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www.prepgmedicos.com 2008 Q.1 1. A 6 yr child presents with fever, non-productive cough & wheezing, he improves over 3 days but then suddenly child deteriorates with increasing respiratory distress & hypoxemia with obstructive pattern on spirometry also chest X-ray shows b/l hyperlucencies, diagnosis of this child is: a) Bronchiolitis obliterans b) Cystic fibrosis c) Bronchial asthma d) Pulmonary Koch's Q.2 2. EXIT Procedure for delivering a baby is most commonly instituted in which clinical condition? a) Congenital diaphragmatic hernia b) Congenital lung emphysema. c) Bronchial asthma d) Hydronephrosis Q.3 3. In double volume exchange transfusion (DVET) What % of infants blood volume is replaced by fresh blood? a) 66% b) 100% c) 87% d) 50% Q.4 4. Beutler test is used in diagnosis of: a) Hypoglycemia b) Hereditary fructose intolerance c) Ataxia telangiectasia d) Galactosemia Q.5 5. A 1 yr old child presented with hepatosplenomegaly & Growth retardation with history of polyuria,the liver biopsy & bone marrow biopsy reveals presence of histiocytes with PAS positive & Birbeck granules in cytoplasm on electron microscopy. diagnosis is: a) Langerhan cell histiocytosis b) Galactosemia c) Gaucher’s disease d) Niemann pick disease Q.6 6. Jargon speech is seen at age of: a) 6 month b) 3 year c) 15- 18 month d) 12 month Q.7 7. VSD- indication of surgery are all except: a) Qp:Qs >2:1 b) Supracristal VSD c) Pulmonary HTN d) Pulmonary vascular disease Q.8 8. Sodium content of breast milk in (mEq/L): a) 0.3 b) 0.4 c) 0.6 d) 0.8 Q.9 9. A one day old term neonate born out of uneventful pregnancy presented with symptoms of respiratory failure with slow & irregular respiratory efforts, long respiratory pauses & cyanosis, also baby fails to respire adequately during sleep with PCO2 on ABG going upto 90 mm of Hg during sleep & returns to normal levels after baby awaken. what is the diagnosis of this baby? a) Ondine’s curse b) Riley-day syndrome c) SMA-I d) Smith-lemli opitz syndrome

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www.prepgmedicos.com 2008 Q.10 11. A 2 year old boy is brought to you after his mother noticed him passing several grossly bloody stools. There is no accompanying abdominal pain,fever,or vomiting. family history is positive for colonic cancer in paternal uncle. on admission, his PCV is 26%,the most likely diagnosis is: a) Colonic polyp b) Intussusception c) Ulcerative colitis d) Meckel’s diverticulum Q.11 12. Hb Bart’s is found in which disorder? a) Homozygous B thalassemia b) Thalassemic hemoglobinopathy c) Homozygous alpha thalassemia d) Combined alpha & beta Thalassemia Q.12 13. While examining a 2-day old baby, small vesicles on an erythematous base are noted on the infants face & chest. Wright's stain of the lesions reveals sheets of eosinophils diagnosis? a) Miliaria rubra b) Milia c) Neonatal acne d) Erythema toxicum Q.13 14. A child is toilet trained,plays interactive games,gives his first & last names,pedals a tricycle,& is able to copy a cross & circle but not a square & triangle.He is not able to catch a bounced ball or dress without supervision. Most likely age of this child? a) 1 year b) 2 years c) 3 years d) 5 years Q.14 15. The most common cardiac defect in VACTERL syndrome is a) VSD b) ASD c) PDA d) Conotruncal anomalies Q.15 16. PANDAS (Pediatric Autoimmune Neuropsychiatric disorders) is associated with : a) S.aureus b) Streptococcus pyogènes c) S.typhi. d) S.pneumoniae Q.16 17. Drug of choice in Listeria Monocytogenes: a) Ampicilline b) Cotrimoxazole c) Ceftriaxone d) Azithromycin Q.17 18. Sternal edema is classically the sign of which infection? a) Measles b) Erythema infectiosum c) Mumps d) Herpes simplex infection Q.18 19. Steinberg sign is seen in: a) Achondroplasia b) Ehlor Danlos syndrome c) Marfans syndrome d) Homocystinuria Q.19 20. Gianotti Crosti syndrome can occur in which hepatotropic viral infection a) HAV b) HCV c) HBV d) HEV

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www.prepgmedicos.com 2008 Q.20 21. A 12 year old child presented with repetitive myoclonic jerks, mental deterioration ,recent onset poor school performance in the pediatric opd.The patient has a past history of fever with maculopapular rash appearing by day four of fever with a prodormal phase of excessive sneezing,lacrimation.The following complication has occurred secondary to which viral exanthema a) Rubella b) Measles c) Mumps d) Varicella Q.21 22. A child presents with recurrent episodes of abscesses of the skin ,lungs and musculoskeletal systems necessitating recurrent admissions. On gram staining and culture of the pus aspirate, it revealed Staph aureus isolates.CBC revealed marked eosinophilia. Which could be the underlying immunodeficiency disorder. a) Hyper IgE syndrome b) Common variable immunodeficiency syndrome c) Hyper IgM syndrome d) Severe combined immunodeficiency syndrome Q.22 23. Brunhilde,Lansing and Leon are the strains used in manufacture of which vaccine? a) IPV b) OPV c) MMR d) DPT Q.23 24. You would investigate this patient by a) Vasography. b) USG. c) Urethrography. d) Prostate biopsy. Q.24 25. Ureteral duplication is commonly associated with a) VUR. b) PUJO. c) Ureterocele. d) Hypospadias. Q.25 26. Pyuria without bacteriuria is seen in a) TB. b) Calculi. c) Malignancy. d) All. Q.26 27. False about testis a) Normal volume is 15-25ml. b) Innermost layer is Tunica vasculosa. c) External pudendal artery does not supply it. d) Blood testis barrier is formed at birth. Q.27 28. Testosterone given before hypospadias repair helps by a) Increasing vascularity and thickness of corpora spongiosum. b) Correcting chordee. c) Correcting preputial hood. d) Preventing bleeding during surgery Q.28 29. Gonococcal stricture involves a) Bulbar urethra. b) Penile urethra. c) Prostatic urethra. d) External meatus. Q.29 30. True about priapism are all except a) It is prolonged erection. b) Results from vascular disorder. c) Arteriolar obstruction prevents blood escape.

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www.prepgmedicos.com 2008 d) Glans and bulbospongiosis remain flaccid. Q.30 31. The vulnerable period where an extra systole can produce ventricular fibrillation coincides with a) Mid-portion of ST segment b) Peak of R wave c) Mid-portion of p wave d) Mid –portion of T wave Q.31 32. Almost all of the cerebral cortex has direct two-way communication with which one of the following sub cortical structures a) Cerebellum b) Thalamus c) Hypothalamus d) Bulboreticular facilitatory area Q.32 33. The PEFR of a group of 11 girls follow a normal distribution with mean 300 l/min and standard deviation 20 l/min: a) About 95% of the girls have PEFR between 260 and 340 l/min. b) The girls have healthy lungs. c) About 5% of girls have PEFR below 260 l/min. d) All the PEFR must be less than 340 l/min. Q.33 34. A large number of HIV physicians across the country were asked to estimate the mean survival time since detection. Surprisingly, there was very little variation among their estimates, but all proved to be consistently pessimistic. Study of actual patients revealed that they lived on an average about 1 and a half year more than the physicians’ estimate. Thus their estimate was: a) Imprecise b) Precise and biased c) Imprecise and unbiased d) Unbiased Q.34 35. Which of the following virus has been implicated in the causation of rheumatic fever? a) Adenovirus b) Coxsackie virus c) Respiratory syncytial virus d) Rhinovirus Q.35 36. All of the following are true about evaluation of prevalence of RHD except: a) Survey is carried out in individuals 1-8 yrs age b) Survey is carried out in 6-14 yrs age group at 5 years interval c) Survey is carried out on samples of schools d) Recommended sample size is 20000 to 30000 children Q.36 37. Most sensitive and specific method of screening for breast cancer is: a) Breast self examination b) Examination by physician c) Mammography d) Thermography Q.37 38. Population above 60 yrs age in India is: a) 2.2% b) 3.4% c) 6.8% d) 10% Q.38 39. Vitamin deficiency common in severe measles is a) Vitamin K b) Vitamin D c) Vitamin A d) Vitamin C Q.39 40. Oxygenated blood from the placenta reaches the fetal heart in utero via: a) Umblical arteries b) Umbilical vein

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www.prepgmedicos.com 2008 c) d) Q.40 a) b) c) d) Q.41 a) b) c) d) Q.42 a) b) c) d) Q.43 a) b) c) d) Q.44 a) b) c) d) Q.45 a) b) c) d) Q.46 a) b) c) d) Q.47 a) b) c) d) Q.48 a) b) c) d) Q.49 a) b) c) d) Q.50 a) b)

Ductus venosus Ductus arteriosus 41. Regarding the renal system changes in pregnancy all are True, EXCEPT : Aldosterone decreases Renal blood flow increases in 1st trimester ADH secretion remains unchanged Plasma osmolality reduction is 10 mosmol/kg 42. AFP is raised in all, EXCEPT : Polycystic kidney Trisomies IUFD Esophageal atresia 43. A 16 weeks pregnant lady with previous history of Down’s syndrome should be best evaluated : CVS Triple markers Amniocentesis Color Doppler 44. All of the following are outcomes of occipito posterior position, EXCEPT : Deep transverse arrest Occipito sacral arrest Face to pubis delivery None of the above 45. Assisted breech delivery involves active delivery of breech after : Delivery of hands Delivery of umbilicus Delivery of neck Delivery of legs 46. Conduplicato corpore is seen in : Brow presentation Face presentation Transverse lie Compound presentation 47. Management of obstructed labour includes all, EXCEPT : IV fluids Oxytocin use Antibiotics Caesarean section 48. Vacuum application is contra indicated in all of the following, EXCEPT : Face presentation Preterm fetus IUFD Maternal heart disease 49. Indications of classical caesarean section include all, EXCEPT : Carcinoma cervix Dense adhesions in pelvis Postmortem CS Placenta praevia type I 50. Trial of scar is not attempted in : Previous LSCS CPD Polyhydramnios IUGR 51. Physiological chill in labour seen in : 1st stage 2nd stage

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www.prepgmedicos.com 2008 c) 3rd stage d) 4th stage Q.51 52. In the Pritchard’s regime the therapeutic level of serum MgSO4 to be achieved is : a) 1 – 2 meq/L b) 4 – 7 meq/L c) 12 – 15 meq/L d) 30 – 35 meq/L Q.52 53. All are true of Acute Fatty liver of Pregnancy, EXCEPT : a) LCHAD is increased b) Periportal sparing c) Hypoglycemia d) High mortality Q.53 54. 20 years old, G4P3 L3 with Mitral Stenosis is in labor, all of the following are indicated, EXCEPT : a) Left lateral position b) Prophylactic forceps c) Active management of 3rd stage d) IV frusemide after 3rd stage of labor Q.54 55. 79 yrs old Kanta, a c/o ovarian Ca, when explored shows bilateral ovarian involve ment with presence of ascitis with positive washings for malignant cells. B/L retroperitoneal LNodes involved. Stage is a) II c b) Ic c) III c d) IV Q.55 56. True and false broad ligaments fibroids differentiated by anatomic position of : a) Ureter b) Internal iliac vein c) External iliac artery d) Descending cervical artery. Q.56 57. 50 yrs. Nagdevi has Pap smear showing HSIL and colposcopic directed biopsy normal. Next line of management is : a) Repeat punch biopsy b) Therapeutic cone biopsy c) Diagnostic Cone biopsy d) Hysterectomy Q.57 58. Lefort’s operation associated with all, EXCEPT : a) Loss of coital function b) Loss of fertility c) Loss of ovarian function d) Loss of menstrual function Q.58 59. All are complications of bladder neck suspension surgeries, EXCEPT : a) Ostits pubis b) Urinary retention c) Urethral hypermobility d) Poor stream Q.59 60. In a ureterovginal fistula, the ‘three swab’ test shows the following result : a) Upper swab wet with methylene blue b) Upper swab wet with urine c) Lower swab wet with urine d) Lower & mid swab wet with methylene blue Q.60 61. Use of oral contraceptive pills are known to protect against following malignancies, EXCEPT : a) Ovarian Ca b) Endometrial Ca c) Uterine sarcoma

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www.prepgmedicos.com 2008 d) Carcinoma Cervix Q.61 62. Contraceptive LNG-IUD has cumulative pregnancy rate at 5 years of : a) 0.5 b) 1 c) 1.5 d) 2 Q.62 63. 35 years old Radha aborted 5 months back at 17 weeks of a gestation. She has not got her periods yet. Urine pregnancy test is negative. Estrogen progesterone withdrawl test negative. The likely diagnosis is a) Pituitary failure b) Ovarian failure c) Anovulation d) Asherman’s syndrome Q.63 64. Muscle relaxant C/I for CVA a) Atracurium b) Suxamethonium c) D-tubocurare d) Pancuronium Q.64 65. Inhalational agent of choice for hepatic failure a) Isoflurane b) Desflurane c) Sevoflurane d) Halothane Q.65 66. A known case of hepatotoxicity with halothane has to undergo surgery. Inhalational agent of choice a) Isoflurane b) Desflurane c) Sevoflurane d) Enflurane Q.66 67. What is the safest time after which heparin can be restarted in post op period after central neuraxial block a) any time b) 2 hours c) 6 hours d) 12 hours Q.67 68. During painless labour with epidural analgesia which of the following drug should be avoided a) Lignocaine b) Bupivacaine with adrenaline c) Lignocaine with adrenaline d) All of the above Q.68 69. A patient of hypertrophic obstructive cardiomyopathy ( HOCM) posted for hystrectomy, anesthesia of choice a) Spinal b) Combined spinal epidural c) GA with halothane d) GA with ketamine Q.69 70. False about a patient of right to left shunt a) Ketamine is the induction agent of choice b) Induction with iv agents is slower c) Increased incidence of paradoxical embolism d) None of the above Q.70 71. A asthma patient on aminophylline is posted for emergency surgery. Inhalational of choice a) Halothane b) Isoflurane c) Desflurane

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www.prepgmedicos.com 2008 d) Sevoflurane Q.71 72. Which epidural opoid causes respiratory depression a) Morphine b) Fentanil c) Alfentanil d) all of the above Q.72 73. Which of the following thing can be detrimental on following situation- a 50 year female with large tumor of brain and raised ICT is posted for surgery a) Hypoventilation b) Hypotension c) Hypercarbia d) All of the above Q.73 74. True statement regarding effect of anesthetics on following situation- a 50 year female with large tumor of brain and raised ICT is posted for surgery a) Inhalational agents well maintain brain auto regulation of BP b) Iv agents well maintain brain auto regulation of BP c) Both iv and inhalational agents well maintain brain auto regulation of BP d) Both iv and inhalational agents does not maintain brain auto regulation of BP Q.74 75. Which muscle relaxant should not be used in this patient on following situation- a 50 year female with large tumor of brain and raised ICT is posted for surgery a) Atracurium b) CIS atracurium c) Suxamethonium d) All of the above Q.75 76. Frontal ß waves on EEG indicate a) Deep anesthesia b) Light anesthesia c) Awake state d) None of the above Q.76 77. Hextend is a) Colloid b) Crystalloid c) Artificial blood d) None of the above Q.77 78. “Rope Sign” seen in patients with poliomyelitis is typically a a) Weakness of the quadriceps occurring asymmetrically b) Paralysis of the facial nerve in poliomyelitis c) Acute angulation between the chin and larynx due to weakness of the hyoid muscles d) Diaphragmatic paralysis leading to air hunger Q.78 79. Which of the following is not a complication of paralytic poliomyelitis in children? a) Acute gastric dilatation b) Melaena c) Hypocalcemia d) Hypertension Q.79 80. Atopic dermatitis in children is known to typically develop at what age? a) Infants b) Toddlers c) Adolescents d) Not common in children Q.80 81. Identify the wrong statement on congenital CMV infection? a) The disease was originally termed the cytomegalic inclusion disease b) Almost 90% of newborns are delivered with severe cytomegalic inclusion disease c) Re-infection with a different strain can lead to symptomatic congenital infection d) Asymptomatic congenital CMV infection is a leading cause of sensorineural hearing loss

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www.prepgmedicos.com 2008 Q.81 82. Transient synovitis or toxic synovitis, presumed to be a type of postinfectious arthritis in children typically affects which joint of the body? a) Knee joint b) Hip joint c) Ankle joint d) Wrist joint Q.82 83. Identify the wrong statement on febrile seizures in children? a) They are the most common type of seizures in childhood b) The peak age of onset of these seizures in children is 14-18 months c) An autosomal dominance inheritance has been demonstrated in some families d) A characteristic feature is no post-ictal drowsiness Q.83 84. The most prevalent type of migraine in children is a) Common migraine b) Classic migraine c) Complicated migraine d) Hemiplegic migraine Q.84 85. A child presents with microcephaly in association with beaked nose, downward slanting of palpebral fissures, epicanthic folds, short stature with broad thumbs and toes. The child is most likely to suffer from which of the following syndromes? a) Rubinstein-Taybi syndrome b) Cri-du-chat syndrome c) Smith-Lemli-Opitz syndrome d) Cornelia de Lange syndrome Q.85 86. Which of the following statement about treatment of lithium poisoning is false? a) No specific antidote is available. b) Osmotic diuretics are contraindicated. c) Sodium bicarbonate promotes its renal excretion. d) Heamodialysis is required if serum levels are more than 4Meq/L. Q.86 87. Which of the following statement about mechanism of action of antidepressants is false? a) Inhibition of dopamine reuptake is seen with bupropion. b) Antidepressants cause indirect fascilitation of dopaminergic transmission in brain. c) Inhibition of dopamine reuptake is primary mechanism of action of antidepressants. d) Amoxapine blocks dopamine receptors. Q.87 88. Which of the following is a kappa (?) receptor antagonist? a) Nalorphine b) Pentozocine c) Butorphenol d) Buprenorphine. Q.88 89. Which of the following is not a side effect associated with pentazocine? a) Bradycardia. b) Dysphoria c) Billiary spasm d) Light headedness. Q.89 90. Which of the following drug is used by night time call centre workers? a) Amphetamine b) Methylphenidate c) Modafinil. d) Doxapram Q.90 91. Which of the following is non-equillibrium type of enzyme inhibitor? a) Physiostigmine. b) Captopril. c) Methotrexate d) Carbidopa Q.91 92. The possible side effect seen with combination of MAO inhibitors with centrally acting anticholinergic are –

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www.prepgmedicos.com 2008 a) Sedation. b) Hallucination. c) Dysphoria d) Delirium Q.92 93. Non-selective beta blocker is used in – a) Angina pectoris b) Bronchial asthma c) Raynauds disease. d) Thyrotoxicosis. Q.93 94. Which of the following is not a cycloplegic drug? a) Tropicamide b) Cyclopentolate c) Homatropine d) Pilocarpine. Q.94 95. Which of the following is a pyrimidine antagonist? a) 5-FU b) Cyclophosphamide c) Bleomycin d) Busulfan Q.95 96. Hypoprothrombinemia is seen due to excessive doses of – a) Aspirin b) Morphine c) Paracetamol d) Codeine Q.96 97. Which of the following statement is false? a) Inhaled glucocorticoids have no role in status asthmaticus. b) Inhaled steroids have high absorption. c) Useful in high dose in severe COPD with frequent exacerbation. d) They are safe in pregnancy. Q.97 98. d- penicillamine is not used in – a) Rheumatoid arthritis. b) Heamochromatosis. c) Wilson’s disease. d) Mercury poisoning. Q.98 99. Pralidoxime is given for the treatment of organophosphorous poisoning because – a) It is muscarinic receptor antagonist. b) Enhances catabolism of acetylcholine c) Reactivates cholinesterase. d) Inhibits release of acetylcholine from nerve terminal. Q.99 100. Which of the following beta blocker has intrinsic sympathomimetic property & membrane stabilizing property? a) Pindolol b) Propranolol. c) Atenolol d) Metaprolol Q.100 101. Which of the following statement about timolol is false? a) It reduces intraocular tension by reducing formation of aqueous humor. b) It belongs to I generation of beta blockers. c) It should be used cautiously in bronchial asthma patients. d) It is cardioselective beta blocker. Q.101 102. Imipramine should not be used in – a) Diabetes. b) Hypertension. c) Glaucoma. d) Peptic ulcer.

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www.prepgmedicos.com 2008 Q.102 a) b) c) d) Q.103 a) b) c) d) Q.104 a) b) c) d) Q.105 a) b) c) d) Q.106 a) b) c) d) Q.107 a) b) c) d) Q.108 a) b) c) d) Q.109 a) b) c) d) Q.110 a) b) c) d) Q.111 a) b) c) d) Q.112 a) b) c) d)

103. Which of the following is not a mitotic inhibitor? Griseofulvin. Vinca alkaloids. Colchicine. Methotrexate. 104. Which of the following is a side effect of cyclosporine? hirsuitism Hypotension Stomatitis Increased weight. 105. Which of the following drug causes hypokalemia? Cyclosporine Amphotericin B ACE inhibitors Spironolactone 106. Which of the following drug is used for malignant pleural effusion? Radiogold Radioiodine Gentamycin None of above. 107. Which of the following statement about management of thyrotoxic crisis is correct? Iodides are to be given first. Reserpine can be given Steroids are contraindicated – severe hypertensions can occur. Digoxin is contraindicated. 108. Which of the following should be avoided in diabetic patients? Thiazides Lithium Propranolol All of above. 109. Which of the following drug is not used in treatment of hyperprolactinemia? Bromocriptine Pergolide Domeperidone Quinagolide 110. Which of the following is not a side effect associated with succinylcholine? Apnea Hyperthermia Muscle soreness Hypokalemia. 111. Which of the following group of drugs are better suited for brain tumors? Cisplatin Bleomycin Nitrosureas Vincristine 112. Palifermin is used in – Cancer induced nausea & vomiting Cancer induced alopecia Cancer induced mucositis. Cancer induced diarrhea. 113. Attainment of 16 years of age in x-rays is diagnosed on : Elbow joint Pelvis Both None

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www.prepgmedicos.com 2008 Q.113 a) b) c) d) Q.114 a) b) c) d) Q.115 a) b) c) d) Q.116 a) b) c) d) Q.117 a) b) c) d) Q.118 a) b) c) d) Q.119 a) b) c) d) Q.120 a) b) c) d) Q.121 a) b) c) d) Q.122 a) b) c) d) Q.123 a) b) c) d)

114. Absolute proof of semen in a sample is At least one unbroken spermatozoon Sperm heads Postiive acid phosphatse test All of teh above 115. Wredins test is done to detect : Forceful sexual intercourse Live birth Age estimation None 116. Pupper’s rule is applied in : Intrauterine age Gunshots Forensic psyhciatry Entomology 117. Garrotting is executed by : Rope Rod Stick All of the above 118. Blood antigen only seen in mongoloids is : Fy (a – b) Dib Fy (a + b) Dia 119. In combined ABO and MNS evaluation, exclusion rate in disputed paternity is : 80% 100% 60% 75% 120. Brain fingerprinting is useful in : Establishing identity Criminal catching Autopsy procedure Detecting fat embolism 121. Automatism is seen with : Organophosphates Alcohol Abrus Nux vomica 122. Statutory rape is termed if female age is below : 15 years 15 years and not his wife 16 years 18 years 123. ‘Psychological autopsy’ is done in : Rape deaths Death is psychiatric patients Suicides Homicides 124. Diagnosis of air embolism should be made by first opening : Neck Head Thorax Abodmen

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www.prepgmedicos.com 2008 Q.124 125. Dysphagia in Ca esophagus occurs after occlussion of ________ % lumen circumference. a) 30% b) 40% c) 60% d) 90%. Q.125 126. 50 yrs old female with family history of HNPCC with 2 brothers affected with colorectal cancer at age of 35 & 45.all the following statements are true regarding this except. a) Screening for colorectal cancer for her starts at the age of 25yrs. b) Screening will be via combination of fobt & flexible sigmoidoscopy. c) On screening she is likely to have polyps before the development of cancer. d) Screening for endometrial cancer starts at usual age as for other cases of HNPCC. Q.126 127. All the following are indications of surgery in Crohn's disease except. a) Massive bleeding b) Growth retardation c) Malabsorption d) Intractable disease. Q.127 128. All the following signs can be elicited on physical examination of acute appendicitis except. a) Rovsing's sign b) Ten Horn sign c) Aaron sign d) Bassler sign. Q.128 129. All the following neuroendocrine tumor of pancreas can be well localized by octreoscan except. a) Glucaganoma b) Insulinoma c) Somatostatinoma d) Gastrinoma. Q.129 130. Most common symptom of Ca head of pancreas is a) Pain b) Weight loss c) Obstructive jaundice d) Pruritis. Q.130 131. All the following are contraindications to laproscopic cholecystectomy except. a) Carcinoma GB b) Mucocele of GB c) Patient's desire for open procedure d) Patient of COPD Q.131 132. 55 yrs old male presented with carcinoma esophagus, all the following investigations can help decide the resectability of tumor except. a) CT scan b) EUS c) PET scan d) video assisted thoracoscopy. Q.132 133. All the following are indications of surgery in chronic pancreatitis except. a) Pancreatic ascites b) Biliary obstruction. c) Intractable pain. d) Malabsorption & steatorrhea. Q.133 134. All false about liver hemangioma except. a) More common in females b) Malignant potential c) Intra abdominal hemorrhage common. d) MRI has higher diagnostic accuracy than CT Q.134 135. All true about gastric resection & vagotomy except.

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www.prepgmedicos.com 2008 a) Dumping is more common after billroth 1 than billroth 2.. b) Fluid emptying is hastened after highly selective vagotomy c) Distal gastrectomy is better in terms of morbidity & mortality that proximal gastrectomy. d) Anemia is the most common metabolic complication after gastrectomy. Q.135 136. All the following are treatment options for barrett's esophagus except. a) Anti-reflux surgery b) Medical management c) Endoscopic ablation d) Trans hiatal esophagectomy. Q.136 137. Emergency Cholecystectomy is ______ type of surgery. a) Clean b) Clean contaminated c) Contaminated d) Dirty. Q.137 138. 25 yrs old male underwent emergency appendicectomy,following after 5 days he developed high grade fever, USG revealed sub-phrenic collection, best treatment option for this patient is. a) Hike up the antibiotics b) Re-exploration with peritoneal wash. c) USG guided pigtail catheter drainage. d) Reasssuring the patient that it will be resolved by itself. Q.138 139. Brown atrophy is due to accumulation of a) Melanin b) Hemosiderin c) Calcium d) Lipofuschin Q.139 140. Free radicals are initiated by a) Transition metals b) Nitric oxide c) Reduction oxidation process d) All Q.140 141. Myelin figures are composed of a) Calcium b) Iron c) Neurons d) Phospholipids Q.141 142. Smeared pattern of DNA fragmentation is indicative of a) Necrosis b) Phagocytosis c) Apoptosis d) All Q.142 143. Which of the following is used to identify apoptosis a) TTC b) Annexin c) Both d) None Q.143 144. Which mechanism of increased vascular permeability is mediated by VEGF a) Direct injury b) Increased transcytosis c) Leucocyte dependant injury d) New blood vessal formation Q.144 145. Which of the following is due to defect in phagolysosome function a) Chediak higashi syndrome b) LAD c) Chronic granulomatous diseases d) Bone marrow suppression

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www.prepgmedicos.com 2008 Q.145 a) b) c) d) Q.146 a) b) c) d) Q.147 a) b) c) d) Q.148 a) b) c) d) Q.149 a) b) c) d) Q.150 a) b) c) d) Q.151 a) b) c) d) Q.152 a) b) c) d) Q.153 a) b) c) d) Q.154 a) b) c) d) Q.155 a) b) c) d)

146. All are true for autoimmune hepatitis except Absence of viral serologic markers Female preponderance Positive ANA Elevated IgG and gamma globulins 147. Onion skin fibrosis is seen in PBC PSC Autoimmune hepatitis Viral hepatitis 148. MC site of development of carcinoma of pancreas is Body Tail Head Entire gland 149. Michaelis Gutman bodies are seen in Exostrophy Malakoplakia Diverticula Retroperitoneal fibrosis 150. Hemorrhagic cystitis is due to Radiation injury Antitumor chemotheraphy Adenovirus infection All 151. Lymphocyitc mastopathy is associated with Tuberculosis Diabetes Fibroadenoma None 152. Oligoclonal bands are seen in Stroke Multiple sclerosis Alzeihmers Parkinsons 153. All are true of secretory otitis media except : Conductive hearing loss Restricted mobility of tympanic membrane Normal bone curve on audiometry Normal X-ray mastoids 154. Fungal otitis externa is usually caused by : Candida Aspergillus Heart Murormycosis 155. In a normal person all the following structures are seen on anterior rhinoscopy except : Inferior tubinate Middle turbinate Superior turbinate Floor of nose 156. Headache in occiput or vertex is caused by infection of which of the following sinuses : Frontal Manillary Ethmoid Sphenoid

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www.prepgmedicos.com 2008 Q.156 157. A patient suffering from CSOM presents with irregular fever, oedema over mastoid & tenderness along the jugular vein likely diagnosis is : a) Mastoiditis b) Lateral sinus thrombosis c) Petrositis d) Furnucle of external meatus Q.157 158. Clinical features seen in meniere’s include all except : a) Positive rinnes test b) Positive fistula test c) Intolernace to loud sounds d) Positive recruitment Q.158 159. Schwartze sign is seen in a) Acute mastoiditis b) Otosclerosis c) Acoustic neuroma d) Menieres Q.159 160. A 4 year old child presents with severe ear ache & fever following URTI. On examination TM is congested & bulging. The management of choice will be : a) Antibiotics b) Wait and watch c) Antibiotics with myringotomy d) Myringotomy with grommet Q.160 161. The quality of voice in a patient with gross adenoid hypertrophy is : a) Rhinolalia clausa b) Rhinolalia aperta c) Mutational falsetto d) Hoarse Q.161 162. Maximum stridor is seen in a) U/L incomplete paralysis b) B/L incomplete paralysis c) U/L complete paralysis d) B/L complete paralysis Q.162 163. “Epigenetics” refers to a) Analysis of proteins being produced in cells b) Gene expression profiling using gene chips c) Chemical Changes altering the gene expression without changing the DNA code d) Study of all the genes in a particular species Q.163 164. The role of mdm-2 in a normal cell is a) Inhibits phosphorylation of Rb gene b) Inactivation of GTP-ras c) Activation of GDP-ras d) Binds p53 and translocates it out of the nucleus for proteolytic degradation Q.164 165. Retinoblastoma tumor suppressor gene is located on a) Chromosome 13 short arm b) Chromosome 13 long arm c) Chromosome 17 short arm d) Chromosome 13 long arm Q.165 166. Regarding chemical carcinogenesis, one of the following statements is false a) Initiation alone is not sufficient for tumor formation b) Promoter chemicals have a memory c) Initiation causes permanent DNA damage d) Promoters are non tumorigenic by themselves and can induce tumors only in initiated cells Q.166 167. “Chromosome painting” is a technique of a) Karyotype b) Real time PCR

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www.prepgmedicos.com 2008 c) FISH d) RFLP Q.167 168. All the following cytogenetic changes in MDS (Myelodysplastic syndromes) are associated with good prognosis except a) Deletion of Y chromosome (-Y) b) Deletion of 5q c) Deletion of 20q d) Monosomy 7 Q.168 169. An automated counter generated total and differential white cell count (TLC and DLC) may be inaccurate because of a) The presence of nucleated RBCs b) The presence of macrocytes c) An increased reticulocyte count d) The presence of microcytic red cells Q.169 170. Osmotic fragility test will show increased fragility in all except a) Hereditary spherocytosis b) Autoimmune hemolytic anemia c) Southeast Asian Ovalocytosis d) Clostridium infection Q.170 171. Ristocetin induced platelet aggregation (RIPA) test is defective in a) Glanzman’s thrombasthenia b) Bernard Soulier syndrome c) Both d) None Q.171 172. Transfusion related acute lung injury (TRALI) is caused by a) Recipient mounting immune response against donor HLA antigen b) Major ABO, Rh mismatch c) Preformed antibodies in donor plasma against recipient neutrophil HLA d) Platelet alloimmunisation leading to pulmonary vasculature obstruction Q.172 173. A 24 year old male presented with abrupt onset of weakness, fever and bleeding manifestations. Peripheral blood counts were Hb 9 g/dl, TLC-3.5 x 109/ L , Platelets-20 x 109/ L with presence of 80% atypical cells. Flow cytometric immunophenotypic analysis of atypical cells is positive for CD13, CD33, CD117, Anti-MPO however negative for CD-10, CD19, CD20, CD34, CD3, CD5, CD7 and HLA-DR. The most likely diagnosis will be a) Undifferentiated leukemia b) Promyelocytic leukemia c) Acute lymphoblastic leukemia d) Biphenotypic acute leukemia Q.173 174. Criteria for remission in acute leukemia includes all except a) Blasts< 5% b) ANC>1000/ul c) Platelets> 1 lakh d) Hb>10 gm% Q.174 175. Sudan Black can be positive in all except a) Ewing’s sarcoma b) ALL-L3 c) Both a, b d) AML-M3 Q.175 176. A 23-year-old man is brought to the Emergency Department after collapsing during basketball practice. On admission he is lethargic and appears confused. His coach reports that it was hot in the gym and he was drinking a lot of water during practice. An increase in which of the following is the most likely cause of his symptoms? a) Intracellular tonicity b) Extracellular tonicity c) Intracellular volume

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www.prepgmedicos.com 2008 d) Extracellular volume Q.176 177. A 40-year-old man with polycystic kidney disease developed nausea, vomiting, and diarrhea. He stopped eating but drank large quantities of water. Over a period of 4 days, he developed progressive lethargy and had a grand mal seizure. Laboratory data included:Na = 108 mEq/L.Cl = 72 mEq/L;BUN = 142 mg/dL;Creatinine = 12 mg/dL.False statement is a) Hyponatremia is cause of his neurological symptoms b) Replacement of sodium rich fluid loss by sodium deficient water is the cause c) Water restriction is the only treatment required d) Patient has resultant in brain swelling. Q.177 178. After an automobile accident, a 30-year-old woman was admitted to the emergency department of a small suburban hospital. She had sustained facial fractures and a possible head injury (evidenced by temporary loss of consciousness at the accident scene). During the first 3 days of her hospitalization, she received an average of 4 liters of fluid daily, despite persistent low urinary output. She became increasingly lethargic and complained of headache and nausea. On the fourth day she had a grand mal seizure and was noted to have papilledema and Babinski's sign. At that time, her serum sodium level was 110 mEq/L. she died within a week. false statements is a) On autopsy, her brain Is expected to be swollen b) she is expected to weighed more than when admitted (despite almost no caloric intake during her hospitalization). c) Inadequate fluid therapy is the cause of her death d) Peripheral edema is unlikely to be present. Q.178 179. A 36 year women presents with fever, chills and flank pain. On exam BP 80/60, p-145, T39.8. She has right flank tenderness and an enlarged spleen. Lab- Na 136, K-7.4, Cl-102, Cr- 1.2, WBC344,000, HCT-22, Plt-34,000UA- Packed field WBC’s and GNR on gram stain. What is the most appropriate initial order? a) ECG b) Calcium gluconate c) IV glucose and insulin d) Kayexalate Q.179 180. A 40-year-old man developed a high-output intestinal fistula after treatment for an intestinal obstruction. For 2 weeks he received only isotonic saline (0.9% NaCl) and 5% dextrose in water with added KCl. He developed choreiform movements of the arms and muscle twitching. In addition, he was noted to be confused. Laboratory findings included:Serum Na = 140 mEq/L;K = 3.3 mEq/L. correct statement a) Fluid imbalance is likely b) Hypomagnesemia is not expected c) Hypokalemia is because of inadequate KCl. d) Hypermagnesemia is not likely. Q.180 181. A 62-year old woman comes into your office with a history of mental confusion. Five years ago she had a right lumpectomy and axillary dissection for breast cancer and was found to have positive lymph nodes. She received postoperative radiation but declined chemotherapy or anti-estrogen therapy. She did not return for postoperative follow-up after the first year. Approximately six months ago she noticed some low back pain which was minor and responded to mild analgesics. Over the past month she has had increasing mental confusion and headaches, polyuria and polydipsia, weakness and anorexia, nausea and vomiting. The EKG (emergency) shows a shortened QT interval and widening of the T wave. On physical examination, her breast exam and axilla are both benign. Clinic exam is unremarkable. Her reflexes on neurologic exam appear somewhat sluggish.What is the most likely electrolyte abnormality in this patient? a) Hypocalcemia b) Hypercalcemia c) Hypomagnesemia d) Hypokalemia Q.181 182. A 6-month-old boy presents with an inguinal hernia, first noticed 2 weeks after birth. What is the best treatment choice? a) Observation

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www.prepgmedicos.com 2008 b) Laparotomy c) Surgical repair when the child is fully grown d) Surgical repair of the affected side Q.182 183. A 2-year-old toddler weighing 11 kg is admitted for observation of abdominal pain. There has been vomiting or diarrhea and the child had been eating normally 7 hours previously. Electrolytes are as follows: Na, 135 mEq/L; K, 3.9 mEq/L; HCO3, 19 mEq/L; CL 110 mEq/L. The most appropriate IV fluid orders would be a) D5 1/4 NS @ 22 mL/hour b) D5 1/2 NS @ 22 mL/hour c) D5 NS @ 22 mL/hour d) D5 1/4 NS @ 44 mL/hour Q.183 184. A 3-year-old, recently adopted boy is referred after his initial pediatrician’s assessment for an undescended testicle. On exam his left testicle is normal and in place. He has no evidence of hernias. However, his right hemiscrotum is empty and there is a testicule sized mass palpable at the pubic tubercle. The most appropriate next step is a) Observation until age 5 b) Right orchiopexy c) Right orchiopexy and right inguinal hernia repair d) Right orchiopexy and right testicle biopsy Q.184 185. A 4-year-old girl is referred to your hospital by the pediatrician for the finding of an abdominal mass on her 4-year-old well child visit. She had been consistently in the seventy-fifth percentile for height and weight and although she is still in the seventy-fifth percentile for height she is only in the fortieth percentile for weight. She has been eating normally.. On examination you palpate an 8-cm right midabdominal mass. It is firm, nontender, and poorly mobile. The most likely diagnosis is a) Constipation with a distended cecum b) Wilms’ tumor c) Neuroblastoma d) Lymphoma Q.185 186. Shortly after an uncomplicated birth a full-term baby boy develops respiratory distress and excessively spits after an unsuccessful feeding trial, requiring endotracheal intubation. A chest x-ray is performed and shows signs of aspiration in the right basilar and apical lung fields. There is air in the stomach, which appears hyperinflated. A trial of NGT placement is unsuccessful. What diagnosis is suspected? a) Duodenal atresia b) Hypertrophic pyloric stenosis c) Tracheoesophageal fistula without esophageal atresia d) Distal tracheoesophageal fistula with proximal esophageal atresia Q.186 187. In fluid replacement following a 20% BSA burn, the fluid requirement for the initial 24-hour period is dependent on which of the following? a) Patient’s weight b) Serum Na c) CO level d) Acid base status Q.187 188. A premature infant is noted at birth to have mild abdominal distention. There are no abnormal pulmonary findings on auscultation. A plain x-ray of the abdomen shows intramural air, which is attributed to which of the following? a) Choledochojejunal fistula b) Perforation of bowel caused by colon cancer c) Perforated gastric ulcer d) Gangrene of the small bowel Q.188 189. All of the following are seen in catatonia except a) Mutism b) Stupor c) Cataplexy

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www.prepgmedicos.com 2008 d) Catalepsy Q.189 190. All of the following are panicogens except a) Flumezenil b) sodium lactate c) Youhimbine d) Inositol Q.190 191. All are true about O.C.D. except a) Majority of patients have obsessive compulsive personality traits b) treatment of choice is behavior therapy c) It is associated with Group A hemolytic streptococcal infection d) Psychodynamicaly characterized by regression to anal sadistic stage of development Q.191 192. A 40 years old female patient had an accident in which there was threat to her life but did not had any kind of injury . Since then she is unable to recall her memories for events in last few days, she is also unable to recall about accident. She can recall about events after the accident .the most likely diagnosis is a) Transient global amnesia b) Dementia c) Dissociative amnesia d) P.T.S.D Q.192 193. All of the following are melancholic feature of major depressive disorder except a) Early morning awakening b) Significant anorexia or weight loss c) Depression worse in morning d) Hypersomnia Q.193 194. Suman a 19 years old female came for evaluation with complaints of feeling sad most of the time, inability to complete her daily household work due to weakness, repeated thoughts of unworthiness and wish to die. she wakes up early in morning and does not feel fresh . she had all these problems after her love break off about one month back. Suman is most likely suffering from. a) Major depressive disorder b) Adjustment disorder c) Minor depressive disorder d) Acute stress disorder Q.194 195. All of the following about mania are true except a) For diagnosis of manic episode the duration of illness should be at least 2 weeks b) It is associated with decreased need of sleep c) Delusion of grandeur is present d) Psychodynamic it is considered to be a defense against underlying depression Q.195 196. A 40 years old widow shanta is overweight, remains in bed for most of time, complains of heaviness of limbs and inability to move them. She had left doing activity which she used to enjoy before .there are frequent crying spells also. shanta is most likely suffering from a) Major depressive disorder with atypical features b) Major depressive disorder with melancholic features c) Major depressive disorder with catatonic features d) Major depressive disorder with psychotic features Q.196 197. Mr. Ramesh a store keeper was fired from work because of decreased sales in his store. Ramesh is very punctual, time bound, hard working person . On further enquiry it was found that he would insist his associates to arrange the goods in exquisitely proper manner. He would micromanage every aspect of store. He repeatedly checked the orderliness of work because of which he was not able to complete the same .ramesh is most likely suffering from a) Anankastic personality disorder b) O.C.D. c) No psychopathology d) Schizophrenia Q.197 198. Dialectical behavior therapy is used in treatment of a) Border personality disorder

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www.prepgmedicos.com 2008 b) Schizophrenia c) Phobia d) Depression Q.198 199. A drug peddler is arrested for trafficking ganja. He was carrying 1 kg of ganja .he had been accused of similar crime before also .the punishment awarded to him will be a) Rigorous imprisonment for 10 yrs and fine 1 lakh rupees b) Rigorous imprisonment for 15 yrs and 1.5 lakh rupees c) Rigorous imprisonment for 5yrs and 0.5 lakh rupees d) Rigorous imprisonment for 10 yrs and 5 lakh rupees Q.199 200. A 30 yrs old Mrs. shalu was brought for evaluation with complaints of excessive preoccupation with memories of her husband who died in car accident 3 month back .she believes that her husband is not dead. she had kept her husbands belongings as it is. She would hear fleeting and transient voices of her husband. Shalu is most likely suffering from a) Major depressive disorder with psychotic features b) Schizophrenia c) Pathological grief d) Acute stress disorder Q.200 201. A 12 yrs boy sachin was under treatment for inability to sit at one place, intruding and disturbing others, inability to sustain attention, difficulty waiting for turn, since last 2 years. His above mentioned symptoms are under control, but since last 6 months he developed repeated movements such as shoulder shrugging, ,eye lid blinking .sachin was most likely treated with a) Methylphenidate b) Clonidine c) Fluoxitine d) Sertraline Q.201 202. The term ‘poppers’ refers to common name of which substance of abuse a) L.S.D. b) Airplane glue c) Nitrite inhalant d) Cannabis Q.202 203. A 27 year old male patient has persistently complaining of pain in abdomen back, legs, and hands for 5 yrs .he also suffers from bloating of abdomen and episodes of diarrohea .he has history of early ejaculation and has suffered from several episodes of vertigo and giddiness the most likely diagnosis is a) Somatization disorder b) Conversion disorder c) Hypochondriasis d) Factitious disease Q.203 204. Acute hemorrhagic conjunctivitis (AHC) is a contagious ocular infection characterized by pain, swelling of the eyelids, and subconjunctival hemorrhages. AHC has been reported to be caused by which of the following viruses? a) Coronavirus b) Enterovirus c) Reovirus d) Respiratory synctial virus Q.204 205. This hepatitis virus is a calcivirus. The reservoir is in pigs, and humans acquire it via the fecal-oral route. Which of the following is the virus? a) Hepatitis A b) Hepatitis B c) Hepatitis C d) Hepatitis D Q.205 206. This is a paramyxovirus and causes the syndrome known as croup. Which of the following is the virus? a) Adenovirus b) Influenza virus

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www.prepgmedicos.com 2008 c) Measles virus d) Parainfluenza virus Q.206 207. Methicillin-resistant S. aureus (MRSA) was isolated from seven patients in a 14-bed intensive care unit. All patients were isolated and the unit closed to any more admissions. Which one of the following reasons best explains these rigorous methods to control MRSA? a) MRSA causes toxic shock syndrome b) MRSA is inherently more virulent than other staphylococci c) MRSA is resistant to penicillin d) MRSA spreads more rapidly from patient to patient than antibiotic-susceptible staphylococci do Q.207 208. After extraction of a wisdom tooth, an 18-year-old male student was diagnosed as having subacute bacterial endocarditis. He has a congential heart disease that has been under control. Which of the following is the most likely organism causing his infection? a) S. aureus b) S. epidermidis c) S. pneumoniae d) Streptococcus viridians Q.208 209. In order to recognize abnormal bacteria, it is necessary to know which bacteria are predominant normal flora of certain body sites. Which of the following is the predominant organism on skin commonly seen as a blood culture contaminant? a) a-hemolytic streptococci b) B. fragilis c) E. coli d) Lactobacillus Q.209 210. An 18-year-old male patent appeared at the emergency room with a three-day history of fever, dry cough, difficulty breathing, and muscle aches and pains. His chest-x-ray showed a diffuse left upper lobe infiltrate. The following five questions focus on the etiology of “atypical” or community-acquired pneumonia. M. pneumoniae pneumonia (walking pneumonia) may be rapidly identified by which of the following procedures? a) Cold agglutinin test b) Culture of respiratory secretions in HeLa cells after centrifugation of the inoculated tubes c) Culture of respiratory secretions on monkey kidney cells d) Detection of specific antigen in urine Q.210 211. Legionnaires’ disease is most rapidly diagnosed by which one of the following procedures? a) Cold agglutinin test b) Culture of respiratory secretions on a charcoal-based nutrient agar c) Detection of antigen in respiratory secretions d) Detection of specific antigen in urine Q.211 212. Lymphogranuloma venereum (LGC) is a venereal disease caused by serotype L1, L2, or L3 of Chlamydia trachomatis. The differential diagnosis should include which of the following? a) Babesiosis b) Chancroid c) Mononucleosis d) Psittacosis Q.212 213. C. tracginatuis is a well-known cause of veneral disease. This organism is also implicated in which of the following? a) Classic trachoma infection b) Middle-ear infection in young children c) Perinatal retinitis d) Sexually transmitted cardiac disease in adults Q.213 214. Chlamydiae are small, gram negative rods once thought to be viruses. Which of the following best characterizes chlamydiae as distinct from viruses? a) Cannot visualize with light microscope b) Independent synthesis of proteins c) Intracellular reproduction d) Susceptibility to antimicrobial agents

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www.prepgmedicos.com 2008 Q.214 215. Which one of the following organisms is associated with nongonococcal urethritis in humans? a) M. fementans b) M. hominis c) M. pneumoniae d) M. orale Q.215 216. A patient with AIDS has a persistent cough and has shown progressive behavioral changes in the past few weeks after eating an undercooked hamburger. A cerebrospinal fluid (CSF) sample is collected and an encapsulated, yeast like organism is observed. Based only on these observations, what is the most likely organism? a) Candida b) Cryptococcus c) Cryptosporidum d) Pneumocytis Q.216 217. Tinea versicolor is caused by which of the following? a) E. floccosum b) E. werneckii c) M. furfur d) M canis Q.217 218. A fur trapper complains of sore muscles, has swollen eyes, and reports eating bear meat on a regular basis. He is at risk for which one of the following? a) Giardiasis b) Schistosomiasis c) Toxoplasmosis d) Trichinosis Q.218 219. A newspaper correspondent has diarrhea for two weeks following a trip to St. Petersburg (Leningrad). You might expect her to have which one of the following? a) Giardiasis b) Schistosomiasis c) Toxoplasmosis d) Trichinosis Q.219 220. A parasite resembling malaria that infects both animals and humans and is carried by the same tick that transmits B. burgdorferi (the bacterium that causes Lyme disease) would most likely be observed in which of the following? a) Biopsied muscle b) Blood c) Duodenal contents d) Sputum Q.220 221. Complications of lateral condylar fracture humerus in children include all except: a) Non union b) Avascular necrosis c) Tardy ulnar palsy d) Cubitus varus Q.221 222. Kocher’s method of reduction is used to reduce which of the following: a) Fracture femur neck b) Hip dislocation c) Shoulder dislocation d) Ankle dislocation Q.222 223. In cervical spondylosis, the most uncommon and late feature is: a) Pain in the neck and shoulder b) Restriction of neck movement c) Compression of vertebral artery by osteophytes d) Canal narrowing Q.223 224. In Colle’s fracture all are true except: a) Involves lower end of radius

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www.prepgmedicos.com 2008 b) Anterior displacement of lower fragment c) Common to elderly d) Unlar styloid is usually avulsed Q.224 225. The best determinant of anterior cruciate instability is all except: a) Lachman test b) Anterior drawer test c) Pivot shift test d) None of the above Q.225 226. In wrist arthrodesis the optimal position of fusion is: a) Neutral b) 10 – 20° palmar flexion c) 10 - 20° dorsiflexion d) 20° dorsiflexion and 5° radial deviation Q.226 227. The differential diagnosis of nonossifying fibroma in X-ray include all except: a) Osteoid osteoma b) Giant cell tumor c) Eosinophilic granuloma d) Chondromixoid fibroma Q.227 228. All are true of adamantinoma except: a) Pain early in the course of disease b) 50% occur in 10 – 20 age group c) Malignant from onset d) Metastasizes several years after onset Q.228 229. Which of the following statements concerning the thalamus is incorrect? a) The anterior nucleus projects fibers to the prefrontal cortex. b) Axons from many of its nuclei project to the cerebral cortex via the internal capsule c) The pulvinar receives sensory information from the geniculate nuclei d) The globus pallidus projects fibers to the ventral anterior nucleus Q.229 230. The superior mesenteric artery: a) Typically arises from the aorta just inferior to the origin of the gonadal (testicular or ovarian) arteries b) Supplies the entire duodenum c) Passes between the pancreas and the second part of the duodenum d) Supplies the jejunum, appendix, and ascending and transverse portions of the colon Q.230 231. The celiac lymph nodes receive lymphatic drainage from all of the following except the: a) Jejunum b) Pancreas c) Spleen d) Duodenum Q.231 232. Injury of the right mandibular division of the trigeminal nerve as it passes through the foramen ovale could logically produce: a) Loss of taste on the right anterior two thirds of the tongue b) Deviation of the soft palate to the left c) Deviation of the chin to the left when the mouth is opened against resistance d) Loss of general sensation on the right posterior third of the tongue Q.232 233. All of the following structures exit from the pelvis by passing through the greater sciatic foramen except the: a) Piriformis muscle b) Obturator internus muscle c) Posterior femoral cutaneous nerve d) Inferior gluteal artery Q.233 234. Afferent lymphatic vessels of lymph nodes open into the: a) Subcapsular sinus b) Trabecular sinuses c) Medullary sinus

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www.prepgmedicos.com 2008 d) None of the above Q.234 235. During long term fasting, the major control of the rate of gluconeogenesis is the a) Cyclic adenosine monophosphate level in the liver b) Adenosine triphosphate level in the liver c) Availability of free fatty acids to the liver d) Availability of alanine in the blood Q.235 236. The enzyme-catalyzed conversion of serine to glycine requires: a) Niacin and vitamin B12 b) Thiamine and vitamin B12 c) Thiamine and folic acid d) Niacin and folic acid Q.236 237. Glycogenolysis in muscle does not contribute directly to blood glucose concentration because muscle lacks the enxyme a) Phosphorylase b) Phosphoglucomutase c) Glucose – 6- phosphatase d) Glucokinase Q.237 238. Under conditions of repeated episodes of hyperglycemia, hemoglobin A1 (Hb A1) may be modified chemically. What is the effect of this chemical modification? a) Hemoglobin loses its ability to show co-operativity in the binding of oxygen b) Hb A1 becomes less soluble, forming long rod-like structures that deform the erythrocyte c) A stable glucose derivative of Hb A1 appears in the blood and may amount to more than 10% of the total hemoglobin d) The synthesis of Hb A1 is depressed in favor of the synthesis of hemoglobin F Q.238 239. Which one of the following restriction enzyme sequences will generate the longest 5` sticky end upon cleavage by the appropriate restriction enzyme (the cleavage site is indicated with a slash)? a) ATGCA/T b) TGG/CCA c) C/CCGGG d) CCTGCA/GG Q.239 240. Where is the effector domain of an antibody located? a) Within the heavy chains b) Within the carboxy terminal domains of the heavy and light chains c) Within the light chains d) Within the variable region of the heavy and light chains Q.240 241. Match the following action with the correct hormone. It binds to a transmembrane tyrosine kinase and activates it a) Atrial natriuretic peptide b) Thyroxine c) Insulin d) Inositol 1,4,5-triphosphate (IP3) Q.241 242. Match the disease with the protein most closely linked to the disease. Diphtheria a) Gs b) ErbB c) Gi d) Adenosine deaminase Q.242 243. Match the following functions with the correct metabolic intermediate. May be converted to precursors for glycogen synthesis or nucleotide synthesis a) Fumarate b) Glucose – 6- phosphate c) Pyruvate d) Acetyl coenzyme A Q.243 244. Match each symptom of a vitamin deficiency with the appropriate vitamin. High serum and urine levels of lactate, b-methylcrotonate, b-hydroxyisovalerate, and b-hydroxypropionate

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www.prepgmedicos.com 2008 a) Cobalamin (vitamin B12) b) Biotin c) Thiamine (Vitamin B1) d) Ascorbic acid (Vitamin C) Q.244 245. Match the correct physiologic function with the high-energy compound listed below. Three moles are generated during one turn of the citric acid cycle a) Reduced nicotinamide adenine dinucleotide (NADH) b) Reduced nicotinamide adenine dinucleotide phosphate (NADPH) c) Reduced flavin adenine dinucleotide (FADH2) d) Uridine triphosphate (UTP) Q.245 246. Action potential of all have plateau except: a) Atrial myocytes b) Bundle of Hb c) Purkinje fibers d) AV node Q.246 247. Following is true about QS2 a) QS2 = PEP + LVET b) QS2 = LVET - PEP c) QS2 = PEP - LVET d) QS2 = 2 (PEP + LVET) Q.247 248. Best gas mixture used in very deep dive a) Nitrogen – O2 mixture b) Helium – O2 mixture c) Nitrogen – O2 – Co2 mixture d) Helium – O2 – Co2 mixture Q.248 249. An un-acclimatized person goes to high attitude and stays there. All are true except: a) Erythropoietin level increases up to 4 days and then start falling b) Alveolar ventilation increases gradually up to 4 days and then start falling c) Arterial Po2 decreases immediately then increases up to 4 days and keeps on increasing after that d) Arterial P co2 decreases up to to 4 days and then start rising Q.249 250. Increase in BP will produce all of the following except: a) filtered load of Na+ b) ¯ Reabsorption rate of Na+ c) Excretion rate of Na+ d) ¯ salt appetite Q.250 251. All are true about PAH except: a) Freely filtered b) Concentration in renal vein is zero c) Clearance is 625 ml/min d) Secreted in tubules Q.251 252. All are true except: a) Endolymph is electrically positive with respect to perilymph b) Fluid in semicircular canal is perilymph c) Membranous labrynth contains endolymph d) Endolymph has more K+ conc. Q.252 253. Creatine clearance is a) 40 ml/min b) 110 ml/min c) 125 ml/min d) 140 ml/min Q.253 254. To estimate cardiac output by dye dilution method, dye is measured in: a) Peripheral artery b) Aorta c) Right atrium

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www.prepgmedicos.com 2008 d) Any venous sample Q.254 255. Subconjunctival Haemorrhage occurs in all the following conditions except a) Passive venous congestion b) Pertussis c) Trauma d) High IOP Q.255 256. Neuroparalytic Keratopathy is caused by paralysis of a) Facial Nerve b) Trigeminal Nerve c) Optic Nerve d) Occulomotor Nerve Q.256 257. Causes of anterior subcapsular cataract are all of following except a) Wilson’s disease b) Miotic therapy c) Complicated cataract d) Glaucomaflecken Q.257 258. Pauciarticular JRA is characterized by all the following except a) Uveitis b) Scleritis c) Cataract d) Keratopathy Q.258 259. Difference between Rods and cones include all except a) Rods are more than cones b) Rods are presents at the Fovea c) Stack of discs in outer segment of cones communicates with outside d) Rods are concerned with scotopic vision Q.259 260. Which of the following muscle is involved along with Superior rectus muscle in Double elevator palsy? a) Inferior rectus b) Inferior oblique c) LPS d) Superior oblique Q.260 261. Which instrument is based on principle of first Purkinje image a) Retinoscope b) Slit lamp c) Cross cylinder d) Keratometer Q.261 262. Colored Haloes are seen in following except a) Cortical cataract b) ACG c) Corneal edema d) Corneal opacity Q.262 263. Which type of exophthalmometer is useful especially in children a) Lueddes b) Hertels c) Mutch d) Gomez Q.263 264. All are complications of chronic staphycoccal Blepharoconjunctivitis except a) Stye b) Marginal keratitis c) Follicular conjunctivitis d) Preseptal cellulites Q.264 265. Subsequent 24 hour Holter monitoring in the preceding patient confirms occasional single unifocal PVCs plus occasional premature atrial contractions (PACs). The most likely antiarrhythmic management in this case would be:

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www.prepgmedicos.com 2008 a) Anxiolytics b) Beta blocker therapy c) Digoxin d) Quinidine Q.265 266. A 60-year-old female cigarette smoker complains of fatigue and dyspnea. The most specific evidence for congestive heart failure in this patient would be: a) Ankle edema b) Wheezes c) S3 gallop d) Weight gain Q.266 267. For each electrolyte abnormality below, select the electrocardiographic finding with which it is most commonly associated. Hypocalcemia (Select one ECG finding) a) No known electrocardiographic abnormalities b) Prolonged QT interval c) Short QT interval d) Widened QRS complex Q.267 268. A 60-year old asymptomatic man was found to have a leukocytosis when a routine CBC was obtained. Physical exam shows no abnormalities. The spleen is of normal size. Lab data includes Hgb 9 g/dL (normal: 14 to 18) Leukocyte 40,000/mm3 (normal: count 4300 to 10800) Peripheral blood smear shows as differential that includes 97% small lymphocytes. The most likely diagnosis is a) Acute monocytic leukemia b) Chronic myelogenous leukemia c) Chronic lymphocyte leukemia d) Tuberculosis Q.268 269. A patient has been complaining of fatigue and night sweats associated with itching for two months. On physical exam there is diffuse nontender lymphadenopathy, including small supraclavicular, epitrochlear, and scalene nodes. A chest x-ray shows hilar lymphadenopathy. The next step in evaluation would be a) Excisional lymph node biopsy b) Monospot test c) Toxoplasmosis IgG d) Angiotensin converting enzyme Q.269 270. Match the clinical description with the most likely diagnosis. Low serum iron, elevated iron-binding capacity of serum a) Sideroblastic anemia b) Thalassemia c) Iron-deficiency anemia d) Anemia of renal disease Q.270 271. Match the clinical description with the most likely disease process. Rapid writhing movements in a 40-year-old associated with dementia. a) Parkinson’s disease b) Wilson’s disease c) Huntington’s chorea d) Dystonia Q.271 272. The initial choice of an antihypertensive agent may depend on concomitant factors. For each of the numbered conditions below, indicate the medication choice from the following list that would give the best additional benefit after blood pressure control. Congestive heart failure a) Alpha blocker b) Beta blocker c) Angiotensin converting enzyme inhibitor d) Angiotensin II receptor blocker Q.272 273. A 92-year-old woman with type 2 diabetes mellitus has developed cellulites and gangrene of her left foot. She requires a lifesaving amputation, But refused to give consent for the surgery. She has been ambulatory in her nursing home but states that she would be so dependent after surgery that

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www.prepgmedicos.com 2008 life would not be worth living for her. She has no living relatives; she enjoys walks and gardening. She is competent and of clear mind. You would a) Perform emergency surgery b) Consult a psychiatrist c) Request permission for surgery from a friend of the patient d) Follow patients wishes Q.273 274. Which of the following is characteristic of a trinucleotide repeat disorder? a) The number of repeats is the same in affected family members b) Clinical features appear later in subsequent generations c) Affected individuals are infertile d) Clinical features worsen in subsequent generations Q.274 275. A young woman is brought into A & E. On initial inspection she is lying on the bed. She does not respond when asked questions, but swears when her BP is being taken. When you apply pressure at her nail bed she opens her eyes, flexes her elbow and adducts her shoulder. Her Glasgow Coma Scale is which of the following? a) 8 b) 9 c) 10 d) 11 Q.275 276. A 70-year-old male if referred to clinic for assessment of a systolic heart murmur, picked up during a routine medical. He is asymptomatic but ECG shows LVH with strain. Echocardiogram shows peak aortic valve gradient of 90 mmHg. What is the correct management? a) Urgent aortic valve replacement b) Routine aortic valve replacement c) Regular outpatient review d) Anticoagulation Q.276 277. A 52-year-old man with known epilepsy and previous history of alcoholism is admitted confused having been found by his social worker. On examination he is not oriented in time or person. However, his GCS is 14/15. He has nystagmus on right lateral gaze. What is the most appropriate investigation? a) Serum thiamine levels b) Serum phenytoin levels c) CT brain d) Skull X-ray Q.277 278. A 62-year-old female is referred to the Parkinson’s clinic for assessment. She has a slow monotonous voice, bradykinesia, rigidity, tremor and loss of upward gaze. She is normotensive with no postural drop. She has a shuffling gait and has diminished arm swing on walking. What is the most likely diagnosis. a) Idiopathic Parkinson’s b) Progressive supranuclear palsy c) Multiple system atrophy d) Cerebrovascular disease Q.278 279. A 21-year-old woman is seen in clinic complaining of dysuria and vaginal discharge. An midstream urine test is negative. An endocervical swab was taken which showed intracellular diplococci. What is the best treatment for this patient? a) Metronidazole b) Doxycycline c) Amoxicillin and probenecid d) Benzylpenicillin intramuscularly Q.279 280. A 55-year-old man is concerned about his risk of venous thromboembolism. Each year he travels by air from the UK to Australia to visit relatives. His air travel will increase his annual risk of venous thromboembolism by which of the following? a) 0.1% b) 2% c) 6%

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www.prepgmedicos.com 2008 d) 12% Q.280 281. A newborn has agenesis and X-ray chest reveals oligemic lung field with normal sized heart. Likely diagnosis is a) Pulmonary atresia b) Transposition of great vessels c) Tetralogy of Fallot d) Ebstein’s anomaly Q.281 282. Investigation of choice for DVT is a) Radioactive fibrinogen uptake studies b) Plethsymography c) Duplex imaging d) Venography Q.282 283. In fluorescin angiography, dye is injected in a) Anterior cubital vein b) Femoral artery c) Femoral vein d) Aorta Q.283 284. Micturating cystourethrogram is not used in a) Renal tumors b) Hydronephrosis c) Urinary obstruction d) Recurrent UTI Q.284 285. Ossification of the lower end of femur is seen at a) 36th week b) 38th week c) 39th week d) 40th week Q.285 286. The weight of each of the 10 babies born in a hospital was 2.5 kg considering distribution was a normal, calculate the SD a) 0 b) 1 c) 2.5 d) 25 Q.286 287. The PEFR of a group of 11 girls follow a normal distribution with mean 300 1/min and standard deviation 20 1/min: a) About 95% of the girls have PEFR between 260 and 340 1/min. b) The girls have healthy lungs. c) About 55 of girls have PEFR below 260 1/min. d) All the PEFR must be less than 340 1/min Q.287 288. After applying a statistical test, an investigator gets the ‘p’ value as 0.01. it means that a) The probability of finding a significant difference is 1% b) The probability of declaring a significant difference, when there is truly no difference, is 1% c) The difference is not significant 1% times and significant 99% times. d) The power of the test used is 99% Q.288 289. What number of doses of measles vaccine is required for immunizing infants in a village of 2500 where the birth rate is 30/1000 midyear population and IMR is 80/1000 LBs assuming a wastage rate of 2? a) 150 doses b) 135 doses c) 138 doses d) 148 doses Q.289 290. Broncho pneumonia secondary to influenza is usually caused by: a) Streptococcus pyogenes b) Staphylococus pyogenes c) Klebsiella pneumonia

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www.prepgmedicos.com 2008 d) Legionella pneumonia Q.290 291. Primordial prevention in coronary heart disease involves: a) Control of blood pressure b) Preserving traditional life style c) Screening high risk presons d) Health check ups Q.291 292. Following are seen in a patient with acute rheumatic fever in the active stage except: a) Fever b) Carditis c) Subcutaneous nodules d) Polyarthrits Q.292 293. Drugs used in multi drug resistant P.falciparum under NAMP is: a) Quinine b) Halofenotrol c) Artimisinine d) Mefloquine Q.293 294. Identification of filaria cases are done in rural areas by: a) Anganwadi workers b) Voluntary workers c) MPWs d) Social workers Q.294 295. Which of the following is not true about revised NTP a) Involvement of NGO’s b) Both active and passive case finding c) Supervisory teams constituted in rural areas per 3 lakh population d) Short term chemotherapy provided free of charge Q.295 296. “Essential health care made universally accessible to all individuals in a community through full participation of its members by means that are acceptable to them and at a cost the community and the country can afford”. This is the definition of? a) Basic health services b) Comprehensive health care c) Primary health care d) Integrated health care Q.296 297. Sensitivity is defined as: a) True positive b) True negative c) True positive d) True positive Q.297 298. Which of the following is not true about ‘case fatality rate’ a) Ratio of deaths to cases b) Case fatality rate varies in different epidemics c) Closely related to virulence d) Useful even for chronic diseases Q.298 299. The mean B.P of a group of persons was determined and after an interventional trial, the mean BP was estimated again. The test to be applied to determine the significance of intervention is a) Chi-square b) Paired ‘t’ test c) Correlation coefficient d) T-test Q.299 300. A drug was tested for its efficacy and the following observations were made: Which of the following test would you employ to establish the usefulness of the drug? a) Chi square test b) Likelihood ratio c) Student t test d) Probability ratio

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This paper is compiled from IAMS free online test no 123 by www.prepgmedicos.com