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AIIMS May 2013 Discussion www.targetpg.in www.mcqsonline.net
Title Pozitive AIIMS May 2013 Discussion Author Dr.Manorajan MD DM Publisher Pozitive Type of Book MCQs with Answers, References, Explanation, Discussion Exams AIIMS 2013 May – One Exam Only covered Subjects All Subjects covered Intended for PG Entrance, AIIMS and All India PG Entrance, State PGs and all PGs Can be Used PG Entrance, AIIMS and All India for PG Entrance, State PGs and all PGs, Undergraduates, Post Graduates Pozitive Book Number First Published Online Current Version Last Updated Price ISBN ISBN of Printed Book Cost of
1 29th May 2013 2 11th July 2013 $5 NA Printed Book yet to be published Printed Book yet to be published
Printed Book Publisher of Printed Book yet to be published Printed Book Printed Book Printed Book yet to be published available at
God is Great
OPERATION HARRI CAPSULE -3 - EVIDENCE BASED-140 QUESTIONS From AIIMS MAY 2013 Was Discussed at various programmes of OHC 3-POZITIVE
POZITIVE - Programmes
OPERATION HARRI CAPSULE-3 [OHC 3] OPERATION HARRI-Book POZITIVE Consultant POZIGOLD MKT-Must Know Tables Exciting 18th POZITIVE-Model exam
Questions covered in AIIMS MAY 2013 (over lap might occur)
110 55 95 55 8 2 5
Total number of questions discussed at OHC-3 - 110 (We promised around 110 -120) Total number of questions discussed at various programmes at POZITIVE - 140 Discussion below with evidence
AIIMS MAY 2013
1. A patient presented with alcohol withdrawl syndrome now having seizure..DOC is [AIIMS MAY 2013] a) Diazepam b) valproate c) carbamazepine Ans (a) Ref-Consultant-POZITIVE Psychiatry hand out-page 18 Withdrawal tremors (shakes/jitters) 6-8 hours after cessation Psychotic/perceptual disturbance – 8-12 hours after cessation Seizure (Rum fits) – 12-24 hours Delirium Tremens – within 72 hours. Detoxification is first step done by Benzodiazepines (chlordiazepoxide) Delirium Tremens – confusion, disorientation, VH, dangerous exhaustion Black out – discrete episodes of anterograde amnesia during intoxication Fetal alcohol syndrome – Microcephaly, Craniofacial malformation, limb,heart defects Disulfiram – inhibits aldehyde dehydrogenase, DA reaction characterised by flushing, tachycardia, palpitation, headache, hot flushes. Alcoholic anonymous – self help group of recovering alcoholics AL anon - Spouses of alcohol Al Ateen – children of alcoholics Deterrants agents – Disulfiram, metronidazole, citrated calcium carbamide Anticraving agents – Naltrexone, Fluoxetine, Acamprosate POZITIVE 2013 4 2. Bells palsy which is not correct [AIIMS MAY 2013] a) steroid is mandatory b) unilateral facial deafness c) immediate surgical decompression d) antiviral Ans (c) REFERENCE Consultant –OHC-2,3 POZITIVE
BELLS PALSY Symptomatic measures include (1) the use of paper tape to depress the upper eyelid during sleep and prevent corneal drying, and (2) massage of the weakened muscles. A course of glucocorticoids, given as prednisone 60–80 mg daily during the first 5 days and then tapered over the next 5 days, appears to shorten the recovery period and modestly improve the functional outcome • A recently published randomized trial found no added benefit of acyclovir (400 mg five times daily for 10 days) compared to prednisolone alone for treatment of acute Bell's palsy; (17TH EDITI0N HARRISON) • the overall weight of evidence suggests that the combination therapy with prednisone plus valacyclovir may be marginally better than prednisone alone(18TH EDITI0N HARRISON) 3. Chromosome dividing perpendicular to usual axis of division forms.. [AIIMS MAY 2013] a.ring chromosome
b.isochromosome c. acrochromosome d. subtelomeric chromosome Ans (b) Ref-OHC Book,POZITIVE consultant * Dysgerminomas - mutations in c-Kit oncogenes [as seen in gastrointestinal stromal tumors (GIST)], whereas a subset of germ cell tumors have isochromosome 12 4. Embryonic hemoglobin is composed of _____chains [AIIMS MAY 2013] a) Alpha&beta b) epsilon& gamma c) gamma &beta d) zeta &epsilon Ans (d) REFERENCE • • • • -POZITIVE-OHC2,3-Hematology OPERATION HARRI- BOOK PAGE 464 CONSULTANT MKT
alpha(2), epsilon (2) Portlandzeta(2), gamma (2)
5. Slow growing tumor affecting cerebellum, spinal cord in chidren is [AIIMS MAY 2013] a) Pilocytic astrocytoma b) Meningioma c) medulloblastoma Ans (a) REF-POZITIVE OHC-2,3,CONSULTANT OHC 3-Class discussion Low Grade Astrocytoma More common in children Pilocytic Astrocytoma - Most common childhood brain Tumor - Cerebellum - Cystic, well demarcated - Spindle shaped cells 6. A young male with genital , oralulcers, and visual disturbance [AIIMS MAY 2013] a) bechets syndrome b) Reiters syndrome c) Oculocutaneous aphthous ulceration syndrome d) Epidermolysis bullosa
Human Heamoglobins Embryonic hemoglobins gower 1zeta(2), epsilon(2) gower 2Fetal hemoglobin Adult hemoglobins
hemoglobin F- hemoglobin Aalpha(2), alpha(2), beta(2) gamma(2) hemoglobin A2-
ANTIBODIES????? • Circulating autoantibodies against -enolase of endothelial cells and anti“Saccharomyces cerevisiae antibodies (ASCA”characteristic of Crohn's disease) are found to be present in the later stages of the disease... Eye – Panuveitis most dreaded complication Nondeforming arthritis – knees Arterial and venous Thrombosis Tt – steroids • The syndrome affects young males and females from the Mediterranean region. hyperkalemia . c. thalidomide (100 mg/d) is effective Early initiation of azathioprine tends to favorably affect the long-term prognosis of BehÃ§et's syndrome Colchicine can be beneficial for the mucocutaneous manifestations of the syndrome glucocorticoid therapy Recurrent oral ulceration plus two of the following: Recurrent genital ulceration Eye lesions Skin lesions Pathergy test • The syndrome affects young males and females • Males and females are affected equally. the Middle East. Sudden onset lbbb seen in all except. but males severe disease HLA B5 Genital ulcers. • A tendency toward venous thrombus formation accounts for many of the consequences of BehÃ§et's syndrome • the strong association with HLA-B5 (B51) alloantigen • Eye involvement with scarring and bilateral panuveitis is the most dreaded complication.Recurrent oral ulceration +2 a) Recurrent genital ulcers b) Eye lesions c) Skin lesions d) Pathergy Test M:F 1:1.3 CONSULTANT Discussion fron OHC3 DAY 8 • • • • • PATHERGY TEST In more serious cases..Non specific skin inflammatory reaction to scratch or Intradermal saline injection. but males often have more severe disease.ASHMAN syndrorme.MI. less common but more specific Pathergy Test . b. suggesting a link with the ancient Silk Route 7. and the Far East. [AIIMS MAY 2013] a. Blacks are very infrequently affected.hypokalemia d. since it occasionally progresses rapidly to blindness • The arthritis of BehÃ§et's syndrome is not deforming and affects the knees and ankles POZITIVE 2013 6 Bechet’s syndrome Diagnostic criteria.Ans (a) REFERENCE POZITIVE-OHC 2.
0 mEq/L is associated with conduction abnormalities and bradycardia: Prolonged QRS interval with bizarre QRS morphology High-grade AV block with slow junctional and ventricular escape rhythms POZITIVE 2013 7 . Dr.5 mEq/L is associated with repolarization abnormalities: Peaked T waves (usually the earliest sign of hyperkalaemia) Serum potassium > 6. or V3.5 mEq/L is associated with progressive paralysis of the atria: P wave widens and flattens PR segment lengthens P waves eventually disappear Serum potassium > 7. POZITIVE BITS * Cabrera’s sign is used to diagnose an acute myocardial infarction in the setting of a left bundle branch block and consists of notching at 40 milliseconds in the upslope of the S wave in lead V3 and V4. Long-Short Rule (Ashman Phenomenon): the refractory period of the ventricular conduction system is proportional to cycle length or heart rate. Sgarbossa Criteria Causes of LBBB are: Aortic stenosis Dilated cardiomyopathy Acute myocardial infarction Extensive coronary artery disease Primary disease of the cardiac electrical conduction system Long standing hypertension leading to aortic root dilatation and subsequent aortic regurgitation The criteria to diagnose a left bundle branch block on the electrocardiogram: The heart rhythm must be supraventricular in origin  The QRS duration must be ≥ 120 ms There should be a QS or rS complex in lead V1 There should be a RsR' wave in lead V6. but a specificity of about 90%. Effects Of Hyperkalaemia On The ECG Serum potassium > 5. however. 5 points 2) ST depression > 1 mm in leads V1. This has a low sensitivity. Richard Ashman The Sgarbossa criteria is used in the diagnosis of an acute myocardial infarction when a left bundle branch block is present. the longer the cycle length or slower the heart rate. LBBB aberrancy is also seen. and a critically timed PAC is therefore more likely to conduct with RBBB than with LBBB. 3 points 3) ST elevation > 5 mm and in the opposite direction (discordant) with the QRS. the longer the recovery time of the conduction system. 2 points A score of 3 points is required to diagnose an acute myocardial infarction. 1) ST elevation > 1 mm and in the same direction (concordant) with the QRS complex. V2. In diseased hearts.Ans (C) and colleagues first described this in 1947 in patients with atrial fibrillation. * Chapman’s sign is used to diagnose an acute myocardial infarction in the setting of a left bundle branch block and consists of a notch in the upslope of the R wave in lead I. aVL or V6. In most individuals the right bundle normally recovers more slowly than the left bundle.
The incidence of WPW is between 0.3 the right ventricle. basal ganglia hemorrhage c. Procainamide. Bilateral babinski sign? AIIMS MAY-2013 a. Any kind of conduction block (bundle branch blocks. diltiazem.OHC 3. 9. in which case it is termed a "type A pre-excitation". WPW is caused by the presence of an abnormal accessory electrical conduction pathway between the atria and the ventricles. Electrical signals travelling down this abnormal pathway (known as the bundle of Kent) may stimulate the ventricles to contract prematurely. wide complex rhythm 8.3%) of the general population.1% and 0.amiodarone or procainamide to stabilize their heart rate. in which case it is termed a "type B pre-excitation" Treatment.3% in the general population The bundle of Kent is an abnormal extra or accessory conduction pathway between the atria and ventricles that is present in a small percentage (between 0. cerebellar hemorrhage Ans (a) REFERNCE .1% and 0. AV node blockers should be avoided in atrial fibrillation and atrial flutter with WPW or history of it. verapamil. POZITIVE CONSULTANT • CONSULTANT Wolff–Parkinson–White syndrome (WPW) is one of several disorders of the conduction system of the heart that are commonly referred to as pre-excitation syndromes. and cardioversion are now accepted treatments for conversion of tachycardia found with WPW. fascicular blocks) Sinus bradycardia or slow AF Development of a sine wave appearance (a pre-terminal rhythm) Serum potassium level of > 9. resulting in a unique type of supraventricular tachycardia referred to as an atrioventricular reciprocating tachycardia. Asymptomatic child with delta wave short PR interval which drug not to be given AIIMS MAY 2013 a) beta blocker b) amiodarone c) adenosine d) procainamide Ans (A) REFERENCE • OHC 2. this includes adenosine. This pathway may communicate between the left atrium and the left ventricle. pons hemorrhage b.0 mEq/L causes cardiac arrest due to: Asystole Ventricular fibrillation PEA with bizarre. or between the right atrium and POZITIVE 2013 8 . other calcium channel blockers and beta blockersThey can exacerbate the syndrome by blocking the heart's normal electrical pathway (therefore favoring transmission through the pre-excitation pathway). amiodarone.
and then heals spontaneously • Approximately 15% of patients with secondary syphilis still have persisting or healing chancres • There are four stages of syphilis in adults primary. seen in frontal lobe lesions and extrapyramidal involvement. passive extension of the knee or passive flexion of the hip and the knee. or mucous patches.Babinski Types of Babinski sign a) Minimal Babinski sign : Contraction of hamstring muscles and tensor faciae latae. may produce a positive Babinski sign. c) Pseudo Babinski sign : One may encounter this type of response in sensitive individuals. which causes pinta. arthralgia. • T.e. pallidum subspecies endemicum. sore throat. latent and tertiary syphilis. Flexor spasms occur in spinal cord disease. d) Exaggerated Babinski sign : It can either be in the form of 'flexor spasm' or 'extensor spasm'. low grade fever. which causes venereal syphilis. Which of the ulcer is painless [AIIMS MAY 2013] A) syphilis POZITIVE 2013 9 B) Herpes C) Chancroid D) chalmydia Ans (a) Reference OHC 2. and in patients with extensive pyramidal tract diseases. secondary. 10. which causes endemic syphilis or bejel.a single painless * In women. have excess of tone. and failure to inhibit the extensor response by pressure over the base of the great toe. anorexia. and generalized lymphadenopathy . and choreo-athetosis due to hyperkinesis. common primary sites are the cervix and labia * Inguinal lymphadenopathy is bilateral Consultant The genus Treponema includes • T. confluent plaques). headache. an extensor response may be obtained. Systemic manifestations include malaise. plantar hyperaesthesia. g) Crossed extensor response/bilateral Babinski sign : Unilateral stimulation produces bilateral Babinski in patients with bilateral cerebral disease and spinal cord disease h) Spontaneous Babinski : In infants and children following manipulation of the foot. bilateral upper motor neuron lesion at a supraspinal level. The patient may also have patchy alopecia. • The primary lesion appears at the site of inoculation. e) Inversion of plantar reflex : If the short flexors of the toe are paralysed or flexor tendons are severed accidentally. • T. True Babinski can be clinically distinguished from the false Babinski by the contraction of hamstring muscles in the former. • T. usually persists for 4–6 weeks. b) True Babinski sign : Includes all the components of the fully developed extensor plantar reflex. while 'extensor spasm' occurs in patients with corticospinal tract lesion when the posterior column function is normal. flat. whether flexors or extensors. pallidum subspecies pallidum. • Manifestations of primary syphilis include a hard painless chancre and regional lymphadenitis • They can occur on the palms and the soles. pallidum subspecies pertenue. carateum. which causes yaws. f) Tonic Babinski reflex : Characterised by slow prolonged contraction of extensors of toe. multiple sclerosis and subacute combined degeneration of the cord. depending upon the muscles i. condyloma lata (moist.3 OPERATION HARRI BOOK PAGE 715 Primary Syphilis * Primary chancre .
3 OH book-page 351 consultant Exiting 18th • • lues maligna. seizures and angiomylipoma in kidney diagnosis is [AIIMS MAY 2013] a) tuberosclerosis Neurofibromatosis type 1 Neurofibromatosis type 2 Nevoid basal cell carcinoma syndrome (Gorlin's syndrome) Tuberous sclerosis NF1 NF2 17 Neurofibroma. a severe Herxheimer reaction. a rare form of secondary syphilis. neurofibrosarcoma.SYPHILIS. medulloblastoma. meningioma. 11. it can manifest itself in several forms. pheochromocytoma Pituitary adenoma. which may take many years to develop. and an excellent response to antibiotic therapy CORONA VENERIS????? • PAPULAR LESIONS OF SEC. malignant schwannomas Parathyroid and pancreatic islet cell Angiofibroma. spine 9 Basal cell carcinoma.lues maligna????? b) von hipple lindau c) struge weber syndrome Ans (a) REF OHC 2. Child with mental retardation .ALONG THE ANTERIOR MARIGIN OF SCALP • Tertiary or late syphilis is a noncontagious but highly destructive phase of syphilis. brain tumor 22 Vestibular schwannoma. renal angiomyolipoma 1 2 Von Hippel–Lindau Multiple Endocrine Neoplasia 1 (Werner's syndrome) VHL AD Mutations in Menin (ch11q13) POZITIVE 2013 10 . jaw cysts 9 16 3 Kidney. The criteria for diagnosis of lues maligna include strongly positive serological test results. cerebellum.
< 10% Nodules.75% Syndenham’s chorea . polyarthralgia d.6. ependymomas Neurofibromatosistype 1 (NF1) AD Mutations inNF1/Neurofibromin (ch17q12-22) Tuberous sclerosis (TSC) (Bourneville's disease) Turcot's syndrome AD Mutations in TSC1/TSC2 Subependymal giant cell (ch9q34/16) astrocytoma. medulloblastomas Adenomatous colon polyps.Mitral . chorea Hemangioblastomas Retinal angiomas.Pancarditis . Erythema marignatum <10% 13. subcutaneous nodule c. pheochromocytoma. adrenals TSC 1 – chr 9 TSC 2 – chr 16 Tuberin 12. pancreatic tumors and cysts. glioma. meningiomas Neurofibromas.No constrictive pericarditis * Migratory Arthritis . ependymomas.tumors Schwannomas. endolymphatic sac tumors of the middle ear Ans (c) Reference • • OHC POZIGOLD • CONSULTANTS C.subcapsular opacity Multiple café au lait spots and peripheral neurofibromas occur rarely Tuberous sclerosis Adenoma Sebaceum Ash leat macule shagreen patch Subependymal giant cell Astrocytoma Rhabdomyomas of myocardium Angiomyomas of kidney. ganglioneuroma. adenocarcinoma Von Hippel–Lindau (VHL) Neurofibromatosis – 2 Bilateral vestibular schwannomas NF2 gene – chr.3. carditis b. others Neurofibromatosis type 2 (NF2) AD Mutations in NF2/Merlin Bilateral vestibular schwannomas. multiple meningiomas. hamartoma AD Mutations in APCa AR (ch5) hMLH1 (ch3p21) AD Mutations in VHL gene (ch3p25) Gliomas. neurofibrosarcomas.5.1. liver. optic nerve gliomas. Forgotten muscle in Rotator cuff [AIIMS MAY 2013] A) supraspinatus B) subscapularis C) teres minor D) infraspinatus 11 POZITIVE 2013 . renal cell carcinoma. (ch22q12) astrocytomas. Rheumatic fever Rheumatogenic serotypes .18 Criterias – Five major Carditis .40 – 60% .22 Neurofibromin – 2 or merlin Juvenile postr. All are major criteria for rheumatic fever except [AIIMS MAY 2013] a. astrocytomas.
CAUSES Priapism may be associated with haematological disorders. and neurologic disorders such as spinal cord lesions and spinal cord trauma Priapism may also be associated with glucose-6phosphate dehydrogenase deficiency The most common medications that cause priapism are intra-cavernous injections for treatment of erectile dysfunction (papaverine. antidepressants (most notably trazodone). within four hours. * High-flow involves a short-circuit of the vascular system partway along the organ. internal rotation of limb. Other groups reported are antihypertensives.g. especially sickle-cell disease.erect penis does not return to its flaccid state. and other conditions such as leukemia. * There are two types of priapism: low-flow and high-flow. infraspinatus. alprostadil). * Low-flow involves the blood not adequately returning to the body from the organ. Which of the following type of hip dislocation is characterised by..Ans (b) rotator cuff muscles (SITS – suprapinatus. clozapine). chlorpromazine. thalassemia. Anterior B. Posterior C. Priapism is also known to occur from bites of the Brazilian wandering spider and the black widow spider Pharmacology 15. teres minor and subscapularis subscapularis-Forgotten muscle 14. Lateral D. sicklecell trait. limb shortening and restriction of abduction ? [AIIMS MAY 2013] A. external rotation Varus Ans (B) Priapism . heroin and cocaine). cantharides (Spanish Fly) and recreational drugs (alcohol. Medial Ans (b) REF MKT-OHC CONSULTANT Typical deformities in dislocations Joint (dislocation) Shoulder (anterior) Elbow (posterior) Hip Posterior Anterior Knee Ankle Deformity Abduction Flexion Flexion adduction internal rotation Abduction external rotation Flexion. despite the absence of both physical and psychological stimulation. and Fabry's disease. 80% to 90% of clinically presented priapisms are low flow disorders. antipsychotics (e. anticoagulants. Priapism is caused by poison of [AIIMS MAY 2013] a) Sea snake b) Spanish fly c) Scorpion d) Rattle snake POZITIVE 2013 12 .
linezolid. aminoglycosides).added to anti-HIV regimens. Time dependent killing. trimethoprimsulfamethoxazole (TMP-SMX). followed by more proximal shunts * Distal shunts. Ritonavir(AIIMS-2010***) Antiviral ritonavir is a very potent CYP3A4 inhibitor . such as the Quackel's * Shunts created between corpora cavernosa and saphenous vein called Grayhack shunt 16. Itraconazole Erythro.bioavailability ranges from as little as 10–20% (erythromycin and penicillin G) -100% [amoxicillin. Clarithro 13 Indinavir. and hence increases efficacy. clindamycin. called cantharidin. doxycycline. levetiracetam b. and most fluoroquinolones]. or time dependent(beta lactams). phenytoin d. metronidazole. Drug for juvenile myoclonic epilepsy in pregnant female? [AIIMS MAY 2013] a.post antibiotic effect is seen in [AIIMS MAY 2013] A) aminoglycosides B) Beta lactams C) Quinolones D) Macrolides Ans (b) REF POZIGOLD OPERATION HARRI BOOK-PAGE-750 OHC • Antibiotic class is characterized as either concentration dependent (fluoroquinolones. causes intense irritation and burning in the urogenital tract.* Probably one of the most famous aphrodisiacs is Spanish fly. of other anti-HIV agents 17. TREATMENT * pseudoephedrine being an alpha-agonist. which then leads to itching and swelling of the genitals. It is made from a beetle that secretes an acid-like juice. such that an increase in antibiotic concentration leads to a more rapid rate of bacterial death. carbamazepine . not because of its antiviral effects but because it decreases clearance. agent that exert a constriction effect on smooth muscle of corpora cavernosum * intracavernosal injections of phenylephrine * Terbutaline being a beta-2 agonist causes smooth muscle relaxation * Methylene blue is used intracavernously to treat priapism * surgical shunts are next attempted. lacosamide c. Distal shunts are the first step. 18. Ritonavir inhibits metabolism of all except [AIIMS MAY 2013] a) midazolam b) amiadarone c) cisapride d) phenytoin Ans (a) REF OHC OH BOOK-PAGE 6 CONSULTANT Molecul Substrates e CYP3A Calcium channel blockers Anti Arrythmics Statins POZITIVE 2013 Inhibitors Amiodarone Ketoconazole. • Absorption . Saquinavir. -But cantharidin is highly toxic. These attempt to reverse the priapic state by shunting blood from the rigid corpora cavernosa into the corpus spongiosum (which contains the glans and the urethra). such as the Winter's * Proximal shunts.
gamma).Lovastatin. Renal Involves joint. simvastatin. gamma. This is believed to impede impulse conduction across synapses.Leuprolide acetate • Antihypertensives . alfa. * The most effective anti-epileptic medication for JME is valproic acid. carbamazepine. lithium. zonisamide Pneumonic ‘ ‘HIPMCQ’ Hydralazine INH procainamide methyl Dopa chlorpromazine Quinidine Others . and hydantoins • Hormonal therapy .Interleukins (eg. Linkage studies have demonstrated at least 6 loci for JME * juvenile myoclonic epilepsy may be a ciliopathy 19. or as an adjunctive therapy for partial. myoclonic and tonic-clonic seizures * the drug binds to a synaptic vesicle glycoprotein.Valproate. also known as Janz syndrome. interferons (eg.Penicillamine and sulfasalazine • Antipsychotics . pct d. carbamazepine. topiramate. methyldopa. is a fairly common form of idiopathic generalized epilepsy. procainamide Ans (a) REF OHC. IL-2).Tiotropium bromide inhaler • Other drug categories . infliximab. medullary collecting duct c.Hydralazine. penicillin b.Ophthalmic timolol 20.Procainamide and quinidine • Antibiotics – Minocycline and isoniazid • Antifungals . SV2A.Griseofulvin and voriconazole • Anticonvulsants . and captopril • Anti-inflammatories . interferons (eg. isoniazid c. Moderate to low risk • Isoniazid • Minocycline • Pyrazinamide • Quinidine • D-Penicillamine • Carbamazepine • Oxcarbazepine • Phenytoin • Propafenone • Biologics such as interleukins (eg. beta. * Most patients also have tonic-clonic seizures and many also have absence seizures. interleukin-2 [IL-2]). Which do not cause SLE? AIIMS MAY2013 a. representing 510% of all epilepsies * manifests itself between the ages of 12 and 18 with myoclonus occurring early in the morning.Phenytoin. and inhibits presynaptic calcium channels. levetiracetam. and gemfibrozil • Biologics . Dct POZITIVE BITS * Juvenile myoclonic epilepsy (JME). skin Less female Predilection Drugs POZITIVE 2013 14 . ethosuximide. * Lamotrigine.CONSULTANT POZIGOLD Drug induced lupus ANA +ve Anti Histone + HLA – DR4 Spares CNS. cortical collecting duct b.Chlorpromazine • Cholesterol-lowering agents .Ans (a) - levetiracetam treatment for epilepsy in the case of partial seizures. hydralazine d. and TNF-α (etanercept. beta). and tumor necrosis factor alpha (TNF-α) inhibitors are associated with musculoskeletal symptoms and antibody production suggestive of a lupuslike autoimmune disorder • Antiarrhythmics . alfa. Vasopressin antagonist acts on? [AIIMS MAY 2013] a. adalimubab) • Inhalers .
Facilitated Diffussion * Carrier mediated eg.Ligand gated . – Na+ . K+ .Open or close when they bind an ion or a specific molecule .Net rate of diffussion = Diffusion co efficient X Area of membrane X (cin – cout) Thickness of membrane * Diffussion by .Lipid solubility * Gated channels .↓ 02 . Fick's law? [AIIMS MAY 2013] a.Temp .Too low Na+.Pump Most common pump in the body * Three α – α1. K+ * Hypothermia * ↓ 02 * Poisons – dinitrophenol [AIIMS MAY 22. β2.Ca2 Pump .↓ size .K+ Pump . Glucose III Active Transport a) Primary active b) Secondary active c) Carrier type process d) Vesicular Transport process Primary active * Directly use energy from ATP POZITIVE 2013 15 eg. active movement Ans (a) REF MODEL EXAM POZITIVE CONSULTANT Discussion from POZITIVE MODEL exam A – simple Diffussion * From high concentration to low concentration * Ficks law of diffussion .Ans (a) Reference OHC CONSULTANT Physiology 21.K+ .Poisons – dinitro phenol Promotors Inhibitors * Insulin * Thyroid * Aldosterone * G – actin * ↓ Na.Voltage gated .1 Receptor Clinical Effect Agonists * Supraspinal * Morphine µ analgesia (µ-1) * Met- . K+ transport occurs through α sub unit * Mode of Function – Phosphorylation dephosphorylation * An Electrogenic pump with a coupling ratio of 3:2 * 3 Na+ à out * 2 K+ à in * Major energy consumer * Inhibitors .↓ distance .Intracellular ligands à 2nd messenger B. β3 subunits * Na.Extracellular ligands à 1st messenger . passive diffusion b.H+ Pump Na+ K+ . Dysphoria occurs due to 2013] a) kappa receptor b) mu receptor c) delta receptor d)all Ans a REF POZIGOLD MKT-OHC-PAGE 55 CONSULTANT 10. α3 and 3 β – β1.Hypothermia . α2. Classification of opioid receptors.
3. Hyperopia C. The detached retina shows. 3.A. Predisposing factors for retinal detachment: . 4. Pseudophakia B. * Morphine * Nalbuphine * Butorphanol * Dynorphin * Oxycodone * Analgesia * Leu* Behavioral enkephalin2 * Epileptogenic *β-endorphin2 * Hallucinations * Pentazocine * Respiratory * Nalorphine stimulation * Ketamine? subretinal space between the sensory retina and the retinal pigment epithelium.The retinal blood vessels appear dark and wavy. Red reflex appears gray in the detached sectors. 5. Complicated cataract.The tear appears red (the colour of underlying choroid). Ans () 24. tears and dialyses. . 2. symptoms: Flashes of light (photopsia) Increase in floaters Ovulation occurs due to [AIIMS MAY 2013] A) before oestrogen surge B) bithermal raise of temperature C) FSH causes rupture of follicle D) cervical mucus disappears Ophthal Signs: 1. . Trauma D. . V.High myopia is the commonest predisposing factor.Intracapsular cataract extraction (ICCE). . Marcus Gun pupillary reaction if the retina is totally detached. sectorial or macular.Lattice degeneration. wavy and tremulous. total detachment of the retina. Complications of neglected cases: 1. .Trauma. .Posterior vitreous face detachment (PVD) leading to acute vitreous traction to an area of abnormally strong vitreo-retinal adhesion causing retinal tears. Fundus examination shows that RD may be total. Iridocyclitis. Retinal breaks are divided into three types holes. is affected only if the macula is detached. 2. Lattice degeneration Ans (b) REF OHC CONSULTANT-page 89-opthal Rhegmatogenous retinal detachment A rhegmatogenous retinal detachment occurs due to a break in the retina that allows fluid to pass from the vitreous space into the POZITIVE 2013 16 . .The detached retina appears grey. IOP is usually decreased.* Respiratory depression (µ2) * Physical dependence * Muscle rigidity enkephalin * β-endorphin * Fentanyl Ќ * Sedation * Spinal analgesia *Dysphoria δ Σ 23. Which of the following is not the risk factor for Rhegmatogenous retinal detachment ? [AIIMS MAY 2013] A.
Betaxolol .increases uveoscleral outflow B. Proliferative vitreo-retinopathy (PVR): migration of RPE cells through the retinal break into the vitreous where they acquire fibroblastic activity. After vitrectomy we may fill the vitreous cavity by silicon oil. Resolving retinal detachment B.carbonic anhydrase inhibitor D. Submacular bleed d. Treatment of Rhegmatogenous Retinal Detachment three general principles: Find all retinal breaks Seal all retinal breaks Relieve present (and future) vitreoretinal traction OH BOOK-PAGE 99 • Separation of sensory retina from retinal pigment epithelium • Causes • Spontaneous in elderly • Trauma • Myopia • After cataract extraction • Lattice degeneration • Simple Detachment or Uncomplicated Type • It is MC type also known as rhegmatogenous retinal detachment due to development of hole in retina. Latanprost . Retinal detachment has convex surface which does not resolve spontaneously. 5. It is necessary to do vitrectomy in order to be able to flatten the retina. Which of the following pair regarding drug and its mechanism is correctly matched ? [AIIMS MAY 2013] A. Fundus flavimaculatus Ans (A) REF OHC OPHTHAL CONSULTANT salt and pepper fundus . Vitreomacular traction c. Ocreoplasmin is the newer drug used in which of the following ? [AIIMS MAY 2013] a. Pilocarpine . [salt and paper retinopathy] are seen in all of following except ? [AIIMS MAY 2013] A. resulting in posterior detachment of the vitreous from the retina 27. a) REF OHC CONSULTANT • BRIMONIDINE-ALFA A2 AGONISTincreases aqueous flow and decrease aqueous production • Carbonic anhydrase inhibitorsbrinzolamide-decreases aqeous production • Pilocarpine-miotic-increase outflow • Betaxolol-cardioselective beta 1 blockerdecrease aqeous production 26. surgery is the TOC. It works by dissolving the proteins that link the vitreous to the macula. for which it received FDA approval on 17 October 2012. • Laser photocoagulation • Cryotherapy (for sealing the hole) • Scleral buckling – encirclage • Drainage of subretinal fluid (can be treated by pneumatic retinopexy) 25. Diabetic macular bleed Ans (b) Ocriplasmin is a recombinant protease with activity against fibronectin and laminin. components of the vitreoretinal interface.decreases synthesis of aqueous humor C.4.Decreases trabecular outflow POZITIVE 2013 17 Ans (b. Retinal break b. It is used for treatment of symptomatic vitreomacular adhesion. Retinal atrophy and consecutive optic atrophy and no PL if detachment is neglected. Brimonidine . Rubella C. Pigmentatory changes between posterior pole and equator . Phenothiazine toxicity D. • Treatment: Aim is to close the retinal tears and to reattach the retina.
-Thioridazine is a phenothiazine antipsychotic agent On clinical exam. Figure 1b. Syphillis (Congenital) 3. The electro-oculography is normal in the early stages and ERG tends to be subnormal. • Choroideremia • Leber's congenital amaurosis. inherited in an autosomal recessive manner. giving sometimes a "bull's-eye" appearance. macular pigmentary changes can develop into a "salt-and-pepper" pattern.5 mg/kg/day of hydroxychloroquine -No patients developed toxicity within the first 6 years(AIIMS NOV***) -recommending a baseline dilated fundus exam. These lesions progress to RPE atrophy and perimacular yellowish fish-tail spots typical of fundus flavimaculatus are observed. and toxicities of systemically administered thioridazine. Usually the pigment alteration is diffuse. • Deferoxamine. Other sulfa-containing Macular Edema • Latanoprost Latanoprost • Epinephrine. Chloroquine and hydroxychloroquine -the classic fundus pattern of bilateral bulls-eye -Retinal toxicity has been shown in patients taking greater than 3 mg/kg/day of chloroquine or 6. Thioridazine toxicity Stargardt disease(of fundus flavimaculatus) Stargardt disease is the most common juvenile macular dystrophy. scotomas. • congenital syphilis Rubella (Congenital) 2. • rubeola. and nyctalopia. • Rosiglitazone. choroquine. Figure 1a. Mayous Batten disease (Maculo-cerebral facial degeneration) 5. as is found in • congenital syphilis. but it may be most prominent either around the macula or in the retinal periphery. • Quinolines. dyschromatopsia. • Other causes of "salt-and-pepper" retinopathy are congenital syphilis.. • fine speckling of the retina is the commonest ocular manifestation of congenital rubella. and deferoxamine. • These signs reflect diffuse damage to the retinal pigment epithelium (RPE). These fish-tail lesions are typically hyperautofluorescent (lipofuscin and A2E accumulation) in contrast with atrophic hypoautofluorescent regions. • Niacin. Ocular signs of toxicity include vision loss. Cystoid macular edema with latanoprost use. • Thioridazine. Leber amaurosis (Congenital) 4. automated macular perimetry and Amsler grid testing. • Salt and pepper fundus—conditions are • Rubella. • cystinosis. Cystoid macular edema with latanoprost use: petalloid pattern of foveal hyperfluorescence on fluorescein angiography. ocular fundus characterized by a stippling of dark pigmented spots and yellowish-red spots of atrophy. • It is called "salt-and-pepper" because there are tiny flecks of dark pigment mixed with fine areas of whitish depigmentation. poliomyelitis. OCULAR TOXICITIES Pigmentary Retinopathy POZITIVE 2013 18 . Choroidal Toxicity • Topiramate. Topiramate (Topamax) • Metronidazole.
-ERG studies may show prolonged b-waves reflecting bipolar and Müller cell dysfunction. Ocular symptoms have been noted most often with doses greater than 120 mg twice per day. Interferon retinopathy: Scattered cotton wool spots are noted in the nasal macula. (Figure 2a. while therapeutic doses are much lower. Talc retinopathy Miscellaneous Medications • Digoxin. Figure 2c. Figure 2a. Crystalline retinopathy with tamoxifen use: Perifoveal leakage on fluorescein angiography. -photopsias.• Tamoxifen. xanthopsia and scotomas. • Sildenafil. b and c images provided courtesy David Sarraf.) POZITIVE 2013 • Interferon. Crystalline retinopathy with tamoxifen use: Foveal cystic changes on optical coherence tomography. Sildenafil is a selective inhibitor of cGMP-specific phosphodiesterase type 5 (PDE5) -sildenafil also acts on the retina to alter cGMP levels by inhibiting retina-specific PDE6. MD. Crystalline retinopathy with tamoxifen use: Refractile crystals are noted in the perifoveal area. • Canthaxanthine. Figure 2b. Canthaxanthine is a vitamin A derivative used in the treatment of psoriasis Crystalline Retinopathy • Talc. Figure 3. 19 .
) • Change in bony density : • Increased : in meningioma.. * Ultrasound or CT scanning is sensitive for detection of buried optic disc drusen because they contain calcium. Persistent hyperplastic primary vitreous C. or surgical) 6. Toxoplasmosis E.. intraretinal and pre-retinal hemorrhage. etc. dermoid cyst. Atheromatous plaque B. and macular edema 28. • retinoblastoma. • optic nerve-sheath meningioma. Band-shaped keratopathy 3. Orbital phleboliths: helical form in veinssmooth. • Superior orbital fissure enlargement : in • infraclinoid carotid aneurysm • intracavernous aneurysm. Secondary to metabolic-endocrine disturbances such as hyperparathyroidism or hypervitaminosis D. Optic disc Drusens D. Malignant lacrimal gland tumor C. * Pseudo papilloedema* * Enlarged blind spot arcuate scotomas. Intraocular calcifications following A. • Intraorbital calcification : in orbital varix. or oval 10. Congenital deformity B. Cysticercosis B. Retinoblastoma 12. Intraocular sarcoma 7. fibrous dysplasia and osteoblastic metastasis. Retinal detachment E. nonperforating. Hemangiopericytoma 5. Intraocular melanoma Ans (B) REF OHC CONSULTANT OH BOOK-PAGE99 • Enlargment of the orbit • Symmetrical : in intra-conal lesion (optic nerve glioma. Retinoblastoma B. etc. Retrolental fibroplasia Calcifications can also be found in intraorbital meningiomas. Trauma (perforating. intracranial • extension of orbital tumours etc. * Glittering particles in the surface of optic disc.Retinopathy is a well-characterized side effect of treatment and includes cotton-wool spots. • Decreased or destruction : in malignant tumours. Calcification of orbital vessels A. Which of the following classically does not have calcified foci ? A. Recurrent iritis and keratitis D. also called 'optic disc drusen'. round. Orbital hematoma C. gliomas Orbital calcifications are common incidental findings that occur in characteristic locations POZITIVE 2013 20 . Other common calcifications are at the optic nerve head within the eye. Paget’s disease. Mucocele 8. Organized hematomas of the orbit 11. • Optic canal enlargement : in optic nerve glioma Optic N – Drusen * Refractile deposits within the substance of optic N head. POZITIVEBITS Calcifications In adults the most common intraorbital calcifications occur at the tendinous insertion of the ocular muscles. Plexiform neurofibroma D. 1. Monkeberg sclerosis C. Chronic inflammatory and parasitic disease of the orbit 4. Calcification of more irregular configuration and texture A. ect) • Asymmetrical : in extra-conal lesions (rhabdomyosarcoma. In children calcifications in the globe means retinoblastoma until proven otherwise even if it is bilateral. Tuberculosis 2. Myositis ossificans 9. haemangioma.
including infection.most common benign orbital tumor in adults * Choroidal metastases are the most common ocular malignancies in adults 29. Bilateral Lamellar Tarsus Rotation D. * MC symptom is leukocoria * MC Sign is In small lesions: simulates endophthalmitis specially when endophytic In large lesions: exophytic simulate Coat’s disease. Most common presentation retinoblastoma ? [AIIMS MAY 2013] A. a shrunken globe with ocular calcification or ossification. and trauma * Orbital varices. inflammation. Visual function is spared B. Leukocoria with strabismus of Ans (d) REF OHC –Ophthal hand out Consultant • • • • • • • • • MC intraocular malignancy of childhood * Types: Heritable—B/L.young patients with diabetes mellitus They typically have a superomedial location within the orbit. POZITIVE 2013 21 . are a cause of Phthisis bulbi. Leucokoria with Hyphema C. Pars plana vitrectomy Ans (b) REF OHC POSIGOLD 31. the most common cause of spontaneous orbital hemorrhage * cavernous hemangioma . Multiple Non heritable solitary * Etiology: Absense of RB genes (due to mutation) as it is a tumor suppressor gene (TSG). Corneal infilteration D. DCR C. Trochlear calcifications . scleral plaques. is the sequela of a wide variety of pathologic ocular processes.Frequently encountered calcifications include trochlear calcifications. Scleral plaques are most commonly seen in elderly patients and are located at the insertion sites of the medial and lateral rectus muscles Optic drusen. Phacoemulcification B. Which of the following is not related to conjuctivitis ? [AIIMS MAY 2013] A. Pupil is spared C. Ans (c) REF OHC Consultant 30. Leucokoria with Heterochromia Iridis D. which appear as punctate calcifications near the optic disc on crosssectional images. and phthisis bulbi. Leukocoria with pseudohypopyon B. An ophthalmologist working in district hospital is likely to perform following surgical procedure most commonly? [AIIMS MAY 2013] A. optic drusen.
Myopic degeneration can lead to retinal detachment C. 34.frontal process of maxilla. Most common intraocular metastasis in females are from which of the following primary tumor ? [AIIMS MAY 2013] A. optic nerve glioma. Quantiferon TB assay D. * Metastatic tumor to the orbit occurs frequently in breast carcinoma. progressive proptosis. Maxilla C.orbital surface of maxilla. neuro -fibroma. optic nerve meningioma. Serum Homocysteine levels C. The floor (inferior wall) . lung carcinoma. Serum ACE levels B. Regarding Myopic degeneration which of the following is True – [AIIMS MAY 2013] A. * The most common primary tumors are hemangioma. Biopsy taken from chalazion shows [AIIMS MAY 2013] A) lipogranulomatous B) inflammatory C) suppurative granulomatous • 33. Ethmoid D.6 D myopia D. and benign mixed tumor of the lacrimal gland.orbital plate frontal bone and the lesser wing of sphenoid. and lymphoma. It is seen more commonly in males than in females B. Zygomatic B. Breast B. Which of the following bone does not form floor of the orbit ? [AIIMS MAY 2013] A. • The Lateral wall -orbital process of zygomatic and the orbital plate of greater wing of sphenoid. POZITIVE 2013 22 . the orbital surface of zygomatic bone and the orbital process of palatine bone. dermoid cyst. Endometrium Ans (a) • • • • • REF OHC OH BOOK PAGE 101 Tumors of the orbit cause painless. Cervix D. lacrimal bone. Ovary C. adenoid cystic carcinoma. Ans (b) REF OHC CONSULTANT-PAGE 104 OPHTHAL BOOK • MYOPIA OF ATLEAST 6D • Choroidal neovascularisation • Tigroid fundus • Posterior retinal detachment 36. Palatine Ans (c) REF • • • • • • • OHC CONSULTANT MKT POZIGOLD The roof (superior wall) . orbital plate of ethmoid and a small part of the body of the sphenoid. lymphangioma. Serum Creatinine levels Ans (B ) 35. The medial wall .32. It is seen in < . which of the following will be the most important investigation in this scenario ? [AIIMS MAY 2013] A. A 60 year old male with history of Diabetes complained of gradual diminution of vision over 2-3 days followed by sudden loss of vision.
Recently.cause? [AIIMS MAY 2013] a. pain shock POZITIVE 2013 23 . 30 yr old Poor patient from hilly area with h/o low grade fever. POZIGOLD. • Initial treatment for a chalazion in the acute stage is hot compresses .However. Shock after normal labour.Chalazion of lid is (AIIMS MAY 2008) a) Caseous necrosis b) Chronic nonspecific inflammation c) Chronic lipogranulomatous inflammation d) Liposarcoma Ans (c) Biochemistry 37.. is expressed in the brain and has been associated with Alzheimer's disease and depression.Ans ( a) REF OHC CONSULTANT POZIGOLD • A chalazion also known as a meibomian gland lipogranuloma. the chalazion does not respond to this conservative treatment and must be incised and curettage. • Recurring chalazia in the same area may sometimes be a symptom of sebaceous cell carcinoma. is a cyst in the eyelid that is caused by inflammation of a blocked meibomian gland. PPH c.OH BOOK POZIGOLD CONSULTANT OG 39) End product of progesterone metabolism found in urine is [AIIMS MAY 2013] A) pregnanediol B)ostriol C) D) Ans (A) REF-POZITIVE CONSULTANT 40. in chronic cases. amniotic fluid embolism d. Which is not seen in Apoptosis [AIIMS MAY 2013] a) Cell shrinkage b) Nuclear condensation c) Inflammation d) blebs Ans (c) REF OHC. it has been suspected that leukotriene receptor antagonists might be associated with suicide Pathology 38. an enzyme involved in leukotriene synthesis. infertility diagnosis is [AIIMS MAY 2013] a) TB endometritis b) c) d) Ans (a) 41. uterine inversion b. usually on the upper eyelid. Suicidal enzyme is [AIIMS MAY 2013] A) 5 lipoxygenase B) cycloxygenase C) Aldolase D) hydrolase Ans (A) 5-lipoxygenase (5-LOX).
Cesarian – in women with viral load > 1000 copies/ml.Zidovidine reduces vertical Transmission by 70%. Diagnosis is [AIIMS MAY 2013] a) Treponemal infection b) Chlamydia c) Gonococcal d) ans b REF43. Female presented with 3X3 cm relatively painless lesion on vulva. OH POZIGOLD BOOK. to induce labor. CONSULTANT. Ans (b) REF OHC. 45.Ans-a REF OHC POSIGOLD 42. HRT in Post menopausal women is given for A/E [AIIMS MAY 2013] a) vasomotor symptom b) prevention of CAD c) Prevention of Osteoporosis ANs (b) Reference OHC.Which is not included in 3rd stage in labour to prevent PPH [AIIMS MAY 2013] a) oxytocin injection with delivery of shoulder b) Immediate cutting n cord clamping c) misoprostol d) controlled and sustained cord traction Ans (c) REF CONSULTANT Misoprostol is a synthetic prostaglandin E1 (PGE1) analog that is used for the prevention of nonsteroidal anti-inflammatory drug (NSAID) induced gastric ulcers. The study which involved a substantial number of patients receiving either 24 POZIGOLD. Misoprostol is also used to prevent and treat postpartum hemorrhage. .HRT is helpful in all of the following except: [AIIMS Nov 2006] a) Vaginal atrophy b) Flushing c) Osteoporosis d) Coronary heart disease Ans (d) 44. and as an abortifacient.POZIGOLD CONSULTANT OPERATION HARRI BOOK PAGE 20 HIV infections * Transmission during perinatal period – predominant cause of HIV in children Risk of mother to child Transmission * Vaginal Delivery * Preterm Delivery * Trauma to foetal skin * Maternal bleeding * High viral load * Low CD4 count * PROM * Other genital infections * Treatment . to treat missed miscarriage. All are done to prevent maternal to fetal transmission of HIV except [AIIMS MAY 2013] a) prenatal Ziduvudine b) Vaginal delivery c) Avoid breast feeding d)universal precaution POZITIVE 2013 . Orally administered misoprostol at a dosage of 600 ug was tested versus oxytocin 10iu in a large randomised controlled study.
Percentage of burn is [AIIMS MAY 2013] a) 0.47 Ans (c) REF OHC POZIGOLD 48.chart used to estimate the percentage of skin burnt to the total body surface area in children 50. True about COELIAC plexus block [AIIMS MAY 2013] A) given for lower abdominal malignancy B) usually given unilateral C) diarrehoea and hypotension are common side effects D) given in retroperitoneum at L3 level Ans a REF-OPERATION HARRI CAPSULE-3 Aortic aneurysm Operative repair with placement of a prosthetic graft is indicated in patients with symptomatic thoracic aortic aneurysms. upper pole is last to leave. Abdominal Aortic Aneurysms Abdominal aortic aneurysms occur more frequently in males At least 90% of all abdominal aortic aneurysms below the level of the renal arteries. A 5yr child burnt with boiling water. Misoprostol should not be taken by pregnant women to reduce the risk of NSAID induced gastric ulcers because it increases uterine tone and contractions in pregnancy which may cause partial or complete abortions. ascending thoracic aortic aneurysms >5 cm should be considered for surgery. The following is true regarding duncans method of seperation of placenta [AIIMS MAY 2013] A) peripheral seperation B) blood is collected between placenta and membranesand escapes out of vagina C) maternal part of placenta present at the vulva after delivery D) Ans (a) WAYS OF PLACENTAL SEPARATION Central Separation (Schultze method ) Marginal Separation (Mathew Duncan) Separation starts at the lower pole .37 b) 0. whereas it is 20–40% for aneurysms >5 cm in diameter. Surgery 47.oral or intravenous oxytocin showed that misoprostol is marginally less effective for this purpose. and those with an aneurysm that has increased by >1 cm per year. those in whom the ascending aortic diameter is >5. A child had circumferential burn ofBOTH thighs. In patients with Marfan syndrome or bicuspid aortic valve. The risk of rupture increases with the size of the aneurysm: the 5-year risk for aneurysms <5 cm is 1–2%. method used to calculate burnt area [AIIMS MAY 2013] a) lund and browder b) rule of 9 c) palm method ANs (a) REF OHC-RECENT ADVANCES Lund and browder chart . buttock. and because its use in pregnancy has been associated with birth defects 46. the operative mortality rate approximates 1–2%.face n scalp.5–6 cm or the descending thoracic aortic diameter is >6. After acute rupture.5-7 cm. the mortality rate of emergent operation is 45–50% 49. With careful preoperative cardiac evaluation and postoperative care. Percentage of death in emergency AAA operation [AIIMS MAY 2013] a ) 40% b)10% c)5% D)1-2% POZITIVE 2013 25 .
A neonate with meningomyelocele awaiting surgery.Solution to cover meningomyelocele is sterile gauze soaked in [AIIMS MAY-2013] a) Normal saline b) Betadine c) SSD d) Ans (a) REF OHC POZIGOLD 52. The Vecchietti procedure????? • The Vecchietti procedure is a procedure that has been shown to result in a vagina that is comparable to a normal vagina in patients with Müllerian agenesis POZITIVE 2013 26 . [AIIMS MAY-2013] a) Mullerian agenesis b) XYY syndrome c) Androgen insensitivity syndrome d) Turners syndrome Ans (a) REF OHC CONSULTANT POZIGOLD OH BOOK PAGE 212 • • • • • • • Müllerian agenesis is a congenital malformation in women characterised by a failure of the Müllerian ducts to develop. It is the second most common cause of primary amenorrhea she will enter puberty with development of secondary sexual characteristics including thelarche (breasts) and adrenarche (pubic hair).27 d) 0. 19 yr old femal with primary amenorrhoea with axillary n pubic hair but absent vagina n uterus. uterus. and vagina. Ovulation usually occurs.c) 0. resulting in a missing uterus and variable malformations of the vagina. Typically.XX. Medical examination supported by gynecologic ultrasonography demonstrates a complete or partial absence of the cervix. Renal anomalies occur in 25-35% of females with mullerian agenesis. Her chromosome constellation will be 46.64 Ans (b) REF OHC CONSULTANT 51. the vagina is shortened and intercourse may in some cases be difficult and painful.
The absence of pubic and axillary hair distinguishes them clinically from patients with müllerian agenesis. XY karyotype. • 46. pancreas. neuroblastoma Most Prostate cancer (in adult common male). ??????? 53. they have severe underandrogenization and female external POZITIVE 2013 27 OHC POZITIVE POZIGOLD 54. minimal androgenic (pubic or axillary) hair at puberty • Childhood growth is normal and the karyotypic incongruity remains unsuspected unless an inguinal lump is discovered to be a testis during surgical repair of an inguinal hernia. Androgen resistance syndrome requires gonadectomy because there is risk of gonadoblastoma in the dysgenetic gonads. malignant carcinoid. a condition once called "testicular feminization" • a person with Androgen Insensitivity Syndrome is a phenotypic female with a chromosomal genotype of 46.• genitalia. • lack of androgen receptor responsiveness • severe underandrogenization and female external genitalia. • A person with complete androgen insensitivity syndrome (CAIS) has a female external appearance despite a 46XY karyotype and undescended testes.CONSULTANT Osteoblastic Bone Metastases = Evidence of slow –growing neoplasm Primary Prostate. mucinous adenocarcinoma of GI tract. of bladder. cause breast cancer (in adult female) ..XY. Whether this should be performed in early childhood or after completion of breast development is controversial. Which of the following has Osteoblastic metastasis rate [AIIMS MAY 2013] A) Ca prostate B) Ca lung C) Ca breast D) RCC Ans (a) REF MKT-RD OHC . testes in the abdomen. • Patients with AIS have a 46. lymphoma. fallopian tubes or ovaries. Earliest complication of Ileostomy [AIIMS MAY 2013] a) Obstruction b) Necrosis c) prolapse d) diarrohea Ans b REF androgen insensitivity syndrome (AIS) • which is an X-linked recessive disorder • 10% of all cases of primary amenorrhea. Complete AIS (CAIS): completely female body except no uterus. medulloblastoma. • 1.XY karyotype. but because of the lack of androgen receptor responsiveness. breast.
How to diagnose [AIIMS MAY 2013] a) KOH mount b) pus culture c) biopsy d) Zeilneilsen stain A B C Y Chemical Current Disease Structure of Epidemiology Oligosacchar ide 2-Acetamido.worldwide mannopyrano syl phosphate alfa-2.propensity to acetylneuram cause inic acid hyperendemic disease alfa-2. thyroid cancer. lung cancer (in adult male).Sporadic disease.on gram staining-Gram negative coccoid seen. A patient presented with corneal ulcer n later on perforation.8-N. Diagnosis is [AIIMS MAY 2013] a) Moraxella b) Neisseria c) Gonococci Structure of the Polysaccharide Capsule of Common DiseaseCausing Meningococci Meningococcal Serogroup EXCITIN G 18TH d) Staphylococci REF B CONSULTANT 56) Meningitis is considered hyperendemic if [AIIMS MAY 2013] a) 2 cases b) 2-10 cases c) more than 10 cases d) more than 100 cases Ans () REF OHC OH BOOK PAGE PAGE 645 • Community-based outbreak-Mass vaccination • occurrence of three or more cases within 3 months in persons who have a common affiliation or reside in the same area but who are not close contacts of one another yl-Nacetylneuram inic acid W135 4-O-alfa-D.Small outbreaks acetylneuram and sporadic inic acid disease 4-O-alfa-D. kidney. galactopyran outbreaks of osyl-Ndisease acetylneuram associated with inic acid mass gatherings. colon May begin in spongy bone (associated with soft tissue mass in ribs) Vertebral pedicles often involved (not in multiple myeloma) SPM 55. breast cancer (in adult female). Boggy swelling with easily pluckable hair. Microbiology 57.Sporadic disease glucopyranos POZITIVE 2013 28 .sporadic cases 2-deoxy-D..9-O.Osteolytic bone Metastases Most common cause : Neuroblastoma (in childhood).
kansassi b) chenolae c) fortuitum d) abcessicum Ans (A) Reference-OHC. Person has respiratory tract infection. chelonae M.730. tuberculosis typically takes ≥ 2 weeks to grow. A patient has RTI and blood pressure of 80/60-causative organism [AIIMS MAY 2013] A) Gonococci B) Syphilis C) Chancroid D) Chlamydia Ans a REF OHC CONSULTANT OPERATION HARRI BOOK 60. or synovial fluid) or from skin lesions. Which is a slow grower [AIIMS MAY 2013] a) m.g.Ans (a) REF OHC CONSULTANT POZIGOLD OH BOOK PAGE 237 POZIGOLD. Rapidly growers Slow-growers M. POZIGOLD • Runyon classification-based on colony pigmentation-replaced by the use of DNA probes • *NTM are broadly differentiated into rapidly growing (<7 days) and slowly growing (≥7 days) forms.gram-negative diplococci that typically utilize maltose and glucose 61. ulcerans M. • *Meningococci grow best on MuellerHinton or chocolate blood agar at 35˚C in an atmosphere that contains 5–10% CO2. Consultant.A 7 year old boy with boggy swelling of the scalp with multiple discharging sinuses with cervical lymphadenopathy with easily pluckable hair.oxidase positive [AIIMS MAY 2013] a) pseudomonas b) meningococci c) Gonococci d) pneumococci POZITIVE 2013 29 .. abscessus M. kansasii M. meningitis-on microscopic examination gram negative diplococci.POZIGOLD • From normally sterile body fluids (e. • *Oxidase-positive. fortuitum M. CSF. OPERATION HARRI BOOK PAGE-732. Because M. 4 year old boy with high fever and drooling of saliva-Xray –thumb print signdiagnosis [AIIMS MAY 2013] A) H.influenza B) Pneumococci C) streptococci D) staphylococci Ans (a) REF OHC CONSULTANT OH BOOK-PAGE 644 . marinum 59. What would be done for diagnosis? [AIIMS NOV 2009] a) Pus for culture b) KOH mount c) Biopsy Ans (b) 58. blood. avium M.
* A Gram's stain of CSF reveals intra. Oxidase-positive. POZITIVE 2013 30 . * From normally sterile body fluids (e. discharge and bleeding is seen Inflammation of the leg and ankles Progressive symptoms: Thickening of the dermis (skin) in the forehead and ear lobes Loss of eyebrows and eyelashes Eye defects such as glaucoma and blindness are seen Nodules in the legs break and form ulcers Enlargement of the breast and sterility occurs in the males Internal infection results in the enlargement of the liver and lymph nodes Loss of sensation in the peripheral nerves. CSF. Ridley jopling classification for leprosy depends on [AIIMS MAY 2013] A) clinical B) bacteriogical C) immunological D) all Ans (a) REF OHC CONSULTANT leprosy is classified into types based on the clinical features (Ridley & Jopling classification): ease Paucibacillary (tuberculoid leprosy) A large red patch with welldefined raised borders or a large hypo pigmented asymmetrical lesion. macules.Ans (b) REF OHC CONSULTANT POZIGOLD OH BOOK-PAGE. papules. and nodules are seen. Lesions have a characteristic inverted saucer like appearance. 62. blood. irregular red lesions are seen Moderate sensory loss is seen It either goes back to the previous stage or progresses to the next Borderline lepromatous Several lesions such as plaques. Nasal congestion. * Meningococci grow best on Mueller-Hinton or chocolate blood agar at 35˚C in an atmosphere that contains 5–10% CO2. leprosy macules. Lesion is dry and hairless Infectivity is minimal at Clinical features this stage Loss of sensation is seen Nerves become thick followed by loss of function It either progresses to the borderline stage or spontaneously get cured Borderline tuberculoid Characterized by small and leprosy numerous skin lesions The disease goes back to the tuberculoid stage or progresses to the next stage Borderline borderline leprosy Several small. or synovial fluid) or from skin lesions. and nodules are seen.g. Disease Multibacillary Hansen’s disease (lepromatous leprosy) Clinical features Early symptoms: Several lesions such as plaques..615 Diagnosis * The most useful clinical finding is the petechial or purpuric rash.gram-negative diplococci * that typically utilize maltose and glucose. papules.or extracellular organisms in ~85% of patients.
tetanus toxoid. EXITING 18th • The first quadrivalent conjugate meningococcal vaccine containing A. The hearing aid can be used once osseointegration is complete. It is primarily suited to people who have conductive hearing losses. Patient complains of left ear pain. Y.J.On examinationtympanic membrane normal. ENT 64. Father of neurootology 2013] a) House b) lempard c) hayes martin d) John.shea Ans (a) 65.has been overcome by chemical conjugation of the polysaccharides to a carrier protein (CRM197. unilateral hearing loss and people with mixed hearing losses who cannot otherwise wear 'in the ear' or 'behind the ear' hearing aids • Bone-anchored hearing aids use a surgically implanted abutment to transmit sound by direct conduction through bone to the inner ear.Lef ear masss coming the posterior part-diagnosis [AIIMS MAY 2013] A) CSOM B) Keratosis obturans C) D) 63.Right ear normal. and W135 polysaccharides conjugated to diphtheria toxoid was initially recommended for all children >11 years of age. usually two to six months after implantation • The Baha must be positioned so that it does not touch the pinna of the ear POSIGOLD BAHA is useful in [TN PGEE 2009] a) Sensory neural deafness b) Congenital ear canal atresia c) Meningitis with ossification d) All of the above Ans (b) 66. bypassing the external auditory canal and middle ear. Conjucated meningococcal vaccine is routinely given to [AIIMS MAY 2013] A) young adolescence B) children -5-7 yrs C) 70yrs D) all Ans (a) OHC EXCITING 18TH • Conjugate Vaccines • The poor immunogenicity of plain polysaccharide vaccines . Ans (b) POZITIVE-RECENT ADVANCES-ENT • A Bone-Anchored Hearing Aid( TN 2009&AIIMS MAY-2013***) is a type of hearing aid based on bone conduction. C. Use of Bone anchoring hearing aid-BAHA [AIIMS MAY 2013] a) person with acousticneuroma in NF 2 b) child with microtia c) old person with profound hearing loss [AIIMS MAY POZITIVE 2013 31 .Deformation of the fingers and toes results due to painless repeated trauma. • A titanium "post" is surgically embedded into the skull with a small abutment exposed outside the skin • The titanium fixture bonds with the surrounding tissue in a process called osseointegration. or diphtheria toxoid).
When growth plate healing is seen radiographically C. Gallows traction in child [AIIMS MAY 2013] A) for fracture of femur shaft B) for tibial fracture C) for femoral neck fracture POZITIVE 2013 32 D) Ans (A) REF POZIGOLD-AIIMS NOV-2009 OHC MKT MKT. Epiglottis B. Which of the following cartilage forms complete cartilagenous ring ? [AIIMS MAY 2013] A. medial meniscus b. When vitamin D levels turn to normal B.Traction systems and their uses. Cuineform D. 2 years old child with rickets is on calcium supplements and has a foot deformity. When bone specific alkaline phosphatase is normal D. When should a decision to undertake corrective surgery be undertaken? [AIIMS MAY 2013] A. Hockey player. Cricoid C.Ans (b) Ref-Consultant 67.injury to? [AIIMS MAY 2013] a. macrocephaly b. ACL anterior part Ans () 70. ACL posterior part c. When serum calcium becomes normal Ans (c) REF OHC POZIGOLD-NOV-AIIMS 2012 69.. affects females more . Thyroid Ans (b) REF OHC POZIGOLD Ortho 68. Seizures d. mental retardation c. Name * Gallow’s traction(AIIMSNOV-2009***) * Bryant’s traction * Russell’s traction * Buck’s traction * Perkin’s traction * 90o-90o traction * Agnes-Hunt traction * Well-leg traction Use Fracture shaft of the femur in children below 2 years Same Trochanteric fractures Conventional skin traction Fracture shaft femur in adults Fracture shaft of femur in children Correction of hip deformity Correction of adduction or abduction deformity of hip Supracondylar fracture of humerus Supracondylar fracture of humerus Open fractures of ankle or leg Open forearm fractures Cervical spine injuries * Dunlop traction * Smith’s traction * Calcaneal traction * Metacarpal traction * Head-halter traction * Crutchfield Cervical spine injuries traction * Halo-pelvic traction Scoliosis Psychiatry 71) All are true in rett's syndrome except? [AIIMS MAY 2013] a.
Ans (a) REF-CONSULTANT OHC POZITIVE RECENT ADVANCES – similair question A 2 year old girl child is brought to OPD with features of hand ringing stereotype movements. What is the most likely diagnosis? a) Asperger syndrome b) Rett syndrome c) Fragile x syndrome d) Colarad syndrome Ans (b) • Asperger syndrome or Asperger's syndrome or Asperger disorder is an autism spectrum disorder that is characterized by significant difficulties in social interaction • It differs from other autism spectrum disorders by its relative preservation of linguistic and cognitive development • Asperger syndrome (AS) is one of the autism spectrum disorders (ASD) or pervasive developmental disorders (PDD). The infant with Rett syndrome often avoids detection until 6–18 months • The syndrome is associated with the expansion of a single trinucleotide gene sequence (CGG) on the X-chromosome. and constipation are very common and can be problematic. growth failure. Her birth record shows HC of 35 cm. or sighing are seen in many. which are a spectrum of psychological conditions that are characterized by abnormalities of social interaction and communication that pervade the individual's functioning. which is difficulty in identifying and describing one's emotions • Rett syndrome is a neurodevelopmental disorder of the grey matter of the brain that affects females more commonly than males. and by restricted and repetitive interests and behavior • Children with AS may have an unusually sophisticated vocabulary at a young age and have been colloquially called "little professors". the exclusive source of noradrenergic innervation to the cerebral cortex and hippocampus Development is typically normal until 6–18 months. breathholding. and about 50% of individuals affected are not ambulatory. Her HC is 42 cm. People with Rett syndrome are prone to gastrointestinal disorders and up to 80% have seizures. The genetic loss of MECP2 changes the properties of cells in the locus coeruleus. Scoliosis. impaired language and communication skills. and acquired deceleration in the rate of head growth (resulting in microcephaly in some) is seen. when language and motor milestones regress. and breathing irregularities such as hyperventilation. purposeful hand use is lost. autistic-like behavior may be seen. and results in a failure to express the protein POZITIVE 2013 33 . • • • • • • • The clinical features include small hands and feet and a deceleration of the rate of head growth (including microcephaly in some). Hand stereotypes are typical. They typically have no verbal skills. Early on. Genetically Rett syndrome (symbolized RTT) is caused by mutations in the gene MECP2 located on the X chromosome and can arise (1) sporadically or (2) from germline mutations Brain levels of norepinephrine are lower in people with Rett syndrome. but have difficulty understanding figurative language and tend to use language literally • Individuals with AS often have excellent auditory and visual perception • AS is also associated with high levels of alexithymia.
Injur D.lying in right lateral position is having bruises over his right scalp. A person found unconsious. which is required for normal neural development Fragile X is the most common known single gene cause of autism and the most common inherited cause of intellectual disability Aside from intellectual disability. and low muscle tone. on investigation calcified mass in right side id abdomen seen.right side of hip. Patients with Rett Syndrome initially have seemingly healthy development. Floor of 4th ventricle not formed by [AIIMS MAY 2013] a) Mammilary body b) 3rd cranial nerve c) Infundibulum d) PITUTARY STALK Ans (b) REF OHC POZIGOLD 74. Radial n.what would be the reason for above clinical condition? [AIIMS MAY 2013] A. Speech may include cluttered speech or nervous speech Fragile X syndrome is an X-linked recessive condition with variable expressivity and possibly reduced penetrance The transmission of fragile X often increases with each passing generation.right knee. A slight increase of limbs of right side is seen. A child prsented with pain abdomen on right side. An early clinical feature is deceleration of head growth that begins when the individual is aged 2-4 months. larger testes (macroorchidism). POZITIVE 2013 34 . RS is a genetic disorder of neurodevelopment arrest rather than a progressive process. This seemingly anomalous pattern of inheritance is referred to as the Sherman paradox. large or protruding ears. sciatica n. Diagnosis is [AIIMS MAY 2013] a) neuroblastoma b) Wilms tumor c) angiomyolipoma d) ARPKD Ans (b) OHC CONSULTANT Wilms' tumor or nephroblastoma Pathologically. right upper limb.• • • • • • • • • coded by the FMR1 gene. flat feet. prominent characteristics of the syndrome include an elongated face. Injury C. Injury B. Injury Ans () Pediatrics 75. After giving iv antibiotics there was sudden pulseness. A period of developmental stagnation is followed by a period of regression.. Trigeminal n.Next step is [AIIMS MAY 2013] a) Chest compression b) call ambulance c) Two round of breaths d) Ans (b) Anatomy 73.peroneal n. The gene for RS is located on the X chromosome (MECP2 gene). Anesthesia Patient with normal Preanaesthetic checkup was connected to monitor in OT. a triphasic nephroblastoma comprises three elements: • blastema • mesenchyme 72.
bone. They were also less fearful of things that would have instinctively panicked them in their natural state. Emotionally. altered sexual behavior. Contrary to popular belief. c) Small tongue d) . This caused the monkeys to develop visual agnosia. 77. Even after being attacked by a snake. they were unable to recognize even previously familiar objects. the monkeys became dulled. stromal and epithelial derivatives. coli C. Staph aures B. E. b) Short soft palate. emotional changes. Infant can breath simultaneously because? [AIIMS MAY 2013] a) High larynx. fibrous tissue Mutations of the WT1 gene on chromosome 11 p 13 are observed in approximately 20% of Wilms' tumors. Though the monkeys could see. cartilage. The stroma may include striated muscle. and Wilms tumor Hemihypertrophy is a disease in which one side of the body or a part of one side is larger than the other. they would willingly approach it again. such as humans or snakes. mesangial renal sclerosis. Kluver Bucy syndrome in young children. The amygdala has been a particularly implicated brain region in the pathogenesis of this syndrome. Characteristic is the presence of abortive tubules and glomeruli surrounded by a spindled cell stroma. the findings did not show an increase in sexual behavior ("hypersexualism"). fat tissue. This aspect of change was termed "placidity". Denys–Drash is characterized by the triad of pseudohermaphroditism. POZITIVE 2013 35 The syndrome is named for Heinrich Klüver and Paul Bucy. hypermetamorphosis and oral tendencies. Group B streptococci Ans (b) REF OHC POZITIVE 78. Isolated hemihypertrophy. [AIIMS MAY 2013] A) hypermetamorphosis B) Hypersexuality C) visual agnosia D) refractory seizures • • • • • Ans (d) REF MODEL EXAM 3 2012-similair question CONSULTANT-PSYCHIATRY BOOK Kluver-Bucy syndrome results from lesions of the POZITIVE MODEL EXAM 3 2012 (a) Parietal lobe (b) Temporal lobe on one side (c) Temporal lobe of both hemispheres (b) Prefrontal cortex Ans (c) • klüver-Bucy syndrome is a behavioral disorder that occurs when both the right and left medial temporal lobes of the brain malfunction. now called isolated hemihyperplasia. klebseilla D. mainly Wilms tumor and hepatoblastoma 76. or their use. is a congenital overgrowth disorder associated with an increased risk for embryonal tumors. In INDIA neonatal sepsis not commonly caused by – [AIIMS MAY 2013] A. and their facial expressions and vocalizations became far less expressive. who removed the temporal lobe bilaterally in rhesus monkeys in an attempt to determine its function.epithelium Wilms' tumor is a malignant tumor containing metanephric blastema. however. They would examine their world with their mouths instead of their eyes ("oral tendencies") and developed a desire to explore everything ("hypermetamorphosis"). heterosexual acts and homosexual acts. The monkeys indulged in indiscriminate sexual behavior including masturbation.
. It is sometimes referred to by dermatologists as "mini lichen planus". Patient presents with left painless scrotal mass. flattopped. abdomen. minimal scaling is present or can be induced by rubbing the surface of the papules The disease usually affects children and young adults and is painless and usually nonpruritic. although protracted itching may occur in some cases.urine examination shows microscopic hematuria likely diagnosis [AIIMS MAY 2013] a) Seminoma b) cystitis c) RCC REF-OHC. the initial lesions are localized.. According to Hean Piaget cognitive developmental theary 'Out of sight is out of mind' belongs to [AIIMS MAY 2013] A) sensiromotor stage... and remain so. pale flesh-colored or reddishbrown papulesthat may appear as hypopigmented against dark skin.. shiny.Ans (a) OHC POZIGOLD-NOV-2012 Dermatology 79. B) Preoperative C) Concrete Operational D) Formal operational Ans (a) REF CONSULTANT PSYCHIATRY BOOK PAGE 5 Stage I Sensory Motor Development Motor and sensory Reflexes coordinating body and five senses imitating novel behavior II 2-7 years Learn without Preoperative reasoning (immanent justice) believes punishment for bad deeds inevitable III Concrete 7-11 years Syllogistic Operational reasoning – all horses are mammals conservation and Reversibility IV Formal 11yrsInductive an operational Adoles-cent Deductive reasoning Age 0-2 years Ans (c) 81. Pin head size lesions on hand and penis..diagnosis??????. After mastoidectmy-pt developed vertigopure tone audiogram revealed sensorineural deafness [AIIMS MAY 2013] a) petrositis b) suppurative labrynthitis c) d) 36 POZITIVE 2013 . CONSULTANT 82.Alfa feto protein and LDH normal. discrete and uniform. [AIIMS MAY 2013] a) scabies b) lichen planus c) lichen nitidus d) molluscum contagious Ans (c) Lichen nitidus is a chronic inflammatory disease of unknown etiology characterized by 1–2 mm. and flexor aspects of the upper extremities Psychiatry 80. glans penis. Occasionally. to the chest.
A patient having PCO2 value of 30mmHg.alkalosis c) Resp acidosis d) Metabolic acidosis Ans (b) REF OHC POZIGOLD-AIIMS MAY 2012 86. Metaprotenolol d.000 D) 40. Salbutamol b.1=100 • P=prevalence • Q=1-prevalence • D=range 88.5x0.000 Ans (b) REF-OHC-SPM 89.000 C) 30.5/0.He has partially compensated [AIIMS MAY 2013] a) Metabolic acidosis b) Resp. Terbutalin c. 60 Year old with D type tympanogrammanagement [AIIMS MAY 2013] a) myringoplasty with grommet incision b) nasopharyngeal endoscopy c) myringoplasty d) Ans (b) Reference-Consultant 84.no of vision centres to be present in the country is [AIIMS MAY 2013] A) 10. As per NPCB . Calculate the sample size of the study for a population whose prevalence is 50% with 95% confidence interval and 45-55% [AIIMS MAY 2013] a) 100 b) 200 c) 300 d) 400 Ans (a) REF OHC-STATISTICS SPM CLASS • Sample size=4pq/D2 • =4x0.45.000 B) 20.1x0. Which of the following is used subcutaneously in the treatment of Asthma attacks [AIIMS MAY 2013] a.Ans (b) 83.PO2 105mmHg pH-7. Pinbuterolol Ans (a) REF-Consultant 87. Non-Hodgkin lymphoma of orbit is due to [AIIMS MAY 2013] a) B-cell b) T-cell c) NK cell d) Pre B cell POZITIVE 2013 37 . Disease not included in the Intergrated disease surveillance project [AIIMS MAY 2013] A) Snake bite B) TB C) ARI D) Leptospirosis Ans (a) List of Core diseases: A total of 13 diseases both communicable and non-communicable have been included for the surveillance as per the decision of the IDSP committee. These have been grouped as per the types of surveillance into • Regular surveillance Ans (b) Ref-Consultant 85.
neurogenic MODY 6 differentiation 1 MODY 7 Kruppel-like factor 11 MODY 8 Bile salt POZITIVE 2013 38 . < 1% cases. Mutations of hepatocyte the HNF1α gene MODY 3 nuclear factor (a homeobox gene). Leishmaniasis. Most common MODY is due to [AIIMS MAY 2013] A) HNF ALPHA B) IPF-1 C) Glukokinase D) HNF -3 Ans (A) REF-OHC Maturity onset diabetes of the young (MODY) -autosomal dominant gene (sex independent. Blood Pressure.Physical Activity. i. HIV / HBV. including atrophy of hepatocyte the pancreas and MODY 5 nuclear factor several forms 1β of renal disease. Hemorrhagic fevers and other undiagnosed conditions Sentinel Surveillance: Sexually transmitted diseases / Blood borne: 10. inherited from any of the parents) disrupting insulin production. Type Gene/protein Description hepatocyte MODY 1 nuclear factor . 30%–70% cases. Blindness & any other unusual Health condition. 90. Menigoencephalitis / Respiratory Distress. 5%–10% cases. Tuberculosis Vaccine Preventable Diseases: 5. Associated with pancreatic agensis. Which of the committee recommends 3 yr course in Bachelor of rural health services [AIIMS MAY 2013] A) Sundar committee B) Srivatsa committee C) CBHI • • Ans () 91.Sentinel surveillance Regular periodic surveys Regular Surveillance: Vector Borne Disease: (Other vector-borne diseases under this group) 1. Typhoid: 4. MODY is often referred to as "monogenic diabetes" to distinguish it from the more common types of diabetes MODY 2 and MODY 3 are the most common forms.Anthropometry. Chikungunniya . Outdoor Air Quality (Large Urban Centres) Regular Periodic Surveys: NCD Risk Factors: 13. JE. Road Traffic Accidents (Link up with Police Computers) Other International Commitments 8. Malaria . Water Borne Disease: 2. Measles Diseases under Eradication: 6. 4α MODY 2 glucokinase . 1α 30%–70% cases insulin MODY 4 promoter factor-1 Mutations of the IPF1 homeobox (Pd x1) gene. Dengue. Nutrition. Polio Other Conditions: 7.e. Plague Unusual Clinical Syndromes: 9.WaterQuality 12. Tobacco. HCV Other Conditions: 11. Acute Diarrhoeal Disease (Cholera) Respiratory Diseases 3.
Silver staining neuro fibrillary Tangle P Anosognosia .occurs late [early in DLB] • P MRI – atrophy of hippocampus • P Hypometabolism of Tempero.parietal cortex • P Risk Factors • . Mutations in the insulin gene. a homeobox gene on chromosome 12.Age. whereas levels of hyperphosphorylated tau protein are elevated. which is BLK 11 also present in pancreatic islet cells. MODY 3 (also known as HNF1A-MODY) is caused by mutations of the HNF1-alpha.Neuritic plaque with Aβ amyloid . as well as lateral and medial parietal lobes and lateral frontal cortex.an early and prominent feature • Simple calculations and clock reading become difficult (ACALCULIA) • CSF A beta 42 levels are reduced. • • • • • • • • • • • • • • MODY 10 INS Mutated B-lymphocyte MODY tyrosin kinase. • Apraxia • Aphasia.10% AIIMS Nov 2011 • patients are unaware of these difficulties (Anosognosia). Usually associated with neonatal diabetes. The cause of ketoacidosis in Von Gierkes disease is due to all except [AIIMS MAY 2013] A) Patient suffers from hypoglycemia B) In most pts glucose level is low C) Fat mobilisation is low d) Ans (c) 93.dependent lipase MODY 9 PAX4 Pax4 is a transcription factor. Alzhiemers disease-atrophy of [AIIMS MAY 2013] A) Parietal and frontal cortex B) Parietal and Temporal cortex C) Parietal and occipital cortex D) Frontal and occipital cortex Ans (b) REF OHC POZIGOLD CONSULTANT Alzhiemers • Pathologically. gene.Unaware of these difficulties P Language . atrophy is distributed throughout the medial temporal lobes. Rare < 1% cases. Female sex may also be a risk factor independent P Commonest Dementia P Microscopy . Positive family History POZIGOLD-Alzheimer’s disease. which is involved? (AIIMS MAY 2008) a) Frontal cortex b) Cortical atrophy of temporoparietal cortex c) Frontal and parietal cortex d) Occipital cortex POZITIVE 2013 39 .fluency –last P Delusions common P Capgras syndrome-OCCURS LATE HERE . This is the most common type of MODY accounting for about 70% of all cases in Europe 92.believing that a careGiven has been replaced by an imposter .naming – affected first . • .
there is a decrease in edema. Area not involved in HIV? [AIIMS MAY 2013] a. Oedema in CT absent in which stage of Neurocysticercosis? [AIIMS MAY 2013]3 A. there is surrounding edema. Findings on MRI include the following: • Vesicular stage: Cysts follow the CSF signal. collapsed ventricles. nodular parenchymal calcifications are seen MRI is the imaging modality of choice for neurocysticercosis. Homogenous opacity in right lung with obscured right cardiac silhouette. which part of lung is involved? [AIIMS MAY 2013] A. T2 hyperintense scolex may be seen. Medial seg of RML B. and nodular or ring enhancement is present 95. with no edema and usually no enhancement • Colloidal stage: Cysts are hyperintense to the CSF.skull skiagram B. A 2 days old neonate presented wit seizures. wat is the next investigation? [AIIMS MAY 2013] A. caudate nucleus b. Lateral seg of RML C.ultrasound C. Medial basal seg of RLL Ans (a) 97. nonenhancing lesions • Colloidal stage (larval degeneration): Hypodense/isodense lesions with peripheral enhancement and perilesional edema • Nodular-granular stage: Nodular-enhancing lesions • Cysticercotic encephalitis: Diffuse edema. Vesicular stage B. Colloid stage C. cingulate gyrus d.MRI Ans (B) REF-CONSULTANT 96. globus pallidus c. and the cyst wall enhances • Nodular-granular stage: The cyst wall thickens and retracts. Apical seg of RLL D.Ans (b) 94. and multiple enhancing parenchymal lesions • Active parenchymal stage: The scolex within a cyst may appear as a hyperdense dot • Calcified stage: When the parasite dies. cerebral white matter POZITIVE 2013 40 . especially for evaluation of intraventricular and cisternal/subarachnoidal cysts. Granular nodular stage D.CT d. depending on the stage of evolution of the infestation: • Vesicular stage (viable larva): Hypodense. Calcified nodular stage Ans (D) CT findings vary as follows.
• The elimination halflife of lithium averages 20 to 24 hours. LITHIUM POTENTIATES NON DEPOLARISING MUSCLE RELAXANTS. Most common stain for fungal hyphae [AIIMS MAY 2013] A) PAS B) Methanamine silver C) Congo red D) Oil red O Ans (B) REF-CONSULTANT 99.000 Ans (C) 100. Half-life in geriatric patients and patients with impaired renal function is increased.000iu b) 1. deep white matter.00. including the basal ganglia. especially the putamen. • there was hypoactivation of the left caudate • fronto-striatal system. • It is suggested that lithium be omitted 2-3 days prior using a muscle relaxant 101. • hypertrophy is apparent in the basal ganglia. • Lithium administration prolongs both depolarizing and non-depolarizing neuromuscular block. • reduced functional connectivity between the left caudate and globus pallidus (basal ganglia output nucleus).[AIIMS MAY 2013] a) 1DAY b) 3 DAYs c) 5 DAY d) 7 DAY Ans (B) • Lithium is rapidly absorbed after oral administration and has 100% bioavailability.HOW MANY DAYS PRIOR TO GIVING IT LITHIUM SHOULD BE STOPED.000 iu d) 3.000iu c) 2.00. Volume of distribution approximates to total body water.. Its action appears to be synergistic with non-depolarizing neuromuscular blocking agents and additive with depolarizing neuromuscular blocking agents. 36 and 40 to 50 .INHALATIONAL AGENT OF CHOICE [AIIMS MAY 2013] a) SEVOFLURANE b) ISOFLURANE c) DESFLURANE d) HALOTHANE Ans (a) REF-CONSULTANT 102.00. VitA prophylaxis given to postpartum women [AIIMS MAY 2013] a) 50. Flavin mononucleotide Flavincontaining monooxygenase L O Oxidase Oxidoreductase Q Quinoneinteracting membrane-bound POZITIVE 2013 .5 Peak plasma levels usually occur 1–4 h after a single dose.. A 57 YR OLD MALE PRESENTING WITH ICSOL. and hippocampal regions. He following enzymes dont participate in Oxygenation Reduction reaction [AIIMS MAY 2013] a) Dehydrogenase b) oxidases c) reductases d) peroxidases Ans d Aequorin Amino acid oxidoreductases C Catechol dioxygenase D 41 F cont.Ans (D) • HIV is associated with pathological changes in mainly subcortical and frontostriatal areas of the brain.the striatum being the structure most notably affected 98.
External genu of facial nerve medially 2. To know how much amplification of DNA has occurred Ans (d) In molecular biology. Method to differentiate entry and exit wounds [AIIMS MAY 2013] a) kennedy phenomenon b) c) d) ans a Ref-CONSULTANT 106. once 42 103. It has a low Km for glucose. Irreversible steps in glycolysis [AIIMS MAY 2013] a) pyruvate kinase b) hexokinase c) pfk d) Ans-b Ref-CONSULTANT Reaction 1: Phosphorylation of glucose to glucose-6 phosphate. Chorda tympani c. Boundaries of facial recess. This surgical approach to the middle ear cavity is known as facial recess approach.Dehydrogenase Dismutase DMSO reductase F Fet3p Luciferase M Methane monooxygenase Mixed-function oxidase N Nitrite oxidoreductase Nitrite reductase oxidoreductase S Superoxide dismutase V Vinylphenol reductase X Xanthine dehydrogenase 3. • This reaction requires energy and so it is coupled to the hydrolysis of ATP to ADP and Pi. real-time polymerase chain reaction. thus. All except? [AIIMS MAY 2013] a. Boundaries: Medial – Facial nerve Lateral – Tympanic annulus Superior – Incus buttress (near the short process of incus) Running through the wall between these two structures with varying degrees of obliquity is the chorda tympani nerve. which is used to amplify and simultaneously quantify a targeted DNA molecule. Used to place cochlear implant electrode into the cochlea via the round window. The acronym "RT-PCR" commonly denotes reverse transcription polymerase chain reaction and not real-time PCR. Facial Nerve d. Hence this approach can be used to perform decompression of horizontal division of facial nerve. Chorda tympani laterally 4. Used to reach hypotympanum of middle ear 2. 3. 105. Chorda tympani nerve always run medial to the tympanic membrane. Horizontal portion of facial nerve can be accessed via this approach. Uses of facial recess approach: 1. • Enzyme: hexokinase. also called quantitative real time polymerase chain reaction (qPCR) or kinetic polymerase chain reaction is a laboratory technique based on the polymerase chain reaction. 104. Tympanic membrane anteriorly and laterally. Short process of Incus b. Multiplication of Proteins d. Fossa incudes superiorly POZITIVE 2013 . Real Time PCR is used for [AIIMS MAY 2013] a. Multiplication of specific segments of DNA c. Stapedius Tendon Ans-d Is defined as an aerated extension posterior superior portion of the middle ear cavity medial to the tympanic annulus and lateral to the fallopian canal. Land marks used to identify this region: 1. Drilling in this area between the facial nerve and annulus in the angle formed by the chorda tympani nerve leads into the middle ear cavity. Multiplication of RNA b.
• Reaction is coupled to the hydrolysis of an ATP to ADP and Pi. Dermatomal distribution painful vesicular lesions [AIIMS MAY 2013] a) HERPES ZOSTER b)Herpes simplex c) d) ans a REF-CONSULTANT.boundingpulse d. • This is the second irreversible reaction of the glycolytic pathway 107. Which of the following cancer can be prevented by preserving the food in refrigertor. pulmonary hemorrhage ans a Ref-OHC POZIGOLD 108. This allosteric enzyme regulates the pace of glycolysis. Contraindicaited in epileptic seizure [AIIMS MAY 2013] a) Ketamine b) succinyl choline c)propfol d) ANS A Ref CONSULTANT 111.OH BOOK 109. • This step is irreversible Reaction 3 hydroxyl group on C1 forming fructose-1..nec c. PDA all except [AIIMS MAY 2013] a. it gets phosphorylated..co2washout b.. Of the Millenium Development Goal How many are directly realated to Health [AIIMS MAY 2013] a) 4 b) 3 c) 2 d) 1 Ans (b) REF OHC CONSULTANT POZIGOLD • Goal 1: Eradicate Extreme Hunger and Poverty • Goal 2: Achieve Universal Primary Education • Goal 3: Promote Gender Equality and Empower Women • Goal 4: Reduce Child Mortality • Goal 5: Improve Maternal Health • Goal 6: Combat HIV/AIDS.glucose enters the cell. Malaria and other diseases • Goal 7: Ensure Environmental Sustainability • Goal 8: Develop a Global Partnership for Development POZITIVE 2013 43 .?? [AIIMS MAY 2013] A oesophagus B stomach C colon D. Ans (b) 110.OHC.6bisphosphate. Not found in IDA [AIIMS MAY 2013] a) Increased RDW b) Decreasd TIBC c) Decreased serum iron d)increased protoporphyrin Ans (b) REF OHC OH BOOK PAGE 462 CONSULTANT 112. • Enzyme: phosphofructokinase.
She should be a literate woman with formal education up to Eighth Class. ASHA gets renumeration for except AIIMS MAY 2013 a) institutional delivery b) zero dose of opv n first dose of BCG c) Recording birth weight d)none Ans (d) REF-OHC RECENT ADVANCES.In tribal. Motorcyclist after multiple trauma is having hypoventilation cause is [AIIMS MAY 2013] A) damage to respiratory center respiratory apparatus both b) c) d) ans115. left atrial appendage. TEE has a very high sensitivity for locating a blood clot inside the left atrium 116. pain in calves. In adults. What is used shelf life of anesthetic agent Succinyl choline [AIIMS MAY 2013] a) 3 month b) 6 month c) 12 month d) 18 month ans-d 117. deficiency of which is seen [AIIMS MAY 2013] a) protien s b) Thrombin c) plasmin d) factor XIII Ans (a) 114.CONSULTANT AccreditedSocial Health Activist (ASHA)???? AccreditedSocial Health Activist (ASHA) general norm will be ‘One ASHA per 1000 population’. several structures can be evaluated and imaged better with the TEE. and coronary arteries. leadership qualities and be able to reach out to the community. A female presented with recurrent abortions. must be primarily a woman resident of the village – Married/Widow/Divorced’ and preferably in the age group of 25 to 45 yrs. The explanation for this is that the heart rests directly upon the esophagus leaving only millimeters that the ultrasound beam has to travel. TEE is better than TTE why [AIIMS MAY 2013] a) Left atrial thrombi b) c) d) ans a REF-POZITIVE OHC 2 RECENT ADVANCES HAND OUT-PAGE 95 TEE The advantage of TEE over TTE is usually clearer images. including the aorta. both atria. desert areas the norm could be relaxed to one ASHA per habitation. atrial septum. ASHA would be an honorary volunteer and all POZITIVE 2013 44 . hilly. Most important function of MHC is [AIIMS MAY 2013] a) Antigen presenting b) c) d) ANS A Ref: Consultant. especially of structures that are difficult to view transthoracicly (through the chest wall). ASHA should have effective communication skills. Insulin resistance in hepatic injury due to [AIIMS MAY 2013] a) damaged hepatocyte decreased sec of insulin b) c) d) 118.113. OHC 119. valves of the heart. pulmonary artery.
OHC-MKT Language Cooing. turns towards sound Nonsense vocalization Babbles syllables - Social Social smile Recognition of mother Laughs Plays interactive games - Transfers objects from one hand to the other Pincer grasp - Key Developmental Milestones : Fine Motor Age Milestone 4 months Grasps a rattle or rings when placed in hand 5 months Reaches out to an object and holds it with both hands (intentional reaching with bidextrous grasp) 7 months Holding objects with crude grasp from palm (palmar grasp) 9 months Holding small object. ‘baba’) 12 months Two words with meaning 18 months Ten words with meaning 24 months Simple sentence 36 months Telling a story Key Developmental Milestones : Personal Social Age Milestone 2 months Social smile 3 months Recognizing mother 6 months Smiles at mirror image 9 months Waves ‘bye-bye’ 12 months (1 yr) Plays a simple ball game 36 months (3 years) Knows gender POZITIVE 2013 45 . like a pellet. between index finger and thumb (pincer grasp) Key Developmental Milestones : Language Age Milestone 1 months Turns head to sound 3 months Cooing 6 months Monosyllables (‘ma’. Which is considered developmental delay [AIIMS MAY 2013] a) pincer grasp 9 mnth b) moving up n downstars 2 n half yr c) Not able to sit at 9 month Cardinal or target developmental milestones Upper age Motor Fine motor limit (months) 2 4 Head control Holds objects 8 12 18 months Sits without support Stands without support Walks independently d) Two word syllable by 1 year age Ans (C) REF CONSULTANT. ‘ba’) 9 months Bisyllables (‘mama’. 120.would not receive any salary or honorarium.
What is most important difference between seizure n syncope [AIIMS MAY 2013] a) Urine incontinence b) LOC c) Injury from fall d) Ans (a) REF CONSULTANT 122. No treatment required in asymptomatic cases. What happens immediately after lying down [AIIMS MAY 2013] a) increase in cerebral flow b) immediate increase venous return to heart c) decrease of blood flow to lung apex d) Ans () 123. B. causes iodism b. Synaptophysin c. Not true about hypothermia anaesthetics [AIIMS MAY 2013] a) Occurs in all agents b) Can be prevented by warm iv fluids c) good for pt Ans () 127. What is signature fracture [AIIMS MAY 2013] a) Depressed fracture b) Ring fracture c) Separation of sutures POZITIVE 2013 46 Ans (a) REF OHC CONSULTANT POZIGOLD 126. Combination therapy for <50 yrs of age. Which of the following nerve affected in sentinel lymph node biopsy of breast tumor [AIIMS MAY 2013] 1)Nerve to latissimus dorsi 2)nerve to pectoralis major 3)nerve to serratus anterior 128. . cannot be given in hyperthyroidism Ans () 129. past HBV infection b. chronic HBV infection c. desmin b. Treatment is curative. D. urgent treatment is to be done. d.121. acute infectious hepatitis Ans (c) REF • • OHC CONSULTANT postive. HBsAg and HBeAg Diagnosis? [AIIMS MAY 2013] a. C. Ans (a) REF CONSULTANT 125. Dx is [AIIMS MAY 2013] a) Acute intermittent porphyria b) c) d) ANS A REF OHC POZIGOLD CONSULTANT 124)Not true in CLL? AIIMS MAY 2013 A. in 130. True about iodine except? [AIIMS MAY 2013] a. Marker for rhabdomyosarcoma? [AIIMS MAY 2013] a. A patient had seizure after injection of sulfonamide. For leucocytosis.
Amphotericin B b. RHO kinase inhibitor [AIIMS MAY 2013] a) Fasudil b) Ranalozine c) d) ans a Ref-OHC POZIGOLD –AIIMS NOV-2012 133.OHC 134.Lytic bone lesions . Vasopressor of choice for hypotension in aortic valve surgery ? [AIIMS MAY 2013] a) Ephedrine b) Dopamine c) Dobutamine d) Phenylephrine Ans a Ref-consultant 135.MKT Detectable Tumor Type Antigen Alpha-fetoprotein Germ cell and (AFP) trophoblastic tumors. corpus uteri (connective tissue part) 131. Pt with renal failure multiple bony lesion plasma cell >35% [AIIMS MAY 2013] a) Multiple myeloma b) smouldering myeloma c) non secretory myeloma d) Walderstorms macroglobulinemia Ans a REF-OHC .CONSULTANT. ovary.Serum / urine M component POZITIVE 2013 47 . cervix antigen (CEA) uteri. urinary tract Chromogranin NET Cytokeratin Broad range of carcinomas and sarcomas Desmin Sarcomas (smooth or skeletal muscle). Itraconazole c) Voriconazole d) Ans (a) REF OHC OH book PAGe 875 132. hepatocellular carcinoma Alpha-1Liver antitrypsin Carcinoembryonic Gut.Marrow plasmacytosis > 10% .Ans (a) REF-Consultant.POZIGOLD MULTIPLE MYELOMA Diagnosis * Triad . lung.OHC.OH BOOK PAGE. pancreas. Which dont utilise ketone bodies [AIIMS MAY 2013] a) Brain b) RBC c) d) Ans b REF CONSULTANT 136. IVC of choice in cmv retinits [AIIMS MAY 2013] a) Nucleic acid analysis in intraocular fluid b) Detecting antibodies in serum c) Detecting antibodies in ocular sample ans-a REF-CONSULTANT. breast. Drug for mucormycosis? [AIIMS MAY 2013] a.
90 c. anococcygeal raphe Ans d REF-CONSULTANT. xray b.1 90 to 109 Average 50.7 < 70 Mentally 2.0 80 to 89 Dull normal 16. dexa c.70 b. * No myeloma-related organ or tissue impairment. 137. amyloidosis.2 challanged 141. Asymptomatic myeloma (smouldering myeloma) * M protein in serum >30 g/L and/or * Bone marrow clonal plasma cells >10%. Which does not contribute to anorectal ring [AIIMS MAY 2013] a. intercostal muscle Ans A 138. * Bone marrow clonal plasmacytosis > 10% or plasmacytoma.2 120 to 129 Superior 6. Orphan drug is [AIIMS MAY 2013] a) for rare diseases b) c) d) POZITIVE 2013 48 .* Bone marrow plasma cells are CD138+ and monoclonal.111 d.80 ANS B REF-CONSULTANT-POZITIVE PSYCHIATRY BOOKLET-PAGE-28 IQ Score Descriptive Level % of Population > 130 Very superior 2. puborectalis b. * Myeloma-related organ or tissue impairment (end organ damage) (ROTI): Calcium levels increased: renal insufficiency . thoracodorsal fascia c.develops the respiratory muscles d.7 110 to 119 Bright normal 16.can lead to RDS c. recurrent bacterial infections (>2 episodes in 12 months). Nonsecretory myeloma * No M protein in serum and/or urine with immunofixation. In pleural tapwhich structure in not pierced [AIIMS MAY 2013] a. Averge iq is [AIIMS MAY 2013] a. Lady with osteoporosis is bisphophonate thrapy which is best investigation to see her bone condition [AIIMS MAY 2013] a. external sphincter c. Pulmonary pleura b. int sphinter d. ct scan ANS b 140.POZIGOLD 139. anemia: bone lesions: symptomatic hyperviscosity.1 70 to 79 Border line 6. * Myeloma-related organ or tissue impairment. skin d.amniotic fluid embolism Ans-d 143.increases towards end of term b. mini mental state examination [AIIMS MAY 2013] a) b) c) d) 142) Breathing movements in a fetus lead to all except [AIIMS MAY 2013] a.
Ans a REF-OHC-POZIGOLD 144.45. For viewing root angulations following angles can be used [AIIMS MAY 2013] a) 90 b) 90. A PATIENT SUFFERING FROM HEAD ache and Temporal arteritis – biopsy will reveal [AIIMS MAY 2013] a) Giant cell arteritis b) migraine c) ICSOL d) POZITIVE 2013 49 . Radiology technicians should not be exposed to radiation per week more than [AIIMS MAY 2013] a)10 ME b) 10 equivalence c) 100 equivalence d) 300 equivalence 150. Social pathology [AIIMS MAY 2013] a) b) c) d) 147.Which of the following causes this? [AIIMS MAY 2013] a) Large cell variant b) Squamous cell Ca c) AdenoCa d) Small cell Ca Ans.Liver biopsy will reveal [AIIMS MAY 2013] a) auto immune hepatitis b) NASH c) d) 151.OHC.POZIGOLD 148.d REF-Consultant. A 4 year old child suffering from vomiting after being treated for a viral illness.Liver biopsy might reveal [AIIMS MAY 2013] a) acute liver cirrhosis b) NASH c) peliosis hepatitis d) autoimmune hepatitis ans b 152. A PREGNANT FEMALE 50 YEARS OLD WITH type 2 dm and hyperlipidemia. Anganawadi centres.OH BOOK PAGE 392 System Character * General * Anorexia.which standards are followed AIIMS MAY 2013 a) IAP b) ICHS c) d) ans 145) Cyanosis does occur [AIIMS MAY 2013] a) critical concentration of reduced hb b) c) d) Ans a REF-CONSULTANT 146.110 d) 149. Hot spot on scan [AIIMS MAY 2013] a)adenolymphoma b)adenocystic carcinoma c) d) ANS-B REF-OHC. cachexia * 30% * Endocrine * 12% * PTH-rP(squamous) * SIADH(small cell) * ACTH 153. A 60 yr old elderly smoking 3 packets of cigarette per day developed features of central obesity with weak peripheral extremities.45 c) 90..
Social pathology is [AIIMS MAY 2013] a) chang in the disease pattern due to change in life style b) c) d) 159. Damage to facial nerve above chorda tympani will lead to all except [AIIMS MAY 2013] a) Hyperacusis b) loss of taste c) loss of sensations 50 POZITIVE 2013 . Type C (the most common subtype) is due to defective transport of cholesterol between cells and has been linked to a defect in NPC-1 gene on chromosome 18 In the classic infantile type A variant. Niemann-Pick cells are CD-68 positive histiocytes. but Sudan Black B and Oil Red O are positive. Bone marrow transplant has been attempted for Type B. PAS staining is only faintly positive. What is associated with strep. as well as "sea-blue histiocytes" on pathology Giemsa staining can highlight “sea blue” histiocytes containing ceroid.ANS A REF-OHC . indicating that neutral fat contained in the vacuoles. Seat belt injury is commonly seen in [AIIMS MAY 2013] a) Liver b) Mesentry c) spleen d) 158.Suspected primary of unknown origin-stage [AIIMS MAY 2013] a) T0 N2a Mx b) c) d) Ans 160. Histology demonstrates lipid laden macrophages in the marrow.CONSULTANT 154. most common in Type C disease. Future prospects include enzyme replacement and gene therapy. All are true regarding METHANOL poisoning except [AIIMS MAY 2013] a) critical level is 1.OHC2RECENT ADVANCES PAGE 106 POZIGOLD Niemann-Pick disease. Neck mass-solitary and nontender4/4cm-biopsy SSC. parallel lamellated structures in the cytoplasm The cells of Gaucher disease are identified by their “crinkled tissue paper” cytoplasm. type C: subacute/juvenile Niemann–Pick disease type D: Nova Scotian Type A and B are due to deficiency of lysosomal sphingomyelinase. Throat infection [AIIMS MAY 2013] a) Rheumatic fever b) AGN c) both Ans c Ref-consultant. Crumpled tissue paper appearance is seen in [AIIMS MAY 2013] a) Gauchers b) Neimann picks c) Galactosemia d) Ans a REF-Consultant.1-15. seen best on touch imprints 156.25 b) fomipazole-inhibits with aldehyde dehydrogenase c) Formic acid is responsible for toxicity d) 157. Electron microscopy shows lamellated structures in the lysosomes (similar to myelin figures) and may also demonstrate “zebra bodies”. a missense mutation causes complete deficiency of sphingomyelinase type A being the neuronopathic form and B the non-neuronopathic form. The involved gene is on chromosome 11p15.4.OHC 155. These lipid deposits are birefringent and have yellow-green fluorescence in UV light.
Technique which shows change in size. Vagina is formed by-AIIMS MAY 2013 a) mesoderm of urogenital sinus b) endoderm of urogenital tract c) mesoderm of urogenital ridge d) endoderm of urogenital ridge 162. Minimum amount of TC required for staining of teeth [AIIMS MAY 2013] a) 5mg/kg/d b) 20mg/kg/d c) 40mg/kg/d d) 80mg/kg/d ans-d Tetracycline must not be taken by pregnant or breast-feeding women. or by children under twelve years. Cell is injured by micro needle.How does it get sealed [AIIMS MAY 2013] a) Enzymatic reaction b) c) d) 163. especially if used in doses greater than 100mg per day Ans a REF-POZITIVE CONSULTANT 166. because it discolours growing teeth and may cause enamel hypoplasia (malformed permanent teeth). Minocycline may occasionally result in prolonged greyish discolouration of teeth. Loss of lacrimation is due to injury of[AIIMS MAY 2013] a) b) c) d) 165. Urethral crest is formed by [AIIMS MAY 2013] a) PROSTATE GLAND b) insertion of detrusor c) insertion of trigone d) pre prostatic sphincter POZITIVE 2013 51 .AnsCONSULTANT 161. It can stain permanent teeth but this effect is usually temporary. shape of chromosome [AIIMS MAY 2013] a) chromosome mapping b) karyotyping c) Genotyping d) 164.
Overestimate it B. scrotum. Damage control surgery [AIIMS MAY 2013] A) Minimum possible intervention B) Maximum possible intervention C) D) 168.Ans a REF-OHC-MKT. Warthims tumor 52 167. A survey on blind school for the prevalence of blindness when compared to prevalence in general population [AIIMS MAY 2013] A. GYNECOLOGY. Underestimate it C.) Seminal vesicles (intermed. duct Uterus. Tc99 pertechnate hot spot on parotid spot? [AIIMS MAY 2013] A. Both are equal POZITIVE 2013 . Fallopian tubes Mesonephric duct Ductus epididymis Duct of epoophoron Ductus differentes Gartner’s duct Mesonephric tubules Ductuli efferentes Epoophoron Paradidymis Paroophoron Undifferentiated gonad Testes Ovary Cortex Seminiferous tubules Ovarian follicles Medulla Rete testis Rete ovary Gubernaculum Gubernaculum Round ligament Testis Ovarian ligament EMBRYOLOGICAL ORIGINS Endoderm Bladder Urethra Prostate Trigone (bladder) Mesoderm Ureter (mesenephros) (intermed.CONSULTANT Male and Female derivatives of embryonic urogenital structures Derivatives Embryonic structure Male Female Labioscrotal swelling Scrotum Labia majora Urogenital folds Ventral aspect of penis Labia minora Genital tubercle Penis Clitoris Urogenital sinus Urinary bladder Urinary bladder Prostate gland Urethral and paraurethral glands Prostatic utricle Vagina Bulbo-urethral glands Bartholin’s glands Paramesonephric Appendix of testes Hydatid of Morgagni. fallopian tubes) External genitalia (penis. mesoderm) Genital ducts (vas deferens. intermed. vagina) 169.) Trigone (ureteric inlets to bladder) Gonads (testes.which of the following cannot be the cause? [AIIMS MAY 2013] A) cryptosporidium B) opisthorcus viverni C) isospora Ans b Ref-POZIGOLD 170. ovaries. mesoderm) Kidney (metanephros) (intermed. A patient complaints of diarrhoea stool examination shows ova of size 100.
* Direct fluorescent antibody (DFA) testdirected primarily at the lipopolysaccharide. Harmartomatous polyp c. SAH B. 177.CONSULTANT. * Mode of Transmission . 4. * 49 species. 64 serogroups. OH BOOK PAGE. The following test is used to differentiate between maternal and foetal blood cell [AIIMS MAY 2013] a. Juvenile rectal polyp b. Oriention c.B. Aerosal transmission b. The following is the mode of transmission of Legionella pneumonia [AIIMS MAY 2013] a.wide spaced nipples hypoplastic uterus. Insight b.OHC 172. * Fastidious Aerobic Gram negative bacilli. * L. bozemanii. A patient presented with sudden onset of severe headache with vomitting and nausea.He complaints of neck stiffness. POZIGOLD. APT test b. and 6 are most common. legionnaire’s disease. L.POZIGOLD. A toddler passes a drop of blood per rectum diagnosis is [AIIMS MAY 2013] a.POZIGOLD. Kleihauer Betke test c. inhalation. * 1st in philadelphia during American legion convention. L.*** * L.microaspiration. A patient develops itchy urticarial plaques tense blisters which of the following can be used to diagnose [AIIMS MAY 2013] a) biopsy b) Direct immunofluorescence c) Indirect immunofluorescence d) POZITIVE 2013 53 . * Can live in years in refrigerated water. Lymphoma Ans-a REF-POZIGOLD.What is the karyotype? [AIIMS MAY 2013] a) 47XXY b) 45XO c) 46XY d) 46XX Ans-b Ref-OHC. Bubblin test d. Adenoid cystic lymphoma C. * Source – water. Blood borne Ans a Ref-OHC. Cluster headache D. Fistula in ano ANS-A REF-CONSULTANT 175. What is the diagnosis? [AIIMS MAY 2013] A.serogroups 1. Infectious droplets c. dumoffii.CONSULTANT 174. Osmotic fragility test ANS-b REF-OHC. A 19 yr old female with primary amenorrhoea. CONSULTANT * Produces pontaic fever. micdadei (Pittsburgh pneumonia agent).CONSULTANT 173. longbeachae. Mucoepidermoid Ca D.Pneumophilia – 80-90% [Buffered charcoal yeast Extract]. Judgement d. and L. Basilar migrane C.CONSULTANT 171. Knowledge of own disease /illness in mental status [AIIMS MAY 2013] a. Rapport Ans a Ref-consultant 176. Extradural hemorrhage ANS A REF-POZIGOLD.
People lacking functional literacy skills (% of people scoring in the range called “Level 1” in the International Adult Literacy Survey. The dimensions used in HPI – 1 A long and healthy life vulnerability to death at a relatively early age (probability at birth of not surviving to age 40.0% for Italy. * incidence of Thyroid abnormalitis. This indicator has by far the greatest variation. while HDI measures average achievements in basic dimensions of human development.HLA B8/DRW3.3% at HDI position 37. * 2nd – 4th decade. Schilling test to establish cause of B12 deficiency. * Primary lesion – papule.IgA anti endomysial antibodies that target tissue Transglutaminase. urticarial plaque. * 90% . • • Bile salt breath test (14C-glycocholate) to determine bile salt malabsorption. with a value as high as 9. The HPI is derived separately for developing countries (HPI-1) and a group of select highincome OECD countries (HPI-2) to better reflect socio-economic differences and also the widely different measures of deprivation in the two groups • Indicators used are: • Probability at birth of not surviving to age 60 (% of cohort). the HPI measures deprivation in those dimensions. This is the indicator that is best known for all countries (including the ones not on the list). papulo vesicular skin disease. 2005. Varies from 7. These figures are higher than most commonly cited illiteracy rates due to the choice of the literacy test. c) It differs from developing and developed countries d) ans d • • Human poverty Index – term was introduced in 1997. The dimensions for HPI – 1. * Associated with gluten sensitive enteropathy.OH BOOK PAGE 239 Dermatitis Herpetiformis * Intensely pruritic. * Auto antibodies . 1994–2003). atrophic gastritis and antigastric parietal cell antibodies. Varies from 0. * Biopsy . extensor surface.8 for the USA. • 179.Sub epidermal bullae with neutrophils in dermal papillae. 178. Long-term unemployment (12 months or more. 2000-2005. age 1665. HPI does not include [AIIMS MAY 2013] a) Child literacy rate b) Life expectancy not beyond 40 yrs POZITIVE 2013 54 • .1% for Japan to 11. Varies from 7.4% for the United States to 5. % of labour force). HLA – DQW2. knowledge and a decent standard of living.Ans a Ref-OHC. * Gluten Restriction. The following are the tests of malabsorption except [AIIMS MAY 2013] a) D-Xylose test b) 13C breath test c) 14 C breath test d) all Ans-b tests no longer used clinically D-xylose absorption test for mucosal disease or bacterial overgrowth. achlorhydria.0% for Germany. .Immuno – Granular deposits of IgA in papillary dermis and along the epidermal basement membrane zone. * Treatment – Dapsone – Response within 24 – 48 hrs. Normal in pancreatic insufficiency. * Symmetrical.5% for Sweden to 47. The HPI concentrates on the deprivation in the three essential elements of human life already reflected in the HDI: longevity.
following angulation can be done [AIIMS MAY 2013] a) 90 b) 90.Possibility [AIIMS MAY 2013] a) Gynecomastia b) Thin limb and obese body c) d) ans-b Cysticercotic encephalitis: Diffuse edema. nonenhancing lesions Colloidal stage (larval degeneration): Hypodense/isodense lesions with peripheral enhancement and perilesional edema Nodular-granular enhancing lesions stage: Nodularstage stage stage 180.110 POZITIVE 2013 55 . and multiple enhancing parenchymal lesions Active parenchymal stage: The scolex within a cyst may appear as a hyperdense dot Calcified stage: When the parasite dies.• Population below 50% of median adjusted household disposable income 184.owl eye nuclei seen in the cytoplasm [AIIMS MAY 2013] a) Nodular sclerosing b) Lymphoyte predominant c) d) 181. Xylocaine (lidocaine) in multiple dose vials: Each mL also contains 1 mg methylparaben as antiseptic preservative • • • • • • 182. collapsed ventricles. • • • • 185. Oedema in CT absent in which stage of Neurocysticercosis? • A. Colloid C. Disease with cervical lymph node involvement. For veiwing root fractures . nonpyrogenic. Preservative used in lignocaine in India [AIIMS MAY 2013] a) methyl benzoate b) sodium parabens c) methylparaben d) ans-c Xylocaine (lidocaine) MPF is a sterile. depending on the stage of evolution of the infestation: Vesicular stage (viable larva): Hypodense. Calcified nodular stage Ans-d CT findings vary as follows. isotonic solution containing sodium chloride.45. Damage to facial nerve above the chordatympani will not cause [AIIMS MAY 2013] a) hyperacusis b) loss of taste sensation c) loss of sensory inneervation d) ans 183. especially for evaluation of intraventricular and cisternal/subarachnoidal cysts. Vesicular B. nodular parenchymal calcifications are seen MRI is the imaging modality of choice for neurocysticercosis.45 c) 90. Man with lung carcinoma and paraneoplastic syndrome. Granular nodular D.
POZITIVE 2013 56 .