AIIMS EXAMINATION PAPER WITH ANSWERS EXPLANATIONS YEAR 2003

Page -3

51 All of the following factors decrease the minimum Alveolar Concentration (MAC) of an inhalation anaesthetic agent except.

1. Hypothermia 
2. Hyponatremia 
3. Hypocalcaemia 
4. Anemia 
Ans 3

52 The narrowest part of larynx in infants is at the cricoid level. In administering anesthesia this may lead to all except.

1. Choosing a smaller size endotracheal tube. 
2. Trauma t the subglottic region. 
3. Post operative stridor 
4. Laryngeal oedema 
Ans ?

53. The administration of succinylocholine to a paraplegic patient led to the appearance of dysarrhythmias, conduction abnormalities and finally cardiac arrest. The most likely cause is:

1. Hypercalcemia 
2. Hyperkalemia 
3. Anaphylaxis 
4. Hyermagnesemia 
Ans 1

54. Following spinal subarachnoid block patient a develop hypotension. This can be managed by the following meAns except.

1. Lowering the head end 
2. Administration of 100 ml of Ringers lacate before the block
3. Vascopressure drug like methoxamine 
4. Us of ionotrope like dopamine. 
Ans 4

55. In the immediate post operative period the common cause of respiratory insufficiency could be because of the following, except. 
1. Residual effect of muscle relaxant 
2. Overdose of narcotic analgesic 
3. Mild Hypovalemia 
4. Mycocardial infarction 
Ans 4

56 On mutation, which of the following may give rise to hereditary glaucoma. 
1. Optineurin 
2. Ephrins 
3. RBA8 
4. Huntingtin 
Ans 1 [Ref : PMID: 11834836 PubMed - indexed for MEDLINE] [PUBMED is a free service by the US Govt health department , it indexes almost all studies/ Research papers published worldwide] It can be found at url http://nlm.nih.gov.

"optineurin gene is implicated in transmission of hereditary primary open angle glaucoma"
Other points about Opitneurin gene taken from the same study:
• Located on chromosome 10 p 14 [Short arm: P = Petite!, Next letter q was taken for long arm]
• Optineurin is expressed in trabecular meshwork, nonpigmented ciliary epithelium, retina, and brain, and we speculate that it plays a neuroprotective role.
• The OPTN gene codes for a conserved 66-kilodalton protein of unknown function that has been implicated in the tumor necrosis factor-alpha signaling pathway and that interacts with diverse proteins including Huntingtin, Ras-associated protein RAB8, and transcription factor IIIA.
• Inheritance is supposedly Autosomal Dominant.

Taken from "Rezaie T, Child A, Hitchings R, Brice G, Miller L, Coca-Prados M, Heon E, Krupin T, Ritch R, Kreutzer D, Crick RP, Sarfarazi M. Molecular Ophthalmic Genetics Laboratory, Surgical Research Center, Department of Surgery, University of Connecticut Health Center, Farmington, CT 06030, USA."

[Dr Sid; Dr Sanjeev Bansal ,LLRM Meerut]

57 Brain lipid binding protein is expressed by which of the following: 
1. Mature astrocytes. 
2. Oligodendrocytes. 
3. Purkinje cells
4. Pyramidal neurons
Ans 2?

58. All of the following ligaments contribute to the stability of ankle (talocrural) joint except.
1. Calcaneonavicular (spring) 
2. Deltoid 
3. Lateral 
4. Posterior tibiofibular 
Ans 1 (associated with arch integrity)

59. In angina pectoris, the pain radiating down the left arm is mediated by increased activity in afferent (sensory) fibres contained in the : -

1. Carotid branch of the glossopharyngeal nerve. 
2. Phrenic nerve 
3. Vagus nerve and recurrent laryngeal nerve. 
4. Thoracic splanchnic nerve 
Ans 4

60. All the following signs could result from infection within the right cavernous sinus except.
1. Constricted pupil in response to light 
2. Engorgement of the retinal veins upon ophthalmoscopic examination.
3. Ptosis of the right eyelid. 
4. Right ophthalmoplegia. 
Ans 1?

61. In dislocation of the jaw, displacement of the articular disc beyond the articular tubercle of the temporomandibular joint results from spasm or excessive contraction of the following muscle? 
1. Buccinator 
2. Lateral pterygoid 
3. Masseter
4. Temporalis 
Ans 2

62. Following surgical removal of a firm nodular cancer swelling in the right breast and exploration of the right axilla, on examination the patient was found to have a winged right scapula. Most likely this could have occurred due to injury to the : 
1. Subscapular muscle 
2 Coracoid process of scapula 
3. Long thoracic nerve 
4. Circumflex scapular artery 
Ans 3

63 A 50 year old man suffering from carcinoma of prostate showed areas of sclerosis and collapse of T10 and T11 vertebrae in X-ray. The spread of this cancer to the above vertebrae was most probably through: 
1. Sacral canal
2. Lymphatic vessels 
3. Internal vertebral plexus of veins
4. Superior rectal veins 
Ans 3 Vertebral plexus also known as bateson's plexus.

64 Father to son inheritance is never seen in case of: 
1. Autosomal dominant inheritance 
2. Autosomal recessive inheritance 
3. X- linked recessive inheritance 
4. Multifactorial inheritance 
Ans 3

65 A 3- year old boy is detected to have bilateral renal calculi. Metabolic evaluation confirms the presence of marked hypercalciuria with normal blood levels of calcium, magnesium, phosphate, uric acid and creatinine. A diagnosis of idiopathic hypercalciuria is made. The dietary management includes all, except 
1. Increased water intake 
2. Low sodium diet 
3. Reduced calcium intake 
4. Avoid meat proteins.
Ans 3

66. The hormone associated with cold adaption is :
1. Growth hormone.
2. Thyroxine.
3. Insulin.
4. Melanocyle Stimulating Hormone.
Ans 2

67. All of the following are characteristic features of Kwashiorkor, except :
1. High blood osmolarity.
2. Hypoalbuminemia.
3. Edema.
4. Fatty liver.
Ans 1

68. Acetyl Co-A acts as a substrate for all the enzymes except :
1. HMG-Co A synthetase.
2. Malic enzyme.
3. Malonyl Co A synthetase.
4. Fatty acid synthetase.
Ans 2[ Dr Kailash Prasad Verma, Calicut]
 

69. The activity of the following enzyme is affected by biotin deficiency:
1. Transketolase,
2. Dehydrogenase.
3. Oxidase.
4. Carboxylase.
Ans 4

70. A 55-year-old male accident victim in casualty urgently needs blood. The blood bank is unable to determine his ABO group, as his red cell group and plasma group do not match. Emergency transfusion of patient should be with:
1. RBC corresponding to his red cell group and colloids/crystalloid.
2. Whole blood corresponding to his plasma group.
3. O positive RBC and colloids/ crystalloid.
4. AB negative whole blood.
Ans 3 

71. Although more than 400 blood groups have been identified, the ABO blood group system remains the most important in clinical medicine because. :
1. It was the blood group system to be discovered.
2. It has four different blood groups A, B, AB, O(H).
3. ABO (H) antigens are present in most body tissues and fluids.
4. ABO (H) antibodies are invariably present in plasma when persons RBC lacks the corresponding antigen.
Ans 4 [Major importance in Clinical medicine is TRANSFUSION] [Sanjay, Assam]

72. Km of an enzyme is :
1. Dissociation constant.
2. The normal physiological substrate concentration.
3. The substrate concentration at half maximum velocity.
4. Numerically indentical for all isozymes that catalyze a given reaction.
Ans 1

73. At the physiological pH the DNA molecules are :
1. Positively charged.
2. Negatively charged.
3. Neutral.
4. Amphipathic.
Ans 2 (harper, this question has been in last 2-3 exams)

74. Cholesterol present in LDL :
1. Represents primarily cholesterol that is being removed from peripheral cells.
2. Binds to a receptor and diffuses across the cell membrance.
3. On acuumulation in the cell inhibits replenishment of LDL receptors.
4. When enters a cell, suppresses activity of acyl-CoA: cholesterol acytranferase ACAT.
Ans 3

75 A newborn infant refuses breast milk since the 2nd day of birth, vomits on force-feeding but accepts glucose-water, develops diarrhea on the third day, by 5th day she is jaundiced with liver enlargement and eyes show signs of cataract. Urinary reducing sugar was positive but blood glucose estimated by glucose oxidation method was found low. The most likely cause is deficiency of :
1. Galactose-1-phosphate uridyl transferase.
2. Beta galactosidase.
3. Glucose-6-phosphatase.
4. Galactokinase.
Ans 4

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