AIIMS May 2013 : Medicine

1. A patient presented with alcohol withdrawl syndrome now having seizure..DOC is a) Diazepam b) valproate Ans (a) Explaination : Re !Consultant!"O#$%$&' "sychiatry hand out!page 1( )ithdrawal tremors (sha*es+,itters) -!( hours a ter cessation "sychotic+perceptual disturbance . (!1/ hours a ter cessation 0eizure (Rum its) . 1/!/1 hours Delirium %remens . within 2/ hours. Deto3i ication is irst step done by 4enzodiazepines (chlordiazepo3ide) Delirium %remens . con usion5 disorientation5 &65 dangerous e3haustion 4lac* out . discrete episodes o anterograde amnesia during into3ication 7etal alcohol syndrome . 8icrocephaly5 Cranio acial mal ormation5 limb5heart de ects Disul iram . inhibits aldehyde dehydrogenase5 DA reaction characterised by lushing5 tachycardia5 palpitation5 headache5 hot lushes. Alcoholic anonymous . sel help group o recovering alcoholics A9 anon . 0pouses o alcohol Al Ateen . children o alcoholics Deterrants agents . Disul iram5 metronidazole5 citrated calcium carbamide Anticraving agents . :altre3one5 7luo3etine5 Acamprosate /. 4ells palsy which is not correct a) steroid is mandatory b) unilateral acial dea ness c) immediate surgical decompression Ans (c) REFERENCE .O6C!/5; "O#$%$&' Consultant 4'990 "A90< 0ymptomatic measures include (1) the use o paper tape to depress the upper eyelid during sleep and prevent corneal drying5 and (/) massage o the wea*ened muscles. A course o glucocorticoids5 given as prednisone -=.(= mg daily during the irst > days and then tapered over the ne3t > days5 appears to shorten the recovery period and modestly improve the unctional outcome ? A recently published randomized trial ound no added bene it o acyclovir (1== mg ive times daily or 1= days) compared to prednisolone alone or treatment o acute 4ell@s palsyA (12%6 'D$%$=: 6ARR$0O:) ? the overall weight o evidence suggests that the combination therapy with prednisone plus valacyclovir may be marginally better than prednisone alone(1(%6 'D$%$=: 6ARR$0O:)

;.

chromosome dividing perpendicular to usual a3is o division orms

a.ring chromosome b.isochromosome c)acrochromosome d)subtelomeric chromosome Ans (b) Ref!O6C 4oo*5"O#$%$&' consultant B Dysgerminomas . mutations in c!Cit oncogenes Das seen in gastrointestinal stromal tumors (E$0%)F5 whereas a subset o germ cell tumors have isochromosome 1/ 1. 'mbryonic hemoglobin is composed o GGGGGchains a)AlphaHbeta b)epsilonH gamma c).gamma Hbeta d)zeta Hepsilon Ans (d) REFERENCE ? !"O#$%$&'!O6C/5;!6ematology ? O"'RA%$O: 6ARR$! 4OOC "AE' 1-1 ? CO:0I9%A:% ? 8C% 6uman 6eamoglobins 'mbryonic hemoglobins 7etal hemoglobin Adult hemoglobins gower 1! zeta(/)5 epsilon(/) gower /! alpha(/)5 epsilon (/) "ortland! zeta(/)5 gamma (/) hemoglobin 7! alpha(/)5 gamma(/) hemoglobin A! alpha(/)5 beta(/) hemoglobin A/! alpha(/)5 delta(/) >. 0low growing tumor a ecting cerebellum5 spinal cord in chidren is a) "ilocytic astrocytoma b)8eningioma c)medulloblastoma Ans (a) ? R'7!"O#$%$&' O6C!/5;5CO:0I9%A:% ? O6C ;!Class discussion 9ow Erade Astrocytoma 8ore common in children "ilocytic Astrocytoma ! 8ost common childhood brain %umor ! Cerebellum ! Cystic5 well demarcated ! 0pindle shaped cells

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A young male with genital 5 oralulcers5 and visual disturbance A$$80 8A< /=1;

a) bechets syndrome b)Reiters syndrome c) Oculocutaneous aphthous ulceration syndrome d). 'pidermolysis bullosa Ans (a) REFERENCE ? "O#$%$&'!O6C /5; ? CO:0I9%A:% ? Discussion ron O6C; DA< ( Recurrent oral ulceration plus two o the ollowingJ Recurrent genital ulceration 'ye lesions 0*in lesions "athergy test ? %he syndrome a ects young males and emales ? 8ales and emales are a ected eKually5 but males o ten have more severe disease. 4lac*s are very in reKuently a ected. A:%$4OD$'0LLLLL ? Circulating autoantibodies against !enolase o endothelial cells and antiM0accharomyces cerevisiae antibodies (A0CANcharacteristic o Crohn@s disease) are ound to be present in the later stages o the disease. ? A tendency toward venous thrombus ormation accounts or many o the conseKuences o 4ehOPet@s syndrome ? the strong association with 69A!4> (4>1) alloantigen ? 'ye involvement with scarring and bilateral panuveitis is the most dreaded complication5 since it occasionally progresses rapidly to blindness ? %he arthritis o 4ehOPet@s syndrome is not de orming and a ects the *nees and an*les ? "A%6'RE< %'0% ? $n more serious cases5 thalidomide (1== mg+d) is e ective ? 'arly initiation o azathioprine tends to avorably a ect the long!term prognosis o 4ehOPet@s syndrome ? Colchicine can be bene icial or the mucocutaneous mani estations o the syndrome ? glucocorticoid therapy 4echet@s syndrome Diagnostic criteria! Recurrent oral ulceration Q / a) Recurrent genital ulcers b) 'ye lesions c) 0*in lesions d) "athergy %est 8J7 1J15 but males severe disease 69A 4> Eenital ulcers5 less common but more speci ic "athergy %est ! :on speci ic s*in in lammatory reaction to scratch or $ntradermal saline in,ection. 'ye . "anuveitis most dreaded complication :onde orming arthritis . *nees Arterial and venous %hrombosis

%t . steroids ? %he syndrome a ects young males and emales rom the 8editerranean region5 the 8iddle 'ast5 and the 7ar 'ast5 suggesting a lin* with the ancient 0il* Route 2. sudden onset lbbb seen in all e3cptR a.8$.. b.A068A: syndrorme. c.hypo*alemia d. hyper*alemia Ans () N!" #isc$ssed (. asymptomatic child with delta wave short "R interval which drug not to be given A$$80 8A< /=1; a) beta bloc*er b)amiodarone c)adenosine Ans (A) R'7'R':C' ? O6C /5; ? CO:0I9%A:% S. bilateral babins*i signL A$$80 8A<!/=1; a. pons hemorrhage b. basal ganglia hemorrhage c. cerebellar hemorrhage Ans (a) R'7'R:C'!O6C ;5"O#$%$&' CO:0I9%A:%

1=. )hich o the ulcer is painless A$$80 8A< /=1; A) syphilis 4) 6erpes C)Chancroid D) Ans (a) Refe%ence O6C /5; O"'RA%$O: 6ARR$ 4OOC "AE' 21> "rimary 0yphilis B "rimary chancre . a single painless B $n women5 common primary sites are the cervi3 and labia B $nguinal lymphadenopathy is bilateral Consultant %he genus %reponema includes ? %. pallidum subspecies pallidum5 which causes venereal syphilisA

? %. pallidum subspecies pertenue5 which causes yawsA ? %. pallidum subspecies endemicum5 which causes endemic syphilis or be,elA ? %. carateum5 which causes pinta. ? %he primary lesion appears at the site o inoculation5 usually persists or 1.- wee*s5 and then heals spontaneously ? Appro3imately 1>T o patients with secondary syphilis still have persisting or healing chancres ? %here are our stages o syphilis in adults primary5 secondary5 latent and tertiary syphilis. ? 8ani estations o primary syphilis include a hard painless chancre and regional lymphadenitis ? %hey can occur on the palms and the soles. %he patient may also have patchy alopecia5 condyloma lata (moist5 lat5 con luent plaKues)5 or mucous patches. 0ystemic mani estations include malaise5 anore3ia5 headache5 sore throat5 arthralgia5 low grade ever5 and generalized lymphadenopathy lues malignaLLLLL

? lues maligna5 a rare orm o secondary syphilis5

? %he criteria or diagnosis o lues maligna include strongly positive serological test results5 a severe 6er3heimer reaction5 and an e3cellent response to antibiotic therapy CORO:A &':'R$0LLLLL ? "A"I9AR 9'0$O:0 O7 0'C.0<"6$9$05A9O:E %6' A:%'R$OR 8AR$E$: O7 0CA9" ? %ertiary or late syphilis is a noncontagious but highly destructive phase o syphilis5 which may ta*e many years to developA it can mani est itsel in several orms.

11. child with mental retardation 5 seizures and angiomylipoma in *idney diagnosis is A$$80 8A< /=1; a)tuberosclerosis 4) von hipple lindau c) Ans (a) REF O6C /5; O6 boo*!page ;>1 consultant '3iting 1(th :euro ibromatosis type 1 :71 12 :euro ibroma5 neuro ibrosarcoma5 brain tumor :euro ibromatosis type / :7/ // &estibular schwannoma5 meningioma5 spine :evoid basal cell carcinoma syndrome (Eorlin@s syndrome) S 4asal cell carcinoma5 medulloblastoma5 ,aw cysts %uberous sclerosis 1 S Angio ibroma5 renal angiomyolipoma / 1&on 6ippel.9indau &69 ; Cidney5 cerebellum5 pheochromocytoma 8ultiple 'ndocrine :eoplasia 1 ()erner@s syndrome) AD 8utations in 8enin (ch11K1;) "ituitary adenoma5 malignant schwannomas "arathyroid and pancreatic islet cell tumors :euro ibromatosistype 1 (:71) AD 8utations in:71+:euro ibromin (ch12K1/!//) 0chwannomas5 astrocytomas5 optic nerve gliomas5 meningiomas :euro ibromas5 neuro ibrosarcomas5 others

:euro ibromatosis type / (:7/) AD 8utations in :7/+8erlin (ch//K1/) 4ilateral vestibular schwannomas5 astrocytomas5 multiple meningiomas5 ependymomas %uberous sclerosis (%0C) (4ourneville@s disease) AD 8utations in %0C1+%0C/ (chSK;1+1-) 0ubependymal giant cell astrocytoma5 ependymomas5 glioma5 ganglioneuroma5 hamartoma %urcot@s syndrome AD AR 8utations in A"Ca (ch>) h8961 (ch;p/1) Eliomas5 medulloblastomas Adenomatous colon polyps5 adenocarcinoma &on 6ippel.9indau (&69) AD 8utations in &69 gene (ch;p/>) 6emangioblastomas Retinal angiomas5 renal cell carcinoma5 pheochromocytoma5 pancreatic tumors and cysts5 endolymphatic sac tumors o the middle ear :euro ibromatosis . / 0 4ilateral vestibular schwannomas 0 :7/ gene . chr.// 0 :euro ibromin . / or merlin Uuvenile postr.subcapsular opacity 8ultiple ca V au lait spots and peripheral neuro ibromas occur rarely %uberous sclerosis 0 Adenoma 0ebaceum Ash leat macule shagreen patch 0 0ubependymal giant cell Astrocytoma 0 Rhabdomyomas o myocardium 0 Angiomyomas o *idney5 liver5 adrenals 0 %0C 1 . chr S 0 %0C / . chr 10 %uberin

1/. all are ma,or criteria or rheumatic ever e3cept A$$80 8A< /=1; a. carditis b. subcutaneous nodule c. polyarthralgia d. chorea Ans (c) Refe%ence ? O6C ? "O#$EO9D ? CO:0I9%A:%0 C. Rheumatic ever Rheumatogenic serotypes

! 15;5>5-51( Criterias . 7ive ma,or Carditis ! "ancarditis ! 1= . -=T ! 8itral ! :o constrictive pericarditis B 8igratory Arthritis ! 2>T 0yndenham@s chorea ! W 1=T :odules5 'rythema marignatum W1=T

1;. 7orgotten muscle in Rotator cu A$$80 8A< /=1; A)supraspinatus 4)subscapularis C)teres minor D) in raspinatus Ans () N!" #ISC&SSE#

11. )hich o the ollowing type o hip dislocation is characterised by5 internal rotation o limb5 limb shortening and restriction o abduction L A$$80 8A< /=1; A. Anterior 4. "osterior C. 9ateral D. 8edial Ans (') REF 8C%!O6C CO:0I9%A:% %ypical de ormities in dislocations Uoint (dislocation) De ormity 0houlder (anterior) Abduction 'lbow (posterior) 7le3ion 6ip "osterior 7le3ion adduction internal rotation Anterior Abduction e3ternal rotation Cnee 7le3ion5 e3ternal rotation An*le &arus "harmacology

1>. "riapism is caused by poison o a) 0ea sna*e b) 0panish ly c) 0corpion d) Rattle sna*e Ans ()

1-. Ritonavir inhibits metabolism o all e3cept a) midazolam b) amiadarone c) cisapride d) phenytoin Ans (a) REF O6C O6 4OOC!"AE' CO:0I9%A:% 8olecule 0ubstrates $nhibitors C<";A Calcium channel bloc*ers Amiodarone Anti Arrythmics Cetoconazole5 $traconazole 0tatins 'rythro5 Clarithro $ndinavir5 0aKuinavir5 Ritonavir(A$$80./=1=BBB) Antiviral ritonavir is a very potent C<";A1 inhibitor . added to anti!6$& regimens5 not because o its antiviral e ects but because it decreases clearance5 and hence increases e icacy5 o other anti!6$& agents

12. %ime dependent *illing5post antibiotic e ect is seen in A)aminoglycosides 4)4eta lactams C)Xuinolones D)8acrolides Ans (') REF "O#$EO9D O"'RA%$O: 6ARR$ 4OOC!"AE'!2>= O6C ? Antibiotic class is characterized as either concentration dependent ( luoroKuinolones5 aminoglycosides)5 such that an increase in antibiotic concentration leads to a more rapid rate o bacterial death5 or time dependent(beta lactams). ? Absorption . bioavailability ranges rom as little as 1=./=T (erythromycin and penicillin E) !1==T Damo3icillin5 clindamycin5 metronidazole5 do3ycycline5 trimethoprim!sul ametho3azole (%8"!08Y)5 linezolid5 and most luoroKuinolonesF.

1(. Drug or ,uvenile myoclonic epilepsy in pregnant emaleL a. levetiracetam b. lacosamide c. phenytoin d. carbamazepine Ans (a)

1S. which do not cause 09'L a. penicillin b. isoniazid c. hydralazine Ans (a) REF O6C5CO:0I9%A:% "O#$EO9D Drug induced lupus A:A Qve Anti 6istone Q 69A . DR1 0pares C:05 Renal $nvolves ,oint5 s*in 9ess emale "redilection Drugs ! "neumonic Z Z6$"8CX@ 6ydralazine $:6 procainamide methyl Dopa chlorpromazine Xuinidine Others ! "henytoin5 carbamazepine5 lithium. 8oderate to low ris* ? $soniazid (antibiotic) ? 8inocycline (antibiotic) ? "yrazinamide (antibiotic) ? Xuinidine (antiarrhythmic) ? D!"enicillamine (anti!in lammatory) ? Carbamazepine (anticonvulsant) ? O3carbazepine (anticonvulsant) ? "henytoin (anticonvulsant) ? "ropa enone (antiarrhythmic) ? 4iologics such as interleu*ins (eg5 interleu*in!/ D$9!/F)5 inter erons (eg5 al a5 gamma5 beta)5 and tumor necrosis actor alpha (%:7![) inhibitors are associated with musculos*eletal symptoms and antibody production suggestive o a lupusli*e autoimmune disorder ? Antiarrhythmics . "rocainamide and Kuinidine ? Antibiotics . 8inocyclineD1=F and isoniazid ? Anti ungals . Eriseo ulvin and voriconazole ? Anticonvulsants . &alproate5 ethosu3imide5 carbamazepine5D11F and hydantoins

? 6ormonal therapy . 9euprolide acetate ? Antihypertensives . 6ydralazine5 methyldopa5 and captopril ? Anti!in lammatories . "enicillamine and sul asalazineD1/F ? Antipsychotics . Chlorpromazine ? Cholesterol!lowering agents . 9ovastatin5 simvastatin5 and gem ibrozil ? 4iologics . $nterleu*ins (eg5 $9!/)5 inter erons (eg5 al a5 beta5 gamma)5 and %:7![ (etanercept5 in li3imab5 adalimubab)D>F ? $nhalers . %iotropium bromide inhalerD1;F ? Other drug categories . Ophthalmic timolol

/=. vasopressin antagonist acts onL a. cortical collecting duct b. medullary collecting duct c. pct d. Dct Ans (a) Refe%ence O6C CO:0I9%A:% "hysiology

/1. ic*@s lawL a. passive di usion b. active movement Ans (a) REF 8OD'9 'YA8 "O#$%$&' CO:0I9%A:% Discussion rom "O#$%$&' 8OD'9 e3am A . simple Di ussion B 7rom high concentration to low concentration B 7ic*s law o di ussion ! :et rate o di ussion \ Di usion co e icient Y Area o membrane Y (cin . cout) %hic*ness o membrane B Di ussion ] by ! ^ distance ! ^ size ! ] %emp ! 9ipid solubility B Eated channels

! &oltage gated ! 9igand gated ! Open or close when they bind an ion or a speci ic molecule ! '3tracellular ligands _ 1st messenger ! $ntracellular ligands _ /nd messenger 4. 7acilitated Di ussion B Carrier mediated eg. Elucose $$$ Active %ransport a) "rimary active b) 0econdary active c) Carrier type process d) &esicular %ransport process "rimary active B Directly use energy rom A%" eg. . :aQ . CQ "ump ! Ca/ "ump ! CQ . 6Q "ump :aQ CQ . "ump 8ost common pump in the body B %hree [ . [15 [/5 [; and ; ` . `15 `/5 `; subunits B :a5 CQ transport occurs through [ sub unit B 8ode o 7unction . "hosphorylation dephosphorylation B An 'lectrogenic pump with a coupling ratio o ;J/ B ; :aQ _ out B / CQ _ in B 8a,or energy consumer B $nhibitors ! %oo low :aQ5 CQ ! 6ypothermia ! ^ =/ ! "oisons . dinitro phenol "romotors $nhibitors B $nsulin B ^ :a5 CQ B %hyroid B 6ypothermia B Aldosterone B ^ =/ B E . actin B "oisons . dinitrophenol

//. dysphoria occurs due to A$$80 8A<!/=1; A)*appa receptor b)mu receptor c)delta receptor

d) ans a REF "O#$EO9D 8C%!O6C!"AE' >> CO:0I9%A:% 1=. Classi ication o opioid receptors.1 Receptor Clinical ' ect Agonists a B 0upraspinal analgesia (a!1) B Respiratory depression (a!/) B "hysical dependence B 8uscle rigidity B 8orphine B 8et!en*ephalin B `!endorphin B 7entanyl b B 0edation B 0pinal analgesia BDysphoria B 8orphine B :albuphine B 4utorphanol B Dynorphin B O3ycodone c B Analgesia B 4ehavioral B 'pileptogenic B 9eu!en*ephalin/ B`!endorphin/ d B 6allucinations B Dysphoria B Respiratory stimulation B "entazocine B :alorphine B CetamineL

/;. Ovulation occurs due to A)be ore oestrogen surge 4)bithermal raise o temperature C)706 causes rupture o ollicle D)cervisal mucus disappears Ans () Ophthal

/1. )hich o the ollowing is not the ris* actor or Rhegmatogenous retinal detachment L A$$80 8A< /=1; A. "seudopha*ia 4. 6yperopia C. %rauma D. 9attice degeneration Ans (') REF O6C CO:0I9%A:%!page (S!opthal Rhegmatogenous retinal detachment A rhegmatogenous retinal detachment occurs due to a brea* in the retina that allows luid to pass rom the vitreous space into the subretinal space between the sensory retina and the retinal pigment epithelium. Retinal brea*s are divided into three types . holes5 tears and dialyses. "redisposing actors or retinal detachmentJ ! 6igh myopia is the commonest predisposing actor. ! 9attice degeneration. ! %rauma. ! $ntracapsular cataract e3traction ($CC'). ! "osterior vitreous ace detachment ("&D) leading to acute vitreous traction to an area o abnormally strong vitreo!retinal adhesion causing retinal tears. symptomsJ 7lashes o light (photopsia) $ncrease in loaters 0ignsJ 1. &.A. is a ected only i the macula is detached. /. 8arcus Eun pupillary reaction i the retina is totally detached. ;. Red re le3 appears gray in the detached sectors. 1. 7undus e3amination shows that RD may be total5 sectorial or macular. %he detached retina showsA ! %he detached retina appears grey5 wavy and tremulous. ! %he tear appears red (the colour o underlying choroid). ! %he retinal blood vessels appear dar* and wavy. >. $O" is usually decreased. Complications o neglected casesJ 1. total detachment o the retina. /. $ridocyclitis. ;. Complicated cataract. 1. "roli erative vitreo!retinopathy ("&R)J migration o R"' cells through the retinal brea* into the vitreous where they acKuire ibroblastic activity. $t is necessary to do vitrectomy in order to be able to latten the retina. A ter vitrectomy we may ill the vitreous cavity by silicon oil. >. Retinal atrophy and consecutive optic atrophy and no "9 i detachment is neglected. %reatment o Rhegmatogenous Retinal Detachment

three general principlesJ 7ind all retinal brea*s 0eal all retinal brea*s Relieve present (and uture) vitreoretinal traction O6 4OOC!"AE' SS ? 0eparation o sensory retina rom retinal pigment epithelium ? Causes ? 0pontaneous in elderly ? %rauma ? 8yopia ? A ter cataract e3traction ? 9attice degeneration ? 0imple Detachment or Incomplicated %ype ? $t is 8C type also *nown as rhegmatogenous retinal detachment due to development o hole in retina. Retinal detachment has conve3 sur ace which does not resolve spontaneouslyA surgery is the %OC. ? %reatmentJ Aim is to close the retinal tears and to reattach the retina. ? 9aser photocoagulation ? Cryotherapy ( or sealing the hole) ? 0cleral buc*ling . encirclage ? Drainage o subretinal luid (can be treated by pneumatic retinope3y)

/>. )hich o the ollowing pair regarding drug and its mechanism is correctly matched L A$$80 8A< /=1; A. "ilocarpine . increases uveoscleral out low 4. 4rimonidine . decreases synthesis o aKueous humor C. 9atanprost . carbonic anhydrase inhibitor D. 4eta3olol . Decreases trabecular out low Ans ('(A) REF O6C CO:0I9%A:% ? 4R$8O:$D$:'!A97A A/ AEO:$0%!increases aKueous low and decrease aKueous production ? Carbonic anhydrase inhibitors!brinzolamide!decreases aKeous production ? "ilocarpine!miotic!increase out low ? 4eta3olol!cardioselective beta 1 bloc*er!decrease aKeous production

/-. Ocreoplasmin is the newer drug used in which o the ollowing L a. Retinal brea* b. &itreomacular traction c. 0ubmacular bleed d. Diabetic macular bleed Ans (') N!" #ISC&SSE#

/2. "igmentatory changes between posterior pole and eKuator 5 Dsalt and paper retinopathyF are seen in all o ollowing e3cept L A. Resolving retinal detachment 4. Rubella C. "henothiazine to3icity D. 7undus lavimaculatus Ans () REF O6C O"6%6A9 CO:0I9%A:% ? salt and pepper undus ocular undus characterized by a stippling o dar* pigmented spots and yellowish!red spots o atrophy5 as is ound in ? congenital syphilis5 ? Choroideremia ? 9eber@s congenital amaurosis5 ? rubeola5 poliomyelitis5. ? 0alt and pepper unduseconditions are ? Rubella5 ? cystinosis5 ? congenital syphilis

/(. )hich o the ollowing classically does not have calci ied oci L A. Retinoblastoma 4. "ersistent hyperplastic primary vitreous C. Optic disc Drusens D. $ntraocular melanoma Ans () REF O6C CO:0I9%A:% O6 4OOC!"AE'SS ? 'nlargment o the orbit ? 0ymmetrical J in intra!conal lesion (optic nerve glioma5 haemangioma5 ect) ? Asymmetrical J in e3tra!conal lesions (rhabdomyosarcoma5 dermoid cyst5 etc.5) ? Change in bony density J ? $ncreased J in meningioma5 "aget@s disease5 ibrous dysplasia and osteoblastic metastasis. ? Decreased or destruction J in malignant tumours. ? $ntraorbital calci ication J in orbital vari35 ? optic nerve!sheath meningioma5 ? retinoblastoma5 etc.5

? 0uperior orbital issure enlargement J in ? in raclinoid carotid aneurysm ? intracavernous aneurysm5 intracranial ? e3tension o orbital tumours etc. ? Optic canal enlargement J in optic nerve ? glioma Optic : . Drusen ? B Re ractile deposits within the substance o optic : head. ? B Elittering particles in the sur ace o optic disc. ? BIltrasound or C% scanning is sensitive or detection o buried optic disc drusen because they contain calcium. ? B "seudo papilloedemaB ? B 'nlarged blind spot arcuate scotomas.

/S. )hich o the ollowing is not related to con,uctivitis L A. &isual unction is spared 4. "upil is spared C. Corneal in ilteration D. Ans (c) REF O6C Consultant

;=. An ophthalmologist wor*ing in district hospital is li*ely to per orm ollowing surgical procedure most commonly L A. "hacoemulci ication 4. DCR C. 4ilateral 9amellar %arsus Rotation D. "ars plana vitrectomy Ans (') REF O6C "O0$EO9D ;1. 8ost common presentation o retinoblastoma L A$$80 8A< /=1; A. 9eu*ocoria with pseudohypopyon 4. 9euco*oria with 6yphema C. 9euco*oria with 6eterochromia $ridis D. 9eu*ocoria with strabismus Ans (d) REF O6C .Ophthal hand out Consultant

? 8C intraocular malignancy o childhood

? B %ypesJ ? 6eritablee4+95 8ultiple ? :on heritable solitary ? B 'tiologyJ Absense o R4 genes (due to mutation) as it is a tumor suppressor gene (%0E). ? B 8C symptom is leu*ocoria ? B 8C 0ign is ? $n small lesionsJ simulates endophthalmitis specially when endophytic ? $n large lesionsJ e3ophytic simulate Coat@s disease.

;/. 8ost common intraocular metastasis in emales are rom which o the ollowing primary tumor L A. 4reast 4. Ovary C. Cervi3 D. 'ndometrium Ans (a) REF ? O6C ? O6 4OOC "AE' 1=1 ? %umors o the orbit cause painless5 progressive proptosis. ? B %he most common primary tumors are hemangioma5 lymphangioma5 neuro ! ibroma5 dermoid cyst5 adenoid cystic carcinoma5 optic nerve glioma5 optic nerve meningioma5 and benign mi3ed tumor o the lacrimal gland. ? B 8etastatic tumor to the orbit occurs reKuently in breast carcinoma5 lung carcinoma5 and lymphoma.

;;. )hich o the ollowing bone does not orm loor o the orbit L A$$80 8A< /=1; A. #ygomatic 4. 8a3illa C. 'thmoid D. "alatine Ans (c) REF ? O6C ? CO:0I9%A:% ? 8C% ? "O#$EO9D ? %he roo (superior wall) . orbital plate rontal bone and the lesser wing o sphenoid. ? %he loor (in erior wall) . orbital sur ace o ma3illa5 the orbital sur ace o zygomatic bone and the orbital process o palatine bone. ? %he medial wall . rontal process o ma3illa5 lacrimal bone5 orbital plate o ethmoid and a small part o the body o the sphenoid. ? %he 9ateral wall !orbital process o zygomatic and the orbital plate o greater wing o sphenoid.

;1. A -= year old male with history o Diabetes complained o gradual diminution o vision over /!; days ollowed by sudden loss o vision. which o the ollowing will be the most important investigation in this scenario L A$$80 8A< /=1; A. 0erum AC' levels 4. 0erum 6omocysteine levels C. . Xuanti eron %4 assay D. 0erum Creatinine levels Ans () )

;>. Regarding 8yopic degeneration which o the ollowing is %rue A. $t is seen more commonly in males than in emales 4. 8yopic degeneration can lead to retinal detachment C. $t is seen in W . - D myopia D. Ans (') REF O6C CO:0I9%A:%!"AE' 1=1 O"6%6A9 4OOC ? 8<O"$A O7 A%9'A0% -D ? Choroidal neovascularisation ? %igroid undus ? "osterior retinal detachment ;-)4iopsy ta*en rom chalazion showsA$$80 8A< /=1; A) lipogranulomatous 4) in lammatory C) suppurative granulomatous Ans ( a) R'7 O6C CO:0I9%A:% "O#$EO9D ? A chalazion also *nown as a meibomian gland lipogranuloma5 is a cyst in the eyelid that is caused by in lammation o a bloc*ed meibomian gland5 usually on the upper eyelid. ? $nitial treatment or a chalazion in the acute stage is hot compresses .6owever5 in chronic cases5 the chalazion does not respond to this conservative treatment and must be incised and curettage. ? Recurring chalazia in the same area may sometimes be a symptom o sebaceous cell carcinoma. "O#$EO9D! Chalazion o lid is (A$$80 8A< /==() a) Caseous necrosis b) Chronic nonspeci ic in lammation c) Chronic lipogranulomatous in lammation d) 9iposarcoma Ans (c) 4iochemistry

;-. 0uicidal enzyme is A)> lipo3ygenase 4) cyclo3ygenase C) D) Ans () *at+olo,y ;2. )hich is not seen in Apoptosis a) Cell shrin*age b) :uclear condensation c) $n lammation Ans (c) REF O6C5O6 4OOC "O#$EO9D CO:0I9%A:% OE

;(. 'nd product o progesterone metabolism ound in urine is A) pregnanediol 4) C) D) Ans (A) REF "O#$%$&' CO:0I9%A:%

;S. ;= yr old "oor patient rom hilly area with h+o low grade ever5 in ertility diagnosis is a) %4 endometritis b) c) d) Ans (a)

1=. shoc* a ter normal labour..causeL a. uterine inversion b. ""6 c)amniotic luid embolism d) ans a REF O6C "O0$EO9D

11. 7emale presented with ;Y; cm relatively painless lesion on vulva. Diagnosis is a) %reponemal in ection b) Chlamydia c)Eonococcal d) ans REF 1/. 6R% in "ost menopausal women is given ir A+' a) vasomotor symptom b) prevention o CAD c) "revention o Osteoporosis Ans (') Refe%ence O6C5O6 4OOC5CO:0I9%A:%5"O#$EO9D "O#$EO9D! 1;. 6R% is help ul in all o the ollowing e3ceptJ a) &aginal atrophy b) 7lushing c) Osteoporosis

d) Coronary heart disease Ans (d) 11. All are done to prevent maternal to etal transmission o 6$& e3cept a) prenatal #iduvudine b) &aginal delivery c) Avoid breast eeding Ans (') REF O6C5"O#$EO9D CO:0I9%A:% O"'RA%$O: 6ARR$ 4OOC "AE' /= 6$& in ections B %ransmission during perinatal period . predominant cause o 6$& in children Ris* o mother to child %ransmission B &aginal Delivery B "reterm Delivery B %rauma to oetal s*in B 8aternal bleeding B 6igh viral load B 9ow CD1 count B "RO8 B Other genital in ections B %reatment . #idovidine reduces vertical %ransmission by 2=T. . Cesarian . in women with viral load f 1=== copies+ml.

1>. )hich is not included in ;rd stage in labour to prevent ""6 a) o3ytocin in,ection with delivery o sh=ulder b) $mmediate cutting n cord clamping c) misoprostol d) controlled n sustained cord traction Ans () REF CO:0I9%A:%

1-. %he ollowing is true regarding duncans method o seperation o placenta A$$80 8A< /=1; A) peripheral seperation 4) blood is collected between placenta and membranesand escapes out o vagina C) maternal part o placenta present at the vulva a ter delivery D) Ans () S$%,e%y 12. true about CO'9$AC ple3us bloc* A) given or lower abdominal malignancy 4) usually given unilateral C) diarrehoea and hypotension are common side e ects D) given in retroperitoneum at 9; level Ans (c) REF O6C "O#$EO9D 1(. "ercentage o death in emergency AAA operation A$$80 8A< /=1;

a ) 1=T b)1=T c)>T D) ans

1S. A >yr child burnt with boiling water. method used to calculate burnt area A$$80 8A< /=1; a) lund and browder b) rule o S c) palm method ANs (a) REF O6C!R'C':% AD&A:C'0 9und and browder chart . chart used to estimate the percentage o s*in burnt to the total body sur ace area in children

>=. A child had circum erential burn o 4O%6 thighs5 buttoc*5 ace n scalp. A$$80 8A<!/=1; "ercentage o burn is a) =.;2 b) =.12 c) =./2 d) =.-1 Ans (') REF O6C CO:0I9%A:%

>1. A neonate with meningomyelocele awaiting surgery.0olution to cover meningomyelocele is sterile gauze soa*ed in a) :ormal saline b) 4etadine c) d) Ans (a) REF O6C "O#$EO9D

>/. 1S yr old emal with primary amenorrhoea with a3illary n pubic hair but absent vagina n uterus. a) 8ullerian agenesis b) Y<< syndrome c) Androgen insensitivity syndrome d) Ans (a) REF O6C CO:0I9%A:% "O#$EO9D O6 4OOC "AE' /1/

? 8gllerian agenesis is a congenital mal ormation in women characterised by a ailure o the 8gllerian ducts to
develop5 resulting in a missing uterus and variable mal ormations o the vagina. $t is the second most common cause o primary amenorrhea ? she will enter puberty with development o secondary se3ual characteristics including thelarche (breasts) and adrenarche (pubic hair). ? 6er chromosome constellation will be 1-5YY. ? Ovulation usually occurs. ? %ypically5 the vagina is shortened and intercourse may in some cases be di icult and pain ul. ? 8edical e3amination supported by gynecologic ultrasonography demonstrates a complete or partial absence o the cervi35 uterus5 and vagina. ? Renal anomalies occur in />!;>T o emales with mullerian agenesis. %he &ecchietti procedureLLLLL ? %he &ecchietti procedure is a procedure that has been shown to result in a vagina that is comparable to a normal vagina in patients with 8gllerian agenesis LLLLLLL androgen insensitivity syndrome (A$0) ? which is an Y!lin*ed recessive disorder ? 1=T o all cases o primary amenorrhea. ? 1-5Y< *aryotype5 ? lac* o androgen receptor responsiveness ? severe underandrogenization and emale e3ternal genitalia. ? A person with complete androgen insensitivity syndrome (CA$0) has a emale e3ternal appearance despite a 1-Y< *aryotype and undescended testes5 a condition once called Mtesticular eminizationN ? a person with Androgen $nsensitivity 0yndrome is a phenotypic emale with a chromosomal genotype o 1-5Y<. ? 1. Complete A$0 (CA$0)J completely emale body e3cept no uterus5 allopian tubes or ovariesA testes in the abdomenA minimal androgenic (pubic or a3illary) hair at puberty ? Childhood growth is normal and the *aryotypic incongruity remains unsuspected unless an inguinal lump is discovered to be a testis during surgical repair o an inguinal hernia5 ? "atients with A$0 have a 1-5 Y< *aryotype5 but because o the lac* o androgen receptor responsiveness5 they have severe underandrogenization and emale e3ternal genitalia. %he absence o pubic and a3illary hair distinguishes them clinically rom patients with mgllerian agenesis.. ? Androgen resistance syndrome reKuires gonadectomy because there is ris* o gonadoblastoma in the dysgenetic

gonads. )hether this should be per ormed in early childhood or a ter completion o breast development is controversial.

>;. 'arliest complication o $leostomy a) Obstruction b) :ecrosis c) d) ans ' REF O6C "O#$%$&' "O#$EO9D

>1. )hich o the ollowing has Osteoblastic metastasis rate A$$80 8A< /=1; A) Ca prostate 4) Ca lung C) Ca breast D) Ans (a) REF 8C%!RD O6C 5CO:0I9%A:% Osteoblastic 4one 8etastases \ 'vidence o slow .growing neoplasm "rimary "rostate5 breast5 lymphoma5 malignant carcinoid5 medulloblastoma5 mucinous adenocarcinoma o E$ tract5 o bladder5 pancreas5 neuroblastoma 8ost common cause "rostate cancer (in adult male)A breast cancer (in adult emale) Osteolytic bone 8etastases 8ost common cause J :euroblastoma (in childhood)A lung cancer (in adult male)A breast cancer (in adult emale)5 thyroid cancerA *idneyA colon 8ay begin in spongy bone (associated with so t tissue mass in ribs) &ertebral pedicles o ten involved (not in multiple myeloma)

S*M >>. A patient presented with corneal ulcer n later on per oration..on gram staining.

Eram negative coccoid seen. Diagnosis is a) 8ora3ella b) :eisseria c)Eonococci d) REF ) CO:0I9%A:%

>-. 8eningitis is considered hyperendemic i a) / cases b) /!1= cases c) more than 1= cases d) more than 1== cases Ans () REF O6C O6 4OOC "AE' "AE' -1> ? Community!based outbrea*!8ass vaccination ? . occurrence o three or more cases within ; months in persons who have a common a iliation or reside in the same area but who are not close contacts o one another 0tructure o the "olysaccharide Capsule o Common Disease!Causing 8eningococci 'YC$%$:E 1(%6 8eningococcal 0erogroup Chemical 0tructure o Oligosaccharide Current Disease 'pidemiology A /!Acetamido!/!deo3y!D!mannopyranosyl phosphate sporadic cases worldwide 4 al a!/5(!:!acetylneuraminic acid propensity to cause hyperendemic disease C al a!/5S!O!acetylneuraminic acid 0mall outbrea*s and sporadic disease < 1!O!al a!D!glucopyranosyl!:!acetylneuraminic acid 0poradic disease )1;> 1!O!al a!D!galactopyranosyl!:!acetylneuraminic acid 0poradic diseaseA outbrea*s o disease associated with mass gatheringsA

Mic%o'iolo,y >2. 4oggy swelling with easily pluc*able hair. 6ow to diagnose a)CO6 mount b)pus culture c)biopsy d) Ans (a) REF O6C CO:0I9%A:% "O#$EO9D O6 4OOC "AE' /;2

"O#$EO9D! A 2 year old boy with boggy swelling o the scalp with multiple discharging sinuses with cervical lymphadenopathy with easily pluc*able hair. )hat would be done or diagnosisL DA$$80 :O& /==SF a) "us or culture b) CO6 mount c) 4iopsy Ans (b)

>(. which is a slow grower a) m.*ansassi b) chenolae c) ortuitum d) abcessicum Ans (A) Refe%ence!O6C5O"'RA%$O: 6ARR$ 4OOC "AE'!2;/52;= 5Consultant5"O#$EO9D ? Runyon classi ication!based on colony pigmentation!replaced by the use o D:A probes ? B:%8 are broadly di erentiated into rapidly growing (11 years o age.

EN" >S. 7ather o neurootology a)6ouse b)lempard c) d) Ans (a):O% D$0CI00'D

-=. use o 4one anchoring hearing aid!4A6A a) person with acousticneuroma in :7 / b)child with microtia c). old person with pro ound hearing loss Ans (') "O#$%$&'!R'C':% AD&A:C'0!':% ? A 4one!Anchored 6earing Aid( %: /==SHA$$80 8A<!/=1;BBB) is a type o hearing aid based on bone conduction. $t is primarily suited to people who have conductive hearing losses5 unilateral hearing loss and people with mi3ed hearing losses who cannot otherwise wear Zin the ear@ or Zbehind the ear@ hearing aids ? 4one!anchored hearing aids use a surgically implanted abutment to transmit sound by direct conduction through bone to the inner ear5 bypassing the e3ternal auditory canal and middle ear. ? A titanium MpostN is surgically embedded into the s*ull with a small abutment e3posed outside the s*in ? %he titanium i3ture bonds with the surrounding tissue in a process called osseointegration. %he hearing aid can be used once osseointegration is complete5 usually two to si3 months a ter implantation ? %he 4aha must be positioned so that it does not touch the pinna o the ear "O0$EO9D 4A6A is use ul in D%: "E'' /==SF

a) 0ensory neural dea ness b) Congenital ear canal atresia c) 8eningitis with ossi ication d) All o the above Ans (b)

-1. "atient complains o le t ear pain.On e3aminationtympanic membrane normal.Right ear normal.9e ear masss coming the posterior part!diagnosis A)C0O8 4)Ceratosis obturans C) D) Ans (') Ref Consultant

-/. )hich o the ollowing cartilage orms complete cartilagenous ring L A. 'piglottis 4. Cricoid C. Cuine orm D. %hyroid Ans (') REF O6C "O#$EO9D Ortho

-;. / years old child with ric*ets is on calcium supplements and has a oot de ormity. )hen should a decision to underta*e corrective surgery be underta*enL A. )hen vitamin D levels turn to normal 4. )hen growth plate healing is seen radio!graphically C. )hen bone speci ic al*aline phosphatase is normal D. )hen serum calcium becomes normal Ans (c) REF O6C "O#$EO9D!:O&!A$$80 /=1/

-1. hoc*ey player..in,ury toL A$$80 8A< /=1; a. medial meniscus b. AC9 posterior part

c. AC9 anterior part Ans ()

->. Eallows traction in child! A) or racture o emur sha t 4) or tibial racture C) D) Ans (A) REF "O#$EO9D!A$$80 :O&!/==S O6C 8C% 8C%! %raction systems and their uses. :ame Ise B Eallow@s traction(A$$80!:O&!/==SBBB) 7racture sha t o the emur in children below / years B 4ryant@s traction 0ame B Russell@s traction %rochanteric ractures B 4uc*@s traction Conventional s*in traction B "er*in@s traction 7racture sha t emur in adults B S=o!S=o traction 7racture sha t o emur in children B Agnes!6unt traction Correction o hip de ormity B )ell!leg traction Correction o adduction or abduction de ormity o hip B Dunlop traction 0upracondylar racture o humerus B 0mith@s traction 0upracondylar racture o humerus B Calcaneal traction Open ractures o an*le or leg B 8etacarpal traction Open orearm ractures B 6ead!halter traction Cervical spine in,uries B Crutch ield traction Cervical spine in,uries B 6alo!pelvic traction 0coliosis

*syc+iat%y --. all r true in rett@s syndrome e3ceptL a. macrocephaly b. mental retardation C)0eizures. Ans (a) REF!CO:0I9%A:% O6C "O#$%$&' R'C':% AD&A:C'0 .similair Kuestion A / year old girl child is brought to O"D with eatures o hand ringing stereotype movements5 impaired language and communication s*ills. 6er 6C is 1/ cm. 6er birth record shows 6C o ;> cm. )hat is the most li*ely diagnosisL

a) Asperger syndrome b) Rett syndrome c) 7ragile 3 syndrome d) Colarad syndrome Ans (b) ? Asperger syndrome or Asperger@s syndrome or Asperger disorder is an autism spectrum disorder that is characterized by signi icant di iculties in social interaction ? $t di ers rom other autism spectrum disorders by its relative preservation o linguistic and cognitive development ? Asperger syndrome (A0) is one o the autism spectrum disorders (A0D) or pervasive developmental disorders ("DD)5 which are a spectrum o psychological conditions that are characterized by abnormalities o social interaction and communication that pervade the individual@s unctioning5 and by restricted and repetitive interests and behavior ? Children with A0 may have an unusually sophisticated vocabulary at a young age and have been colloKuially called Mlittle pro essorsN5 but have di iculty understanding igurative language and tend to use language literally ? $ndividuals with A0 o ten have e3cellent auditory and visual perception ? A0 is also associated with high levels o ale3ithymia5 which is di iculty in identi ying and describing one@s emotions ? Rett syndrome is a neurodevelopmental disorder o the grey matter o the brain that a ects emales more commonly than males. %he clinical eatures include small hands and eet and a deceleration o the rate o head growth (including microcephaly in some). ? "eople with Rett syndrome are prone to gastrointestinal disorders and up to (=T have seizures. ? %hey typically have no verbal s*ills5 and about >=T o individuals a ected are not ambulatory. 0coliosis5 growth ailure5 and constipation are very common and can be problematic. ? Eenetically Rett syndrome (symbolized R%%) is caused by mutations in the gene 8'C"/ located on the Y chromosome and can arise (1) sporadically or (/) rom germline mutations ? 4rain levels o norepinephrine are lower in people with Rett syndrome. %he genetic loss o 8'C"/ changes the properties o cells in the locus coeruleus5 the e3clusive source o noradrenergic innervation to the cerebral corte3 and hippocampus ? Development is typically normal until -.1( months5 when language and motor milestones regress5 purpose ul hand use is lost5 and acKuired deceleration in the rate o head growth (resulting in microcephaly in some) is seen. ? 6and stereotypes are typical5 and breathing irregularities such as hyperventilation5 breathholding5 or sighing are seen in many. 'arly on5 autistic!li*e behavior may be seen. ? %he in ant with Rett syndrome o ten avoids detection until -.1( months

? %he syndrome is associated with the e3pansion o a single trinucleotide gene seKuence (CEE) on the Y!chromosome5
and results in a ailure to e3press the protein coded by the 78R1 gene5 which is reKuired or normal neural development ? 7ragile Y is the most common *nown single gene cause o autism and the most common inherited cause o intellectual disability ? Aside rom intellectual disability5 prominent characteristics o the syndrome include an elongated ace5 large or protruding ears5 lat eet5 larger testes (macroorchidism)5 and low muscle tone. 0peech may include cluttered speech or nervous speech ? 7ragile Y syndrome is an Y!lin*ed recessive condition with variable e3pressivity and possibly reduced penetrance ? %he transmission o ragile Y o ten increases with each passing generation. %his seemingly anomalous pattern o inheritance is re erred to as the 0herman parado3.

? "atients with Rett 0yndrome initially have seemingly healthy development. ? An early clinical eature is deceleration o head growth that begins when the individual is aged /!1 months. ? A period o developmental stagnation is ollowed by a period o regression. ? R0 is a genetic disorder o neurodevelopment arrest rather than a progressive process. ? %he gene or R0 is located on the Y chromosome (8'C"/ gene).

Anest+esia -2. "atient with normal "reanaesthetic chec*up was connected to monitor in O%. A ter giving iv antibiotics there was sudden pulseness.:e3t step is a) Chest compression b) call ambulance c) %wo round o breaths Ans ()

Anato-y -(. 7loor o 1th ventricle not ormed by a) 8ammilary body b) ;rd cranial nerve c) $n undibulum d) "$%I%AR< 0%A9C Ans (') REF O6C "O#$EO9D -S. A person ound unconsious5lying in right lateral position is having bruises over his right scalp5 right upper limb5right side o hip5right *nee.what would be the reason or above clinical conditionL A. %rigeminal n. $n,ury 4. Radial n. $n,ury C. sciatica n. $n,ur D.peroneal n. $n,ury Ans () *ediat%ics 2=. A child prrsented with pain abdomen on right side.. A slight increase o limbs o right side is seen. on investigation calci ied mass in right side id abdomen seen. Diagnosis is a) neuroblastoma b) )ilms tumor c) angiomyolipoma d) AR"CD Ans (') O6C CO:0I9%A:%

21. Cluver 4ucy syndrome in young children. A) hypermetamorphosis 4) 6yperse3uality C) visual agnosia D) re ractory seizures Ans (d) REF 8OD'9 'YA8 ; /=1/!similair Kuestion CO:0I9%A:%!"0<C6$A%R< 4OOC . Cluver!4ucy syndrome results rom lesions o the "O#$%$&' 8OD'9 'YA8 ; /=1/ (a) "arietal lobe (b) %emporal lobe on one side (c) %emporal lobe o both hemispheres (b) "re rontal corte3 Ans (c) ? *lgver!4ucy syndrome is a behavioral disorder that occurs when both the right and le t medial temporal lobes o the brain mal unction. %he amygdala has been a particularly implicated brain region in the pathogenesis o this syndrome. ? %he syndrome is named or 6einrich Clgver and "aul 4ucy5 who removed the temporal lobe bilaterally in rhesus mon*eys in an attempt to determine its unction. %his caused the mon*eys to develop visual agnosia5 emotional changes5 altered se3ual behavior5 hypermetamorphosis and oral tendencies. ? %hough the mon*eys could see5 they were unable to recognize even previously amiliar ob,ects5 or their use. %hey would e3amine their world with their mouths instead o their eyes (Moral tendenciesN) and developed a desire to e3plore everything (MhypermetamorphosisN). ? %he mon*eys indulged in indiscriminate se3ual behavior including masturbation5 heterose3ual acts and homose3ual acts. Contrary to popular belie 5 however5 the indings did not show an increase in se3ual behavior (Mhyperse3ualismN). ? 'motionally5 the mon*eys became dulled5 and their acial e3pressions and vocalizations became ar less e3pressive. %hey were also less ear ul o things that would have instinctively panic*ed them in their natural state5 such as humans or sna*es. 'ven a ter being attac*ed by a sna*e5 they would willingly approach it again. %his aspect o change was termed MplacidityN 2/. $n $:D$A neonatal sepsis not commonly caused by A. 0taph aures 4. '. coli C. *lebseilla D. Eroup 4 streptococci Ans () REF O6C "O#$%$&' 2;. $n ant can breath simultaneously because L A$$80 8A< /=1; a) 6igh laryn35

b) 0hort so t palate5 c) 0mall tongue Ans (a) O6C "O#$EO9D!:O&!/=1/

#e%-atolo,y 21. pin head size lesions on hand and penisRRdiagnosisLLLLLL a) scabies b) lichen planus c) lichen nitidus d) molluscum contagious Ans ()

*syc+iat%y 2>. According to 6ean "iaget cognitive developmental theary ZOut o sight is out o mind@ belongs to A) !sensiromotor stage. 4) "reoperative C) Concrete Operational D) 7ormal operational Ans (a) REF CO:0I9%A:% "0<C6$A%R< 4OOC "AE' > 0tage Age Development $ 0ensory 8otor =!/ years 8otor and sensory Re le3es coordinating body and ive senses imitating novel behavior $$ "reoperative /!2 years 9earn without reasoning (immanent ,ustice) believes punishment or bad deeds inevitable $$$ Concrete Operational 2!11 years 0yllogistic reasoning . all horses are mammals conservation and Reversibility $& 7ormal operational 11yrs! Adoles!cent $nductive an Deductive reasoning

2-. "atient presents with le t painless scrotal mass5Al a eto protein and 9D6 normal.urine e3amination shows microscopic hematuria li*ely diagnosis a) 0eminoma b) cystitis c) RCC Ans (c) REF!O6C5 CO:0I9%A:% (/)A ter mastoidectmy!pt developed vertigo!pure tone audiogram revealed sensorineural dea ness A$$80 8A< /=1; a) petrositis

b) suppurative labrynthitis c) d) Ans (b) (;)-= <ear old with D type tympanogram!management A$$80 8A< /=1; a) myringoplasty with grommet incision b) nasopharyngeal endoscopy c) d) Ans (b) Re erence!Consultant (1))hich o the ollowing is used subcutaneously in the treatment o Asthma attac*s A$$80 8A< /=1; a. 0albutamol b. %erbutalin c. 8etaprotenolol d. "inbuterolol Ans (b) Re !Consultant (>)A patient having "CO/ value o ;=mm6g5"O/ 1=>mm6g p6!2.1>.6e has partially compensated A$$80 8A< /=1; a) 8etabolic acidosis b) Resp.al*alosis c) Resp acidosis d) 8etabolic acidosis Ans (b) R'7 O6C "O#$EO9D!A$$80 8A< /=1/ (-):on!6odg*in lymphoma o orbit is due to A$$80 8A< /=1; a) 4!cell b) %!cell c) :C cell d) "re 4 cell Ans (a) R'7!Consultant (2Calculate the sample size o the study or a population whose prevalence is >=T with S>T con idence interval and 1>!>>TA$$80 8A< /=1; a) 1== b) /== c) ;== d) 1== Ans (a) R'7 O6C!0%A%$0%$C0 0"8 C9A00 ? 0ample size\1pK+D/

? \1h=.>h=.>+=.1h=.1\1== ? "\prevalence ? X\1!prevalence ? D\range (()As per :"C4 5no o vision centres to be present in the country isA$$80 8A< /=1; A) 1=5=== 4) /=5=== C) ;=5=== D) 1=5=== Ans (b) R'7!O6C!0"8 (S)Disease not included in the $ntergrated disease surveillance pro,ect A) 0na*e bite 4) %4 C) AR$ D) 9eptospirosis Ans () S=))hich o the committee recommends ; yr course in 4achelor o rural health services A) 0undar committee 4) 0rivatsa committee C) C46$ Ans () S1)8ost common 8OD< is due to A) 6:7 A9"6A 4) $"7!1 C) Elu*o*inase D) 6:7 !; Ans (A) R'7!O6C S/)%he cause o *etoacidosis in &on Eier*es disease is due to all e3cept A) "atient su ers rom hypoglycemia 4) $n most pts glucose level is low C) 7at mobilisation is low d) Ans (c) S;)Alzhiemers disease!atrophy o A$$80 8A< /=1; A) "arietal and rontal corte3 4) "arietal and %emporal corte3 C) "arietal and occipital corte3 D) 7rontal and occipital corte3 Ans (b) R'7 O6C "O#$EO9D

CO:0I9%A:% alzhiemers ? "athologically5 atrophy is distributed throughout the medial temporal lobes5 as well as lateral and medial parietal lobes and lateral rontal corte3. ? 7emale se3 may also be a ris* actor independent ? " Commonest Dementia ? " 8icroscopy ? . :euritic plaKue with A` amyloid ? . 0ilver staining neuro ibrillary %angle ? " Anosognosia ? . Inaware o these di iculties ? " 9anguage ? . naming . a ected irst ? . luency .last ? " Delusions common ? " Capgras syndrome!OCCIR0 9A%' 6'R' ? . believing that a careEiven has been replaced by an imposter ? . 1=T A$$80 :ov /=11 ? patients are unaware o these di iculties (Anosognosia)5 ? Apra3ia ? Aphasia! an early and prominent eature ? 0imple calculations and cloc* reading become di icult (ACA9CI9$A) ? C07 A beta 1/ levels are reduced5 whereas levels o hyperphosphorylated tau protein are elevated5 ? . occurs late Dearly in D94F ? " 8R$ . atrophy o hippocampus ? " 6ypometabolism o %empero.parietal corte3 ? " Ris* 7actors ? . Age5 "ositive amily 6istory "O#$EO9D!Alzheimer@s disease5 which is involvedL (A$$80 8A< /==() a) 7rontal corte3 b) Cortical atrophy o temporoparietal corte3 c) 7rontal and parietal corte3 d) Occipital corte3 Ans (b) S1) Oedema in ct absent in which stage o :eurocysticercosisL A$$80 8A< /=1; A. &esicular stage 4. Colloid stage C. Eranular nodular stage D. Calci ied nodular stage Ans () S>). A / days old neonate presented wit seizuresA wat is the ne3t investigationL A$$80 8A< /=1; A.s*ull s*iagram 4.ultrasound

C.ct d.mri Ans (4) R'7!CO:0I9%A:% S- 6omogenous opacity in right lung wit obscured right cardiac silhouette. which part o lung is involvedL A$$80 8A< /=1; A. 8edial seg o R89 4. 9ateral seg o R89 C. Apical seg o R99 D. 8edial basal seg o R99 Ans () S2) Area not involved in 6$&L A$$80 8A< /=1; a. caudate nucleus b. globus pallidus c. cingulate gyrus d. cerebral white matter Ans () S()8ost common stain or ungal hyphae A$$80 8A< /=1; A) "A0 4) 8ethanamine silver C) Congo red D) Oil red O Ans (4) R'7!CO:0I9%A:% SS)vitA prophyla3is given to postpartum women A$$80A8A< /=1; a) >=5===iu b) 15==5===iu c) /5==5=== iu d) Ans () 1==)9$%6$I8 "O%':%$A%'0 :O: D'"O9AR$0$:E 8I0C9' R'9AYA:%0.6O) 8A:< DA<0 "R$OR %O E$&$:E $% 9$%6$I8 06OI9D 4' 0%O"'D! A$$80 8A< /=1; a) 1DA< b) / DA<s c) ; DA< d) 1 DA< Ans (C) 1=1)A >2 <R O9D 8A9' "R'0':%$:E )$%6 $C0O9.$:6A9A%$O:A9 AE':% O7 C6O$C'!A$$80 8A< /=1; a) 0'&O79IRA:' b) $0O79IRA:' c) D'079IRA:' d) 6A9O%6A:' Ans (a) R'7!CO:0I9%A:%

1=/)6e ollowing enzymes dont participate in O3ygenation Reduction reaction A$$80 8A< /=1; 1) Dehydrogenase /)o3idases ;)reductases 1)pero3idases 1=;)4oundaries o acial recess. All e3ceptL A$$80 8A< /=1; a) b) c) d) 1=1)Real %ime "CR is used or . A$$80 8A< /=1; a. 8ultiplication o R:A b. 8ultiplication o speci ic segments o D:A c. 8ultiplication o "roteins d. %o *now how much ampli ication o D:A has occurred Ans () 1=>)8ethod to di erentiate entry and e3it wounds A$$80 8A< /=1; a) *ennedy phenomenon b) c) d) ans a Re !CO:0I9%A:% 1=-). irreversible steps in glycolysis..A$$80 8A< /=1; a)pyruvate *inase b) he3o*inase c)p * d) ans!b re !CO:0I9%A:% Reaction 1J "hosphorylation o glucose to glucose!- phosphate. ? %his reaction reKuires energy and so it is coupled to the hydrolysis o A%" to AD" and "i. ? 'nzymeJ he3o*inase. $t has a low Cm or glucoseA thus5 once glucose enters the cell5 it gets phosphorylated. ? %his step is irreversible Reaction ; hydro3yl group on C1 orming ructose!15-! bisphosphate. ? 'nzymeJ phospho ructo*inase. %his allosteric enzyme regulates the pace o glycolysis. ? Reaction is coupled to the hydrolysis o an A%" to AD" and "i. ? %his is the second irreversible reaction o the glycolytic pathway 1=2)"DA all e3cept A$$80 8A< /O1; 1.co/washout /.nec

;.boundingpulse 1.pulmonary hemorrhage ans a Re !O6C "O#$EO9D 1=()Dermatomal distribution pain ul vesicular lesions A$$80 8A< /=1; a)6'R"'0 #O0%'R b) c) d) ans a R'7!CO:0I9%A:%5O6C5O6 4OOC 1=S)which o the ollowing cancer can be prevented by preserving the ood in re rigertor..LL A oesophagus 4 stomach C colon DR Ans () 11=)contraindicaited in epileptic seizure A$$80 8A< /=1; a)Cetamine b) c) d) A:0 A re CO:0I9%A:% 111):ot ound in $DA A$$80 8A< /=1; a) $ncreased RD) b) Decreasd %$4C c) Decreased serum iron Ans (b) R'7 O6C O6 4OOC "AE' 1-/ CO:0I9%A:% $ron de iciency Anemia ; 0tages 11/) O the 8illenium Development Eoal 6ow many are directly realated to 6ealth A$$80 8A< /=1; a) 1 b) ; c) / d) 1 Ans (b) R'7 O6C CO:0I9%A:% "O#$EO9D

? Eoal 1J 'radicate '3treme 6unger and "overty ? Eoal /J Achieve Iniversal "rimary 'ducation ? Eoal ;J "romote Eender 'Kuality and 'mpower )omen ? Eoal 1J Reduce Child 8ortality ? Eoal >J $mprove 8aternal 6ealth ? Eoal -J Combat 6$&+A$D05 8alaria and other diseases ? Eoal 2J 'nsure 'nvironmental 0ustainability ? Eoal (J Develop a Elobal "artnership or Development 11;)A emale presented with recuurent abortions5 pain in calves5 de icincy o which is seen A$$80 8A< /=1; a) protien s b) %hrombin c) plasmin d) actor Y$$$ Ans () 111)motorcyclist a ter multiple trauma is having hypoventilation cause is A$$80 8A< /=1; A) damage to respiratory center respiratory apparatus both b) c) d) 11>)%'' is better than %%' why !A$$80 8A< /=1; a)9e t atrial thrombi b) c) d) ans d R'7!"O#$%$&' O6C / R'C':% AD&A:C'0 6A:D OI%!"AE' S> %'' %he advantage o %'' over %%' is usually clearer images5 especially o structures that are di icult to view transthoracicly (through the chest wall). %he e3planation or this is that the heart rests directly upon the esophagus leaving only millimeters that the ultrasound beam has to travel. $n adults5 several structures can be evaluated and imaged better with the %''5 including the aorta5 pulmonary artery5 valves o the heart5 both atria5 atrial septum5 le t atrial appendage5 and coronary arteries. %'' has a very high sensitivity or locating a blood clot inside the le t atrium 11-))hat is used shel li e o anesthetic agent 0uccinyl choline A$$80 8A< /=1; a) b) c) d) 112)insulin resistance in hepatic in,ury due to A$$80 8A< /=1; a)damaged hepatocyte decreased sec o insulin b) c) d) 11()8ost important unction o 86C is A$$80 8A< /=1;

1)Antigen presenting /) ;) 1) A:0 A Re !consultant5O6C 11S)A06A gets renumeration or all e3cept A$$80 8A< /=1; a) institutional delivery b) zero dose o opv n irst dose o 4CE c) Recording birth weight d)none Ans (d) R'7!O6C R'C':% AD&A:C'05CO:0I9%A:% Accredited0ocial 6ealth Activist (A06A)LLLL Accredited0ocial 6ealth Activist (A06A) general norm will be ZOne A06A per 1=== population@.$n tribal5 hilly5 desert areas the norm could be rela3ed to one A06A per habitation5 must be primarily a woman resident o the village . 8arried+)idow+Divorced@ and pre erably in the age group o /> to 1> yrs. A06A should have e ective communication s*ills5 leadership Kualities and be able to reach out to the community. 0he should be a literate woman with ormal education up to 'ighth Class. A06A would be an honorary volunteer and would not receive any salary or honorarium. 1/=)which is considered developmental delay A$$80 8A< /=1; a) pincer grasp S mnth b) moving up n downstars / n hal yr c) :ot able to sit at S month d) %wo word syllable by 1 year age Ans (C) R'7 CO:0I9%A:%5O6C!8C% Cardinal or target developmental milestones Ipper age limit (months) 8otor 7ine motor 9anguage 0ocial / . ! . 0ocial smile 1 6ead control 6olds ob,ects Cooing5 turns towards sound Recognition o mother ( 0its without support %rans ers ob,ects rom one hand to the other :onsense vocalization 9aughs 1/ 0tands without support "incer grasp 4abbles syllables "lays interactive games 1( months )al*s independently . ! ! Cey Developmental 8ilestones J 7ine 8otor Age 8ilestone 1 months Erasps a rattle or rings when placed in hand > months Reaches out to an ob,ect and holds it with both hands (intentional reaching with bide3trous grasp) 2 months 6olding ob,ects with crude grasp rom palm (palmar grasp) S months 6olding small ob,ect5 li*e a pellet5 between inde3 inger and thumb (pincer grasp) Cey Developmental 8ilestones J 9anguage Age 8ilestone

1 months %urns head to sound ; months Cooing - months 8onosyllables (Zma@5 Zba@) S months 4isyllables (Zmama@5 Zbaba@) 1/ months %wo words with meaning 1( months %en words with meaning /1 months 0imple sentence ;- months %elling a story Cey Developmental 8ilestones J "ersonal 0ocial Age 8ilestone / months 0ocial smile ; months Recognizing mother - months 0miles at mirror image S months )aves Zbye!bye@ 1/ months (1 yr) "lays a simple ball game ;- months (; years) Cnows gender 1/1)what is most important di erence between seizure n syncopeA$$80 8A< /=1; a)Irine incontinence b)9OC c)$n,ury rom all d) Ans (a) R'7 CO:0I9%A:% 1//))hat happens immediately a ter lying down A$$80 8A< /=1; a) increase in cerebral low b) immediate increase venous return to heart c) decrease o blood low to lung ape3 d) Ans () 1/;)A patient had seizure a ter in,ection o sul onamide. D3 is A$$80 8A< /=1; a) Acute intermittent porphyria b) c) d) A:0 A R'7 O6C "O#$EO9D CO:0I9%A:% 1/1):ot true in C99L A$$80 8A< /=1; A. %reatment is curative. 4. :o treatment reKuired in asymptomatic cases. C. 7or leucocytosis5 urgent treatment is to be done. D. Combination therapy or ;>T A$$80 8A< /=1;

a)8ultiple myeloma b)smouldering myeloma c)non secretory myeloma d))alderstorms macroglobulinemia ans a R'7!O6C 5O6 4OOC "AE'5CO:0I9%A:%5"O#$EO9D 8I9%$"9' 8<'9O8A Diagnosis B %riad ! 8arrow plasmacytosis f 1=T ! 9ytic bone lesions ! 0erum + urine 8 component B 4one marrow plasma cells are CD1;(Q and monoclonal. B 8yeloma!related organ or tissue impairment (end organ damage) (RO%$)J Calcium levels increasedJ renal insu iciency A anemiaJ bone lesionsJ symptomatic hyperviscosity5 amyloidosis5 recurrent bacterial in ections (f/ episodes in 1/ months). Asymptomatic myeloma (smouldering myeloma) B 8 protein in serum f;= g+9 and+or B 4one marrow clonal plasma cells f1=T. B :o myeloma!related organ or tissue impairment. :onsecretory myeloma B :o 8 protein in serum and+or urine with immuno i3ation. B 4one marrow clonal plasmacytosis f 1=T or plasmacytoma. B 8yeloma!related organ or tissue impairment. 1;2) $n pleural tap which structure in not pierced A$$80 8A< /=1; 1."ulmonary pleura /.thoracodorsal ascia ;s*in 1 Ans A 1;( which does not contribute to anorectal ring A$$80 8A< /=1; a. puborectalis b. e3ternal sphincter c. int sphinter d) Ans R'7!CO:0I9%A:%5"O#$EO9D 1;S) lady with osteoporosis is bisphophonate thrapy which is best investigation to see her bone condition A$$80 8A< /=1; 1 3ray / de3a ; ct scan A:0

11=) averge iK is A$$80 8A< /=1; 1.2= /. S= ;.111 1.(= A:0 S= R'7!CO:0I9%A:%!"O#$%$&' "0<C6$A%R< 4OOC9'%!"AE'!/( $X 0core Descriptive 9evel T o "opulation f 1;= &ery superior /./ 1/= to 1/S 0uperior -.2 11= to 11S 4right normal 1-.1 S= to 1=S Average >=.= (= to (S Dull normal 1-.1 2= to 2S 4order line -.2 W 2= 8entally challanged /./ 111) mini mental state e3amination A$$80 8A< /=1; a) b) c) d) 11/) breathing movements in a etus lead to all e3cept A$$80 8A< /=1; 1.increases towards end o term /.can lead to RD0 ;.develops the respiratory muscles 1.amniotic luid embolism 11;) orphan drug is A$$80 8A< /=1; a) or rare diseases b) c) d) ans a R'7!O6C!"O#$EO9D 111) anganawadi centres..which standards are ollowed A$$80 8A< /=1; a)$A" b)$C60 c) d) 11>) cyanosis does occur . A$$80 8A< /=1; a)critical concentration o reduced hb b) c) d) ans a

R'7!CO:0I9%A:% 11- social pathology A$$80 8A< /=1; a) b) c) d) 112)6ot spot on scan a)adenolymphoma b)adenocystic carcinoma c) d) A:0!4 R'7!O6C5"O#$EO9D 11()7or viewing root angulations ollowing angles can be used a)S= b)S=51> c)S=51>511= d) 11S)Radiology technicians should not be e3posed to radiation per wee* more than A$$80 8A< /=1; a)1= 8' b) 1= eKuivalence c) 1== eKuivalence d) ;== eKuivalence 1>=) a1 year old child su ering rom vomiting a ter being treated or a viral illness.9iver biopsy will reveal A$$80 8A< /=1; a)auto immune hepatitis b):A06 c) d) 1>1 A "R'E:A:% 7'8A9' >= <'AR0 O9D )$%6 type / dm and hyperlipidemia.9iver biopsy might reveal A$$80 8A< /=1; a)acute liver cirrhosis b):A06 c)peliosis hepatitis d)autoimmune hepatitis ans ? 1>/) A -= yr old elderly smo*ing ; pac*ets o cigarette per day developed eatures o central obesity with wea* peripheral e3tremities.)hich o the ollowing causes thisL A$$80 8A< /=1; a. 9arge cell variant b. 0Kuamous cell Ca c. AdenoCa d)0mall cell Ca ans! d R'7!Consultant5O6C5O6 4OOC "AE' ;S/

0ystem Character B Eeneral B Anore3ia5 cache3ia B ;=T B 'ndocrine B 1/T B "%6!r"(sKuamous) B 0$AD6(small cell) B AC%6 1>;) A "A%$':% 0I77'R$:E 7RO8 6'AD ache and %emporal arteritis .biopsy will reveal A$$80 8A< /=1; a)Eiant cells b) c) d) A:0 A R'7!O6C 5CO:0I9%A:% 1>1))hat is associated with strep. %hroat in ection a)Rheumatic ever b)AE: c)both ans c Re !consultant5O6C 1>>)Crumpled tissue paper appearance is seen in A$$80 8A< /=1; a)Eauchers b):eimann pic*s c) d) ans a R'7!Consultant5O6C! /R'C':% AD&A:C'0 "AE' 1=- "O#$EO9D :iemann!"ic* disease5 type CJ subacute+,uvenile :iemann."ic* disease type DJ :ova 0cotian %ype A and 4 are due to de iciency o lysosomal sphingomyelinase. %he involved gene is on chromosome 11p1>.1! 1>.1. %ype C (the most common subtype) is due to de ective transport o cholesterol between cells and has been lin*ed to a de ect in :"C!1 gene on chromosome 1( $n the classic in antile type A variant5 a missense mutation causes complete de iciency o sphingomyelinase type A being the neuronopathic orm and 4 the non!neuronopathic orm. 6istology demonstrates lipid laden macrophages in the marrow5 as well as Msea!blue histiocytesN on pathology Eiemsa staining can highlight Msea blueN histiocytes containing ceroid5 most common in %ype C disease. 7uture prospects include enzyme replacement and gene therapy. 4one marrow transplant has been attempted or %ype 4. :iemann!"ic* cells are CD!-( positive histiocytes. "A0 staining is only aintly positive5 but 0udan 4lac* 4 and Oil Red O are positive5 indicating that neutral at contained in the vacuoles. %hese lipid deposits are bire ringent and have yellow!green luorescence in I& light. 'lectron microscopy shows lamellated structures in the lysosomes (similar to myelin igures) and may also demonstrate

Mzebra bodiesN5 parallel lamellated structures in the cytoplasm %he cells o Eaucher disease are identi ied by their Mcrin*led tissue paperN cytoplasm5 seen best on touch imprints 1>-) All are true regarding 8'%6A:O9 poisoning e3cept a)critical level is 1./> b) omipazole!inhibits with aldehyde dehydrogenase c) d) 1>2) seat belt in,ury is commonly seen in a)9iver b)8esentry c)spleen d) 1>()social pathology is! A$$80 8A< /=1; a)chang in the disease pattern due to change in li e style b) c) d) 1>S):ec* mass!solitary and nontender!1+1cm!biopsy 00C.0uspected primary o un*nown origin!stage A$$80 8A< /=1; A)%= :/a 83 b) c) d) ans 1-=)damage to acial nerve above chorda tympani will lead to all e3cept A$$80 8A< /=1; a)6yperacusis b)loss o taste c)loss o sensations ans! CO:0I9%A:% 1-1)minimum amount o %C reKuired or staining o teeth A$$80 8A< /=1; a)>mg+*g+d b) /=mg+*g+d c) 1=mg+*g+d d) (=mg+*g+d 1-/)cell is in,ured by micro needle.6ow does it get sealed A$$80 8A< /=1; A)'nzymatic reaction b) c) d) 1-;)techniKue which shows change in size5 shape o chromosome A$$80 8A< /=1; a)chromosome mapping b)*aryotyping c)Eenotyping

d) 1-1) 9oss o lacrimation is due to in,ury o ! A$$80 8A< /=1; a) b) c) d) 1->)urethral crest is ormed by A$$80 8A< /=1; a)"RO0%A%' E9A:D 4)insertion o detrusor c)insertion o trigone d)pre prostatic sphincter ans a R'7!"O#$%$&' CO:0I9%A:% 1--)&agina is ormed by!A$$80 8A< /=1; a)mesoderm o urogenital sinus b)endoderm o urogenital tract c) mesoderm o urogenital ridge d) endoderm o urogenital ridge ans a R'7!O6C!8C%!E<:'CO9OE<5CO:0I9%A:% 8ale and 7emale derivatives o embryonic urogenital structures 'mbryonic structure Derivatives 8ale 7emale 9abioscrotal swelling 0crotum 9abia ma,ora Irogenital olds &entral aspect o penis 9abia minora Eenital tubercle "enis Clitoris Irogenital sinus Irinary bladder "rostate gland "rostatic utricle 4ulbo!urethral glands Irinary bladder Irethral and paraurethral glands &agina 4artholin@s glands "aramesonephric duct Appendi3 o testes 6ydatid o 8orgagni5 Iterus5 7allopian tubes 8esonephric duct Ductus epididymis Ductus di erentes Duct o epoophoron Eartner@s duct 8esonephric tubules Ductuli e erentes "aradidymis 'poophoron "aroophoron Indi erentiated gonad Corte3

8edulla %estes 0emini erous tubules Rete testis Ovary Ovarian ollicles Rete ovary Eubernaculum Eubernaculum %estis Round ligament Ovarian ligament '84R<O9OE$CA9 OR$E$:0 'ndoderm 8esoderm 4ladder Ireter (mesenephros) (intermed. mesoderm) Irethra Cidney (metanephros) (intermed.) "rostate 0eminal vesicles (intermed.) %rigone (bladder) %rigone (ureteric inlets to bladder) Eonads (testes5 ovariesA intermed. mesoderm) Eenital ducts (vas de erens5 allopian tubes) '3ternal genitalia (penis5 scrotum5 vagina)

? 1-2) Damage control surgery A$$80 8A< /=1;

a) 8inimum possible intervention b) 8a3imum possible intervention c) C) d) D) ? 1-() A survey on blind school or the prevalence o blindness when compared to prevalence in general population A$$80 8A< /=1; a) Overestimate it b) Inderestimate it c) 4oth are eKual ? 1-S) . A patient complaints o diarrhoea stool e3amination shows ova o size 1==5which o the ollowing cannot be the causeL A$$80 8A< /=1; ? A) cryptosporidium ? 4) opisthorcus viverni ? C) isospora ? Ans b ? Re !"O#$EO9D ? 12=) %cSS pertechnate hot spot on parotid spotL A$$80 8A< /=1; a) )arthims tumor b) Adenoid cystic lymphoma c) 8ucoepidermoid Ca d) 9ymphoma Ans!a R'7!"O#$EO9D5CO:0I9%A:%

? 121) A patient presented with sudden onset o severe headache with vomitting and nausea.6e complaints o nec*
sti ness .)hat is the diagnosisL A$$80 8A< /=1; a) 0A6

b) 4asilar migrane c) Cluster headache d) '3tradural hemorrhage A:0 A R'7!"O#$EO9D5CO:0I9%A:%5O6C

? 12/) A 1S yr old emale with primary amenorrhoea5wide spaced nipples hypoplastic uterus.)hat is the *aryotypeL
A$$80 8A< /=1; a) 12YY< b) 1>YO c) 1-Y< d)1-YY ans!b re !O6C5"O#$EO9D5CO:0I9%A:%

? 12;) %he ollowing test is used to di erentiate between maternal and oetal blood cell A$$80 8A< /=1;
a) A"% test b) Cleihauer 4et*e test c) 4ubblin test d) Osmotic ragility test A:0!A R'7!O6C5"O#$EO9D5CO:0I9%A:% 121) A toddler passes a drop o blood per rectum diagnosis is A$$80 8A< /=1; a) Uuvenile rectal polyp b) 6armartomatous polyp c) 7istula in ano A:0!A R'7!CO:0I9%A:% 12>Cnowledge o own disease +illness in mental status A$$80 8A< /=1; a) $nsight b) Oriention c) Uudgement d) Rapport Ans a Re !consultant 12-) %he ollowing is the mode o transmission o 9egionella pneumonia A$$80 8A< /=1; a) Aerosal transmission b) $n ectious droplets C)4lood borne Ans a Re !O6C5O6 4OOC "AE'5"O#$EO9D5CO:0I9%A:% B "roduces pontaic ever5 legionnaire@s disease. B 1st in philadelphia during American legion convention. B 7astidious Aerobic Eram negative bacilli. B 1S species5 -1 serogroups. B 9."neumophilia . (=!S=T D4u ered charcoal yeast '3tractF! serogroups 15 15 and - are most common.BBB

B 9. micdadei ("ittsburgh pneumonia agent)5 9. bozemanii5 9. dumo ii5 and 9. longbeachae. B Direct luorescent antibody (D7A) test!directed primarily at the lipopolysaccharide. B Can live in years in re rigerated water. B 0ource . water. B 8ode o %ransmission . microaspiration5 inhalation. 122) A patient develops itchy urticarial plaKues tense blisters which o the ollowing can be used to diagnose A$$80 8A< /=1; a) biopsy b) Direct immuno luorescence c)$ndirect immuno luorescence d) ans a re !O6C5O6 4OOC "AE' /;S Dermatitis 6erpeti ormis B $ntensely pruritic5 papulo vesicular s*in disease. B 0ymmetrical5 e3tensor sur ace. B "rimary lesion . papule5 urticarial plaKue. B Associated with gluten sensitive enteropathy. B S=T . 69A 4(+DR);5 69A . DX)/. B /nd . 1th decade. B 4iopsy ! 0ub epidermal bullae with neutrophils in dermal papillae. ! $mmuno . Eranular deposits o $gA in papillary dermis and along the epidermal basement membrane zone. B Auto antibodies ! $gA anti endomysial antibodies that target tissue %ransglutaminase. B ] incidence o %hyroid abnormalitis5 achlorhydria5 atrophic gastritis and antigastric parietal cell antibodies. B %reatment . Dapsone . Response within /1 . 1( hrs. B Eluten Restriction. 12() %he ollowing are the tests o malabsorption e3cept A$$80 8A< /=1; a) D!Yylose test b) 1;C breath test c) 1;C breath test d) 11 C breath test 12S) 6"$ does not include A$$80 8A< /=1; a) Child literacy rate b) 9i e e3pectancy not beyond 1= yrs c) $t di ers rom developing and developed countries 0ocial pathology ? 0tudy o social problems which undermine the social5 psychological and economical health o population ? Describes relationship between disease and social condition ? Incovered by social surveys ? 0ocial problems are o three types ? 0ocial constraints ? 0ocial evils

? 0ocial deviance ? 6uman poverty $nde3 . term was introduced in 1SS2. ? %he dimensions or 6"$ . 15 while 6D$ measures average achievements in basic dimensions o human development5 the 6"$ measures deprivation in those dimensions. %he dimensions used in 6"$ . 1 ? A long and healthy li e vulnerability to death at a relatively early age (probability at birth o not surviving to age 1=.