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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-
but males often have more severe disease. but males severe disease HLA B5 Genital ulcers. hyperkalemia .hypokalemia d.. 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. 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. 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. Sudden onset lbbb seen in all except.. • 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. c.Non specific skin inflammatory reaction to scratch or Intradermal saline injection.MI. suggesting a link with the ancient Silk Route 7.3 CONSULTANT Discussion fron OHC3 DAY 8 • • • • • PATHERGY TEST In more serious cases.Ans (a) REFERENCE POZITIVE-OHC 2. [AIIMS MAY 2013] a. Blacks are very infrequently affected. 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..Recurrent oral ulceration +2 a) Recurrent genital ulcers b) Eye lesions c) Skin lesions d) Pathergy Test M:F 1:1. and the Far East. less common but more specific Pathergy Test .ASHMAN syndrorme. the Middle East. b.
1) ST elevation > 1 mm and in the same direction (concordant) with the QRS complex. the longer the cycle length or slower the heart rate. 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. or V3. * 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. This has a low sensitivity. however. In diseased hearts. but a specificity of about 90%. In most individuals the right bundle normally recovers more slowly than the left bundle. 3 points 3) ST elevation > 5 mm and in the opposite direction (discordant) with the QRS. Dr.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. aVL or V6.5 mEq/L is associated with repolarization abnormalities: Peaked T waves (usually the earliest sign of hyperkalaemia) Serum potassium > 6.0 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 . 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. LBBB aberrancy is also seen. the longer the recovery time of the conduction system. V2. Richard Ashman The Sgarbossa criteria is used in the diagnosis of an acute myocardial infarction when a left bundle branch block is present.Ans (C) and colleagues first described this in 1947 in patients with atrial fibrillation. 5 points 2) ST depression > 1 mm in leads V1. Effects Of Hyperkalaemia On The ECG Serum potassium > 5. 2 points A score of 3 points is required to diagnose an acute myocardial infarction. and a critically timed PAC is therefore more likely to conduct with RBBB than with LBBB.
3%) of the general population. Electrical signals travelling down this abnormal pathway (known as the bundle of Kent) may stimulate the ventricles to contract prematurely. fascicular blocks) Sinus bradycardia or slow AF Development of a sine wave appearance (a pre-terminal rhythm) Serum potassium level of > 9. cerebellar hemorrhage Ans (a) REFERNCE . this includes adenosine. Bilateral babinski sign? AIIMS MAY-2013 a. verapamil. resulting in a unique type of supraventricular tachycardia referred to as an atrioventricular reciprocating tachycardia. AV node blockers should be avoided in atrial fibrillation and atrial flutter with WPW or history of it.1% and 0. WPW is caused by the presence of an abnormal accessory electrical conduction pathway between the atria and the ventricles. in which case it is termed a "type B pre-excitation" Treatment. in which case it is termed a "type A pre-excitation".amiodarone or procainamide to stabilize their heart rate.3 the right ventricle. diltiazem.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. Procainamide. 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). wide complex rhythm 8. 9. 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. or between the right atrium and POZITIVE 2013 8 . Any kind of conduction block (bundle branch blocks. amiodarone. The incidence of WPW is between 0.0 mEq/L causes cardiac arrest due to: Asystole Ventricular fibrillation PEA with bizarre. and cardioversion are now accepted treatments for conversion of tachycardia found with WPW. This pathway may communicate between the left atrium and the left ventricle. basal ganglia hemorrhage c.OHC 3. 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 2.1% and 0. pons hemorrhage b.
usually persists for 4–6 weeks. which causes pinta. d) Exaggerated Babinski sign : It can either be in the form of 'flexor spasm' or 'extensor spasm'. headache. secondary. depending upon the muscles i. may produce a positive Babinski sign. and failure to inhibit the extensor response by pressure over the base of the great toe. which causes venereal syphilis. plantar hyperaesthesia. sore throat. confluent plaques).3 OPERATION HARRI BOOK PAGE 715 Primary Syphilis * Primary chancre . 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. which causes endemic syphilis or bejel. • The primary lesion appears at the site of inoculation. • T. whether flexors or extensors. low grade fever. 10. pallidum subspecies endemicum. which causes yaws. seen in frontal lobe lesions and extrapyramidal involvement. Systemic manifestations include malaise. passive extension of the knee or passive flexion of the hip and the knee. f) Tonic Babinski reflex : Characterised by slow prolonged contraction of extensors of toe. Flexor spasms occur in spinal cord disease. pallidum subspecies pallidum.e. b) True Babinski sign : Includes all the components of the fully developed extensor plantar reflex. e) Inversion of plantar reflex : If the short flexors of the toe are paralysed or flexor tendons are severed accidentally. • T. 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. anorexia. and choreo-athetosis due to hyperkinesis. while 'extensor spasm' occurs in patients with corticospinal tract lesion when the posterior column function is normal. flat. or mucous patches. c) Pseudo Babinski sign : One may encounter this type of response in sensitive individuals. condyloma lata (moist. an extensor response may be obtained. pallidum subspecies pertenue. carateum. common primary sites are the cervix and labia * Inguinal lymphadenopathy is bilateral Consultant The genus Treponema includes • T.Babinski Types of Babinski sign a) Minimal Babinski sign : Contraction of hamstring muscles and tensor faciae latae. and in patients with extensive pyramidal tract diseases. have excess of tone. True Babinski can be clinically distinguished from the false Babinski by the contraction of hamstring muscles in the former. 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. The patient may also have patchy alopecia. multiple sclerosis and subacute combined degeneration of the cord. and generalized lymphadenopathy . arthralgia. • T. • Manifestations of primary syphilis include a hard painless chancre and regional lymphadenitis • They can occur on the palms and the soles. latent and tertiary syphilis.a single painless * In women. bilateral upper motor neuron lesion at a supraspinal level.
meningioma. 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. pheochromocytoma Pituitary adenoma.3 OH book-page 351 consultant Exiting 18th • • lues maligna. brain tumor 22 Vestibular schwannoma.SYPHILIS. spine 9 Basal cell carcinoma. renal angiomyolipoma 1 2 Von Hippel–Lindau Multiple Endocrine Neoplasia 1 (Werner's syndrome) VHL AD Mutations in Menin (ch11q13) POZITIVE 2013 10 . neurofibrosarcoma.ALONG THE ANTERIOR MARIGIN OF SCALP • Tertiary or late syphilis is a noncontagious but highly destructive phase of syphilis. which may take many years to develop. a rare form of secondary syphilis. Child with mental retardation . a severe Herxheimer reaction. it can manifest itself in several forms. medulloblastoma.lues maligna????? b) von hipple lindau c) struge weber syndrome Ans (a) REF OHC 2. malignant schwannomas Parathyroid and pancreatic islet cell Angiofibroma. 11. and an excellent response to antibiotic therapy CORONA VENERIS????? • PAPULAR LESIONS OF SEC. The criteria for diagnosis of lues maligna include strongly positive serological test results. jaw cysts 9 16 3 Kidney. cerebellum.
ependymomas. Erythema marignatum <10% 13. (ch22q12) astrocytomas.tumors Schwannomas.Pancarditis .22 Neurofibromin – 2 or merlin Juvenile postr. medulloblastomas Adenomatous colon polyps. endolymphatic sac tumors of the middle ear Ans (c) Reference • • OHC POZIGOLD • CONSULTANTS C. multiple meningiomas. hamartoma AD Mutations in APCa AR (ch5) hMLH1 (ch3p21) AD Mutations in VHL gene (ch3p25) Gliomas. astrocytomas. polyarthralgia d.1.75% Syndenham’s chorea .40 – 60% . adenocarcinoma Von Hippel–Lindau (VHL) Neurofibromatosis – 2 Bilateral vestibular schwannomas NF2 gene – chr. pheochromocytoma. ganglioneuroma.5.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. pancreatic tumors and cysts. carditis b. liver. glioma. chorea Hemangioblastomas Retinal angiomas. adrenals TSC 1 – chr 9 TSC 2 – chr 16 Tuberin 12. All are major criteria for rheumatic fever except [AIIMS MAY 2013] a. 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. optic nerve gliomas. meningiomas Neurofibromas. Forgotten muscle in Rotator cuff [AIIMS MAY 2013] A) supraspinatus B) subscapularis C) teres minor D) infraspinatus 11 POZITIVE 2013 .Mitral .No constrictive pericarditis * Migratory Arthritis . subcutaneous nodule c. renal cell carcinoma.6.< 10% Nodules.18 Criterias – Five major Carditis .3. others Neurofibromatosis type 2 (NF2) AD Mutations in NF2/Merlin Bilateral vestibular schwannomas. Rheumatic fever Rheumatogenic serotypes . neurofibrosarcomas.
especially sickle-cell disease. 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. clozapine). internal rotation of limb. thalassemia. cantharides (Spanish Fly) and recreational drugs (alcohol. and other conditions such as leukemia. * High-flow involves a short-circuit of the vascular system partway along the organ. 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. antipsychotics (e. Priapism is also known to occur from bites of the Brazilian wandering spider and the black widow spider Pharmacology 15. and Fabry's disease.g. Other groups reported are antihypertensives. heroin and cocaine). Anterior B. Posterior C. * There are two types of priapism: low-flow and high-flow. external rotation Varus Ans (B) Priapism . 80% to 90% of clinically presented priapisms are low flow disorders.Ans (b) rotator cuff muscles (SITS – suprapinatus. sicklecell trait. * Low-flow involves the blood not adequately returning to the body from the organ. within four hours. antidepressants (most notably trazodone). teres minor and subscapularis subscapularis-Forgotten muscle 14. limb shortening and restriction of abduction ? [AIIMS MAY 2013] A..erect penis does not return to its flaccid state. alprostadil). CAUSES Priapism may be associated with haematological disorders. Priapism is caused by poison of [AIIMS MAY 2013] a) Sea snake b) Spanish fly c) Scorpion d) Rattle snake POZITIVE 2013 12 . Which of the following type of hip dislocation is characterised by. chlorpromazine. Lateral D. despite the absence of both physical and psychological stimulation. anticoagulants. infraspinatus.
metronidazole. 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. or time dependent(beta lactams).bioavailability ranges from as little as 10–20% (erythromycin and penicillin G) -100% [amoxicillin. clindamycin. Clarithro 13 Indinavir. Drug for juvenile myoclonic epilepsy in pregnant female? [AIIMS MAY 2013] a. and most fluoroquinolones]. Time dependent killing. trimethoprimsulfamethoxazole (TMP-SMX). not because of its antiviral effects but because it decreases clearance. 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). Ritonavir(AIIMS-2010***) Antiviral ritonavir is a very potent CYP3A4 inhibitor . of other anti-HIV agents 17. TREATMENT * pseudoephedrine being an alpha-agonist. -But cantharidin is highly toxic. aminoglycosides). 18.* Probably one of the most famous aphrodisiacs is Spanish fly. followed by more proximal shunts * Distal shunts. carbamazepine . It is made from a beetle that secretes an acid-like juice. called cantharidin. lacosamide c. which then leads to itching and swelling of the genitals. such as the Winter's * Proximal shunts. doxycycline. Saquinavir. Itraconazole Erythro.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. 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. such as the Quackel's * Shunts created between corpora cavernosa and saphenous vein called Grayhack shunt 16. causes intense irritation and burning in the urogenital tract. levetiracetam b. linezolid.added to anti-HIV regimens. Distal shunts are the first step. phenytoin d. such that an increase in antibiotic concentration leads to a more rapid rate of bacterial death. and hence increases efficacy. • Absorption .
isoniazid c. or as an adjunctive therapy for partial. This is believed to impede impulse conduction across synapses. penicillin b. Which do not cause SLE? AIIMS MAY2013 a. Dct POZITIVE BITS * Juvenile myoclonic epilepsy (JME). zonisamide Pneumonic ‘ ‘HIPMCQ’ Hydralazine INH procainamide methyl Dopa chlorpromazine Quinidine Others . carbamazepine.Tiotropium bromide inhaler • Other drug categories . * The most effective anti-epileptic medication for JME is valproic acid.Hydralazine. interferons (eg. and tumor necrosis factor alpha (TNF-α) inhibitors are associated with musculoskeletal symptoms and antibody production suggestive of a lupuslike autoimmune disorder • Antiarrhythmics . Vasopressin antagonist acts on? [AIIMS MAY 2013] a. myoclonic and tonic-clonic seizures * the drug binds to a synaptic vesicle glycoprotein. representing 510% of all epilepsies * manifests itself between the ages of 12 and 18 with myoclonus occurring early in the morning. interleukin-2 [IL-2]). skin Less female Predilection Drugs POZITIVE 2013 14 . hydralazine d. methyldopa.Interleukins (eg. levetiracetam.Penicillamine and sulfasalazine • Antipsychotics . carbamazepine. Linkage studies have demonstrated at least 6 loci for JME * juvenile myoclonic epilepsy may be a ciliopathy 19. topiramate. simvastatin. pct d. Renal Involves joint. alfa. and hydantoins • Hormonal therapy .Procainamide and quinidine • Antibiotics – Minocycline and isoniazid • Antifungals . infliximab. cortical collecting duct b. and inhibits presynaptic calcium channels.Phenytoin. adalimubab) • Inhalers . beta). lithium. and TNF-α (etanercept. and captopril • Anti-inflammatories . * Most patients also have tonic-clonic seizures and many also have absence seizures. beta. interferons (eg.CONSULTANT POZIGOLD Drug induced lupus ANA +ve Anti Histone + HLA – DR4 Spares CNS.Chlorpromazine • Cholesterol-lowering agents . Moderate to low risk • Isoniazid • Minocycline • Pyrazinamide • Quinidine • D-Penicillamine • Carbamazepine • Oxcarbazepine • Phenytoin • Propafenone • Biologics such as interleukins (eg.Valproate. also known as Janz syndrome. ethosuximide. * Lamotrigine. SV2A. and gemfibrozil • Biologics .Lovastatin. medullary collecting duct c. procainamide Ans (a) REF OHC. gamma. is a fairly common form of idiopathic generalized epilepsy.Ophthalmic timolol 20.Griseofulvin and voriconazole • Anticonvulsants .Leuprolide acetate • Antihypertensives . IL-2).Ans (a) - levetiracetam treatment for epilepsy in the case of partial seizures. gamma). alfa.
Pump Most common pump in the body * Three α – α1.Poisons – dinitro phenol Promotors Inhibitors * Insulin * Thyroid * Aldosterone * G – actin * ↓ Na. 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.Voltage gated . β2.Ca2 Pump . – Na+ . 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.Ligand gated .K+ Pump . 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 .Temp .↓ 02 .Ans (a) Reference OHC CONSULTANT Physiology 21.H+ Pump Na+ K+ .Extracellular ligands à 1st messenger .Net rate of diffussion = Diffusion co efficient X Area of membrane X (cin – cout) Thickness of membrane * Diffussion by . Fick's law? [AIIMS MAY 2013] a.1 Receptor Clinical Effect Agonists * Supraspinal * Morphine µ analgesia (µ-1) * Met- .K+ .Too low Na+. K+ * Hypothermia * ↓ 02 * Poisons – dinitrophenol [AIIMS MAY 22. β3 subunits * Na.↓ distance . K+ . Facilitated Diffussion * Carrier mediated eg.Open or close when they bind an ion or a specific molecule . α3 and 3 β – β1.↓ size . passive diffusion b. 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 . α2. Classification of opioid receptors.Hypothermia .Lipid solubility * Gated channels .Intracellular ligands à 2nd messenger B.
Marcus Gun pupillary reaction if the retina is totally detached. Fundus examination shows that RD may be total. Predisposing factors for retinal detachment: . * 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. IOP is usually decreased. Pseudophakia B.Trauma. .* Respiratory depression (µ2) * Physical dependence * Muscle rigidity enkephalin * β-endorphin * Fentanyl Ќ * Sedation * Spinal analgesia *Dysphoria δ Σ 23. 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. sectorial or macular. Retinal breaks are divided into three types holes. . . 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 . Complicated cataract.The tear appears red (the colour of underlying choroid). Which of the following is not the risk factor for Rhegmatogenous retinal detachment ? [AIIMS MAY 2013] A. . tears and dialyses. 3.A. 2.Posterior vitreous face detachment (PVD) leading to acute vitreous traction to an area of abnormally strong vitreo-retinal adhesion causing retinal tears.Lattice degeneration.The retinal blood vessels appear dark and wavy. 3.Intracapsular cataract extraction (ICCE). V. . Trauma D. . 5. Complications of neglected cases: 1. Ans () 24. 2. . wavy and tremulous. is affected only if the macula is detached. Iridocyclitis. Hyperopia C.The detached retina appears grey. total detachment of the retina.High myopia is the commonest predisposing factor. 4. Red reflex appears gray in the detached sectors. The detached retina shows.
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. Brimonidine .carbonic anhydrase inhibitor D.Decreases trabecular outflow POZITIVE 2013 17 Ans (b. Pilocarpine .decreases synthesis of aqueous humor C. [salt and paper retinopathy] are seen in all of following except ? [AIIMS MAY 2013] A.4. Latanprost . Retinal break b. Retinal atrophy and consecutive optic atrophy and no PL if detachment is neglected. Ocreoplasmin is the newer drug used in which of the following ? [AIIMS MAY 2013] a. Phenothiazine toxicity D. surgery is the TOC. Pigmentatory changes between posterior pole and equator . Rubella C. It works by dissolving the proteins that link the vitreous to the macula. resulting in posterior detachment of the vitreous from the retina 27. 5. Resolving retinal detachment B. Proliferative vitreo-retinopathy (PVR): migration of RPE cells through the retinal break into the vitreous where they acquire fibroblastic activity. • Laser photocoagulation • Cryotherapy (for sealing the hole) • Scleral buckling – encirclage • Drainage of subretinal fluid (can be treated by pneumatic retinopexy) 25. for which it received FDA approval on 17 October 2012. After vitrectomy we may fill the vitreous cavity by silicon oil. It is used for treatment of symptomatic vitreomacular adhesion. Submacular bleed d.increases uveoscleral outflow B. 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. • Treatment: Aim is to close the retinal tears and to reattach the retina. Fundus flavimaculatus Ans (A) REF OHC OPHTHAL CONSULTANT salt and pepper fundus . Retinal detachment has convex surface which does not resolve spontaneously. Vitreomacular traction c. Betaxolol . Which of the following pair regarding drug and its mechanism is correctly matched ? [AIIMS MAY 2013] A. components of the vitreoretinal interface. Diabetic macular bleed Ans (b) Ocriplasmin is a recombinant protease with activity against fibronectin and laminin. It is necessary to do vitrectomy in order to be able to flatten the retina.
• congenital syphilis Rubella (Congenital) 2. • rubeola. and deferoxamine. Cystoid macular edema with latanoprost use: petalloid pattern of foveal hyperfluorescence on fluorescein angiography. OCULAR TOXICITIES Pigmentary Retinopathy POZITIVE 2013 18 . but it may be most prominent either around the macula or in the retinal periphery. Other sulfa-containing Macular Edema • Latanoprost Latanoprost • Epinephrine. Ocular signs of toxicity include vision loss. inherited in an autosomal recessive manner. macular pigmentary changes can develop into a "salt-and-pepper" pattern. automated macular perimetry and Amsler grid testing. as is found in • congenital syphilis.. • Salt and pepper fundus—conditions are • Rubella. • These signs reflect diffuse damage to the retinal pigment epithelium (RPE). • Thioridazine. scotomas. Leber amaurosis (Congenital) 4. Choroidal Toxicity • Topiramate. • Niacin. Thioridazine toxicity Stargardt disease(of fundus flavimaculatus) Stargardt disease is the most common juvenile macular dystrophy. • Other causes of "salt-and-pepper" retinopathy are congenital syphilis. poliomyelitis. • Deferoxamine. • Choroideremia • Leber's congenital amaurosis. -Thioridazine is a phenothiazine antipsychotic agent On clinical exam. These lesions progress to RPE atrophy and perimacular yellowish fish-tail spots typical of fundus flavimaculatus are observed. dyschromatopsia. The electro-oculography is normal in the early stages and ERG tends to be subnormal. Topiramate (Topamax) • Metronidazole. Syphillis (Congenital) 3.5 mg/kg/day of hydroxychloroquine -No patients developed toxicity within the first 6 years(AIIMS NOV***) -recommending a baseline dilated fundus exam. 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. Mayous Batten disease (Maculo-cerebral facial degeneration) 5. and toxicities of systemically administered thioridazine. • fine speckling of the retina is the commonest ocular manifestation of congenital rubella. Figure 1a. and nyctalopia. ocular fundus characterized by a stippling of dark pigmented spots and yellowish-red spots of atrophy. • Quinolines. These fish-tail lesions are typically hyperautofluorescent (lipofuscin and A2E accumulation) in contrast with atrophic hypoautofluorescent regions. giving sometimes a "bull's-eye" appearance. Cystoid macular edema with latanoprost use. Usually the pigment alteration is diffuse. choroquine. • Rosiglitazone. • cystinosis. Figure 1b. • It is called "salt-and-pepper" because there are tiny flecks of dark pigment mixed with fine areas of whitish depigmentation.
Canthaxanthine is a vitamin A derivative used in the treatment of psoriasis Crystalline Retinopathy • Talc. -photopsias. -ERG studies may show prolonged b-waves reflecting bipolar and Müller cell dysfunction. b and c images provided courtesy David Sarraf.) POZITIVE 2013 • Interferon. Crystalline retinopathy with tamoxifen use: Perifoveal leakage on fluorescein angiography. Figure 2b. Talc retinopathy Miscellaneous Medications • Digoxin. MD. xanthopsia and scotomas. • Sildenafil. (Figure 2a. Crystalline retinopathy with tamoxifen use: Refractile crystals are noted in the perifoveal area. Ocular symptoms have been noted most often with doses greater than 120 mg twice per day. 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. Figure 3. Figure 2a. while therapeutic doses are much lower. • Canthaxanthine. 19 . Interferon retinopathy: Scattered cotton wool spots are noted in the nasal macula. Figure 2c.• Tamoxifen.
. Band-shaped keratopathy 3. Malignant lacrimal gland tumor C. Congenital deformity B. Intraocular sarcoma 7. Calcification of orbital vessels A. Orbital hematoma C. haemangioma. Calcification of more irregular configuration and texture A. or oval 10. Orbital phleboliths: helical form in veinssmooth. * Pseudo papilloedema* * Enlarged blind spot arcuate scotomas. 1. also called 'optic disc drusen'. Hemangiopericytoma 5. round. and macular edema 28. Mucocele 8.Retinopathy is a well-characterized side effect of treatment and includes cotton-wool spots. dermoid cyst. fibrous dysplasia and osteoblastic metastasis. intraretinal and pre-retinal hemorrhage. • optic nerve-sheath meningioma. • Intraorbital calcification : in orbital varix. ect) • Asymmetrical : in extra-conal lesions (rhabdomyosarcoma.. Plexiform neurofibroma D. Retinoblastoma 12. intracranial • extension of orbital tumours etc. POZITIVEBITS Calcifications In adults the most common intraorbital calcifications occur at the tendinous insertion of the ocular muscles. Other common calcifications are at the optic nerve head within the eye. Atheromatous plaque B. Optic disc Drusens D. • Superior orbital fissure enlargement : in • infraclinoid carotid aneurysm • intracavernous aneurysm. * Glittering particles in the surface of optic disc. Organized hematomas of the orbit 11. • Decreased or destruction : in malignant tumours. Monkeberg sclerosis C. Chronic inflammatory and parasitic disease of the orbit 4. etc. Cysticercosis B. or surgical) 6. Trauma (perforating. Retinal detachment E. Tuberculosis 2. Secondary to metabolic-endocrine disturbances such as hyperparathyroidism or hypervitaminosis D.) • Change in bony density : • Increased : in meningioma. Intraocular melanoma Ans (B) REF OHC CONSULTANT OH BOOK-PAGE99 • Enlargment of the orbit • Symmetrical : in intra-conal lesion (optic nerve glioma. Which of the following classically does not have calcified foci ? A. Retinoblastoma B. Recurrent iritis and keratitis D. Retrolental fibroplasia Calcifications can also be found in intraorbital meningiomas. nonperforating. etc. Persistent hyperplastic primary vitreous C. gliomas Orbital calcifications are common incidental findings that occur in characteristic locations POZITIVE 2013 20 . Toxoplasmosis E. • Optic canal enlargement : in optic nerve glioma Optic N – Drusen * Refractile deposits within the substance of optic N head. Myositis ossificans 9. In children calcifications in the globe means retinoblastoma until proven otherwise even if it is bilateral. Intraocular calcifications following A. • retinoblastoma. * Ultrasound or CT scanning is sensitive for detection of buried optic disc drusen because they contain calcium. Paget’s disease.
Which of the following is not related to conjuctivitis ? [AIIMS MAY 2013] A. which appear as punctate calcifications near the optic disc on crosssectional images. 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. Leukocoria with pseudohypopyon B. Pars plana vitrectomy Ans (b) REF OHC POSIGOLD 31. are a cause of Phthisis bulbi. a shrunken globe with ocular calcification or ossification. Bilateral Lamellar Tarsus Rotation D. the most common cause of spontaneous orbital hemorrhage * cavernous hemangioma . optic drusen. including infection. Most common presentation retinoblastoma ? [AIIMS MAY 2013] A. * MC symptom is leukocoria * MC Sign is In small lesions: simulates endophthalmitis specially when endophytic In large lesions: exophytic simulate Coat’s disease.Frequently encountered calcifications include trochlear calcifications. Trochlear calcifications . scleral plaques. Visual function is spared B. Phacoemulcification B. inflammation. and phthisis bulbi. 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. An ophthalmologist working in district hospital is likely to perform following surgical procedure most commonly? [AIIMS MAY 2013] A. is the sequela of a wide variety of pathologic ocular processes. Leucokoria with Heterochromia Iridis D. DCR C. Multiple Non heritable solitary * Etiology: Absense of RB genes (due to mutation) as it is a tumor suppressor gene (TSG). POZITIVE 2013 21 . Corneal infilteration D. Pupil is spared C.most common benign orbital tumor in adults * Choroidal metastases are the most common ocular malignancies in adults 29. Ans (c) REF OHC Consultant 30. Leucokoria with Hyphema C. and trauma * Orbital varices.
optic nerve meningioma. Which of the following bone does not form floor of the orbit ? [AIIMS MAY 2013] A. neuro -fibroma. Ans (b) REF OHC CONSULTANT-PAGE 104 OPHTHAL BOOK • MYOPIA OF ATLEAST 6D • Choroidal neovascularisation • Tigroid fundus • Posterior retinal detachment 36. the orbital surface of zygomatic bone and the orbital process of palatine bone. Regarding Myopic degeneration which of the following is True – [AIIMS MAY 2013] A. * The most common primary tumors are hemangioma. which of the following will be the most important investigation in this scenario ? [AIIMS MAY 2013] A. Most common intraocular metastasis in females are from which of the following primary tumor ? [AIIMS MAY 2013] A. Serum ACE levels B. Breast B. • The Lateral wall -orbital process of zygomatic and the orbital plate of greater wing of sphenoid. Ethmoid D. adenoid cystic carcinoma.frontal process of maxilla.orbital plate frontal bone and the lesser wing of sphenoid.6 D myopia D. lung carcinoma. optic nerve glioma. and benign mixed tumor of the lacrimal gland. * Metastatic tumor to the orbit occurs frequently in breast carcinoma. Serum Creatinine levels Ans (B ) 35. It is seen in < . Cervix D. Palatine Ans (c) REF • • • • • • • OHC CONSULTANT MKT POZIGOLD The roof (superior wall) . progressive proptosis. lacrimal bone.32. The medial wall . It is seen more commonly in males than in females B. Zygomatic B. and lymphoma. Quantiferon TB assay D.orbital surface of maxilla. Serum Homocysteine levels C. Myopic degeneration can lead to retinal detachment C. 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. orbital plate of ethmoid and a small part of the body of the sphenoid. Biopsy taken from chalazion shows [AIIMS MAY 2013] A) lipogranulomatous B) inflammatory C) suppurative granulomatous • 33. lymphangioma. Ovary C. 34. Endometrium Ans (a) • • • • • REF OHC OH BOOK PAGE 101 Tumors of the orbit cause painless. Maxilla C. POZITIVE 2013 22 . The floor (inferior wall) . dermoid cyst.
Recently.cause? [AIIMS MAY 2013] a.However. POZIGOLD. it has been suspected that leukotriene receptor antagonists might be associated with suicide Pathology 38. an enzyme involved in leukotriene synthesis. amniotic fluid embolism d.Chalazion of lid is (AIIMS MAY 2008) a) Caseous necrosis b) Chronic nonspecific inflammation c) Chronic lipogranulomatous inflammation d) Liposarcoma Ans (c) Biochemistry 37. PPH c.Ans ( a) REF OHC CONSULTANT POZIGOLD • A chalazion also known as a meibomian gland lipogranuloma. in chronic cases. usually on the upper eyelid. infertility diagnosis is [AIIMS MAY 2013] a) TB endometritis b) c) d) Ans (a) 41. 30 yr old Poor patient from hilly area with h/o low grade fever.. the chalazion does not respond to this conservative treatment and must be incised and curettage. is expressed in the brain and has been associated with Alzheimer's disease and depression. Shock after normal labour.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. Which is not seen in Apoptosis [AIIMS MAY 2013] a) Cell shrinkage b) Nuclear condensation c) Inflammation d) blebs Ans (c) REF OHC. uterine inversion b. is a cyst in the eyelid that is caused by inflammation of a blocked meibomian gland. Suicidal enzyme is [AIIMS MAY 2013] A) 5 lipoxygenase B) cycloxygenase C) Aldolase D) hydrolase Ans (A) 5-lipoxygenase (5-LOX). • Initial treatment for a chalazion in the acute stage is hot compresses . pain shock POZITIVE 2013 23 . • Recurring chalazia in the same area may sometimes be a symptom of sebaceous cell carcinoma.
and as an abortifacient. OH POZIGOLD BOOK. CONSULTANT. Diagnosis is [AIIMS MAY 2013] a) Treponemal infection b) Chlamydia c) Gonococcal d) ans b REF43. The study which involved a substantial number of patients receiving either 24 POZIGOLD.Zidovidine reduces vertical Transmission by 70%.Cesarian – in women with viral load > 1000 copies/ml. . Misoprostol is also used to prevent and treat postpartum hemorrhage. Ans (b) REF OHC.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 .Ans-a REF OHC POSIGOLD 42. to treat missed miscarriage. Orally administered misoprostol at a dosage of 600 ug was tested versus oxytocin 10iu in a large randomised controlled study.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. to induce labor.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. 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. Female presented with 3X3 cm relatively painless lesion on vulva. 45. 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 .
A 5yr child burnt with boiling water. and because its use in pregnancy has been associated with birth defects 46. 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.chart used to estimate the percentage of skin burnt to the total body surface area in children 50.47 Ans (c) REF OHC POZIGOLD 48. 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 . 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.oral or intravenous oxytocin showed that misoprostol is marginally less effective for this purpose. 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. buttock. In patients with Marfan syndrome or bicuspid aortic valve. A child had circumferential burn ofBOTH thighs. and those with an aneurysm that has increased by >1 cm per year. those in whom the ascending aortic diameter is >5. 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 . ascending thoracic aortic aneurysms >5 cm should be considered for surgery. The risk of rupture increases with the size of the aneurysm: the 5-year risk for aneurysms <5 cm is 1–2%. the mortality rate of emergent operation is 45–50% 49. Percentage of burn is [AIIMS MAY 2013] a) 0.5–6 cm or the descending thoracic aortic diameter is >6. whereas it is 20–40% for aneurysms >5 cm in diameter. the operative mortality rate approximates 1–2%. With careful preoperative cardiac evaluation and postoperative care. After acute rupture. Surgery 47.37 b) 0.face n scalp. upper pole is last to leave. Percentage of death in emergency AAA operation [AIIMS MAY 2013] a ) 40% b)10% c)5% D)1-2% POZITIVE 2013 25 .5-7 cm.
uterus. Typically.c) 0.XX. Ovulation usually occurs. [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.27 d) 0. 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 . A neonate with meningomyelocele awaiting surgery. resulting in a missing uterus and variable malformations of the vagina.64 Ans (b) REF OHC CONSULTANT 51. the vagina is shortened and intercourse may in some cases be difficult and painful.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. and vagina. 19 yr old femal with primary amenorrhoea with axillary n pubic hair but absent vagina n uterus. Renal anomalies occur in 25-35% of females with mullerian agenesis. Medical examination supported by gynecologic ultrasonography demonstrates a complete or partial absence of the cervix. Her chromosome constellation will be 46. 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).
they have severe underandrogenization and female external POZITIVE 2013 27 OHC POZITIVE POZIGOLD 54. 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. • Patients with AIS have a 46. Androgen resistance syndrome requires gonadectomy because there is risk of gonadoblastoma in the dysgenetic gonads. cause breast cancer (in adult female) . but because of the lack of androgen receptor responsiveness. neuroblastoma Most Prostate cancer (in adult common male).XY. • 1. Whether this should be performed in early childhood or after completion of breast development is controversial. malignant carcinoid. 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. fallopian tubes or ovaries. mucinous adenocarcinoma of GI tract.• genitalia. Complete AIS (CAIS): completely female body except no uterus.. • A person with complete androgen insensitivity syndrome (CAIS) has a female external appearance despite a 46XY karyotype and undescended testes. breast. ??????? 53.CONSULTANT Osteoblastic Bone Metastases = Evidence of slow –growing neoplasm Primary Prostate. pancreas.XY karyotype. 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. of bladder. • 46. XY karyotype. • lack of androgen receptor responsiveness • severe underandrogenization and female external genitalia. The absence of pubic and axillary hair distinguishes them clinically from patients with müllerian agenesis. medulloblastoma. lymphoma. a condition once called "testicular feminization" • a person with Androgen Insensitivity Syndrome is a phenotypic female with a chromosomal genotype of 46.
Sporadic disease. thyroid cancer.worldwide mannopyrano syl phosphate alfa-2. Boggy swelling with easily pluckable hair.Osteolytic bone Metastases Most common cause : Neuroblastoma (in childhood). 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).. Microbiology 57.propensity to acetylneuram cause inic acid hyperendemic disease alfa-2. 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.sporadic cases 2-deoxy-D.Sporadic disease glucopyranos POZITIVE 2013 28 .on gram staining-Gram negative coccoid seen. A patient presented with corneal ulcer n later on perforation. lung cancer (in adult male). galactopyran outbreaks of osyl-Ndisease acetylneuram associated with inic acid mass gatherings. 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.Small outbreaks acetylneuram and sporadic inic acid disease 4-O-alfa-D.9-O.8-N. kidney.
Person has respiratory tract infection. fortuitum M.g.kansassi b) chenolae c) fortuitum d) abcessicum Ans (A) Reference-OHC.730. 4 year old boy with high fever and drooling of saliva-Xray –thumb print signdiagnosis [AIIMS MAY 2013] A) H.gram-negative diplococci that typically utilize maltose and glucose 61. kansasii M. avium M. or synovial fluid) or from skin lesions. Because M. What would be done for diagnosis? [AIIMS NOV 2009] a) Pus for culture b) KOH mount c) Biopsy Ans (b) 58. • *Oxidase-positive.A 7 year old boy with boggy swelling of the scalp with multiple discharging sinuses with cervical lymphadenopathy with easily pluckable hair. Consultant. ulcerans M. Rapidly growers Slow-growers M.Ans (a) REF OHC CONSULTANT POZIGOLD OH BOOK PAGE 237 POZIGOLD. OPERATION HARRI BOOK PAGE-732.influenza B) Pneumococci C) streptococci D) staphylococci Ans (a) REF OHC CONSULTANT OH BOOK-PAGE 644 .. meningitis-on microscopic examination gram negative diplococci. CSF. 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. Which is a slow grower [AIIMS MAY 2013] a) m. tuberculosis typically takes ≥ 2 weeks to grow. abscessus M. marinum 59. • *Meningococci grow best on MuellerHinton or chocolate blood agar at 35˚C in an atmosphere that contains 5–10% CO2. 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.oxidase positive [AIIMS MAY 2013] a) pseudomonas b) meningococci c) Gonococci d) pneumococci POZITIVE 2013 29 . blood.POZIGOLD • From normally sterile body fluids (e. chelonae M.
615 Diagnosis * The most useful clinical finding is the petechial or purpuric rash. and nodules are seen. Disease Multibacillary Hansen’s disease (lepromatous leprosy) Clinical features Early symptoms: Several lesions such as plaques. * A Gram's stain of CSF reveals intra. CSF. 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. 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.. blood. macules. Nasal congestion. 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.gram-negative diplococci * that typically utilize maltose and glucose. Lesions have a characteristic inverted saucer like appearance. papules. * From normally sterile body fluids (e. or synovial fluid) or from skin lesions. and nodules are seen. Oxidase-positive.g. leprosy macules. * Meningococci grow best on Mueller-Hinton or chocolate blood agar at 35˚C in an atmosphere that contains 5–10% CO2.Ans (b) REF OHC CONSULTANT POZIGOLD OH BOOK-PAGE. POZITIVE 2013 30 . papules. 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 extracellular organisms in ~85% of patients. 62.
• 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. It is primarily suited to people who have conductive hearing losses. or diphtheria toxoid).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.shea Ans (a) 65.Lef ear masss coming the posterior part-diagnosis [AIIMS MAY 2013] A) CSOM B) Keratosis obturans C) D) 63.J. Patient complains of left ear pain. ENT 64.Right ear normal.On examinationtympanic membrane normal. bypassing the external auditory canal and middle ear. C. 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 . The hearing aid can be used once osseointegration is complete. Father of neurootology 2013] a) House b) lempard c) hayes martin d) John. and W135 polysaccharides conjugated to diphtheria toxoid was initially recommended for all children >11 years of age.Deformation of the fingers and toes results due to painless repeated trauma. tetanus toxoid. EXITING 18th • The first quadrivalent conjugate meningococcal vaccine containing A. 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. 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. Y. 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 .
affects females more .injury to? [AIIMS MAY 2013] a. Seizures d. ACL posterior part c. 2 years old child with rickets is on calcium supplements and has a foot deformity. Which of the following cartilage forms complete cartilagenous ring ? [AIIMS MAY 2013] A. 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. Epiglottis B. 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. When should a decision to undertake corrective surgery be undertaken? [AIIMS MAY 2013] A. Hockey player. When bone specific alkaline phosphatase is normal D.Ans (b) Ref-Consultant 67. ACL anterior part Ans () 70. mental retardation c. When vitamin D levels turn to normal B. When growth plate healing is seen radiographically C.. Cricoid C. medial meniscus b. When serum calcium becomes normal Ans (c) REF OHC POZIGOLD-NOV-AIIMS 2012 69. Thyroid Ans (b) REF OHC POZIGOLD Ortho 68. Cuineform D. macrocephaly b.Traction systems and their uses.
They typically have no verbal skills. the exclusive source of noradrenergic innervation to the cerebral cortex and hippocampus Development is typically normal until 6–18 months. People with Rett syndrome are prone to gastrointestinal disorders and up to 80% have seizures. and acquired deceleration in the rate of head growth (resulting in microcephaly in some) is seen.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. purposeful hand use is lost. Her HC is 42 cm. 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). autistic-like behavior may be seen. 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 about 50% of individuals affected are not ambulatory. 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. Early on. Scoliosis. breathholding. 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. The genetic loss of MECP2 changes the properties of cells in the locus coeruleus. which are a spectrum of psychological conditions that are characterized by abnormalities of social interaction and communication that pervade the individual's functioning. impaired language and communication skills. and constipation are very common and can be problematic. when language and motor milestones regress. Hand stereotypes are typical. 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). or sighing are seen in many. Her birth record shows HC of 35 cm. 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". and breathing irregularities such as hyperventilation. growth failure.
The gene for RS is located on the X chromosome (MECP2 gene). 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. large or protruding ears. Injur D.what would be the reason for above clinical condition? [AIIMS MAY 2013] A. RS is a genetic disorder of neurodevelopment arrest rather than a progressive process. Diagnosis is [AIIMS MAY 2013] a) neuroblastoma b) Wilms tumor c) angiomyolipoma d) ARPKD Ans (b) OHC CONSULTANT Wilms' tumor or nephroblastoma Pathologically. Radial n. 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. POZITIVE 2013 34 . After giving iv antibiotics there was sudden pulseness. Anesthesia Patient with normal Preanaesthetic checkup was connected to monitor in OT.• • • • • • • • • coded by the FMR1 gene. A person found unconsious.Next step is [AIIMS MAY 2013] a) Chest compression b) call ambulance c) Two round of breaths d) Ans (b) Anatomy 73. Injury C.peroneal n.lying in right lateral position is having bruises over his right scalp. on investigation calcified mass in right side id abdomen seen. A child prsented with pain abdomen on right side. 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 side of hip. and low muscle tone.right knee. right upper limb. sciatica n. Injury B. a triphasic nephroblastoma comprises three elements: • blastema • mesenchyme 72. Injury Ans () Pediatrics 75. A period of developmental stagnation is followed by a period of regression. flat feet. A slight increase of limbs of right side is seen. An early clinical feature is deceleration of head growth that begins when the individual is aged 2-4 months. prominent characteristics of the syndrome include an elongated face. Patients with Rett Syndrome initially have seemingly healthy development. Trigeminal n. larger testes (macroorchidism).. This seemingly anomalous pattern of inheritance is referred to as the Sherman paradox.
Kluver Bucy syndrome in young children. altered sexual behavior. b) Short soft palate. They were also less fearful of things that would have instinctively panicked them in their natural state. Though the monkeys could see. E. The stroma may include striated muscle. klebseilla D. such as humans or snakes. Contrary to popular belief. This aspect of change was termed "placidity". Isolated hemihypertrophy. mesangial renal sclerosis. emotional changes. the monkeys became dulled. the findings did not show an increase in sexual behavior ("hypersexualism"). Characteristic is the presence of abortive tubules and glomeruli surrounded by a spindled cell stroma. 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. The amygdala has been a particularly implicated brain region in the pathogenesis of this syndrome. Denys–Drash is characterized by the triad of pseudohermaphroditism. heterosexual acts and homosexual acts. c) Small tongue d) . 77. they were unable to recognize even previously familiar objects. [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. Emotionally. This caused the monkeys to develop visual agnosia. Even after being attacked by a snake. and their facial expressions and vocalizations became far less expressive. stromal and epithelial derivatives. who removed the temporal lobe bilaterally in rhesus monkeys in an attempt to determine its function. however. hypermetamorphosis and oral tendencies. fibrous tissue Mutations of the WT1 gene on chromosome 11 p 13 are observed in approximately 20% of Wilms' tumors. bone. they would willingly approach it again. cartilage. mainly Wilms tumor and hepatoblastoma 76. or their use. fat tissue. In INDIA neonatal sepsis not commonly caused by – [AIIMS MAY 2013] A.epithelium Wilms' tumor is a malignant tumor containing metanephric blastema. The monkeys indulged in indiscriminate sexual behavior including masturbation. They would examine their world with their mouths instead of their eyes ("oral tendencies") and developed a desire to explore everything ("hypermetamorphosis"). Infant can breath simultaneously because? [AIIMS MAY 2013] a) High larynx. Staph aures B. coli C. POZITIVE 2013 35 The syndrome is named for Heinrich Klüver and Paul Bucy. Group B streptococci Ans (b) REF OHC POZITIVE 78. now called isolated hemihyperplasia. is a congenital overgrowth disorder associated with an increased risk for embryonal tumors.
. shiny.Alfa feto protein and LDH normal. discrete and uniform. the initial lesions are localized. Patient presents with left painless scrotal mass. It is sometimes referred to by dermatologists as "mini lichen planus".diagnosis??????. After mastoidectmy-pt developed vertigopure tone audiogram revealed sensorineural deafness [AIIMS MAY 2013] a) petrositis b) suppurative labrynthitis c) d) 36 POZITIVE 2013 . and flexor aspects of the upper extremities Psychiatry 80. Pin head size lesions on hand and penis. and remain so. 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... to the chest. [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..Ans (a) OHC POZIGOLD-NOV-2012 Dermatology 79. Occasionally. flattopped. abdomen.. pale flesh-colored or reddishbrown papulesthat may appear as hypopigmented against dark skin. 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.urine examination shows microscopic hematuria likely diagnosis [AIIMS MAY 2013] a) Seminoma b) cystitis c) RCC REF-OHC. CONSULTANT 82. glans penis. According to Hean Piaget cognitive developmental theary 'Out of sight is out of mind' belongs to [AIIMS MAY 2013] A) sensiromotor stage. although protracted itching may occur in some cases..
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 .000 B) 20.45.He has partially compensated [AIIMS MAY 2013] a) Metabolic acidosis b) Resp.000 D) 40. As per NPCB . Salbutamol b.000 C) 30.1x0. A patient having PCO2 value of 30mmHg. 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. 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.000 Ans (b) REF-OHC-SPM 89. Metaprotenolol d.5x0.1=100 • P=prevalence • Q=1-prevalence • D=range 88.PO2 105mmHg pH-7. Pinbuterolol Ans (a) REF-Consultant 87. 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 • =4x0.5/0. Which of the following is used subcutaneously in the treatment of Asthma attacks [AIIMS MAY 2013] a. These have been grouped as per the types of surveillance into • Regular surveillance Ans (b) Ref-Consultant 85. Terbutalin c.no of vision centres to be present in the country is [AIIMS MAY 2013] A) 10.alkalosis c) Resp acidosis d) Metabolic acidosis Ans (b) REF OHC POZIGOLD-AIIMS MAY 2012 86.Ans (b) 83.
Menigoencephalitis / Respiratory Distress. Tobacco. HIV / HBV. Tuberculosis Vaccine Preventable Diseases: 5. Water Borne Disease: 2. JE. Nutrition.Physical Activity. Polio Other Conditions: 7. Blood Pressure. Type Gene/protein Description hepatocyte MODY 1 nuclear factor . 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. Plague Unusual Clinical Syndromes: 9. 1α 30%–70% cases insulin MODY 4 promoter factor-1 Mutations of the IPF1 homeobox (Pd x1) gene. 5%–10% cases. including atrophy of hepatocyte the pancreas and MODY 5 nuclear factor several forms 1β of renal disease. < 1% cases.Sentinel surveillance Regular periodic surveys Regular Surveillance: Vector Borne Disease: (Other vector-borne diseases under this group) 1. neurogenic MODY 6 differentiation 1 MODY 7 Kruppel-like factor 11 MODY 8 Bile salt POZITIVE 2013 38 . i. 30%–70% cases. 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. Blindness & any other unusual Health condition. inherited from any of the parents) disrupting insulin production.WaterQuality 12.Anthropometry. 4α MODY 2 glucokinase . 90. Acute Diarrhoeal Disease (Cholera) Respiratory Diseases 3. Malaria . 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. Dengue. HCV Other Conditions: 11. Mutations of hepatocyte the HNF1α gene MODY 3 nuclear factor (a homeobox gene). Associated with pancreatic agensis. Road Traffic Accidents (Link up with Police Computers) Other International Commitments 8. Chikungunniya . Hemorrhagic fevers and other undiagnosed conditions Sentinel Surveillance: Sexually transmitted diseases / Blood borne: 10. Typhoid: 4. Measles Diseases under Eradication: 6. Outdoor Air Quality (Large Urban Centres) Regular Periodic Surveys: NCD Risk Factors: 13.e. Leishmaniasis.
Female sex may also be a risk factor independent P Commonest Dementia P Microscopy .occurs late [early in DLB] • P MRI – atrophy of hippocampus • P Hypometabolism of Tempero.Neuritic plaque with Aβ amyloid .Silver staining neuro fibrillary Tangle P Anosognosia . 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 .Unaware of these difficulties P Language .10% AIIMS Nov 2011 • patients are unaware of these difficulties (Anosognosia). as well as lateral and medial parietal lobes and lateral frontal cortex. 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 . gene. • • • • • • • • • • • • • • MODY 10 INS Mutated B-lymphocyte MODY tyrosin kinase. • .parietal cortex • P Risk Factors • . MODY 3 (also known as HNF1A-MODY) is caused by mutations of the HNF1-alpha. Usually associated with neonatal diabetes. Rare < 1% cases.fluency –last P Delusions common P Capgras syndrome-OCCURS LATE HERE . whereas levels of hyperphosphorylated tau protein are elevated.naming – affected first . • Apraxia • Aphasia.Age. atrophy is distributed throughout the medial temporal lobes. Positive family History POZIGOLD-Alzheimer’s disease. Mutations in the insulin gene. 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. 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.an early and prominent feature • Simple calculations and clock reading become difficult (ACALCULIA) • CSF A beta 42 levels are reduced.dependent lipase MODY 9 PAX4 Pax4 is a transcription factor. a homeobox gene on chromosome 12. which is BLK 11 also present in pancreatic islet cells.
Medial basal seg of RLL Ans (a) 97. Findings on MRI include the following: • Vesicular stage: Cysts follow the CSF signal. Oedema in CT absent in which stage of Neurocysticercosis? [AIIMS MAY 2013]3 A. nodular parenchymal calcifications are seen MRI is the imaging modality of choice for neurocysticercosis. which part of lung is involved? [AIIMS MAY 2013] A. A 2 days old neonate presented wit seizures. Area not involved in HIV? [AIIMS MAY 2013] a. 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. Apical seg of RLL D. and the cyst wall enhances • Nodular-granular stage: The cyst wall thickens and retracts. there is a decrease in edema. Granular nodular stage D. Medial seg of RML B.MRI Ans (B) REF-CONSULTANT 96. there is surrounding edema. Lateral seg of RML C. depending on the stage of evolution of the infestation: • Vesicular stage (viable larva): Hypodense. 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. Calcified nodular stage Ans (D) CT findings vary as follows. wat is the next investigation? [AIIMS MAY 2013] A.skull skiagram B. Homogenous opacity in right lung with obscured right cardiac silhouette. with no edema and usually no enhancement • Colloidal stage: Cysts are hyperintense to the CSF.ultrasound C. T2 hyperintense scolex may be seen.Ans (b) 94. Colloid stage C. cingulate gyrus d. and nodular or ring enhancement is present 95. Vesicular stage B. especially for evaluation of intraventricular and cisternal/subarachnoidal cysts.CT d. collapsed ventricles. caudate nucleus b. globus pallidus c. cerebral white matter POZITIVE 2013 40 .
00. • The elimination halflife of lithium averages 20 to 24 hours. Half-life in geriatric patients and patients with impaired renal function is increased. A 57 YR OLD MALE PRESENTING WITH ICSOL.000 Ans (C) 100. Volume of distribution approximates to total body water.00. • Lithium administration prolongs both depolarizing and non-depolarizing neuromuscular block.000 iu d) 3. • hypertrophy is apparent in the basal ganglia.5 Peak plasma levels usually occur 1–4 h after a single dose.Ans (D) • HIV is associated with pathological changes in mainly subcortical and frontostriatal areas of the brain.HOW MANY DAYS PRIOR TO GIVING IT LITHIUM SHOULD BE STOPED.. • reduced functional connectivity between the left caudate and globus pallidus (basal ganglia output nucleus).000iu b) 1. LITHIUM POTENTIATES NON DEPOLARISING MUSCLE RELAXANTS.[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. deep white matter. Flavin mononucleotide Flavincontaining monooxygenase L O Oxidase Oxidoreductase Q Quinoneinteracting membrane-bound POZITIVE 2013 .INHALATIONAL AGENT OF CHOICE [AIIMS MAY 2013] a) SEVOFLURANE b) ISOFLURANE c) DESFLURANE d) HALOTHANE Ans (a) REF-CONSULTANT 102.. 36 and 40 to 50 .the striatum being the structure most notably affected 98. • there was hypoactivation of the left caudate • fronto-striatal system. 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. VitA prophylaxis given to postpartum women [AIIMS MAY 2013] a) 50. especially the putamen. • It is suggested that lithium be omitted 2-3 days prior using a muscle relaxant 101.000iu c) 2. including the basal ganglia. Its action appears to be synergistic with non-depolarizing neuromuscular blocking agents and additive with depolarizing neuromuscular blocking agents. 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. and hippocampal regions.00.
The acronym "RT-PCR" commonly denotes reverse transcription polymerase chain reaction and not real-time PCR. • Enzyme: hexokinase. External genu of facial nerve medially 2. Boundaries of facial recess. Multiplication of RNA b. 104. Land marks used to identify this region: 1. Real Time PCR is used for [AIIMS MAY 2013] a. All except? [AIIMS MAY 2013] a. Tympanic membrane anteriorly and laterally. This surgical approach to the middle ear cavity is known as facial recess approach. 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. Uses of facial recess approach: 1. Method to differentiate entry and exit wounds [AIIMS MAY 2013] a) kennedy phenomenon b) c) d) ans a Ref-CONSULTANT 106. Multiplication of Proteins d. which is used to amplify and simultaneously quantify a targeted DNA molecule. Used to reach hypotympanum of middle ear 2. 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. 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. Chorda tympani laterally 4. thus. Hence this approach can be used to perform decompression of horizontal division of facial nerve. To know how much amplification of DNA has occurred Ans (d) In molecular biology. Chorda tympani nerve always run medial to the tympanic membrane.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. Used to place cochlear implant electrode into the cochlea via the round window. 3. also called quantitative real time polymerase chain reaction (qPCR) or kinetic polymerase chain reaction is a laboratory technique based on the polymerase chain reaction. It has a low Km for glucose. Multiplication of specific segments of DNA c. Short process of Incus b. real-time polymerase chain reaction. Chorda tympani c. • This reaction requires energy and so it is coupled to the hydrolysis of ATP to ADP and Pi. 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. Fossa incudes superiorly POZITIVE 2013 . 105. once 42 103. Horizontal portion of facial nerve can be accessed via this approach. Facial Nerve d.
. Contraindicaited in epileptic seizure [AIIMS MAY 2013] a) Ketamine b) succinyl choline c)propfol d) ANS A Ref CONSULTANT 111. 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.nec c.co2washout b. PDA all except [AIIMS MAY 2013] a. Which of the following cancer can be prevented by preserving the food in refrigertor. Malaria and other diseases • Goal 7: Ensure Environmental Sustainability • Goal 8: Develop a Global Partnership for Development POZITIVE 2013 43 . pulmonary hemorrhage ans a Ref-OHC POZIGOLD 108. Ans (b) 110. • Enzyme: phosphofructokinase.boundingpulse d.?? [AIIMS MAY 2013] A oesophagus B stomach C colon D..OHC.6bisphosphate. This allosteric enzyme regulates the pace of glycolysis.glucose enters the cell. 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. it gets phosphorylated.OH BOOK 109. • This step is irreversible Reaction 3 hydroxyl group on C1 forming fructose-1.. • 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. • This is the second irreversible reaction of the glycolytic pathway 107.
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. both atria. 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. pulmonary artery. OHC 119. Insulin resistance in hepatic injury due to [AIIMS MAY 2013] a) damaged hepatocyte decreased sec of insulin b) c) d) 118. valves of the heart. desert areas the norm could be relaxed to one ASHA per habitation. She should be a literate woman with formal education up to Eighth Class. Most important function of MHC is [AIIMS MAY 2013] a) Antigen presenting b) c) d) ANS A Ref: Consultant. several structures can be evaluated and imaged better with the TEE. ASHA should have effective communication skills. In adults. and coronary arteries. TEE has a very high sensitivity for locating a blood clot inside the left atrium 116. A female presented with recurrent abortions.113. deficiency of which is seen [AIIMS MAY 2013] a) protien s b) Thrombin c) plasmin d) factor XIII Ans (a) 114. pain in calves. including the aorta. 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. especially of structures that are difficult to view transthoracicly (through the chest wall).CONSULTANT AccreditedSocial Health Activist (ASHA)???? AccreditedSocial Health Activist (ASHA) general norm will be ‘One ASHA per 1000 population’.In tribal. hilly. must be primarily a woman resident of the village – Married/Widow/Divorced’ and preferably in the age group of 25 to 45 yrs. ASHA would be an honorary volunteer and all POZITIVE 2013 44 . leadership qualities and be able to reach out to the community. The explanation for this is that the heart rests directly upon the esophagus leaving only millimeters that the ultrasound beam has to travel. 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. atrial septum.
‘ba’) 9 months Bisyllables (‘mama’. 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 . 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’. 120.would not receive any salary or honorarium. like a pellet.OHC-MKT Language Cooing. 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.
Combination therapy for <50 yrs of age. C. No treatment required in asymptomatic cases. . in 130. desmin b.121. 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. 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. A patient had seizure after injection of sulfonamide. 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. urgent treatment is to be done. 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. D. Ans (a) REF CONSULTANT 125. For leucocytosis. Marker for rhabdomyosarcoma? [AIIMS MAY 2013] a. cannot be given in hyperthyroidism Ans () 129. d. chronic HBV infection c. acute infectious hepatitis Ans (c) REF • • OHC CONSULTANT postive. 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. True about iodine except? [AIIMS MAY 2013] a. Treatment is curative. 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. HBsAg and HBeAg Diagnosis? [AIIMS MAY 2013] a. past HBV infection b. B. causes iodism b. Synaptophysin c.
Itraconazole c) Voriconazole d) Ans (a) REF OHC OH book PAGe 875 132. urinary tract Chromogranin NET Cytokeratin Broad range of carcinomas and sarcomas Desmin Sarcomas (smooth or skeletal muscle).OHC 134.MKT Detectable Tumor Type Antigen Alpha-fetoprotein Germ cell and (AFP) trophoblastic tumors. Which dont utilise ketone bodies [AIIMS MAY 2013] a) Brain b) RBC c) d) Ans b REF CONSULTANT 136. 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 . 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. RHO kinase inhibitor [AIIMS MAY 2013] a) Fasudil b) Ranalozine c) d) ans a Ref-OHC POZIGOLD –AIIMS NOV-2012 133.Ans (a) REF-Consultant.OH BOOK PAGE. pancreas. corpus uteri (connective tissue part) 131.Marrow plasmacytosis > 10% . cervix antigen (CEA) uteri. Drug for mucormycosis? [AIIMS MAY 2013] a. 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. breast.OHC.Serum / urine M component POZITIVE 2013 47 .POZIGOLD MULTIPLE MYELOMA Diagnosis * Triad . ovary.Lytic bone lesions . hepatocellular carcinoma Alpha-1Liver antitrypsin Carcinoembryonic Gut. Amphotericin B b.CONSULTANT. lung.
skin d. * Bone marrow clonal plasmacytosis > 10% or plasmacytoma. 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. Pulmonary pleura b. dexa c.1 90 to 109 Average 50. * Myeloma-related organ or tissue impairment.7 < 70 Mentally 2.can lead to RDS c. anococcygeal raphe Ans d REF-CONSULTANT. Lady with osteoporosis is bisphophonate thrapy which is best investigation to see her bone condition [AIIMS MAY 2013] a. 137.amniotic fluid embolism Ans-d 143. Nonsecretory myeloma * No M protein in serum and/or urine with immunofixation. ct scan ANS b 140. thoracodorsal fascia c. intercostal muscle Ans A 138. Which does not contribute to anorectal ring [AIIMS MAY 2013] a. Averge iq is [AIIMS MAY 2013] a. In pleural tapwhich structure in not pierced [AIIMS MAY 2013] a. int sphinter d. amyloidosis.111 d.develops the respiratory muscles d.70 b. anemia: bone lesions: symptomatic hyperviscosity.80 ANS B REF-CONSULTANT-POZITIVE PSYCHIATRY BOOKLET-PAGE-28 IQ Score Descriptive Level % of Population > 130 Very superior 2. puborectalis b.2 challanged 141.2 120 to 129 Superior 6. * Myeloma-related organ or tissue impairment (end organ damage) (ROTI): Calcium levels increased: renal insufficiency . xray b.* Bone marrow plasma cells are CD138+ and monoclonal. recurrent bacterial infections (>2 episodes in 12 months). * No myeloma-related organ or tissue impairment.1 70 to 79 Border line 6.POZIGOLD 139. Asymptomatic myeloma (smouldering myeloma) * M protein in serum >30 g/L and/or * Bone marrow clonal plasma cells >10%. Orphan drug is [AIIMS MAY 2013] a) for rare diseases b) c) d) POZITIVE 2013 48 . 90 c.0 80 to 89 Dull normal 16.7 110 to 119 Bright normal 16. external sphincter c.increases towards end of term b.
A PREGNANT FEMALE 50 YEARS OLD WITH type 2 dm and hyperlipidemia.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.Ans a REF-OHC-POZIGOLD 144.Liver biopsy will reveal [AIIMS MAY 2013] a) auto immune hepatitis b) NASH c) d) 151. For viewing root angulations following angles can be used [AIIMS MAY 2013] a) 90 b) 90. Anganawadi centres.45.Liver biopsy might reveal [AIIMS MAY 2013] a) acute liver cirrhosis b) NASH c) peliosis hepatitis d) autoimmune hepatitis ans b 152. cachexia * 30% * Endocrine * 12% * PTH-rP(squamous) * SIADH(small cell) * ACTH 153.d REF-Consultant. A 60 yr old elderly smoking 3 packets of cigarette per day developed features of central obesity with weak peripheral extremities.OH BOOK PAGE 392 System Character * General * Anorexia.POZIGOLD 148. Social pathology [AIIMS MAY 2013] a) b) c) d) 147. Hot spot on scan [AIIMS MAY 2013] a)adenolymphoma b)adenocystic carcinoma c) d) ANS-B REF-OHC.45 c) 90. 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.Which of the following causes this? [AIIMS MAY 2013] a) Large cell variant b) Squamous cell Ca c) AdenoCa d) Small cell Ca Ans. 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 .110 d) 149..OHC. A 4 year old child suffering from vomiting after being treated for a viral illness.
type C: subacute/juvenile Niemann–Pick disease type D: Nova Scotian Type A and B are due to deficiency of lysosomal sphingomyelinase. Neck mass-solitary and nontender4/4cm-biopsy SSC. most common in Type C disease.4. but Sudan Black B and Oil Red O are positive.Suspected primary of unknown origin-stage [AIIMS MAY 2013] a) T0 N2a Mx b) c) d) Ans 160. as well as "sea-blue histiocytes" on pathology Giemsa staining can highlight “sea blue” histiocytes containing ceroid. Bone marrow transplant has been attempted for Type B. Niemann-Pick cells are CD-68 positive histiocytes. 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.1-15. Future prospects include enzyme replacement and gene therapy. Electron microscopy shows lamellated structures in the lysosomes (similar to myelin figures) and may also demonstrate “zebra bodies”.CONSULTANT 154. a missense mutation causes complete deficiency of sphingomyelinase type A being the neuronopathic form and B the non-neuronopathic form.25 b) fomipazole-inhibits with aldehyde dehydrogenase c) Formic acid is responsible for toxicity d) 157. PAS staining is only faintly positive. What is associated with strep. 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. seen best on touch imprints 156.ANS A REF-OHC . 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 . Histology demonstrates lipid laden macrophages in the marrow. These lipid deposits are birefringent and have yellow-green fluorescence in UV light. The involved gene is on chromosome 11p15. All are true regarding METHANOL poisoning except [AIIMS MAY 2013] a) critical level is 1. Social pathology is [AIIMS MAY 2013] a) chang in the disease pattern due to change in life style b) c) d) 159. indicating that neutral fat contained in the vacuoles. parallel lamellated structures in the cytoplasm The cells of Gaucher disease are identified by their “crinkled tissue paper” cytoplasm.OHC2RECENT ADVANCES PAGE 106 POZIGOLD Niemann-Pick disease. Seat belt injury is commonly seen in [AIIMS MAY 2013] a) Liver b) Mesentry c) spleen d) 158.OHC 155.
shape of chromosome [AIIMS MAY 2013] a) chromosome mapping b) karyotyping c) Genotyping d) 164. especially if used in doses greater than 100mg per day Ans a REF-POZITIVE CONSULTANT 166. 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. Technique which shows change in size. Loss of lacrimation is due to injury of[AIIMS MAY 2013] a) b) c) d) 165. Cell is injured by micro needle. It can stain permanent teeth but this effect is usually temporary. Minocycline may occasionally result in prolonged greyish discolouration of teeth.AnsCONSULTANT 161.How does it get sealed [AIIMS MAY 2013] a) Enzymatic reaction b) c) d) 163. or by children under twelve years. because it discolours growing teeth and may cause enamel hypoplasia (malformed permanent teeth). 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 . 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.
A patient complaints of diarrhoea stool examination shows ova of size 100. 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. Tc99 pertechnate hot spot on parotid spot? [AIIMS MAY 2013] A. A survey on blind school for the prevalence of blindness when compared to prevalence in general population [AIIMS MAY 2013] A. Both are equal POZITIVE 2013 . Warthims tumor 52 167. mesoderm) Genital ducts (vas deferens. duct Uterus. Underestimate it C. mesoderm) Kidney (metanephros) (intermed.) 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. vagina) 169. ovaries. scrotum. Overestimate it B.Ans a REF-OHC-MKT.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. intermed. GYNECOLOGY.) Seminal vesicles (intermed. fallopian tubes) External genitalia (penis. Damage control surgery [AIIMS MAY 2013] A) Minimum possible intervention B) Maximum possible intervention C) D) 168.
microaspiration. * L. Lymphoma Ans-a REF-POZIGOLD. Harmartomatous polyp c.CONSULTANT 171. Basilar migrane C. Juvenile rectal polyp b. A 19 yr old female with primary amenorrhoea.He complaints of neck stiffness. Judgement d. Kleihauer Betke test c. Mucoepidermoid Ca D. Bubblin test d. Adenoid cystic lymphoma C. bozemanii. Fistula in ano ANS-A REF-CONSULTANT 175. * 1st in philadelphia during American legion convention. legionnaire’s disease.CONSULTANT.What is the karyotype? [AIIMS MAY 2013] a) 47XXY b) 45XO c) 46XY d) 46XX Ans-b Ref-OHC. 64 serogroups. Blood borne Ans a Ref-OHC.CONSULTANT 174.POZIGOLD. * Source – water.CONSULTANT 173. L. Rapport Ans a Ref-consultant 176. and 6 are most common.*** * L. 4. and L. A toddler passes a drop of blood per rectum diagnosis is [AIIMS MAY 2013] a. What is the diagnosis? [AIIMS MAY 2013] A. * 49 species. * Direct fluorescent antibody (DFA) testdirected primarily at the lipopolysaccharide. Insight b. SAH B. * Can live in years in refrigerated water. The following test is used to differentiate between maternal and foetal blood cell [AIIMS MAY 2013] a. Extradural hemorrhage ANS A REF-POZIGOLD. Knowledge of own disease /illness in mental status [AIIMS MAY 2013] a. * Fastidious Aerobic Gram negative bacilli. Aerosal transmission b. Osmotic fragility test ANS-b REF-OHC. longbeachae.Pneumophilia – 80-90% [Buffered charcoal yeast Extract].serogroups 1. The following is the mode of transmission of Legionella pneumonia [AIIMS MAY 2013] a.OHC 172.B. dumoffii. APT test b.POZIGOLD. L. 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 . inhalation. micdadei (Pittsburgh pneumonia agent). * Mode of Transmission . Infectious droplets c. POZIGOLD. OH BOOK PAGE. A patient presented with sudden onset of severe headache with vomitting and nausea.wide spaced nipples hypoplastic uterus. 177. Cluster headache D. Oriention c. CONSULTANT * Produces pontaic fever.
c) It differs from developing and developed countries d) ans d • • Human poverty Index – term was introduced in 1997. Normal in pancreatic insufficiency. • 179. Varies from 0. The dimensions for HPI – 1.0% for Italy. urticarial plaque. atrophic gastritis and antigastric parietal cell antibodies. knowledge and a decent standard of living. * 90% . papulo vesicular skin disease.Immuno – Granular deposits of IgA in papillary dermis and along the epidermal basement membrane zone. * Biopsy . HLA – DQW2. This is the indicator that is best known for all countries (including the ones not on the list). % of labour force). These figures are higher than most commonly cited illiteracy rates due to the choice of the literacy test. Schilling test to establish cause of B12 deficiency.3% at HDI position 37. * 2nd – 4th decade. while HDI measures average achievements in basic dimensions of human development.4% for the United States to 5. 2005. * Gluten Restriction. Varies from 7. 2000-2005. extensor surface. Varies from 7. 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.HLA B8/DRW3. * Treatment – Dapsone – Response within 24 – 48 hrs. 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.Sub epidermal bullae with neutrophils in dermal papillae. 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).Ans a Ref-OHC. People lacking functional literacy skills (% of people scoring in the range called “Level 1” in the International Adult Literacy Survey.5% for Sweden to 47. * Associated with gluten sensitive enteropathy. This indicator has by far the greatest variation. Long-term unemployment (12 months or more. 1994–2003). .1% for Japan to 11. the HPI measures deprivation in those dimensions. HPI does not include [AIIMS MAY 2013] a) Child literacy rate b) Life expectancy not beyond 40 yrs POZITIVE 2013 54 • . The HPI concentrates on the deprivation in the three essential elements of human life already reflected in the HDI: longevity. achlorhydria. 178.0% for Germany. • • Bile salt breath test (14C-glycocholate) to determine bile salt malabsorption.OH BOOK PAGE 239 Dermatitis Herpetiformis * Intensely pruritic. with a value as high as 9. age 1665. * incidence of Thyroid abnormalitis. * Auto antibodies .8 for the USA. * Primary lesion – papule. * Symmetrical.IgA anti endomysial antibodies that target tissue Transglutaminase.
110 POZITIVE 2013 55 . Calcified nodular stage Ans-d CT findings vary as follows. nonenhancing lesions Colloidal stage (larval degeneration): Hypodense/isodense lesions with peripheral enhancement and perilesional edema Nodular-granular enhancing lesions stage: Nodularstage stage stage 180. Xylocaine (lidocaine) in multiple dose vials: Each mL also contains 1 mg methylparaben as antiseptic preservative • • • • • • 182. depending on the stage of evolution of the infestation: Vesicular stage (viable larva): Hypodense. 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.owl eye nuclei seen in the cytoplasm [AIIMS MAY 2013] a) Nodular sclerosing b) Lymphoyte predominant c) d) 181. collapsed ventricles. 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. Granular nodular D. Colloid C. especially for evaluation of intraventricular and cisternal/subarachnoidal cysts. Oedema in CT absent in which stage of Neurocysticercosis? • A. Disease with cervical lymph node involvement. nodular parenchymal calcifications are seen MRI is the imaging modality of choice for neurocysticercosis. • • • • 185. nonpyrogenic.45 c) 90.45. 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.following angulation can be done [AIIMS MAY 2013] a) 90 b) 90.• Population below 50% of median adjusted household disposable income 184. Man with lung carcinoma and paraneoplastic syndrome.Possibility [AIIMS MAY 2013] a) Gynecomastia b) Thin limb and obese body c) d) ans-b Cysticercotic encephalitis: Diffuse edema. Vesicular B. For veiwing root fractures . isotonic solution containing sodium chloride.
POZITIVE 2013 56 .
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