fmge 2004

ALL INDIA
PAPER 2004
SOLVED
QUESTIONS AND ANSWERS

Anatomy
Q 1. False statement regarding pudendal nerve is:
A. Both sensory and motor
B. Derived from S2,3,4 spinal nerve roots
C. Leaves pelvis through the lesser sciatic foramen
D. It is the only somatic nerve to innervate the pelvic organs
Ans. C
Q 2. Wrong statement regarding the coronary artery is:
A. Left coronary artery is present in anterior interventricular groove
B. Usually 3 obtuse marginal arteries arise from left coronary artery
C. Posterior interventricular artery arises from right coronary artery
D. Left atrial artery is a branch of left coronary artery
Ans. B
Q 3. All are true statements regarding inguinal canal except:
A. Roof is formed by conjoint tendon
B. Deep inguinal ring is formed by transversus abdominis
C. Superficial inguinal ring is formed by external oblique muscle
D. Internal oblique forms anterior and posterior wall
Ans. B
Q 4. Right gastroepiploic artery is a branch of:
A. Left gastric
B. Coeliac trunk
C. Splenic
D. Gastroduodenal
Ans. D
Q 5. In FRACTURE of middle cranial fossa, absence of tears is due to lesion in the:
A. Trigeminal ganglion
B. Ciliary ganglion
C. Lesser petrosal nerve
D. Greater petrosal nerve
Ans. D
Q 6. Motor supply to diaphragm is by:
A. Thoracodorsal nerve
B. Phrenic nerve
C. Intercostal nerves
D. Sympathetic nerves
Ans. B
Q 7. All of the following are supplied by facial nerve except:
A. Lacrimal gland
B. Submandibular gland
C. Nasal glands
D. Parotid gland
Ans. D
Q 8. In left coronary artery thrombosis, area most likely to be involved is:
A. Anterior wall of right ventricle
B. Anterior wall of left ventricle
C. Anterior wall of right atrium
D. Inferior surface of right ventricle
Ans. B
Physiology
Q 9. Tidal volume is calculated by:
A. Inspiratory capacity minus the inspiratory reserve volume
B. Total lung capacity minus the residual volume
C. Functional residual capacity minus residual volume
D. Vital capacity minus expiratory reserve volumes
Ans. A
Q 10. Surfactant production in lungs starts at:
A. 28 weeks
B. 32 weeks
C. 34 weeks
D. 36 weeks
Ans. A
Q 11. Initiation of nerve impulse occurs at the axon hillock because:
A. It has a lower threshold than the rest of the axon
B. It is unmyelinated
C. Neurotransmitter release occurs here
D. None of the above
Ans. A
Q 12. Albumin contributes the maximum to oncotic pressure because it has:
A. High molecular weight, low concentration
B. Low molecular weight, low concentration
C. High molecular weight, high concentration
D. Low molecular weight, high concentration
Ans. D


Q 13. After 5 days of fasting a man undergoes oral GTT, true is all except:
A. GH levels are increased
B. Increased glucose tolerance
C. Decreased insulin levels
D. Glucagon levels are increased
Ans. B
Q 14. Metalloproteins help in jaundice by the following mechanism:
A. Increased glucoronyl transferase activity
B. Inhibit heme oxygenase
C. Decrease RBC lysis
D. Increase Y and Z receptors
Ans. B
Q 15. Which protein prevents contraction by covering binding sites on actin and myosin:
A. Troponin
B. Calmodulin
C. Thymosin
D. Tropomyosin
Ans. D
Q 16. Which of the following is not correct regarding capillaries:
A. Greatest cross sectional area
B. Contain 25% of blood
C. Contains less blood than veins
D. Have single layer of cells bounding the lumen
Ans. B
Q 17. A 0.5 litre blood loss in 30 minutes will lead to:
A. Increase in HR, decrease in BP
B. Slight increase in HR, normal BP
C. Decrease in HR and BP
D. Prominent increase in HR
Ans. B
Q 18. Single most important factor in control of automatic contractility of heart is:
A. Myocardial wall thickness
B. Right atrial volume
C. SA node pacemaker potential
D. Sympathetic stimulation
Ans. D
Q 19. Which of the following is not mediated through negative FEEDBACK mechanism:
A. TSH release
B. GH formation
C. Thrombin formation
D. ACTH release
Ans. C
Q 20. Force generating proteins are:
A. Myosin and myoglobin
B. Dynein and kinesin
C. Calmodulin and G protein
D. Troponin
Ans. B
Q 21. Which is true about measurement of BP with sphygmomanometer versus intraarterial pressure measurements:
A. Less than intravascular pressure
B. More than intravascular pressure
C. Equal to intravascular pressure
D. Depends upon blood flow
Ans. B
Q 22. Secondary hyperparathyroidism due to vitamin D deficiency shows:
A. Hypocalcemia
B. Hypercalcemia
C. Hypophosphatemia
D. Hyperphosphatemia
Ans. C
Q 23. Maximum absorption of water takes place in:
A. Proximal convoluted tubule
B. Distal convoluted tubule
C. Collecting duct
D. Loop of Henle
Ans. A
Biochemistry
Q 24. Basic amino acids are:
A. Aspartate and glutamate
B. Serine and glycine
C. Lysine and arginine
D. None of the above
Ans. C
Q 25. Amino acid with dissociation constant closest to physiological pH is:
A. Serine
B. Histidine
C. Threonine
D. Proline
Ans. B
Q 26. Sources of the nitrogen in urea cycle are:
A. Aspartate and ammonia
B. glutamate and ammonia
C. Arginine and ammonia
D. Uric acid
Ans. A
Q 27. If urine sample darkens on standing: the most likely condition is:
A. Phenylketonuria
B. Alkaptonuria
C. Maple syrup disease
D. Tyrosinemia
Ans. B
Q 28. A baby presents with refusal to feed, SKIN lesions, seizures, ketosis organic acids in urine with normal ammonia; likely diagnosis is:
A. Propionic aciduria
B. Multiple carboxylase deficiency
C. Maple syrup urine disease
D. Urea cycle enzyme deficiency
Ans. B
Q 29. Force not acting in an enzyme substrate complex:
A. Electrostatic
B. Covalent
C. Van der Wall
D. Hydrogen
Ans. C
Q 30. Cellular oxidation is inhibited by:
A. Cyanide
B. Carbon dioxide
C. Chocolate
D. Carbonated beverages
Ans. A
Q 31. Triple bonds are found between which base pairs:
A. A-T
B. C-G
C. A-G
D. C-T
Ans. B
Q 32. Which of the following RNA has abnormal purine bases:
A. tRNA
B. mRNA
C. rRNA
D. 16SRNA
Ans. A
Q 33. False regarding gout is:
A. Due to increased metabolism of pyrimidines
B. Due to increased metabolism of purines
C. Uric acid levels may not be elevated
D. Has a predilection for the great toe
Ans. A
Q 34. All of the following statements are true regarding lipoproteins except:
A. VLDL transports endogenous lipids
B. LDL transports lipids to the tissues.
C. Increased blood cholesterol is associated with increased LDL receptors
D. Increased HDL is associated with decreased risk of coronary disease
Ans. C
Q 35. A destitute woman is admitted to the hospital with altered sensorium and dehydration; urine analysis shows mild proteinuria and no sugar; what other test would be desirable:
A. Fouchet
B. Rothera
C. Hays
D. Benedict’s
Ans. B
Q 36. Which of these fatty acids is found exclusively in breast milk:
A. Linolaete
B. Linolenic
C. Palmitic
D. d-hexanoic
Ans. A
Q 37. Blood is not a newtonian fluid because:
A. Viscosity does not changing with velocity
B. Viscosity changes with velocity
C. Density does not change with velocity
D. Density changes with velocity
Ans. B
Microbiology
Q 38. Regarding NK cells, false statement is:
A. It is activated by IL-2
B. Expresses CD 3 receptor
C. It is a variant of large lymphocyte
D. There is antibody induced proliferation of NK cells
Ans. D
Q 39. Adenosine deaminase deficiency is seen in the following:
A. Common variable immunodeficiency.
B. Severe combined immunodeficiency
C. Chronic granulomatous disease
D. Nezelof syndrome
Ans. B
Q 40. A beta hemolytic bacteria is resistant to vancomycin, shows growth in 6.5% NaCI, is non-bile sensitive. It is likely to be:
A. Strep. agalactiae
B. Strep. pneumoniae
C. Enterococcus
D. Strep. bovis
Ans. C
Q 41. False statement about the streptococcus is:
A. M protein is responsible for production of mucoid colonies
B. M protein is the major surface protein of group A streptococci
C. Mucoid colonies are virulent
D. Endotoxin causes rash of scarlet fever
Ans. A
Q 42. Toxin involved in the streptococcal toxic shock syndrome is:
A. Pyrogenic toxin
B. Erythrogenic toxin
C. Hemolysin
D. Neurotoxin
Ans. A
Q 43. A child presents with a white patch over the tonsils; diagnosis is best made by culture in:
A. Loeffler medium
B. LJ medium
C. Blood agar
D. Tellurite medium
Ans. A
Q 44. A patient with 14 days of fever is suspected of having typhoid. What investigation should be done:
A. Blood culture
B. Widal test
C. Stool culture
D. Urine culture
Ans. B
Q 45. All are true about EHEC except:
A. Sereny test is positive
B. Fails to ferment sorbitol
C. Causes HUS
D. Elaborates shiga like exotoxin
Ans. A
Q 46. An organism grown on agar shows green coloured colonies, likely organism is:
A. Staphylococcus
B. E. coli
C. Pseudomonas
D. Peptostreptococcus
Ans. C
Q 47. Congenital syphilis can be best diagnosed by:
A. IgM FTAbs
B. IgG FTAbs
C. VDRL
D. TPI
Ans. A
Q 48. All are features of Ureaplasma urealyticum except:
A. Non gonococcal urethritis
B. Salpingitis
C. Epididymitis
D. Bacterial vaginosis
Ans. D
Q 49. Regarding HIV infection, not true is:
A. p24 is used for early diagnosis
B. Lysis of infected CD 4 cells is seen
C. Dendritic cells do not support replication
D. Macrophage is a reservoir for the virus
Ans. C
Q 50. A pregnant woman from Bihar presents with hepatic encephalopathy. The likely diagnosis:
A. Hepatitis E
B. Hepatitis B
C. Sepsis
D. Acute fatty liver of pregnancy
Ans. A
Q 51. Virus causing hemorrhagic cystitis, diarrhea and conjunctivitis is:
A. RSV
B. Rhinovirus
C. Adenovirus
D. Rotavirus
Ans. C
Q 52. Cystine lactose enzyme deficient (CLED) medium is preferred over McConkey agar in UTI because:
A. Former prevents swarming of proteus
B. Is a selective medium
C. Prevents growth of pseudomonas
D. Promotes growth of candida
Ans. A
Q 53. In which stage of filariasis are microfilaria seen in peripheral blood:
A. Tropical eosinophilia
B. Early adenolymphangitis stage
C. Late adenolymphangitis stage
D. Elephantiasis
Ans. B
Q 54. Pancreatic CA is caused by:
A. Fasciola
B. Clonorchis
C. Paragonimus
D. None
Ans. B
Q 55. All of the following are true except:
A. E.coli is an aerobe and facultative anaerobe
B. Proteus forms uric acid stones
C. E. coli is motile by peritrichate flagella
D. Proteus causes deamination of phenylalanine to phenylpyruvic acid
Ans. B
Q 56. Consumption of uncooked pork is likely to cause which of the following helminthic disease:
A. Tinea saginata
B. Tinea solium
C. Hydatid cyst
D. Trichuris trichura
Ans. B
Pathology
Q 57. Enzyme that protects the brain from free radical injury is:
A. Myeloperoxidase
B. Superoxide dismutase
C. MAO
D. Hydroxylase
Ans. B
Q 58. Autoimmune haemolytic anemia is seen in:
A. ALL B. AML
C. CLL D. CML
Ans. C
Q 59. All of following are correct about thromboxane A2 except:
A. Low dose aspirin inhibits its synthesis
B. Causes vasoconstriction in blood vessels
C. Causes broncoconstriction
D. Secreted by WBC
Ans. D
Q 60. Which of the following complications is likely to result after several units of blood have been transfused:
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Respiratory acidosis
Ans. A
Q 61. The mother has sickle cell disease and father is normal. Chances of children having sickle cell disease and sickle cell trait respectively are:
A. 0 and 100%
B. 25 and 25%
C. 50 and 50%
D. 10 and 50%
Ans. A
Q 62. Father has a blood group B, mother has AB; children are not likely to have the following blood group:
A. O
B. A
C. B
D. AB
Ans. A
Q 63. Protein involved in intercellular connections is:
A. Connexin
B. Integrin
C. Adhesin
D. None of the above
Ans. A

Pharmacology
Q 64. All are reasons for reducing drug dosage in elderly except:
A. They are lean and their body mass is less
B. Have decreasing renal function with age
C. Have increased baroceptor sensitivity
D. Body water is decreased
Ans. C
Q 65. True statement regarding inverse agonists is:
A. Binds to receptor and causes intended action
B. Binds to receptor and causes opposite action
C. Binds to receptor and causes no action
D. Binds to receptor and causes submaximal action
Ans. B
Q 66. True statement regarding first order kinetics is:
A. Independent of plasma concentration
B. A constant proportion of plasma concentration is eliminated
C. T½ increases with dose
D. Clearance decreases with dose
Ans. B
Q 67. A diabetic female on INH and rifampicin for TB suffers DVT. She is started on warfarin. PT is not raised. Next step should be:
A. Long term heparin therapy
B. Replace warfarin with acecoumarin
C. Switch ethambutol for rifampin
D. Use LMW heparin
Ans. C
Q 68. Beta blocker that can be used in renal failure is:
A. Propranolol
B. Pindolol
C. Sotalol
D. Nadolol
Ans. A
Q 69. All of the following are correct about steroids except:
A. Inhibit the release of arachidonic acid from vessel wall through action of phospholipase A2
B. Bind plasma membrane receptors and following internalization influence nuclear changes
C. Inhibit vascular membrane permeability
D. Increase glucose synthesis, glycogen deposition in liver
Ans. B
Q 70. All of the following statements are true except:
A. PGs and leukotrienes are derived from arachidonic acid
B. COX I is an inducible enzyme
C. COX II is induced by cytokines at sites of inflammation.
D. Leukotrienes cause smooth muscle constriction
Ans. B
Q 71. Which of the following is a false statement:
A. IV noradrenaline increases systolic and diastolic BP and cause tachycardia
B. IV adrenaline increases systolic BP, no change or increase diastolic BP and causes tachycardia
C. IV isoproterenol causes increase in systolic BP, decreases diastolic BP and causes tachycardia
D. Dopamine improves renal function, increases cardiac output and systolic BP
Ans. A
Q 72. Digoxin is not indicated in:
A. Atrial flutter
B. Atrial fibrillation
C. High output failure
D. PSVT
Ans. C
Q 73. All of the following statements are true about theophylline except:
A. Increase in dose is required in cardiopulmonary disease
B. Increases cAMP
C. Increase in dose is required in smokers
D. Inhibits phosphodiesterase
Ans. A
Q 74. Mechanism of action of tetracycline is:
A. Binds to A site and inhibit attachment of t-RNA.
B. Inhibits peptidyl transferase
C. Causes misreading of mRNA
D. Causes termination of peptide chain elongation
Ans. A
Q 75. False statement about selegeline is:
A. It is a MAO-A inhibitor
B. Does not cause cheese reaction
C. Not useful in advanced cases of on-off phenomenon
D. It is used in parkinsonism
Ans. A
Q 76. A patient on phenytoin for treatment of seizures develops depression for which he is prescribed tricyclics. He now complains of lassitude and his Hb reads 8. Next step in managing this patient should be:
A. Chest X-ray
B. MCV should be estimated
C. GGT should be estimated
D. Bone marrow examination
Ans. B
Q 77. Which of the following drugs would be removed by dialysis?
A. Digoxin
B. Salicylates
C. Benzodiazepines
D. Organophosphates
Ans. B
Q 78. In low doses aspirin acts on:
A. Cyclooxygenase
B. Thromboxane A2
C. PGI2
D. Lipoxygenase
Ans. B
Q 79. True statement about ticlopidine is:
A. Directly interacts with platelet membrane
B. Onset of action is delayed
C. Inhibits platelet gp IIb/IIIa receptors
D. Has fibrinolytic activity
Ans. A
Q 80. All of the following statements about methotrexate are true except:
A. Folinic acid enhances the action of methotrexate
B. Methotrexate inhibit dehydrofolate reductase
C. Non proliferative cells are resistant to metho- trexate
D. Methotrexate is used in treatment of PSORIASIS
Ans. A
Q 81. Drug containing two sulfhydryl groups in a molecule:
A. BAL
B. EDTA
C. Pencillamine
D. Desferioxamine
Ans. A
Forensic Medicine
Q 82. Gettler’s test is done for death by:
A. Drowning B. Hanging
C. Bums D. Phophorus poisoning
Ans. A

Q 83. Feature indicative of antimortem drowning is:
A. Cutis anserina
B. Rigor mortis
C. Washer woman’s feet
D. Grass and weeds grasped in the hand
Ans. D
Q 84. A boy has 20 permanent teeth and 8 temporary teeth. His age is likely to be:
A. 9 years
B. 10 years
C. 11 years
D. 12 years
Ans. C
Q 85. A patient has sensation of bugs crawling all over his body. This may be effect of:
A. Cocaine
B. Alcohol
C. Cannabis
D. Benzodiazepines
Ans. A
Q 86. A person comes in contact with other. This is called:
A. Locard principle
B. Quetlet’s rule
C. Petty’s principle
D. None of the above
Ans. A
Q 87. A patient of head injury, has no relatives and requires urgent cranial decompression; Doctor should:
A. Operate without formal consent
B. Take police consent
C. Wait for relatives to take consent
D. Take magistrate consent
Ans. A
Q 88. A boy attempts suicide. He is brought to a private doctor and he is successfully cured. Doctor should:
A. Inform police
B. Not required to inform police
C. Report to magistrate
D. Refer to a psychiatrist
Ans. B
PREVENTIVE AND SOCIAL Medicine
Q 89. All are true about DOTS except:
A. Continuation phase drugs are given in a multi- blister combipack
B. Medication is to be taken in presence of a health worker
C. Alternate day treatment
D. Improves compliance
Ans. C
Q 90. Basanti a 29 years aged female from Bihar presents with active tuberculosis. She delivers baby. All of the following are indicated except:
A. Administer INH to the baby
B. Withhold breastfeeding
C. Give ATT to mother for 2 years
D. Ask mother to ensure proper disposal of sputum
Ans. B
Q 91. Under the national TB programme, for a PHC to be called a PHC-R, requisite is:
A. Microscopy
B. Microscopy plus Radiology
C. Radiology
D. None of the above
Ans. B
Q 92. A person has received complete immunization against tetanus 10 years ago, now he presents with a clean wound without any lacerations from an injury sustained 3 hours ago. He should now be given:
A. Full course of tetanus toxoid
B. Single dose of tetanus toxoid
C. Human tetanus globulin
D. Human tetanus globulin and single dose of toxoid
Ans. B
Q 93. The false statement regarding tetanus is:
A. Five doses of immunisation provide life long immunity
B. TT affords no protection in the present injury
C. TIG is useful in lacerated wound
D. TT and Ig both may be given in suspected tetanus
Ans. A
Q 94. A certain community has 100 children out of whom 28 are immunised against measles. 2 of them acquired measles simultaneously. Subsequently 14 get measles. Assuming the efficacy of the vaccine to be 100%. What is the secondary attack rate?
A. 5%
B. 10%
C. 20%
D. 21.5%
Ans. C
Q 95. A community has a population of 10,000 and a birth rate of 36 per 1000. 5 maternal deaths were reported in the current year. The MMR is:
A. 14.5
B. 13.8
C. 20
D. 5
Ans. B
Q 96. 10 babies are born in a hospital on same day. All weigh 2.8 kg each. Calculate the standard deviation:
A. Zero
B. One
C. Minus one
D. 0.28
Ans. A
Q 97. Out of 11 births in a hospital, 5 babies weighed over 2.5 kg and 5 weighed less than 2.5 kg. What value does 2.5 represent:
A. Geometric average
B. Arithmetic average
C. Median
D. Mode
Ans. C
Q 98. A man weighing 68 kg, consumes 325 gm carbohydrate, 65 gm protein and 35 gms fat in his diet. The most applicable statement here is:
A. His total calorie intake is 3000 kcal
B. The proportion of proteins, fats and carbohydrates is correct and in accordance with a balanced diet
C. He has a negative nitrogen balance
D. 30% of his total energy intake is derived from fat
Ans. B
Q 99. A country has a population of 1000 million; birth rate is 23 and death rate is 6. In which phase of the demographic cycle does this country lie:
A. Early expanding
B. Late expanding
C. Plateau
D. Declining
Ans. B
Q 100. In a population of 10,000, beta carotene was given to 6000; it was not given to the remainder. 3 out of the first group got lung cancer while 2 out of the other 4000 also got lung cancer. The best conclusion is:
A. Beta carotene and lung cancer have no relation to one another
B. The p value is not significant
C. The study is not designed properly
D. Beta carotene is associated with lung cancer
Ans. A
Q 101. A subcentre in a hilly area caters to a population of:
A. 1000
B. 2000
C. 3000
D. 5000
Ans. C
Q 102. In a community, an increase in new cases denotes:
A. Increase in incidence rate
B. Increase in prevalence rate
C. Decrease in incidence rate
D. Decrease in prevalence rate
Ans. A
Q 103. More false positive cases on screening in a community signify that the disease has:
A. High prevalence
B. High sensitivity
C. Low prevalence
D. Low sensitivity
Ans. C
Q 104. The same screening test is applied to two communities X and Y; Y shows more false +ve cases as compared to X. The possibility is:
A. High sensitivity
B. High specificity
C. Y community has high prevalence
D. Y community has low prevalence
Ans. C
Q 105. ELISA is performed on a population with low prevalence of hepatitis B. What would be the result of performing double screening ELISA tests?
A. Increased sensitivity and positive predictive value
B. Increased sensitivity and negative predictive value
C. Increased specificity and positive predictive value
D. Increased specificity and negative predictive value
Ans. C
Q 106. While testing a hypolipidemic drug, serum lipid levels were tested both before and after its use. Which test is best suited for the statistical analysis of the result:
A. Paired t-test
B. Student’s test
C. Chi square test
D. None of the above
Ans. A
Q 107. Type 1 sampling error is classified as:
A. Alpha error
B. Beta error
C. Gamma error
D. Delta error
Ans. A
Q 108. Virulence of a disease is indicated by:
A. Proportional mortality rate
B. Specific mortality rate
C. Case fatality ratio
D. Amount of GDP spent on control of disease
Ans. C
Q 109. Which of the following diseases needs not to be screened for in workers to be employed in a dye industry in Gujarat ?
A. Anemia
B. Bronchial asthma
C. Bladder cancer
D. Precancerous lesion
Ans. A
Q 110. Best test to detect iron deficiency in community is:
A. Serum transferrin
B. Serum ferritin
C. Serum iron
D. Hemoglobin
Ans. B
Q 111. Which of the following is not a complete sterilization agent:
A. Glutaraldehyde
B. Absolute alcohol
C. Hydrogen peroxide
D. Sodium hypochlorite
Ans. B
Q 112. Seasonal trend is due to:
A. Vector variation
B. Environmental factors
C. Change in herd immunity
D. All of the above
Ans. B
Medicine
Q 113. False statement about type I respiratory failure is:
A. Decreased PaO2
B. Decreased PaCO2
C. Normal PaCO2
D. Normal A-a gradient
Ans. D
Q 114. A 60 years old man presents with nonproductive cough for 4 weeks. He has grade III clubbing, and a lesion in the apical lobe on X-ray. Most likely diagnosis here is:
A. Small cell CA
B. Non-small cell CA
C. Fungal infection
D. Tuberculosis
Ans. B
Q 115. A 60 years old man is suspected of having bronchogenic CA. TB has been ruled out in this patient. What should be the next investigation:
A. CT guided FNAC
B. Bronchoscopy and biopsy
C. Sputum cytology
D. X-ray chest
Ans. B
Q 116. A man presents with fever, weight loss and cough. Mantoux reads an induration of 17 × 19 mm; sputum cytology is negative for AFB. Most likely diagnosis is:
A. Pulmonary tuberculosis
B. Fungal infection
C. Viral infection
D. Pneumonia
Ans. A
Q 117. Pulmonary edema associated with normal PCWP is observed, which of these is not a cause:
A. High altitude
B. Cocaine overdose
C. Post cardiopulmonary bypass
D. Bilateral renal artery stenosis
Ans. D
Q 118. An ABG analysis shows: pH 7.2, raised pCO2, decreased HCO3. Diagnosis is:
A. Respiratory acidosis
B. Compensated metabolic acidosis
C. Respiratory and metabolic acidosis
D. Respiratory alkalosis
Ans. C
Q 119. ABG analysis of a patient on ventilator shows decreased pCO2, normal pO2, pH 7.5. Diagnosis is:
A. Respiratory acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Metabolic acidosis
Ans. C
Q 120. In a patient of acute inferior wall MI. Best modality of treatment is:
A. IV fluids
B. Digoxin
C. Diuretics
D. Vasodilators
Ans. A
Q 121. A 26 years old asymptomatic woman is found to have arrhythmias and a systolic murmur associated with midsystolic ? . Which investigation would you use:
A. Electrophysiological testing
B. CT scan
C. Echocardiography
D. Angiography
Ans. C
Q 122. A patient complains of intermittent claudication, dizziness and headache. Most likely cardiac lesion is:
A. TOF
B. ASD
C. PDA
D. Coarctation of aorta
Ans. D
Q 123. All of the following are true about ASD except:
A. Right atrial hypertrophy
B. Left atrial hypertrophy
C. Right ventricular hypertrophy
D. Pulmonary hypertension
Ans. B
Q 124. Mitral valve vegetations do not usually embolise to:
A. Lung
B. liver
C. spleen
D. brain
Ans. A
Q 125. A woman has septic abortion done, vegetation on tricuspid valve is likely to go to:
A. Septic infarcts to lung
B. liver
C. spleen infarcts
D. Emboli to brain
Ans. A
Q 126. Kussmaul’s sign is not seen in:
A. Restrictive cardiomyopathy
B. Constrictive pericarditis
C. Cardiac tamponade
D. RV infarct
Ans. C
Q 127. A patient presents with engorged neck veins, BP 80/50 mmHg and pulse rate of 100/min following blunt trauma to the chest. Diagnosis is:
A. Pneumothorax
B. Right ventricular failure
C. Cardiac tamponade
D. Hemothorax
Ans. C
Q 128. Which of the following is not seen on hemoglobin electrophoresis in sickle cell anemia:
A. HbA
B. HbA2
C. HbF
D. HbS
Ans. A
Q 129. False statement regarding DIC is:
A. Thrombocytopenia
B. Decreased fibrinogen
C. Decreased PTT
D. Increased PT
Ans. C
Q 130. Thrombocytopenia occurs in all except:
A. Henoch Schonlein purpura
B. TTP
C. DIC
D. Leukemia
Ans. A
Q 131. A patient with an Hb of 6 g%, WBC count of 2000/cmm, has a normal different count except for having 6% blasts, platelets are reduced to 80,000/cmm; moderate splenomegaly is present. Possible diagnosis is:
A. Leukemia
B. Aplastic anemia
C. HEMOLYSIS
D. lTP
Ans. A
Q 132. A patient being investigated for anemia has a dry marrow tap; peripheral smear reveals tear drop cells. Most likely diagnosis is:
A. Leukemia
B. Lymphoma
C. Myelofibrosis
D. Polycythemia rubra vera
Ans. C
Q 133. Tumor associated with polycythemia vera is:
A. Sarcoma
B. Pituitary adenoma
C. Cerebellar haemangioblastoma
D. None of the above
Ans. C
Q 134. A young patient presents with jaundice. Total bilirubin is 21 mg%, direct is 9.6 mg%, alkaline phosphatase is 84 KA units. Diagnosis is:
A. Hemolytic jaundice
B. Viral hepatitis
C. Chronic active hepatitis
D. Obstructive jaundice
Ans. D
Q 135. A young male with gallbladder stones shows the following test results: serum bilirubin 2.5 mg%, Hb 6 g%, urine test positive for urobilinogen. Diagnosis is:
A. Hemolytic jaundice
B. Obstructive jaundice
C. Hepatocellular jaundice
D. Protoporphyria
Ans. A
Q 136. An 18 years old male presents with massive hematemesis. He has history of fever for the past 14 days for which he was managed with drugs. Moderate splenomegaly is present. Diagnosis is:
A. NSAID induced duodenal ulcer
B. Drug induced gastritis
C. Esophageal varices
D. None of the above
Ans. C
Q 137. Urinalysis shows RBC casts. Likely source is:
A. kidney
B. Ureter
C. Bladder
D. Urethra
Ans. A
Q 138. A young man develops gross hematuria 3 days after an attack of URTI. Most likely renal Pathology is:
A. Acute glomerulonephritis
B. Minimal change disease
C. IgA nephropathy
D. Membranous glomerulonephritis
Ans. C
Q 139. A patient’s CSF report reads as follows: sugar 40 mg%, protein 150 mg%, chloride 550 mg%; lymphocytosis present. The picture is suggestive of:
A. Fungal meningitis
B. Viral meningitis
C. TB meningitis
D. Leukemia
Ans. C
Q 140. Lacunar infarcts are caused by:
A. Lipohyalinosis of penetrating arteries
B. Middle carotid artery involvement
C. Emboli to anterior circulation
D. None of the above
Ans. A
Q 141. Dinesh, a 56 years aged man presents with complaints of slowness of movements, postural instability, tremors, rigidity and memory loss. Most likely diagnosis is:
A. Multi-infarct dementia
B. Alzheimer’s disease
C. Parkinsonism
D. None of the above
Ans. C
Q 142. All of the following may be seen in Wilson’s disease except:
A. Cerebellar ataxia
B. Peripheral neuropathy
C. Dysphagia
D. Chorea
Ans. B
Q 143. An elderly man presents with features of dementia, ataxia, difficulty in downward gaze and a history of frequent falls. Likely diagnosis is:
A. Parkinson disease
B. Progressive supranuclear gaze palsy
C. Alzheimer’s disease
D. None of the above.
Ans. B
Q 144. A chromosomal anomaly associated with Alzheimer’s dementia is:
A. Trisomy 18
B. Patau syndrome
C. Trisomy 21
D. Turner syndrome
Ans. C
Q 145. All are true about Huntington’s disease, except:
A. Chorea
B. Depression, apathy
C. Progressive dementia
D. Cog-wheel rigidity
Ans. D
Q 146. A 30-year-old male complains of loss of erection; he has low testosterone and high prolactin level in blood. What is the likely diagnosis:
A. Pituitary adenoma
B. Testicular failure
C. Craniopharyngioma
D. Cushing’s syndrome
Ans. A
Q 147. A patient meets with an accident with resultant transection of the pituitary stalk. What will not occur:
A. Diabetes mellitus
B. Diabetes insipidus
C. Hyperprolactinemia
D. Hypothyroidism
Ans. A
Q 148. A woman has bilateral headache that worsens with emotional stress. She has two children, both doing badly in school. Diagnosis is:
A. Migraine
B. Cluster headache
C. Tension headache
D. Trigeminal neuralgia
Ans. C
Q 149. A female aged 30 years, presents with episodic throbbing headache for past 4 years with nausea and vomiting. Most likely diagnosis is:
A. Migraine
B. Cluster headache
C. Angle closure glaucoma
D. Temporal arteritis
Ans. A
Q 150. A woman complains of headache associated with paresthesias of the right upper and lower limb. Most likely diagnosis is:
A. Trigeminal neuralgia
B. Glossopharyngeal neuralgia
C. Migraine
D. Cluster headache
Ans. C
Q 151. All of the following are features of MEN IIa, except:
A. Pituitary tumor
B. Pheochromocytoma
C. Medullary CA thyroid
D. Parathyroid adenoma
Ans. A
Q 152. A patient with Cushingoid features presents with hemoptysis. He shows no response to dexamethasone suppression test. Most likely diagnosis is:
A. Adrenal hyperplasia
B. Adrenal adenoma
C. CA lung with ectopic ACTH production
D. Pituitary microadenoma
Ans. C
Q 153. An obese patient presented in casualty in an unconscious state. His blood sugar measured 400 mg%, urine tested positive for sugar and ketones. Drug most useful in management is:
A. Glibenclamide
B. Troglitazone
C. Insulin
D. Chlorpropamide
Ans. C
Q 154. Which of the following is not associated with thymoma:
A. Red cell aplasia
B. Myasthenia gravis
C. Hypergammaglobulinemia
D. Compression of the superior mediastinum
Ans. C
Q 155. A young basketball player with height 188 cm and arm span 197 cm has a diastolic murmur best heard in second right intercostal space. Likely cause of murmur is:
A. AS
B. Coarctation of aorta
C. AR
D. MR
Ans. C
Q 156. A patient presents with arthritis, hyperpigmen- tation of SKIN and hypogonadism. Likely diagnosis is:
A. Hemochromatosis
B. Ectopic ACTH secreting tumor of lung
C. Wilson’s disease
D. Rheumatoid arthrits
Ans. A
Q 157. In myasthenia gravis, correct statement regarding thymectomy is:
A. Should be done in all cases
B. Should be done in cases with ocular involvement only
C. Not required if controlled by medical management
D. Should be done only in cases that are associated with thymoma
Ans. A
Q 158. Most common fungal infection in febrile neutropenia is:
A. Aspergillus niger
B. Candida
C. Mucormycosis
D. Aspergillus fumigatus
Ans. B
Q 159. The following group of tests should be done to optimise graft uptake in bone marrow transplant:
A. Blood grouping
B. HLA matching
C. Culture for infection
D. All of the above
Ans. B
Q 160. True statement about neurocysticercosis is:
A. Seizures due to neurocysticercosis are resistant to antiepileptic drugs
B. Albendazole is superior to praziquantel in the treatment of above condition
C. Common presentation is 6th cranial nerve palsy and hemiparesis
D. Steroids are used in the management of hydrocephalus
Ans. B
Q 161. All of the following are true regarding a patient with acid peptic disease except:
A. Misoprostol is the drug of choice in patients on NSAIDs
B. DU is preventable by the use of single night-time H2 blockers
C. Omeprazole may help ulcers refractory to H2 blockers
D. Misoprostol is DOC in pregnant patients
Ans. D
Q 162. A man presents with mass at duodenojejunal flexure invading renal papillae. Histopathology reports it as lymphoma. True statement is:
A. II E stage
B. III E stage
C. IV E stage
D. Staging cannot be done until bone marrow examination is performed
Ans. C
Q 163. A 45 years male presents with hypertension. He has sudden abnormal flinging movements in right upper and lower limbs. Most likely site of hemorrahge is:
A. Substantia nigra
B. Caudate nuclei
C. Pons
D. Subthalamic nuclei
Ans. D
Q 164. True about haemophilia A are all except:
A. PTT increased
B. PT increased
C. Clotting time is increased
D. Serum levels of factor VIII are decreased
Ans. B
Q 165. IPPV can cause:
A. Barotrauma
B. Pleural effusion
C. Increased venous return
D. None of the above
Ans. A
Q 166. Characteristic finding in CT in a TB is:
A. Exudate seen in basal cistern
B. Hydrocephalus is non communicating
C. Calcification commonly seen in cerebellum
D. Ventriculitis is a common finding
Ans. A

Q 167. Vegetations on undersurface of AV valves are found in:
A. Acute rheumatic carditis
B. Limban Sack’s endocarditis
C. Non thrombotic bacterial endocarditis
D. Chronic rheumatic carditis
Ans. B
Q 168. Triage means:
A. Sorting out of cases on availability of medical resources and severity of patient’s condition
B. Patients are divided into 3 groups
C. Severely injured patients are attended first in military camps
D. None of the above
Ans. A
PEDIATRICS
Q 169. Which of the following is not true about atrial septal defect:
A. There is a defect in region of fossa ovalis
B. Blood flow from left atrium to right atrium
C. Increased blood flow through lungs lead to pulmonary plethora
D. There is splitting of first heart sound
Ans. D
Q 170. A neonate presents with jaundice and clay white stools. On liver biopsy giant cells are seen. Most likely diagnosis is:
A. Physiological jaundice
B. Neonatal hepatitis with extra biliary atresia
C. Neonatal hepatitis with physiological jaundice
D. Extra biliary atresia
Ans. B
Q 171. A newborn has dribbling after feeds. He has respiratory distress and froth at the mouth. Diagnosis is:
A. Tracheoesophageal fistula
B. Tetralogy of Fallot
C. Respiratory distress syndrome
D. None of the above
Ans. A
Q 172. Ramu, a 8-years-old boy presents with upper GI bleeding. On examination, he is found to have splenomegaly; there are no signs of ascites, or hepatomegaly; esophageal varices are found on UGIE. Most likely diagnosis is:
A. Budd Chiari syndrome
B. Non cirrhotic portal fibrosis
C. Cirrhosis
D. Veno-occlusive disease
Ans. B
Q 173. A 5-years-old child suffering from nephrotic syndrome is responding well to steroid therapy. What would be the most likely finding on light microscopy:
A. No finding
B. Basement membrane thickening
C. Hypercellular glomeruli
D. Fusion of foot processes
Ans. A
Q 174. Most common cause of urinary obstruction in a male infant is:
A. Anterior urethral valves
B. Posterior urethral valves
C. Stone
D. Stricture
Ans. B
Q 175. A 5-years-old child presents with a calculus of size 2 cm in the upper ureter. He also complains of haematuria. USG shows no further obstruction in the urinary tract. Treatment of choice for this patient would be:
A. Ureterolithotomy
B. Endoscopic removal
C. ESWL
D. Observation
Ans. C
Q 176. A patient presents with LVH and pulmonary complications. ECG shows left axis deviation. Most likely diagnosis is:
A. TOF
B. Tricuspid atresia
C. TAPVC
D. VSD
Ans. B
Q 177. Potts shunt is anastomosis of:
A. Right subclavian artery to right pulmonary artery
B. Descending aorta to left pulmonary artery
C. Left subclavian to left pulmonary artery
D. Ascending aorta to right pulmonary artery
Ans. B
Q 178. A neonate has recurrent attacks of abdominal pain, restless, irritability and diaphoresis on feeding. Cardiac auscultation reveals a nonspecific murmur. He is believed to be at risk for MI. Likely diagnosis is:
A. ASD
B. VSD
C. TOF
D. Anomalous coronary artery
Ans. D
Q 179. A child aged 2 years presents with nonspecific symptoms suggestive of anemia. On peripheral blood smear target cells are seen. He has hypochromic microcytic picture and Hb of 6 gm%. He also has ‘a positive family history’. Next investigation of choice is:
A. Hb electrophoresis
B. Coombs’ test
C. liver function tests
D. Osmotic fragility test
Ans. A
Q 180. Most common cause of meningitis in children between 6 months to 2 years of age is:
A. Pneumococcus
B. Staphylococcus
C. H. influenzae
D. E. coli
Ans. C
Q 181. A child presents with seborrheic dermatitis, lytic skull lesions, ear discharge and hepatosplenomegaly. Likely diagnosis is:
A. Leukemia
B. Lymphoma
C. Histiocytosis X
D. Multiple myeloma
Ans. C
Q 182. Which of the following is true regarding cretinism:
A. Short limbs compared to trunk
B. Proportionate shortening
C. Short limbs and short stature
D. Short limbs and long stature
Ans. C
Q 183. Manifestations of endemic cretinism include:
A. Deafness and facial nerve involvement
B. Blindness and hypothyroidism
C. Goitre and hypothyroidism
D. Multinodular goitre and mental retardation
Ans. A
Q 184. A 10 day old male pseudohermaphrodite child with 46 XY karyotype presents with BP of 110/80 mmHg. Most likely enzyme deficiency is:
A. 21 hydroxylase
B. 17 hydroxylase
C. 11 hydroxylase
D. 3-beta hydroxylase
Ans. B
Q 185. Treatment of Kawasaki disease in children is:
A. Oral steroids
B. IV steroids
C. IV Ig
D. Mycophenolate mefentil
Ans. C
Q 186. A neonate delivered at 32 weeks, is put on a ventilator. X-ray shows ‘white out lung’ and ABG reveals PO2 of 75. Ventilator settings are on, FIO2 of 70, and rate of 50/minute. Next step to be taken should be:
A. Increase rate to 60 per minute
B. Increase FIO2 to 80
C. Continue ventilation with the same settings
D. Weaning ventilator
Ans. C
Dermatology
Q 187. A man aged 50 years presents with, alopecia, boggy scalp swelling and easily pluckable hair. Next step in establishing the diagnosis would be:
A. KOH smear
B. Culture sensitivity
C. Biopsy
D. None of the above
Ans. A
Q 188. Most common organism causing tinea capitis is:
A. Trichophyton tonsurans
B. Microsporum
C. Epidermophyton
D. Candida albicans
Ans. A
Q 189. A young man aged 19 years develops a painless penile ulcer 9 days after sexual intercourse with a professional SEX worker. Most likely diagnosis is:
A. Chancroid
B. Herpes
C. Primary chancre
D. Traumatic ulcer
Ans. C
Q 190. An infant presents with itchy lesions over the groin and prepuce. All of the following are indicated in this patient except:
A. Bathe and apply scabicidal solution
B. Treatment should be extended to all family members
C. Dispose all clothes by burning
D. Start the patient on IV antibiotics
Ans. D
Q 191. A boy aged 8 years from Tamil Nadu presents with a white, non anesthetic, nonscaly, hypopigmented macule on his face. Most likely diagnosis is:
A. Pityriasis alba
B. Pityriasis versicolor
C. Indeterminate leprosy
D. Pure neuritic leprosy
Ans. C
Q 192. A 20 years old, male patient, from jaipur presents with an erythematous lesion on the cheek with central crusting. Most likely diagnosis is:
A. SLE
B. LUPUS vulgaris
C. Chillblains
D. Cutaneous leishmaniasis
Ans. D
Q 193. A 19 year old pregnant girl presents with light brown pigmentation over the malar eminences. Most likely diagnosis is:
A. Chloasma
B. SLE
C. Melasma
D. Melanoma
Ans. A
Q 194. A girl aged 19, presents with arthritis and a photosensitive rash on the cheek. Likely diagnosis is:
A. SLE
B. Chloasma
C. Stevens Johnson syndrome
D. Lyme’s disease
Ans. A
Psychiatry
Q 195. A patient with pneumonia for 5 days is admitted to the hospital. He suddenly ceases to recognize the doctor and staff, thinks that he is in jail and complains of scorpions attacking him. He is in altered sensorium. This condition is:
A. Acute delirium
B. Acute dementia
C. Acute schizophrenia
D. Acute paranoia
Ans. A
Q 196. A person missing from home, is found wandering purposefully. He is well groomed, and denies of having any amnesia. Most likely diagnosis is:
A. Dissociative fugue
B. Dissociative amnesia
C. Schizophrenia
D. Dementia
Ans. A
Q 197. Babu, a 40 years aged male complains of sudden onset palpitations and apprehension. He is sweating for the last 10 minutes and fears of impending death. Diagnosis is:
A. Hysteria
B. Cystic fibrosis
C. Panic attack
D. Generalized anxiety disorder
Ans. C
Q 198. A lady, while driving a car meets with an accident. She was admitted in an ICU for 6 months. After being discharged, she often gets up in night and feels terrified She is afraid to sit in a car again. The diagnosis is:
A. Panic disorder
B. Phobia
C. Conversion disorder
D. Post traumatic stress disorder
Ans. D
Q 199. A patient present with waxy flexibility, negativitism and rigidity. Diagnosis is:
A. Catatonic schizophrenia
B. Paranoid schizophrenia
C. Hebephrenic schizophrenia
D. Simple schizophrenia
Ans. A
Q 200. Chandu, age 32 presents with abdominal pain and vomiting. He also complains of some psychiatric symptoms and visual hallucinations. Most likely diagnosis is:
A. Intermittent porphyria
B. Hypothyroidism
C. Hyperthyroidism
D. Hysteria
Ans. A
Q 201. Basanti 27 years aged, female thinks her nose is ugly; her idea is fixed and not shared by anyone else. Whenever she goes out of home, she hides her face with a cloth. She visits a Surgeon. Next step would be:
A. Investigate and then operate
B. Refer to psychiatrist
C. Reassure the patient
D. Immediate operation
Ans. B
Surgery
Q 202. A male aged 60 years has foul breath. He regurgitates food that is eaten 3 days ago. Likely diagnosis is:
A. Zenker’s diverticulum
B. Meckel’s diverticulum
C. Scleroderma
D. Achalasia cardia
Ans. A
Q 203. Most common site for squamous cell carcinoma esophagus is:
A. Upper third
B. Middle third
C. Lower third
D. Gastro-esophageal junction.
Ans. B
Q 204. What is true regarding congenital hypertrophic pyloric stenosis:
A. More common in girls
B. Hypochloremic alkalosis
C. Heller’s myotomy is the procedure of choice.
D. Most often manifests at birth
Ans. B
Q 205. Patient presents with recurrent duodenal ulcer of 2.5 cm size. Procedure of choice is:
A. Truncal vagotomy and antrectomy
B. Truncal vagotomy and gastrojejunostomy
C. Highly selective vagotomy
D. Laparoscopic vagotomy and gastrojejunostomy
Ans. A
Q 206. All are features of hyperplastic tuberculosis of gastrointestinal tract except:
A. Presents with a mass in RIF
B. Barium meal shows pulled up caecum
C. Most common site is ileocecal junction
D. ATT is the treatment of choice
Ans. D
Q 207. A 56 year old woman has not passed stools for the last 14 days. X-ray shows no air/fluid levels. Probable diagnosis is:
A. Paralytic ileus
B. Aganglionosis of the colon
C. Intestinal pseudo-obstruction
D. Duodenal obstruction.
Ans. C
Q 208. A man aged 60 years has history of IHD and atherosclerosis. He presents with abdominal pain and maroon stools. Most likely diagnosis is:
A. Acute intestinal obstruction
B. Acute mesenteric ischemia
C. Peritonitis
D. Appendicitis
Ans. B
Q 209. True statement regarding ‘fistula in ano’ is:
A. Posterior fistulae have straight tracks
B. High fistulae can be operated with no fear of incontinence
C. High and low divisions are made in relation to the pelvic floor
D. Intersphincteric is the most common type
Ans. D
Q 210. In a 27 year old male most common cause of a colovesical fistula would be:
A. Crohn’s disease
B. Ulcerative colitis
C. TB
D. Cancer colon
Ans. A
Q 211. Following trauma, a patient presents with a drop of blood at the tip of urinary meatus. He complains of inability to pass urine. Next step should be:
A. IVP should be done
B. MCU should be done
C. Catheterize, drain bladder and remove the catheter thereafter
D. Catheterize, drain bladder and retain the catheter thereafter
Ans. D
Q 212. Chandu, a 45 years male shows calcification on the right side of his abdomen in an AP view. In lateral view the calcification is seen to overlie the spine. Most likely diagnosis is:
A. Gallstones
B. Calcified mesenteric nodes
C. Renal stones
D. Calcified rib
Ans. C
Q 213. CA prostate commonly metastasises to the vertebrae because:
A. Valveless communication exist with Batson’s prevertebral plexus
B. Via drainage to sacral lymph node
C. Of direct spread
D. None of above
Ans. A
Q 214. Following sexual intercourse, a person develops pain in the left testes that does not get relieved on elevation of scrotum. Diagnosis is:
A. Epididymo-orchitis
B. Torsion testis
C. Fournier’s gangrene
D. Tumor testes
Ans. B
Q 215. A testicular tumor in a man aged 60 years is most likely to be:
A. Germ cell tumor
B. Sertoli cell tumor
C. Teratocarcinoma
D. Lymphoma
Ans. D
Q 216. A patient presents with bilateral proptosis, heat intolerance and palpitations. Most unlikely diagnosis here would be:
A. Hashimoto’s thyroiditis
B. Thyroid adenoma
C. Diffuse thyroid igoitre
D. Reidel’s thyroiditis
Ans. D
Q 217. A patient with long standing multinodular goitre develops hoarseness of voice. Also, the swelling undergoes sudden increase in size. Likely diagnosis is:
A. Follicular CA
B. Papillary CA
C. Medullary CA
D. Anaplastic CA
Ans. A
Q 218. A patient presents with swelling in the neck following a thyroidectomy. What is the most likely resulting complication:
A. Respiratory obstruction
B. Recurrent laryngeal nerve palsy
C. Hypovolemia
D. Hypocalcemia
Ans. A
Q 219. A patient on the same evening following thyroidectomy presents with a swelling in the neck and difficulty in breathing. Next management would be:
A. Open sutures immediately
B. Intubate oro-tracheally
C. Wait and watch
D. Administer oxygen by mask
Ans. A
Q 220. Patient presents with neck swelling and respiratory distress few hours after a thyroidectomy Surgery . Next management would be:
A. Open immediately
B. Tracheostomy
C. Wait and watch
D. Oxygen by mask
Ans. A
Q 221. A patient undergoes thyroid Surgery , following which he develops perioral tingling. Blood Ca2+ is 8.9 mEq. Next step is:
A. Vitamin D orally
B. Oral Ca2+ and vitamin D
C. Intravenous calcium gluconate and serial monitoring
D. Wait for Ca2+ to decrease to < 7.0 before taking further action
Ans. C
Q 222. A case of blunt trauma is brought to the emergency in a state of shock. He is not responding to IV crystalloids. Next step in his management would be:
A. Immediate laparotomy
B. Blood transfusion
C. Albumin transfusion
D. Abdominal compression
Ans. A
Q 223. Babu is brought to the emergency as a case of road- traffic accident. He is hypotensive. Most likely ruptured organ is:
A. spleen
B. Mesentery
C. kidney
D. Rectum
Ans. A
Q 224. A patient is brought to the emergency as a case of head injury, following a head on collision road traffic accident. His BP is 90/60 mmHg. Tachycardia is present. Most likely diagnosis is:
A. EDH
B. SDH
C. Intracranial hemorrhage
D. Intra-abdominal bleed
Ans. D
Q 225. Ulcer that may develop in burn tissue is:
A. Marjolin’s
B. Rodent
C. Melanoma
D. Curling’s
Ans. A
Q 226. An elderly man presents with history of abdominal pain. He is found to have a fusiform dilatation of the descending aorta. Likely cause is:
A. Trauma
B. Atherosclerosis
C. Right ventricular failure
D. Syphilitic aortitis
Ans. B
Q 227. All of the following are correct regarding AV fistula except:
A. Arterialization of the veins
B. Proximal compression causes increase in heart rate
C. Overgrowth of a limb
D. Causes LV enlargement and LV failure
Ans. B
Q 228. All of the following are correct about axillary vein thrombosis except:
A. May be caused by a cervical rib
B. Treated with IV anticoagulant
C. Embolectomy is done in all cases
D. May occur following excessive exercise
Ans. C
Q 229. A 80 year old patient presents with a midline tumor of the lower jaw, involving the alveolar margin. He is edentulous. Treatment of choice is:
A. Hemimandibulectomy
B. Commando operation
C. Segmental mandiblectbmy
D. Marginal mandibulectomy
Ans. C
Q 230. Most common cause of unilateral parotid swelling in a 27 year old male is:
A. Warthin’s tumor
B. Pleomorphic adenoma
C. Adenocarcinoma
D. Haemangioma
Ans. B
Q 231. A 45 year old woman presents with a hard and mobile lump in the breast. Next investigation is:
A. FNAC
B. USG
C. Mammography
D. Excision biopsy
Ans. A
Q 232. A 45 years old man presents with progressive cervical lymph nodes enlargement since 3 month. Most diagnostic investigation is:
A. X-ray soft tissue
B. FNAC
C. Lymph node biopsy
D. None of the above
Ans. C
Q 233. All of the following are true about fibrolamellar carcinoma of the liver except:
A. Equal incidence in males and females
B. Better prognosis than HCC
C. AFP levels always greater than > 1000
D. Occur in younger individuals
Ans. C
Q 234. A child presents with an expansible swelling on medial side of the nose . Likely diagnosis is:
A. Teratoma
B. Meningocele
C. Dermoid cyst
D. Lipoma
Ans. B
orthopaedics
Q 235. Following anterior dislocation of the shoulder, a patient develops weakness of flexion at elbow and lack of sensation over the lateral aspect fore arm. Nerve injured is:
A. Radial nerve
B. Musculocutaneous nerve
C. Axillary nerve
D. Ulnar nerve
Ans. B
Q 236. Babloo a 10 years old boy presents with FRACTURE of humerus. X-ray reveals a lytic lesion at the upper end. Likely condition is:
A. Unicameral bone cyst
B. Osteosarcoma
C. Osteoclastoma
D. Aneurysmal bone cyst
Ans. A
Q 237. A patient sustained injury to the upper limb 3 years back. He now presents with valgus deformity in the elbow and paresthesias over the medial border of the hand. The injury is likely to have been:
A. Supracondylar FRACTURE humerus
B. Lateral condyle FRACTURE humerus
C. Medial condyle FRACTURE humerus
D. Posterior dislocation of the humerus
Ans. B
Q 238. A woman aged 60 years suffers a fall. Her lower limb is abducted and externally rotated. Likely diagnosis is:
A. Neck of femur FRACTURE
B. Intertrochanteric femur FRACTURE
C. Posterior dislocation of hip
D. Anterior dislocation of hip
Ans. D
Q 239. Triple arthrodesis involves:
A. Calcaneocuboid, talonavicular and talocalcaneal
B. Tibiotalar, calcaneocuboid and talonavicular
C. Ankle joint, calcaneocuboid and talonavicular
D. None of the above
Ans. A
Q 240. Babu a 19 years old male has a small circumscribed sclerotic swelling over diaphysis of femur. Likely diagnosis is:
A. Osteoclastoma
B. Osteosarcoma
C. Ewing’s sarcoma
D. Osteoid osteoma
Ans. D
Q 241. Most common site of osteogenic sarcoma is:
A. Femur, upper end
B. Femur, lower end
C. Tibia, upper end
D. Tibia, lower end
Ans. B
Q 242. Involvement of PIP joint, DIP joint and the carpometacarpal joint of base of thumb with sparing the wrist is seen in:
A. Rheumatoid arthritis
B. Osteoarthritis
C. Psoriatic arthritis
D. Pseudogout
Ans. B
Q 243. The pivot test is for:
A. Anterior cruciate ligament
B. Posterior cruciate ligament
C. Medial meniscus
D. Lateral meniscus
Ans. A
Q 244. Iliotibial band contracture following polio is likely to result in:
A. Extension at hip
B. Extension at knee
C. Flexion at hip and knee
D. Extension at hip and knee
Ans. C
Anaesthesia
Q 245. All of the following agents can be given for induction of Anaesthesia in children except:
A. Halothane
B. Servoflurane
C. Morphine
D. Nitrous oxide
Ans. C
Q 246. Anaesthetic agent of choice in renal failure is:
A. Methoxyflurane
B. Isoflurane
C. Enflurane
D. None of the above
Ans. B
Q 247. A man with alcoholic liver failure requires general Anaesthesia for Surgery . Anaesthetic agent of choice is:
A. Ether
B. Halothane
C. Methoxyflurane
D. Isoflurane
Ans. D
Q 248. All of the following are true except:
A. Halothane is good as an analgesic agent
B. Halothane sensitises the heart to action of catacholamines
C. Halothane relaxes brochi & is preferred as anaesthetics
D. Halothane may cause liver cell necrosis
Ans. A
Ophthalmology
Q 249. A patient has a miotic pupil, IOP= 25, normal anterior chamber, hazy cornea and a shallow anterior chamber in fellow eye . Diagnosis is:
A. Acute anterior uveitis
B. Acute angle closure glaucoma
C. Acute open angle glaucoma
D. Senile cataract
Ans. A
Q 250. A woman complains of coloured haloes around lights in the evening, with nausea and vomiting, IOP is normal. Diagnosis is:
A. Incipient stage, glaucoma open angle
B. Prodromal stage, closed angle glaucoma
C. Migraine
D. Raised ICT
Ans. B
Q 251. Babloo, a 5 years old child, presents with large cornea, lacrimation and photophobia. Diagnosis is:
A. Megalocornea
B. Congenital glaucoma
C. Congenital cataract
D. Anterior uveitis
Ans. B
Q 252. Herpes zoster ophthalmicus causes all except:
A. Nummular keratitis
B. Vitreal haemorrhage
C. Uveitis
D. Cranial nerve palsies
Ans. B
Q 253. Bilateral ptosis is not seen in:
A. Marfan’s syndrome
B. Myaesthenia gravis
C. Myotonic dystrophy
D. Kearns-Sayre syndrome
Ans. A
Q 254. eye is deviated laterally and downwards and patient is unable to look up or medially. Likely nerve involved is:
A. Trochlear
B. Trigeminal
C. Oculomotor
D. Abducent
Ans. C
Q 255. Left sided lateral gaze is affected in lesion of:
A. Right frontal lobe
B. Right occipital lobe
C. Left occipital lobe
D. Left frontal lobe
Ans. A
Q 256. An elderly male with heart disease presents with sudden loss of vision in one eye . Examination reveals cherry red spot. Diagnosis is:
A. Central retinal vein occlusion
B. Central retinal artery occlusion
C. Amaurosis fugax
D. Acute ischemic optic neuritis
Ans. B
Q 257. Which of following, is not a feature in diabetic retinopathy on fundus examination:
A. Microaneurysms
B. Retinal hemorrhages
C. Arteriolar dilatation
D. Neovascularisation
Ans. C
Q 258. Vitamin B12 deficiency is likely to cause:
A. Bitemporal hemianopia
B. Binasal hemianopia
C. Heteronymous hemianopia
D. Centrocecal scotoma
Ans. D
Q 259. All are true regarding optic neuritis except:
A. Decreased visual acuity
B. Decreased pupillary reflex
C. Abnormal electroretinogram
D. Abnormal visual evoked response retinogram
Ans. C
Q 260. Chalky white optic disc on fundus examination is seen in all except:
A. Syphilis
B. Leber’s hereditary optic neuropathy
C. Post papilledema optic neuritis
D. Traumatic injury to the optic nerve
Ans. D
ENT
Q 261. A 3 months old child presents with intermittent stridor. Most likely cause is:
A. Laryngotracheobronchitis
B. Laryngomalacia
C. Respiratory obstruction
D. Foreign body aspiration
Ans. B
Q 262. A patient presents with facial nerve palsy following head trauma with FRACTURE of the mastoid. Best intervention here is:
A. Immediate decompression
B. Wait and watch
C. Facial sling
D. Steroids
Ans. A
Q 263. A case of Bell’s palsy on steroids shows no improvement after 2 weeks. The next step in management should be:
A. Vasodilators and ACTH
B. Physiotherapy and electrical stimulation
C. Increase steroid dosage
D. Electrophysiological nerve testing
Ans. D
Q 264. Chandu a 15 years aged boy presents with unilateral nasal blockade, mass in the cheek and epistaxis. Likely diagnosis is:
A. Nasopharyngeal CA
B. Angiofibroma
C. Inverted papilloma
D. None of the above
Ans. B
Q 265. A 40 years old diabetic presents with blackish nasal discharge and a mass in the nose . Likely diagnosis is:
A. Mucormycosis
B. Actinomycosis
C. Rhinosporiodosis
D. Histoplasmosis
Ans. A
Q 266. Most radiosensitive tumour of the following is:
A. Supraglortic CA
B. CA glottis
C. CA nasopharynx
D. Subglottic CA
Ans. C
OBSTETRICS & Gynaecology
Q 267. Rokitansky Kuster Hauser syndrome is associated with:
A. Ovarian agenesis
B. Absent fallopian tube
C. Vaginal atresia
D. Bicornuate uterus
Ans. C
Q 268. A patient of 47 XXY karyotype presents with features of hypogonadism. The likely diagnosis is:
A. Turner syndrome
B. Klinefelter syndrome
C. Edward syndrome
D. Down syndrome
Ans. B
Q 269. A girl presents with primary amenorrhea, grade V thelarche, grade II pubarche, no axillary hair. The likely diagnosis is:
A. Testicular feminization
B. Mullerian agenesis
C. Turner syndrome
D. Gonadal dysgenesis
Ans. A
Q 270. A woman presents with amenorrhea of 6 weeks duration and lump in the right iliac fossa. Investigation of choice is:
A. USG abdomen
B. Laparoscopy
C. CT scan
D. Shielded X-ray
Ans. A
Q 271. A woman presents with amenorrhea of 2 months duration lower abdominal pain, facial pallor, fainting and shock. Diagnosis is:
A. Ruptured ovarian cyst
B. Ruptured ecotopic pregnancy
C. Threatened abortion
D. Septic abortion
Ans. B
Q 272. A young woman with six weeks amenorrhea presents with mass abdomen. USG shows empty uterus. Diagnosis is:
A. Ovarian cyst
B. Ectopic pregnancy
C. Complete abortion
D. None of the above
Ans. B
Q 273. A 30 years old female, presents to the emergency with complaint of sudden severe abdominal pain. An abdominal mass is palpable on examination. Mo