(Study Material) ALL INDIA 2005 (AIPGE 2005 January, Answers, Explanation and Notes)
PAPER : ALL INDIA 2005 (AIPGE 2005 January, Answers, Explanation and Notes)
Q.1 The parvocellular pathway from lateral geniculate nucleus to visual
cortex is most sensitive for the stimulus of:
1. Color contrast.
2. Luminance contrast.
3. Temporal frequency.
4. Saccadic eye movements.
Answer is 1
GANONG ,S REVIEW OF PHYSIOLOGY ED 19 Pg- 163
Q.2 The fibers from the contralateral nasal hemiretina project to the following
layers of the lateral geniculate nucleus:
1.Layers 2, 3 & 5.
2.Layers 1, 2 & 6
3.Layers 1, 4 & 6
4.Layers 4, 5 & 6
Answer is 3
GANONG ,S REVIEW OF PHYSIOLOGY ED 19- 163
Q.3 All endothelial cells produce thrombomodulin except those found in:
1. Hepatic circulation.
2. Cutaneous circulation
3. Cerebral microcirculation.
4. Renal circulation.
Answer is 3
GANONG, S REVIEW OF PHYSIOLOGY ED 19 Pg- 546
Q.4 S.A. node acts as a pacemaker of the heart because of the fact that it:
1. Is capable of generating impulses spontaneously.
2. Has rich sympathetic innervations.
3. Has poor cholinergic innervations.
4. Generates impulses at the highest rate.
Answer is 4
GANONG, S REVIEW OF PHYSIOLOGY ED 19 Pg-549
Q.5 The first physiological response to high environmental temperature is:
1 Sweating
2 Vasodilation
3 Decreased heat production
4 Non-shivering thermogenesis
Answer is 2
GANONG ,S REVIEW OF PHYSIOLOGY ED 19 Pg-257, 599
Q.6 All of the following factors normally increase the length of the ventricular
cardiac muscle
fibres except:
1. Increased venous tone.
2. Increased total blood volume.
3. Increased negative intrathoracic pressure.
4. Lying-to-standing change in posture.
Answer is 4
Q.7 The vasodilatation produced by carbon dioxide is maximum in one of the
following
1. Kidney
2. Brain
3. Liver.
4. Heart.
Answer is 2
GANONG ,S REVIEW OF PHYSIOLOGY ED 19 Pg-599
Q.8 Which one of the following statements regarding water reabsorption in the
tubules?
1. The bulk of water reabsorption occurs secondary to Na+ reabsorption.
2. Majority of facultative reabsorption occurs in proximal tubule.
3. Obligatory reabsorption is ADH dependent.
4. 20% of water is always reabsorbed irrespective of water balance.
Answer is 1
GANONG ,S REVIEW OF PHYSIOLOGY ED 19 Pg-717
Q.9 Urinary concentrating ability of the kidney is increased by:
1. ECF volume contraction.
2. Increase in RBF.
3. Reduction of medullary hyperosmolarity
4. Increase in GFR.
Answer is 1
GANONG ,S REVIEW OF PHYSIOLOGY ED 19 Pg-722
Q.10 Distribution of blood flow is mainly regulated by the:
1 Arteries
2 Arterioles
3 Capillaries
4 Venules
Answer is 2
GANONG ,S REVIEW OF PHYSIOLOGY ED 19 Pg-579
Blood flow in the vessels primarily
due to pumping action of the heart
Other factors are diastolic recoil of walls of arteries, pumping action skeletal
muscle on
veins and negative intrathoracic pressure
Regulation of Blood flow to each
tissue is depends on the diameter of the vessels
principally of arterioles. Resistance to flow mostly depends on diameter of
arterioles and to a minor degree on the viscosity of the blood. Arterioles are
the major site of the resistance to blood flow and small change in their caliber
causes large change in the total peripheral resistance.
Q.11 In which of the following a reduction in arterial oxygen tension occurs?
1. Anaemia.
2. CO poisoning.
3. Moderate exercise
4. Hypoventilation.
Answer is 3
Harrison priciple of internal medicine 15th ed/209,1502
PaO2 is normal in
Anemic Hypoxia
Carbon Monoxide Intoxication
Histotoxic hypoxia
Anemic Hypoxia
There is Decline in the O2-carrying capacity of the blood.
In anemic hypoxia, the PaO2 is normal
Carbon Monoxide Intoxication
Carbon monoxide preferentially displaces O2 from hemoglobin, essentially making
a portion of hemoglobin unavailable for binding to O2. In this circumstance,
carbon monoxide saturation is high and O2 saturation is low, even though the
driving pressure for O2 to bind to hemoglobin,
reflected by PO2, is normal.
Respiratory Hypoxia ?The most common cause of respiratory hypoxia is
ventilation-perfusion mismatch. It also caused by hypoventilation, and it is
then associated with an elevation of PaCO2 and low PaO2.
In moderate exercises? po2 is decreased (ganong)
Q.12 Neuronal degeneration is seen in all of the following except:
1. Crush nerve injury
2. Fetal development.
3. Senescence
4. Neuropraxia.
Answer is 4
Apley,s orthopedics 8th ed/ 230
Maheshwari essential orthopedics 2nd ed/51 (table 10.1)
Neuropraxia- is a reversible physiological nerve conduction block in which
spontaneous complete
recovery occurs and there is no chances of degeneration.
Axonotmesis –degeneration occurs distal to the lesion and for a few mm
retrograde. The axon
disintegrates and is resorbed by phagocytes called WALLERIAN DEGENERATION.
In fetal development degeneration is by mechanism of apoptosis
In senescence nerve starts degenerate because of no use of nerve.
Q.13 With which one of the following Lower motor neuron lesions are associated?
1. Flaccid paralysis.
2. Hyperactive stretch reflex.
3. Spasticity.
4. Muscular in coordination.
Answer is 1
Harrison principle of internal medicine 15th Ed /134
Lower Motor Neuron Weakness
Lesion of ant. Horn cell or cranial nerve nuclei.
Flaccid weakness of muscle
Loss of deep tendon reflexes
Fasciculation of muscle fibers
Atrophy of muscle
Lesion of the cell bodies of brainstem motor cranial nerve nuclei and the
anterior horn of the spinal cord. Or from dysfunction of the axons of these
neurons as they reaches to skeletal muscle.
| Spasticity | Upper motor neuron disease |
| Rigidity Lead pipe" or "plastic" stiffness Cogwheel |
Extrapyramidal disorders Red nucleus Parkinson’s disease |
| Paratonia (gegenhalten) | Disease of the frontal lobes |
| Flaccidity | Lower motor neuron lesion |
Q.14 Aspermia is the term used to describe:
1. Absence of semen.
2. Absence of sperm in ejaculate.
3. Absence of sperm motility.
4. Occurrence of abnormal sperm.
Answer is 1
DORLAND DICTIONARY
ASPERMIA is absence of semen
AZOOSPERMIA mean absence of sperm
OLIGOZOOSPERMIA IS less than 20 millon sperm per ml of semen.
Q.15 Which of the following statements can be regarded as primary action of Inhibin?
1. It inhibits secretion of prolactin.
2. It stimulates synthesis of estradiol
3. It stimulates secretion of TSH.
4. It inhibits secretion of FSH.
Answer is 4
Harrison priciple of internal medicine 15th ed /2157
GANONG REVIEW OF PHYSIOLOGY 19TH EDITION/127
Inhibin inhibits the release of FSH by the hypothalamic-pituitary unit.
Activin enhance FSH secretion as well as having local effects on ovarian steroidogenesis.
Follistatin attenuates the actions of Activin and other members of the transforming growth factor (TGF) family.
Q.16 A 40 year old male, with history of daily alcohol consumption for the last 7 years, is brought to the hospital emergency room with acute onset of seeing snakes all around him in the room, not recognizing family members, violent behavior and tremulousness for few hours. There is history of his having missed the alcohol drink since 2 days. Examination reveals increased blood pressure, tremors, increased psychomotor activity, fearful affect, hallucinatory behavior, disorientation,
impaired judgement and insight. He is most likely to be suffering from:
1. Alcoholic hallucinosis.
2. Delirium tremens.
3. Wernicke encephalopathy.
4. Korsakoff’s psychosis.
Answer is 2
Harrison priciple of internal medicine 15th ed/2565
All India repeat Q of 2003
When a chronic alcoholic stops taking alcohol then withdrawal symptoms generally begin within 5 to 10 h of decreasing ethanol intake, peak in intensity on day 2 or 3, and improve by day 4 or 5.
Features include tremor of the hands (shakes or jitters); agitation and anxiety; autonomic nervous system over activity. The term delirium tremens (DTs) refers to delirium (mental confusion with fluctuating levels of consciousness) along with a tremor, severe agitation, and autonomic over activity). It is to be noted that only 5 to 10% of alcohol-dependent individuals ever experience DTs.
Q.17 A 45 year male with a history of alcohol dependence presents with confusion, nystagmus and ataxia. Examination reveals 6th cranial nerve weakness. He is most likely to be suffering from:
1. Korsakoff’s psychosis.
2. Wernicke’s encephalopathy.
3. De Clerambault syndrome.
4. Delirium tremens.
Answer is 2
Harrison principle of internal medicine 15th ed /2562
All India repeat Q of 2004
Wernicke's disease is a common and preventable disorder due to a deficiency of thiamine vitamin.
Alcoholic’s account for most of the cases of it. The characteristic clinical triad is that of
ophthalmoplegia, ataxia, and global confusion. However, only one -third of patients of
Wernicke's disease have this classic clinical triad.
Ocular motor abnormalities include horizontal nystagmus on lateral gaze, lateral rectus palsy (usually bilateral), conjugate gaze palsies, and rarely ptosis.
The pupils are usually spared, but they may become miotic with advanced disease.
Atrophy of the Mamillary bodies is seen in most chronic cases.
Q.18 A 25year old female presents with 2year history of repetitive, irresistible thoughts of contamination with dirt associated with repetitive hand washing. She reports these thoughts to be her own and distressing; but is not able to overcome them along with medications. She is most likely to benefit from which of the following therapies:
1. Exposure and response prevention.
2. Systematic desensitization.
3. Assertiveness training.
4. Sensate focusing.
Answer is 1
New oxford textbook of psychiatry 1st ed/827-828
Although it is a repeat question, many guides has been given the answer systemic desensitizationBut according to oxford “the behavioral therapy is as effective as pharmacotherapy in O.C.D.
Recently 2 neuroimaging studies found that patient with O.C.D., who are successfully treated with behavioral therapy shows changes in cerebral metabolism similar to those found by successful treatment with S.S.R.I.”
The principle behavioral approach in O.C.D. is exposure for obsession and response prevention for virtual.
Desensitization, thought stopping, flooding, implosion therapy and aversion conditioning have also been used in-patient with O.C.D.
Q 19 An 18 year old boy came to the Psychiatry OPD with a complaint of feeling changed from inside. He described himself as feeling strange as if he is different from his normal self. He was very tense and anxious yet could not point out the precise change in him. This phenomena is best called as:
1. Delusional mood.
2. Depersonalization.
3. Autochthonous delusion.
4. Over valued idea.
Answer is 2
Neeraj ahuja psychiatry 5th ed/113
Charlis G Morris psychology 10th ed/522
Essential feature of depersonalization is that person suddenly feels changed or different in a strange way. This kind of feeling is especially common during adolescence and young adult E.g. A 20 yr old college student sought professional help experiencing episodes of feeling outside of himself for 2 yr. At these times he felt groggy, dizzy, and preoccupied.
Delusion mood and autochthonous delusion are the false belief as per definition, but this boy doesn’t have false belief
Q.20 The major difference between typical and atypical antipsychotics
is that:
1. The latter cause minimal or no increase in prolactin.
2. The former cause tardive dyskinesia.
3. The former area available as parenteral preparation.
4. The latter cause substantial sedation.
Answer is 2
K.D.T. Essential of pharmacology p396
Atypical anti psychotic
| Clzapine | Tardive dyskinesia rase | Prolactin level |
| Resperidone | Tardive dyskinesia rase | prolaction level |
| Olanapine | Tardive dyskinesia rase | little in prolactin level |
Q.21 Dry mouth during antidepressant therapy is caused by blockade of:
1. Muscarinic acetylcholine receptors.
2. Serotonergic receptors.
3. Dopaminergic receptors.
4. GABA receptors.
Answer is 1
K.D.T. Essential of pharmacology p410
Anticholinergic side effect of antidepressant leads to dry mouth in the patients on these drugs.
Dry mouth is due to the Muscarinic acetylcholine receptor antagonism of these drugs.
Q.22 All of the following are hallucinogens, except:
1. LSD.
2. Phenylcyclidine.
3. Mescaline
4. Methylphenidate.
Answer is 4
Charlis G Morris psychology 10th ed/175
Hallucinogen
LSD
Mescaline
Psilocybin
Phenylcyclidine
Peyote
Phenylcyclidine is also known as angel dust.?Methylphenidate is not a hallucinogen. It is a CNS stimulant and used in treatment of narcolepsy.
Q.23 An 18-year-old student complains of lack of interest in studies for last 6 months. He has frequent quarrels with his parents and has frequent headaches. The most appropriate clinical approach would be to:
1. Leave him as normal adolescent problem.
2. Rule out depression.
3. Rule out migraine.
4. Rule out an oppositional defiant disorder.
Answer is 1
Charlis G Morris psychology 10th ed/416
Adolescence is a period of storm and stress, fraught with suffering, passion,
and rebellion against adult authority (so they may have frequent quarrels with
his parents). Between 15-30% of adolescent student dropout of high school, many
regularly abuse drugs. So the problem of in this q. is a normal adolescent
problem.
There is no sadness in mood. So it excludes depression
Frequent quarrels and loss of interest in studies only, exclude Migraine.
Oppositional defiant disorder- age group is 8-12 yr.
Q.24 Preservation is:
1. Persistent and inappropriate repletion of the same thoughts.
2. When a patient feels very distressed about it.
3. Characteristic of schizophrenia.
4. Characteristic of obsessive compulsive disorder (OCD)
Answer is 1
New oxford textbook of psychiatry 1st ed/63
Neeraj ahuja psychiatry 5th ed/13
Perservation is found in many organic mental disorders, it is not characteristic
of
schizophrenia.
It is defined as an inability to shift from one theme to another one. A thought
is retained long after it has become inappropriate in the given context. For
e.g. a patient may give a correct answer to the first question, but repeats the
same response to a subsequently completely different question.
Q.25 One of the following usually differentiates hysterical symptoms from
hypochondriacal symptoms:
1. Symptoms do not normally reflect understandable physiological or pathological
mechanisms.
2. Physical symptoms are prominent which are not explained by organic factors.
3. Personality traits are significant.
4. Symptoms run a chronic course.
Answer is 1
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