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NIMSET-2011 Question Booklet Entrance Examination for Admission to MD/MS Subject

20 March 2011

NIMSET-2011
Marks 150 Time: 02 hrs:30 min

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Select the one that is most appropriate and darken the corresponding Oval in the OMR-Answer sheet

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UPLOADED BY - RAJASEKHARR

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Q1. A 24-year female involved in a road traffic accident presents in shock with raised jugular venous pressure and is disoriented. Her heart sounds are feeble. Which of the following interventions is/are recommended in her initial management. 1. left atrial pressure measurement 2. intravenous fluid replacement 3. central venous pressure monitorng 4. closed pericardiocentesis A) B) C) D)
only 1, 2, and 3 are correct only 1 and 3 are correct only 2 and 4 are correct only 4 is correct

Q2. Which one of the following diagrams best represents the resection portion (below the line) for Whipple's surgical procedure

A) B) C) D)

diagram 1 diagram 2 diagram 3 diagram 4

Q3. Given below is a depiction of graphical trends of ventilation (V), perfusion (Q), and ventilation-perfusion ratio (V/Q) as related to lung zones. The lines 1,2, and 3 represent which one of the following respectively.

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A) B) C) D)

V/Q ratio, V, Q V, Q, and V/Q ratio Q, V, and V/Q ratio V, V/Q ratio, Q

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Shown below is the double reciprocal (Lineweaver-Burk) plot of enyzme kinetics in Q4. the presence and absence of an inhibitor

Assertion: the graph represents reversible non-competitive inhibition Reason: in this graph, presence of inhibitor changes the Km A) Both Assertion and Reason are true, and Reason is the correction explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correction explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true A 60-year old debilitated woman recovering from an operation for gallstone ileus on Q5. the fifth postoperative day develops fever and complains of pain in the region of the left parotid gland. The most likely causative organism A) staphylococcus aureus B) escherichia coli C) bacteroides D) streptococci

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Q6.

Regarding schematic representation of the surgical procedure shown below,

Assertion: the procedure is a corrective surgical procedure in the management of a patient with tetralogy of Fallot Reason: the procedure corrects the cyanosis by increasing pulomary blood flow

A) Both Assertion and Reason are true, and Reason is the correction explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correction explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true
A 40-year old female patient with severe mitral stenosis underwent hysterectomy. Q7. In the immediate postoperative period, she developed pulmonary edema and died. The correct sequence of entries in the international death certificate for the following items respectively: condition directly leading to death, antecedent cause/causes, and other significant conditions , is A) pulmonary edema, hysterectomy, mitral stenosis B) mitral stenosis, pulmonary edema, hysterectomy C) pulmonary edema, mitral stenosis, hysterectomy D) hysterectomy, mitral stenosis, pulmonary edema

Q8. In the evaluation of kidneys, the risk of radiation exposure to the patient is maximum with which one of the following investigations: A) B) C) D)
Intravenous urography magnetic resonance urography ultrasonograhy renal scintigraphy

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The graph is a record of the changes in intestinal smooth muscle membrane potential Q9. to various agents (physical/chemical).

Agents that produce response Y 1. epinephrine 2. cold 3. sympathetic stimulation 4. acetylcholine A) only 1, 2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correct

Q10. The excessive bleeding due to tissue plasminogen activator (alteplase) is best treated with A) desmopressin B) tranexamic acid C) vitamin K D) fibrinogen

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Q11. Shown below is the risk (relative risk and 95% confidence intervals) of gastrointestinal (GI) complications of various non-steroidal antiinflammatory drugs with data derived from a meta-analysis of 12 comparative studies. The risk is shown relative to ibuprofen. Ibuprofen itself carries relative risk of 2, compared to placebo. Which one of the following represents the correct interpretation of the graph

A) the relative risk for aspirin compared to ibuprofen is 1 B) the point estimate of relative risk of fenoprofen is 1 C) GI complications of diclofenac are higher than that of placebo but lower than that of
ibuprofen D) the risk of GI complications of all the 12 drugs is higher than that of ibuprofen

Q12.

All of the following are grouped under 'pre-invasive' lesions of vulva except A) Bowen's disease B) intraepithelial vulval carcinoma C) hidradenoma D) Paget's disease

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Q13. Skeletal survey of a 5-year old anaemic boy showed dense bones with fractures. The most probable diagnosis is A) B) C) D) Q14.
osteogenesis imperfecta osteopetrosis achondroplasia chronic renal failure

Regarding methanol poisoning

Assertion: administration of ethanol is one of the treatment modalities Reason: ethanol inhibits alcohol dehydrogenase

A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

Q15. Regarding screening profile for a pregnant woman in first trimester, Assertion: Testing for herpes simplex virus 2 is not a part of the screening profile Reason: It causes perinatal infection A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true Q16. Subacromial and subdeltoid bursae separate the supraspinatus tendon from 1.pectoralis major muscle 2.deltoid muscle 3.subscapularis muscle 4.acromion process A) only 1,2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correct Q17.
Which one of the following is the most common type of congenital cataract

A) B) C) D)

coronary cataract blue dot cataract anterior polar cataract zonular cataract

Q18. Antiseptic solutions useful for surgical skin preparation 1. isopropyl alcohol 2. hexachlorophane

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3. povidone-iodine 4. cetrimide

A) B) C) D)

only 1, 2, and 3 are correct only 1 and 3 are correct only 2 and 4 are correct only 4 is correct

Q19. Given below is a scheme of chest radiograph with 4 lines a, b, c, d representing different lengths

Which one of the following correctly represents the formula for calculating cardiothoracic ratio

A) B) C) D)

(a + b) / (2 x d) a/d (a + b) / c (a + b) / d

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thondamanati.raj@gmail.com

Q20. The surgical needle types shown in figures 1, 2 and 3 represent which one of the following respectively

A) B) C) D)

standard cutting, reverse cutting and round bodied reverse cutting, standard cutting, and round bodied reverse cutting, round bodied and standard cutting round bodied, standard cutting and reverese cutting

Q21. Recurrent laryngeal nerve is to be protected in thyroid surgery as it is intimately related to A) superior thyroid artery near the gland B) superior thyroid artery away from the gland C) inferior thyroid artery near the gland D) inferior thyroid artery away from the gland Q22.
Given below is a figure demonstrating a type of regional block used for anesthesia

All of the following statements are true about the block except A) the needle enters the required space via sacrococcygeal membrane B) is an intrathecal block C) blocks the perineal area D) suitable technique for anal dilatation in cases of fissure in ano

Q23. In the management of hyperkalemia which drug acts without reducing serum potassium level A) intravenous calcium gluconate B) insulin and glucose infusion 10 of 48
dr.rajasekharr@gmail.com

C) intravenous sodium bicarbonate D) cation exchange resin enema Q24. A) B) C) D) Q25.

Nutritive sucking in fetus develops by 28 weeks of gestation 32 weeks of gestation 34 weeks of gestation 36 weeks of gestation

Cleft palate repair is frequently performed between A) 3 and 6 months B) 6 and 18 months C) 3 and 6 years D) ideally at birth

Q26. Regarding laryngeal cancers Assertion: prognosis is better in glottic cancers compared to supraglottic cancers Reason: true vocal cords possess little or no lymphatic drainage A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true Q27. A person with a myopic eye cannot see objects distinctly beyond 120 cm. The refractive power of the lens to restore proper vision is A) -1.2 D B) -0.83 D C) -0.0083 D D) 0.83 D Q28. A well proven psychological treatment in the management of obsessive compulsive disorder is A) Flooding B) Systematic desensitization C) Exposure and response prevention D) Jacobsen's progressive muscular relaxation therapy

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Q29. Which one of the following laboratory indicators of sepsis is most helpful in differentiating severe bacterial infections from other infectious or noninfectious causes of systemic inflammatory response. A) leukocytosis B) C-reactive protein C) procalcitonin D) blood lactate Q30. Shown below is the schematic representation of characteristic pain patterns for various causes of colicky abdominal pain. Graph lines 1,2,3 represent which one of the following respectively

A) B) C) D)

intestinal, biliary, ureteric ureteric, biliary, intestinal ureteric, intestinal, biliary biliary, intestinal, ureteric

Q31. Regarding immediate complications of tracheostomy, Assertion: Apnoea follows the opening of trachea in a patient who had prolonged respiratory obstruction Reason: loss of respiratory stimulus resulting from sudden wash out of carbon dioxide A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

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Q32. A 16-month old male infant presented with an enlarging abdominal mass. Laboratory investigations revealed increased urinary levels of metanephrine and vanillylmandelic acid. Biopsy showed small tumor cells with hyperchromatic nuclei and little or no cytoplasm. Occasional focal groups of tumor cells were arranged in a ring around central space. The most likely diagnosis is A) adrenal cortical carcinoma B) ganglioneuroma C) neuroblastoma D) nephroblastoma Q33.
Telomerase activity is usually absent in A) germ cells B) somatic cells C) stem cells D) cancer cells

Q34. Regarding, systemic changes associated with inflammation Assertion: measure of ESR (erythrocyte sedimentation rate) is a simple test for systemic inflammatory response Reason: fibrinogen, an acute phase protein, can cause stacking of erythrocytes A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true Q35. The factor/factors that differentiate acute lung injury (ALI) from acute respiratory distress syndrome. 1. timing of etiological factor 2. level of PEEP 3. pattern of infiltrates on chest radiograph 4. PaO2/FiO2 ratio A) B) C) D) only 1,2 and 3 are correct only 1 and 3 are correct only 2 and 4 are correct only 4 is correct

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Q36. The figure shown below represents a trimodal pattern of an event occurring after major trauma. The 'y' axis best represents the rate of

A) B) C) D) Q37.

fat embolism infection blood loss mortality

Ondanstetron acts as an antiemetic by A) suppressing the activity of chemoreceptor trigger zone B) constricting the lower esophageal sphincter C) depressing the efferents from vomiting centre D) virtue of its antidopaminergic activity

Q38. Radio Iodine treatment is contraindicated in thyrotoxicosis associated with 1.pregnancy 2.toxic solitary nodule 3.active Graves ophthalmopathy 4.patients age more than 40 years A) only 1,2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correct

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Q39. Shown below is the schematic representation of extent of different types of epithelial lining of the respiratory tract

The epithelium types 1, 2 and 3 represent which one of the following respectively A) pseudostratified, ciliated, and simple squamous B) ciliated, pseudostratified, and simple squamous C) simple squamous, ciliated, and pseudostratified D) ciliated, simple squamous, and pseudostratified

Q40.

A) B) C) D) Q41.

Elective tracheostomy is usually done by incising cricothyroid membrane thyroid cartilage cricoid and first cartilage 2nd and 3rd cartilages

'Honeycombed' appearance of the liver is seen in cases of A) post mortem staining B) putrefaction

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C) mummification D) autolysis Q42. Figure below depicts receiver operating characteristic (ROC) curves for four tests ( tests 1,2,3 & 4) for detection of coronary artery disease. Which one of the following statements is true

A) B) C) D) Q43.

area under the curve for test 1 is equal to 1 test 2 has better utility than test 1 test 3 can replace test 1 for routine use test 4 provides no additional information

An important advantage of MRI over CT is that it A) provides more information on electron density B) has no geometric distortion C) provides superior soft tissue delineation D) precisely defines the bony landmarks

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Q44. A 35yr old female presented with secondary amenorhhea of 8 months duration. The last child birth was 2yrs ago. Pregnancy test was negative. Thyroid function tests were normal, prolactin level was normal and estrogens were decreased and FSH was high. This is most probably A) Asherman syndrome B) polycystic ovarian disease C) premature ovarian failure D) Sheehan syndrome Q45. Regarding pathophysiology of atherosclerosis, Assertion: homocysteine is risk factor for development of atherosclerosis Reason: homocysteine is metabolized by enzymes which are dependent on vitamin B6, vitamin B12 and folic acid A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true Q46. A) B) C) D)
Aerosol therapy is useful in providing all of the following except humidification a means to deliver medication decrease coughing expectoration promotion

Q47. The chain terminating codon UAA in a m-RNA has been changed to UAG due to mutation. As a result, in the protein synthesised A) one of the amino acids is substituted by a different amino acid B) number of amino acids is increased C) number of amino acids is decreased D) there is no change in either number or sequence of amino acids

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Q48. Drugs A and B were given by intravenous bolus every 24 hours. From the graph, it can be concluded that

A) drug A does not maintain persistent therapeutic levels when administered every 24 hours B) drug A exhibits cumulative properties C) drug B is non-cumulative when administered every 24 hours D) drug B is completely destroyed in less than 24 hours Q49. The mechanism of action of vancomycin, erythromycin and metronidazole on microbials respectively are A) DNA damage, inhibition of protein synthesis and cell wall damage B) DNA damage, cell wall damage, and inhibition of protein synthesis C) cell wall damage, DNA damage, and inhibition of protein synthesis D) cell wall damage, inhibition of protein synthesis, and DNA damage Q50. Which one of the following statements is correct regarding true labour pain A) unrelated to hardening of uterus B) results in progressive cervical dilatation and effacement C) pain unaffected by walking D) intensity of pain remains same over time

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Q51. A woman aged 20 years presents to emergency with complaints of pain in the hypogastrium and history of not passing urine since last 12 hours. She had no history of fever or any other complaints. Her last menstrual period was 3 months back. On examination the vital signs were normal, no pallor was noted. Abdominal examination revealed a soft palpable mass in hypogastrium and vaginal examination showed cervix to be high under pubic symphysis and a separate mass palpable in pouch of Douglas. The most probable diagnosis is A) ectopic pregnancy with rupture B) retention of urine due to retroverted gravid uterus C) acute renal failure in pregnancy D) urinary tract infection Q52. The diagram shown below is a schematic representation of a surgical procedure for portal hypertension bleed and is known as

A) B) C) D)

proximal spleno-renal shunt distal spleno-renal shunt non-selective shunt non-selective shunt with devascularisation

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Q53. A CT-angiography of a patient with peripheral vascular disease is depicted below. The ideal type of surgical procedure indicated is

A) B) C) D) Q54. A) B) C) D) Q55.

right axillary femoral bypass femoro-femoral bypass aortobifemoral bypass femoro-popliteal bypass

Isolated conjugated hyperbilirubinemia is seen in haemolytic jaundice Gilbert's syndrome Dubin johnson syndrome Criggler Najjar syndrome

Which one of the following secondary skin lesions represents excessive accumulation of stratum corneum A) lichenification B) scale C) crust D) scar

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Q56.

For prospective renal allograft recipient hyper acute rejection can be avoided by A) by detection of sensitisation to HLA class I antigens B) by HLA crossmatching alone C) preoperative methyl prednisolone administration D) testing compatability for Rh Antigens

Q57. Consider the following hypothetical situation. A family has 8 members consisting of 2 grandparents and 2 parents (already immune to measles) and 4 children who are susceptible to measles. There occurs a primary case and within a short time 2 secondary cases among the remaining children ". What is the secondary attack rate? A) B) C) D) Q58.
75% 66.6% 50% 37.5%

A) B) C) D)

In paralysis of the left superior oblique muscle, patients head is tilted downwards and towards right shoulder downwards and towards left shoulder upwards and towards right shoulder upwards and towards left shoulder

Q59. A 54-year old man becomes ill 3 hours after eating Chinese fried rice. He began vomiting, and developed watery diarrhoea without blood. The most most likely cause of his illness is A) Camphylobacter jejuni B) Salmonella typhi C) Bacillus cereus D) Staphylococcus aureus

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Q60. True statements regarding the congenital condition of gastrointestinal tract depicted in the diagram below

1.associated with renal agenesis 2.enterocolitis is a potential complication 3.colonic distension extends upto the anal canal 4. majority of cases manifest clinically in the first 48 hours after birth

A) B) C) D)

only 1, 2, and 3 are correct only 1 and 3 are correct only 2 and 4 are correct only 4 is correct

Q61. A 50 year old man has 2x2cm carcinomatous ulcer in the rectum. The ulcer is situated 6cm from anal verge. On investigation it is staged as T2N0M0. He does not have any comorbid condition. He would be best managed by A) abdominoperineal resection B) low anterior resection C) Hartmann's operation D) chemoradiation followed by surgery

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Q62. Consequent to partial or total absence of the decidua basalis and imperfect development of fibrinoid layer (Nitabuch layer), the placental villi are attached to myometrium in A) placenta accreta B) placenta increta C) placenta percreta D) placenta previa Q63. How much of glucose is reabsorbed in a minute when the blood glucose level is 100 mg/dL and the GFR 120 ml/min? A) 60 mg/min B) 100 mg/min C) 120 mg/min D) 180 mg/min Q64. A patient is to be operated on for a tumor of the small bowel.In the preoperative interview, a history of flushing, diarrhea, and joint pain is elicited.There are also symptoms compatible with congestive heart failure. A likely diagnosis is A) carcinoid syndrome B) pheochromocytoma C) Peutz-Jegher's syndrome D) adrenal tumor with metastasis Q65. The disorders 1,2, and 3 depicted in the figure below represent which of the following gynecological conditions respectively

A) B) C) D)

cystocele, rectocele, and enterocele cystocele, enterocele, and rectocele rectocele, cystocele, and enterocele rectocele, enterocele, and cystocele

Q66. A 12 year old boy complained of painful enlarging mass, fever and X-ray showed an osteolytic lesion in the diaphysis of femur. The histopathology showed small blue round cells with rosettes. The most likely diagnosis in this case is A) osteosarcoma 23 of 48

B) osteoclastoma C) chondrosarcoma - small cell variant D) Ewing's sarcoma Q67. The skin lesions shown in the diagram below are most likely to result from which one of the following conditions

A) B) C) D)

allergic contact dermatitis hypersensitivity reaction to drugs fulminant meningococcemia fat embolism

Q68. Which of the following statements regarding the role of 2,3 disphosphoglycerarate (DPG) in red blood cell physiology is true A) B) C) D)
it binds with greater affinity to hemoglobin F than to hemoglobin A it decreases in concentration as an adaptive mechanism at high altitudes it decreases the affinity of hemoglobin A for oxygen its synthesis is decreased by tissue hypoxia

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Q69.

Shown below is the schematic diagram of cell cycle phases.

The numbers 1,2 and 3 depicted in the boxes correspond to which one of the following correctly A) mitogens, mitosis, DNA replication B) mitosis, DNA replication, mitogens C) DNA replication, mitogens, mitosis D) mitogens, DNA replication, mitosis
Regarding the treatment of acute primary angle closure glaucoma Assertion: Mechanical pressure applied to the center of cornea may help as an adjunct to drug therapy Reason: It increases the pressure in the anterior chamber A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

Q70.

Q71. Regarding sampling of arterial blood acid base gas analysis, Assertion: Ideally, the sample should be taken to the laboratory in a ice slush and be analyzed within 15 minutes. Reason: Heparin anticoagulant used in the sample is acidic A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

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Q72. Shown in the figure is an entry wound of rifled firearm. A,B and C in the figure correspond to which of the following respectively

A) B) C) D)

A-abrasion collar, B-dirt collar, C-tattooing A-dirt collar, B-abrasion collar, C-tattooing A-tattooing, B-abrasion collar, C-dirt collar A-abrasion collar, B-tattooing, C-dirt collar

Q73. Ureteric blood supply 1. renal artery 2. testicular or ovarian artery 3. superior vesical artery 4. inferior vesical artery A) only 1, 2, and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correct Q74.
Fetal assessment by bio-physical profile includes all except A) fetal gross body movements B) amniotic fluid index C) fetal weight D) fetal breathing movements

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Q75. Given below are performance characteristics of a diagnostic test for a particular disease .

Which one of the following formulae represents that for calculation of predictive value of a positive test

A) B) C) D)

a/(a + c) b/(b +d) a/(a + b) (a+b)/(a + b+c+d)

Q76. A mother has brought her 3 months old baby to the pediatrician and informs that the child is lethargic, has poor suckling and seems uninterested in feeding. In addition, the mother also informs that the baby's diapers often smell like burnt sugar. The infant likely has a defect in which of the following enzymes A) B) C) D)
cystathionine synthase homogentesic acid oxidase phenylalanine hydroxylase branched chain alpha ketoacid dehydrogenase

Q77. Which one of the following manifestations of menopausal syndrome is not responsive to local estrogen therapy A) dyspareunia B) vaginal relaxation C) atrophic vaginitis D) urethral syndrome

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Q78. Shown below is the anterior surface of the right kidney. The areas 1,2 and 3 are related to which of the following structures respectively

A) B) C) D)

coils of small intestine, duodenum, jejunum duodenum, coils of intestine, jejunum jejunum, coils of intestine, duodenum coils of small intestine, jejunum, duodenum

Q79. In prolonged starvation (after 7 days of fasting), 75% of the fuel needs of the brain are met by A) glucose B) glucogenic aminoacids C) aceto-acetate D) acetone Q80. Regarding the human placenta
Assertion: Both the amniotic membrane and the chorionic laeve contribute to the tensile strength of the foetal membranes Reason: The amniotic membrane and chorionic laeve are adherent at term A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

Q81.

Frequency of rest tremor in Idiopathic Parkinson's Disease is A) 2/sec B) 4-6/sec

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C) 8-10/sec D) 12-16/sec Q82. Which one of the following clinical signs would favour a diagnosis of panophthalmitis in a patient presenting with acute inflammatory proptosis A) B) C) D)
complete loss of vision from the beginning bilateral involvement severe constitutional symptoms clear cornea and anterior chamber

Q83. The flowchart shown below depicts few steps of glycolysis indicated by numbers. Substrate level phosphorylation takes place in step

A) B) C) D)

8 7 6 5

Q84. Which one of the ankle brachial pressure index (ABI) values given below indicate severe peripheral vascular disease of lower extremities with high risk of gangrene A) 0.9 B) 0.3 C) 1.1 D) 1.6

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Q85.

The bleed in this CT scan is located in the

A) B) C) D)

basal ganglia thalamus temporal lobe frontal lobe

Q86. In the schematic representation of designs, the study designs 1, 2 and 3 represent which one of the following

A) B) C) D) Q87.

retrospective case-control, prospective cohort, retrospective cohort retrospective cohort, prospective cohort, retrospective case-control retrospective cohort, retrospective case-control, prospective cohort. prospective cohort, retrospective case-control, retrospective cohort

Scoliosis that disappears on sitting is

A) structural scoliosis

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B) sciatic scoliosis C) congenital scoliosis D) postural scoliosis Q88. In telemedicine, the recommended file formats suitable for transmission of medical images (e.g. CT scan) from a remote end to the specialist end is A) B) C) D) Q89. A) B) C) D)
powerpoint DICOM JPEG MPEG

Frequency of tuning fork utilized for Weber's and Rinne's test is 128 Hz 256 Hz 512 Hz 1024 Hz

Q90. Tenderness in the anatomical snuff box indicates fracture of which one of the following bones (indicated by numbers) depicted in the diagram given below

A) B) C) D) Q91.

bone 1 bone 2 bone 3 bone 4

Regarding the presentation depicted in the figure below

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Assertion: there is no mechanism for normal delivery Reason: fundal height is less than expected for the period of gestation A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true Q92.
All of the following statements regarding lithium carbonate are true except

A) it prevents both manic and depressive relapses B) it causes neutropenia C) screening of renal function and thyroid function is required prior to initiation of lithium therapy D) levels of 0.8 to 1.2 milliequivalents/L are usually required to treat acute phase

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Q93.

In the schematic diagram shown below, the cell type indicated by arrow typically is

A) B) C) D) Q94.

CD4 T cell CD 8 T cell dendritic cell B lymphocyte

Superantigens activate the immune system through A) specific contact between antigen presenting cells and the T lymphocytes B) nonspecific interaction with the T lymphocytes and the MHC class II receptors C) specific contact with B lypmphocytes D) direct activation of complement cascade.

Q95. Regarding, Intrauterine contraceptive device (IUD) Assertion: Copper-T device should be replaced every 3 to 5 years Reason: The IUD undergoes slow migration in the uterine cavity and may cause uterine perforation. A) Both Assertion and Reason are true, and Reason is the correct explanation for
Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

Q96. The role of microbial biofilm in pathogenesis of infections 1.provides protection against epithelial adherence by microbes 2.conisists of many cells and polysaccharides 3.is important in microbial shedding from host 4.contributes to drug resistance of microbes A) B) C) D) Q97. only 1, 2, and 3 are correct only 1 and 3 are correct only 2 and 4 are correct only 4 is correct

Mc Naughten's Rule is useful to establish

A) identification of a person B) criminal responsibility of insane

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C) civil responsibility of insane D) drunkenness Q98. The deformity of the right upper extremity shown in the diagram below results most commonly from complication of which one of the following fractures

A) B) C) D)

olecrenon fracture coronoid process of ulna supracondylar fracture fracture of upper third of ulna with dislocation of head of radius

Q99. In a 5-year old male child with history of fever and convulsions, the finding/findings that can be used to detect meningitis clinically 1.hip flexion induces knee pain 2.loss of knee jerk 3.inability to hold neck 4. spontaneous similar movement of hips and knees upon flexion of neck A) B) C) D) only 1, 2, and 3 are correct only 1 and 3 are correct only 2 and 4 are correct only 4 is correct

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Q100. In the schematic diagram of endothelium, conditions 1, 2, and 3 represent which of the following pathological states respectively

A) B) C) D)

inflammation, thrombosis, hypersensitivity hypersensitivity, thrombosis, inflmmation thrombosis, inflammation, hypersensitivity thrombosis, hypersensitivity, inflammation

Q101. Regarding undescended testis Assertion: Orchidopexy should be performed at an early age Reason: There is an increased liability for malignant disease with advancing age A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true Q102. A 12 years old otherwise healthy girl sleeping on floor bed woke in the midnight with pain in abdomen, nausea, vomiting, followed by weakness in four limbs, ptosis and bulbar palsy. The most likely diagnosis is A) Guillain barre syndrome B) periodic paralysis C) myasthenia gravis D) krait bite

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Q103. Given below is the coronal section of the brain with an arrow pointing to a ventricle

All of the following are true about the ventricle except

A) B) C) D)

communicates with fourth ventricle via cerebral aqueduct it communicates with subarachnoid space by a foramen in its roof communicates with the lateral ventricle through interventricular foramina it is situated between the two parts of the thalamus

Q104. Regarding treatment of cerebral malaria,

Assertion: quinine in glucose infusion is recommended Reason:quinine is a powerful stimulant of pancreatic insulin secretion A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

Q105. Osteochondritis dissecans most commonly affects A) hip B) knee C) elbow D) ankle

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Q106. Dose response curves for isoprenaline-control both alone and in the presence of two betareceptor antagonists, drugs 'X' and 'Y' are shown. The responses being measured
are increase in heart rate (graph 1) and relaxation of invitro strip of human bronchiolar smooth muscle (graph 2). Drug 'X' is most likely

A) B) C) D)

metoprolol propranolol pindolol timolol

Q107. Which of the following structures cannot be palpated by a vaginal examination A) sigmoid colon B) ureters C) perineal body D) iliopectineal line Q108. Both unfractionated heparin and low molecular weight heparin are similar with respect to which of the following biologic properties A) microvascular permeability B) anti-Xa activity C) platelet inhibition D) anti-IIa activity Q109. In Patey's mastectomy for carcinoma breast, the structure/structures removed include/includes 1.skin overlying the tumor 2.all fat, fascia and lymph nodes of the axilla 3.nipple 4.pectoralis minor A) only 1,2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correct Q110. A transplant performed between two non identical twins is termed A) allograft B) xenograft C) isograft 37 of 48

D) syngeneic graft Q111. Last long bone epiphysis to unite in upper limb is A) head of humerus B) medial epicondyle of humerus C) head of ulna D) head of radius Q112. Which of the following physical findings indicative of compartment syndrome is typically the earliest to occur A) pain on passive stretching of muscles B) loss of pulses C) paresthesias D) paralysis of the extremity Q113. Shown below are few stages in the life cycle of Taenia solium. The stage that infects the intermediate host i..e. the pig is

A) B) C) D)

stage 1 stage 2 stage 3 stage 4

Q114. The difference between the incidence rates among exposed and incidence rates among non exposed is A) incidence rate B) relative risk C) attributable risk D) positive predictive value Q115. A man aged 25 years was evaluated in the emergency services and was found to have severe metabolic acidosis. The calculated anion gap was 10 mEq/L. The cause can be A) renal tubular acidosis B) acute renal failure C) ethylene glycol poisoning D) salicylate poisoning

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Q116. Shown below is the chest radiograph of a patient with peroforating esophageal ulcer.

Positive findings include 1. suppurative mediastinitisdds 2. pneumothorax 3. colonic interposition surgery 4. pneumopericardium A) only 1, 2, and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correct

Q117. Regarding, treatment of eclampsia Assertion: magnesium is used to treat hypertension Reason: magnesium produces peripheral vasodilation A) Both Assertion and Reason are true, and Reason is the correct explanation for
Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

Q118. Which of these organisms mediate their intestinal toxicity through production of a
toxin

A) clostridusim difficile B) entamoeba histolytica C) giardia lambia D) helicobacter pylori Q119. Regarding prophylaxis for hepatitis B, Assertion: administration of hepatits B vaccine and hepatitis B immunoglobulin at birth is indicated to all babies born by normal vaginal delivery to HBsAg positive mothers Reason: majority of babies acquire the infection in utero A) Both Assertion and Reason are true, and Reason is the correction explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correction

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explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true Q120. Early signs of fat embolism in a patient with multiple fractures A) breathlessness B) mild mental confusion C) slight rise of temperature and pulse rate D) restlessness Q121. An adolescent aged 18 years presented with multiple umbilicated hypopigmented papules of 4.5mm in diameter over trunk and arms. He recently attended a swimming camp for 15 days. Biopsy of lesions revealed cytoplasmic eosinophilic inclusions. Which one of the following statements is true A) specific treatment includes topical erythromycin B) there are no systemic complications C) vaccination is one of the components in the management D) the skin lesions will also be photosensitive Q122. A child is born with Apgar scores of 2 and 5 at 1 minute and 5 minutes of life, respectively. Initial resuscitation includes all of the following except A) oxygen B) radiant heat C) intubation D) glucose Q123. The RMP of the nerve cell is equal to which ions equillibrium potential A) Na+ B) K+ C) ClD) HCO3Q124. Regarding influenza virus infection Assertion: outbreaks are difficult to control with vaccination Reason: influenza virus is known for its frequent change in antigenic structure A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true Q125. Which is the correct statement regarding umbilical cord blood stem cells A) has less graft versus host disease B) has more HLA restriction than adult marrow stem cells C) contamination with herpes virus is more D) large quantities can be obtained from a single source Q126. All of the following form part of the critieria used to diagnose Systemic Inflammatory Response syndrome except: A) a total count of less than 4000/cu.mm 40 of 48

B) a heart rate of more than 90 beats per minute C) temperature of more than 38o C D) at least 5% band forms on the differential count Q127. Presence of gram negative diplococci within polymorphonuclear cells in Gram's stained smear of centrifuged deposit of CSF sample indicates A) tubercular meningitis B) meningococcal meningitis C) cryptococcal meningitis D) poliomyelitis Q128. A patient is on category III treatment under DOTS. If his sputum smear examination at two months is positive, then action to be taken is: A) extend the intensive phase by one more month B) reregister the patient and begin category I treatment C) reregister the patient and begin category II treatment D) start continuation phase and test sputum again at 4 months

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Q129. The curves 1, 2 and 3 respectively depict the growth pattern of which one of the following organ systems in a child

A) B) C) D)

brain, lymphoid, gonadal lymphoid, brain, gonadal lymphoid, gonadal, brain gonadal, brain, lymphoid

Q130. The cause/causes of positive Trendelenburg test

1.fracture of neck of femur 2.dislocation of hip 3.weakness of hip abductors 4.weakness of hip extensors

A) B) C) D)

only 1, 2, and 3 are correct only 1 and 3 are correct only 2 and 4 are correct only 4 is correct

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Q131. Figure below shows different phases (numbered 1 to 4) of ventricular diastoli. The phase number 4 represents which one of the following

A) B) C) D)

atrial systole slow ventricular filling isovolumetric relaxation rapid ventricular filling

Q132. Shown below is the radiograph of knee of a boy aged 15 years presenting with swelling on the medial side of the knee. The most probable diagnosis is

A) B) C) D)

Ewings sarcoma osteochondroma osteoclastoma aneurysmal bone cyst

Q133. Regarding post operative management of differentiated thyroid carcinoma Assertion: Suppressive dose of thyroxin is given for all patients Reason: The levels of thyroglobulins are increased in recurrent disease after thyroidectomy 43 of 48

A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true Q134. A newborn baby born to a primi gravida by normal vaginal delivery was referred at 2 hours after birth with severe chest retraction on inspiration, cyanosis. The cyanosis is relieved during crying. Other systemic examination was normal. The most probable diagnosis is A) cyanotic congenital heart disease B) bilateral choanal atresia C) neonatal tetanus D) congenital pneumonia Q135. Given below is a schematic representation of spermatogenesis

The stage at which 46 chromosomes become 23 is A) stage 1 B) stage 2 C) stage 3 D) stage 4

Q136. In which one of the following organisms inhibition of lysosomal fusion plays an
important role in bacterial mechanisms for escaping phagocytic clearance A) Salmonella typhi B) Staphylococcus aureus C) Streptococcus pneumoniae D) Mycobacterium tuberculosis

Q137. Good prognostic factor/factors in breast cancer 1.Estrogen Receptor positivity 2.HER-2 receptor overexpression 3.Progesteron receptor positivity 4.Lymph node involvement 44 of 48

A) B) C) D)

only 1,2 and 3 are correct only 1 and 3 are correct only 2 and 4 are correct only 4 is correct

Q138. Shown below is a barium swallow radiograph at thoracic level in a patient with dsyphagia. The image is suggestive of which one of the following

A) B) C) D)

squamous cell carcinoma of esophagus leiomyoma of esophagus achalasia cardia esophageal pouch

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Q139. All are alkylating agents except A) cisplatinum B) cyclophosphamide C) methotrexate D) dacarbazine Q140. The most common site of stapedial otosclerosis is A) round window B) cochlear capsule C) promontary D) fistula ante fenestram Q141. In the pedigree chart shown below, which one of the following statements regarding the inheritance of disease is true

A) B) C) D)

unaffected mother cannot transmit to her children affected father transmits to his children successive generations are always affected all children from an affected mother will inherit the abnormal gene

Q142. A 25-year old man who sufferred from a deep penetrating wound has had a booster dose of tetanus toxoid 12 years ago. The recommendation for prevention of tetanus is A) one dose of tetanus toxoid B) nothing more required C) toxoid complete course plus human tetanus immunoglobulin D) one dose of toxoid plus human tetanus immunoglobulin Q143. Regarding diabetes mellitus Assertion: polyphagia is a symptom of diabetes mellitus Reason: there is a deficiency of glucose utilization in the cells of the "feeding centre" of hypothalmus A) Both Assertion and Reason are true, and Reason is the correct explanation for
Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

Q144. Regarding endometriosis 46 of 48

Assertion: Pelvic symptoms and infertility are uncommon as presenting features of endometriosis Reason: Endometriosis is diagnosed by the presence of stromal and glandular elements outside the uterus A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

Q145. In kidney, the term "dense deposit disease" refers to A) rapidly progressive glomerulonephritis type I B) membranoproliferative glomerulonephritis type I C) membranoproliferative glomerulonephritis type II D) rapidly progressive glomerulonephritis type II Q146. With regard to bacterial genetics, mobile genetic nonreplicable elements that can transfer DNA within a cell, from one position to another in the genome are known as A) episomes B) bacteriophages C) transposons D) plasmids Q147. Differential diagnosis of radiolucent filling defect in the pelvi calyceal system on intravenous urography include all of the following except A) uric acid stone B) calcium oxalate dihydrate stones C) blood clots D) transitional cell carcinoma Q148. Regarding treatment of bipolar disease Assertion antidepressants are used in maintenance phase Reason they can increase the cycle frequency A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

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Q149. The diameter used in obstetric practice shown in the diagram below is described as

A) B) C) D)

anterior sagittal diameter anatomic anteroposterior diameter posterior sagittal diameter obstetric anteroposterior diameter

Q150. Regarding Coombs test. Assertion: Indirect antiglobulin testing is useful for antibody screening in pre transfusion testing . Reason: Direct globulin testing detects the presence of antibody bound to the red cell surface. A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

RAJASEKHARR

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