. Which of the following is the most appropriate next step in the workup of his hypotension?
Neurosurgical consultation for emergent ventriculostomy to manage his intracranial pressure
Neurosurgical consultation for emergent craniotomy for suspected subdural hematoma
Emergent burr hole drainage at the bedside for suspected epidural hematoma
Abdominal ultrasound (focused assessment with sonography in trauma, or FAST)
A 42-year-old man is undergoing chemotherapy after resection of a cecal adenocarcinoma with positive lymph nodes. You are asked to see him regarding a potential surgical complication. Which of the following potentially operable complications is a common occurrence among patients receiving systemic chemotherapy?
Acute cholecystitis
Perirectal abscess
Appendicitis
Incarcerated femoral hernia
A cirrhotic patient with abnormal coagulation studies due to hepatic synthetic dysfunction requires an urgent cholecystectomy. A transfusion of FFP is planned to minimize the risk of bleeding due to surgery. What is the optimal timing of this transfusion?
The day before surgery
The night before surgery
On call to surgery
Intraoperatively
Your patient is receiving mechanical ventilation after surgery. A blood gas sample is sent to determine if weaning is possible. The Pco2 is 40. Which of the following conclusions is most accurate?
There is probably a paradoxical aciduria.
Alveolar ventilation is adequate.
Arterial Po2 will indicate the adequacy of alveolar ventilation.
Arterial Po2 will indicate the degree of ventilation-perfusion mismatch.
A 32-year-old man with a history of Crohn disease develops an enterocutaneous fistula and is placed on total parenteral nutrition through a right subclavian central venous catheter. After 5 days, the patient develops a fever and leukocytosis; CT scan of the abdomen reveals no intra-abdominal abscess. The subclavian catheter insertion site is inspected and noted to be erythematous and painful. Blood cultures are positive. Which of the following organisms is the most likely cause of his fever?
Coagulase-positive staphylococci
Coagulase-negative staphylococci
Group A streptococcus
Enterococcus
A 25-year-old Police officer from Patna is involved in a gang shoot-out and sustains an abdominal gunshot wound from a .22 pistol. At laparotomy, it is discovered that the left transverse colon has incurred a through-and-through injury with minimal fecal soilage of the peritoneum. Which of the following is the most appropriate management of this patient?
A colostomy should be performed regardless of the patient's hemodynamic status to decrease the risk of an intraabdominal infection.
Primary repair should be performed, but only in the absence of hemodynamic instability.
Primary repair should be performed with placement of an intraabdominal drain next to the repair.
The patient should undergo a two-stage procedure with resection of the injured portion and reanastomosis 48 hours later when clinically stabilized.
A 51-year-old man presents with a 2-cm left thyroid nodule. Thyroid scan shows a cold lesion. FNA cytology demonstrates follicular cells. Which of the following statements regarding this patient's condition is true?
Thyroid nodules in men are rarely malignant.
Increased age is associated with improved prognosis in patients with follicular carcinomas.
In the setting of abnormal cytology, an initial course of TSH suppression by thyroid hormone is recommended.
Thyroid lobectomy is an acceptable treatment for this patient.
A 47-year-old asymptomatic woman is incidentally found to have a 5-mm polyp and no stones in her gallbladder on ultrasound examination. Which of the following is the best management option?
Aspiration of the gallbladder with cytologic examination of the bile
Observation with repeat ultrasound examinations to evaluate for increase in polyp size
Laparoscopic cholecystectomy
Open cholecystectomy with frozen section
False regarding embryology of eye
Hyaloid artery bringing temporary nourishment to the developing structures
Vitreous is largely secreted by mesoderm
Surface ectoderm forms corneal and conjunctival epithelium
Mesodermal condensations form the anterior layers of the iris
SAFE strategy for control of trachoma include all except
Surgery
Antibiotics
Face-washing
Enucleation
Formation of the aqueous humour is mainly by mechanism of
Ultrafiltration
Diffusion
Secretion
Osmosis
False regarding cortical blindness
Unilateral infarction leads to contralateral homonymous congruous hemianopia
Central macular region become involved very early
Bilateral occipital infarcts result in cortical blindness characterized by its denial is known as anton syndrome .
Falcotentorial meningioma can lead to cortical blindness
A single rod is able to detect a single photon of light with a peak sensitivity of light in the colour of
Red
Blue
Green
Yellow
False regarding optical lens
Convex lenses are indicated by a plus sign (+),
If you hold a concave lens up near the eye and look at distant objects through it; Then move the lens a little from side-to-side: the distant object will seem to move in the opposite direction to that in which the lens is moved
Convex lens forms an inverted image
The strength of a lens can be determined by exactly neutralizing the movement of images with a lens of the opposite sign
When the refraction is estimated under cycloplegia a correction must be made to compensate for the normal tone of the ciliary muscle .On average how much of power is deducted when using atropine
1D
2D
3D
0.5 D
False regarding glaucoma drugs
Cholinergic agents help to improve the trabecular out­flow of aqueous
In eyes having a narrow angle recess or angle-closure glaucoma, constriction of the pupil pulls the peripheral iris away from the angle structures, opening a functionally closed angle.
Dipivefrine is converted to epinephrine once inside the eye
Alpha-agonists help to improve the trabecular out­flow of aqueous
False regarding ophthalmic involvement in leprosy
The eyes are usually involved late in the lepromatous type of disease
Visual loss arises because of corneal and lens opacities associated with small, non-reacting pupils and atrophy of the iris
Uveitis is more common in tuberculoid leprosy than in lepromatous form
Lepromatous leprosy is associated with small, non-reacting pupils and atrophy of the iris
False regarding diabetic cataract
Senile cataract tends to develop at an earlier age and more rapidly than usual in diabetic subjects
True diabetic cataract initially manifest as early onset presbyopia
Snowflake' cataract occurs
Cataracts are more prevalen, and dependent on the duration of diabetes
The organism most commonly associated with postpartum mastitis is
Group b streptococcus
Streptococcus pneumoniae.
Coagulase-positive staphylococcus aureus.
Coagulase-negative staphylococcal species.
Which of !he following statements about primary dysmenorrhea is true?
The condition usually worsens with the use of oral contraceptives.
It is thought lo be associated with excessive prostaglandin activity.
The onset of symptoms typically begins after 30 years of age.
Endometriosis is a common cause,
A 30-year-old woman is admitted at 30 weeks' gestation with severe constant abdominal pain. She looks pale with BP 110/70, pulse 100/min. Fetal heart beat is absent. Hb 11 g/dl, platelet count 25 000/ml:
Epidural anaesthesia is contraindicated.
The most likely diagnosis is disseminated sepsis.
Depletion of FDP is likely.
Fibrin degradation product levels are likely to be low.
Admission to a psychiatric hospital for psychotic depression associated with pregnancy is most frequent
In the 1st trimester.
In the 2nd trimester.
In the 3rd trimester.
In the puerperium.
Dysfunctional uterine bleeding is most common
During pregnancy
After sexual intercourse
At the time of menopause
With the development of pid
The following drugs are teratogenic:
Warfarin.
Phenytoin.
Thalidomide.
Azathioprine.
A 33-year-old woman who delivered last week presents to your office with questions about her gestational diabetes that developed during the first trimester. You explain
Her risk of developing type 2 diabetes in the future is no different than anyone else
She should be checked yearly for diabetes
No further monitoring is necessary unless she develops symptoms of diabetes
She should be tested for diabetes 6 months after delivery via fasting blood glucose measurements on two occasions or a 2-hour oral 75-g glucose tolerance test
Clear cell adenocarcinoma of the vagina:
Typically presents in post-menopausal women.
Is associated with in utero exposure to diethylstilboestrol.
Should be treated by chemotherapy.
Is associated with true gonadal dysgenesis.
Low apgar scores at 1 min and 5 min in a term infant indicate
Future neurological impairment.
The infant needs resuscitation.
The infant will develop seizures.
Perinatal asphyxia.
False about Chlamydia trachomatis:
Is sensitive to erythromycin.
Is sensitive to clindamycin.
Is typically resistant to azythromycin.
Is associated with silent relatively asymptomatic PID.
Which of the following is most commonly associated with nongonococcal urethritis?
Gonorrhea
Ureaplasma
Chlamydia
Trichomonas
The fetus or new-born infant with intra-uterine growth retardation shows the LEAST retardation in which one of the following organs?
Brain
Heart
Liver
Kidney
The following are recognized complications of magnesium sulphate therapy except:
Bradypnoea
Flushing of the skin.
Hyperreflexia.
Nausea and vomiting.
Which of the following statements about exercise-induced amenorrhea is true?
The condition is rareiy reversible with weight gain.
It usually affects women who weigh > 115 lb or those who have gained >10% to 15% in muscle mass.
Osteoporosis can be associated.
It is usually associated with prolactinomas.
Abnormalities in the vessels of the umbilical cord are often associated with fetal malformation. Which of the following VESSEL PATTERNS would make you suspect an underlying cardiac abnormality may exist in the fetus?
One artery and two veins.
One artery and one vein.
Two arteries and a venous plexus.
Two arteries and two veins.
There is an increased risk of postpartum haemorrhage in association with all except:
Multiparity
Instrumental delivery.
Active management of the third stage.
Haemophilia A carriers.
Painless and profuse vaginal bleeding in the third trimester is most likely
Placenta acreda
Placenta previa
Vaso previa
Bloody show
Which one of the following drugs is NOT considered to have adverse effects on the human fetus?
Diethylstilboestrol
Phenytoin.
Nalidixic acid.
Tetracycline.
With respect to breech presentation:
ECV carried out at 36 weeks' gestation significantly reduces the incidence of breech presentation at term.
ECV need not be always preceded by an ultrasound scan.
ECV is contraindicated when there has been antepartum haemorrhage of any cause.
ECV should only be undertaken in conjunction with the use of toe oly tics.
The normal amount of blood loss for a vaginal delivery is
250 mL
500 mL
1000 mL
1500 mL
Which one of the following statements about the circulatory transition from fetal to extrauterine life is CORRECT?
Gaseous expansion of the lungs at birth is associated with a dramatic decline in pulmonary vascular resistance and a decrease in pulmonary blood flow.
The foramen ovale is a flap valve and when left atrial pressure increases over the right side, the opening is functionally closed.
With the occlusion of the umbilical cord, the large flow of blood to the placenta is interrupted causing a decrease in systemic pressure.
Prostaglandin metabolism has been shown to play a minor role in the closure of the ductus arteriosus.
In a 30-year-old woman with severe endometriosis and infertility:
IVF has a higher success rate compared to a woman with tubal disease.
Intrauterine insemination is effective therapy.
Ovulation induction is not effective therapy.
Ovarian stimulation with intrauterine insemination has been shown to be more effective than no treatment.
Which of the following statements about epidural anesthesia is true?
It provides anesthesia only for lumbar and sacral nerve roots.
It can be used in hemophiliacs.
It can be associated with hypotension.
Placement of the catheter should be at the L2-L3 level.
The following maternal infections may be transmitted to the neonate as a result of vaginal delivery:
HPV virus.
Listeria monocytogenes.
Falciparum malaria.
Both A and B
The following have been shown to be effective in the relief of vasomotor menopausal symptoms:
Transdermal clonidine.
Vitamin E supplementation.
Raloxifene
All of above
Premature ovarian failure:
Is usually associated with an identifiable autoimmune factor.
Is associated with chromosomal anomalies in <10% of women affected below the age of 30 years.
Is clinically indistinguishable from the resistant ovary syndrome.
Has an autoimmune aetiology in over 30% of cases.
Administration of epidural analgesia in early labour is associated with:
An increased risk of caesarean section.
Prolongation of the first stage of labour compared to use of intramuscular opioids.
Prolongation of the second stage of labour compared to use of intramuscular opioids.
Lower intrapartum pain scores compared to use of intramuscular opioids.
In a pregnant woman over the age of 35 years, False among following :
An increased risk of multiple pregnancy.
An increased risk of hyperthyroidism.
An increased risk of gestational diabetes.
An increased risk of hypertension in pregnancy.
Which of the following is the most important risk factor in the transmission of HIV from an infected mother to her newborn?.
Preterm delivery (<34 weeks' gestation)
Low birth weight
Low maternal CD4 count
Prolonged rupture of membranes (>4 hours)
Which laboratory test would best support lung maturity in a fetus whose mother has shown signs of premature labor?
Lecithin-sphingomyelin (L/S) ratio of 1.75
L/S ratio of 1.5
Absence of phosphatidylinositol
L/S ratio of 1.8 with a positive PG level
Patients with the following conditions are at significant risk for endocarditis ,except
Aortic stenosis
Bicuspid aortic valve
Persistent ductus arteriosus
Mitral valve prolapse
All of the following muscles are innervated by the medial division of the sciatic nerve EXCEPT the
semimembranosus
long head of the biceps femoris
semitendinosus
short head of the biceps femoris
Which of the following is NOT likely to be a complication of cyclosporine therapy in the cardiac transplant recipient?
Gingival hyperplasia
Myelosuppression
Hypertension
Tremor
55. An 18-year-old man presents with fever, stridor and trismus. His breathing becomes laboured with use of accessory muscles. He becomes cyanosed with a respiratory rate of 35, despite oxygen by face mask. He had initially presented to his gp a few days ago with a sore throat. He takes salbutamol inhaler for his asthma. The most appropriate management in casualty would be:
Endotracheal intubation
Needle cricothyroidotomy
Tracheostomy
Iv hydrocortisone
Which of the following statements regarding hyperparathyroidism is false?
Decreased vitamin D production by the failing kidney contributes to increased parathyroid hormone (PTH) levels
Decreased absorption of calcium from the gastrointestinal tract contributes to increased PTH levels
Restriction of dietary calcium will decrease PTH levels
Restriction of dietary phosphorus will diminish the rise in PTH levels
57. Weakness of elbow flexion in its fully supine and half-pronated positions, associated with deep aching pain spreading down the lateral forearm to the thumb and index finger, affecting both the palmar and dorsal aspects of the hand
First thoracic root lesion (Tl)
Fifth cervical root lesion (C5)
Sixth cervical root lesion (C6)
Seventh cervical root lesion (C7)
Which disorder occurs predominantly in children?
Wegener's granulomatosis
Takayasu's arteritis
Behcet's disease
Henoch-Schonlein purpura
A 65yo man presents with painless hematuria, IVU is normal, prostate is mildly enlarged with mild frequency. What is the most appropriate next step?
US Abdomen
Flexible cystoscopy
MRI
Nuclear imaging
A 74yo smoker presented to his GP with cough and SOB.. Tests show that he is diabetic and hypokalemic. What is the most probable dx?
Pseudocushing syndrome
Conns disease
Ectopic ACTH
Cushings disease
A 44yo woman has lost weight over 12 months. She has also noticed episodes where her heart beats rapidly and strongly. She has a Irregular pulse rate of 90bpm. Her ECG is shown in Figure . What is the most appropriate investigation to be done?
Thyroid antibodies
TFT
ECG
Echocardiogram
79yo anorexic male complains of thirst and fatigue. He has symptoms of frequency, urgency and terminal dribbling. His urea and creatinine levels are high. he is anemic.His ECG Shown is typical of dyselectrolytemia .His BP is 165/95 mmHg. What is the most probable dx?
BPH
Prostate carcinoma
Chronic pyelonephritis
Benign nephrosclerosis
A 64yo man is on aspirin, atorvastatin and ramipril. He has been having trouble sleeping and has been losing weight for the past 4 months. He doesn’t feel like doing anything he used to enjoy and has stopped socializing. He says he gets tired easily and can’t concentrate on anything. His ECG is shown in Figure .What is the most appropriate tx?
Lofepramine
Dosulepin
Citalopram
Fluoxetine
A 67yo man after a stroke, presents with left sided ptosis and constricted pupil. He also has loss of pain and temp on the right side of his body and left side of his face. Which part of the brain is most likely affected?
Frontal cortex
Parietal cortex
Pons
Medulla
A 60yo man presents with dysphagia and pain on swallowing both solids and liquids. A barium Meal is shown in Fig . What is the SINGLE most likely cause of dysphagia?
Achalasia
Systemic sclerosis
Esophageal carcinoma
Esophageal web
A man undergoes a pneumonectomy. After surgery, invs show hyponatremia. What could be the cause of the biochemical change?
Removal of hormonally active tumor
Excess dextrose
Excess colloid
Excessive K+
A pregnant lady came with pain in her calf muscle with local rise in temp to the antenatal clinic. What tx should be started?
Aspirin
LMWH
Paracetamol
Aspirin and heparin
A 53yo female presents with an acute painful hot knee joint. She is a known case of RA. On examination, the knee is red, tender and swollen. The hamstring muscles are in spasm. Her temp is 38.5C and BP is 120/80mmHg. What is the SINGLE best next inv?
Joint aspiration for cytology and culture and sensitivity
Joint aspiration for positive birefrengent crystals
Joint aspiration for negative birefrengent crystals
Blood culture
An 80yo man presented with pain in his lower back and hip. He also complains of waking up in the night to go to the washroom and has urgency as well as dribbling. What is the most likely dx?
BPH
Prostatitis
UTI
Prostate carcinoma
An 18yo female has periorbital blisters. Some of them are crusted, others secreting pinkish fluid. What is the most likely dx?
Shingles
Chicken pox
Varicella
Rubella
A 32 yo lady who is a bank manager from New Delhi is referred by the GP to the medical OPC due to a long hx of tiredness and pain in the joints. An autoimmune screen result showed smooth muscle antibodies positive. What is the most appropriate next inv?
ECG
TFT
LFT
Jejunal biopsy
A 5yo with recurrent chest pain, finger clubbing with offensive stool. Choose the single most likely inv?
Endomysial/Alpha gliadin antibody
Sweat test
Barium meal
Glucose tolerance test
A patient is brought to the ED with a 1 day hx of being listless. On examination, the he is drowsy with an extensive non-blanching rash. What advice would you give the parents?
All family members need antibiotic therapy
Only the mother should be given rifampicin prophylaxis
All family members need isolation
All family members should be given rifampicin prophylaxis
A 47yo man has a temp of 39C and is delirious. He has developed blisters mainly on his trunk, which appeared a few hours ago. He is well and not on any medications. He last travelled 5 months ago to Puri to attend Radha Yatra . Which of the following is the most likely dx?
Shingles
Chicken pox
Pemphigoid
Bullous pemphigus
A 64yo pt has been having freq episodes of secretory diarrhea, which is extremely watery, with large amts of mucus.. His Endoscopy and Biopsy What electrolyte abnormality is most likely in this pt?
Hyperkalemia
Hypernatremia
Hyponatremia
Hypokalemia
A pt with an acute gout attack came to the ED. What drug should be given to relieve symptoms?
NSAIDs
Allopurino
Ibuprofen
Rasburicase
A pt was lying down on the operating table in a position with his arms hanging down for 3 hours. Soon after he woke up, he complains of numbness and weakness in that hand and and sensory loss over dorsum of that hand, weakness of extension of the fingers and loss of sensation at the web of the thumb. What structure is likely to be damaged?
Radial nerve
Median nerve
Ulnar nerve
Axillary nerve
A pt who was previously on 120mg slow release oral morphine has had his dose increased to 200mg. He is still in significant pain. He complains of drowsiness and constipation. What is the next step in the management?
Increase slow release morphine dose
Fentanyl patch
Replace morphine with oral hydromorphone
Replace morphine with oxycodone
A 40yo woman notices increasing lower abdominal distention with little/no pain. On examination, a lobulated cystic mass is felt and it seems to be arising from the pelvis. What is the most appropriate inv?
CA 125
CA 153
CA 199
AFP
A resident of a nursing home presented with rashes in his finger webs and also on his abdomen, with complaints of itching which is severe at night.. What the best tx for his condition?
0.5% permethrin
Doxycycline
5% permethrin
Reassure
0
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