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NIZAM’S INSTITUTE OF MEDICAL SCIENCES                      Punjagutta, Hyderabad – 500 082, A.P., India.                  ...
Q1.    Figure below depicts splitting of 2nd heart sound (S2) in normal and three differentabnormal conditions. The condit...
Q3.      Which one of the following secondary skin lesions represents excessive accumulation ofstratum corneum      A) lic...
Q8.      To reduce pain during her childbirth, an obstetrician performs a local nerve block on his25-year-old patient whil...
Q9.        The histology of endometrium shown below depicts which one of the phases      A)   postmenstrual      B)   earl...
Q11.         The pattern of inheritance shown in this pedigree is seen in which genetic condition       A)   neurofibromat...
Q15.        The fundus picture below depicts       A)   central retinal artery occlusion       B)   age related macular de...
Q19.        The earliest imaging finding in chronic pancreatitis is       A)   dilatation of the main pancreatic duct     ...
Q24.        Regarding acute pancreatitisAssertion: choledocholithiasis has to be evaluated in all casesReason: pancreatic ...
Q30. A woman aged 22 years with 8 weeks of gestation presents with sudden onset of severeabdominal pain associated with lo...
Q34. Shown below is the dorsal view of the hand. The shaded area indicated by an arrow issupplied by       A)   dorsal bra...
Q38. A bruise in the centre of the neck, across the windpipe is seen in which of the followingmethods of strangulation    ...
Q43.        The abnormality detected in the radiographs below is       A)   scaphoid fracture       B)   keinbocks disease...
Q44. Shown below is the visceral surface of the spleen. The area indicated by an arrowrepresents which one of the followin...
Q46.        The bony abnormalities shown in the pictures are seen in which genetic metabolic            disorder       A) ...
Q47.        Complement can be activated by all of the following except       A)   immunoglobulin G (IgG) combined with ant...
Q53.        Regarding osteomalaciaAssertion: there is accumulation of unmineralized bone matrixReason: there is an over pr...
Q56.     The schematic diagram below demonstrates the neurotransmitters, marked as numbers,in the peripheral nervous syste...
Q60. Tympanogram is constructed by recording the range of compliance on altering thepressure within the external auditory ...
Q66. A surgeon has resected a part of the intestines following laporotomy. As per the Bio-medical waste Rule1998, the surg...
Q70.        In the diagram depicted below, the pelvic dimension that is being measured is       A)   bi-ischial diameter  ...
Q71. Which of the following can be inferred from the given graph that plots changes in thepercentage of the filtered amoun...
Q73. A 20 year old girl comes with complaints of decreased blood flow during menstrualcycle. She also gives history of gal...
Q75. Shown below is a diagramatic representation of the femur in individuals of different agegroups. YM = yellow marrow, R...
Q76.        Shown below is a schematic representation of a type of malignant tumor of tibia.The tumor is most likely to be...
Q79. Voriconazole can be used for the treatment of infections caused by which of the followingfungi1. Fluconazole resistan...
Q81. Which one of the following structures is not present with in the free border of lesseromentum    A) hepatic artery   ...
Q87.        The most specific feature for esophageal rupture is       A)   substernal chest pain       B)   subcutaneous e...
Q91.        Endothelial / leukocyte adhesion molecules include/includes1. p-selectin2. tumor necrosis factor3. VCAM-14. in...
Q95. A 36 yr old gentleman complained of instability in his right knee. On examination withhips flexed to 45 degrees and k...
Q100. The finding of porphyrin in urine is very suggestive of poisoning with which of thefollowing metals     A) iron     ...
Q102. Shown below is the graphical depiction of temporal trends of growth of different tissues.The graphs 1, 2 and 3 repre...
Q106. A 24 year old man came with the complaints of increased joviality, overactivity withreduced sleep for 1 month durati...
Q109. Given below is the schematic diagram of lacrimal apparatus. The valve that preventsreflux of tears is located at whi...
Q112. A 38-year-old man has had thyroid surgery to remove his papillary carcinoma. Theexternal laryngeal nerve that accomp...
Q117. A 2 year old child is brought to a primary health centre with the complaints of 4 episodesof loose stools over 24 ho...
Q121. Shown below is a barium swallow radiograph at thoracic level in a patient withdsyphagia. The image is suggestive of ...
Q122. Mother of a 6-month baby complained that her childs legs do not open equally whilechanging napkins. Given below is t...
Q125. A woman aged 24 years appears at 8 weeks of pregnancy and reveals a history ofpulmonary embolism seven years ago dur...
Q130. Regarding umbilical cord blood stem cells    A)   have less graft versus host disease    B)   have more HLA restrict...
Q136. The facial skeleton is primarily derived from which of the following embryonic tissues    A) sixth pharyngeal arch  ...
Q139. All of the following statements are true regarding left ventricular pressure volume loopgiven below except     A) 4 ...
Q143. Which one of the statements regarding arterial supply of uterus and ovary is true    A) uterine artery arises from i...
Q148. During DNA synthesis the Okazaki fragments in the lagging strand are joined togetherby which of the following enzyme...
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Nimset2012 setc

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Medical Postgraduation MD/MS question paper of nizams institute of medical sciences (nims), andhra pradesh for the year 2012

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Nimset2012 setc

  1. 1. NIZAM’S INSTITUTE OF MEDICAL SCIENCES Punjagutta, Hyderabad – 500 082, A.P., India. Set: C NIMSET 2012 Question Booklet Entrance Examination for Admission to MD/MSSubject NIMSET 201219 February 2012 Marks 150 Time: 2 hours: 30 min • Please verify whether the number printed on this question booklet corresponds to your hall-ticket number • Please read the instructions on the OMR-Answer sheet carefully • Each question in this booklet is followed by four alternative answers Select the one that is most appropriate and darken the corresponding Oval in the OMR-Answer sheet • Please return this question booklet along with your OMR-Answer sheet • Answer sheets not accompanied with the question booklets will not be corrected • Wrong answers carry negative marks 1 of 44
  2. 2. Q1. Figure below depicts splitting of 2nd heart sound (S2) in normal and three differentabnormal conditions. The conditions 1,2 and 3 represent which one of the following respectively: A) atrial septal defect (ASD), tetralogy of Fallot (TOF), left bundle branch block (LBBB) B) LBBB, TOF, ASD C) TOF, LBBB, ASD D) ASD, LBBB, TOFQ2. In which of the following conditions is endoscopic sinus surgery contraindicated A) choanal atresia B) lateral frontal sinus disease C) frontoethmoid mucocoele D) CSF leak 2 of 44
  3. 3. Q3. Which one of the following secondary skin lesions represents excessive accumulation ofstratum corneum A) lichenification B) scale C) crust D) scarQ4. Which of the following drug acts by inhibiting the enzyme inosine monophosphatedehydrogenase A) azathioprine B) alefacept C) mycophenolate mofetil D) pimecrolimusQ5. Which of the following is most suggestive of neonatal small bowel obstruction A) generalized abdominal distension B) failure to pass meconium in the first 24 hours C) bilious vomiting D) refusal of feedsQ6. Nonscarring alopecia can be seen in all of the following except A) hypothyroidism B) hyperthyroidism C) tinea capitis D) sarcoidosisQ7. Gluteus maximus muscle A) is supplied by inferior gluteal nerve B) is supplied by superior gluteal nerve C) is supplied by both superior and inferior gluteal nerves D) takes part in the formation of gluteal fold 3 of 44
  4. 4. Q8. To reduce pain during her childbirth, an obstetrician performs a local nerve block on his25-year-old patient while she is in the lithotomy position, as depicted in the given figure. Whichof the following structures will remain fully sensitive following administration of this localanesthetic A) lower anal canal B) rectum C) perineal body D) urogenital diaphragm 4 of 44
  5. 5. Q9. The histology of endometrium shown below depicts which one of the phases A) postmenstrual B) early proliferative C) late proliferative D) secretory phaseQ10. Effectiveness of oral contraceptive is reduced during concomitant use with antiepilepticdrugs because of their A) increased rate of excretion B) decreased rate of metabolism C) increased rate of metabolism D) decreased rate of excretion 5 of 44
  6. 6. Q11. The pattern of inheritance shown in this pedigree is seen in which genetic condition A) neurofibromatosis B) beta thalassemia C) Duchenne muscular dystrophy D) Huntington diseaseQ12. Regarding HIV virus1. HIV belongs to the family Rhabdoviridae.2. Hypochlorite solution at a concentration of 0.5% available chlorine is recommended forinactivation of HIV.3. HIV is an extremely heat resistant virus.4.It may take 2-8 weeks for antibodies to appear after infection 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 correctQ13. Which of the following is commonly referred to as the "21" amino acid A) Homocysteine B) Selenocysteine C) Cystine D) TaurineQ14. Most frequent arterial involvement by arteriography in Takayasus arteritis A) common carotid B) renal C) aortic arch D) subclavian 6 of 44
  7. 7. Q15. The fundus picture below depicts A) central retinal artery occlusion B) age related macular degeneration C) retinitis pigmentosa D) papillitisQ16. In obstetric practice, contraction stress testing is primarily a test of A) fetal condition B) uterine function C) uteroplacental function D) maternal circulatory statusQ17. Supramalleolar osteotomy is a procedure suitable for correction of which one of thefollowing deformities of the lower extremity A) external tibial torsion B) equinus deformity of foot C) pes varus deformity D) equinovarus deformity of footQ18. Regarding medullary carcinoma of thyroid,Assertion: total thyroidectomy is the operation of choiceReason: these tumours are usually multicentric 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true 7 of 44
  8. 8. Q19. The earliest imaging finding in chronic pancreatitis is A) dilatation of the main pancreatic duct B) dilatation of the secondary duct C) small calcifications in parenchyma D) ductal stonesQ20. In chest radiograph in frontal view detection of pleural fluid is feasible when the fluidvolume is at least A) 10 to 20 ml B) 50 to 80 ml C) 100 to 200 ml D) 300 mlQ21. Following feature/features of indirect inguinal hernia differentiate it from direct inguinalhernia1.neck of indirect hernia is lateral to epigastric vessels2.indirect hernia occurs in the elderly3.surgery of choice for indirect hernia in young adults is herniotomy alone4.indirect hernia never strangulate 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 correctQ22. Carbon dioxide narcosis may be a feature of A) obesity hypoventilation syndrome B) atypical pneumonia C) interstitial pulmonary fibrosis D) farmers lungQ23. Regarding tinnitus,Assertion: it is more annoying in quiet surroundings, particularly at nightReason: ambient noise has a masking effect 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true 8 of 44
  9. 9. Q24. Regarding acute pancreatitisAssertion: choledocholithiasis has to be evaluated in all casesReason: pancreatic calculi are invariably seen in association with cholelithiasis A) Both Assertion and Reason are true, and Reason is the correction explanation forAssertion B) Both Assertion and Reason are true, and Reason is not the correction explanation forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ25. The treatment of choice in a newly diagnosed achalasia cardia is A) radiofrequency ablation B) laparoscopic cardiomyotomy C) botulinum toxin D) pneumatic dilatationQ26. A researcher is testing the antipyretic effect of a new drug against paracetamol in 50patients of fever, half of whom were assigned to each drug. Which of the following statements istrue A) this is a retrospective case control study. B) a t test is an appropriate test to analyse the results. C) since this is an observational study, it will not have a p value. D) a correlation regression analysis will help decide if the new drug is better.Q27. In a woman presenting to the emergency outpatient of a hospital with uterine bleeding inthe second half of pregnancy, the simplest and safest method for diagnosis of placenta previa is A) digital vaginal examination in the outpatient B) transabdominal ultrasound C) speculum examination D) computerised tomographyQ28. The delivery of breech of fetus spontaneously as far as umbilicus followed by assistedmaneuvers by the operator with or without maternal expulsive efforts is called as A) spontaneous breech delivery B) total breech extraction C) partial breech extraction D) assisted breech deliveryQ29. Anticentromere antibody is typically associated with A) psoriatic arthritis B) Behcets syndrome C) limited forms of systemic sclerosis D) eosinophilic fasciitis 9 of 44
  10. 10. Q30. A woman aged 22 years with 8 weeks of gestation presents with sudden onset of severeabdominal pain associated with loss of consciousness. Per vaginal examination revealed tendercervical movements. The most probable diagnosis is A) hypoglycemia B) ruptured ectopic pregnancy C) appendicitis D) ovarian cystQ31. A 3 year male child presented with complaints of recurrent upper respiratory tractinfections, recurrent skin boils from the age of 6months. He was a product of a consanguineousmarriage. On examination he was malnourished , had nystagmus, hypopigmented hair, multipleskin boils, generalized lymphadenopathy and mild hepatosplenomegaly. His elder sibling alsohad similar complaints and died at the age of 5yrs. A blood examination done showed Hb of9gm%, TLC 15,000,Platelet 1.5 lakhs , normochromic,normocytic picture, large inclusions in allthe nucleated blood cells.The most probable diagnosis is A) Chediak -Higashi syndrome B) chronic granulomatous disease C) hyper Ig E syndrome D) leukocyte adhesion deficiencyQ32. A 50 year old man with history of persistent shoulder pain had a jerking injury of theshoulder. On examination, 6 weeks later, he is unable to abduct his arm. Passive abduction wasnormal and he could keep the arm up once it had been raised above the right angle. This suggests A) partial tear of rotator cuff B) full thickness tear of rotator cuff C) isolated infraspinatus weakness D) isolated subscapularis weaknessQ33. Clinical features of prolapsed intervertebral disk at L5-S1 level include all of thefollowing except A) loss of ankle jerk B) weakness of flexor hallucis longus C) straight leg raising test positive D) loss of knee jerk 10 of 44
  11. 11. Q34. Shown below is the dorsal view of the hand. The shaded area indicated by an arrow issupplied by A) dorsal branch of ulnar B) radial nerve C) posterior cutaneous nerve of forearm D) median nerveQ35. During a clinical assessment done with the purpose of forming an opinion about thepatients mind and degree of responsibility, which of the following suggests feigned insanity A) peculiar fixed facial expression B) dirty and filthy habitus C) resentment to frequent examination D) gradual onsetQ36. Punched-out ulcer covered with a blackened scab (eschar) is characteristic of A) Plague B) Scrub typhus C) Q fever D) LeptospirosisQ37. A 24 year old woman attempts suicide by ingesting 50 acetaminophen tablets. She isrushed to the emergency department. Which of the following treatments would the attendingphysician most likely order A) Alkalinization of urine B) Ca 2+ / EDTA chelation C) Protamine sulfate D) N-acetylcysteine 11 of 44
  12. 12. Q38. A bruise in the centre of the neck, across the windpipe is seen in which of the followingmethods of strangulation A) bansdola B) garrotting C) mugging D) throttlingQ39. Which of the following is the most common cause of uniocular polyopia A) cataract B) subluxated lens C) third nerve palsy D) rupture of superior oblique muscleQ40. The instrument shown below is primarily used to clamp which one of the followingstructures during surgery A) intestines B) ureter C) blood vessels D) Fallopian tubeQ41. An infant aged 10 months chokes while feeding. He becomes apneic and obtunded. Onecan do all these manouveres except A) Heimlichs maneuver B) back blows and chest thrust C) rescue breaths D) jaw liftQ42. Frontal bone scalloping and or bowing of cerebellum with effacement of cisterna magnafound in the fetus in second trimester ultrasound are diagnostic of A) hydrocephalus B) open spina bifida C) omphalocoele D) intestinal obstruction 12 of 44
  13. 13. Q43. The abnormality detected in the radiographs below is A) scaphoid fracture B) keinbocks disease C) March fracture D) Boxers fracture 13 of 44
  14. 14. Q44. Shown below is the visceral surface of the spleen. The area indicated by an arrowrepresents which one of the following impressions A) renal B) colic C) gastric D) pancreaticQ45. Substance which is incapable of inducing antibody formation by themselves but can reactspecifically with antibodies A) complete antigen B) hapten C) epitope D) paratope 14 of 44
  15. 15. Q46. The bony abnormalities shown in the pictures are seen in which genetic metabolic disorder A) mucopolysaccharidosis B) metachromatic leucodystrophy C) Gauchers disease D) glycogen storage disorder 15 of 44
  16. 16. Q47. Complement can be activated by all of the following except A) immunoglobulin G (IgG) combined with antigen B) complex polysaccharides C) killer T cells D) endotoxinQ48. Post-exposure prophylaxis involves administration of immune globulin and vaccinationfor all of the following infections except A) hepatitis B B) tetanus C) rabies D) hepatitis CQ49. In a solitary pulmonary nodule detected on a plain radiograph which of the followingfeatures will have the highest weight in favour of a diagnosis of malignancy A) ex smoker, quit smoking for 8 years B) smooth margins C) size more than 3 cm D) popcorn ball calcificationQ50. "Citron bodies"seen in a Gram stained film from an exudate suggests infection due to A) Clostridium perfringens B) Clostridium novyi C) Clostridium tetani D) Clostridium septicumQ51. The presence of cleaved active caspases in a cellular microenvironment is suggestive of A) impending cell division B) coagulative necrosis C) cellular apoptosis D) cell differentiationQ52. After the first few breaths in a normal new born all of the following changes occur in thecirculation except A) systemic vascular resistance increases B) the shunt through ductus arteriosus reverses to left to right C) pulmonary vascular resistance increases D) the ductus venosus closes 16 of 44
  17. 17. Q53. Regarding osteomalaciaAssertion: there is accumulation of unmineralized bone matrixReason: there is an over production of bone matrix 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ54. In collagen synthesis, Vitamin C is required for A) Oxidation of procollagen B) Hydroxylation of procollagen C) Glycosylation of preprocollagen D) Cross linking between collagen chainsQ55. True statement/statements regarding confidence intervals1. they reflect the precision of the statistic measured.2. they provide an estimate of significance of difference in means .3. they provide an estimate of the magnitude of difference between two groups4. overlapping confidence interval between two groups suggests a difference between the twogroups 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 17 of 44
  18. 18. Q56. The schematic diagram below demonstrates the neurotransmitters, marked as numbers,in the peripheral nervous system. The option which represents the correct sequence ofneurotransmitter 1,2,3 and 4 is A) acetylcholine,noradrenaline,acetylcholine,noradrenaline B) acetylcholine,noradrenaline,acetylcholine,acetylcholine C) acetylcholine,acetylcholine,noradrenaline,noradrenaline D) acetylcholine,noradrenaline,acetylcholine,adrenalineQ57. The mechanisms of antimicrobial action of vancomycin, erythromycin and metronidazoleis respectively A) DNA damage, inhibition of protein synthesis, cell wall damage B) DNA damage, cell wall damage, inhibition of protein synthesis C) cell wall damage, DNA damage, inhibition of protein synthesis D) cell wall damage, inhibition of protein synthesis, DNA damageQ58. A 20 year old female requests for postcoital contraceptive after having unprotected sex.Drug/ drugs which can be used as postcoital contraceptive are1.Levonorgestrel and Ethinylestradiol combination.2.Mifepristone.3.Levonorgestrel alone.4.Norethindrone enanthate. 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 correctQ59. Kussmauls sign is A) a paradoxical fall in jugular venous pressure (JVP) during inspiration B) a paradoxical fall in JVP during expiration C) a paradoxical rise in JVP during inspiration D) a paradoxical rise in JVP during expiration 18 of 44
  19. 19. Q60. Tympanogram is constructed by recording the range of compliance on altering thepressure within the external auditory meatus from A) +200 mm H2O to -200 mm H2O B) +100 mm H2O to -500 mm H2O C) +300 mm H2O to -300 mm H2O D) +50 mm H2O to -1000 mm H2OQ61. Thirst centre in the hypothalamus is stimulated effectively by A) increased plasma osmolality and volume B) increased plasma osmolality and decreased blood volume C) decreased plasma osmolality and increased pasma volume D) injection of vasopressin into the hypothalamusQ62. A 50 year old lady, a recently diagnosed patient of schizophrenia was started onolanzapine. After 10 days of medication she developed high grade fever with confusion,dysarthria, rigidity and elevated serum creatinine phosphokinase. The most likely possibility is A) agranulocytosis with sepsis B) severe psychosis C) neuroleptic malignant syndrome D) myocarditisQ63. Management of massive pulmonary oedema due to Indian scorpion sting include all ofthe following except A) sodium nitroprusside B) hydralazine C) prazosin D) phenylephrineQ64. Regarding injection of sodium tetradecyl sulphate(sclerosant) into superficial varicosevein of legs,Assertion :After the injection local compression is not requiredReason :the sclerosant destroys lipid membranes of the endothelial cells leading to thrombosis,fibrosis and obliteration (sclerosis) of veins 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ65. A 12 year old boy presented with fresh bleeding per rectum. Colonoscopy revealed apedunculated single rectal polyp-1cm in diameter with a smooth and glistening surface. This typeof rectal polyp would be A) tubulovillous adenoma B) inflammatory pseudopolyp C) lymphomatous polyp D) juvenile polyp 19 of 44
  20. 20. Q66. A surgeon has resected a part of the intestines following laporotomy. As per the Bio-medical waste Rule1998, the surgeon is expected to place surgically removed human organs in A) yellow plastic bag B) red plastic bag C) white puncture proof container D) black plastic bagQ67. Progesterone causes A) myometrial contraction B) development of breast ducts C) inhibition of LH secretion D) a fall in body temperature at ovulationQ68. The factor/factors that differentiate acute lung injury (ALI) from acute respiratorydistress syndrome.1. timing of etiological factor2. level of PEEP3. pattern of infiltrates on chest radiograph4. PaO2/FiO2 ratio 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 correctQ69. Feature/features of alcohol withdrawal with delirium tremens1. auditory hallucinations2. tremors3. increased drowsiness4. autonomic disturbances 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 20 of 44
  21. 21. Q70. In the diagram depicted below, the pelvic dimension that is being measured is A) bi-ischial diameter B) diagonal conjugate C) posterior saggital diameter D) inter-spinous diameter 21 of 44
  22. 22. Q71. Which of the following can be inferred from the given graph that plots changes in thepercentage of the filtered amount of substances remaining in the tubular fluid along the length ofthe nephron A) nearly 40% of Na+ and water are reabsorbed in the proximal tubule B) fluid leaving the proximal tubule is isotonic C) fluid in loop of henle is isotonic D) most of the water is reabsorbed in collecting ductQ72. A 20 year old girl presented with a bony swelling in the distal femur. The biopsy revealedthe following picture. The likely diagnosis is A) osteosarcoma B) Ewings tumor C) giant cell tumor D) tuberculous osteomyelitis 22 of 44
  23. 23. Q73. A 20 year old girl comes with complaints of decreased blood flow during menstrualcycle. She also gives history of galactorrhea and headache. The investigation of choice is A) ultrasound pelvis B) serum progesterone C) serum prolactin D) mammographyQ74. The structure/structures which constitute Caudal Pharyngeal complex1. Dorsal portion of the fourth pharyngeal pouch.2. Ventral portion of the fourth pharyngeal pouch.3. Lower part of the ultimobranchial body.4. Third pharyngeal pouch. 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 23 of 44
  24. 24. Q75. Shown below is a diagramatic representation of the femur in individuals of different agegroups. YM = yellow marrow, RM = red marrow.The age groups with femur depicted in figures1,2 and 3 respectively are A) child, adult, aged B) aged, adult, child C) adult, child, aged D) adult, aged, child 24 of 44
  25. 25. Q76. Shown below is a schematic representation of a type of malignant tumor of tibia.The tumor is most likely to be A) osteosarcoma B) Ewings tumor C) Multiple myeloma D) metastatic tumorQ77. Correct position of the neck for performing bronchoscopy is A) flexed on thorax with head flexed on atlanto-occipital joint B) extended on thorax with head extended on atlanto-occipital joint C) flexed on thorax with head extended on atlanto-occipital joint D) extended on thorax with head flexed on atlanto-occipital jointQ78. Complications of chronic anterior uveitis include1. glaucoma2. cystoid macular edema3. band keratopathy4. retinal breaks 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 25 of 44
  26. 26. Q79. Voriconazole can be used for the treatment of infections caused by which of the followingfungi1. Fluconazole resistant candida albicans2. Fluconazole resistant non albicans candida species3. Aspergillus species4. Zygomycetes A) only 1, 2 and 3 are correct B) only 1and 3 are correct C) only 2 and 4 are correct D) only 4 is correctQ80. In the histology of renal corpuscle shown below, the structure pointed by the arrow is A) glomerular capillary epithelium B) capsular epithelium C) mesangial cells D) macula densa 26 of 44
  27. 27. Q81. Which one of the following structures is not present with in the free border of lesseromentum A) hepatic artery B) portal vein C) inferior vena cava D) bile ductQ82. An 18 year old nulliparous woman complained of right lower quadrant pain over severalyears and had a right adnexal mass which on ultrasonogram was suggestive of dermoid cyst. Shehad a guaiac positive stool in the past but none currently. During surgery for removal of dermoidshe is found to have a Meckels diverticulum with slight thickening at the tip. Regarding furthermanagement of diverticulum A) leave the patient alone B) it should be removed as it is symptomatic and has atypical features C) it should be removed at a later date to prevent future complications D) to be removed only if symptoms recurQ83. In primary open angle glaucoma, demonstration of which of the following is enough tomake the diagnosis in the presence of normal open angle on gonioscopy A) raised intraocular pressure B) characteristic optic nerve head changes C) visual field abnormalities D) characteristic optic nerve head changes and visual field abnormalitiesQ84. A point mutation at the third nucleotide of a codon changing AGA to AGG did notchange the final protein structure as both encode for arginine.This illustrates A) acceptable missense mutation B) ambiguous genetic code C) transversion D) degeneracy of genetic codeQ85. Which of the following exerts the greatest effect on parathyroid hormone secretion A) plasma phosphate level B) 1.25 dihydroxy cholecalciferol C) intracellular Ca ++ concentration D) extracellular Ca ++ concentrationQ86. Anatomical relationship of structures at renal hilum from anterior to posterior A) vein, pelvis, artery B) artery, vein, pelvis C) pelvis, artery, vein D) vein, artery, pelvis 27 of 44
  28. 28. Q87. The most specific feature for esophageal rupture is A) substernal chest pain B) subcutaneous emphysema C) raised serum amylase D) pleural effusion on chest radiographQ88. For a 7 year old child, with body weight of 21 kg, who cannot be fed enterally but has noother requirement for volume adjustment, the calculated fluid maintenance volume requirementover 24 hours is . A) 1610 ml B) 1520 ml C) 1450 ml D) 1370 mlQ89. In the schematic representation of the fibrinolytic system shown below, the productdepicted by "?" is A) bradykinin B) prekallikrein C) Hagemen factor D) C3aQ90. Which of the following can be used to prevent neonatal cretinism in babies, in areaswhere endemic goitre in highly prevalent1. giving thyroxine tablets to women of child bearing age2. periodic parenteral administration of iodised oil to women of child bearing age3. enrichment of agricultural land with iodine4. providing iodised salt for cooking 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 28 of 44
  29. 29. Q91. Endothelial / leukocyte adhesion molecules include/includes1. p-selectin2. tumor necrosis factor3. VCAM-14. interleukin-1 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 correctQ92. Which of the following findings suggest strangulation by ligature A) oblique ligature mark B) emphysematous bullae on the surface of the lung C) stretched and elongated neck D) carotid artery damageQ93. In biochemical reaction depicted below, the process that takes place is A) deamination B) decarboxylation C) hydroxylation D) carboxylationQ94. True statement/statements regarding cyanide poisoning,1. some compounds can produce corrosive changes in the oral and oesophageal mucosa2. by any route, death due to cyanide is instantaneous3. hydrocyanic acid is unstable in light4. causes cellular dysfunction by coagulative necrosis A) only 1,2 and 3 are correct B) only 1and 3 are correct C) only 2 and 4 are correct D) only 4 is correct 29 of 44
  30. 30. Q95. A 36 yr old gentleman complained of instability in his right knee. On examination withhips flexed to 45 degrees and knees flexed to 90 degrees, there was increased movement of tibiaposteriorly (posterior drawer test positive). The injured structure is A) anterior cruciate ligament B) medial meniscus C) posterior cruciate ligament D) lateral meniscusQ96. Regarding plasma HIV RNA levelsAssertion: they increase with duration of illness, irrespective of treatment effects.Reason: they indicate the magnitude of HIV replication and the rate of CD4+ Tcell destruction 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ97. An acute extradural hematoma is seen on CT as A) hyperdense concave lesion B) isodense lentiform (biconvex) lesion C) hypderdense lentiform (biconvex) lesion D) hypodense lentiform (biconvex) lesionQ98. Regarding cromolyn sodiumAssertion: It is useful for the treatment of an acute attack of bronchial asthma.Reason: It inhibits the degranulation of mast cell, thereby preventing the release of chemicalmediators of asthma. 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ99. A 40-year adult male weighing 50 kg suffered circumferential second and third degreeburns involving both lower limbs. The approximate requirement of parenteral fluid (lactatedRingers solution) in the first 8 hours, as calculated by Parklands formula, is A) 1800 ml B) 2400 ml C) 3600 ml D) 7200 ml 30 of 44
  31. 31. Q100. The finding of porphyrin in urine is very suggestive of poisoning with which of thefollowing metals A) iron B) thallium C) lead D) mercuryQ101. Regarding ESBL producing strains of Gram negative bacilli,Assertion: are resistant to multiple antibiotic groups and may include fluoroquinolones,aminoglycosides, beta lactamase inhibitor combinations and carbapenems.Reason: A single determinant on a resistance plasmid codes for resistance to all the groups ofantibiotics. 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true 31 of 44
  32. 32. Q102. Shown below is the graphical depiction of temporal trends of growth of different tissues.The graphs 1, 2 and 3 represent which one of the following respectively. A) brain, lymphoid, viscera B) viscera, brain, lymphoid C) lymphoid, brain, viscera D) brain, viscera, lymphoidQ103. In humans if both noradrenergic and cholinergic systems are blocked, the approximateheart rate would be approximately A) 70 B) 50 C) 100 D) 120Q104. In ABCD of current basic life support algorithm "D" stands for A) disability B) diagnosis C) defibrillation D) drugsQ105. Which of the following structures cannot be palpated by a vaginal examination A) sigmoid colon B) ureters C) perineal body D) iliopectineal line 32 of 44
  33. 33. Q106. A 24 year old man came with the complaints of increased joviality, overactivity withreduced sleep for 1 month duration. He also had the belief that he had supernatural powers andwas spending money recklessly. Which of the following drugs can be used as prophylaxis toprevent recurrence A) tricyclic antidepressants B) monoamine oxidase inhibitors C) mirtazapine D) carbamazepineQ107. Which one of the following is not a function of state medical councils A) issue of warning notices B) maintenance of medical register C) maintenance of standards of medical education D) disciplinary control over the medical practitionersQ108. In the figure given below,the abnormality can be explained by weakness of A) Right gluteus medius B) Right gluteus maximus C) Left gluteus medius D) Left gluteus maximus 33 of 44
  34. 34. Q109. Given below is the schematic diagram of lacrimal apparatus. The valve that preventsreflux of tears is located at which site in the diagram A) site 1 B) site 2 C) site 3 D) site 4Q110. In Whipples procedure, which of the following structures is not removed A) duodenum B) common bile duct C) portal vein D) head of pancreasQ111. The factor/factors playing a part in the closure of ductus arteriosus at birth1. increased arterial oxygen tension2. increased left atrial pressure3. decreased prostaglandin E24. fetal metabolic acidosis 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 34 of 44
  35. 35. Q112. A 38-year-old man has had thyroid surgery to remove his papillary carcinoma. Theexternal laryngeal nerve that accompanies the superior thyroid artery is damaged during thesurgery. This injury could result in a severe impairment of which of the following function A) relaxing the vocal cords B) rotating the arytenoid cartilages C) tensing the vocal cords D) widening the rima glottidisQ113. A 10 year old girl was admitted with fever and migratory polyarthritis. She also hadtachycardia, arrhythmia and pericardial friction rubs. The distinctive pathologic feature withinthe heart is A) Aschoff bodies B) Asteroid bodies C) Ferruginous bodies D) Schaumann bodiesQ114. Regarding management of traumatic dislocation of hipAssertion: the joint should be reduced as an emergencyReason: the longer the head of femur remains out, there is more chance of its becoming avascular 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ115. Regarding pathogenesis of chronic myeloid leukemiaAssertion it is caused BCR-ABL gene fusion.Reason : fusion leads to activation of retinoic acid receptor blocking differentiation of cells 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ116. In which of the following diseases does the activation of T cells play a central role ininitiating tissue damage A) penicillin induced anaphylaxis B) rheumatoid arthritis C) Goodpastures syndrome D) autoimmune hemolytic anemia 35 of 44
  36. 36. Q117. A 2 year old child is brought to a primary health centre with the complaints of 4 episodesof loose stools over 24 hours.On evaluation the child has no signs of dehydration. According toWHO plan A the following is advised except A) Keep the child home and advise to return if child is not better in 3 days B) advise to give plenty of oral fluids at home C) continue feeding at home D) initial treatment with ORS at a dose of 75ml/kg over 4 hrs in outpatient departmentQ118. The fourth stage of labour is from A) delivery of fetus to delivery of placenta B) first 24 hours following delivery C) the hour immediately following delivery D) time between delivery and lactationQ119. All the following viruses are associated with malignancies in humans except A) HBV B) HCV C) HAV D) HPVQ120. Reagrding treatment of depression with mono amine oxidase inhibitor -tranylcypramineAssertion: It should not be combined with selective serotonin reuptake inhibitors (SSRI) likeescitalopramReason Thy are counteractive and cancel each others actions 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true 36 of 44
  37. 37. Q121. Shown below is a barium swallow radiograph at thoracic level in a patient withdsyphagia. The image is suggestive of which one of the following A) squamous cell carcinoma of esophagus B) leiomyoma of esophagus C) achalasia cardia D) esophageal pouch 37 of 44
  38. 38. Q122. Mother of a 6-month baby complained that her childs legs do not open equally whilechanging napkins. Given below is the diagrammatic representation of pelvic skeletal abnormalityin the child.The abnormality is most likely to be A) Perthes disease B) rickets C) congenital dislocation of hip D) epiphyseal fractureQ123. In the process of secondary active transport involved in molecule movement across cellmembranes A) energy expenditure is minimal B) transport of Na + is coupled to that of other molecules C) osmotic gradient is established across cells D) size of intercellular junction is a limiting factorQ124. Regarding features of human enzymes with the temperature coefficient of 2Assertion: A 10 degree celsius increase in temperature will double the rate of the enzymaticreactionReason: Heat causes protein denaturation 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true 38 of 44
  39. 39. Q125. A woman aged 24 years appears at 8 weeks of pregnancy and reveals a history ofpulmonary embolism seven years ago during her first pregnancy. She was treated withintravenous heparin followed by several months of oral warfarin and had no further evidence ofthromboembolic disease for over six years. Which one of the following treatment modalities ismost appropriate now A) no specific management with regard to thromboembolism problem B) oral warfarin therapy in the first two trimesters and heparin therapy during 3rd trimesterand peuperium C) warfarin therapy throughout pregnancy and peuperium D) the patient should be placed on low dose heparin therapy through out pregnancy andpeurperiumQ126. Regarding influenza virus infectionAssertion: outbreaks are difficult to control with vaccinationReason: 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ127. With regard to the obstetric condition, vasa previa,Assertion : bleeding results in hypovolemia and hypotension in motherReason: bleeding occurs from the fetal side of the placenta A) Both Assertion and Reason are true, and Reason is the correction explanation forAssertion B) Both Assertion and Reason are true, and Reason is not the correction explanation forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ128. A patient complains on swaying in dark surroundings and on examination swaysmarkedly on eyes closure. The probable structure involved is A) posterior column B) spinothalamic tract C) cerebellum D) cerebral cortexQ129. In chronic osteomyelitis, a sequestrum represents which one of the following A) vascular bone from periosteum B) cortical bone devoid of vascularity C) bone marrow D) bone chip from the epiphysis 39 of 44
  40. 40. Q130. Regarding umbilical cord blood stem cells A) have less graft versus host disease B) have more HLA restriction than adult marrow stem cells C) more likely to be contaminated with herpes virus D) large quantities can be obtained from a single sourceQ131. In the Mallory - weiss syndrome A) the esophageal mucosa is torn away from the gastro - esophageal junction B) patients present with upper GI bleeding which may be severe C) the lesion is usually the result of blunt trauma to the chest D) surgery is required in a majority of casesQ132. The best method for random allocation of treatment groups is A) based on the day of the week B) based on assignment of a previous patient C) using hospital chart numbers D) computer-generated random numberingQ133. Which of the following blood vessel is likely to be damaged in femoral hernia repair A) pubic branch of obrurator artery B) aberrant obturator artery C) cremasteric artery D) testicular arteryQ134. The results of various tests in a person with hearing loss are as followsroll over phenomenon present, recruitment present, stapedial reflex present, SISI score 75%. Thesite of lesion is likely to be in A) middle ear B) cochlea C) retrocochlea D) Heschls gyrusQ135. Left atrial enlargement can be recognized on a chest radiograph as1. rounding of left heart border2. double contouring of right cardiac shadow3. elevated cardiac apex4. widening of carina 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 40 of 44
  41. 41. Q136. The facial skeleton is primarily derived from which of the following embryonic tissues A) sixth pharyngeal arch B) endoderm C) skin ectoderm D) neural crestQ137. With reference to radiation induced damage to tissues:Assertion : neurons are more resistant compared to gonadal cells Reason : poorly vascularised tissues with low oxygenation are more resistant than tissues with increased oxygenation 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ138. As per national blood safety policy in India, every unit of blood product should be testedfor detection of A) HIV, Hepatitis A, Hepatitis B, CMV and malaria B) HIV, Hepatitis A, Hepatitis B Hepatitis C and malaria C) HIV, Hepatitis B, Hepatitis C, malaria, and syphilis D) HIV, Hepatitis A, Hepatitis B, Hepatitis E and malaria 41 of 44
  42. 42. Q139. All of the following statements are true regarding left ventricular pressure volume loopgiven below except A) 4 to 1 represents isovolumetric relaxation B) point 1 represents opening of mitral valve C) slope of the line 1 to 2 increases with decrease in ventricular compliance (e.g. acuteinfarction) D) point 4 represents opening of aortic valveQ140. Telomerase activity is usually absent in A) germ cells B) somatic cells C) stem cells D) cancer cellsQ141. Woods light used to map areas of depigmentation works on the principle of A) reduction of specular reflection B) differential reflection of light between heme and melanin C) fluorescence of collagen in the dermis D) visualisation of antigens using fluorecin labelled antibodiesQ142. Which of the following phases of wound healing is characterized by erythema and edemaof the wound edges A) proliferation B) remodelling C) inflammation D) hemostasis 42 of 44
  43. 43. Q143. Which one of the statements regarding arterial supply of uterus and ovary is true A) uterine artery arises from internal iliac and ovarian artery from aorta B) uterine artery arises from aorta and ovarian artery from internal iliac C) both uterine artery and ovarian artery arise from aorta D) both uterine artery and ovarian artery arise from internal iliacQ144. The condition depicted below is A) thyroglossal cyst B) pharyngeal diverticulum C) laryngeal diverticulum D) branchial cystQ145. In an infant breathing and feeding are possible simultaneously due to A) conical shape of the larynx B) soft , collapsible laryngeal cartilages C) high position of the larynx in the neck D) narrow cricothyroid spaceQ146. The ideal candidate for an intrauterine contraceptive device is one who is A) nulliparous B) has multiple sexual partners C) has no history of pelvic inflammatory disease D) want to avoid need for medical followup after contraceptive useQ147. An infant aged six months presents with recurrent vomitings and abnormal movements.On examination he was noted to have lighter complexion than his elder sibling. His urine had amusty odour, the most probable diagnosis is: A) phenyl ketonuria B) alkaptonuria C) homocystinuria D) maple syrup urine disease 43 of 44
  44. 44. Q148. During DNA synthesis the Okazaki fragments in the lagging strand are joined togetherby which of the following enzyme A) DNA polymerase B) DNA ligase C) DNA helicase D) RNA polymeraseQ149. Regarding treatment of malaria with Artesunate combination therapy (ACT),Assertion: it can not be used in the treatment of plasmodium vivax infectionReason: it is not effective for plasmodium vivax 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 forAssertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ150. Regarding lower limb deep venous thrombosis, the commonest site of origin of thrombusis A) soleal sinusoids B) femoral vein C) saphenous vein D) pelvic veins 44 of 44

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