(Paper) Sample Paper For Medical Exams : Solved Version With Few Explanations (Pg- 10)

Paper : Sample Paper For Medical Exams : Solved Version With Few Explanations

Page -10

226 A 23- year old woman has experience episod of myalgias, pleural effusion, peicarditis and arthralgias without joint deformity over course of several years.

The best laboratory screening test to diagnose her disease would be:

1. CD4 Lymphocyte count.
2. Erythrocyte sedimentation rate.
3. Antinuclear antibody.
4. Assay for thyroid hormones.

Ans. 3

227. A5-year old boy is detected to be HBs A g positive in two separte occasions during a screening program for hepatitis B He is otherwise asymptomatic. Child was given 3 doses of recombinant hepatitis B vaccine at the age of one year. His mother was treated for chronic hepatitis B infection around the same time The next relevant step for further investigating the child ould be to:

1. Obtain Hbe antibodies.
2. obtain anti - HBs levels.
3. Repeat HBs Ag
4. Repeat antother cours of hepatitis B vaccine.

Ans. 1 [ we now would like to know whether the child is chronically affected/ Carrier]

228. Which of the following hepatitis viruses have significant perinatal transmission:

1. Hepatitis E virus.
2. Hepatitis C virus.
3. Hepatitis B virus.
4. Hepatitis A virus.

Ans. 3

229.The diffusion capacity of lung (DL CO)is decreased in all of the following conditions except:

1. Interstitial lung disease.
2. Goodpastur’s syndrome.
3. Emphysema.
4. primary pulmonary hypertension.

Ans.2

230.Osler;s nodes are typically seen in which one of the follwing :

1. chronic candida endocarditis.
2. Acute staphylococcal endocarditis
3. pseuduomonas endocarditis.
4. Libman sack’s endocarditis.

Ans. 2

231. Thiamine deficiency is known to occur in all of the following except:

1. Food faddist.
2. Homocstinemia
3. Chronic alcoholic.
4. chronic heart failure patient on diuretics.

Ans.2

232 . During cardiopulmonary resusitaton intravenous calcium glouconate is indicated under all for the follwing circumstances except:

1. After I min. of arrest routinely.
2. Hypocalcemia
3. Calcium channel blocker toxicity
4. Electromechanical dissociaton.

Ans.1

233. Radiaton exposure during infancy has been linked to which one of the following carcinoma :

1. Breast.
2. Melanoma.
3. Thyroid.
4. Lung.

Ans.3

234. The induction agent of choice in day care anaesthesia is :

1. Sevoflurane.
2. Ketamine .
3. propofol.
4. Methohexitone .

Ans.3

235. Bostentan is a:

1. Serotonin uptake injibitor.
2. Endothelin receptor antagonist.
3. Leukotriene modifier.
4. Calciuim sensitizer.

Ans. 2 [ Generic name: Bosentan

Manufacturer: Actelion
Drug Class: Dual endothelin receptor antagonist
Indications: Treatment of pulmonary arterial hypertension
taken from http://www.pharmacist.com/new_drug/tracleer.cfm ] [Dr Bruno]

236. Recurrent ischemic events following thrombolysis has been patho-physiologically linked to which of the following factors :

1. Antivodies to thrombolytic agents
2. fibrinopeptide A
3. Lipoprotein (a) [LP(a)]
4. Triglycerides.

Ans. 3

237 The middle cardiac vein is locted at the

1. Anterior interventricular sulcus.
2. Posterior interventricular sulcus.
3. Posterior AV groove.
4. Anterior AV groove

Ans. 2

238. Induction agent that may cause adrenal cortex suppeession is :

1. Ketamine
2. Etomidate.
3. propofol.
4. Thiopentone

Ans.2

239 Which of the following statements is true about the autonomic nerves system

1. The sympathetic outflow the CNS is through both the cranial nerves and the sympathetic chain
2. The parasympathetic outflow from the CNS is through cranial nerves only
3. The superior hypogastric plexus is located at the anterior aspect of the aortic befrucation and fifth lumbar vertebra.
4. The superir hypogastric plexus contains sympathetic fibers only.

Ans.3

240. Which of the following is pan - T laymphocyte marier?

1. CD 2.
2. CD 3.
3. CD 19.
4. CD 25.

Ans.1

241. Study this formula carefully:

True positives

--------------------------------X100

True positives +False negatives

This denotes:

1. Sensitivity.
2. Specificity.
3. Positive Predctive value.
4. Negative Predictive value.

Ans. 1

242 A oisteriorly perforating ulcer in the pyloric antrum of the stomach is most likely to produce initial localized peritonitis or abscess formation the following :

1. Omental bursa [lesser sac].
2. Greater sac.
3. Right subphrenic space.
4. Hepatorenal space [ pouch of Morison].

Ans 1

243 The “P” value of a randomised controlled trial comparing operation A [new procedure] &opertion B [ Gold standard] is 0.04. From this, we conclude that:

1. Type II error is small & we can accept the findings of the study.
2. The probability of false negative conclusion that operation A is better than operation B, when in truth it is not, is 4%.
3. The power of study to detect a difference between operation A&B is 96% .
4. the probability of a false positive conclusion that operation ‘a is better that operation B, when in truth it is not, is 4%.

Ans. 4 [ Question taken verbatim from sabiston surgery pretest, chapter 2 q no 22]

244. Which of the following statements is true for excitat0ry postsynaptic potentials [EPSP];

1. Are self propagating.
2. Show all or none response.
3. Are proportional to the amount of transmitter released by the presynaptic neuron.
4. Are inhibitory at presynaptic terminal.

Ans.3

245. Synaptic conduction is mostly orthodromic because:

1 Dendrities cannot be depolarized.
2. Once repolariced, an area cannot be depolarized,
3. The strength of antidromic impulse is less esynatic ter minal.
4. Chemical mediator is located only in the presynatic terminal.

Ans.4

246. Following are the reatures of corticospinal involvement except;

1. Cog-wheel rigidity.
2. Spasicity.
3. Planter extensor response.
4. Exaggerated deep tenedon reflexes.

Ans. 1

247. A 55- year -old woman has recurrent urinary retention after a hysterectomy done for huge fibroid. The most likely cause is:

1. Atrophic and stenotic urethra.
2. Lumbar disc prolapse.
3. Injury to the bladder neck.
4. Injury to the hypogastric plexi.

Ans.?

248. The cell junctions allowing exchange of cytoplasmic molecules between the two cells are called:

1. Gap junctions.
2. Tight junctions.
3. Anchoring junctions.
4. Focal junctions.

Ans.1

249. The collagen triple helix structure is not found in :

1. Cytoplasm.
2. Golgi apparatus.
3. Lumen of endoplasmic reticulum.
4. Intracellular vesicles.

Ans 1

250. Restriction fragment length polymophism is used for:

1. Analysis of chromosome structure.
2. DNA estimation.
3. Synthesis of nucleic acid.
4. Detecting proteins in a cell.

Ans 1

251. Positive feedback action of estrogen for inducing lulteinizing hormone surge is associated with one of the follwing steroid hormone ratios in peripheral circulation:

1. High estrogen: low progesterone.
2. Low estrogen: high progesterone.
3. Low estrogen: low progesterone.
4. High estrogen: high progesterone.

Ans.1

252. All of the following are impulse control disorders except;

1. Pyromania.
2. Trichotillomania.
3. Kleptomania.
4. Capgras’ sydrome.

Ans.4

253. A 20- year-old man has presented with increased alcohol consumption and sexual indulgence, irritability, lack of sleep, and not feeling fatigued even on prolonged periods of activity. Activity. All these changes have beenpresent for 3 weeks . The most likely diagnosis is:

1. Alcohol dependence.
2. Schizophrenia.
3. Mania.
4. Impulsive control disorder .

Ans.3

254. An alcoholic is brought to the Emergency OPD with the complaint of irrelevant talking. He had stopped using alcohol three days back. On examination, he is found to be disoriented to time, place and person. He also has visual illusions and hallucinations. ‘There is no history of head injury. The most likely diagnosis is:

1. Dementia praecox.
2. Delirium tremens.
3. Schizophrenia.
4. Korsakoff’s psychosis.

Ans.2

255. A 41 year lod married female presented with headacje for the last six month . she had several consultations. All her investigatons were found to be within normal limits. She still insists that threr is something wrong in her head and seeks another consulatatin. The most likel diagnosis is :

1. Phobia .
2. Psychogenic headache.
3. Hypochondriasis Depression.
4. Depression

Ans.3

256. Behaviour therapy to change maladaptive behaviors using reponse as reinforcer uses the principles of :

1. Classical conditioning
2. Moneling.
3. Social learning.
4. Operant conditioning.

Ans.4

257. A 15 year old boy feels that the dirt has hung onto him whenever he passes through the dirty street. This repetitive thought causes much distress and anxiety. He knows that there is actually no such thing after he has cleaned once but he is not satisfied and is compelled to think so. This has led to social withdrawal. He spends much of his time thinking about the dirt and contamination. This has affected his studies also. The most likely diagnosis is:

1. Obsessive compulsive disorder.
2. Conduct disorder.
3. Agoraphobia.
4. Adjustment disorder.

Ans.1

258. A 50 year old man has presented with pain in back, lack of interest in recreational activities. Low mood, lethargy, decreased sleep and appetite for two months. There was no history suggestive of delusions or hallucination. He did not suffer from any chronic medical illness. There was no family history of psychiatric illness. Routine investigations including hacmogram, renal function tests, liver function tests, electrocardiogram did not reveal any abnormality. This patient sould be treated with:

1.Haloparidol.
2. Sertraline.
3. Alprazolarn.
4. Olanzapine.

Ans.2

259. Fraying and cupping of metaphyses of long bones in an child does not occur in:

1. Rickets.
2. Lead poisoning.
3. Metaphyseal dysplasia.
4. Hypophosphatasia.

Ans.2 [ Ref Stephen Chapman & Richard Nakielny Radiology Diffrential Diagnosis Page 52,3rd ed. In Lead poisoning a dense metaphyseal band is seen]

260. A classical expansive lytic lesion in the transverse process of a vertebra is seen in:

1. Osteosarcoma.
2. Aneurysmal bone cyst.
3. Osteoblastoma.
4. Metastasis.

Ans. 2 [EXPANSILE lytic lesion sen in this Ref : Das Textbook of surgery]

261. CT scan of a patient with history of head injury shows a biconvex hyperdense lesion displacing the grey-white matter interface. The most likely diagnosis is:

1. Subdural hematoma.
2. Diffuse axonal injury.
3. Extradural hematoma.
4. Hemorrhagic contusion.

Ans.4 [ Since grey white matter interface is disturbed that is inside barin tissue, also infarts are pale, hemorrhages are brighter on CT within 2 weeks of injury]

262. Which of the following is the best choice to evaluate radiologically a posterior fossa tumor?

1. CT scan.
2. MRI.
3. Angiography
4. Myelography.

Ans. 2

263. Most suitable radioisotope of iodine for treating hyperthyroidism is:

1. I 123
2. I 125
3. I 131
4. I 132

Ans.3

264. In the presence of vasopressin the greatest fraction of filtered water is re-absorbed which part of the nephron:

1. Proximal tubule.
2. Distal tubule.
3. Loop of Henle.
4. Collecting duct.

Ans.1 [ Do not get distracted by "in presence of vasopressin" as greatest fraction is always absorbed from PT; Vasopressin acts on remaining fraction of water after absorbtion from PT]

265. A one-year-old child having leucocoria was detected to be having a unilateral, large retinoblastoma filling half the globe. Current therapy would involve:

1. Enucleation.
2. Chemotherapy followed by local dyes.
3. Direct Laser ablation using photo dynamic cryotherapy.
4. Scleral radiotherapy followed by chemotherapy.

Ans.1

266. A child has got a congenital catract involving the visual axis which was detected by the parents right at birth. This child should be operated.

1. Immediately.
2. At 2 months of age.
3. At 1 year of age when the globe becomes normal sized.
4. After 4 year when entire ocular and orbital growth become normal.

Ans.?4

267. A lady wants LASIK surgery for her daughter. She asks for your opinion. All the following things are suitable for performing LASIK except:

1. Myopia of 4 Diopters.
2. Age of 15 years.
3. Stable refraction for 1 year.
4. Corneal thickness of 600 microns.

Ans.2

268. Fasanella Servat operation is specififcally indicated in:

1 Congenital ptosis.
2. Steroid induced ptosis.
3. Myasthenia gravis.
4. Horner’s syndrome.

Ans. 1

269. The operation of plication of inferior lid retractors is indicated in:

1. Senile ectropion.
2. Senile entropion.
3. Cicatricial entropion.
4. Paralytic entropion.

Ans. 2

270. Which of the following lasers is used for treatment of bening prostatic hyperplasia as well as urinary calculi?

1. CO2 laser.
2. Excimer laser.
3. Ho: YAG laser.
4. Nd: YAG laser.

Ans. 3 Bailey Page 1247 , This is Holmium YAG laser.There has been considerable interest in this device, as it seems to combine the cutting properties of the carbon dioxide laser with the coagulation properties of the neodymium:YAG laser, making it particularly appealing for many surgical applications. Recently being used as a subsitute for ESWL (lithotripsy).
Prostate: Holmium Laser Resection of the Prostate (HoLRP) for BPH- Using HOLRP, the prostate can be accurately resected down to the capsule with minimal bleeding, little fluid absorption or secondary haemorrhage. Journal of Endourology, Vol. 13 Supplement 1, A98, Sep 1999

271. A 65-year-old male smoker presents with gross total painless hematuria. The most likely diagnosis is:

1. Carcinoma urinary bladder.
2. Benign prostatic hyperplasia.
3. Carcinoma prostate.
4. Cystolithiasis.

Ans.1

272. A 10-mm calculus in the right lower ureter associated with proximal hydrouretero-nephrosis is best treated with:

1. Extracorporeal shockwave lithotripsy.
2. Antegrade percutaneous access.
3. Open ureterolithotomy.
4. Ureteroscopic retrieval.

Ans.3 [Ref Das Text book of surgery]

273. Semen analysis of a young man who presented with primay infertility revealed low volume, fructose negative ejaculate with azoospermia. Which of the following is the most useful imaging modality to evaluate the cause of his infertility?

1. Colour duplex ultrasonography of the scrotum.
2. Transrectal ultrasonography.
3. Retrograde urethrography.
4. Spermatic venography.

Ans.2 [ For fructose negetive azoospermia - causes may be Ejaculatory duct obstruction, Atresia of vas / seminal vesicle. And investigations for Obstructive pathology in seminal pathology are Transrectal USG / pelvic CT with Vasography. Choices 1,4 will be fructose +ve ]

274. An eight-year-old boy presents with back pain and mild fever. His plain X-ray of the dorso-lumbar vertrbra with preserved disc spaces. There was no associated soft tissue shadow. The most likely diagnoisi is:

1. Ewing’s sarcoma.
2. Tuberculosis.
3. Histiocytosis.
4. Metastasis.

Ans. 4 [ Maheshewari Orthopaedics textbook says that in TB spine disc spaces are narrowed which is to be compaerd with normal disc space in metastasis ]

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