Ans: B Dipicolinic acid is exclusively found in bacterial spores.
2. “Boiled lobster syndrome” is seen in poisoning with:
a. Hydrochloric acid
b. Boric acid
c. Oxalic acid
d. Chromic acid
Ans: B in boric acid poisoning, the major symptom is erythema, desquamation and exfoliation. The skin of the patient looks like a boiled lobster.
3. Ohngern’s classification is used for”
a. Ca maxillary sinus
b. Ca nasopharynx
c. Ca oropharynx
d. Ca tongue
And: A line from medial canthers to angle of mandible divides maxilla, used for staging of Ca maxillary sinus.
4. The antibody seen in miller Fischer syndrome is:
a. Anti GM1
b. Anti GD1a
c. Anti GQ1b
d. Anti GM2
Ans: C the different types of antibodies seen in GBS are
Variant of GBS antibodies
a. AIDP anti GM1
b. AMAN anti GD1a
c. Miller fisher syndrome anti GQ1b
5. Lubiprostone is chloride channel opener used in the management of
b. Idiopathic constipation
d. Urinary retention
e. Ulcerative colitis
Ans: B Lubiprostone is a gut selective chloride channel opener used exclusively in the management of idiopathic constipation.
6. Triple vessel disease refers to A/E:
a. Rt. Coronary artery
b. Circumflex artery
c. Lt. anterior descending artery
d. Post. Inter-ventricular artery
Ans: A Posterior interventicular artery is not included in the group “Triple vessel disease” (lt. ant. Descending artery is also called left anterior inter-ventricular artery or even Widow’s Artery)
7. Hingorani sign is associated with which disease in pregnancy:
a. Overian tumor
d. Lymphogranuloma venereum
Ans A in a case of ovarian tumor abdominal examaiton reveals the cystic swelling felt separated from gravid uterus. In later month of pregnancy confusion may arise. The pt is examined vaginally in head down trendelenburg position to elicit the groove between the two swelling i.e. gravid uterus and the ovarian tumor (hingorani sign).
8. Blount’s disease is a cause of?
a. Coax vara
b. Coax magna
c. Genu valgum
d. Genu varum
Ans: D it is a typical disorder affecting the postero-medial epiphysis of proximal tibia (due to avascular necrosis) thereby leading to over growth of the lateral epiphysis resulting in agene / tibia vara deformity. It is common in West Indies & Africans.
9. Highest incidence of pneumothorax occurs when branchial plexus is blocked by which route:
Ans: B the incidence of pneumothorax may be as high as 1 to 6% when brachial plexus is blocked through supraclavicular route but fortunately most of these pneumothorax resolve by themselves without t/t.
10. Which is true about LAD-2 disease?
a. Defect in beta chain of CD11/CD18 integrin
b. Defect in fucosyl transferase required for synthesis of sialyted oligosaccharide
c. Defect in chemotaxis
d. Defect in adhesion
Ans: B R-62
11. Surgery’s ear is:
Ans: A due to swollen epiglottis on lateral X ray of neck
12. DVT is more common on the left lower limb as compared to the right lower limb. This finding is easily explained by what is known as:
a. May – Thurner (Cockett) syndrome
b. Kasabach Merritt syndrome
c. Nutcracker syndrome
d. Subclavian steal syndrome
Ans : A May – Thurner syndrome:
The right common iliac vein ascends almost vertically to the inferior vena cava, while the left common iliac vein takes a more transverse course. For this reason, the left common iliac vein may be compressed between the right common iliac artery and lumbosacral spine, a condition known as May-Thurner (Cockett) syndrome resulting in decreased venous return in left leg.
Kasabach Merritt syndrome: Consists of haemangioma or haemangio-endothelioma or angiosarcoma with consumptive thrombocytopaenia with resulting purpura.
Nutcracker syndrome is the compression of the left renal vein between the superior mesenteric artery and aorta. This can lead to renal venous hypertension, resulting in rupture of thin-walled veins into the collecting system.
Subclavian steal syndrome: Subclavian steal syndrome and subclavian steal phenomenon both result from occlusion or severe stenosis the proximal subclavian artery resulting in development of neurologic symptoms (due to cerebral ischemia resulting in syncopal attacks, visual disturbances & decreased blood pressure in affected limb) on exercise of upper limb due to proximal subclavian stenosis or occlusion with reversal of flow thru vertebral artery. Symptoms aggravated by exercise of arm. Javid test: Compression of carotid artery makes ipsilateral pulse feeble
13. The commonest cause of death in flail chest is:
a. Lung Injury
c. Mediastinal flutter
Ans: B Penulufft
All of the above are causes of unmanaged Flail chest but it is pendulufft (movement of air from one lung to another due to paradoxical movement of chest wall resulting in decreased exchange of gases) which results in most deaths in case of flail chest.
14. “Criminal Nerve of Grassi” is a branch of:
a. Hepatic branch of Anterior Vagus
b. Br. Of Anterior nerve of Latarjet
c. Celiac branch of Posterior Vagus
d. Direct branch of Posterior Vagus
Ans : D
Left or Anterior Vagus Right or Posterior Vagus
Parasymp = Vagus ® Eso. Hiatus ® Lesser Curvature (90% sensory) / 10% Efferent /
Right or Posterior Vagus = Posterior surface – branch to Gastric Fundus (Criminal nerve of Grassi can result in hyperacidity if left behind since arises before the main trunk) + Posterior nerve of Latarget + Crow’s feet
Left or Anterior Vagus = Anterior surface ® br. to Liver & GB & continue as Anterior Nerve of Latarget which supply acid & pepsin secreting area of stomach & end as ‘Crow’s feet’ to supply pyloric antrum.
Post. Trunk ® Coeliac plexus ® Remnant of G.I. (Posterior trunk of Lt. Vagus) /
* Pregang Fib. of Vag. synapse with Auerbach's Plexus / Postgang Fib. To smooth muscle + mucosa
Sympathetic – via Gr. Splanchnic nerve ® celiac ganglion ® post ganglionic fibers along gastric arteries to stomach (afferent fibers for visceral pain)
Motility: * Pacemaker in Fundal Mus. Near GC - 3 Peristalsis/min
* Vol. of empty gastric lumen = 50cc (cf GB) ® Receptive dilatation = 1000cc
* Gastric emptying = By Vagus / ¯ By Gastrin
15. Osteopenia definition according to WHO is
a. T score < - 2.5
b. T score between - 1 and – 2.5
c. Z score < - 2.5
d. Z score between - 1 and – 2.5
16. Which of the following represents compound myopic astigmatism..?
a. -2D sph
b. -2D sph/-2 D cyl 180°
c. -2D sph/+2 D cyl 180°
d. +1D sph/-2.5D cyl at 90°
Ans: B Both sphere and cylinder are with- ve sign in compound myopic astigmatism.
17. ‘Jack in the Box’ effect of aphakic eye corrected by spectacles is due to
a. Spherical aberration
b. Ring scotoma
d. Inaccurate correction
Ans: A also seen – pin cushion effect, roving ring scotoma.
18. “Starry sky” appearance in immunofluorescence is seen in
a. Post streptococcal glomerulonephritis
b. Goodpasture’s syndrome
c. IgA nephropathy
d. Wegener’s granulomatosis
Ans: A the renal biopsy in poststreptococcal glomerulonephritis demonstrates hypercellularity of mesangial and endothelial cells, glomerular infiltrates of polymorphonuclear leukocytes, granular subendothelial immune deposits of IgG, IgM, C3, C4, and C5-9, and subepithelial deposits (which appear as “humps”). Immunofluorescence staining gives “starry sky” representing deposition of IgG & C3.
19. Features of Hashimoto’s encephalopathy includes all except
b. Slow-wave activity in EEG
c. Associated with TPO antibodies
d. Resistant to steroids
Ans : D Hashimoto’s encephalopathy has been defined as a steroid-responsive syndrome associated with TPO antibodies, myoclonus, and slow-wave activity on electroencephalography, but the relationship with thyroid autoimmunity or hypothyroidism is not established. The hoarse voice and occasionally clumsy speech of hypothyroidism reflect fluid accumulation in the vocal cords and tongue.
20. Vagal nerve stimulation is used in the treatment of which of the following?
d. Seasonal affective disorder
Ans: C VNS is an emerging method of treatment of depression. It is offered thorugh the cervical portion of the left vagus which is stimulated in a pulsatile manner (like a pace maker). Preliminary studies showing promising results. The VNS received the FDA approval for the treatment of resistant depression since the year 2005, July. Ref: Kaplan, charles B, J Neuropsychopharmacology (2006), 31, 1345-1355.
21. Which of the following is the itegrase inhibitor approved for treatment of HIV
Ans: A this is a new drug approved for the treatment of advanced HIV in combination with other anti-HIV durgs