KARNATAKA 2004 (M8-VERSION)

1. Myelin around central nervous axons is laid down by:

(a)        Microglia.         (b)        Schwann cells.

(c)        Oligodendrocytes.        (d)        Protoplasmic astrocytes.

2.         Posterior belly of digastric is supplied by:

(a)        Facial nerve.     (b)        Mandibular nerve.

(c)        Spinal accessory nerve. (d)        Ansa cervicalis.

3. The parai air sinuses opening into the middle meatus include all except:

(a).       Frontal sinus.    (b)        Maxillary sinus.

(c)        Posterior ethmoidal sinus.          (d)        Anterior ethmoidal sinus.

4. The following are the branches of the internal iliac artery except:

(a)        Ovarian artery..            (b)        Uterine artery.

(c)        Superior vesical artery. (d)        Obturator artery.

5. Which one of the following is attached to the lIngula of the mandible?

(a)        Stylomandibular ligament.          (b) Sphenomandibular ligament.

(c) . Pterygomandibular raphe. . (d) Middle constrictor of pharynx.

6. The distance by which two touch stimuli must be separated to be perceived as two separate stimuli

is greatest on:    . .         . .

(a)        The lips.           (b)        The palm of the hand.

(c)        The back of scapula.     (d)        The dorsum of the hand.

7. The visceral pain: . . .

(a) Shows relatively rapid adaption.

(b) Mediated by ‘B’ fibres in the dorsal root of spinal nerves.

(c) Can sometimes be relieved by applying an irritant to the skin.

(d) Most closely resembles fast pain produced by noxious stimulation of the skin.

8; The fourth heart sound is caused by:

(a)        Closure of aortic .and pulmonary orifices.

(b)        Vibrations of the ventricular wall during systole.

(c)        Ventricular filling.

(d)        Closure of mitral and tricuspid orifices..

9. Lymphocytes:

(a)        All originate from bone marrow after birth.

(b)        Are unaffected by hormones.    .. .

(c)        Convert to monocytes in response to antigens.

(d)        Are part of body’s defence against cancer. 

10. Which of the following has the highest pH?

(a)        Gastric juice.    (b) Bile in the gallbladder.

(c)        Pancreatic juice.           (d) Saliva.

11. The concentrations of sphingomyelins are increased in:

(a)        Gaucher’s disease.        (b) Fabry’s disease.

(c)        Febrile disease. (d) Niemann-Pick disease.

12 Salivary amylase is activated by:

(a)        Nat      (b) Kt

(c)        HC0     (d) C

13. Glucose increases plasma insulin by a process that involves:

(a)        GLVT1.           (b) GLVT2.

(c)        GLVT3.           (d) SGLT1.

14. In the body, metabolism of 10 gms. of protein would produce approximately:

(a)        1 K. calories     (b) 41 K. calories.

(C)       410 K. calories.            (d) 41 calories.

15. Refsum’s disease is a rare neurological disorder caused by:

(a)  Accumulation of glutamic acid.  (b) Accumulation of glycine.

(c)  Accumulation of phytanic acid.  (d) Accumulation of phenylalanine.

16. The term physical half-life is applicable to:

(a)        Repository preparations.           (b) Prodrugs.

(c)        Radioactive isotopes.    (d) Alkylating agents.

17 The antiretroviral drug which is also effective in chronic active hepatitis-B infection is

(a)        Zidovudine.      (b) Nelfinavir.

(c)        Efavirenz.         (d) Lamivudine.

18. The drug of choice for chronic .myeloid. leukaemja is:

(a)        Chiorambucil.   (b) Busulfan.

(c)        Vincristine.       (d) Procarbazine.

19 Which of the following antiepileptic drug does not produce Hepatic Micromosomal enzyme induction?

(a)        Phenobarbitone.           (b) Carbamazepine.

(c)        Phenytoin.        (d) Sodium vaiproate.

20. The antithyroid drug preferred for use during pregnancy and lactation is:

(a)        Propyithiouracil.            (b) Methimazole.

(c)        Carbimazole.    (d) Radioactive iodine.

21. The antibiotic known to cause “Red Man” syndrome is:

(a)        Clindamycin.     (b) CefadrOxil.

(c)        Vancomycin.    (d) Azithromycin.

22. The local anaesthetic known to cause Methaemoglobinaemia as adverse effect is:

(a)        Lidocaine.        (b) Bupivacaine.

(c)        Tetracaine.       (d) Prilocaine.

23. Which of the following skeletal muscle relaxants undergoes Hoffmann elimination ?

(a)        Pancuronium.    (b) Rcrnum.

(c)        Atracurium.      (d) Succinyl choline.

24. Which of the following antitubercular drugs does not cause hepatotoxicity?

(a)        Isoniazid.          (b) Ethambutol.

(c)        Pyrazinamide.   (d) Rifampicin.

25 The betablocker having intrinsic sympathomimetic activity is:

(a)        Propronolol.     (b) Atenolol

(c)        Sotalol. (d) Pindolol.

26. All of the following are chromosomal breakage syndromes except:

(a)        Fanconi’s anaemia.       (b) Ehiers-Danlos syndrome.

(c)        Bloom syndrome.         (d) Ataxia telengiectasia,

27. All of the following are morphologic features of apoptosis except:

(a)        Cell shrinkage.  (b) Chromatin condensation.

(c)        Inflammation.    d) Apoptotic bodies.

28. “Macropolycyte” in peripheral smear is a feature of:

(a)        hereditary spherocytosis.           (b) Iron deficiency anaemia.

(c)        Sickle cell anaemia.       (d) Megaloblastic anaemia.

29. Most common second malignancy in patients with Familial Retinoblastoma is:

(a)        Teratoma.         (b) Medullary carcinoma.

(c)        Osteosarcoma. (d) Malignant melanoma.

30. Polyps in Peutz Jeghers syndrome are:

(a)        Adenomatous polyps.   (b) Hyperplastic polyps.

(c)        Hamartomatous polyps.            (d) Pseudopolyps.

31. Histologic hallmark of rapidly progressive glonierulonephritis is:

(a) Crescents in most of th glomeruli.

(b) Loss of foot processesof epithelial cells.

(c) Subendothelial electron dense deposits.

(d) ‘Diffuse thickening of glomerular capillary wall.

32. All of the following tare true f.or complete mole except:.

(a) Diffuse circumferential trophoblastic proliferation

(b) Hydropic swelling of villi.

(c) No fetal parts seen.

(d) Triploid karyotype.

33. Histologic hallmark of Paget disease of nipple is

(a) Comedo necrosis.

(b) Infiltration of the epidermis by malignant cells.

(c) Atypical lobular hyperplasia.

(d) Desmoplasia.

34 In early gastnc carcinoma malignancy is confined to

(a) Mucosa.

(b) Mucosa and submucosa.

(c) Gastric wall without lymphnode meI

(d) Gastric glands.

35 Which hepatitis virus is notorious for causing a chronic hepatitis evolving to cirrhosis

(a)        Hepatitis C virus           (b) Hepatitis B virus

(c)        Hepatitis E virus.           (d) Cytomegalo virus.

36.       Example of type 4 hypersensitivity:

(a)        Coagulase test  (b) Mantoux test

(c)        Schick test.       (d) Elek’s test.

37. Recommended vaccines for rabies

(a)        DPT.    (b) MMR.

(c)        BCG.   (d) HDCV.

38.       Pigment producing colonies are seen in:

(a)        Pseudomonas.  (b). Atypical mycobacteria.

(c)        Serratia marcescens.     (d) All of the above.

39. Fluorescent microscopy is used to diagnose:

(a)        Mycobacterium tuberculosis.     (b)        Staphylococcus aureus.

(c)        Streptococcus viridans. (d)        Kiebsiella aerogenes.

40. Germ tube test is diagnostic for:

(a)        Candida albicans.         (b)        Cryptococcus neoformans.

(c)        Histoplasma capsulatum.           (d)        Coccidiodomycosis.

41. pH of Sabouraud’s dextrose agar is adjusted to:

(a)        4—6.   (b)        1—2.

(c)        6—S.   (d)        8—10.

42. Painless hematuria is seen in:

(a)        Schistostoma hematobium.        (b)        Schistostoma mansoni.

(c)        Schistostoma japonicum.           (d)        Paragonium westermani.

43.       Babesoisis is transmitted by:

(a)        Tick.    (b) Mites.

(c)        Flea.     (d) Mosquito.

44. Dengue fever is transmitted by:

(a)        Tiger mosquito. (b) Jackal mosquito.

(c)        Wolf mosquito. (d) Lion mosquito.

45. Complications in Malaria are commonly seen with:

(a)        Plasmodium ovale.        (b) Plasmodium vivax.

(c)        Plasmodium falciparum.            (d) Plasmodium malariae.

46. Type III category of basal fractures of skull are:

(a) Those that run in the coronal plane from lateral end of one petrous ridge through sella turcica to lateral end of contralateral petrous ridge.

(b) Run from side to side in the coronal plane but do not pass through the sella turcica.

(c) Run from front to the contra lateral back passing through the sella turcica.

(d) Run from front to back involving all cranial fossae. and sella turcica.

 47. The various components of a will to be valid are:

(a) A knowledge of the property to be disposed of.

(b) A legatee can attest a will.

(c) Presence of delusions not affecting in any way the disposal of the property or the persons affected by the will.

(d) It should be made during lucid intervals.

48. Reasons for marked variations in the s,hape of exit wounds of rifled weapons:

(a) Deformation of bullet during its passage through body and thereby presenting an irregular wound.

(b) Absence of tumbling of the bullet in the body and hence it may not be able to exit with nose end first.

(c) Intact bullet in the body after striking bone.

(d) At times, both entry and exit wounds are of the same size as in the assassination of Kennedy, President of USA.

49. “Dry Submarine” in custodia torture injuries refers to:

(a) Falanga beating on soles of feet.

(b) Tying of a plastic bag over the ears.

(c) Immersing head in contaminated water.

(d) Suspending the accused by ankles.

50. “CAFE coronary” refers to death in intoxicated person during meals due to•:

(a)        Suffocation.      (b) Natural cardiac death.

(c)        Choking.          (d) Smothering.

51. PQLI stands for:

(a) Physical quality of life index.

(b) Physical quantity of life index.

(c) Physiological quality of life index.

(d) Psychological quality of life index.

52. Mean, Median and Mode are:

(a) Measures of dispersion.

(b) Measures association between two variables

(c) Test of significance.

(d) Measures of central tendency.

53.       Incidence rate refers to:

(a)        Only old cases. (b) Both old and new cases.

(c)        Only new cases.           (d) None of the above.

54. Generation time in epidemiology is defined as:

(a) The interval between marriage and the birth of first child.

(b) The interval of time between the receipt of infection by host and maximal infectivity of the host.

(c) The interval of time between primary case and secondary cases.

(d) Interval of time between invasion by infectious agent and appearance of first sign or symptom of the disease/in question.

55. In the demographic cycle, India is in the:

(a)        High stationary stage.    (b)        Early expanding stage.

(c)        Late expanding stage.   (d)        Low stationary stage.

56. The overall prevalence of tuberculosis infection in India as per 4th round of longitudinal survey was:

(a)        20 %.   (b)        30 %.

(c)        40 %.   (d)        50 %.

57. Pulse polio immunization is administration of OPV to:

(a) All children between 0—5 years of age on a single day, irrespective of their previous immunization status.

(b) Children in the age group of 0—1 year only who have not been immunized earlier.

(c) Children in the age group of 12—24 months only, as the booster dose.

(d) All children between 0—5 years of age, whenever there is an outbreak of poliomyelitis.

58. In high risk areas the radical treatment for Plasmodium vivax infection after microscopic confirmation is administration of tablets primaquine in the daily dosage of:

(a)        0 mg.fkg. body weight. (b)        050 mg.Ikg. body weight.

(c)        075 mg.fkg. body weight.         (d)        100 mg./kg. body weight.

59.       Couple protection rate in India is:

(a)        30 %.   (b)        462 %.

(c)        624 %. (d)        857 %.

60. By international agreement, low birth weight has been defined as a birth weight when measured within the first hour of life is

(a) Less than 2000 grams. (b) Less than 2500 grams. (c> Less than 2800 grams. (d) Less than 3000 grams.

61. For an adult Indian male the daily requirement of protein is expressed as:

(a)        0 gms./kg. body weight.            (b)        075 gms/kg. body weight.

(c)        10 gms./kg. body weight.          (d)        150 gms/kg. body weight.

62.       Lathyrism is due to consumption of:

(a)        Red gram dhal. (b) Contaminated ground nuts.

(c)        Bengal gram dhal.         (d) Khesari dhal.

63. Temporary hardness of water is due to the presence of:

(a) Bicarbonates of calcium and magnesium.

(b) Chlorides of calcium and magnesium.

(c) Nitrates of calcium and magnesium.

(d) Oxides of calcium and magnesium.

64. Kata thermometer measures:

(a)        Air temperature only.

(b)        Air temperature and humidity.

(c)        Air temperature, humidity and air movemei        -

(d)        None of the above.

65. The optimum floor space recommended per adult person in a dwelling place is:

(a)        50—100 sq.ft.  (b) 101-450 sq.ft.

(c)        151—200 sq.ft.            (d) 201—250 sq.ft.

66. An upper limit of noise which people can tolerate without substantial damage to their hearing is:

(a)        45 db.  (b) 65 db.

(c)        85 db.  (d) 105 db.

67. The permissible dose of man-made radiation should not exceed:

(a)        3 rads per year.            (b)        5 rads per year.

(c)        8 rads per year.            (d)        10 rads per year.

68. The mean radiant temperature is measured by:

(a) Dry bulb thermometer.

[b] Wet bulb thermometer.

(c) Six’s maximum and minimum thermometer.

[d] Globe thermometer.      .

69.Following latrines are suitable for camps and temporary use except:

(a)        Shallow trench latrine.   (b) Pit latrine.

(c)        Borehole latrine.           (d) Septic tank.

70. Sand fly transmit the following diseases except:

(a)        Relapsing fever.  (b) Kala azar.

(c)        Sand-fly fever.   (d) Oraya fever.

71. The following drugs cause methemoglobinemia:

(a)        Aniline. (b)        Dapsone.

(c)        Nitrates.           (d)        All of the above.

72. The following drugs are useful in the treatment of i poisoning:

(a)        Pyridoxine.       (b)        Diazepam.

(c)        Bicarbonate.     (d)        All of the above.

73. Gastric lavage is contraindicated in the following:

(a)        Barbiturate poisoning.   (b)        Kerosene poisoning.

(c)        Paracetamol poisoning. (d)        None of the above.

74. The following is not a feature of Wernicke’s encephalopathy:

(a)        Lateral rectus palsy.      (b)        Paralysis of conjugate gaze.

(c)        Pupilary dilatation.        (d)        Nystagmus.

75. The inheritance in Dechenne muscular dystrophy is:

(a)        X-linked reèessive.       (b)        Autosomal dominant.

(c)        Autosomal recessive.    (d)        Polygenic.

76. Myasthenia gravis may be associated with:

(a)        Thyrnoma.        (b)        Systemic lupus erythematosus.

(c)        Hyperthyroidism.          (d)        All of the above.

77. Examples of PRION diseases include:

(a)        Creutzfeldt-Jakob disease.        (b)        Subacute scierosing panencephalitis.

(c)        Alzheimer’s disease.     (d)        None of the above.

78. The treatment of Herpes simplex viral encephalitis should include:

(a)        Zidovudine.      (b)        Acyclovir.

(c)        Didanosine.      (d)        Symptomatic treatment only.

79. The drug found to be beneficial in amytrophic lateral sclerosis is:

(a)        Riluzole.           (b)        Methylprednisolone.

(c)        Hydroxyurea.   (d)        None of the above.

80. The drug of choice for a patient with a combination of primary generalized tonic-clonic seizures and absence seizures is :

(a)        Ethosuximide.   (b) Carbamazepine.

(c)        Valproic acid.   (d) Phenytoin sodium.

81. Complications of Paget’s disease include:

(a)        High output cardiac failure.        (b) Osteogenic sarcoma.

(c)        Pathologic fractures.     (d) All of the above.

82. Causes of Rickets include:

(a) Dietary phosphate deficiency.

(b) Distal renal tubular acidosis.

(c) Small intestinal disease with malabsorption.

(d) All of the above.

83.       Causes of hypercalcemia include:

(a)        Hyperthyroidism.          (b) Hypothyroidism.

(c)        Hypoparathyroidism.    (d) None of the above.

84. Drugs useful in the treatment of acute gouty arthritis include:

(a)        Allopurinol.       (b) Colehicine.

(c)        Probenicid.       (d) Sulfinpyrazone.

85. Drugs considered safe in patients with acute intermittent porphyria include:

(a)        Phenobarbitone.           (b) Vaiproic acid.

(c)        Carbamazepine.            (d) Narcotic analgesics

86. The level of LDL cholesterol at which therapy should be initiated in a patient without coronary

artery disease and no risk factors is:

(a)        100 mgidL.       (b) 130 mgidL.

(c)        160 mgidL.       (d) 190 mgidL.

87. The most common karyotypic abnormality associated with Turner syndrome is:

(a)        45,X.   (b) 46,XY.

(c)        47,XXY.          (d) 45,Y.

88. Insulin resistance is defined as a daily requirement of insulin greater than:

(a)        100 units.         (b) 150 units.

(c)        200 units.         (d) 250 units.

89. The treatment of choice for hypertension in a patient with phaeochromocytoma:

(a) Alpha adrenergic blocking agents.

(b)        Beta adrenergic blocking agents.

(c)        Calcium channel blockers.

(d)        Angiotensin receptor blockers.

90. Nelson’s syndrome is a complication of:

(a) Unilateral adrenalectomy for Cushing’s syndrome.

(b) Bilateral adrenalectomy for bilateral adrenal hyperplasia.

(c) Excision of a pituitary tumor for bilateral adrenal hyperplasia.

(d) Excision or a hypothalamic tumor’ for bilateral adrenal hyperplasia.

91. The electrolyte abnormality typicallyseen in primary aldosteronism is:

(a)        Hypokalemia.   (bY Hyperkalemia.

(c)        Hyponatremia.  (d) Hypernatremia.

92. The features of subacute thyroiditis include:

(a)        Elevated T3 and T4 levels.        (b) Depressed TSH levels.

(c)        Depressed RAIU.         (d) All of the above.

93. SIADH typically cauaes:

(a) Hypernatremia and a urinary osmolality < 300 mmollkg.

(b) Hypernatremia and a urinary osmolality> 300 mmol.fkg.

(c) Hyponatremia and a urinary osmolality < 300 mmolikg.

(d) Hyponatremia and a urinary osmolality> 300 mmolfkg.

94. The most common clinical manifestations in Takayasu’s arteritis are related to occlusion of:

(a)        Abdominal aorta.          (b) Renal arteries.

(c)        Subclavian arteries.       (d) Pulmonary arteries.

95. Nucleoside analogues used in the treatment of HW infection include:

(a)        Indinavir.          (b) Nevirapine.

(c)        Didanosine.      (d) Efavirenz.

96. Drugs used in the treatment of pneumocystis carinii pneumonia include:

(a)        Trimethoprim-sulfamethoxazole.            (b) Dapsone.

(c)        Clindamycin.     (d) All of the above.

97. Drugs useful in the treatment of chronic hepatitis C include:

(a)        Glucocorticoids.           (b) Interferon alpha.

(c)        Hydroxyurea.   ‘           (d) None of the above.

98. Finding suggestive of an obstructive jaundice on a liver function test is a marked elevation of

(a)        Unconjugated bilirubin. (b)        Conjugated bilirubin.

(c)        Alkaline phosphatase.   (d)        AST and ALT.

99. An abnormal D-xylose test is suggestive of:

(a) Pancreatic insufficiency.

(b) Hepatic insufficiency.

(c) A mucosal abnormality of proximal small intestine.

(d) Colonic disease.

100. In a patient with hypoxemia the finding suggestive of hypoventilation on an arterial blood

analysis is

(a)        Elevated PaCO            (b)        Decreased PaCO

(c)        Elevated pH.    (d)        None of the above.

101. The single test that confirms the diagnosis of autoimmune hemolytic anemia is:

(a)        Coombs test.    (b)        Reticulocyte count.

(c)        Peripheral smear.          (d)        Hemoglobin electrophoresis.

102. The advantages of breast feeding to the mother includes:

(a)        Decreases postpartum bleeding.            (b) Prevention of breast cancer.

(c)        Spacing of pregnancies.            (d) All of the above.

103. All these conditions can produce metabolic acidosis except:

(a)        Diabetic ketoacidosis.   (b)        Salicylate poisoning.

(c)        Gastroenteritis with dehydration.           (d)        Congenital hypertrophic pyloric stenosis

104. All these conditions are autosomal dominant disorders except:

(a)        Marfan’s syndrome.      (b)        Hunter syndrome.

(c)        Osteogenesis imperfecta.          (d)        Achondroplasia.

105. All these conditions can produce first day jaundice in newborn except:

(a) RH incompatibility.

(b) TORCH infections.

(c) Congenital hypertrophic pyloric stenosis.

(d) G6PD deficiency.

1 Infantile hemiplegia can occur due to cerebrovascular accidents resulting in:

(a)        Thrombosis.     (b)        Embolism.

(c)        Hemorrhage.    (d)        All of the above.

107. Common cause for epiglottitis in children is due to:

(a)        Hemiphilus influenza.     (b)        Pneumococci.

(c)        Staphylococci.  (d)        Streptococci.

108. The cause for anoxic spells in children include all except:

(a)        Transposition of great vessels.   (b)        Tricuspid atresia.

(c)        Total anomalous venous return. (d)        Coarctation of aorta.

109. Gower sign is classical of one of the following condition

(a)        Congenital myopathy.   (b)        Werdnig-Hoffman disease.

(c)        Duchenne muscular dystrophy.  (d)        Guillain-Barre syndrome.

110. All these conditions are sex chromosome disorders except:

(a)        Turner syndrome.         (b)        Kline filter syndrome.

(c)        Super female.   (d)        Down’s syndrome.

111.     Thought disorder is seen in:

(a)        Obsessive compulsive disorder.            (b)        Anxiety neurosis.

(c)        Schizophrenia.  (d)        Psychopathic personality.

112. Repetitive hand washing is a symptom of:

(a)        Post-traumatic stress disorder.  (b)        Depression.

(c)        Anorexia nervosa          (d)        Obsessive compulsive disorder.

113.     Clozapine is a:

(a)        Atypical anti-psychotic drug.     (b)        Anti-anxiety drug.

(c)        Used in dementia.         (d)        Also known as disulfiram.

114. Flouxetine is a:

(a)        Anti-psychotic drug.     (b)        Used in opiate poisoning.

(c)        Tricyclic antidepressant.           (d) Selective serotonin reuptake inhibitor.

115. Fluctuating level of consciousness is seen in:

(a)        Hysteria.           (b)        Delirium.

(c)        Dementia.         (d)        Mania.

116. After oral ingestion. of 8-methoxypsoralen, how long an interval should be allowed before UVA radiation is given in PUVA treatment?

(a)        1 hour.             (b) 2 hours.

(c)        3 hours.            (d) 4 hours.

117. Which positive test does not necessarily indicate HJV infection in a newborn?

(a)        ELISA for 11W IgG antibody.  (b)        p24 antigen.

(c)        Virus culture.    (d)        ELISA for 11W IgA antibody.

118. Each of the following is caused by a pathogen of a Borrelia species, except:

(a)        Erythema chronicum migrans.    (b)        Acrodermatitis chronica atrophicans.

(c)        Epidemic relapsing fever.          (d)        Rat bite fever.

119. Which of the following may occur either as a result of an elevated androgen level or an exaggerated clinical  response of tissues to androgen,?

(a)        Acne.   (b) Hirsutism.

(c)        Alopecia.          (d) All of these.

120. Which of the following is found least frequently in patients with TEN (Toxic Epidermal Necrolysis)?

(a)        Anemia (erythrocytic).  (b)        Lymphopenia.

(c)        Neutropenia.    (d)        Eosinophilia.

121. The target material used in X-ray tube:

(a)        Tin.      (b) Tungsten.

(c)        Platinum.          (d) Copper.

122.’ The following are radiological features of sigmoid volvulus except:

(a)        Inverted U shaped bowel ioop. (b) Liver overlap sign.

(c)        Bird of prey sign.          (d) Cupola sign.

1 Medical sonography employs ultrasound frequency between:

(a)        1—20 MHz.    (b)        Less than 1 MHz.

(c)        100 Hz.            (d)        Greater than 100 MHz.

124. Color Doppler study can evaluate the following except:

(a)        Direction of blood flow. ,          (b) Velocity of blood flow.

(c)        Impedance index.         (d) Intravascular pressure.

125. The Radionuclide used in assessing the renal morphology:

(a)        Thallium—201. (b) 99mTc—DMSA.

(c)        99mTc—DTPA.          (d) 99mTc-MAG.

126. Who said these words : “To study the phenomenon of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all”.

(a)        Hamilton Bailey.           (b) Sir Robert Hutchison.

(c)        Sir William Osler.         (d) J.B. Murphy.

127. Ti and T2 images are a feature of which diagnostic test?

(a)        Ultrasound.       (b) C.T. scan.

(c)        Duplex scan.     (d) MRI scan.

128. Who said : “Skin is the best dressing”?

(a) Joseph Lister. , (b) John Hunter.

(c)        James Paget.    (d) McNeill Love.

129. How do you get an ideal scar?

(a)        Achieve quiet, secondary healing.          (b)        Ensure tight closure of the skin.

(c)        Give antibiotics.            (d)        Minimize tension.

130. Hypokalemic alkalosis is commonly seen in surgical wards in:

(a)        Excessive absorption of alkali.   (b) Excessive vomiting in pyloric stenosis.

(c)        Excessive steroid use.   (d) Diarrhea with dehydration.

131.     5 % dextrose in normal saline is:

(a)        Hypotonic.       (b) Isotonic.

(c)        Hypertonic.      (d) A blood substitute.

132. Infection with Hepatitis B virus is associated with the appearance in the blood of all of the following except:

(a)        Hepatitis B antibody.    (b) Hepatitis B surface antigen.

(c)        The Dane particle.        (d) DNA polymerase activity.

133. Earliest changes of neoplastic transformation as seen at a microscopic level is called:

(a)        Hyperplasia.     (b)        Metaplasia.

(c)        Dysplasia.         0          (d)        Carcinoma in situ.

34. The best guide to adequate tissue perfusion in the fluid management of a patient with burns, is to ensure  a minimum hourly urine output of—:

(a)        10—30 ml.       (b)        30—50 ml.

(c)        50—70 ml.       (d)        70—100 ml.

135. Examples of indirect traumatic gangrene are all except:

(a) Use of local anesthetic with adrenaline and tourniquet for digits.

(b) Pressure of fractured bone on main artery to a limb.

(c) Thrombosis of large artery following injury.

(d) That resulting from crush or pressure injury.

136. Axillary vein thrombosis is NOT a complication of:

(a)        Thoracic outlet syndrome.         (b)        Simple mastectomy.

(c)        Excessive upper limb exercise.  (d)        Strap-hangers.

137. The four points of probe placement in Focused Abdominal Sonogram for Trauma (FAST) in blunt thoraco-abdominal trauma are:

(a) Epigastrium, ® hypochondrium, (L) Lower chest, hypogastrium.

(b) Epigastrium, ® and (L) Hypochondria, ® Iliac fossa.

(c) Epigastrium, ® and (L) Lumbar regions, hypogastrium.

(d) Hypogastrium, ® and (L) Lumbar regions, ® lower chest.

138. In the acronym “SWELLING” used for the history and examination of a lump or swelling, letter ‘N’ stands for:

(a)        Nodes. (b) Noise (Thrill/bruit).

(c)        Numbness.       (d) Neurological effects.

139 A positive Froment’s sign is associated with palsy of which nerve

(a)        Median.            (b) Axillary.

(c)        Radial.  (d) Ulnar.

140. Acute bacterial sialadenitis is managed by:

(a)        Immediate sialography.

(b)        Fluid intake restriction.

(c)        Culture of the FNAC from the involved gland.

(d)        Use of broad spectrum antibiotics.

141. A branchial cyst develops from the vestigial remnants of the:

(a)        2nd branchial cleft         (b) 3rd branchial cleft

(c)        1st branchial cleft          (d) 4th branchial cleft

142. About follicular carcinoma of the thyroid gland:

(a)        FNAC is diagnostic.

(b)        Lymph node metastases are common.

(c)        Distant metastases are more common.

(d)        Local recurrence rates are low.

143. Poland’s syndrome of the congenital absence of the sternal he of the pectoralis major muscle associated with:

(a)        Mastalgia.         (b) Amazia.

(c)        Polymazia.        (d) Gynecomazia.

144. Chest drain insertion is. safest when performed:

(a) In the apex of the chest for pneumothorax.

(b) In the base of the chest for haemothorax.

(c) In the “triangle of safety” on the antero-lateral. chest wall.

(d) With the smallest bore chest tube available.       .          

145. Disparity of the bowel ends during end to end anastamosis is corrected by:

(a) Cheatle’s manoeuvre .  (b) Connell suture.

(c) Lembert suture. . . (d) Czerny technique.

146. Odynophagia is:

(a) Throat pain.      (b) Pain on swallowing.

(c) Heartburn.         (d) Painless dysphagia.

147. For inoperable gastric neoplasms involving the cardia, the best palliation is by:

(a)        Intubation.                 (b). Exclusion.

(c)        Pre-sternal bypass.       (d) Gastroenterostomy.

148. Vascular inflow occlusion of the liver is by:

(a)        Clamping the hepatic artery.      (b) Occluding the portal vein.

(c)        Clamping the hepatic veins.       (d) The Pringle manoeuvre.

149. Splenic abscess is best treated by:

(a) Open splenectomy.

(b) Laparoscopic splenectomy.

(c) Percutaneous drainage under image guidance.

(d) Antibiotics only

15O “Limey bile” is:

(a) Present in the CBD.

(b) Thin and clear.

(c) Like toothpaste emulsion in the gall bladder.

(d) Bacteria rich

151. In. Ranson’s criteria to predict severity of acute pancreatitis:

(a) A serum amylase that is 4times normal is significant.

(b) Serum amylase level is not a criteria.

(c) Rising serum amylase levels are important

 (d) Serum amylase equals urine amylase.

152 Non-propulsive peristalsis is a feature of

(a)        Paralytic ileus.   (b)        Impacted faeces.

(c)        Mesenteric vascular occlusion.  (d)        Incarceration.

153 The operative wound after surgery for gangrenous, perforated appendicitis is best managed by

(a)        Primary suture. (b) Delayed primary closure.

(c)        Healing by secondary intention  (d) Antibiotic lavage

154. A thrombosed external haemorrhoid (or perianal haematoma) is:

(a)        Painless, with gradual onset       (b) The 5 day, painflil, self curing lesion

(c)        Part of internal haemorrhoids     (d) A sentinel pile

155. The ratio of males to females in the incidence of strangulated inguinal hernia in infancy is:

(a)        5 : 1.           (b) 1 : 2.

(c)        2 : 1       (d) 1 : 5

156. Treatment of intracapsular fracture in a man aged 60 years:

(a)        Dynamic hip screw fixation.       (b) Total hip replacement.

(c)        Hemiarthroplasty.         (d) Austin Moore pinning.

157. Barlows test is done to diagnose:

(a)        C.D.H. (b) Cruciate ligament tear.

(c)        Shoulder dislocation.     (d) Anlde joint instability.

158. Osteochonclritis of lunate bone is known as:

(a)        Perthes disease.            (b) Osgood schiatters disease;

(c)        Kohier’s disease.          (d) Kienbock’s disease.

159. Spina ventosa is caused by

(a)        Leprosy.           (b). Defect in the spine.

(c)        Tuberculosis.    (d) Gout.

160. Calcification of inter vertebral disc is a feature of:

(a)        Ankylosing spondilitis.   (b) Hyper parathyroidism.

(c)        Charcot’s disease.        (d) Alkaptonuria.

161. Tom Smith’s arthritis of hip joint is due to:

(a)        C.D.H. (b) Post polio.

(c)        Pyogenic infection.        (d) Cerebral palsy.

162. Osteosarcoma arises from:

(a)        Epiphysis.         (b) Diaphysis.

(c)        Metaphysis.      (d) Bone marrow.

163. Reversal of albumin-globulin ratio is seen in:

(a)        Osteochondroma.         (b) Multiple myeloma.

(c)        Osteoclastoma. (d) Osteoid osteoma.

164.     Treatment of bone cyst:

(a)        Amputation.      (b)        Bone grafting.

(c)        Chemotherapy. .           (d)        Disarticulation.

165. 1t Osteochondroma is also known :

(a)        Exostosis.         (b) Giant cell tumor.

(c)        Ivory osteoma. (d) Osteoblastoma.

166. Oxyhaemoglobin dissociation curve is shifted to the right in the following condition:

(a)        Acidosis.          Lb) Increased 2—3 DPG level.

(c)        Hyperthermia.   (d) All the above.

167. Following are the effects of thiopentone sodium anaesthesis except:

(a)        Respiratory depression.            (b) Reduced cardiac output.

(c)        Good uterine relaxatinn.            (d) Low, intraocular tension.

168. Contra indication for nasotracheal intubation:

(a)        Basal skull fractures.     (b) Neonates.

 c) Difficult intubation.   (d) Prolong intubation.

169. Blood collected from acid citrate dextrose can be storage form:

 (a)       28 days.           (b) 21 days.

(c)        14 days.           (d) 7 days.

170. Advantages of regional analgesia blockade are all these except:

(a) A reduced need for opioids.

(b) Early resumption for normal activity and ambuIation

(c) A quick awakening from general anaesthesis.

(d) Increase of the stress response.

171. Corneal manifestation of Wilson’s disease is:

(a) Fleischer Ring.

(b) Arcus Juvinilis

(c) Keyser Fleischer Ring.

(d) Band Keratopathy

172. Diabetic Retinopathy causes:

(a) Traction Retinal Detachment.

(b) Arcus Juvenilis.

(c) Vitreous haemorrhage.

(d) All of the above

 173. Giant Papillary conjunctivitis is caused by:

(a) Contact Lens wear. (b) Ocular Prosthesis.

(c) Protruding corneal sutures.  (d) All of the above.

 174. Ethambutol toxicity leads to

(a) Steven Johnson syndrome.

(b) Pupillary dilatation.

(c) Visual loss with colour vision defects.

(d) Bull’s eye retinopathy.

175. Field defect seen in papilledema:

(a)        Seidel’s scotoma.         (b) Constriction of peripheral fields

(c) Centro-caecal scotoma. , (d) None of the above.

176. Dysphagia for fluids but not to solids is seen in:

(a)        Stricture.          (b) Achalasia cardia.

(c)        Caréinôma oe   (d) Reflux oesopagitis.

177.     Epistaxis in elderly person is common in.:

(a)        Foreign body.   (b)        Allergic rhinitis.

(c)        Hypertension    (d)        Nasopharyngeal carcinoma

178. Cerebello pontine angle tumour is most commonly:

(a)        Acoustic neuroma.        (b) Cholesteatoma.

(c)        Meningioma      (d) All of the above

179. Gradenigo’s syndrome does not consist of :.

(a)        Abduscent nerve palsy. (b) Palatal palsy.

(c)        Aural discharge.    (d) Retro orbital pain.

180. F symptom of carcinoma larynx:

(a)        Dysphagia.       (b) Cough.

(c)        Haemoptysis.    (d) Hoarseness of voice.

181. Physiologically, Oxytocin is characterized by all except:

(a)        Circu1ates entirely in free form. (b) Plasma half-life 5-7 minutes.

(c)        Levels increase during labor.     (d) Released in pulsatile fashion.

182. Studies have indicated the most important of the components of the Bishop score to be related to:

(a)        Dilatation.         (b)        Effacement.

(c)        Station. (d)        Consistency.

183. The factor that is likely to influence the rate of relapse and prognosis in patients with ovarian cancer is:

(a)        Tumor grade.    (b) Tumor stage.

(c)        Intraoperative Rupture of tumor.           (d) Presence of dense adhesions.

184. Most common symptom associated with uterine myomas:

(a)        Menorrhagia.    (b) Metrorrhagia.

(c)        Pressure.          (d) Urinary frequency

185. How much is the risk of ovarian cancer increased above normal in a woman with nonautosomal  dominant genotype with one first degree relative with ovarian cancer?

(a)        2-3 times          (b)        5 times

(c)        10 times.          (d)        20 times.

186. What is the most common method for detecting early stage ovarian cancer?

(a) Evaluation of vague gastrointestinal symptoms.

(b) Palpation of an asymptomatic mass during routine pelvic examination

(c) Screening CA 125.

(d) Screening vaginal ultrasound.           .

187 Which ultrasound finding with an adnexal mass is most suspicious for

(a)        8 cm. in diameter.         (b) Several internal excrescences.

(c)        Cystic with two thin septations. (d) Free pelvic fluid

188 The most common major complication with Laparoscopic hysterectomy is
(a) Urinary tract injury (b) Bowel injury
(c) Uncontrolled bleeding. (d) Pulmonary embolus.

189 The patient with pre-eclampsia diagnosed remote from tGrm, which of the following is NOT necessarily an indication for expeditious delivery:
(a) Blood Pressure 170/115 on medication.
(b) Proteinuria 5 g. per 24 hours.
(c) Platelet count 80,000/ui.
(d) Serum transaminase levels three times normal.

190. Independent risk factors for pre-eclampsia include all, except:

(a)        Hyper homocysteinemia.           (b) Race.

(c)        Number of partners.     (d) Family history.

191. Pregnancy-associated risk factors for pre-eclampsia include all except:

(a)        Rh Incompatibility.        (b) Multiple pregnancy.

(c)        Fetal structural abnormalities.    (d) Trisomy 13.

192 The severity of pelvic pain in patients with endometriosis correlated best with

(a)        Number of implants.     (b)        Depth of invasion of Lesions

(c)        Types of lesions.           (d)        Stage of disease.

193. Accepted indications for Assisted Reproductive Technologies (ART) in endometriosis patients

includes all of the following except:

(a)        Advanced disease.        (b) At least one year of infertility.

(c)        Multifactorial infertility.  (d) Advanced disease.

194. The data are most convincing for which theory as the pathogenesis of endometriosis in the peritoneal cavity:

(a)        Coelomic metaplasia.    (b) Induction.

(c)        Embryonic rests.           (d) Lymphatic and vascular metastasis.

195. Endometriosis has been found in all of the following locations except:

(a)        Spleen. (b)        Central Nervous system.

(c)        Extremities.       (d)        Pancreas.

196 Controlled ovarian hyperstimulation as a treatment for infertility is most useful in which patients

(a) Women with premature ovarian failure.

(b) Women undergoing cancer therapy.

(c) Couples undergo artificial insemination.

(d) Perimenopausal women.

197. The formation of primordial follicles in human fetus is completed by:

(a)        4 weeks.          (b)        8 weeks.

(c)        13 weeks.        (d)        18 weeks.

198. During pregnancy there is an increased respiratory sensitivity to Carbon dioxide due to higher circulating levels of:

(a)        Progesterone.   (b) Estrogen.

(v)        Estriol.  (d) Prolactin.

199 An effective and safe treatment for recurrent lag cramps in the second half Of pregnancy is:

(a)        Vitamin C.        (b) Vitamin D.

(c)        Acetaminophen.            (d) Calcium 1 gm. twice daily for 2 weeks.

200. The Ureter:

(a) Crosses superior to the uterine artery in the Broad ligament.

(b) Derives its sympathetic nerve supply from the 2 and 3’ lumbar nerve roots.

(c) Is widest at the pelvi ureteric junction.

(d) Derives its blood supply entirely from the renal’ and superior vesical arteries.

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