1. Which of the following techniques carries the highest contraceptive failure rate?

a) Laparoscopic ring application

b) Pomeroy’s

c) Irving’s

d) Parkland’s

2. Which statement regarding testicular feminisation syndrome is FALSE?

a) Presents as primary amenorrhea

b) Inherited as X linked recessive

c ) Phenotypically male

d) Karyotype is 46,XY

3. Diethyl stilbesterol exposure in utero may cause the following EXCEPT

a) T- shaped uterus

b) Increased renal anomalies

c) vaginal adenosis

d) Cervical hoods and cockscombs

4. In a vaginal wet smear, ‘ clue cells’ indicate infection by

a) Gardnerella vaginalis

b) Trichomonas vaginalis

c) Candida albicans

d) Chalmydia trachomatis

5. After 72 hours following unprotected coitus, the emergency contraception of choice is

a) Levonorgestrel

b) Premarin

c) Yuzpe method

d) Copper T
6. The following are indications for Cesarean section EXPECT

a) Mentoanterior face presentation

b) Persistent Brow presentation

c) Central placenta previa

d) Constriction ring with fetal distress

7. Stargazer fetus is seen in

a) Chalmydia trachomatis infection of the new born

b) Breech presentation with fetal head in extrme hyperextension

c) Bilateral retinoblastoma in utero causing bilateral cat’s eye reflex

d. Face to pubis occurrence in occipitoposterior position

8. select the true statement regarding Hydatiform mole

a) Complete set has a dual set of maternal genes

b) Uterus is larger than the period of amenorrhea

c) Fetal parts are felt separately from the molar tissue

d) all the above are true

9. All the following indicate severe preeclampsia EXCEPT

a) Gross hematuria

b) Pulmonary edema

c) Visual disturbances

d) Platelet count of 0.6 lakhs/cu.mm

10. Kleihauer Betke test is used to detect

a) Ferning pattern in follicular phase

b) Cephalopelvic disproportion

c) Fetomaternal blood leak

d) Sperm-cervical mucus interaction

11. The following is / are helpful in a child with severe falciparum malaria with high parasitemia

a) IV corticosteroids (dexamethasone)

b) Exchange transfusion

c) Hyperbaric oxygen

d) All the above

12. Continuous prophylactic anticonvulcontinusant therapy is not needed in a child with febrile
convulsion with

a) Developmental delay

b) Family history of Epilepsy

c) Typical simple febrile fits

d) Persistent neurological deficit

13. Key features of kangaroo mother care are all the following EXCEPT

a) skin to skin contact between mother and baby

b) Exclusive breast feeding

c) Initiated in a facility and continued at home

d) Done for babies with cyanosis

14. Nipple confusion means

a) Baby fed with a bottle finding it difficult and confusing to suckle at breast

b) Baby not able to suckle with bottle

c) Baby not able to feed with spoon

d) Baby not able to feed with paladin

15. Bag and mask ventilation is contraindicated in newborn resuscitation with clinical suspicion of

a) Diaphragmatic hernia

b) Intracranial hemorrhage

c) Meconium aspiration

d) Pneumothorax

16. When mother complains that baby is more comfortable and breathes better when held against
shoulder, what important clinical problem do you suspect?

a) Nose block

b) Psychological anxiety or insecurity

c) Aerophagy with abdominal fullness

d) Orthopnea

17. Commenest cause of meningoencephalitis in children is

a) HSV

b) Measles

c) Arbovirus

d) Enterovirus
18. The following component of human milk is protective against Giardia lambia infection

a) Lysozyme

b) Lactoferrin

c) Bifidus factor

d) Glycoconjugate

19. Mutation in NPHS1 gene causes which disease?

a) Alport syndrome

b) Congenital finnish type nephritic syndrome

c) Focal segmental glomerulosclerosis

d) Nail patella syndrome

20. Concerning attention deficit hyperactivity disorder, which is true?

a) Impulsive behaviour is a feature

b) Higher incidence in tic disorders

c) May respond to treatment with stimulants such as amphetamine

d) All the above

21. Bohler’s angle is decreased in fracture of

a) Calcaneum

b) Talus

c) Navicular

d) Cuboid
22. Select the true statement regarding “Wandering” Acetabulum

a) acetabulum moves forward in central fracture dislocation

b) protrusion acetabulum in post operative complication of Moores prosthesis in old age

c) in tuberculosis of the hip femoral head dislocate from acetabulum on the illinum and forms

a pseudo acetabulum

d) acetabulum changes its position on to illiium in suppurative infections of hip

23. The classification for diaphyseal femoral fracture comminution was given by

a) Sciensheimer

b) Evans

c) Winquist and Hansen

d) Frykman

24. Treatment of choice ifor fracture shaft fumur in adults is

a) Locked intra medullary nailing

b) External fixation

c) Closed reduction and cast immobilisation

d) Plate fixation

25. All are bone forming tumors EXPCEPT

a) Osteosarcoma

b) Osteoid osteoma

c) Osteochondroma

d) Osteoblastoma
26. Hill sach’s lesion is seen in which aspect of the head of the humerus?

a) posterolateral

b) posteromedial

c) Anterolateral

d) Anteromadial

27. Never most likely to be injured in anterior dislocation of shoulder joint

a) Musculocutaneous

b) Radial

c ) Ulnar

d) Axillary

28. Jefferson’s fracture is

a) Fracture of C1 vertebra

b) Fracture of C2 vertebra

c) Fracture dislocation of C1 over C2 vertebra

d) Fracture of C5 vertebra

29. Which one of the following bone tumors typically affects the epiphysis of a long bone?

a) Osteosarcoma

b) Ewing’s sarcoma

c) Chondroblastoma

d) Chondromyxoid fibroma

30) Clawing of the medial 2 fingers is seen more pronounced following the

a) High Ulnar nerve palsy

b) combined ulnar and medial nerve palsy

c) Low ulnar nerve palsy

d) Tardy ulnar nerve palsy

31. Atopic dermatitis is characterised by the following EXCEPT

a) Pruritic exudative eruptions on upper body

b) onset after 30 years of age

c) Tendency to recur

d) Elevated Ig E

32. All the following are true regarding Porphyrea cutanea tarda EXCEPT

a) inflammatory Blisters on sun exposed sites

b) Hypertrichosis

c) Hydroxychloroquine is useful

d) Skin fragility of dorsal surfaces of hands

33. The following are true regarding Leprosy EXCEPT

a) Anesthetic skin lesions

b) Blindness due to optic neuritis

c) Worse prognosis in lepromatous leprosy compared to tuberculoid leprosy

d) Testicular atrophy and azoospermia

34. A woman came with dysuria and purulent vaginal discharge . Smear shows Gram negative
intracellular diplococcic. Which one of the following is true

a) Treponemal Elisa Immunoassay will confirm diagnosis

b) Chlamydia trachomatis is the likely etiological agent

c) A single dose of ciproflaxin or ceftriaxone will suffice

d) Her sexual partner cn be reassured that it s not a sexually transmitted disease

35. Which of the following is a Non Nucleoside Reverse transcriptase inhibitor?

a) Emtricitabine

b) Delavirdine

c) Nelfinavir

d) Didanosine

36. Buruli ulcer is caused by

a) Mycobacterium ulcerans

b) Fusobactrium ulcerans + Treponema vencenti

c) Leishmania tropica

d) Dracunculus medinensis

37. An elderly patient come with severe depression, delusions, agitation, with mild liver
dysfunction. The most effective treatment option would be

a) Electroconvulsive therapy

b) Amitryptiline

c) Selegiline skin patches

d) Cognitive behavioural therapy

38. Briquet’s syndrome refers to

a) chronic somatisation disorder with pain, vomiting, dizziness and sexual dysfunction

b) recurrent abdominal surgeries and scars for abdominal pain

c) catatonic schizophrenia

d) agoraphobia + anxiety + anhodynia

39. Positive end expiratory pressure ventilation can cause the following EXCEPT

a) sodium retention

b) Decreased cardiac output

c) Increased residual volume

d) Decreased central venous pressure

40. Which of the following general anesthetics can provoke seizures?

a) desflurane

b) Sevoflurane

c) Isoflurane

d) Enflurane

41. Which of the following indicates potency of general anesthetics?

a) minimal alveoral concentration

b) solubility of anesthetic in blood

c) solubility of anesthetic in tissues

d) alveolar exchange

42. Anaesthesia for head and neck surgeries is challenging due to concerns about airway safety .
Following tubes helps to secure the airway for head and neck surgeries, EXCEPT

a) Double lumen endotracheal tubes

b) south pole endotracheal tubes

c) flexometallic tubes

d) Tracheostomy tubes
43. Cells are most radioresistant in

a) S phase

b) M phase

c) G2 phase

d) G1 phase

44. Male breast cancer is most commonly associated with mutation of

a) BRCA 1

b) BRCA 2

c) C-myc

d) N-myc

45. Calcification in plain x-ray abdomen is seen in

a) Wilm’ tumor

b) Mesoblastic nephroma

c) Hepatoblastoma

d) Neuroblastoma

46. The following are sonographic signs of Deep Vien thrombosis EXCEPT

a) ‘Winking’ sign positive

b) Loss of vein compressibility

c) Blunted Doppler flow response to calf compression

d) Visualisation of low echognic, homogenous mass

47. the following are true regarding Interferon Gamma release assays in tuberculosis EXCEPT

a) Antigens from all BCG strains and nontuberculous mycobacteria are present in the assay

b) Specificity of the test is superior to Tuberculin skin test in BCG vaccinated patients

c) Sensitivity is comparable to Tuberculin skin test

d) Sensitivity is reduced in HIV infection with low CD4 count

48. Regarding cryptic miliary tuberculosis all are correct EXCEPT

a) It has a chronic course

b) It causes mild intermittent fever and anemia

c) Meningeal involvement precedes death

d) It is commonly seen in children

49. A patient with pleural effusion has the following test results

Serum protein= 7G/dL

Pleural fluid protein=5G/dL

Serum glucose=90mg/dL

Pleural fluid glucose=20mg/dL

Pleural fluid LDH =300 units

Probable diagnosis is

a) CHF patient not on diuretics

b) CHF patient with diabetes and on insulin
c) Renal failure
d) Rheumatoid arthritis

50. A 30 year previously healthy male came with 2 days fever and cough with purulent sputum.
Examination reveals an impaired note with bronchial breathing and crackles and increased vocal
resonance. He is alert. BP=100/70. Respiratory rate =24/min. Blood urea=20 mg%. Which of the
following is the best treatment for him?

a) OP treatment with Clarithromycin 500mg BID for one week

b) Admit in ward and give Levofloxacin orally 750mg OD + Inj. Ceftriaxone 1G IV BID for one week

c) Admit in ICCU and give Inj. Ceftriaxone 2G IV OD + IV levofloxacin 750mg OD for one week

d) Piperacillin + tazobactam 4.5 G qid for one week

51. Lymphatics from the testis drain into

a) Superficial inguinal lymph nodes

b) Internal iliac lymph nodes

c) Common iliac lymph nodes

d) Paraaortic lymph nodes

52. Cricothyroid muscle is supplied by

a) Internal branch of superior laryngeal nerve

b) External branch of superior laryngeal nerve

c) Ansa cervicalis

d) Recurrent laryngeal nerve

53. Herniation of intervertebral disc between fifth and sixth cervical vertebrae to compression of

a) Fourth cervical nerve root

b) fifth cervical nerve root

c) Sixth cervical nerve root

d) seventh cervical nerve root

54. Nissel’s substance of the neurons is made up of

a) Mitochondria

b) Rough endoplasmic reticulum

c) Smooth endoplasmic reticulum

d) Lysosomes
55) Which of the following is a remnant of the paramesonephric duct in males?

a) appendix of epididymis

b) appendix of testis

c) paradidymis

d) superior aberrant ductules

56. Secrection of hydrogen ion in the proximal convoluted tubular cell is

a) by antiport in exchange for sodium ion

b) by an ATP driven proton pump

c) facilitated by aldosterone

d) by H+/k+ATPase activity

57. Which of the following is not produced by increased baroreceptor afferent discharge?

a) decrased sympathetic tone to blood vessels

b) inhibition of respiration

c) decreased caudo ventro lateral medulla activity

d) Decrased muscle tone

58. Plasma levels of calcium can be increased most rapidly by the direct action of Parathormone on
which of the following?

a) kidney

b) Intestine

c) Thyroid harmone

d) Bones
59. All the following statements regarding Migrating Motor Complexes (MMCs) are true EXCEPT

a) It is stimulated by a meal

b) It is principally regulated by Motilin hormone

c) It controls gastrointestinal motility

d) Phase II and phase III of MMCs are associated with spike potentials

60. Which of the following is FALSE regarding oxygen haemoglobin interaction?

a) Affinity of haemoglobin for the fourth oxygen molecule is more than that for the first molecule

b) In deoxyhaemoglobin, globin units are in relaxed (R) configuration

c) one gram haemoglobin can bind to 1.34 ml of oxygen

d) the value of p50 in HbF is less than that of HbA

61. Oxidation of which of the following yields the highest number of calories per gram

a) Glucose

b) Alcohol

c) Animal protein

d) Triglyceride

62. Hopkins – Cole test is performed on proteins to detect the following

a) Peptide bond

b) Imidazole group

c) Indole group

d) Guanidino group
63. Factor Xa is necessary for conversion of prothrombin to thrombin

a) Only in the extrinsic pathway

b) Only in the intrinsic pathway

c) As part of both intrinsic and extrinsic pathways

d) Only if normal blood clotting cascade is inhibited

64. The following are true regarding Telomerase EXCEPT

a) It provides a mechanism for replication of ends of linear chromosomes

b) It recognises a Gn rich strand of DNA

c) It has a reverse transcriptase function

d) It adds telomeric repeats to the 5’ – end of the DNA strands

65. Alcohol dehydrogenase requires NAD+ for catalytic activity. Here NAD functions as

a) Apoenzyme

b) Coenzyme-Co substrate

c) Coenzyme-prosthetic group

d) Cofactor

66. The only pathogenic true yeast is

a) Candida

b) Saccharomucis

c) Cryptococcus

d) Trichophyton
67. The following media can be used to culture Mycobacterium tuberculosis EXCEPT

a) Dorsett’s egg

b) Middlebrook 7H10

c) LJ medium

d) McLeod’s Medium

68. Mc-Fadyean reaction is shown by

a) Bacillus anthracis

b) Clostridium diphtheria

c) Escherichia coli

d) Listeria monocytogenes

69. All the following parasites enter the human body penetrating the skin EXCEPT

a) Ancylostoma duodenale

b) Necator americanus

c) Strongyloides stercoralis

d) Trichinella spiralis

70. All are mosquito borne viral fevers EXCEPT

a) Dengue

b) Kysanur Forest disease

c) Yellow fever

d) Japanese encephalitis
71. Chemical modification of a drug like oxidation by cytochrome P450 is called

a) First pass effect

b) Presystemic extraction

c) Phase I metabolism

d) Phase Ii metabolism

72. Only oral drug used to treat ectoparasites

a) Crotamiton

b) Ivermectin

c) Gammabenzine hexachloride

d) permethrin

73. Which receptor is not a G protein coupled receptor?

a) 5-HT

b) D2

c) GABA-A

d) GABA-B

74. Which of the following is a Neurokinin receptor antagonist?

a) Granisteron

b) Aprepitant

c) Metaclopramide

d) Trimethobenzamide
75. The most abundant cytochrome (CYP) monoxygenase member responsible for metabolising
most drug is

a) CYP 3A4

b) CYP 2D6

c) CYP 2K9

d) CYP 2C19

76. Following body part is used in Boyde’s method of age estimation by using incremental lines

a) Palpable rugae

b) Teeth

c) Skull surface

d) Finger nails

77. The cause of death in Cafe coronary is

a) Laryngeal obstruction

b) Coronary insufficiency

c) Myocardial ischemia

d) Cardiac rupture

78. To detect seminal stains on the clothes of the victim of rape, the clothes should be examined in

a) Infrared light

b) Ultra violet light

c) Broad day light

d) Artificial light
79. Immediate rigidity of a group of muscles after death is called

a) Cadaveric rigidity

b) Cadaveric lividity

c) Cataleptic rigidity

d) Trismus

80. Poisoning resembling viper snake bite is

a) Ricin

b) Crotin

c) Bhilawnol

d) Abrin

81. Flexner wintersteiner rosettes are seen in

a) Heptoblastoma

b) Neuroblastoma

c) Nephroblastoma

d) Retinoblastoma

82. Biomarkers of kidney injury include the following EXCEPT

a) Kidney injury molecule-1

b)Neutrophil Gelatinase associated lipocalsin

c) N-acetyl beta D Glucosaminidase

d) Myoglobin
83. which plasma protein is necessary for adhesion of platelets to subendothelial fibers?

a) Glycoprotein IIb

b) Von Willebrand factor

c) Platelet factor 3

d) Factor x

84. Characteristic feature of Good pasture’s syndrome

a) Lumpy-bumpy deposits on immunoflorescence

b) Serum antibodies against alpha 3 NCI domain of collagen-IV

c) Serum antibodies against alpha 1 NCI domain of collagen III

d) Anti DNAse antibodies positive

85. Invasion of perineural space is a feature of

a) Plemomorphic adenoma

b) Warthin’s tumor

c) Mucoepidermoid carcinoma

d) Adenoid cystic carcinoma

86. commonest site for extra nodal Lymphoma is

a) Liver

b) Stomach

c) Small intestine

d) Large intestine
87. call-Exner bodies are the histological hallmark of

a) Yolk sac tumor (endodermal sinus tumor)

b) dysgerminoma

c) granulose cell tumor

d) Krukenberg’s tumor

88. In patients with chronic Myeloid Leukemia

a) Bcr gene on chr.22 is trans-located to abl gene on Chr.9

b) The fusion gene Bcr-abl forms a protein with tyrosine kinase activity

c) Splenomegaly is unusual

d) Philadelphia chromosome positive patients respond poorly to Imatinib

89. Crystic spaces lined by double layer of neoplastic epithelial cells resting on dense lymphoid
tissue is a feature of

a) Hashimoto’s thyroiditis

b) Dermoid cyst

c) Warthin’s tumor

d) Aneurysmal bone cyst

90. Renal biopsy of a 14 year old boy with nephric syndrome shows proliferation of mesangial cells
with Glomerular basement membrane thickening and mesangial cell interposition. What is the most
likely diagnosis?

a) Diffuse proliferative Glomerulonephritis

b) Mesangiocapillary GLOMERULONEEPHRITIS

C) Membranous nephropathy

d) Hemolytic Uremic syndrome

91. The minimum recommended concentration of free chlorine in drinking water at the end of one
hour is

a) 0.1 mg/L

b) 0.5 mg/L

c) 1.0 mg/ L

d) 1.5 mg/L

92. Squre root of (pq) divided by (n) i.e. √pq/n is

a) Standard error of proportion

b) Standard error of mean

c) Standard error of difference between means

d) Standard error of difference between proportions

93. Height in cms. Minus 100 is

a) Ponderal Index

b) Broca Index

c) Lorentz formula

d) Corpulence index

94. recommended content of iodine in salt at the consumer level is

a) 10 ppm

b) 15 ppm

c) 20 ppm

d) 25 ppm
95. The first step in conducting an epidemic investigation is

a) Determinig the case count

b0 Calculating the incubation period

c) Determinig the population at risk

d) Verifying the diagnosis

96. All the following are proven Lung carcinogens EXCEPT

a) Nickel

b) Asbestos

c) Lead

d) Chromates

97. Which of the following undergo developmental changes but no multiplication?

a) Plague bacilli in rat flea

b) Malarial parasite in mosquito

c) Microfilariae in mosquito

d) All of the above

98. Which of the following is NOT TRUE of case control studies?

a) Involves fewer number of subjects

b) Not suitable for study of rare diseases

c) Relatively inexpensive

d) Yields results relatively quickly

99. A new blood test for tuberculosis was tested in 60 patients of sputum proven Tuberculosis and
40 healthy controls. It was positive in 54 patients and 10 of the healthy subjects. What is the
sensitivity of the test?

a) Cannot be calculated with the data unless we know prevalence in the given population

b) 0.9

c) 0.75

d) 0.64

100. Theme for World Health Day 2014 is

a) Ageing

b) Antimicrobial resistance

c) Vector borne diseases

d) Hypertension

101. Following are causes of follicular conjunctivitis EXCEPT

a) Epidemic Keratoconjunctivitis

b) Molluscum contagiosum

c) Opthalmia nodosa

d) Herpes simplex

102. The following can present as a bluish red conjunctival nodule resembling subconjunctival
hemorrhage

a) Kaposi’s sarcoma

b) Lymphoma

c) Anterior staphyloma

d) Corneal fistula
103. ‘b’ wave in ERG arises from

a) Rods and Cones

b) Bipolar cells

c) Gangilion cells

d) Retinal pigment epithelium

104. Early stages of Keratoconus can be diagnosed by

a) Corneal topography

b) Keratometry

c) Ultrasonic pachymetry

d) Distant direct ophthalmoccopy

105. HLA B5 antigen is a significant association of

a) Vogt-koyanagi-Harada syndrome

b) Posner’s Schlossman syndrome

c) Behcet’s syndrome

d) Reiter’s syndrome

106. Cattle truck appearance is seen in

a) Retinal arteries in Central Retinal Artery occlusion

b) Retinal veins in Central Retinal Artery occlusion

c) Retinal arteries in Central Retinal Vein Occlusion

d) Retinal veins in Central Retinal Vein occlusion

107. Most common malignant tumor of orbit in children

a) Retinoblastoma

b) Neuroblastoma

c) Rhabdomyosarcoma

d) Chloroma

108. Primary action of superior Oblique is

a) Extortion

b) Depression

c) Intorsion

d) Elevation

109. Homonymous hemianopia is extremely congruous in lesions of

a) Optic tract

b) Optic radiation

c) Lateral geniculate body

d) Primary visual cortex

110. Optic neuritis is characterised by the following EXCEPT

a) Strongly associated with demyelination disease

b) Subacute unilateral visual loss

c) Pain exacerbated by eye movements

d) Optic disk is always abnormal in acute stage

111. Complete absence of bony and membranous labyrinth is seen in

a) Mondini’s aplasia

b) Bing-Siebenmann apalasia

c) Michel’s aplasia

d) Cochleosaccular dysplasia

112. The gold standard imaging modality for diagnosis of Vestibular schwannoma is

a) HRCTscan

b) MRI with gadolinium contrast

c) PET scan

d) Vertebral angiography

113. Temporary and permanent threshold shift are characteristically seen in

a) Ototoxicity

b) Noise induced hearing loss

c) Presbyacusis

d) Sudden sensorineural loss

114. Apple jelly nodules on the nose are found in case of

a) Cutaneous anthrax

b) Syphilis

c) Rhinoscleroma

d) Lupus vulgaris
115. Holman Miller sign is pathognomonic of

a) Juvenile nasopharyngeal angiofibroma

b) Antrochoanal polyp

c) Olfactory neuroblastoma

d) Inverted papilloma

116. Bryce’s sign is seen in

a) Pharyngeal pouch

b) Laryngocele

c) Brachial cyst

d) Thyroglossal cyst

117. Malignant external otitis is caused by

a) Borrlia vincenti

b) Pseudomonas Aeruginosa

c) Klebsiella oezena

d) Proteus mirabilis

118. All the following are true regarding Maxillary sinus EXCEPT

a) Largest sinus

b) Commonest sinus involved in acute bacterial sinusitis

c) Pain refer to lower incisor and canine teeth via trigeminal nerve

d) Opens into the middle meatus

119. True statement regarding Reactionary hemorrhage after tonsillectomy

a) Commonly due to infection

b) Occurs within 24 hours after tonsillectomy

c) Commonly due to injury to internal carotid artery

d) Usually needs major surgical exploration under general anesthesia

120. A 2.5 year old fully immunised child developed sore throat’ Dysphagia, fever and stridor in
quick succession. Within 2 hours of onset of symptoms the child was very sick, pale and looked
terrified. An hour later, the child became quiet and floppy. And with in next one hour yhe child
expired. The most likely diagnosis was

a) Acute laryngotracheal bronchitis

b) Acute epiglottitis

c) Laryngeal diphtheria

d) Foreign body aspiration

121. Regarding Iron deficiency which of the following statements is TRUE

a) Commonest cause in adults is chronic blood loss

b) Reduced MCV precedes depletion of iron stores

c) Hepcidin levels are high in isolated iron deficiency

d) Out of an oral tablet of 325 mg. TID, 100 mg is absorbed

122. A tall male patient with arachnodactyly and subluxated lens came with sudden, sharp, severe
chest pain and sweating. Left arm pulses are weak. ECG appears normal. Further steps include the
following EXCEPT

a) IV hydralazine or sublingual nifedipine immediately to reduce blood pressure and pain

b) Echo and CT angiogram

c) IV labetalol

d) Plan for surgery with an inter position graft

123. Which of the following is NOT a feature of Weil’s disease?

a) Fever and jaundice

b) Hepatic encephalopathy

c) Renal failure

d) Conjunctival hyperaemia and skin purpura

124. Chinese restaurant syndrome after eating fried rice vanilla sauce is due to

a) Clostridium perfringens

b) Bacillus cereus

c) Staphylococcus aureus

d) Clostridium botulinum

125. The following causes Normal Anion Gap acidosis

a) Diarrhea

b) Starvation ketoacidosis

c) Methanol poisoning

d) All the above

126. The following help to treat hiccups EXCEPT

a) Corbonated beverages

b) Valsalva maneuver

c) Carotid massage

d) Eating a spoon of dry granulated sugar

127. A patient came with chronic postprandial diarrhea. His stool has increased osmotic gap and
normal fecal fat content. The probable diagnosis is

a) Lactose intolerance

b) Pancreatic insufficiency

c) Irritable bowel syndrome

d) Zollinger Ellison syndrome

128. An alcoholic had a vomiting and continuous retching. This was followed by a bout of
hematemesis. The most probable diagnosis of the following is

a) Bleeding peptic ulcer

b) Boerhaave’s syndrome

c) Mallory weiss tear

d) Acute gastric dilatation

129. A Serum-Ascitic Albumin Gradient greater than 1.1 is seen in ascities due to the following
EXCEPT

a) Alcoholic cirrhosis

b) Nephrotic syndrome due to Minimal change disease

c) Congestive cardiac failure after one dose of diuretic

d) Budd Chiari Syndrome

130. Choose the correct statement regarding Pseudomembranous colitis

a) Causes yellowish adherent plaques and hyperaemic colonic mucosa

b) Is aften due to vancomycin

c) Is best treated by ampicillin

d) All the above are true

131. Natalizumab is a

a) Monoclonal Ab against alpha-4 integrin used in multiple sclerosis

c) Monoclonal Ab against IL-23 used in multifocal leukoencephalopathy

d) VEGF inhibitor used in hepatocellular carcinoma

132. In which of the following situations would you use the P-SPIKES approach?

a) Soon after your patient has died in the ICCU

b) When you interview an alchoholic

c) When you assess level of consciousness in the Emergency room

d) When you assess for suspected depression

133. Select the TRUE statement among the following

a) Anti-D is used in Immune Thrombocytopenic purpura

b) DDAVP is used in von Willebrand disease type 3

c) DDAVP is used in severe form of Hemophilia A

d) EACA is used in Factor XI deficiency for minor bleeds

134. Following are useful in treatment of apalastic anemia EXCEPT

a) Epoetin and Filgrasatim

b) Equine ATG+Cyclosporin

c) Fluoxymesterone

d) Autologous bone marrow transplantation

135. Least likely cause of renal papillary necrosis

a) Sickle cell disease

b) Analgesic nephropathy

c) Posterior urethral valves

d) Diabetes with UTI

136. Captopril enhanced renography is useful to exclude

a) Diabetic nephropathy

b) Renal vein thrombosis in a patient with renal cell carcinoma

c) Renal artery stenosis in a young hypertensive

d) A kidney donar who may be a mismatch

137. A patient of congestive heart failure was treated with IV Frusemide for 3 days. On the 3 rd day,
there was still pedal edema and he complained of anorexia and vomiting; he became apathetic and
lethargic. Bp 120/80. Pulse 90. Ser Creat=1.6 mg% . K=3.5 Na=128. The next treatment in him would
be

a) 1.5 li. Of Normal saline over 2 hours

b) Judicious continuation of diuretic with restriction of free water

c) IV potassium chloride 2 amp. At a rate of 20 meq/hour

d) Begin chlorthiazide and carbamazepine

138. Which of the following is NOT part of the Mini Mental State examination?

a) What is the year, month, date, day of Today

b) What is your name and age

c) Spell ‘World’ backward

d) Follow a 3 stage command

139. Which of the following is known as a ‘GREAT MASQUERADER’?

a) Leprosy

b) Syphilitic aortic aneurysm

c) Pulmonary embolism

d) Chronic HIV infection

140. A patient appears awake and is not talking. No voluntary movements. He can signal with
vertical eye movements. The CT scan shows infarction of ventral pons. The diagnosis is

a) Coma

b) Abulia

c) Locked in state

d) Catatonia

141. A patient with Acute kidney injury and RBCs and red cell casts in urine probably has

a) Thrombotic microangiopathy

b) Pyelonephritis

c) Rhabdomyolysis

d) Allergic interstitial nephritis

142. Calciphylaxis refers to

a) Anaphylactic reaction to IV calcium in a patient on digoxin

b) Tolerence to increasing calcium doses in patients with Hyperkalemia

c) Calcific arteriopathy in chronic kidney disease

d) one variant of tachyphylaxis

143. Following conditions must be fulfilled in a person before taking him as a kidney donor EXCEPT

a) ABO compatability with recipient

b) Presence of two normally functioning kidneys

c) No HIV infection

d) Zero HLA mismatch with recipient

144. The following inheritance patterns are correct EXCEPT

a) Huntington’s chorea -Autosomal Recessive

b) Marfan’s syndrome- Autosomal dominant

c) Duchenne’s myotonic dystrophy - X linked recessive

d)Romano Ward Syndrome – Autosomal dominant

145. A 60 year old patient with past history of Myocardial infarction on irregular treatment came
with a one year history of exertional dyspnea, occational PND, easy fatigabiity and pedal edema. On
examination, BP is 130/80. Mitral regurgitation+. X-ray shows cardiomegaly. Echo shows an EF of
35% Ser. Creatinine = 1.5 mg%. In him, the following are true EXCEPT?

a) Enalapril is contraindicated

b) Frusemide will relieve symptoms through it has no mortality benefit

c) Digoxin is useful if he has artrial fibrillation

d) Eplerenone is beneficial

146. While ausculcating the heart, a doctor heard an additional sound just after the second heart
sound. The patient could be suffering from any of the following EXCEPT

a) Bicuspid aortic valve with moderate aortic stenosis

b) Mitral rigaration with heart failure

c) Moderate mitral stenosis in sinus rhythm

d) Chronic constrictive pericarditis

147. A young male came with history of episodses of palpitation. Cardiovascular examination – No
abnormality detected. He says his doctor treated his palpitation by pressing the side of his neck. The
ECG shows a PR interval of two small boxes (2mm) and a slurring of the initial part of the QRS
complex. The diagnosis is

a) Brugada syndrome

b) Wolff Parkinson white syndrome

c) Lown ganong Levine syndrome

d) Jervell Lange Nielsen syndrome

148. Microscopic polyangiitis is characterised by the following features EXcEPT

a) Involves small and medium size arteries and veins

b) 75% cases are associated with ANCA positivity

c) Palpable purpura, ulcers and vesiculobullous lesions seen

d) Unlokely to cause pulmonary- renal syndrome

149. The following statements are true regarding Nephrogenic Systemic Fibrosis EXCEPT

a) Commonly seen in patients of Chronic Kidney disease with a GRF of above 30ml/min/1.73sq.m.

b) Increase in dermal spindle cells positive for CD 34 and procollagen I

c) It is a multi-organ fibrosis involving muscle, lungs and heart

d) Skin lesions include erythematous papules and woody painful skin

150. The following statements regarding autologous stem cell transplantation are true EXCEPT

a) It is used in some relapsed lymphomas that are responsive to chemotherapy

b) It is used in treatment of Acute Myeloid Leukemia

c) Hematopoeitic stem cells are mobilised from the marrow into the blood using filgrastim

d) Unlike allogenic stem cell transplantation, there is no period of pancytopenia after

myelosupression and before recovery of infused cells
151. FALSE statement regarding Hirschprung disease is

a) Aganglionosis always involves distal rectum

b) Non passage of meconium in first 24 hours is a cardinal feature

c) Diagnosis is established by Suction rectal biopsy

d) No passage of stools after per rectal examination

152. Best prognosis in carcinoma stomach is seen in

a) Superficial spreading type

b) Ulcerative type

c) Linitis plastic type

d) polypoidal type

153. Kasai’s operation is done for

a) Biliary atresia

b) Choledochal cyst

c) Klatskin tumor

d) caroli’s disease

154. Venous ulceration of the lower limb is most often due to

a) Deep venous thrombosis

b) Post phelebitic syndrome

c) Arterovenous fistula

d) Ambulatory venous hypertension

155. Which of the following malignancies of the breast is often bilateral?

a) Infiltrating duct carcinoma

b) Lobular invasive carcinoma

c) Inflammatory carcinoma

d) colloid carcinoma

156. a known patient of untreated peptic ulcer disease came with sudden severe generalised
abdominal pain. Examination reveals a rigid abdomen with rebound tenderness. The following help
to confirm diagnosis EXCEPT

a) x-ray abdomen in erect posture

b) Abdominal CT scan

c) Laparotomy

d) Selective celiac artery angiography

157. Following abdominal surgery, motility recovers first in which of among the following?

a) Stomach

b) Small intestine

c) Colon

d) All recover simultaneously

158. Ogilive syndrome refers to

a) Acute gastric dilatation

b) Acute colonic Dilatation

c) Anticlockwise volvulus of sigmoid

d) Cockwise volvulus of sigmoid

159. In the imminent Necrosis, The Ankle-Brachial Index is

a) Below 0.9

b) Above 1.0

c) Less than 0.3

d) Above 2

160. Kehr’s sign, pain over left shoulder is a clinical feature of

a) Acute cholecystitis

b) Acute pancreatitis

c) Rupture of Spleen

d) Peptic perforation

161. In a patient with a badly contaminated wound all the statements given below regarding tetanus
prophylaxis are correct EXCEPT

a) Tetanus prophylaxis depends, even in an actively immunized patient, on meticulous immediate

debridement of the wound

b) Tetanus prophylaxis should include administration of tetanus toxoid

c) Tetanus prophylaxis should include antibiotic therapy

d) Tetanus prophylaxis is unnecessary in patients who have been recently actively immunized

162. A young male patient comes to the emergency room with history of vehicular accident. Clinical
examination reveals pelvic fracture and blood at the external urethral meatus. Following are true
EXCEPT

a) Anterior urethra is ruptured

b) Retrograde Urethrography is to be performed

c) Per Rectal examination reveals a floating prostate

d) Catheterization is done carefully after a normal retrograde urethrographic examination

163. Pneumatosis intestinalis on plain abdominal radiograph is seen in

a) Congential atresia of bowel

b) meconium ileus

c) Volvulus neonatorum

d) Necrotizing enterocolitis

164. A patient has been subjected to hemithyroidectomy for a solitary thyroid nodule and the histo-
pathology is well differentiated occult papillary carcinoma. Which one of the following plan is
recommended for further management?

a) Completion thyroidectomy

b)Regular follow up with TSH suppression

c) Radioactive iodine abalation

d) Propylactic central neck node dissection

165. Most common site for deep brain stimulation in parkinson’s disease is

a) Thalamus

b) Globus pallidus externa

c) Subthalamic nucleus

d) Motor cortex

166. Choose the false statement regarding Hodkin’s ymphoma

a) Affected lymph nodes become painful with alcohol injection

b) Ann Arbor Stage II is involvement of two or more lymph node groups on both sides of the
diaphragm

c) ‘B symptoms’ are fever, night sweats and ≥10% weight loss in 6 months

d) ABVD regimen is standard line of treatment

167. True regarding Struviite urinary stone

a) Commonly associated with a sterile urine

b) Unlikely to grow to a staghorn calculus

c) Rectangular prisms resembling coffin lids on urine microscopy

d) All the above

168.A 40 year male with untreated chronic duodenal ulcer came with persistent vomiting. 4 days
later he had muscle cramps. He had a BP of 90/60. H+=28 nmol. HCO3=40 meq/L. K=3.5 meq/L.
Which of the following statements is TRUE in him?

a) This is a case of compensated metabolic acidosis

b) Vomiting is secondary to the acid base disorder

d) Immediate surgery will correct the acid base disorder

169. A 45 year male came with hypertension. Bilaterally palpable renal masses. Ser.creat=2.0mg%.
BP=180/100. An ultra sound scan revealed the diagnosis. Regarding this patient the following are
true EXCEPT

a) His parents must have had a consanguineous for him to develop this disease

b) Chromosome 16 is implicated in this disorder

c) He is likely to have hepatic cysts

d) He may have colonic diverticula

170. Which of the following DOES NOT cause bilious vomiting?

a) Hirschprung’s disease

b) Infantile hypertrophic pyloric stenosis

c) Duodenal atresia

d) Volvulus of small intestine

171. A one year old boy, Previously healthy, was brought because he had vomited – initially milk and
later bile stained fluid. The baby passed small amounts of red blood stained stools. The baby has
been crying due to abdominal colic and appears dehydrated. The baby has mild abdominal
distension and a small curved swelling above to the right of the umbilicus. Select the TRUE statement
regarding the baby.

a) Ultrasound is of no help in diagnosing the cause

b) The possible diagnosis is volvulus of sigmoid colon

c) The baby will mostly be relieved of symptoms by air enema

d) All the above are true

172. A baby is born with large swelling on the abdomen consisting of a membranous sac containing
intestines and a part of the liver. The ambilical cord is arising from this. The possible diagnosis is

a) Gastroschisis

b) Exomphalos major

c) Polyhydramnios abdominis totalis

d) Diaphramatic hernia

173. Regarding ‘ABCDE’ of trauma care, choose the correct statement.

a) B=Bony injury

b) C=chest injury

c) D=Defibrillation

d) E=Exposure and undressing

174. A man came with head injury. He is opening his eyes on painful stimulus but not to verbal
commands. He is uttering only sounds and no words. He is withdrawing limbs on painful stimulus
but cannot localise it. His Glasgow coma score is

a) 5

b) 8

c) 10
d) 13

175. Urodynamic testing is useful in the following EXCEPT

a) To distinguish genuine stress Incontinence from Detrusor Instability in women

b) For classifying neurogenic bladder dysfunction

c) To decide on the plan of bladder repair during treatment in Vesico-vaginal fistula

d) To distinguish bladder outflow obstruction from Detrusor instability in men

176. A 50 year man of 60 kg was admitted with 40% burns. As per parkland Formula, the fluid to be
given in him would be

a) 4.8L of Ringer’s Lactate in the first 8 hours and 4.8 L in next 16 hours

b) 4.8 L of RL in first 6 hours, 2.4L of normal saline in next 6 hours and 2.4 L of dextrose in next 12
hours

c) 6 L of RL in first 6 hours and 6L in 18 hours

d) 4L of RL in first 8 hours and 4L of NS in next 16 hours

177. The following statements regarding salivary glands are true EXCEPT

a) Sialolithiasis is more common in parotid glands than in Submandibular glands

b) The commonest site for salivary tumors in the paroyid

c) Most of the parotid tumors are malignant

d) Ranula refers to a mucous extravasation cyst arising from the sublingual gland

178. Ultrasound feature suggesting malignancy in thyroid swelling

a) Macroscopic capsular breach

b) Microcalcification

c) Increased vascularity
d) All the above

179. Skin transfer where the blood supply has been isolated, and disconnected, and reconnected at
the new site using microsurgery is referred to as

a) Wolffe full thickness skin graft

b) Composite skin graft

c) Islanded flap

d) Free flap

180. The commonest intracranial tumor is

a) Glioma

b) Pitutary tumor

c) Meningioma

d) Metastases

181. Clinical interpretation of the nonstress test for fetal well-being may be difficult because of

a) High false negative tests

b) High false positive tests

c) Low positive predictive values

d) High negative predictive values

182. Regarding progestational contraceptives, all the statements are correct EXCEPT

a) They are safe during the period of lactation

b) They may sometimes worsen acne

c) They have no side effects

d) In combination with breast feeding, they are virtually 100% effective

183. Treament of Trichomoniasis infection of vagina

a) Oral ciprofloxacin

b) Oral metronidazole

c) Oral doxycylin

d) Topical nystatin cream

184. Following is not a vulval cyst

a) Bartholin cyst

b) Sebaceous cyst

c) Cyst of canal of nuck

d) Gartener’s cyst

185. Which of them is NOT a risk factor for development of gestational hypertension?

a) Nulliparity

b) Advanced maternal age

c) Smoking

d) Multiple gestation

186. Elevated levels of the tumor marker CA-125 are NOT found in which of the following
conditions?

a) Ovarian epithelial carcinoma

b) Endometriosis

c) Ectopic pregnancy

d) Leiomyoma
187. Which of the following muscles DOES NOT contribute to the perineal body?

a) Levator ani

b) Ischiocavernosus

c) Bulbospongiosus

d) Transverse perinea

188. In breech delivery, Lovset’s manoeuvre is used for the delivery of

a) Leg

b) Buttock

c) Shoulder

d) After coming head

189. Levels of all coagulation factors are increased in pregnancy EXCEPT

a) Factor VIII

b) Factor IX

c) Factor X

d) Factor XI

190. Maternal serum alpha fetoprotein is decreased in

a) Polyscystic kidney

b) Gastroschisis

c) Placental chorioangioma

d) Trisomy 18
191. Modified biophysical score includes

a) Nonstress test and fetal movements

b) Contraction stress test and amniotic fluid index

c) Nonstress test and amniotic fluid index

d) Contraction fetal stress and fetal tone

192. In an Rh positive neonate born to an Rh negative woman, If coomb’s test is positive, all the
following are indications for exchange transfusion EXCEPT

a) Cord blood Hemoglobin less than 11G%

b) Total bilirubin level of 10mg%

c) Cord blood bilirubin more than 4mg%

d) Bilirubin rise of over 1 mg% per hour despite phototherapy

193. All the following are biochemical serum markers in second trimester screening of Down’s
syndrome EXCEPT

a) PAPP-A

b) Beta HCG

c) Inhibin

d) Unconjugated oestriol

194. Spiegelberg’s criteria are used in the diagnosis of

a) Cervical pregnancy

b) Corneal pregnancy

c) Tubal pregnancy

d) Ovarian pregnancy
195. The Lambda sign in ultrasonography indicates

a) Conjoint twins

b) Monochorioni twins

c) Dichorionic twins

d) Twin to twin transfusion

196. Oligohydramnios is defined as amniotic fluid index of less than

a) 2cms

b) 5cms

c) 8cms

d) 10cms

197. Which of the following cardiac conditions is least likely to cause maternal complication?

a) Patent ducttus arteriosus

b) Coarctation aorta

c) Eisenmenger’s syndrome

d) Fallot’s tetralogy

198. Which of the following is FALSE regarding usage of combined oral contraceptive pills?

a) Rifampicin reduces drug availability

b) Prolonged use may increase risk of endocervical cancer

c) Carbohydrate tolerance is reduced

d) Lactation is not affected

199. Which of the following is used for ‘medical method of abortion’?

a) Mifepristone 200 mg and misopristol 400 mcg

b) Mifepristone 400 mg and misopristol 600 mcg

c) Mifepristone 600 mg and misopristol 800 mcg

d) Mifepristone 800 mg and misopristol 1000 mcg

200. All the following are causes of oligomenorrhea EXCEPT

a) Chronic tubo-ovarian mass

b) Android obesity

c) Stress and exercise

d) Premenopausal period