1

1. Ligamentum teres is formed after:

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a. Obliteration of the umbilical vein
b. Obliteration of the ductus venous
c. Obliteration of the ductus arteriosus
d. Obliteration of the hypogastric artery

Correct answer
a. Obliteration of the umbilical vein
Feedback
a. Umbilical Arteries= Medial Umbilical Ligaments
b. Left umbilical vein =Ligamentum teres of the liver
c. Ductus venosus =Ligamentum venosum
d. Ductus arteriosus =Ligamentum arteriosum

2. Cardiac activity of fetus by transabdominal USG is seen earliest at what gestational age?
1/1
a. 5th week
b. 6th week
c. 8th week
d. 9th week
Feedback
Gestational sac
4 and half weeks by TVS
5 weeks 5 days by TAS

Yolk sac
5 weeks by TVS
7 weeks by TAS
Cardiac activity

6 weeks by TVS
7–8 weeks by TAS

3. Lochia in correct order: during puerperium:

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a. Rubra, serosa, alba
b. Serosa, rubra, alba
c. Alba, serosa, rubra
d. Alba, mucosa, serosa

Correct answer
a. Rubra, serosa, alba
Feedback
2

LOCHIA:
• It is the vaginal discharge for the first fortnight during puerperium
• The discharge originates from the uterine body, cervix and vagina.
• It has got a peculiar offensive fishy smell.
• Its reaction is alkaline tending to become acid towards the end.
• Depending upon the variation of the color of the discharge, it is named as:
– Lochia rubra (red) 1-4 days.
– Lochia serosa (5-9 days) — the color is yellowish or pink or pale brownish.
– Lochia alba — (pale white) — 10-15 days

4. A 28-year-old female with a history of 8 weeks amenorrhoea complains of vaginal bleeding and
lower abdominal pain. On USG examination there is gestational sac with absent fetal parts. The
diagnosis is:
1/1
a. Ectopic pregnancy
b. Incarcerated abortion
c. Threatened abortion
d. Corpus luteum cyst
Feedback
• Amenorrhea of 8 weeks (incarcerated abortion is seen
in fetus before 12 weeks).
• USG showing gestational sac with no fetal part.
(In incarcerated abortion - small repeated hemorrhage occur in the choriodecidual space, dis-rupting
the villi from its attachment. The clotted blood with
the contained ovum in called as blood mole. The
ovum is dead and is either absorbed or remains
as a rudimentary structure. So on USG - although
gestational sac is seen, no fetal parts are seen .

The only point which goes against incarcerated abortion

is that patient does not present with vaginal bleeding
and pain but friends, this can be explained on the basis
that initially in missed abortion there is no bleeding or
pain but later on the uterus itself tries to expel the dead
fetus and patient at that time may present with bleeding
and pain.

5. False about H mole:

1/1
a. Always associated with raised uterine size for gestational age
b. Raised hCG
c. Hysterectomy in selected cases
d. Thyrotoxicosis rare
Feedback
“The size of the uterus is more than that expected for the period of amenorrhea in 70%, corresponds
with the
period of amenorrhea in 20% and smaller than the period of amenorrhea in 10%.
3

6. Regimen followed in expectant management of placenta previa

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a. Liley’s method
b. Crede’s method
c. Macafee and Johnson regime
d. Brandt-Andrews Method
Feedback
Macafee and Johnson regime is the name given to the expectant management of placenta previa as it
was advocated
by McAfee and Johnson.

Aim of expectant management in case of placenta previa is to continue pregnancy for fetal maturity
without compromising
the maternal health.
Prerequisites for expectant management:
Availability of blood for transfusion whenever required
Facilities for caesarean section should be available throughout 24 hours.

Candidates: Suitable for expectant management are:

• Mother in god health status- Hemoglobin > 10 gm%
• Hematocrit > 30% and she should be hemodynamically stable.
• Duration of pregnancy less than 37 weeks
• Active vaginal bleeding is absent
• Fetal well being is assured by USG and cardiotocography
The expectant management is carried upto 37 weeks of pregnancy until baby matures.

Expectant management includes (i.e. MacAfee and Johnson regime includes)

Hospitalisation till active bleeding stops and then readmission at 34 weeks
Complete bed rest
Anaemia corrected with blood transfusion (if necessary), but blood should always to be kept ready as
placenta previa
is a recurrent condition.
Antenatal steroids to promote fetal lung maturity
Anti D if patient is Rh negative
If uterine contractions are present - tocolytics (magnesium sulphate/nifedipine) can be given as it
leads to more
advanced gestational age at delivery, greater birth weight of fetus, less neonatal complications, and
decreased cost of
hospitalization. Tocolytics should not be used for more than 48 hours.
Some obstetricians do cervical encirclage in case of placenta previa.
The rationale behind the use of cervical cerclage in placenta previa, is that it limits the development of
the low uterine
segment brought about by advancing gestation and the effect of uterine contraction. But other studies
have failed to
confirm these findings. Thus, RCOG doesnot recommend the use of cervical cerclage in placenta
previa till further data
is available.

7. All of the following are used in the treatment of postpartum hemorrhage except
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a. Misoprostol
4

b. Mifepristone
c. Carboprost
d. Methyl ergometrine

Correct answer
b. Mifepristone
Feedback
Commonly used oxytocics in the management of PPH are:
• Oxytocin
• Methergin
• Syntometrine – oxytocin + methergin
• 15 methyl PGF2a (carboprost)
• Misoprostol (PGE1)

8. Most common heart disease associated with pregnancy is:

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a. Mitral stenosis
b. Mitral regurgitation
c. Patent ductus arteriosus
d. Tetralogy of fallot

Correct answer
a. Mitral stenosis
Feedback
In developing countries like India:
Most common heart disease in pregnancy is of rheumatic origin, followed by the congenital heart
disease.
Most common rheumatic valvular lesion is mitral stenosis (in 80%) followed by mitral regurgitation and
aortic stenosis.

In developed countries:
Most common heart disease is congenital heart disease
Most common lesion is Atrial septal defect

9. Antihormonal substance used to induce ovulation:

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a. Mifepristone
b. Clomiphene citrate
c. Tamoxifen
d. Raloxifene

Correct answer
b. Clomiphene citrate
Feedback
5

Clomifene, also known as clomiphene, is a medication used to treat infertility in women who do not
ovulate, including those with polycystic ovary syndrome. Use results in a greater chance of twins. It is
taken by mouth once a day, with a course of treatment that usually lasts for 5 days.

10. All changes occur in fibroid uterus except:

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a. Atrophy
b. Squamous metaplasia
c. Hyaline degeneration
d. Calcification

Correct answer
b. Squamous metaplasia
Feedback
Degenerations in a fibroid

Atrophy
Red degeneration
Hyaline degeneration (MC)
Fatty degeneration or calcification
Myxomatous degeneration
Cystic degeneration

Mnemonic: Avoid Red hot fatty meat of chicken

11. All are true regarding endometriosis, except:

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a. Hormone dependent condition
b. Can involve lung, pleura
c. Contains clear fluid
d. Ovary is the most common site

Correct answer
c. Contains clear fluid
Feedback
Endometriosis is occurence of functioning endometrial tissue (glands + stroma) outside the uterine
cavity.
Whatever the inital genesis of endometriosis its further development depends mainly on estrogen
• It can occur anywhere in body, Most common site being ovary
• Can also involve lungs and pleura
• In endometriosis ovary contains tarry dark brown fluid (due to presence of blood pigments like
hemosiderin) and cul de sac has yellow brown fluid.
Clear fluid is not seen anywhere, So, Option “c” is incorrect

12. The following are indications for postoperative radiotherapy in a case of carcinoma endometrium
except:
0/1
6

a. Myometrial invasion of more than half thickness

b. Positive lymph nodes
c. Endocervical involvement
d. Tumor positive for estrogen receptors

Correct answer
d. Tumor positive for estrogen receptors
Feedback
Indications of adjuvant radiotherapy:
• Extrauterine extension.
• Lower uterine or cervical involvement.
• Papillary serous or clear cell histology.
• Poor histologic differentiation (Grade III).
• Myometrial penetration greater than 1/2 of thickening.
• Pelvic node involvement

13. . Theory of web of causation was given by?

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(a) Mc Mohan and Pugh
(b) Pettenkoffer
(c) John snow
(d) Louis Pasteur

Correct answer
(a) Mc Mohan and Pugh
Feedback
Germ theory of disease: Louis Pasteur
• Multi-factorial causation of disease: Pattenkoffer
• Spontaneous generation theory: Aristotle

14. Which of the following is a Mortality Indicator?

1/1
(a) Life Expectancy
(b) Notification Rate
(c) DALY
(d) Bed turn-over ratio
Feedback
Life Expectancy is a ‘Positive mortality indicator’

• DALY is a type of disability rate

• Bed turn-over ratio is a type of heath care utilization rate

15. Organism multiplying and developing in the hosts is called as:

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(a) Cyclopropagative
7

(b) Cyclodevelopmental
(c) Developmental
(d) Propagative

Correct answer
(a) Cyclopropagative
Feedback
Common Diseases spread by mosquitoes are Malaria, Filaria, Viral Encephalitis (e.g. Japanese
encephalitis), Viral Fevers (e.g. Dengue, West Nile, Viral Haemorrhagic Fevers (eg., Yellow Fever,
Dengue Haemorrhagic Fever). They are often spread disease by biological transmission when the
disease agent multiplies or undergoes some developmental change with or without multiplication in
the arthropod host, it is called biological transmission. This may be of three types:

Propagative: When the disease agent undergoes no cyclical change but multiplies in the body of the
vector, transmission is said to be propagative, e.g. plague bacilli in rat fleas

Cyclopropagative: The disease agent undergoes cyclical change, and multiplies in the body of the
arthropod, e.g. malaria parasite in anopheline mosquito

Cyclo-developmental: When the disease agent undergoes cyclical change but does not multiply in the
body of the arthropod, e.g. filarial parasite in Culex mosquito and guinea worm embryo in Cyclops.

16. Double blind study means:

1/1
(a) Observer is blind about the study
(b) Person or group being observed is blind about the study
(c) Both observer and person or group being observed is blind about the study
(d) Interpreters and analyzer are blind about the study
Feedback
Single blinding
Method: Study subjects are not aware of the treatment they
are receiving
Minimizes Subject bias

Double blinding
Method: Study subjects as well as investigator are not aware
of the treatment study subjects are receiving
Minimizes Subject bias + Investigator bias

Triple blinding
Method: Study subjects, investigator as well as analyzer are not aware of the treatment study subjects
are receiving
Minimizes Subject bias + Investigator bias + Analyzer bias

17. Validity of a test is based upon all except:

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(a) Sensitivity
(b) Specificity
(c) Precision
8

(d) Accuracy

Correct answer
(c) Precision
Feedback
Validity: Refers to what extent the test measures which it purports to measure (adequacy/accuracy of
measurement)
• Validity has 2 components:
– Sensitivity
– Specificity
• Inherent properties of a screening test:
– Sensitivity
– Specificity
– Predictive accuracy

Reliability is precision, while validity is accuracy

18. Risk of the damage of fetus by maternal rubella is maximum if mother gets infected in:
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(a) 6-12 weeks of pregnancy
(b) 20-24 weeks of pregnancy
(c) 24-28 weeks of pregnancy
(d) 32-36 weeks of pregnancy

Correct answer
(a) 6-12 weeks of pregnancy
Feedback
Other manifestations of CRS may include: spleen, liver or bone marrow problems, mental retardation,
microcephaly, low birth weight, thrombocytopenic purpura (characteristic ‘blueberry muffin’ rash),
hepatomegaly, micrognathia

19. Corpulence index measure:

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(a) Hypertension
(b) Obesity
(c) Diabetes
(d) Malnutrition

Correct answer
(b) Obesity
Feedback
Corpulence Index=Actual weight/ Desired weight

20. Which of the following is false about scrub typhus?

Timely reporting of any suspected or confirmed case should be done to EDCD
9

Insect repellents containing benzyl benzoate can be applied to the skin and clothing to prevent
chigger bites.
Vaccine is available for scrub typhus.
There is no human to human transmission

Correct answer
Vaccine is available for scrub typhus.
Feedback
No vaccine is available to prevent scrub typhus.
Reduce your risk of getting scrub typhus by avoiding contact with infected chiggers.
When traveling to areas where scrub typhus is common, avoid areas with lots of vegetation and brush
where chiggers may be found.

21. Population explosion is defined as population growth rate > _____ per year:
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(a) 1.8
(b) 2.0
(c) 2.5
(d) 3.5

Correct answer
(b) 2.0
Feedback
From 2.0 onwards value of annual growth rate, term population explosion is used.

22. The 'AAMA SURAKSHYA PROGRAM' is related to

1/1
Family Planning Programme
Safe Motherhood Programme
Adolescent and sexual reproductive health programme
Female Community Health Volunteers programme
Feedback
Aama surakshya program also called Aama and Newborn programme is part of Safe Motherhood
program where incentives are provided to women for institutional delivery which encourages safe
delivery and timely intervention in complicated cases preventing maternal and child mortality.

23. A child's growth variation is normal but bone development is not acc to the chronological age.
What is the diagnosis?
1/1
a) Genetic
b) Dwarfism
c) Constitutional delay
d), Familial short stature
Feedback
10

In constitutional delay the bone age is less than chronological age, while in familial short stature bone
age is normal for the chronological age.
So, the most likely diagnosis of this child is constitutional delay in growth.

24. True about cow's milk are all except-

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a) Cow's milk contains 80% whey protein not casein
b) Cow milk has less carbohydrate than mothers milk
c) Has more K+ and Na+ than infant formula feeds
d) Has more protein than breast milk

Correct answer
a) Cow's milk contains 80% whey protein not casein
Feedback
Whey protein constitutes 80% of the protein in human milk, while the main protein in cow's milk is
casein.

25. Administration of glucose solution is prescribed for all of the following situations except
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a) Neonates
b) Child of a diabetic mother
c) History of unconsciousness
d) History of hypoglycemia

Correct answer
c) History of unconsciousness
Feedback
Neonates are susceptible for developing hypoglycemia during the first 2-4 hours of life. If the breast
feeding is not started within 24 hour of life about 10% of normal neonates are likely to develop
hypoglycemia
This hypoglycemia is corrected either by starting breast-feeding or by administering glucose.

Child of diabetic mother is prone for hypoglycemia Glucose solution is given if the child develops
symptoms of hypoglycemia
In a child with history of hypoglycemia, glucose administration is indicated if the symptoms of
hypoglycemia recur.

26. The commonest cyanotic heart disease manifesting as congestive cardiac failure during first
week of life ls-
0/1
a) Pulmonary stenosis
b) Fallot's tetralogy
c) Tricuspid atresia
d) Hypoplastic left heart syndrome

Correct answer
11

d) Hypoplastic left heart syndrome

Feedback
Amongst the given options, hypoplastic left heart syndrome causes CHF in First week
The most common cause of CHF in infants : Congenital heart disease
The most common cause of CHF in the older children : Rheumatic fever & rheumatic heart disease

27. A 6 months old baby coming with H/o increasing difficulty in breathing of 2 days duration and on
examination baby is afebrile & B/L wheeze & CXR shows B/L hyperinflation of the lungs with normal
WBC count, the diagnosis is
1/1
a. Bronchiolitis
b. Asthma
c. Chronic bronchitis
d. Pneumonia
Feedback
Bilateral wheeze, hyperinflation of lungs and normal WBC with respiratory distress in a 6 months old
infant are characteristic of acute bronchiolitis.

28. Pneumatosis intestinalis is most often seen in

1/1
a) Neonatal necrotising enterocolitis
b) Midgut volvulus
c) Meconium peritonitis
d) Neonatal visual perforation
Feedback
Bell stages for necrotizing enterocolitis

Bell's stage 1 (suspected disease):

Mild systemic disease (apnea, lethargy,[14] slowed heart rate, temperature instability)
Mild intestinal signs (abdominal distention, increased gastric residuals, bloody stools)
Non-specific or normal radiological signs

Bell's stage 2 (definite disease):

Mild to moderate systemic signs
Additional intestinal signs (absent bowel sounds, abdominal tenderness)
Specific radiologic signs (pneumatosis intestinalis or portal venous gas
Laboratory changes (metabolic acidosis, too few platelets in the bloodstream)

Bell's stage 3 (advanced disease):

Severe systemic illness (low blood pressure)
Additional intestinal signs (striking abdominal distention, peritonitis)
Severe radiologic signs (pneumoperitoneum)
Additional laboratory changes (metabolic and respiratory acidosis, disseminated intravascular
coagulation)
12

29. 12 years old Shyam presented with gross hematuria with 80% dysmorphic RBC's 2 days after a
attack of upper respiratory tract infection diagnosis is
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a) Microangiopathic thrombotic anaemia
b) IgA Nephropathy
c) PSGN
d) H.S. purpura

Correct answer
b) IgA Nephropathy
Feedback
The patient is having glomerulonephritis gross hematuria and dysmorphic RBCs 2 days after upper
respiratory
tract infection.
Three conditions can manifest like this: IgA nephropathy, Post streptococcal glomerulonephritis, HS
Purpura.
IgA nephropathy after 2 days of upper respiratory tract infection while PSGN and HSP after 7-10 days
of URTI.

30. A l0 yr old boy presents with midline swelling arising from cerebellum the diagnosis is
0/1
a) Astrocytoma
b) Glioblastoma multiforme
c) Ependymoma
d) Medulloblastoma

Correct answer
d) Medulloblastoma
Feedback
Midline swelling arising from cerebellum in a child favour the diagnosis of medulloblastoma.
In children medulloblastomas are located in midline but in adults they are found in lateral locations
Note -
Astrocytoma is also a posterior fossa tumor, but it does not commonly present as midline mass.

31. In beta thalassemia, there is

1/1
a) Increase in beta chain, decrease in alpha chain
b) Decrease in beta chain, increase in alpha chain
c) Decrease in beta chain, decrease in alpha chain
d) Increase in beta chain, increase in alpha chain
Feedback
The abnormality common to all Beta thalassemias is diminished
coupled with unimpaired synthesis of alpha-chain.

32. The most common cause of ambiguous genitalia in a newborn is -

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0/1
a) 21 hydroxylase deficinecy
b) 11 beta - hydroxylase deficiency
c) 17 alpha - hydroxyalse deficiency
d) 3 beta - hydroxysteroid deficiency

Correct answer
a) 21 hydroxylase deficinecy
Feedback
Congenital adrenal hyperplasia due to classic 21-Hydroxylase deficiency is the most common cause of
ambiguous genitalia in the newborn. Virilization is apparent at birth in the female and within the first 2-
3 years of life in the male.

33. Which of the following nerve palsy is responsible for positive Trendelenburg test?
0/1
a. Inferior gluteal nerve
b. Superior gluteal nerve
c. Pudendal nerve
d. Obturator nerve

Correct answer
b. Superior gluteal nerve
Feedback
Correct answer is ‘b’. Trendelenburg test is positive due to the paralysis of abductors, chiefly gluteus
medius. The latter is supplied by superior gluteal nerve

34. Which of the following spinal cord tracts carries light touch sensation?
0/1
a. Ventral corticospinal tract
b. Lateral spinothalamic tract
c. Dorsal column
d. Anterior spinothalamic tract

Correct answer
d. Anterior spinothalamic tract
Feedback
The correct answer is “d”

Anterior or ventral spinothalamic tract perceive light touch and pressure. Lateral spinothalamic tract
transmit pain, temperature and crude touch sensations. The anterior or ventral corticospinal tract
transmit motor impulses. Dorsal column transmit fine touch, vibration, two-point discrimination, and
proprioception (position) from the skin and joints. There is a difference between fine touch and light
touch

35. In Froment’s sign, the action of which of the following muscle is unopposed.
14

1/1
a. Adductor pollicis
b. Flexor pollicis longus
c. Flexor carpi ulnaris
d. Opponens pollicis
Feedback
Correct answer is ‘b‘. Due to ulnar nerve palsy, the adductor pollicis is paralyzed. Thus, while
performing Froment’s sign, there is flexion of the thumb interphalangeal joint, mediated by the flexor
pollicis longus (FPL). The anterior interosseous nerve, supplies the FPL

36. Bone within bone is seen in which of the following disease?

1/1
a. Paget’s disease
b. Osteopetrosis
c. Rickets
d. Scurvy
Feedback
The correct answer is ‘b’. Osteopetrosis or ALBERS–SCHÖNBERG DISEASE is a disease
characterized by defective osteoclastic resorption of bone. Hence, abnormal deposition of bone in
various sites lead to the term ‘bone within bone’ or marble bone disease.

Paget’s disease is characterized by abnormal bone remodelling in people over age of 50 years. Due to
this process, thickened and brtille bones are produces. Osteoporosis circumscripta is a feature of this
disease

37. Lisfranc amputation is done through which level?

0/1
a. Metatarsals
b. Subtalar joint
c. Ankle joint
d. Tarsometatarsal joints

Correct answer
d. Tarsometatarsal joints
Feedback
Lisfranc amputation is at the level of tarsometatarsal joints. Chopart amputation is at the transverse
tarsal joints. Syme amputation is at the level of ankle joint

38. Which of the following is not a variety of osmotic diarrhoea?

1/1
A. Whipple's disease
B. Coeliac disease
C. Lactase deficiency
D. Laxative abuse
15

Feedback
Surreptitious laxative abuse is the most frequent cause of factitious diarrhea and often presents as
chronic watery diarrhea of unknown etiology. All other options cause malabsorption and related
osmotic diarrhea.

39. Acid peptic disease is rarely found in:

0/1
A. Cushing's syndrome
B. Pregnancy
C. Polycythaemia vera
D. Chronic obstructive pulmonary disease

Correct answer
B. Pregnancy
Feedback
Peptic ulcer disease (PUD) is uncommon during pregnancy, with a reported incidence rate of 0.005%,
although this is probably underestimated. PUD is believed to improve during pregnancy as a result of
decreased gastric acid secretion

40. Which of the following may develop into intestinal lymphoma?

0/1
A. Coeliac disease
B. Ulcerative colitis
C. Eosinophilic enteritis
D. Intestinal lymphangiectasia

Correct answer
A. Coeliac disease
Feedback
Enteropathy associated T-cell lymphoma (EATL) is a T-cell lymphoma that arises in the
gastrointestinal tract and is highly associated with celiac disease. Patients with untreated celiac
disease have a substantially increased risk of developing EATL, especially among those diagnosed at
an older age. Ulcerative colitis is associated with increased risk of colorectal cancer.

41. Commonest cause of chronic relapsing pancreatitis is:

1/1
A. Trauma
B. Gallstones
C. Alcohol abuse
D. Infection
Feedback
16

Toxic effect of alcohol causes obstruction of duct with protein precipitates. The precipitates block the
pancreatic duct and eventually calcify which is followed by fibrosis and glandular atrophy. Pseudocyst
and abscesses commonly develop.

42. Digitalis toxicity is precipitated by all except:

1/1
A. Old age
B. Hypokalaemia
C. Renal failure
D. Hepatic encephalopathy

Feedback
Hypokalemia, Renal failure, Hepatic failure, Hypomagnesemia, Hypercalcemia, WPW syndrome,
Myocarditis , Thiazides, Verapamil and Amiodarone are known to precipitate digitalis toxicity.
Advanced age (>80 y) is an independent risk factor for digitalis toxicity

43. All are commonly seen in Legionella pneumophila-induced pneumonia except:

0/1
A. Cavitation
C. Proteinuria
B. Hyponatraemia
D. Confusion

Correct answer
A. Cavitation
Feedback
On chest radiographs Legionella typically produces focal parenchymal opacities and confluent lobar
consolidation.

44. Albumino-cytological dissociation is not a feature of:

0/1
A. Guillain-Barre syndrome
B. Acoustic neurofibroma
C. Froin's loculation syndrome
D. Meningism

Correct answer
D. Meningism
Feedback
Besides GBS Albuminocytologic dissociation is also seen in Spinal compression, neoplasia, non
inflammatory degeneration of brain parenchyma, Froin syndrome, Acoustic neuroma.

45. All are true in 'dialysis dementia' except:

1/1
17

A. Raised intracranial tension

B. Myoclonus
C. Seizures
D. Related to aluminium toxicity
Feedback
The researchers found blood flow to the brain was reduced during dialysis and patients' cognitive
function decreased as well. Those who remained on dialysis were more at risk of memory loss due to
reduced blood flow during the procedure.

46. Which of the following is associated with prolonged bleeding time?

0/1
A. Polycythaemia vera
B. von Willebrand's disease
C. Antiphospholipid syndrome
D. Haemophilia

Correct answer
B. von Willebrand's disease
Feedback
Platelet-type von Willebrand disease (PT-VWD), also known as pseudo-von Willebrand disease, is an
extremely rare genetic disorder characterized by prolonged bleeding time.

47. Drug of choice in paracetamol poisoning is:

1/1
A. Penicillamine
B. Amyl nitrite
C. N-acetylcystine
D. Cholestyramine
Feedback
Penicillamine in Wilson disease or Copper poisoning.
Amyl nitrite in Cyanide poisoning
NAC in PCM poisoning

The standard administration of NAC is a 2 stage infusion (recently changed from 3 stage infusion)
giving a total dose of 300 mg/kg:

200 mg/kg over 4 hours

100 mg/kg over the next 16 hours

48. Epstein-Barr virus is associated with all except:

0/1
A. Nasopharyngeal carcinoma
B. Hairy cell leukaemia
C. Burkitt' s lymphoma
18

D. Infectious mononucleosis

Correct answer
B. Hairy cell leukaemia
Feedback
As with many cancers, the cause of hairy cell leukemia is unknown. Exposure to tobacco smoke,
ionizing radiation, or industrial chemicals (with the possible exception of diesel) does not appear to
increase the risk of developing HCL. Human T-lymphotropic virus 2 (HTLV-2) has been isolated in a
small number of patients with the variant form of HCL.

49. CREST syndrome is aggregation of calcinosis, Raynaud's phenomenon, sclerodactyly,

telangiectasia and __
0/1
A. Oedema
B. Endomyocardial fibrosis
C. Oesophageal hypomotllity
D. Exophthalmos

Correct answer
C. Oesophageal hypomotllity
Feedback
CREST syndrome, also known as the limited cutaneous form of systemic sclerosis (lcSSc), is a
multisystem connective tissue disorder. The acronym "CREST" refers to the five main features:
calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia

50. Tetany is characterised by all of the following signs except:

0/1
A. Trousseau's sign
B. Tinel's sign
C. Erb's sign
D. Peroneal sign

Correct answer
B. Tinel's sign
Feedback
Signs of hypocalcemic tetany

Contraction of facial muscle in response to tapping the facial nerve, (insensitive test) =Chvostek’s sign

Carpal spasm occurring after occlusion of the brachial artery with BP cuff with pressure 20 mm of Hg
above systolic BP for 3-5min= Trousseau’s sign

Hyperexcitability of muscle by subthreshold electrical stimulus is called Erbs sign of hypocalcemia.

Chronic hypocalcemia cause laryngeal stridor.

19

The Tinel's sign test is often used to help diagnose carpal tunnel syndrome, cubital tunnel syndrome,
or tarsal tunnel syndrome. A positive result means you feel a tingling sensation when the affected
nerve is tapped.

51. Most common site of metastasis from breast carcinoma:

0/1
a. Thoracic vertebra
b. Pelvis
c. Femur
d. Lumbar vertebra

Correct answer
d. Lumbar vertebra
Feedback
Most common site of metastasis from breast carcinoma is lumbar vertebra.
Bailey says that “It is by this route (spread by the bloodstream) that skeletal metastases occur,
although the initial spread may be
via the lymphatic system. In order of frequency the lumbar vertebrae, femur, thoracic vertebrae, rib
and skull are affected and
these deposits are generally osteolytic.

52. All of the following are true regarding FNH except:

1/1
a. Not frequently associated with OCPs
b. Surgical resection is required due to risk of malignancy
c. Stellate scar is diagnostic
d. Typical hepatic vascularity is not seen with spoke wheel pattern
Feedback
Focal nodular hyperplasia (FNH) is a benign condition of the liver that is often discovered incidentally
on radiological investigation. FNH has no malignant potential, is rarely symptomatic and surgical
intervention is almost never required.

53. Veno-occlusive disease is seen in all except:

0/1
a. Bone marrow transplant
b. Bush teas
c. Mushroom poisoning
d. Cytosine arabinoside

Correct answer
c. Mushroom poisoning
Feedback
20

Risk Factors for veno occlusive disease

• In the western hemisphere, MC cause of VOD is bone marrow transplantation
• Chemotherapy: Cytosine arabinoside, Thioguanine, Carmustine, Gemtuzumab ozogamocin
• Long term immunosuppression with azathioprine in renal and liver transplantation
• Ingestion of bush teas (pyrrolizidine alkaloids) from plants of Crotalaria and Scenacio genera. These
plants and plants of
Heliotropium genus produce liver failure in herbivores.

54. Grey Turner’s sign is seen in:

1/1
a. Acute appendicitis
b. Acute pancreatitis
c. Acute cholecystitis
d. Acute hepatitis
Feedback
Signs indicative of retroperitoneal bleeding in severe pancreatitis
Flank ecchymosis= Grey Turner sign
Periumbilical ecchymosis= Cullen’s sign
Inguinal ecchymosis= Fox sign

55. In Forrest classification, high-risk of bleeding is associated with all except:

1/1
a. Visible vessel
b. Visible pulsatile bleeding
c. Adherent clot
d. Visible oozing from vessel
Feedback
Forrest classification (Endoscopic findings and Rebleeding risk) for peptic ulcer bleeding

Grade= Description =Rebleeding Risk

Ia Active, pulsatile bleeding High
Ib Oozing, non-pulsatile bleeding High
IIa Non-bleeding visible vessel High
IIb Adherent clot Intermediate
IIc Black dot Low
III Clean base Low

56. Most common site of intra peritoneal abscess?

1/1
a. Morrison’s pouch
b. Omental bursa
c. Pelvic region
d. Left subhepatic pouch
Feedback
21

Pelvic abscesses are the most common intraperitoneal abscesses. An inflamed appendix, pelvic
inflammatory disease and acute diverticulitis can cause local pelvic peritonitis and eventually result in
an abscess formation.

57. Acute intestinal obstruction is characterized by all except

1/1
a. Vomiting is common in duodenal obstruction
b. Pain after each attack of vomiting is characteristic of ileal obstruction
c. In colonic obstruction distension is common than vomiting
d. X-ray erect posture is diagnostic
Feedback
Nausea and vomiting are more common with proximal obstruction
Abdominal distention is more common in distal obstruction

58.All of the following is true regarding superior mesenteric artery syndrome, except:
0/1
a. Common in young females
b. Caused by compression of third part of duodenum
c. Vomiting and post-prandial abdominal pain are typical symptoms
d. Gastrojejunostomy is treatment of choice in chronic case

Correct answer
d. Gastrojejunostomy is treatment of choice in chronic case
Feedback
. d. Gastrojejunostomy is treatment of choice in chronic cases
• TOC in annular pancreas: Duodenoduodenostomy
• TOC in duodenal atresia: Diamond shaped Duodenoduodenostomy
• TOC in SMA syndrome: Duodenojejunostomy

59. True statements about congenital megacolon include all of the following except:
0/1
a. Dilatation and hypertrophy of pelvic colon
b. Loud borborygmi
c. Symptoms appear within 3 days following birth
d. Large stool

Correct answer
d. Large stool
Feedback
Clinical Presentation
Neonates
• Suspected in all neonates
presenting with:
- Delayed passage of meconium
beyond the first 24 hours of life
22

- Abdominal distension following

feeds

First few weeks of life

• Suspected in any child presenting
in first few weeks of life with:
- Gross abdominal distension
- Chronic constipation
- Failure to thrive

Otherwise healthy children and adults

• Short segment Hirschprung disease should
be suspected in otherwise healthy children
and adults presenting with:
- Severe constipation without fecal soiling
- Faecal soiling is usually not a feature of this
condition

60. Early postoperative complication of ileostomy:

0/1
A. obstruction
B. Prolapse
C. Diarrhea
D. Necrosis

Correct answer
D. Necrosis
Feedback
Schwartz says “Stoma necrosis may occur in the early post-operative period and usually is caused by
skeletonizing the distal small
bowel and/e por creating an overly tight fascial defect

61. Shouldice repair is:

0/1
a. Multilayered repair of inguinal canal
b. Conjoint tendon is sutured to inguinal ligament
c. Conjoint tendon is sutured to Cooper’s ligament
d. Transabdominal repair

Correct answer
a. Multilayered repair of inguinal canal
Feedback
Shouldice repair

Primary tenets of the procedure involve extensive dissection and reconstruction of inguinal canal
anatomy
• The use of a continuous suture in multiple layers resulted in the dual advantage of distributing
tension over several layers
23

and preventing subsequent herniation between interrupted sutures

• Consists of division and double breasting of the transversalis fascia

62. Most common cause of emphysematous pyelonephritis:

0/1
a. E. coli
b. Proteus
c. Klebsiella
d. Pseudomonas

Correct answer
a. E. coli
Feedback
Bacteria most frequently cultured from the urine include E. coli (MC), Klebsiella pneumoniae, and
Enterobacter cloacae.
Decreased host immunity is most important factor

63. Vicryl, the commonly used suture material is a:

0/1
a. Homopolymer of polydiozanone
b. Co-polymer of glycolide and lactide
c. Homopolymer of glycolide
d. Homopolymer of lactide

Correct answer
b. Co-polymer of glycolide and lactide
Feedback
Vicryl (Co-polymer of glycolide and lactide) maintains tensile strength for 28-30 days and gets
absorbed in 80-90 days (Delayed absorption)
Vicryl is used for bile duct surgeries.

64. Transplantation between genetically different members of the same species is termed as:
1/1
a. Autograft
b. Isograft
c. Allograft
d. Xenograft
Feedback
• Tissue transplanted from
one site to another on
the same patient =autograft

Transplant from a genetically identical donor, such

as an identical twin=isograft
24

Transplant from
another species=xenograft

65. Presence of collateral circulation of hand is demonstrated by:

0/1
a. Swan Ganz test
b. Sellick's test
c. Allen’s test
d. Katy schmiolt test

Correct answer
c. Allen’s test
Feedback
Allens test
• Allen test (AT) is used to assess collateral blood flow within the hands, specifically testing for the
presence of a complete palmar arch
• A positive Allen test means that the patient does not have an adequate dual blood supply to the hand
which would be a negative indication for catheterization, removal of the radial artery or any procedure
which may result in occlusion of the vessel

66. In renal failure muscle relaxant of choice is:

0/1
a. Atracurium
b. Doxacurium
c. Pancuronium
d. Tubocurarine

Correct answer
a. Atracurium
Feedback
Atracurium undergoes Hoffmann elimination, so safer in renal failure.

67. Color of cylinder of oxygen is:

1/1
a. Blue
b. Orange
c. Purple
d. Black and white

Feedback
Oxygen: White shoulder & black body
N2O: Blue CO2: Grey
25

68. Entonox is:

0/1
a. 10% O2 & 90% N2O
b. 40% O2 & 60% N2O
c. 50% O2 & 50% N2O
d. 75% O2 & 25% N2O

Correct answer
c. 50% O2 & 50% N2O
Feedback
Entonox
• Entonox is mixture of 50% O2 & 50% N2O.
• Uses of Entonox include relief of pain during surgical dressings, chest physiotherapy, removal of
thoracotomy drains and MI.

69 Benzodiazepine can be used in all of the following except:

0/1
a. Painful minor procedure
b. Premedication
c. To prevent hallucination caused by ketamine
d. Convulsion

Correct answer
a. Painful minor procedure
Feedback
Uses of Benzodiazepine
• Premedication
• Adjunct to regional anaesthesia
• In non-painful procedures
• To prevent hallucination in ketamine
• To control convulsions
• Rarely as induction agent

70 Which of the following is the most common post-op complication related to intubation?
1/1
a. Bleeding
b. Malposition
c. Sore throat
d. Adductor Paralysis
Feedback
Postoperative complication of intubation are Sore Throat(commonest), Laryngealedema, Laryngeal
nerve palsy, Infections

71. Local anaesthetic with vasoconstrictor is contraindicated in:

26

0/1
a. Finger block
b. Spinal block
c. Epidural block
d. Regional anesthesia

Correct answer
a. Finger block
Feedback
Addition of vasoconstrictor in local anaesthetic is contraindicated in Digits, Penis, Ear, Nose (@ Digital
PEN) as these structures lack collaterals. Addition of vasoconstrictor can seriously compromise blood
flow to those structures.

72. Normal dead space is of tidal ventilation.

0/1
a. 60%
b. 50%
c. 30%
d. 40%

Correct answer
c. 30%
Feedback
A portion (30%) of the fresh air inspired with each breath does not reach the alveoli but remains in the
conducting airways of the lung. This component of each breath is called the anatomic dead space
component.

73. Tinea "incognito" is due to inappropriate use of systemic and topical:

1/1
a. Antibiotics
b. Antifungals
c. Steroids
d. Antivirals
Feedback
• Tinea incognito: Tinea infection treated with steroid modifies the lesion.
• Tinea capitis: Dermatophytic infection of scalp & hair
• Tina barbae: Also known as barber itch, T. sycosis infection of beard region of face
• Tinea corporis: Infection of upper trunk &limbs
• Tinea cruris: Infection of groin region
• Tinea unguium: Infection of nail
• Tinea pedis: Infection of soles and toes. Also known as Athlete foot

74. Which of the following can cause dermatophysis?

0/1
27

a. Mycetoma
b. Candida
c. Trichophyton
d. P. versicolor

Correct answer
c. Trichophyton
Feedback
Causes of dermatophysis
• Microsporum (doesn't involve nail)
• Trichophyton
• Epidermophyton (doesn’t involve Hair)

75. Rose spots are seen in:

1/1
a. Malaria
b. Typhus Fever
c. Typhoid Fever
d. Rheumatic Fever
Feedback
Rose spots appear as small, pale red, blanching slightly raised macules and are frequently seen on the
chest and abdomen during the 1st week in typhoid fever. They evolve into non-blanching small
hemorrhages.

76. Sun downing phenomenon is seen in:

0/1
a. Schizophrenia
b. Mania
c. Delirium
d. Depression

Correct answer
c. Delirium
Feedback
"Sun downing phenomenon” is defined as agitation, confusion and restlessness that occurs after the
sunset. It is characteristically seen in delirium.

77. Which of the following is not a classical "4 As” of Eaugen Bleuler's fundamental symptoms of
schizophrenia?
1/1
a. Automatism
b. Ambivalence
c. Autism
d. Affect Disturbance
28

Feedback
Bleuler's 4 As" of schizophrenia
• Ambivalence
• Autism
• Affect disturbance
• Association disturbance

78. Ulcus serpens is caused by:

0/1
a. Pseudomonas
b. Staphylococcus
c. Pneumococcal
d. Gonococcus

Correct answer
c. Pneumococcal
Feedback
The characteristic hypopyon corneal ulcer caused by Pneumococcus is called Ulcus serpens.

79. True statement regarding myopia:

1/1
a. Parallel rays comes to focus posterior to the retina
b. Parallel rays comes to focus anterior to the retina
c. An abnormal shortness of the axial length of the eye
d. Newborn’s eye is myopic
Feedback
Eyeball is too long or the cornea has too much curvature, so the light entering the eye is focused in
front of retina.
Corrected with concave lens.

80. Bitemporal Hemianopia is seen in the lesion of:

0/1
a. Lateral geniculate body
b. Optic Nerve
c. Optic chiasma
d. Optic tract

Correct answer
c. Optic chiasma
Feedback
-Bitemporal hemianopia: sagittal lesion of optic chiasma
-Homonymous hemianopia: optic tract
29

81. In children most common intraocular tumor is:

1/1
a. Hemangioma
b. Rhabdomyosarcoma
c. Neuroblastoma
d. Retinoblastoma

Feedback
Most common intraocular malignancy of childhood.
Histopathological findings: Flexner- Wintensteiner rosettes, Homer-Wright rosettes.

82. The normal pH of tears is:

0/1
a. 6.0
b. 6.5
c. 7.0
d. 7.5

Correct answer
c. 7.0
Feedback
Range : 6.5-7.5
Human tears have 3 layers:
• Lipid layer secreted by meibomian glands (outermost).
• Aqueous layer secreted by lacrimal glands.
• Mucous layer secreted by conjunctival globet cells.

83. Schirmer’s test is done for:

0/1
a. Epiphora
b. Dacrocystitis
c. Myopia
d. Dry eye

Correct answer
d. Dry eye
Feedback
Causes of Dry eye:
• Aging
• Dehydration
• Corneal ulcers and infections
• Eye infection (Eg:conjunctivitis)
• Vit. Adeficiency
• Sjogren’s syndrome
• Secondary tear deficiency (lymphoma, leukemia, rheumatoid arthritis)
30

84. Hoarseness of voice is an early symptom of:

1/1
a. Carcinoma of glottis area
b. Carcinoma of pyriform fossa
c. Carcinoma of subglottic area
d. Carcinoma of supraglottic area
Feedback
Earliest symptoms:
• Suproglottic cancer: Throat pain, dysphagia and referred pain in ear
• Glottic Cancer: Hoarseness of voice
• Subglottic cancer: Stridor & laryngeal obstruction

85. A 55 year old man bleeds from nose posteriorly. What is the most probable area of epistaxis in
this patient?
0/1
a. Retrocolumellar vein
b. Woodruff's area
c. Little’s area
d. Floor of nasal cavity

Correct answer
b. Woodruff's area
Feedback
Woodruffs area:
• Situated under the posterior end of inferior turbinate where sphenopalatine artery anastomizes with
posterior pharyngeal artery
• Site for posterior epistaxis in older people mostly due to HTN.

86. Secondary hemorrhage after tonsillectomy usually presents at:

1/1
a. 12 hours
b. 24 hours
c. 6 days
d. 12 days
Feedback
Secondary hemorrhage alter tonsillectomy is usually seen between the 5th and 10th postoperative
day.
Primary or immediate: Hemorrhage at the time of surgery.
Reactionary or early: Hemorrhage after surgery within 24 hours (75% occur within first6 hours). It may
occur due to slipping of ligature or clot.
Secondary or delayed: Hemorrhage that usually occurs after 24 hours. It may occur due to
infection/sepsis or premature separation of membrane

87. What is the type of joint between the ossicles of ear ?

31

0/1
a. Fibrous joint
b. Primary cartilaginous joint
c. Secondary cartilaginous joint
d. Synovial joint

Correct answer
d. Synovial joint
Feedback
Both the articulation between three ossicles are synovial joint
Joint between Malleus & Incus: Saddle type
Joint between Incus & Stapes: Ball and socket type

88. LMN facial palsy is most commonly caused by:

1/1
a. Trauma
b. Melkersson’s syndrome
c. Brain Abscess
d. Bell’s palsy

Feedback
Bell's palsy:
• Most common cause of facial palsy
• Cause: Idiopathic (may be viral, ischemic or Autoimmune Bell's phenomenon: On attempt to close
eye, eyeball turns up and out
• Treatment: Prednisolone is drug of choice if do not respond to steroid – surgical decompression

89. A 2 year old child presented with acute respiratory distress. Examination revealed decreased
breath sounds with wheeze on the right side. Chest X-ray showed diffuse opacity in the right
hemithorax. Most likely diagnosis is:
0/1
a. Unilateral emphysema
b. Pleural effusion
c. Foreign body aspiration
d. Pneumothorax

Correct answer
c. Foreign body aspiration
Feedback
Foreign body aspiration is common in child and the foreign body generally goes to the right lung.
Reduced breath sounds in one side leads us toward this diagnosis.

90. Which of the following is not safe in pregnancy:

0/1
32

a. USG
b. Doppler
c. MRI
D. CT

Correct answer
D. CT
Feedback
CT uses X-rays so it is not safe during pregnancy. CT scan during first trimester has the highest risk to
the developing fetus due to carcinogenic and teratogenic effect of the ionizing radiation.

91. Golden S is seen in

1/1
a. Left upper lobe collapse
b. Pleural Effusion
c. Left lower lobe collapse
d. Bronchogenic carcinoma

Feedback
Golden S sign is seen in bronchogenic carcinoma due to collapse of mainly right upper lobe.

92. Rib notching is seen in

0/1
a. Tetralogy of fallot
b. Atrial septal defect
c. Ventricular septal defect
d. Coarctation of aorta

Correct answer
d. Coarctation of aorta
Feedback
In Tetralogy of fallot boot shaped heart is seen.
In Coarctation of aorta rib notching is seen on X-ray.

93. The lateral ventricles communicates with the third ventricle through:
1/1
a. Foramen of Monro
b. Foramen of Luschka
c. Foramen of Magendi
d. Aqueduct of Sylvius
Feedback
The foramen of Monro is a short conduit between the paired lateral ventricles and the third ventricle of
the brain. Etiologies of obstruction at the foramen of Monro include infections, congenital atresia,
vascular malformations, and neoplastic processes
33

94. Referred pain from ureteric colic is felt in the groin due to involvement of the following nerve :
0/1
a. Subcostal
b. Illiohypogastric
c. Ilioinguinal
d. Genitofemoral

Correct answer
d. Genitofemoral
Feedback
Referred pain is pain perceived at a location other than the site of the painful stimulus/ origin. It is the
result of a network of interconnecting sensory nerves, that supplies many different tissues.

95. Middle meningeal artery is a direct branch of :

0/1
a. Superior temporal artery
b. Internal maxillary artery
c. External carotid artery
d. Middle cerebral artery

Correct answer
b. Internal maxillary artery
Feedback
The middle meningeal artery is typically the third branch of the first portion of the maxillary artery.
After branching off the maxillary artery in the infratemporal fossa, it runs through the foramen
spinosum to supply the dura mater (the outer meningeal layer) and the calvaria.

96. Structure passing through diaphragm through aortic hiatus are all except :
0/1
a. Hemiazygous vein
b. Azygous vein
c. Aorta
d. Thoracic duct

Correct answer
a. Hemiazygous vein
Feedback
The diaphragm separates the abdominal and thoracic cavities but does allow
certain structures to pass through via its three openings: The inferior vena cava passes through the
diaphragm at the venacaval foramen. The thoracic duct and azygos vein pass through the aortic
hiatus.

97. Nerve roots in Erb's palsy is :

34

1/1
a. C5.C6
b. C7,C8
c. C7,C8,T1
d. None
Feedback
Erb's palsy is a paralysis of the arm caused by injury to the upper group of the arm's main nerves,
specifically the severing of the upper trunk C5–C6 nerves. These form part of the brachial plexus,
comprising the ventral rami of spinal nerves C5–C8 and thoracic nerve T1.

98. Pentose Pathway produces :

0/1
a. ATP
b. ADP
c. NADH
d. Acetyl COA

Correct answer
c. NADH
Feedback
The pentose phosphate pathway (also called the phosphogluconate pathway and the hexose
monophosphate shunt) is a metabolic pathway parallel to glycolysis. It generates NADPH and
pentoses (5-carbon sugars) as well as ribose 5-phosphate, a precursor for the synthesis of
nucleotides.

99. In which of the following conditions a low/controlled glycemic index diet is preferred :
1/1
a. Diabetes
b. Children
c. Hypertension
d. Normal adults
Feedback
Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Foods with low
glycemic index help to keep the blood glucose low.

100. Which among following is not steroid hormone :

0/1
a. Aldosterone
b. Testosterone
c. Cortisol
d. Thyroxine

Correct answer
d. Thyroxine
35

Feedback
Thyroxine is a hormone the thyroid gland secretes into the bloodstream. Once in the bloodstream,
thyroxine travels to the organs, like the liver and kidneys, where it is converted to its active form of
triiodothyronine.

101. Serum enzyme used for MI is :

0/1
a. CPK
b. Alkaline Phosphatase
c. Acid Phosphatase
d. Lipase

Correct answer
a. CPK
Feedback
Creatine kinase, also known as creatine phosphokinase or phosphocreatine kinase, is an enzyme
expressed by various tissues and cell types. CK catalyses the conversion of creatine and uses
adenosine triphosphate to create phosphocreatine and adenosine diphosphate. CPK is raised in MI.
Other enzymes raised are LDH, Troponin, Myoglobin, etc.

102. Method of transport of glucose in intestine:

0/1
a. Primary active transport
b. Secondary active transport
c. Simple diffusion
d. Counter transport

Correct answer
b. Secondary active transport
Feedback
Secondary active transport is a form of active transport across a biological membrane in which a
transporter protein couples the movement of an ion (typically Na+ or H+) down its electrochemical
gradient to the uphill movement of another molecule or ion against a concentration/electrochemical
gradient.

103. In deep incised wounds , Langer's lines determine :

0/1
a. Direction
b. Gaping
c. Shelving
d.Healing

Correct answer
b. Gaping
Feedback
36

Langer's lines, Langer lines of skin tension, or sometimes called cleavage lines, are topological lines
drawn on a map of the human body. They correspond to the natural orientation of collagen fibers in
the dermis, and are generally perpendicular to the orientation of the underlying muscle fibers.

104. The most fragile bone to get fractured in skull is :

0/1
a. Occipital
b. Parietal
c. Frontal
d. Temporal

Correct answer
d. Temporal
Feedback
A skull fracture is a break in one or more of the eight bones that form the cranial portion of the skull,
usually occurring as a result of blunt force trauma. If the force of the impact is excessive, the bone
may fracture at or near the site of the impact and cause damage to the underlying structures within the
skull such as the membranes, blood vessels, and brain.

105. A consent is held invalid if obtained from :

1/1
a. Intoxicated
b. Insane
c. Under threat
d. All of above

Feedback
Consent occurs when one person voluntarily agrees to the proposal or desires of another. For a
consent to be valid, the person giving the consent has to know the nature of the consent given, hence
cannot be obtained if intoxicated, insane or under threat.

106. Best method to prove paternity is :

1/1
a. Blood Groupings
b. Finger prints
c. Phenotypic resemblance
d. DNA profile

Feedback
DNA profiling (also called DNA fingerprinting) is the process of determining an individual's DNA
characteristics. DNA analysis intended to identify a species, rather than an individual, is called DNA
barcoding.

107. In a suspended body, the postmortem staining is seen on :

37

0/1
a. Face
b. Back
c. Neck
d. Leg

Correct answer
d. Leg
Feedback
A purple coloration of dependent parts, except in areas of contact pressure, appearing within 30
minutes to 2 hours after death, as a result of gravitational movement of blood within the vessels.
Synonym(s): postmortem hypostasis, postmortem lividity, postmortem suggillation.

108. Minimum quantity of blood required to be preserved for chemical analysis is :

0/1
a. 2 ml
b. 10 ml
c. 50 ml
d. 100 ml

Correct answer
b. 10 ml
Feedback
Ethyl alcohol-saline-sugar solutions preserve erythrocytes for at least 150 days; they are excellent
preservatives for the agglutinogens. Whole blood preserved with glycerin-raffinose- glucose may be
frozen at —20° C. for at least two months, and probably for a longer period, without excessive
hemolysis after thawing.

109. Genital elephantiasis is caused by :

1/1
a. Lymphogranuloma venerum
b. Chancroid
c. Syphilis
d. Ricketssia
Feedback
Lymphogranulomavenereum (LGV) is a disease caused by 3 unique strains of Chlamydia trachomatis
and characterized by a small, often asymptomatic skin lesion, followed by regional lymphadenopathy
in the groin or pelvis. Alternatively, if acquired by anal sex, it may manifest as severe proctitis.

110. Which of the following causes Traveler's diarrhoea :

1/1
a. Entero-toxigenic Escherichia coli

b. Entero-pathogenic Escherichia coli

38

c. Entero-hemorrhagic Escherichia coli

d. Entero-invasive Escherichia coli
Feedback
Travelers' diarrhea (TD) is a stomach and intestinal infection. TD is defined as the passage eof
unformed stool (one or more by some definitions, three or more by others) while traveling. It may be
accompanied by abdominal cramps, nausea, fever, and bloating. Occasionally bloody diarrhea may
occur.

111. Pneumatocele is most commonly caused by

0/1
a. Streptococcus Pneumoniae
b. Staphylococcus Aureus
c. Hemophilus Infuenza
d. Kliebsella

Correct answer
b. Staphylococcus Aureus
Feedback
A pneumatocele is a cavity in the lung parenchyma filled with air that may result from pulmonary
trauma during mechanical ventilation. Gas-filled, or air-filled lesions in bone are known as
pneumocysts.

112. Epitope is present in :

0/1
a. Antigen
b. Antibody
c. Both a and b
d. None

Correct answer
a. Antigen
Feedback
Epitope, capable of sensitizing an immunocyte is present in antigen, while paratope is present in
antibody corresponding to epitope of antigen.
Haptens are substances which are incapable of inducing antibody formation by themselves but can
react specifically with antibodies.

113. The most common site for peptic ulcer is :

0/1
a. Antrum
b. Lesser curvature
c. Anterior wall of duodenum
d. Posterior wall of duodenum

Correct answer
39

c. Anterior wall of duodenum

Feedback
Duodenal ulcer is most common than gastric ulcer commonly occurs in anterior wall of duodenum .
Peptic ulcer is chronic,most often solitary lesions that occur in any part of GI tract exposed to
agressive action of acid/peptic juices.

114. Teratozoospermia refers to :

1/1
a. Absence of semen
b. Absence of sperm
c. All dead sperms in ejaculate
d. Morphologically defective sperms

Feedback
The causes of teratozoospermia are unknown in most cases. However, Hodgkin's disease, coeliac
disease, and Crohn's disease may contribute in some instances. Lifestyle and habits (smoking, toxin
exposure, etc.) can also cause poor morphology. Varicocele is another condition that is often
associated with decreased normal forms (morphology).

115. Stain used for fat is:

1/1
a. Oil red -O
b. Congo red
c. Perl stain
d. PAS
Feedback
Oil red O – fats
Congo red – Amyloid
PAS - Glycogen

116. Which is the first organ to be affected in left ventricular failure :

0/1
a. Lungs
b. Liver
c. Kidney
d. Brain

Correct answer
a. Lungs
Feedback
Left-sided heart failure occurs when the left ventricle, the heart's main pumping power source, is
gradually weakened. When this occurs, the heart is unable to pump oxygen-rich blood from the lungs
to the heart's left atrium, into the left ventricle and on through the body and the heart has to work
harder.
40

117. Barrett's Oesophagous

1/1
a. Columnar epithelium
b. Squamous epithelium
c. Irreversible
d. Cancerous
Feedback
Barrett's esophagus is a condition in which there is an abnormal (metaplastic) change in the mucosal
cells lining the lower portion of the esophagus, from normal stratified squamous epithelium to simple
columnar epithelium with interspersed goblet cells that are normally present only in the small
intestine, and large intestine.

118. Bone marrow in lead poisoning contains :

0/1
a. Ringed siderocytes
b. Giant metamyelocytes
c. Dwarf megakaryocytes
d. Fibrotic changes

Correct answer
a. Ringed siderocytes
Feedback
The presence of sideroblasts and siderocytes in the bone marrow indicates that the red cell
precursors have an ample supply of iron. If five or more siderotic granules form a ring around
at least half the periphery of the nucleus of a nucleated red blood cell, the cell is referred to as a ringed
sideroblast.

119. Verrucous carcinoma is :

1/1
a. Extremely well differentiated squamous cell carcinoma
b. Poorly differentiated squamous cell Ca
c. Example of condyloma
d. An example of adenocarcinoma
Feedback
Verrucous carcinoma (VC) is an uncommon variant of squamous cell carcinoma. This form of
cancer is often seen in those who chew tobacco or use snuff orally, so much so that it is sometimes
referred to as "Snuff dipper's cancer".

120. Which of the following is longest acting beta-2-agonist :

0/1
a. Salmetrol
b. Salbutamol
41

c. Terbutaline
d. None

Correct answer
a. Salmetrol
Feedback
Salmeterol is a long-acting β₂ adrenergic receptor agonist used in the maintenance and prevention of
asthma symptoms and maintenance of chronic obstructive pulmonary disease symptoms. Symptoms
of bronchospasm include shortness of breath, wheezing, coughing and chest tightness.

121. Which of the folllowing drug is a hepatic enzyme inducer :

1/1
a. Rifampicin
b. Propanolol
c. Phenylalanine
d. Benzodiazepine
Feedback
An enzyme inducer is a type of drug that increases the metabolic activity of an enzyme either by
binding to the enzyme and activating it, or by increasing the expression of the gene coding for the
enzyme. It is the opposite of an enzyme repressor.
Enzyme inducers :
Griseofulvin,Isoniazid,NSAIDs,Rifampicin,Erythromycin,Alcohol,Phenytoin,Phenobarbitone,S moking
Carbamazepine,Glucocorticoid

122. Which of the following is not a ototoxic drug :

1/1
a. Paracetamol
b. Cisplatin
c. Erythromycin
d. Quinine
Feedback
Ototoxic drugs include antibiotics such as gentamicin, streptomycin, tobramycin, loop diuretics such
as furosemide and platinum-based chemotherapy agents such as cisplatin and carboplatin. A number
of nonsteroidal anti-inflammatory drugs (NSAIDS) have also been shown to be ototoxic.

123. Which of the following causes OCP failure :

1/1
a. Cimetidine
b. NSAIDs
c. Ethambutol
d. Rifampicin

Feedback
42

Rifampicin, also known as rifampin, is an antibiotic used to treat several types of bacterial infections,
including tuberculosis, Mycobacterium avium complex, leprosy, and Legionnaires' disease.

124. Transport of substance in same direction is called :

1/1
a. Symport
b. Antiport
c. Exocytosis
d. Pinocytosis
Feedback
Symport a transport mechanism that moves two compounds simultaneously across a cell membrane
in the same direction, one compound being transported down a concentration gradient and the other
against a gradient.

125. Maximum prostaglandin concentration is seen in :

0/1
a. Seminal fluid
b. Tear
c. Amniotic fluid
d. Saliva

Correct answer
a. Seminal fluid
Feedback
Semen, also known as seminal fluid, is an organic fluid created to contain spermatozoa. It is secreted
by the gonads (sexual glands) and other sexual organs of male or hermaphroditic animals and can
fertilize the female ovum.

126. Hormone which is not increased in stress :

0/1
a. Insulin
b. Glucagon
c. Cortisol
d. Epinephrine

Correct answer
a. Insulin
Feedback
Insulin is a peptide hormone produced by beta cells of the pancreatic islets; it is considered to be the
main anabolic hormone of the body. It regulates the metabolism of carbohydrates, fats and protein by
promoting the absorption of glucose from the blood into liver, fat and skeletal muscle cells.

127. Defect in leptin leads to :

43

0/1
a. Obesity
b. Anorectic
c. Both
d. None

Correct answer
a. Obesity
Feedback
Leptin is a hormone predominantly made by adipose cells and enterocytes in the small intestine that
helps to regulate energy balance by inhibiting hunger, which in turn diminishes fat storage in
adipocytes.

128. Adrenal medulla secretes :

0/1
a. Neurohormones
b. Aldosterone
c. Cortisol
d. Vasopressin

Correct answer
a. Neurohormones
Feedback
The adrenal medulla, the inner part of an adrenal gland, controls hormones that initiate the flight or
fight response. The main hormones secreted by the adrenal medulla include epinephrine (adrenaline)
and norepinephrine (noradrenaline), which have similar functions.

129. A patient taking inhaled corticosteroid has a white lesion on the mouth. The organism involved
may be
1/1
a. Candida
b. Trichomonasvaginalis
c. Staphyloccus
d. Streptoccus
Feedback
Oral thrush (oral candidiasis): Candida albicans

130. Dental plaque is formed by:

1/1
a. E. coli
b. Streptococcus mutans
c. S. aureus
d. HSV
44

Feedback
Dental caries: Deficiency of fluorine /(Streptococcus mutans). Dental fluorosis: Excess of fluorine
Denial plaque: Acid forming bacteria/(Streptococcus mutans), de elops rapidly during sleep.

131. While on duty, you are asked to give orders for a 62 year old woman admitted to the ICU in
septic shock. The patient is receiving intravenous vancomycin, levofloxacin, and gentamicin for
suspected urosepsis and potential pneumonia. The vital signs indicate the BP: 80/50 mm Hg, HR 120
bpm, RR 30 bpm, with a urinary output of 20 ml/hr. Two liters of normal saline was given within one
hour without a noticeable improvement in BP or heart rate. A central venous line recorded a venous
02 saturation of 60%. Calculate Mean arterial pressure. (NEXT 4 QUESTIONS ARE ALSO RELATED
TO THIS QUESTION)
1/1
a. 60 mmHg
b. 70 mmHg
c. 75 mmHg
d. 65 mmHg

132. What will be the next step in the management of such patients?
···/1
a. Dextran
b. Blood transfusion
c. Dialysis
d. Vasopressors

No correct answers

133. Which of the statement is false?

0/1
a. IV fluids is usually the first therapy for hypotension
b. Aggressive resuscitation with crystalloids increases intracellular fluid than colloids
c. Vasopressor therapy is used when hypotension by sepsis is unresponsive to fluid therapy
d. CVP measurements would guide the volume status of patient

Correct answer
b. Aggressive resuscitation with crystalloids increases intracellular fluid than colloids

134. Which of the following is the best first-line pharmacological intervention likely to improve the
patient's BP?
0/1
a. Epinephrine alone
b. Norepinephrine
c. Dobutamine
d. Vasopressin
45

Correct answer
b. Norepinephrine

135. Feature of septic shock is

0/1
a. Acute tubular necrosis
b. Acute cortical necrosis
c. Acute glomerulonephritis
d. Acute papillary damage

Correct answer
a. Acute tubular necrosis
Feedback
• MAP= (SBP+2DBP)/3
• After fluids, vasopressors should be given in treatment of shock. Resuscitation with crystalloids
increases intravascular volume.
• Norepinephrine is vasopressor of choice in septic shock.

136. A 52 year old woman develops fatigue and dyspnea that have been worsening over
approximately 6 months. She also complains of occasional palpitations. She describes a serious
illness she had as a child, with fever, rash, joint pain, and difficulty controlling her movements. She
recovered after approximately a month. Cardiac examination reveals a loud S1, an opening snap and
a diastolic rumble. A chest radiograph shows an enlarged left atrium. What is the most likely
diagnosis? (NEXT 4 QUESTIONS ARE ALSO RELATED TO THIS QUESTION)
1/1
a. Mitral stenosis
b. Aortic stenosis
c. Pulmonary stenosis
d. Aortic regurgitation

137. Which of the following types of infection, precede by several weeks, the development of acute
rheumatic fever?
1/1
a. Group A β-hemolytic streptococcal infection of the pharynx
b. Group B alpha-hemolytic streptococcal infection of the pharynx
c. Staphylococcus aureus infection of the heart
d. Streptococcus pyogenes infection of the skin

138. Laboratory examination finds an elevated erythrocyte sedimentation rate along with an elevated
antistreptolysin O titer. Which of the following abnormalities is most characteristic of the disease?
···/1
46

a.Anitschkow cells within the epidermis

b.Aschoff bodies within the myocardium
c.Langhans giant cells within the dermis
d. Psammoma bodies within the endocardium

No correct answers

139. Major Jones criteria includes all, EXCEPT

···/1
a. Subcutaneous nodule
b. Carditis
c. Arthralgia

d. Erythema marginatum

No correct answers

140 Which of the following statement is wrong?

0/1
a. Drug of choice is benzyl penicillin 1.2 million units.
b. For patients with residual heart disease, prophylaxis should continue until 5 years after the last
episode or 40 years of age.
c. Patients without carditis in a previous attack should have prophylaxis for a minimum of five years
after the last attack, and at least until age 18.

d. None of the above

Correct answer
b. For patients with residual heart disease, prophylaxis should continue until 5 years after the last
episode or 40 years of age.
Feedback
• Patient has fever, joint pain, rash, chorea which are features of rheumatic fever.
• Loud S1, opening snap and diastolic murmur due to mitral stenosis.
• Acute rheumatic fever is preceded by Group A β-hemolytic streptococcal infection of the pharynx.
• Aschoff bodies are pathognomic of rheumatic carditis.
• Major jones criteria includes carditis, arthritis, subcutaneous nodules, erythema marginatum, and
chorea.
• Arthralgia is a minor jones criteria.
• Prophylaxis for patient with residual heart disease should continue until 10 years after last episode or
40 years of age.

141. A patient presents with history of RTA to your clinic. The x-ray done shows associated fracture
of skull bone and CT scan shows biconvex shaped haematoma. On neurological assessment he
opens eye to pain, speaks inappropriate words and withdraws to pain. What is the type of
Haemorrhage? (NEXT 4 QUESTIONS ARE ALSO RELATED TO THIS QUESTION)
1/1
47

a. Intracerebral hemorrhage
b. EDH
c. SDH
d. Pontine hemorrhage

142. Which artery is most commonly injured in this type of haematoma?

1/1
a. Anterior cerebral artery
b. Middle meningeal artery

c. Middle cerebral artery

d. Posterior cerebral artery

143. Prognosis in head injury is best given by

1/1
a. GCS

b. Age ofpatient
c. Mode of injury
d. CT head

144. What will be the GCS of above patient?

0/1
a.7
b.8
c. 9
d. 10

Correct answer
c. 9

145. Management of extradural hemorrhage is:

1/1
a. Antibiotics
b. Immediate evacuation

c. Evacuation after 24 hours

d. Observation
Feedback
Presence of biconvex shaped hematoma denotes EDH, in which trauma to lateral part of head leads to
bleeding from the middle meningeal artery. Prognosis is given by GCS and management is
craniotomy.
48

146. A 30 year old female presented with insidious onset swelling along inner aspect of right leg for 2
years which started around ankle and later extended up to the upper part of thigh. The swelling gets
aggravated and is associated with dull aching pain on prolonged standing and walking and relieved
on lying down. Which of the following is not the differential diagnosis of above given condition?
(NEXT 4 QUESTIONS ARE ALSO RELATED TO THIS QUESTION)
0/1
a. Varicose vein
b. Cellulitis of leg
c. DVT
d. Intermittent claudication

Correct answer
a. Varicose vein

147. Diagnosis is made as varicose vein. Which of the following test is not done for varicose vein
0/1
a. Morrisey's test
b. Trendelenberg test
C. Swartz test
d. Adson test

Correct answer
d. Adson test

148. Flush ligation of long saphenous vein at Saphenofemoral junction is called as

0/1
a. Trendlenburg operation
b. Cockett and Dodd operation

C. Swartz operation
d. Morrisey operation

Correct answer
a. Trendlenburg operation

149. Which of the following carcinoma is most likely to be developed in longstanding venous ulcer
0/1
a. Adenocarcinoma
b. Squamous cell carcinoma
c Oat cell carcinoma
d. Basal cell carcinoma

Correct answer
49

b. Squamous cell carcinoma

150. Which of the following is not related to DVT

1/1
a. Hoffman's test
b. d-dimer
c. Calf tenderness
d. Shorten of breath

Feedback
Varicose veins:
 MC vein – long saphenous vein (Anteromedial)
 Dull aching pain and edema
 Complication: Venous ulcer, Hyperpigmentation, Lipodermatosclerosis, Eczema
 IOC: Duplex USG T/t: Limb elevation, compression stocking
 Gold standard treatment: Endothermal ablation EVLA(Endovenous laser ablation), RFA
(Radiofrequency ablation)

151. A 32-year-old G2P1 at 28 weeks gestation presents to labor and delivery with the complaint of
vaginal bleeding. It was bright red and she denies any pain abdomen and states that the baby is
moving normally. On examination pt. was vitally stable, P/A uterus corresponds to period of
gestation. FHS normal On Per Speculum exam; minimal bleeding noted. What is likely diagnosis?
(NEXT 4 QUESTIONS ARE ALSO RELATED TO THIS QUESTION)
0/1
a. Placental abruption
b. Ectopic pregnancy
c. Placenta previa
d. Vasa previa

Correct answer
c. Placenta previa

152. Which of the following investigation will you order first?

1/1
a. USG
b. CTG
c. TC/DC
d. MRI

153. What is likely finding in USG?

0/1
a. Placenta located normally in upper uterine segment
b. Placenta located in lower uterine segment
c. Snow storm pattern
50

d. Huge amount of retro-placental hematoma

Correct answer
b. Placenta located in lower uterine segment

154. How will you manage this case?

1/1
a. Wait & watch
b. Immediate LSCS
c. Induction of labor
d. Pt. can be discharged

155. Which of the following is usually not associated with above condition?
1/1
a. Malpresentation
b. Recurrent bleeding
c. DIC
d. Prematurity
Feedback
Placenta previa is a condition where placenta is located over or very near the internal os. Patient
present with painless and always revealed PV bleeding. USG is a diagnostic tool for this condition. As
per the condition of mother and fetus, conservative management can be done. It is not usually
associated with DIC in contrast to abruptio placentae

156. A 24-year-old P2+0 woman presents to the emergency department complaining of fever for last 5
days. The patient is postpartum day 10 from difficult vacuum vaginal delivery at 41 weeks. Vacuum
was applied for prolonged 2nd stage of labor. Fever was recorded max. 1030F. She complains of
lower abdominal pain with foul smelling PV discharge. On Examination she was febrile. B/L chest &
breast exam was unremarkable. Uterus was palpable just below umbilicus and was tender.
Extremities were non tender. What is likely diagnosis? (NEXT 4 QUESTIONS ARE ALSO RELATED TO
THIS QUESTION)
1/1
a. Puerperal sepsis
b. Breast abscess
c. Enteric fever
d. DVT

157. How will you manage the case?

1/1
a. Admission &broad spectrum antibiotics
b. Reassurance & follow up in OPD
c. Immediate laparotomy
51

d. Urgent CT scan

158. What is the normal physiological discharge of puerperium?

1/1
a. Lochia
b. Puerperal bleed
c. Decidua
d. Leukorrhoea

159. When the uterus will be pelvic organ if patient had uneventful puerperium?
1/1
a. In 1 week
b. In 2 week
c. In 3 week
d. In 4 week

160. Which of the following is suitable method of contraception in lactating mother?

1/1
a. OCP
b. Depo medroxyprogesterone Acetate

c. Estrogen only pill

d. Natural method
Feedback
• An infection of the genital tract which occurs as a complication of delivery is puerperal sepsis.
• Most female pelvic infections are polymicrobial in origin.
• C/F: Fever, Foul-smelling lochia, abdominal/uterine tenderness
• Mx: Broad spectrum antibiotics (Clindamycin + Gentamycin) or (Ampicillin +Gentamycin +
Metronidazole) later modified as per culture & sensitivity
Physiological discharge of puerperium is called lochia. Normally uterus becomes pelvic organ by 2nd
week and pre-pregnant size by 6th week.
Progesterone only pills/ Injectable DMPA/ Progesterone containing Implant are suitable method of
contraception in lactating mother.

161. A 15 months old baby presents with excessive crying followed by cyanosis, unconsciousness
and occasional seizures since 9 months of age. The most likely diagnosis is (NEXT 4 QUESTIONS
ARE ALSO RELATED TO THIS QUESTION)
···/1
a. Epilepsy
b. Anoxic spells
c. Breath holding spells
d. Vasovagal attack

No correct answers
52

162. Which of the following congenital heart disease doesn't cause central cyanosis?
0/1
a. Tetralogy of fallot
b. Severe aortic stenosis
c. Tricuspid atresia
d. Ebstein's anomaly

Correct answer
b. Severe aortic stenosis

163. Which of the following defines pentalogy of fallot?

0/1
a. TOF with PDA
b. TOF with ASD
c. TOF with CoA
d. TOF with polysplenia

Correct answer
b. TOF with ASD

164. Regarding the above mentioned condition, one of the following is incorrect:
0/1
a. It is fairly common in 1st 2 years of life.
b. It doesn't contribute to increased risk of seizure disorders
c. Parents are advised to ignore and not to reinforce these attacks.
d. It must be immediately attended to prevent hypoxia and onset of seizures.

Correct answer
d. It must be immediately attended to prevent hypoxia and onset of seizures.

165. Not a component of tetralogy of Fallot:

0/1
a. VSD
b. Pulmonary Stenosis

c. Overriding of aorta
d. Left ventricular Hypertrophy

Correct answer
d. Left ventricular Hypertrophy
Feedback
Episodes of breath holding spell start with cry, and progress to apnea and cyanosis. Syncope, tonic
posturing and reflex anoxic seizures may follow. Spells begin between 6 to 18 months of age.
Education and reassurance of the parents should be done. Parents should be taught not to provide
53

secondary gain to patients when the attack occurs so as not to reinforce the spells.
Severe aortic stenosis does not cause central cyanosis. Pentalogy of fallot consists of TOF with ASD.
Components of tetralogy of fallot: Pulmonary stenosis, VSD, Overriding of aorta, Right ventricular
hypertrophy.

166. A young boy presents in OPD with history of sudden painful swelling of joints after minor
trauma since childhood. Which is the most probable diagnosis? (NEXT 4 QUESTIONS ARE ALSO
RELATED TO THIS QUESTION)
0/1
a. Disseminated intravascular coagulation
b. Glanzmann’s thrombasthenia

c. ITP
d. Hemophilia A

Correct answer
d. Hemophilia A

167. The condition is inherited as

0/1
a. Autosomal Dominant
b. Autosomal recessive
c. X-linked recessive
d. None of the above

Correct answer
c. X-linked recessive

168. Factor Deficiency in Christmas disease is:

0/1
a. II
b. VII
c. VIII
d. IX

Correct answer
d. IX

169. True about Hemophilia are all except

0/1
a. PTT increased
b. PT increased
c. Clotting time is increased
d. Serum levels of factor VIII are decreased
54

Correct answer
b. PT increased

170. All are the vitamin K dependent clotting factors except

0/1
a. II
b. VII
c. X
d. XI

Correct answer
d. XI
Feedback
The child has history of joint swelling after minor injuries which suggests diagnosis of Hemophilia A.
In hemophilia A, there is defect in coagulation system and presents with large post traumatic
ecchymosis, prolonged bleeding after laceration or surgical procedure, bleeding in weight bearing
joints. It is inherited as an X- linked recessive disease. Christmas disease is the deficiency of factor IX.
Lab findings: elevated aPTT, normal PT, BT and platelet counts.

171. An 18 year old boy was playing football, when he suddenly twisted his knee on the ankle and he
fell down. After 10 minutes of this injury he again got up and started playing. But on next day, his
knee was swollen and he could not move his knee. Most likely diagnosis is: (NEXT 4 QUESTIONS
ARE ALSO RELATED TO THIS QUESTION)
0/1
a. Posterior cruciate ligament injury
b. Medial collateral ligament injury
c. Anterior cruciate ligament injury

d. Medial meniscus tear

Correct answer
d. Medial meniscus tear

172. All are tests that are useful for supporting your clinical diagnosis in this case, except:
···/1
a. McMurray's test
b. Apley's grinding test
c. Lachman's test

d. Thessaly test

No correct answers

173. Unhappy triad of knee injury includes all except

0/1
55

a. Medial collateral ligament, anterior cruciate ligament and medial meniscus

b. Lateral collateral ligament, posterior cruciate ligament and medial meniscus
c. Anterior cruciate ligament, medial collateral ligament and posterior cruciate ligament

d. Medial meniscus, posterior cruciate ligament and medial collateral ligament

Correct answer
a. Medial collateral ligament, anterior cruciate ligament and medial meniscus

174. Medial meniscus tear is more common than lateral because it is:
0/1
a. Larger in size
b. Medial rotation is more than the lateral rotation

c. Less mobile
d. Fibro-elastic

Correct answer
c. Less mobile

175. How will you manage this condition?

0/1
a. Arthroscopic repair in all cases

b. Manual unlocking of knee, if fails then arthroscopic repair

c. Cast application for 8 weeks
d. Only NSAIDs and bed rest is sufficient

Correct answer
b. Manual unlocking of knee, if fails then arthroscopic repair
Feedback
 Meniscal tear presents with pain localizing to medial or lateral side, mechanical symptoms (locking
and clicking), especially with squatting anddelayed or intermittent swelling.
 Lachman test is used for ACL injury while others are used for meniscal injury.
 Unhappy Triad of O’ Donoghue includes Medial meniscus tear, ACL tear and Medial collateral
ligament tear.
 Medial meniscus is less mobile as it is held by medial collateral ligament.
 First conservative treatment is tried, if not successful then arthroscopic repair is done.

176. First local anesthetic used in clinical anaesthesia was (NEXT 4 QUESTIONS ARE ALSO
RELATED TO THIS QUESTION)
1/1
a. Bupivacaine
b. Procaine
c. Lidocaine
d. Cocaine
56

Feedback
First local anaesthetic to be used clinically was cocaine by Carl Koller.

177. Methemoglobinemia is caused by:

0/1
a. Prilocaine
b. Ropivacaine

c. Bupivacaine
d. Procaine

Correct answer
a. Prilocaine
Feedback
The administration of large doses (> 10 mg/kg) of prilocaine during regional anesthesia may lead to
accumulation of the metabolite o-toluidine, an oxidizing agent capable of converting hemoglobin to
methemoglobin.
The treatment of methemoglobinemia involves the intravenous administration of reducing agents (eg,
methylene blue or ascorbic acid), which rapidly convert methemoglobin to hemoglobin.

178. The local anaesthetic with the longest duration of action

0/1
a. Procaine
b. Chlorprocaine
c. Lignocaine

d. Dibucaine

Correct answer
d. Dibucaine
Feedback
Longest acting, most potent and most toxic LA is dibucaine.
Chlorprocaine is the shortest acting LA.

179. All are vasodilators except:

0/1
a. Procaine

b. Lidocaine
c. Cocaine
d. Chlorprocaine

Correct answer
c. Cocaine
Feedback
57

All local anaesthetics cause vasodilation except cocaine. It blocks reuptake of nor-adrenaline and
result in sympathetic overactivity. Therefore, cocaine can cause hypertension and cardiac
arrhythmias.

180. An agent added to local anesthetics to speed the onset of action is:
1/1
a. Methylparapben
b. Bicarbonate

c. Fentanyl
d. Adrenaline