AIIMS Nov 2012 Answers, Explanations : From OHC Course and Book : POSITIVE EVIDENCE BASED

AIIMS Nov 2012 Answers, Explanations : From OHC Course and Book : POSITIVE EVIDENCE BASED

1. A GIRL WITH PRECOCIOUS PUBERTY WITH Laughter for unknown reasons-MRI [AIIMS NOV 2012]

A. HYPOTHALAMIC HAMARTOMA

B. PINEAL GERMINOMA

C. CRANIOPHARYNGIOMA

D.HISTIOCYTOMA

Ans A

REF-HARRISON

• Hypothalamic hamartomas and gangliocytomas may arise from astrocytes, oligodendrocytes, and neurons with varying degrees of differentiation.
• These tumors may overexpress hypothalamic neuropeptides, including GnRH, GHRH, and CRH. With GnRH-producing tumors, children present with precocious puberty, psychomotor delay, and laughing-associated seizures
• Rarely, hamartomas also are associated with craniofacial abnormalities; imperforate anus; cardiac, renal, and lung disorders; and pituitary failure as features of Pallister-Hall syndrome, which is caused by mutations in the carboxy terminus of the GLI3 gene.
• Hypothalamic hamartomas are often contiguous with the pituitary, and preoperative MRI diagnosis may not be possible
• Pituitary gland height ranges from 6 mm in children to 8 mm in adults; during pregnancy and puberty, the height may reach 10–12 mm.
• Anterior pituitary gland soft tissue consistency is slightly heterogeneous on MRI, and signal intensity resembles that of brain matter on T1-weighted imaging
• Adenoma density is usually lower than that of surrounding normal tissue on T1-weighted imaging, and the signal intensity increases with T2-weighted images.
• The high phospholipid content of the posterior pituitary results in a “pituitary bright spot.”

2. A PT ON AMPHOTERICIN WITH HYPOKALEMIA-2.3-TREATMENT [AIIMS NOV 2012]

a. 40 MEQ/24HRS

b. 60 MEQ/24HRS

c. 80 MEQ/24HRS

d. 120 MEQ/24HRS

Ans ?D(question is ambiguous)

REF OPERATION HARRI BOOK-PAGE 193,OHC

• If hypokalemia is severe (<2.5 mmol/L) and/or critically symptomatic, intravenous K⁺-Cl^– can be administered through a central vein with cardiac monitoring in an intensive care setting at rates of 10–20 mmol/h; higher rates should be reserved for acutely life-threatening complications.
• The absolute amount of administered K⁺ should be restricted (e.g., 20 mmol in 100 mL of saline solution)

3. BLINK REFLEX IS USEFULL FOR DIAGNOSIS OF  LESION AT[AIIMS NOV 2012]

A. NMJ

B. MIDPONTINE LESION

C. AXONAL NEUROPATHY

D. MND

ANS-B

REF-OHC2-NEURO

BLINK REFLEX

• Electrical or mechanical stimulation of the supraorbital nerve on one side leads to two separate reflex responses of the orbicularis oculi—an ipsilateral R1 response having a latency of approximately 10 ms and a bilateral R2 response with a latency in the order of 30 ms.
• The trigeminal and facial nerves constitute the afferent and efferent arcs of the reflex, respectively.

Abnormalities of either nerve or intrinsic lesions of the medulla or pons may lead to uni- or bilateral loss of the response, and the findings may therefore be helpful in identifying or localizing such pathology.

4. MARKER OF GLIOMA [AIIMS NOV 2012]

A) CD133

B) CD 24

C) CD 44

D) CD 33

Ans A

REF-OHC

5. WHICH IS NOT SEEN  IN FTD [AIIMS NOV 2012]

A. LESS THAN 65 YEARS

B. AFFECTIVE SYMPTOMS

C. STEREOTYPE BEHAVIOUR

D. INSIGHT

Ans-d

REF-OHC2- NEUROLOGY

*Frontotemporal dementia  – in the fifth to seventh decades

*Cognitive testing typically reveals spared memory but impaired planning, judgment, or language. Poor business decisions and difficulty organizing work tasks are common, and speech and language deficits often emerge.

*Patients with often show an absence of insight into their condition

  Exciting 18^th–

• A major clinical form of FTLD known as the behavioral variant of frontotemporal dementia (bvFTD) causes a progressive frontal lobe syndrome that can start as early as the fifth decade of life.
• In these patients, the anterior temporal lobe and caudate nucleus are also atrophic.
•  The behavioral changes can include shoplifting, compulsive gambling, sexual indiscretions, and obsessive-compulsive preoccupations.

6. COL4A5 SEEN [AIIMS NOV 2012]

A. ALPORT

B. THIN BASEMENT DISEASE

C.GOOD PASTURE SYNDROME

D. NAIL PATELLA

ANS A

Ref-OHC-2-NEPHRO,CONSULTANT,RECENT ADVANCES BOOK-OHC2

I	This is the most abundant collagen of the human body. It is present in scar tissue, the end product when tissue heals by repair. It is found in tendons, skin, artery walls, the endomysium of myofibrils, fibrocartilage, and the organic part of bones and teeth.	COL1A1, COL1A2	osteogenesis imperfecta, Ehlers–Danlos syndrome, Infantile cortical hyperostosis aka Caffey’s disease
II	Hyaline cartilage, makes up 50% of all cartilage protein. Vitreous humour of the eye.	COL2A1	Collagenopathy, types II and XI
III	This is the collagen of granulation tissue, and is produced quickly by young fibroblasts before the tougher type I collagen is synthesized. Reticular fiber. Also found in artery walls, skin, intestines and the uterus	COL3A1	Ehlers–Danlos syndrome, Dupuytren’s contracture
IV	basal lamina; eye lens. Also serves as part of the filtration system in capillaries and the glomeruli of nephron in the kidney.	COL4A1, COL4A2, COL4A3, COL4A4, COL4A5, COL4A6	Alport syndrome, Goodpasture’s syndrome
V	most interstitial tissue, assoc. with type I, associated with placenta	COL5A1, COL5A2, COL5A3	Ehlers–Danlos syndrome (Classical)
VI	most interstitial tissue, assoc. with type I	COL6A1, COL6A2, COL6A3	Ulrich myopathy and Bethlem myopathy
VII	forms anchoring fibrils in dermal epidermal junctions	COL7A1	epidermolysis bullosa dystrophica
VIII	some endothelial cells	COL8A1, COL8A2	Posterior polymorphous corneal dystrophy 2

 

Hereditary nephritis with sensori Neural hearing loss

Predominantly

–  X. linked dominant

Ocular

–  15 – 30%

–  Lenticonus

– ‘Oil drop’ cataract

Ear

–  Sensori Neural Deafness

(Never from birth)

• COL 4 A5 Chain abnormality in the GBM(COL 4 A3-Good pasture)

 

7. TYPE 1 RTA ALL EXCEPT [AIIMS NOV 2012]

A. HYPOKALEMIA

B. RENAL STONES

C. Inability to acidify URINE PH LESS THAN 5.5

D. HCO3 MORE THAN 4

Ans D

REF-OPERATION HARRI-page 202,OHC,POSIGOLD-AI-2012

DISTAL	PROXIMAL
*    Normal anion gap*    Inappropriately high urine pH (pH > 5.5). *FeHCO3   -5% *  Hypokalemia *Nephrocalcinosis , Stones. *PositiveUAG, low urine [NH4+]	*  Normal anion Gap*  Urine pH < 5.5 *  FeHCO3   >  15 – 20 % *  Hypokalemia *  No nephrocalcinosis , Stones. * PositiveUAG, low urine [NH4+]

Classic distal RTA (type 1 RTA)

*    Hypokalemia, hyperchloremic acidosis, low urinary NH₄⁺ excretion (positive UAG, low urine [NH₄⁺]), and inappropriately high urine pH (pH > 5.5).

*    Such patients are unable to acidify the urine below a pH of 5.5.

* Most patients have hypocitraturia and hypercalciuria, so nephrolithiasis, nephrocalcinosis, and bone disease are common.

8. A PATIENT WITH MULTIPLE RENAL STONES ANALYSIS REVEALED CYSTINE CRYSTALS-TREATMENT – ALL EXCEPT [AIIMS NOV 2012]

a. CYSTEAMINE

b. D PENCILLAMINE

c. ALKALINISATION OF URINE

d. ADEQUATE HYDRATION

Ans A

REF-EXCITING 18^TH-OHC 2 DISCUSSION

CYSTINURIA

• In type I cystinuria, -autosomal recessive pattern of inheritance.
• A gene on chromosome 2 -designated SLC3A1 encodes the heavy chain of the transporter -abnormal in type I.
• Non-type I -dominant trait -mutations in the SLC7A9 gene on chromosome 19, which encodes the light chain of the heteromeric transporter.
• typical hexagonal, platelike cystine crystals.
• Cystinuria can also be detected by using the urine sodium nitroprusside test.
• the test is sensitive, it is positive for cystinuria in many asymptomatic heterozygotes.
• Treatment-high fluid intake,alkalinising urine,dpencillamine,tiopronin,captopril
• Diagnosis -hexagonal cystine crystals on urinalysis, and 24-h urinary cystine excretion that exceeds 400 mg (normal less than 30 mg/d).
• penicillamine, tiopronin, and captopril

EXCITING 18^TH EDITION

CYSTINOSIS

• multisystem autosomal recessive disease
•  caused by mutations of cystinosin, a hydrogen ion–driven transporter responsible for exporting cystine from lysosomes.
• infantile (nephropathic), adolescent, and adult forms.
• The nephropathic form -most common,

 

• Fanconi syndrome, salt and water wasting, growth retardation, rickets,
• . End-stage renal disease occurs by age 10
•  photophobia and blindness, hypothyroidism, delayed pubertal development, and late-onset neurologic disease.
• diagnosis -cystine content of peripheral blood leukocytes.
• Cysteamine provides a direct treatment
• cystinosis does not recur in transplanted kidneys

9. RENAL CALCULI-WHAT IS NOT REQUIRED [AIIMS NOV 2012]

a. PROTEIN RESTRICTION

b. CALCIUM RESTRICTION

c. SALT RESTRICTION

d. PLENTY OF WATER

Ans B

REF-OHC ,POSIGOLD

10. COGNITIVE DECLINE IN AGING-IS DUE TO INCREASE LEVEL OF WHICH AMINOACID [AIIMS NOV 2012]

A. TAURINE

B. CYSTINE

C. HOMOCYSTINE

D. METHIONINE

Ans-c

Ref-POSIGOLD,OHC

11. POLYMYOSITIS-ALL EXCEPT [AIIMS NOV 2012]

A. OPTHALMOPLEGIA

B. PROXIMAL MUSCLE WEAKNESS

C. PNS

D.

Ans A

REF-POSIGOLD-AI-2006,OHC2-DISCUSSION

12.  WILSON DISEASE [AIIMS NOV 2012]

A. LOW URINARY COPPER

B. HIGH SRUM CERULOPLASMIN

C. INCREASED SERUM AND URINARY COPPER

D. DECREASED SERUM COPPER

Ans C

REF-OHC2 DISCUSSION,CONSULTANT

MODIFIED POSIGOLD

• 154. Which of the following statements about Wilson’s disease is true: (AI 2010)
• A. Low serum ceruloplasmin and low urinary copper
• B. Low serum ceruloplasmin and high urinary copper
• C. High serum ceruloplasmin and low urinary copper
• D. High serum ceruloplasmin and high urinary copper
• ANS-B

Diagnosis (neuro./ psych. WD) (strongly suggested ) based on at least two of the following;

• Low serum Cerulplasmin
• High 24 HR urine copper
• K.F Ring

13. BONE MARROW APIRATE WAS DRY,BM BIOPSY WAS POSSIBLE-ACUTE LEUKEMIA WITH MYELOFIBROSIS [AIIMS NOV 2012]

A. UNDIFFERNTIATED AML

B. ERYTHOBLASTIC AML

C. MEGAKARYOCYTIC AML

D. BURKITS LEUKEMIA

ANS-C

REF-OPERATION HARRI PAGE-487 TABLE,OHC

Disorders Causing Myelofibrosis
Malignant	Nonmalignant
Acute leukemia(lymphocytic, myelogenous, megakaryocytic) Chronic myelogenous leukemia Hairy cell leukemia Hodgkin disease Idiopathic myelofibrosis Lymphoma Multiple myeloma Myelodysplasia Polycythemia vera Systemic mastocytosis	HIV infection Hyperparathyroidism Renal osteodystrophy Systemic lupus erythematosus

Tuberculosis

Vitamin D deficiency

Thorium dioxide exposure

Gray platelet syndrome

14. 2^ND DECADE RENAL FAILURE,IST DEGREE RELATIVE ALSO HAD SAME SYMPTOMS AND DIED AT THE AGE OF 28-KERATOCONUS [AIIMS NOV 2012]

A. ALPORTS

B. ADPKD

C. ARPKD

D. OXALURIA

ANS A

REF-POSITIVE MKT-BOOK(ENT-POSITIVE PEARL),OHC2-DISCUSSION,POSIGOLD

• Alport’s Syndrome
• Symptoms and signs
• Presenile familial nerve deafness (Bilateral)
• Congenital haemorrhagic nephritis
• Keratoconus and cataracts
• Aetiology
• Hereditary familial disorder, more frequently occurring in males

ALPORTS SYNDROME

• Hereditary nephritis (Alport’s syndrome)—clinical profile and inheritance in 28 … retinal flecks in 22.2%, cataract in 20%, and keratoconus in 6.7% patients.

POSITIVE MKT-ENTAlport’s Syndrome

Symptoms and signs Presenile familial nerve deafness (Bilateral) Congenital haemorrhagic nephritis Keratoconus and cataracts Aetiology Hereditary familial disorder, more frequently occurring in males

15. FLOW CYTOMETRY DONE FOR [AIIMS NOV 2012]

A. LYMPHOCYTE

B. MONOCYTE

C. NEUTROPHIL

D. POLYCYTHEMIA

Ans A

REF-OHC 2 DISCUSSION

18^TH EDITION HARRISOSN

RENAL TRANSPLANT

• few absolute “immunologic” contraindications -harmful antibody against the donor kidney at the time of the anticipated transplant
• direct cross-matching of candidate serum with lymphocytes of the donor.
• deceased-donor kidneys – maintain for up to 48 h on cold pulsatile perfusion
• More sensitive tests, such as the use of flow cytometry

16. LASER UVULOPALATOPHARYNGEAL PLASTY [AIIMS NOV 2012]

A. SNORING

B. CLEFT PALATE

C. STAMMERING

D.

ANS A

REF-OHC,CONSULTANT

17. CD 95 IS ASSOCIATED WITH [AIIMS NOV 2012]

A. INTRINSIC PATHWAY OF APOPTOSIS

B. EXTRINSIC PATHWAY OF APOPTOSIS

C. CELL NECROSIS

ANS B

REF-POSITIVE GENETICS-OHC 2,CONSULTANT,OPERATION HARRI BOOK-PAGE 358

The mitochondrion[AI 2009***]- a central regulatory structure of the apoptotic process.

*    The extrinsic pathway of apoptosis is activated by cross-linking members of the tumor necrosis factor (TNF) receptor superfamily, such as CD95 (Fas) and death receptors DR4 and DR5, by their receptors, Fas ligand or TRAIL (TNF-related apoptosis-inducing ligand), respectively.

*    The extrinsic pathway -Caspase-8[AI 2010***] is activated and then cleaves and activates effector caspases-3 and -7, which then target cellular constituents.

*    The intrinsic pathway of apoptosis is initiated by the release of cytochrome c and SMAC[AIIMS Nov 2006***] (second mitochondrial activator of caspases) from the mitochondrial intermembrane space – leading to the sequential activation of caspase-9 and effector caspases

 

• A German scientist Carl Vogt was first to describe the principle of apoptosis

The apoptosis starts from the Fas ligand binding to Fas receptors and ends in the fragmentation of genomic DNA, which is used as a hallmark of apoptosis

18. PENCILLIN G-TRUE STATEMENT

A. ORALLY ACTIVE

B. USEFULL FOR RATBITE FEVER

C. BROAD SPECTRUM

D. OTOTOXICITY

ANS B

REF-POSITIVE CONSULTANT,OHC,OPERATION HARRI BOOK

RAT BITE FEVER

Responds to penicillin antibiotics or where allergic to this erythromycin or tetracyclines for respectively streptobacillary or spirillary infections

OPERATION HARRI BOOK PAGE 614

 

Drug	Spectrum
Penicillin G	*Syphilis, yaws, leptospirosis, groups A and B streptococcal infections, pneumococcal infections, actinomycosis, oral and periodontal infections, meningococcal meningitis and meningococcemia, viridans streptococcal endocarditis, clostridial myonecrosis, tetanus, anthrax, rat-bite fever, Pasteurella multocida infections, and erysipeloid (Erysipelothrix rhusiopathiae) –ALL INDIA-06***

 

19. PINNA CALCIFICATION ALL EXCEPT [AIIMS NOV 2012]

A. GOUT

B. OOCHRONOSIS

C. FROST BITE

D. ADDISONS DISEASE

ANS A

OLD POSIGOLD

• Trauma Causes Ear trauma Cauliflower ear Electromagnetic, Physics, trauma, Radiation Causes Frostbite Surgical, Procedure Complication Ear surgery Infected organ, Abscesses Cellulitis/pinna
• Allergic, Collagen, Auto-Immune Disorders Polychondritis Polychondritis, relapsing Metabolic, Storage Disorders Diabetes mellitus Hemochromatosis Alkaptonuria/Ochronosis Vegetative, Autonomic, Endocrine Disorders Addison’s disease (chronic adrenal ins) Acromegaly (Gigantism) Adrenocorticoid (Isolated) Deficiency

20. 60 YR OLD MALE TYPICAL LYMPHOCYTE 70 ATYPICAL 30-TOTAL COUNT 20000 [AIIMS NOV 2012]

A. LYMPH NODE BIOPSY

B. BM BIOPSY

C. PERIPHERAL CYTOGENETICS

D. PERIPHERAL IMMUNOCHEMISTRY

ANS

21. CILIARY MUSCLE IS DERIVED FROM [AIIMS NOV 2012]

A. NEUROECTODERM

B. SURFACE ECTODERM

C. MESODERM

D. NEURAL CREST

ANS-C

REF-POSITIVE MKT-OPHTHAL,OHC

Surface ectoderm	Mesoderm	Neural ectoderm
Conjunctiva Corneal epithelium Eyelash Epithelium of – meibomian  glands – glands of Moll – glands of Zeis – lacrimal gland – acc.lacrimal glands Crystalline lens Corneal stroma Corneal endothelium and Descemet’s mem. Sclera Choroid Iris stroma Extraocular muscles Ciliary muscles Bony orbit Vitreous Sensory retina Retinal pigment epithelium Ciliary body epithelium Pigmented epithelium of the iris Sphincter pupillae Dilator pupillae Neural part of the optic nerve Melanocytes Eyelids    :  Both from surface ectoderm and mesoderm Zonules (tertiary vitreous) :  Surface ectoderm and mesoderm Bruch’s membrane :  Neural ectoderm and mesoderm

22. RHO KINASE INHIBITOR[AIIMS NOV 2012]

A. RANALOZINE

B. FASUDIL

C. AMRINONE

D. NICORANDIL

ANS B

HARRISON

• Phosphorylation of the myosin-binding subunit (thr695) of myosin light chain phosphatase by Rho kinase inhibits phosphatase activity and induces calcium sensitization of the contractile apparatus.
• Rho kinase is itself activated by the small GTPase RhoA, which is stimulated by guanosine exchange factors and inhibited by GTPase-activating proteins.
• Nitric oxide, which induces vascular relaxation, promotes erection and is opposed by endothelin 1 (ET-1) and Rho kinase, which mediate vascular contraction
• Detumescence is mediated by norepinephrine from the sympathetic nerves, endothelin from the vascular surface, and smooth-muscle contraction induced by postsynaptic -adrenergic receptors and activation of Rho kinase.

23. PARASITE AFFECTING EYE [AIIMS NOV 2012]

A. E.HISTOLYTICA

B. E.COLI

C. TOXOPLASMA

D. TOXOCARA

ANS-C-REF-POSITIVE CONSULTANT,OHC

OPERATION HARRI BOOK

TOXOPLASMOSIS

Ocular Infection.

–     Due to congenital infection, with a very low incidence following acquired infection.

–     Loss of central vision,  nystagmus, strabismus, glaucoma.

–    Located near the posterior pole of the retina.

Ocular Toxoplasmosis

–     Antibody production is expressed in terms of the Goldmann-Witmer coefficient (C), in which C = [anti-Toxoplasma IgG (aqueous humor/serum)]/[total IgG (serum/aqueous humor)]. The positive cutoff of is 3.

24. TRACHOMA-COMMON AGE IN WHICH PREVALENCE IS MEASURED [AIIMS NOV 2012]

A. 2-9YRS

B.

C.

D.

ANS-A

REF-OPHTHAL CONSULTANT

25. which lesion there is no reversal of shunt?  [AIIMS NOV 2012]

A. PDA

B. TOF

C. VSD

D. ASD

ANS-B

REF-CONSULTANT,OHC

26. SEBACEOUS GLAND CA-STAIN USED [AIIMS NOV 2012]

A. PAS

B. MASON TRICHROME

C. OIL RED

D. MUCICARMINE

ANS-?D

REF-POSITIVE MKT

 

Microscopic clues of Tumor origin

Potentially Helpful Findings	Primary site or Tumor type
HISTOPATHOLOGY
Signet ring cells	Gastrointestinal tract, pancreas, ovary, breast (lobular carcinoma), prostate
Psammoma bodies	Ovary, thyroid, breast, meningioma
Papillary	Thyroid, ovary, breast, pancreas, mesothelioma
Indian file tumor cells	Breast (especially lobular), pancreas, mesothelioma, small cell carcinoma, carcinoid
Nonacinar cell nests	Carcinoid, melanoma, paraganglioma
Intranuclear inclusions	Breast (especially lobular) papillary thyroid, melanoma
Rosettes	* Neuroblastoma, retinoblastoma, granulosa cell tumor, neuroendocrine carcinoma* Sarcomas;Ewing’s, synovial cell, rhabdomyosarcoma
Neural crest tumors	Primitive neuroendocrine tumors (PNET), Ewing’s sarcoma, paraganglioma, neuroblastoma, ganglioneuroblastoma
Clear cell neoplasms
Very poorly differentiated small cell neoplasms
HISTOCHEMISTRY
Mucin stains (eg:mucicarmine)	Adenocarcinoma (absent in renal cell carcinoma)
Glycogen stains (PAS-Positive, removed by diastase)	*Abundant in renal cell carcinoma, germ cell tumors, and some adrenocortical carcinomas* Seminoma, melanoma, chordoma, mesothelioma * Sarcomas: Alveolar soft parts, Ewing’s clear cell, leiomyosarcoma, rhabdomyosarcoma
Silver impregnation (eg:Fontana-Masson,Grimelius, Sevier-Munger)	* Tumors of polypeptide-forming endocrine cells, enterochromaffin cells, melanoma

 

 

 

27. MEGALOBLASTIC ANEMIA-ALL EXCEPT [AIIMS NOV 2012]

A. MILD SPLENOMEGALY

B. NUCLEATED RBCS

C. INCREASED BILIRUBIN

D. RETICULOCYTOSIS

ANS D

REF-OHC 2,OPERATION HARRI BOOK –PAGE 472

MEGALOBLASTIC ANEMIA

MCV > 100 FL

* WBC, Platelets ¯

* PS – Anisopioiklocytosis, macrocytosis

* Low retic index(AIIMS NOV-2012***)

* Basophillic stippling (in RBC), normoblast

* Neutrophils – Hypersegmentation of nucleus (characteristic)

* Bone marrow

– Hyper cellular

– ¯ myeloid/erythroid ratio

– Abundant iron

– Nuclear chromatin – a peculiar fenestrated pattern very characteristic

– ¯ megakaryocytes

* ­ LDH, bilirubin

* Cobalamin level

– 160-200ng/ml

– < 100 – deficiency

* Folate level – 6-20 micro/ml < 4 microg – deficiency

• Ineffective Hemopoiesis
• * Unconjugated bilirubin , raised urine urobilinogen, reduced haptoglobins and positive urine hemosiderin, and a raised serum lactate dehydrogenase&a weakly positive direct antiglobulin test

28. RIGHT AXIS FACTOR-IN EEG [AIIMS NOV 2012]

A. OBESE

B. THIN AND TALL INDIVUDAL

C. END OF EXIRATION

D. LYING DOWN

29. RADIOSENSITIVE PHASE OF CELL CYCLE [AIIMS NOV 2012]

A. G2/M

B. GI/S

C. M

D.G1

ANS-A

REF- POSIGOLD,CONSULTANT,OHC

30. ENZYME PRESENT IN RIBOZYME  [AIIMS NOV 2012]

A. Peptidyl transferase

B. Peptidase

 

C. Aminoacyl tRNA synthetase

D. GTPase

 

REF-POSIGOLD,OHC

• 31. Ribosome has following enzymatic activity? [AIIMS NOV 2008]
• a) Peptidyl transferase                        b) Peptidase
• c) Aminoacyl tRNA synthetase          d) GTPase
• Ans (A)

31. EPIGLOTTIS DEVELOPS FROM [AIIMS NOV 2012]

A.2^ND ARCH

B.3RD

C.4TH

D.5TH

ANS-D

REF-CONSULTANT

32. GAIT APRAXIA IS DUE TO LESION IN WHICH ARTERY  [AIIMS NOV 2012]

A. ANT.CEREBRAL

B. ANT.CHOROIDAL

C. POSTERIOR CEREBRAL

D.

ANS A

REF-OHC 2,OPERATION HARRI BOOK-PAGE 86

Frontal Gait Disorder

*    Frontal gait disorder- known as “gait apraxia.”

*    Common in the elderly

The term lower body parkinsonism is also used to describe such patients.

*    Strength is generally preserved.

*    The most common cause of frontal gait disorder is vascular disease, particularly subcortical small-vessel disease.

*    Lesions are frequently found in the deep frontal white matter and centrum ovale.

HARRISON MEDICINE

ANTERIOR CEREBRAL ARTERY

Signs and symptoms:Structures involved

Paralysis of opposite foot and leg: Motor leg area

Urinary incontinence: Sensorimotor area in paracentral lobule

Abulia (akinetic mutism), slowness, delay, intermittent interruption, lack of spontaneity, whispering, reflex distraction to sights and sounds: Uncertain localization—probably cingulate gyrus and medial inferior portion of frontal, parietal, and temporal lobes

Impairment of gait and stance (gait apraxia): Frontal cortex near leg motor area

REF-OHC2

33. ENZYME PRESENT IN CSF [AIIMS NOV 2012]

A. LDH&CK

B. GGT&ALT

C. CKMB

D. PEROXIDASE

34. A COUPLE FOR COUNSELLING WITH UNBALANCED ROBERTSONIAN TRANSLOCATION OF 15/21-THE OPTION OF TREATMENT [AIIMS NOV 2012]

A. ADOPTION

B. IVF

C. NO THERAPY

D. ANTENATAL DIAGNOSIS AND ABORTION

ANS-?A

REF-OPERATION HARRI BOOK,OHC

REF-OPERATION HARRI PAGE 363

Robertsonian and reciprocal. Robertsonian rearrangements -, in which the long arms of two acrocentric chromosomes (chromosomes 13, 14, 15, 21, and 22) join together, generating a fusion chromosome that contains virtually all of the genetic material of the original two chromosomes.

If the Robertsonian translocation is present in unbalanced form, a monosomic or trisomic conception ensues.

* ~3% of Down syndrome cases are due to unbalanced Robertsonian translocations, most often involving chromosomes 14 and 21.

As a rule, monosomic conditions are incompatible with fetal development. In fact, the only monosomy compatible with live birth is the 45,X condition, which causes Turner syndrome.

35. BHIMA SURKA YOGNA [AIIMS NOV 2012]

A. CONTRIBUTION FROM FAMILY AND GOVT

B. FOR OP AND HOSPITALISIED PATIENT

C. 30,000 PER FAMILY

D.

ANS-C

REF-OHC-2-RECENT ADVANCES- SPM CONSULTANT

• Rashtriya Swasthya Bima Yojana
• Central Government

smart card-based cashless health insurance cover upto 30,000 rupees annually to the people living Below Poverty Line (BPL).

36. INTRATYMPANIC INJECTION OF GM [AIIMS NOV 2012]

A. DIRECT OUTTER HAIR CELL DAMAGE

B. DECREASE ATP EFFECT IN HAIR CELL

C.

D.

37. Marker of lymphoma  [AIIMS NOV 2012]

A. S 100

B. Hmb 45

C. Leucocyte common antigen(LCA)

D. Cytokeratin

ANS-C

REF-OHC,,MKT,OPERATION HARRI BOOK

 

	CK	Vim		S-100		LCA		Other
Adenocarcinoma	+	0	+	+	0	0	+	+: CD15,B72,3,BerEP4 + : Mucin
Mesothelioma	+	+	0	0	0	0	+	0:CD15,B72.3,BerEP4 + :Calretinin
Squamous cell carcinoma	+	0	+	0	0	0	0	See
Transitional cell carcinoma	+	0	+	0	0	0	+
Small cell carcinoma	+	0	+	0	+	0	+
Neuroendocrine tumors	+	+	+	+	+	0	+
Carcinoid, Islet cell	+	+	+	+	+	0	+	+ Hormones
Sarcoma	0	+	0	+	0	0	0	See
Melanoma	0	+	0	+	0	0	0	+ see II,, VIII
Lymphoma	0	+	0	0	0	+	0

38. PROPERTIES SHOWN BY BCELL AND T CELL ARE ALL EXCEPT  [AIIMS NOV 2012]

A. positive selection

B. specific receptor antigen

C. MHC I

D. require cytokines from other cells for activation

ANS-A

REF-POSIGOLD,MKT,OHC

• Character not shared by B cell & T cell is: [AI 2012]
• a) Positive selection during development
• b) Class 1 MHC expression
• c) Antigen specific receptors
• d) Depends on cytokine by other cells
• Ans-a
• POSITIVE MKT-MICRO

Characteristic	B cells	T cells
Interaction with antigen	Involves binary complex of membrane Ig and Ag	Involves ternary complex of T-cell receptor, Age and MHC molecule
Binding of soluble antigen	Yes	No
Involvement of MHC molecules	None required	Required to display processed antigen
Chemical nature of antigens	Protein, Polysaccharide, lipid	Mostly proteins, but some lipids and glycolipids present on MHC-like molecules
Epitope properties	Accessible, hydrophilic, mobile peptides containing sequential or nonsequential amino acids	Internal linear peptides produced by processing of antigen and bound to MHC molecules

39. ALL ARE UNFAVOURABLE DRUG INTERACTION EXCEPT [AIIMS NOV 2012]

A. OMEPRAZOLE-DECREASE OF ACID SECRETION

B. B12 ABSORPTION AND BARBITURATES

C. METHOTREXATE AND FOLATE ABSORTION

D. RETINOIDS AND VITAMIN E ABSORPTION

ANS

40. SAPHENOFEMORAL INCOMPETENCE WITH PERFORATORS BEING COMPETENT-TREATMENT OF CHOICE ALL EXCEPT [AIIMS NOV 2012]

A. SCLEROTHERAPY

B. SF LIGATION

C. SF LIGATION AND STRIPPING

D. LASER RADIOFREQUNCY LIGATION

Ans A

REF HARRISON

• Varicose veins usually can be treated with conservative measures. Symptoms often decrease when the legs are elevated periodically, prolonged standing is avoided, and elastic support hose are worn. External compression stockings provide a counterbalance to the hydrostatic pressure in the veins
• Ablative procedures, including sclerotherapy, endovenous radiofrequency or laser ablation, and surgery
• Small, symptomatic varicose veins can be treated with sclerotherapy, in which a sclerosing solution is injected into the involved varicose vein and a compression bandage is applied.
• Percutaneous, endovenous delivery of radiofrequency or laser energy can be used to treat incompetent great saphenous veins. Surgical therapy usually involves ligation and stripping of the great and small saphenous veins.

41. SMALL SCALE MUTATION IS SEEN BY ALL EXCEPT [AIIMS NOV 2012]

A. INSERTION

B. BASE SUBSTITUTION

C. DELETION

D. PARTIAL DUPLICATION

ANS? D

REF-HARRISON

• Kearns-Sayre syndrome (KSS), sporadic progressive external ophthalmoplegia (PEO), and Pearson syndrome are three disease phenotypes caused by large-scale mtDNA rearrangements, including partial deletions or partial duplication

42. 4 YEAR OLD CHILD HB 3.8GM MCV 55.1 TRANSFUSION HAS BEEN GIVEN ALREADY-DIAGNOSIS [AIIMS NOV 2012]

A. ALFA THALESSMIA

B. BETA  THALESSMIA MAJOR

C. sickle cell

 

D.G6PD DEFICIENCY

ANS-B

REF-OHC 2,OPERATION HARRI BOOK-PAGE-467,CONSULTANT

Beta thalassemia major

* Severe anemia , massive ineffective erythropoiesis: hepatosplenomegaly, microcytosis,  and elevated HbF

*Require chronic hypertransfusion therapy- hematocrit of at least 27–30%

43. IMPLANTABLE CARDIAC DEVICE DEVELOPED SHOCK.INVESTIGATION TO ASSESS THE INTEGRITY OF ICD [AIIMS NOV 2012]

A. X RAY

B. CONTRAST CT

C. MRI

D. USG

44. which doesnt arise from peritoneum of stomach  [AIIMS NOV 2012]
liver
spleen
pancreas
kidney

ANS D

REF-CONSULTANT,MKT,OHC

Foregut	Midgut	Hindgut
Pharyngealpouches*	Lowerduodenum	Distal onethird of transverse colon
Lungs	Jejunum	Descendingcolon
Esophagus	Ileum	Sigmoid colon
Stomach	Cecum	Rectum
Liver	Appendix	Upper part ofanal can
Gallbladder andbile ducts	Ascendingcolon	Urogenitalderivatives
Pancreas	Proximal twothirds of transverse colon

45. not common in normal pregnancy and hypertension during pregnancy? [AIIMS NOV 2012]

A. pedal edema

B. engorged veins

C. dyspnea

D. SYSTOLOC HYPOTENSION

ANS-D

REF-CONSULTANT,OHC-RECENT ADVANCES –BOOKLET(I hope my OHCians have gone through the RECENT ADVANCES booklet sent to them??!!-this question was extremely satisfying for POSITIVE)

RECENT ADVANCES-HAND OUT-OG

 

46. PLANTAR FLEXION LEADS TO RUPTURE OF  [AIIMS NOV 2012]

A. ANT.TALO FIBULAR LIGAMENT

B. POST.TIBIO FIBULAR LIGAMENT

C. CALCANEO FIBULAR LIGAMENT

D. POSTERIOR DELTOID FIBRES

47. LIGAMENT WHICH ATTACHES MENISCI TO TIBIA [AIIMS NOV 2012]

A. CORONARY LIGAMENT

B. Arcuate ligament

 

C.

D.

ANS-A

REF-POSIGOLD,OHC-MODIFIED,CONSULTANT

• 267. Coronary ligaments of the knee are[AI 2008]
• a) Ligaments connecting the menisci to femur
• b) Ligaments connecting the menisci to tibia
• c) Ligaments connecting the anterior horns of both menisci
• d) Ligaments connecting the lateral meniscus to capsule

ANS-B

48. ABDUCTION AND DIRECT HIT OF KNEE WILL CAUSE RUPTURE OF [AIIMS NOV 2012]

A. MEDIAL COLLATERAL LIGAMENT

B. LATERAL COLLATERAL LIGAMENT

C. ANTERIOR CRUCIATE LIGAMENT

D. MEDIAL MENISCUS

49. NERVE WHICH DOES NOT SUPPLY GLUTEAL REGION [AIIMS NOV 2012]

A. SCIATIC NERVE

B. OBTURATOR  NERVE

C. INFERIOR GLUTEAL NERVE

D. SUPERIOR GLUTEAL NERVE

ANS A

REF-CONSULTANT

50. a hyertensive man on medication with normal activity is graded under  [AIIMS NOV 2012]

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

ANS-B

REF-OHC-RECENT ADVANCES BOOK LET,MKT,CONSULTANT

 

POSITIVE -RECENT ADVANCES-OHC 2

n  The ASA physical status classification system is a system for assessing the fitness of patients before surgery. In 1963 the American Society of Anesthesiologists (ASA) adopted the five-category physical status classification system; a sixth category was later added. These are:

n  A normal healthy patient.

n  A patient with mild systemic disease.

n  A patient with severe systemic disease.

n  A patient with severe systemic disease that is a constant threat to life.

n  A moribund patient who is not expected to survive without the operation.

n  A declared brain-dead patient whose organs are being removed for donor purposes.

 POSITIVE MKT

1.   Preoperative physical status classification of patients according to the American Society of Anesthesiologists.

Class	Definition
P1	A normal healthy patient
P2	A patient with mild systemic disease (no functional limitations)
P3	A patient with severe systemic disease (some functional limitations)
P4	A patient with severe systemic disease that is a constant threat to life (functionality incapacitated)
P5	A moribund patient who is not expected to survive without the operation
P6	A brain dead patient whose organs are being removed for donor purposes
E	If the procedure is an emergency, the physical status is followed by “E” (for example, “2E”)

51. A GUNSHOT AT T8 LEVEL. nerve regeneration not in spinal cord not due to  [AIIMS NOV 2012]

1) no endoneurium
2) lack of nerve growth factor
3) no myelin inhibiting factor
4) glial scar

52. PROPHYLACTIC CRANIAL IRRADIATION IS  NOT REQUIRED IN [AIIMS NOV 2012]

A. NEUROBLASTOMA

B.

C.

D.

53. HEPATOMEGALY WITH LIVER TENDERNESS AND ELEVATED DIAPHRAGM-ALL EXCEPT [AIIMS NOV 2012]

A. AMEBIC ABSCESS

B. PYEMIC LIVER ABSCESS

C. ACUTE CHOLECYSTITIS

D.

ANS-C

REF-CONSULTANT

54. RADIOLOGICAL DIAGNOSIS BY USG IN SURGICAL OBSTRUCTION-ALL EXCEPT [AIIMS NOV 2012]

A. GALL STONES

B. PERITONEAL SEEDLING

C. LEVEL OF OBSTRUCTION

D. ABSENT FLUID LEVEL

ANS-B

• REF-CONSULTANT-OPERATION HARRI  PAGE 222
• * Direct visualization of the peritoneum (laparoscopy) may disclose peritoneal deposits of tumor
• 18^TH EDITION
• Peritoneal carcinomatosis can result from primary peritoneal malignancies such as mesothelioma or sarcoma, abdominal malignancies such as gastric or colonic adenocarcinoma, or metastatic disease from breast or lung carcinoma or melanoma

55. INTESTINAL OBSTRUCTION SURGERY AND BIOPSY OF ILEAL LOOP WAS DONE AND SENT FOR HISTOLOGY-IT WILL CONTAIN [AIIMS NOV 2012]

A. VILLOUS ADENOMA

B. SMOOTHMUSCLE TUMOR

C. CARCINOID

D. LYMPHOMA

ANS-A

REF-CONSULTANT-SURGERY NOTES-POSITIVE

REF-POSITIVE SURGERY

Intususception

Commonest pathology is Adenoma in adults
In adolescents, Meckel’s diverticulum is the  commonest.

Primary treatment in children is hydrostatic reduction

Commonest type of Intussusception in adults is  Colo colic

56. on intubation of child problem in anesthesia machine collapse after 2 min what to do?  [AIIMS NOV 2012]

A. bigger tube

B. continue as such

C. increase flow

D. manually ventilate

57. Pregnant. 36wks..BP.176/80.and blurring vision and epigastric pain present..management is..  [AIIMS NOV 2012]

a.ADMIT,ANTIHYPERTENSIVES,mgso4 AND OBSERVATION
b.admit. Give mgso4 and terminate
C. ADMIT &Observation
D.Give only antihypertensive

ANS A

REF-CONSULTANT

58 ON ALANSTRON FOR 7 YEARS-WORSENING OF SYMPTOMS-WHAT INVESTIGATION YOU WILL CONSIDER [AIIMS NOV 2012]

A. DEXA

B. ALKPO4

C. CALCIUM

D.

59. CHILD WITH RICKETS WITH DEFORMITIES-CORRECTIVE SURGERY IS PLANNED AFTER CORRECTION OF [AIIMS NOV 2012]

A. VIT D

B. CALCIUM

C. ALKPO4

D. GROWTH PLATE

60. FOLLOWING DIFFICULT INTUBATION-TO CONFIRM POSITION [AIIMS NOV 2012]

A. TACHYCARDIA

B. BRADYCARDIA

C. NORMAL CAPNOGRAM

D. PULSEOXIMETRY

61. KYNOMYOGRAPH IS FOR  [AIIMS NOV 2012]

A.

B.

C.

D.

62. IV DRUG DEPENDING ON TOTAL BODY WEIGHT ,NOT ON IDEALBODY WEIGHT [AIIMS NOV 2012]

A. ATRACURIUM

B. VECRONIUM

C. PANCURONIUM

D. ROCURIUM

63. MAXIMUM ANALGESIC EFFECT [AIIMS NOV 2012]

A. NO

B. HALOTHANE

C. ETHER

D.

ANS-A

REF-POSIGOLD,OHC,CONSULTANT

64. POOR SCHOOLPERFORMANCE-A EEG WAS GIVEN-DIAGNOSIS [AIIMS NOV 2012]

A. ABSENCE SEIZURE

B. COMPLEX PARTIAL SEIZURES

C.

D.

ANS-A

REF-CONSULTANT,OHC

65. FIXATIVE IN TISSUE SPECIMEN  [AIIMS NOV 2012]

A gluteraldehide
b formalin
c alcohol
d.picric acid

Ans-a

Ref-consultant

Modified posigold

• Which of the following is the most commonly used ‘fixative’ in diagnostic pathology[AI 2011]
• a) Formaldehyde         b) Ethyl alcohol
• c) Mercuric chloride    d) Picric acid
• ANS-A

66. person had a fight with a neighbour where he assaulted him,he can be booked under ipc [AIIMS NOV 2012]

A. 320

B. 319

C. 44

D. 351

ANS-D

REF-CONSULTANT

67. HEALTH EXPENDITUREIN GDP IN INDIA [AIIMS NOV 2012]

A. 1.2

B. 2

C. 10

D. 15

ANSB

REF-POSITIVE MKT,OHC

National Health Policy – 2002

Goals to be achieved by – 2015

* Eradicate Polio and Yaws* Eliminate Leprosy * Eliminate kala – azar * Eliminate Lymphatic Filarisasis Achieve zero level growth of HIV/AIDS * Reduce mortality by 50% on account of TB, * Malaria and other vector and water borne diseases * Reduce prevelence of blindness to 0.5% * Reduce IMR to 30/100 And MMR to 100/Lakh * Increase utilization of public health facilities from current level of < 20% to > 75% * Establish an integrated system of surveillance, National Health Accounts and Health Statistics. * Increase health expenditure by Government as a % of GDP from the existing 0.9% to 2.0% * Increase share of central grants to constitute at least 25% of total health spending * Increase state sector health spending from 5.5% to 7% of the budget * Further increase to 8% of the budget

20052005 2010 2015 2007 2010 2010 2010 2010 2005 2010 2010 2005 2010

 

68. WHICH IS TRUE [AIIMS NOV 2012]

A. DOBUTAMINE INCREASES PERIPHERAL RESISTANCE

B. NORADRENALINE-INCREASES RENAL VASODILATION

C. DOPAMINE-INCREASES HEPATIC BLOOD FLOW

D.

69. ECTOPIC PREGNANCY CAN BE DIAGNOSED BY ALL EXCEPT [AIIMS NOV 2012]

A. PELVIC EXAMINATION

B. HYSTEROSALPHINGOGRAM

C. URINE HCG

D. USG

70. A psychiatric patient he is clear about his disease-this is [AIIMS NOV 2012]

A. Insight

B. Judgement

C. orientation

D.

ANS-A

REF-CONSULTANT

71. A chronic alcoholic used to consume 5 bottles per day of liquor.Recently he attains kick with I bottle-this is called as [AIIMS NOV 2012]

A. Tolerance

B. Reverse tolerance

C. mallen by

D.

72. A female patient with cord like lesions in both temporal regions- a biopsy was done which revealed granulomatous lesion involving all layers [AIIMS NOV 2012]

A. Temporal arteritis

B. Wegeners granulomatosis

C.

D.

ANS-A

REF-OHC

73. Persistent hyperplastic vitreous-after surgery the commonest complication [AIIMS NOV 2012]

A. Retinal detachment

B. Vitreous hge

C. orbital cellulitis

D. keratitis

Ans-a

Ref-consultant

74. Gram negative bacteria without endotoxin  [AIIMS NOV 2012]

A. Cholera

B. E.COLI

C. KLEBSIELLA

D. PSEUDOMONAS

ANS-A

REF-POSIGOLD,OHC,CONSULTANT

• 1. Endotoxin of which gram negative bacteria has no part in pathogenesis of disease: [AI 2012]
• a) E.Coli                   b) Klebsiella
• c) Vibrio Cholera     d) Pseudomonas aerginosa
• ANS C

75. Which is a contraindication for vaginal delivery after CS in the previous delivery [AIIMS NOV 2012]

A. Classical cs

B. CPD in the previous delivery

C. breech

ANS-A

REF-CONSULTANT,MODIFIED POSIGOLD,OHC

• Which of the following is not a contraindication for vaginal delivery after previous cesarean section (CS)? [AI 2008]
• a) Previous Classical C/S
• b) No Vaginal delivery in the past
• c) Breech presentation
• d) Puerperial infection in previous pregnancy
• ANS-C

76. A patient presented with maculopapular rash in trunk, with generalized lymphadenopathy and a flat painless genital ulcer with a mass in the palatal region-treatment [AIIMS NOV 2012]

A. Acylovir

B. Pencillin

C. amphotericin

ANS-B

REF-OHC,OPERATION HARRI BOOK-PAGE 736,CONSULTANT

Secondary Syphilis

*   Primary chancre is still present in 15% of cases

*   Necrotic lesions (lues maligna)- patchy alopecia

*   Highly infectious lesions (condylomata lata) in 10%

*   Syphilitic hepatitis-an unusually high serum level of alkaline phosphatase- no cholestasis

*    Manifestations of the secondary stage resolve spontaneously, usually within 1–6 months.

*Lue maligna,Corona veneris

Treatment of Acquired Syphilis

*    Penicillin G is the drug of choice for all stages of syphilis

77. Which is not a 2nd gen antihistamine ?  [AIIMS NOV 2012]

A. cetrizine

B. loratidine

C. fexofenadine

D. cyclizine

ANS-D

REF-POSIGOLD,CONSULTANT,OHC

78. All are used in erectile dysfunction except [AIIMS NOV 2012]

A. TADANAFIL

B. Phenylephrine

C. PROSTAGLANDIN E

D. APOMORPHINE

ANS-B

• REF-OHC,POSIGOLD,OPERATION HARRI BOOK PAGE 261

Male Sexual Dysfunction: Treatment

*    Oral Agents-Sildenafil, tadalafil, and vardenifil. Intraurethral Alprostadil, Various combinations of alprostadil, phentolamine, and/or papaverine are  used.

79. Ca cervixIIIB-TRT OF CHOICE [AIIMS NOV 2012]

A. SURGERY

B. RT

C. CHEMORADIATION

D. NEOADJUVANT RADIATION

ANS

REF-CONSULTANT

OPERATION HARRI BOOK PAGE 437,POSIGOLD-AIIMS NOV-2010

Patients with disease stages II–IV are primarily managed with external beam irradiation and intracavitary treatment or combined modality therapy.(AIIMS-NOV-2010***)

 

80. A DIABETIC PATIENT WITH A BLACK ESCHAR IN THE NOSE SPREADING TO ORBIT-MANAGEMENT [AIIMS NOV 2012]

A. AMPHOTERICIN

B. BROAD SPECTRUM ANTIBIOTIC

C.

D.

ANS-A

REF-CONSULTANT,OHC,OPERATION HARRI BOOK

Black eschar of the palate is widely described as a hallmark of rhinocerebral mucormycosis.

81. MILITARY RETIRED MAN WITH CLEAN HABITS DEVELOPS HEADACHE WHICH IS MORE ON LYING DOWN AND RELIEVES ON GETTING UP.MASSAGE IN THE NECK REGION RELEIVES THE PAIN-DIAGNOSIS [AIIMS NOV 2012]

A. TENSION HEADACHE

B. TEMPORAL ARTERITIS

C. MIGRAINE

D. PAN

82. STRUCTURE NOT INVOLVED DURING VASECTOMY[AIIMS NOV 2012]

A. SPERMATIC CORD

B. ILIOINGUINAL NERVE

C. PAMPINIFORM PLEXUS

D.

ANS-B

REF-CONSULTANT

83. PERSISTENT ORAL LESIONS FOR 12 MONTHS WITH BULLOUS LESIONS [AIIMS NOV 2012]

A. INTRA DERMALDERMAL BULLA

B. DERMOEPIDERMAL BULLA

C. SUBCORNEAL BULLA

D. SUPRABASAL

ANS D

REF,CONSULTANT,OHC,OPERATION HARRI BOOK,MODIFIED POSIGOLD

• REF-OPERATION HARRI-PAGE238
• Intraepidermal blistering diseases characterized by loss of cohesion between epidermal cells (a process termed acantholysis).
• *          Manual pressure to the skin of these patients may elicit the separation of the epidermis (Nikolsky’s sign)-also seen in toxic epidermal necrolysis, Stevens-Johnson syndrome.
• *          Predominates in patients >40 years.
• *          PV typically begins on mucosal surfaces.
• *          PV may be associated with severe skin pain.
•  *         Lesions  heal without scarring.
• *          Postinflammatory hyperpigmentation is usually present at sites of healed lesions.
• *          Biopsies – intraepidermal vesicle formation secondary to loss of cohesion between epidermal cells (i.e., acantholytic blisters).
• *          Blister formation is within the suprabasal portion of the epidermis.
• *          Direct immunofluorescence microscopy of lesional or intact patient skin shows deposits of IgG on the surface of keratinocytes.

 

• MODIFIED POSIGOLD
• A 40 yr old Female developed persistant oral ulcers followed by multiple flaccid bullae on trunk and extremeties. Direct examination of a skin biopsy immunoflurescene showed intercellular IgG deposits in the epidermis and suprabasal split with acantholytic cells. The probable diagnosis is  [AI 2008]
• a) Pemphigus vulgaris
• b) Pemphigoid
• c) Erytheme multiforme
• d) Dermatitis herpetiformis
• ANS-A

84. 3^RD WINDOW EFFECT IS FOUND IN [AIIMS NOV 2012]

A) PERFORATED OF TM

B) DEHISCENCE OF SEMICIRCULAR CANAL

C) ROUND WINDOW

D) OVAL WINDOW

ANS B

REF-EXCITING 18^TH,OHC 2

18^TH EDITION HARRISON

• K) Conductive hearing loss
• * Disorders that lead to the formation of a pathologic “third window” in the inner ear can be associated with conductive hearing loss.
• * Normally two major openings, or windows, that connect the inner ear with the middle ear(oval) and serve as conduits for transmission of sound(round windows)
• * A third window is formed where the normally hard otic bone surrounding the inner ear is eroded; – “inner ear conductive hearing loss.”
• *The superior semicircular canal dehiscence syndrome resulting from erosion of the otic bone over the superior circular canal can present with conductive hearing loss that mimics otosclerosis.

85. HIGH FREQUENCY AUDIOMETRY[AIIMS NOV 2012]

A) DRUG TOXICITY

B) Otosclerosis

C) Non- organic hearing loss

D) Meniere’s disease

ANS A

REF-POSIGOLD,CONSULTANT,OHC,RECENT ADVANCES BOOK LET

RECENT ADVANCES OHC

 

HIGH FREQUENCY AUDIOMETRY

• Pure tone audiometry (PTA) is the key hearing test used to identify hearing threshold levels of an individual, enabling determination of the degree, type and configuration of a hearing loss. Thus, providing the basis for diagnosis and management.
• Conventional audiometry tests frequencies lie in between .25 Hz and 8 kHz. Whereas, high frequency audiometry tests in the region of 8-20 kHz. The effects of ototoxic medication and noise exposure for example, appear to be more detrimental to the high frequencies, than mid or low frequencies.
• Therefore, high frequency audiometry is an effective method of monitoring losses that are suspected to have been caused by these factors. It is also effective in detecting the auditory sensitivity changes which occur with aging
• HFA might be used as an early indicator for noise-induced hearing loss and acoustic trauma rather than audiometry at a conventional frequency (4 kHz), particularly for younger groups.
• High Frequency audiometry is used in: [AIIMS MAY 2009]
• a) Otosclerosis
• b) Ototoxicity
• c) Non- organic hearing loss
• d) Meniere’s disease

ANS-B

86. EEG IN ANESTHESIA [AIIMS NOV 2012]

A. REGIONAL ANSTHESIA

B. DEPTH OF  GENERALANESTHESIA

C. NEUROMUSCULAR BLOCK

D. ANALGESIA

ANS-B

REF-CONSULTANT

87. PT WITH ACTIVE TB MENINGITIS -1 MONTH ON ATT-CLINICAL DETORIATION-WHICH IS NOT USEFULL IMMEDIATELY [AIIMS NOV 2012]

A. MRI

B. NONCONTRAST CT

C. LFT,ELECTROLYTES

D. CSF ANALYSIS

88. CHILD  WITH GRUNTING NO NASAL FLARE WITH CHEST RETRACTION –SILVERMAN SCORE [AIIMS NOV 2012]

A. 3

B. 4

C. 5

D. 6

ANS B

REF-POSIGOLD AIIMS NOV-2010,OHC

• Clinical scores:  it was applied a synthesis of Silverman

• Normal babies have a cumulative score close to “0”.
• Severely depressed babies score close to “10”.

89. BI-RADS SCORE(All POSITIVIANS&OHCIANS should have squealed in delight on seeing this question in the exam!!!) [AIIMS NOV 2012]

A. BREAST IMAGING REPORTING AND DATA BASE SYSTEM

B. BRAIN IMAGING REPORTING AND DATA BASE SYSTEM

C. Best Imaging Reporting and Data System

 

D.

ANS A

REF-OHC,CONSULTANT-SURGERY

• Mammography is the process of using low-dose  (usually around 0.7 mSv) to examine the human breast and is used as a diagnostic as well as a screening tool. The goal of mammography is the early detection of breast cancer,
• “BI-RADS score????
• Mammogram results are often expressed in terms of the BI-RADS Assessment Category, often called a “BI-RADS score.” The categories range from 0 (Incomplete) to 6 (Known biopsy – proven malignancy). In the UK mammograms are scored on a scale from 1-5 (1 = normal, 2 = benign, 3 = indeterminate, 4 = suspicious of malignancy, 5 = malignant).

Breast Imaging Reporting and Database System (BI-RADS)
Category	Assessment	Follow-up
0	Need additional imaging evaluation	Additional imaging needed before a category can be assigned
1	Negative	Continue annual screening mammograms (for women over age 40)
2	Benign (noncancerous) finding	Continue annual screening mammograms (for women over age 40)
3	Probably benign	Receive a 6-month follow-up mammogram
4	Suspicious abnormality	May require biopsy
5	Highly suggestive of malignancy (cancer)	Requires biopsy
6	Known biopsy-proven malignancy (cancer)	Biopsy confirms presence of cancer before treatment begins

• cancers missed by mammography are usually around 10%–30%
• one form of breast cancer, lobular cancer, has a growth pattern that produces shadows on the mammogram which are indistinguishable from normal breast tissue.

90. Ca prostate is followed with[AIIMS NOV 2012]

A) PSA

B) PSA+CEA

C) PSA+CA-125

D) ANDROGEN

ANS A

REF-CONSULTANT,OHC,OPERATION HARRI BOOK,MKT

MARKER	CANCER
Oncofoetal antigens: i) Alpha-foetoprotein (AFP)

ii) Carcino-embryonic antigen (CEA)Hepatocellular carcinoma, non-seminomatous germ cell tumours of testis
Cancer of bowel, pancreas, breast

1. Cytoplasmic proteins:

i) Immunoglobulins
ii) Prostate specific antigen (PSA)

Multiple myeloma, other gammapathies
Prostate carcinoma

1. Enzymes:
   i) Prostate acid phosphatase(PAP)
   ii) Neuron-specific enolase (NSE)

Prostatic carcinoma

Neuroblastoma, oat cell carcinoma lung

Hormones:
i) Human chorionic gonadotropin (HCG)
ii) Calcitonin
iii) Catecholamines and vanilly mandelic acid (VMA)
iv) Ectopic  hormone productionTrophoblastic tumours, non-seminomatous germ cell tumours of testis
Medullary carcinoma thyroid

 

Neuroblastoma, pheochromocytoma

Paraneoplastic syndromes

1. Secreted cancer antigens:

i)            CA-125

ii)            CA-15-3

Ovary
Breast

 

PSA relapse –PSA relapse is defined as three consecutive risingPSA values from the nadir value, with the time to failure as a rise by 2 ng/mL or greater above the posttreatment nadir value.

*    Neoadjuvant hormone therapy.

*Brachytherapy

* After surgery à RT – indications.

1)   positive surgical marigin.

2) a long interval from surgery toPSAfailure.

3)   a slowPSAdoubling time.

4)   lowPSA- < 0.5 – 1.0 ng/L.

91. PREGNANT LADY PT WITH PAINFULL LUMP IN BREAST.WHAT IS THE NEXT INVESTIGATION[AIIMS NOV 2012]

A. USG

B. MRI

C. CT

D. MAMMOGRAM

ANS A

REF-CONSULTANT

92. DENNIS SPINAL INJURY SYSTEM[AIIMS NOV 2012]

A. COLUMN 2

B. COLUMN 3

C. COLUMN 4

D. COLUMN  5

ANS-B

93. Commonest cause of NMR IN INDIA [AIIMS NOV 2012]

A. INFECTIONS

B. BIRTH ASPHYXIA

C. CONGENITAL MALFORMATION

D. PREMATURITY

ANS-B

• REF POSIGOLD,MKT,OHC
• Primary causes of neonatal deaths in India (NNPD data 2002) n = 1800

94. EYE LESION IN PATAU SYNDROME [AIIMS NOV 2012]

A. BILATERAL MICROOPTHALMIA

B. neurofibroma

C. Capillary hemangioma

D. Dermoid cyst

 

REF-OHC-2 GENETICS

Symptoms and findings may be extremely variable from case to case. However, in many affected infants, the following may be found:

Growth deficiency

Feeding difficulties

Breathing difficulties

Developmental delays

Mental Retardation

Undescended testicles in males

Prominent back portion of the head

Small head (microcephaly)

Low-set, malformed ears

Abnormally small jaw (micrognathia)

Small mouth

Cleft lip/palate

Upturned nose

Narrow eyelid folds (palpebral fissures)

Widely-spaced eyes (ocular hypertelorism)

Dropping of the upper eyelids (ptosis)

Overlapped, flexed fingers

Underdeveloped or absent thumbs

Underdeveloped nails

Webbing of the second and third toes

Clubfeet

Small pelvis with limited movements of the hips

Short breastbone

Kidney malformations

Structural heart defects at birth (i.e., ventricular septal defect, atrial septal defect, patent ductus arteriosus)

MODIFIED POSIGOLD

Persistant Primary Hyperplastic Vitreous (PHPV) is associated with: [AI 2008]

a) Patau syndrome       b) Edward syndrome

c) Trisomy 14              d) Downs syndrome

ANS-A

95 23. All are second messengers except:  [AIIMS NOV 2012]

a) Guanylyl cyclase     b) cAMP

c) IP3                          d) DAG

ANS-A

REF-POSIGOLD,OHC

All are second messengers except: [AIIMS NOV 2008]

a) Guanylyl cyclase           b) cAMP

c) IP3        d) DAG

96. Sternocleidomastoid is supplied by all of the following arteries except?  [AIIMS NOV 2012]

a) Occipital                        b) Posterior auricular

c) Thyrocervical trunk       d) Superior thyroid

ANS-B

REF-POSIGOLD,OHC,CONSULTANT

. Sternocleidomastoid is supplied by all of the following arteries except? [AIIMS NOV 2008]

a) Occipital                        b) Posterior auricular

c) Thyrocervical trunk                   d) Superior thyroid

97. A gardener has multiple vesicles on hand and multiple eruptions along the lymphatics. Most common fungus responsible is?  [AIIMS NOV 2012]

a) Sporothrix schenckii     b) Cladosporium

c) Histoplasma                  d) Candida

ANS A

REF,CONSULTANT,POSIGOLD,OHC

A gardener has multiple vesicles on hand and multiple eruptions along the lymphatics. Most common fungus responsible is? [AIIMS NOV 2008]

a) Sporothrix schenckii    b) Cladosporium

c) Histoplasma                  d) Candida

ANS-A

98. Mass chemoprophylaxis is not indicated in [AIIMS NOV 2012]

A. scabies

B. lymphatic filariasis

 

C. vit A deficiency

 

D. worm infestation

 

ANS-A

REF-POSIGOLD,OHC

Mass chemoprophylaxis is endemic area is recommended for all of the following, except: (AI 2010)

A. Yaws          B. Leprosy

C. Trachoma    D. Filaria

ANS-B

99. Variable area tonometry  [AIIMS NOV 2012]

A. Mackey marg tonometer

B.

C.

D.

ANS-A

100. A patient with bilateral proptosis [AIIMS NOV 2012]

A. Leukemia

B. Cavernous hemangioma

C. Fibrous histiocytoma

D.

101. Best agent for premenstrual syndrome management?

A. Progesterone

 

B. SSRI

C. ANXIOLYTIC

D. VITAMIN E

ANS-B

REF-CONSULTANT

102. Helminthic infection from fish?  [AIIMS NOV 2012]

A. clonorchis

B. diminuta

C.tenia

D.

ANS-A

REF-CONSULTANT,OPERATION HARRI BOOK,POSIGOLD,OHC

A man on return from a country complains of pain in abdomen, jaundice, with increased alkaline phosphatase and conjucated hyperbilirubinemia. U.S.G. shows blockage in the biliary tree. What could be the cause –[AIIMS MAY 2009]

a) Fasciola buski    b) Clonorchis sinensis

c) Stronglyliodes   d) Ancylostoma

Ans (B)

103. Best agent for premenstrual syndrome management?  [AIIMS NOV 2012]

A. Progesterone

B. SSRI

C. ANXIOLYTIC

D. HRT

ANS-b

REF-CONSULTANT

104.  rupture of urethra above the the deep perineal pouch…..causes urine retention in which region???  [AIIMS NOV 2012]

a. anterior abd. wall
b. medial aspect of thigh
c.scrotum
p.true pelvis only

ANSd

RER-CONSULTANT,MODIFIED POSIGOLD,OHC

Injury to the male urethra below the perineal membrane causes urine to accumulate in [AI 2007]

a) Superificial perineal pouch

b) Deep perineal pouch

c) Space of retzius       d) Pouch of douglas

Ans (a)

105.  A neonate with poor respiration at birth starts throwing seizures after 10hrs of birth. Antiepileptic of choice wud be  [AIIMS NOV 2012]

A. Levetiracetam

B. Phenytoin

C. Phenobarbitone

D. Lorazepam

ANS-C

REF-CONSULTANT

106. pt with central incisor fracture after fight and abrasions in limbs And trunk  [AIIMS NOV 2012]

A) grevious
B) fatal
C) simple
D) dangerous

ANS-A

REF-CONSULTANT,MODIFIED POSIGOLD,OHC

30. A teacher slapped a 6th standard student after which she suffered from 25% hearing loss in left ear. This was corrected after a surgery. Which type of injury is this? [AIIMS NOV 2009]

a) Simple                     b) Grievous

c) Dangerous               d) Serious

Ans B

107.  female with vaginal dischage,no active cx dischage,rx??  [AIIMS NOV 2012]

A. metro,azithromycinm
B. metro,fluco..
C. Metro & doxyclyclin
D. Metro & ceftriaxone

Ans-b

REF-CONSULTANT

108. Testis origin  [AIIMS NOV 2012]

A) ectodermal origin
B) gabernaculum attached to caudal end
C) surrounded by peritoneal tunica albuginea
D) 28th weak reach at scrotum

109. Causes of acute anal pain –ALL EXCEPT [AIIMS NOV 2012]

A. thrombosed hemorrhoids
B. acute anal fissure
C. fistula in ano

D. anorectal abscess

Ans-b

• Ref-consultant,HARRISON
• hemorrhoids
  Pain is less common than with fissures and, if present, is described as a dull ache from engorgement of the hemorrhoidal tissue. Severe pain may indicate a thrombosed hemorrhoid

*A patient with a fistula in ano will complain of constant drainage from the perianal region

*A fissure can be easily diagnosed on history alone. The classic complaint is pain, which is strongly associated with defecation and is relentless.

110. Child with seizures, oval hypopigmented macules on trunk, subnormal IQ–  [AIIMS NOV 2012]

A. Neurofibromatosis
B. sturge Weber
C. Tuberous sclerosis
D. Incontinentia Pigmenti

ANS-C

REF-CONSULTANT,OHC

111. Which of following malign do not require routine CSF puncture in children  [AIIMS NOV 2012]

A. ALL
B. HODGKIN LYMPHOMAS
C. NON HODGKIN LYMPHOMAS.
D. AML

ANS-

112. multigravida36 weeks-WITH PREVIOUS 2 NORMAL DELIVERIES presented with unstable lie. It is due to..  [AIIMS NOV 2012]

A.placenta previa
B.oligohydramnios.
C. Pelvic tumor

D.UTERINE ANOMALIES

ANS?B

REF-CONSULTANT

113 Not True is  [AIIMS NOV 2012]

a.forcep delivery facial palsy and brain damage
b.vacum delivery require more skill than forcep
c. Vacum associated  with cephal hematoma

d.

ANS

114.  long thoracic nerve root value  [AIIMS NOV 2012]

A. C567

B. C678

C. C8T1

D. C56

ANS- A

REF-CONSULTANT

115. area of brain can be self stimulated under experimental conditions –  [AIIMS NOV 2012]

A. Medial forebrain bundle
B. Area around aqueduct of sylvius
C. PEriventricular region of hypothalamus
D. Mesenchephalon

ANS-

116. Tibia pain,fever,inc ESR:INVESTIGATION????  [AIIMS NOV 2012]

A. Blood culture
B. Pus culture
C. MRI

D.

ANS

117. Known RA female pt presented wth quadriplegia -INVESTIGATION
Cervicle spine flexion extension xray [AIIMS NOV 2012]

A. MRI brain
B. Carotid angio
C. NCV

D.

ANS-B

REF-OHC,OPERATION HARRI BOOK-PAGE 61,

Other Causes of Neck Pain

*    Rheumatoid arthritis – forward displacement of the atlas on the axis (atlantoaxial subluxation). – in 30% of patients with RA.

When subluxation is present, MRI is the imaging modality of choice

118. Newborn with resp distress which is suggestive of RDS
onset after 6hrs  [AIIMS NOV 2012]

A. Air bronchogram
B. Term pregnancy
C. Antenatal steroid

D.seen after 6 hrs

ANS-A

REF-CONSULTANT

119 Pt>60yr leukocyte= 20,000 with generalized lympadenopathy
Next test u should do?  [AIIMS NOV 2012]

A. Lymph node Bx
B. BM aspiration
C. Peripheral blood immunohistochemistry
D. Peripheral blood cytogenetics

ANS-C

REF-CONSULTANT

120. Allen’s test done for collateral arterial supply at  [AIIMS NOV 2012]

A. Arm
B. forearm
C. Wrist
D. Elbow

ANS-C

REF-CONSULTANT,OHC,EXCITING 18^TH

The brachial or radial artery may also be used as an arterial access site in patients with peripheral arterial disease that involves the abdominal aorta, iliac, or femoral vessels; severe iliac-artery tortuosity; morbid obesity; or preference for early postprocedure ambulation. Use of radial-artery access is gaining popularity owing to a lower rate of access-site bleeding complications. A normal Allen’s test confirming dual blood supply to the hand from the radial and ulnar arteries is a prerequisite to access this site

121. PDA-NOT SEEN [AIIMS NOV 2012]

A. APNOEA

B. ISCHEMIC COLITIS

C. NARROW PULSE PRESSURE

D. BRADYCARDIA

ANS-

122.  With reference to Bacteroides fragilis, the following statements are true except?(AIIMS-NOV-2011,12) [AIIMS NOV 2012]

a.B.fragilis is the same frequent anaerobe isolated from clinical samples
b.B.fragilis is not uniformly sensitive to metronidazole
c.The lipopolysaccaride formed by B.fragilis is structurally and functionally different from the conventional endotoxin
d.Shock and disseminated intravascular coagulation are common in Bacteroides bacteremia

ANS-REF-POSIGOLD,2006,2011)

REF-POSIGOLD,OPERATION HARRI-PAGE 699 ,OHC

Occur when an anatomic barrier becomes disrupted and constituents of the local flora enter a site that was previously sterile.

*          Prevotella melaninogenica attaches to other microorganisms- fimbriae that facilitate attachment.

*          Some Bacteroides strains have pili.

*          Virulence factor-polysaccharide complex of B. fragilis.

*          Interleukin (IL) 8, IL-17, and tumor necrosis factor (TNF)alfa-stimulate abscess formation.

*

IL-10- the cytokine inhibits of abscess formation.**

*          The collagenase produced by P. gingivalis may enhance tissue destruction.

*          An enterotoxin has been identified in B. fragilis strains associated with diarrheal disease.

*          B. fragilis possess lipopolysaccharides (LPSs, endotoxins) that are 100–1000 times less biologically potent than endotoxins associated with aerobic gram-negative bacteria-lower frequency of DIC and purpura in Bacteroides bacteremia (AIIMS-NOV-06***,AIIMS-N0V-2011).

123. A patient develops urticaria after sunexposure and exercise [AIIMS NOV 2012]

A. Cholinergic urticaria

B. dermographism

C. SOLAR URTICARIA

D.

ANS-A

REF-HARRISON

• Cholinergic urticaria is precipitated by heat, exercise, or emotion and is characterized by small wheals with relatively large flares.

124.  Loss of extension of little ring finger, hypothenar atrophy [AIIMS NOV 2012]

A. post interosseous nerve

B. radial trunk

C.

D.

ANS

125. AN ABORTUS WAS REMOVED FROM PM-LENGTH 2CM,WT-      WHAT IS THE APPROXIMATE AGE OF IT-(ULTIMATE QUESTION TO PROVE THE EFFICACY OF MKT!!!) [AIIMS NOV 2012]

A. 2WK

B. 4WK

C. 6WK

D. 8WK

ANS-C

REF-POSITIVE MKT,OHC

Milestones of Prenatal Development

126. REGARDING PRION DISEASE [AIIMS NOV 2012]

A.CHRONIC INCUBATION PERIOD

B.

C.

D.

ANSA

REF-CONSULTANT,OHC,MKT

127.  A WOMEN WITH HEPATITIS C WITH RENAL DISEASE [AIIMS NOV 2012]

A. MPGN

B. ESSENTIAL CRYO

C.

D.

 

ANS-A

REF-POSIGOLD,CONSULTANT,OHC

128. Health related millennium development goal in India is: [AIIMS NOV 2012]

a) Decrease by 2/3^rd between 1990 & 2015 – infant mortality rate

b) Decrease by 3/4^th between 1990 & 2015 – MMR

c) Have halted by 2015, begin to reverse the spread of HIV

d) Have halted by 2015, begin to reveerse the incidence of TB

ANS-C

REF-OHC,POSIGOLD-AI2012

Goal 4: Reduce Child Mortality

Target: Reduce by two-thirds, between 1990 and 2015, the under five mortality rate

Indicator 1990 Levels Goal for 2015 Current Levels

Under-five mortality rate(per 1000 live birth) 42

Infant mortality rate (per 1000 live birth) 27

Proportion of 1 year-old children immunised

against measles100%

Goal 5: Improve Maternal Health

• Target: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio
• Goal for 2015
• Maternal mortality ratio (per 100000 live
• Birth) 109
• Proportion of births attended by skilledhealth personnel (Not fixed target)

Goal 6: Combat HIV/AIDS, Malaria and Other Diseases

• Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS
• Target 6B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it

129.  double base smokeless gun powder contains [AIIMS NOV 2012]

A nitrocellulose n nitroglycerine

B. pot nitranate n nitro

C. pot nitrate n lead

D.

ANS-A

REF-CONSULTANT

BLACK	SMOKELESS
a) Contains * Pot.Nitrate (75%) * Sulfur (10%) * Charcoal (15%) b) 1 gm     – 3000, – 4500        c.c of gas	* Nitrocellulose * Nitroglycerine c) 12,000      – 13,000       c c gas

 Semi smokeless powder

     Black powder (80%)

                  +

     Smokless powder (20%)

 

• Gunpowder, also called black powder, is an explosive mixture of sulfur, charcoal and potassium nitrate, KNO3

130.  AMEOBIC ABSCESS 4CM DRAINED 3 TIMES-MANAGEMENT [AIIMS NOV 2012]

A. WEEKLY USG

B. SERIAL STOOLCULTURES

C. USG,CT,STOOL EXAMINATION

D.

ANS

131. BLUE COLOUR IN UV RAYS [AIIMS NOV 2012]

A. SEMEN

B. PUS

C. BLOOD

D. LEUCORRHEA

ANS-A

CONSULTANT

132. COCHLEAR TRANSPLANT-IF ONE OF THE FOLLOWING IS INTACT [AIIMS NOV 2012]

A. OUTTER  HAIR CELLS

B. INNER HAIR CELLS

C. COCHLEAR NERVE

D. AUDITORY NERVE

ANS-D

REF-CONSULTANT,OPERATION HARRI BOOK-PAGE 119,OHC

Cochlear implant (AIIMS – NOV -2010***)-Criteria for implantation include severe to profound hearing loss with word recognition score 30% under best aided conditions – are neural prostheses that convert sound energy to electrical energy and can be used to stimulate the auditory division of the eighth nerve directly.

133. The least likely change to occur in leomyoma [AIIMS NOV 2012]

a) sarcomatous change

b) red degeneration

c) fatty generation

d) hyaline generation

ans A

REF-CONSULTANT

134. A child is not eating vegetables.Mother starts giving CHOCOLATES –it is [AIIMS NOV 2012]

a) operant conditioning

b) classical conditioning

c) social training

d)

ans A

REF-CONSULTANT

135. SYRINGOMYELIA-all except [AIIMS NOV 2012]

a) hypertrophy of abductor pollicis brevis

b) burning sensation

c) absent upper limb reflexes

d) plantar extensor

ans

ref-OHC,CONSULTANT

136. Drugs not given to glaucoma pt who s hypertensiv [AIIMS NOV 2012]

a) brimonidine

b) dorzolamide

c)

d)

ans A

REF-CONSULTANT

137. GRISEL syndrome-all except [AIIMS NOV 2012]

a) post adenoidectomy

b) neurosurgical consult not required

c)

d)

ans

REF-

138. Drug used in ESBL RESISTANCE [AIIMS NOV 2012]

a)piperacillin

b)amoxiclav

c)ampisulbactum

d)ceftrioxone

ans ?c

REF-CONSULTANT,OPERATION HARRI BOOK-PAGE 656,OHC

Extended-spectrum beta-lactamases (ESBLs) confer resistance to the same drugs as broad-spectrum beta-lactamases as well as to third-generation cephalosporins, aztreonam, and  fourth-generation cephalosporins-The acquisition of ESBL-encoding genes via transferable plasmids.

*   ESBLs are most prevalent in Klebsiella pneumoniae, K. oxytoca, and E. coli.

*   GNB that expresses ESBLs possesses porin mutations.

*   The carbapenems are the most reliably active beta-lactam agents against ESBL-expressing strains- ESBL-producing isolates should be considered resistant to all penicillins, cephalosporins, and aztreonam*.

*   AmpC beta lactamases confer resistance to the same substrates as ESBLs plus the cephamycins-AmpC enzymes resist inhibition by betalactamase inhibitors-The fourth-generation cephalosporin cefepime is stable to AmpC beta lactamases and is an appropriate treatment option*

*   Carbapenemases confer resistance to the same drugs as ESBLs plus cephamycins and carbapenems-Tigecycline  and the polymyxins  are the most active drugs in vitro.

139. Pseudosulcus in larynx is due to [AIIMS NOV 2012]

a) laryngotracheobronchitis

b) vocal abuse

c) laryngopharyngeal reflux

d) chronic steroid therapy

ans c

REF-PODIGOLD,OHC

140. Disability certicate for poor vision if 4/60 [AIIMS NOV 2012]

a) 0.75

b) 0.3

c) 0.4

d) 1

ans A

REF-CONSULTANT

141. child intubatd, aftr 2 min, bellows seen in anaesthetic machine, nxt best step? [AIIMS NOV 2012]

a) Ventilate manually

b) continue

c) increase flow

d) increase the lumen of the tube

ans

142. Lady with progressive loss of vision with photopic vision [AIIMS NOV 2012]

a) Stargradts Disease

b)

c)

d)

ans

143. SARS causative agent [AIIMS NOV 2012]

a) Corona virus

b) picorna virus

c)

d)

ans-a

REF-CONSULTANT,OHC,OPERATION HARRI BOOK-PAGE 783,OHC

CORONA VIRUS

Pleomorphic, single-stranded RNA viruses.

 *  Infect a wide variety of animal species and have been divided into three antigenic groups.

 *  That infect humans – two of these groups (serogroups I and II), which include human isolates HCoV-229E and HCoV-OC43, respectively.

 *  Human coronaviruses have been difficult to cultivate in vitro, and some strains grow only in human tracheal organ cultures-SARS-CoV is an exception – ready growth in African green monkey kidney (Vero E6) cells.

 *  Coronaviruses account for 10–35% of common colds.

 *  Natural reservoir of SARS-CoV – the horseshoe bat.

 *  Infection was transmitted from human to human.

ans

144. HIV sentinel surveillance is done for [AIIMS NOV 2012]

a)high risk cases

b)

c)

d)

ans

145. Most susceptible stage of cell cycle for radiation [AIIMS NOV 2012]

a)G2/M

b)G1/S

c)S

d)M

ans A

REF-OHC,POSIGOLD,CONSULTANT

146. Which vertebra doesn’t show variation in number [AIIMS NOV 2012]

a)cervical

b)vertebral

c)thoracic

d)sacral

ans

147. Which of the following is not a use of cholimimetic [AIIMS NOV 2012]

a) bradycardia

b) glaucoma

c) myasthenia

d) post op atony

ans a

ref-consultant

148. Nanotechnology is usd in Chromosal stdy cause –  [AIIMS NOV 2012]

a) Nanocrystals shws intense and longlasting flourescence at target sites.

b)

c)

d)

ans

149. Histological change associated with malignant hypertension [AIIMS NOV 2012]

a) Hyperplastic Arteriosclerosis

b)HYAINE ARTERIOSCLEROSIS

c)

d)

ans a

ref, POSIGOLD,OHC

150 . Value of Shock Index in Acute PPH [AIIMS NOV 2012]

a) 0.9-1.1

b)

c)

d)

ans

151. Best trt of a single extend Indx finger at DIP Jnt aftr Sports Inj –  [AIIMS NOV 2012]

a)  Splint

b)

c)

d)

ans

152.  Case of Suddn Fall with B/L intrnal rotatd and adductd Shldr –  [AIIMS NOV 2012]

a) B/L Post dislocatn of Shldr

b) ANTERIOR DISLOCATION

c)

d)

ans A

REF-CONSULTANT

153. Causative agnt of Pneumonia assoctd with Aerosols sprd –  [AIIMS NOV 2012]

a) Legionella

b)Streptococci

c)bordetella

d)

ans a

ref-consultant,OHC,OPERATION HARRI BOOK PAGE 650

LEGIONELLA

Natural habitats for L. pneumophila are lakes and streams.

*   Amplification of legionellae – warm temperatures (25°–42°C), stagnation, and scale and sediment.

*   Multiple modes of transmission of Legionella to humans exist, including aerosolization, aspiration, and direct instillation into the lungs.

154. Mc Fayden Rxn is assoctd with [AIIMS NOV 2012]

a)Bacillus anthrax

b)pneumococci

c)

d)

ans a

ref-consultant,OHC,OPERATION HARRI BOOK

155.  Village With pop 2050 [AIIMS NOV 2012]

a)50

b)

c)

d)

ans A

REF-POSIGOLD,CONSULTANT

156. S/E of HAART therapy [AIIMS NOV 2012]

a)UVEITIS

b)IRITIS

c)RETINITIS

d)OPTIC NEURITIS

ans A

157. Choking is seen in [AIIMS NOV 2012]

a)Shot gun

b)revolver

c)rifle

d)

ans-a

ref-POSIGOLD,CONSULTANT

158. Child unable to Use bld Glucose –  [AIIMS NOV 2012]

a) Def of Glu-6-phosphatase

b)

c)

d)

ans

159. Dephosphorylatn to Phosphorylatn of Hepatic enzyms occurs during [AIIMS NOV 2012]

a) more commonly seen in fasting state than in fed state

b) always activates d enzyme

c) catecholamines stimulate it

d) always activated by camp dependent tyrosine kinase

ans a

ref-consultant

160. 14 year old boy, not able to get good grades on 9th standard exam. But very sharp and intelligent. Best test to diagnose his problem – [AIIMS NOV 2012]

a) Neuropsychological battery

b) bhatia’s battery

c) specific learning disability test

d) Child behaviour battery

ans

161. Case of Intranuclear Opthalmoplegia. Cause is [AIIMS NOV 2012]

a) MEDIAL LONGITUDEINAL FASCICULUS

b)

c)

d)

ans A

REF-OHC,CONSULTANT,OPERATION HARRI BOOK

162. Woman with Nrmal ext features, breast and Pubic hair but abs Uterus and Part of Vagina –  [AIIMS NOV 2012]

a) Mullerian Agenesis

b) xyy syndrome

c) ovarian dysgenesis

d) klinefelter syndrome

ans a

ref-POSIGOLD-AIIMS NOV-2010,OHC,OPERATION HARRI BOOK-PAGE-222

Patients with AIS have a 46, XY karyotype, but because of the lack of androgen receptor responsiveness, they have severe underandrogenization and female external genitalia. The absence of pubic and axillary hair (AIIMS-NOV-2010***)distinguishes them clinically from patients with müllerian agenesis.

114. Primary amenorrhoea Public hair +, absent uterus and ovaries [AIIMS NOV 2010]

A Androgen insensitivity

B Mullerian agenesis

C Gonadal dysgenesis

ANS-B

163. Stereotactic Rad Surgery dn for [AIIMS NOV 2012]

a)BRAIN

b)LUNGS

c)PROSTATE

d)

ans A

REF-OHC,CONSULTANT

164. Effect of B/L Carotid comp above Carotid Sinus  [AIIMS NOV 2012]

a) -increase in vasomotor centre activity

b) -increase in discharge of carotid sinus afferent nerves

c)

d)

ans

REF-POSIGOLD

165. Actual body wt is required instead of average body wt [AIIMS NOV 2012]

a)atracurium

b)pancuronium

c)Vecuronium

d)rocurium

ans

166. Fastest test for Hearing assessment in Child [AIIMS NOV 2012]

a)OAE

b)BERA

c)

d)

ans A

REF-CONSULTANT

167.  Not a Part of Roll Back Malaria initiative –  [AIIMS NOV 2012]

a) Development of new poweful insecticides

b) insecticide nets

c) strengthning health system

d) training health workers

ans A

REF-CONSULTANT,OPERATION HARRI BOOK PAGE-3,OHC

Malaria

*          World’s 3^rd largest infectious killer.

*          RBM – Roll Back malaria campaign by WHO

– 3 pronged strategy

– Insecticide – Treated bed nets (ITNS)

– Combination malaria Treatment

– Indoor residual spraying

EXCITING 18TH

* Malaria decreased 50% in patients sleeping in ITNS.

*percentage of children <5 years of age using an ITN (24%) remains  below the World Health Assembly’s target of 80%.

*ITNs offer a supplemental benefit by preventing transmission of lymphatic filariasis, cutaneous leishmaniasis, Chagas’ disease, and tick-borne relapsing fever.

*In 2008, the RBM partnership launched the Global Malaria Action Plan (GMAP).

*Indoor Residual Spraying-DDT-controls malaria transmission only if most (~80%) of the structures in the targeted community are treated

168. All are cause for the high frequency of Ovulatn of Rt ovary as comp to Left [AIIMS NOV 2012]

a)Right handedness

b) different  vascular  supply

c) Variation in development

d) anatomical asymmetry

ans a

REF-POSIGOLD,OHC

169. End diastolic volume increases in [AIIMS NOV 2012]

a) decrease in total blood volume

b) increase in intra pericardial pressure

c) increase in negative intrathoracic pressure

d) decrease inventricular compliance

ans

170. Mechanism of gentamicin ototoxicity [AIIMS NOV 2012]

a) inactivation of local Na-k atpase channels

b) directly destroys hair cells

c) calcium channel

d)

ans

171. What age child can eat food without spilling, identify her gender,say her full name [AIIMS NOV 2012]

a) 2

b) 3

c) 4

d) 5

ans b

ref-consultant,MKT,OHC

172. Regaarding blood supply increase in exercise muscle all execpt [AIIMS NOV 2012]

a)  local metabolite

b) sympathetic stimulation

c) cholinergic

d) inhibition of beta receptor

ans

173. In insomnia patient sleep most acurately recorded by [AIIMS NOV 2012]

a) barogragph

b) kymograph

c) actigraph

d) plethysmography

ans

174. Knowledge of illness in MMSE –  [AIIMS NOV 2012]

a) insight

b) judgement

c) orientation

d)

ans

175.  Child with hypoglycemia unable utilize glucose from glycogenolysis, gluconeogenesis [AIIMS NOV 2012]

a) glucose 6 phosphatase deficiency

b) glucokoinase deficiency

c)

d)

ans

REF-CONSULTANT

176. True about NPCDCS – [AIIMS NOV 2012]

a) subcentre has facility for DM and HTN diagnosis and treatment

b)

c)

d)

ans

177. RCT to asses dating in adolescents, random school chosen, random class choses, random students chosen method of sampling –  [AIIMS NOV 2012]

a) multistage sampling

b) stratified sampling

c) simple random sampling

d) cluster sampling

ans A

REF -CONSULTANT

178. Principle of MRCP [AIIMS NOV 2012]

a)

b)

c)

d)

ans

179. Population of yearly patients with cervical cancer based on present incidence [AIIMS NOV 2012]

a).1 million

b)1 million

c)10 million

d)

ans

180. Bispectral imagine to monitor depth of anaesthesia [AIIMS NOV 2012]

a)

b)

c)

d)

ans

ref-POSIGOLD,OHC

181. Contraindicated in corneal ulcer –  [AIIMS NOV 2012]

a) flurometholone 

b)

 c)

d)

ans A

REF-CONSULTANT

182. Transition from infectious diseases to manmade and non communicable disease – [AIIMS NOV 2012]

a) epidemiological transition

b) paradoxic transition

c) reversal of transition

d)

ans A

REF-CONSULTANT

183. Curve with mean > mode –  [AIIMS NOV 2012]

a) right positive skew

b)Negative skew

c) normal

d) symmetrical

ans A

REF-POSIGOLD,OHC,CONSULTANT

184. Population of 10lakh with 30% under 16yrs, with prevalence of blindness 0.8 per 1000 in that age group, population affected [AIIMS NOV 2012]

a) 240

b)320

c)

d)

ans B

REF-consultant

185. True about tetanus toxoid A/E – [AIIMS NOV 2012]

a) passed from mother to foetus

b) useless in a pt with no past history of immunization with trauma

c) herd immunity present

d)

ans

REF-consultant,OHC,

186. Population 5000 with myopic prevalence of 500. New cases of 90, incidence is [AIIMS NOV 2012]

a) 1.8%

b)

 c)

d)

ans A

REF-CONSULTANT

187. Child with mass in upperhumerus with cortical thinning and periosteal reaction, toc A/E – [AIIMS NOV 2012]

a) bone radiotherapy

b) bone curettage and implant

c) intralesional steroid

d)

ans

REF-

188. Patient with first metatarsophal jt involvement with CKD – [AIIMS NOV 2012]

a) RA

b)URIC ACID

c)

d)

ans

REF-

189. Radiographical diagnosis of intestinal obstruction –  [AIIMS NOV 2012]

a) proximal intestine 3 cm

b) on lying supine fluid air gap absence does not signify obstruction

c) volvulus shows a characteristic appearnce on radiograph

d) large intestine 9 cm small intestine 3 cm

ans

REF-

190. A/E true about Lidocaine –  [AIIMS NOV 2012]

a) most cardiotoxic lethal antiarrhythmic

b) it acts on sodium channels in both active and inactive state

c) it is given iv in cardiac arrythmias

d)

ans A

REF-CONSULTANT

191. Seen in Burger’s Disease – [AIIMS NOV 2012]

a) neural involvement present

b) Ulnar artery and peroneal arteries involved

c) small acral vessels of limb involved

d)

ans A

REF-CONSULTANT

192. Pathogenesis of Raynaud’s phenomenon [AIIMS NOV 2012]

a)

b)

c)

d)

ans

REF-

193. Associated with membrane raft – [AIIMS NOV 2012]

a) GPI anchored protein

b)

c)

d)

ans a

REF-operation harri book page 477,OHC

194.  IOC for lady with dysmenorrhoea with cyclical pain and infertility – [AIIMS NOV 2012]

a) diagnostic laparascopy

b)

c)

d)

ans A

REF-CONSULTANT

195. Hyperacute transplant rejection due to [AIIMS NOV 2012]

a) PREFORMED ANTIBODIES

b)IMMUNE COMPLEX DEPOSITION

c)

d)

ans

REF-OHC,CONSULTANT

196.  Comparative chromosomal analysis of normal cell genetics with neoplastic cell –  [AIIMS NOV 2012]

a) comparative genomic hybridization

b)

c)

d)

ans a

REF-

197. Patient with heroin addiction comes with pinpoint pupil and coma, doc [AIIMS NOV 2012]

a) IV naloxone

b)oral naltrexone

c)

d)

ans

REF-

198. Numbness of litle and ring finger,atofy of hypothenar musles nerve dammaged? [AIIMS NOV 2012]

a) palmar cut br of ulnar

b) deep branch of ulnar

c) ulnar nerve before division

d)

ans c

REF-consultant

199. Disruption of myelin with intact axons [AIIMS NOV 2012]

a) NEUROPRAXIA

b)NEURONOTEMESIS

c)

d)

ans A

REF-CONSULTANT

200.  Inc of Mutations in Sickle cell anemia and thalessemia patients in Malaria endemic areas due to –  [AIIMS NOV 2012]

a. Resistant to Malaria in Heterozygotes

b.

c.

d

ans

102. Not used in erectile dysfunction? (AIIMSMAY2008)

a)PGE-2                     b) Vardalafil

c) Phenylephrine           d) Alprostadil

REF-OPERATION HARRI-PAGE 129

Criteria for implantation include severe to profound hearing loss with word recognition score 30% under best aided conditions – are neural prostheses that convert sound energy to electrical energy and can be used to stimulate the auditory division of the eighth nerve directly.

* Cochlear implants consist of electrodes that are inserted into the cochlea through the round window.

 

Signs and symptoms of normal pregnancy versus heart failure