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Topic: AIPGMEE 2007 Rank Projector is online now


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Admin Total Posts: 890	Posted: Thu Jan 25, 2007 07:46 pm Dear Users, AIPGMEE 2007 Rank Projector is online now and can be accessed below: https://www.netmedicos.com/?aipgmee2007/rankprojector/ Note: Questions in the rank projector are under updation. So, you can check back after every few hours to update your answers to newly updated questions. Your rank will be updated automatically. For correction of answers to any of the questions, you can reply in our aipgmee forums or reply in this thread. With regards, Netmedicos

nanu Total Posts: 228	Posted: Thu Jan 25, 2007 10:51 pm Q. Which of he following does not pass behind the diaphragm from thorax to abdomen? a. Aorta b. Thoraciz ducts c. Azygos vein d. Greater splanchnic n (d)bdc3e,vol2/274;snell 6e/107 ANS IS 'D' AND NOT 'A' SO PLEASE CORRECT IT NETMEDICOSE.

Admin Total Posts: 890	Posted: Thu Jan 25, 2007 11:29 pm Dear Nanu, It has been Updated. With regards, Netmedicos

nanu Total Posts: 228	Posted: Fri Jan 26, 2007 03:37 am hi, i think the scoring in rank projector is being done by AIIMS PG PAPER i.e. 3 marks for one correct respone and 1 mark deduced for a wrong ans. however in AIPG EXAM. marking is 4 marks for a correct ans and 1 mark deduced for wrong ans. kindly check netmedicos and correct. thanks.

Admin Total Posts: 890	Posted: Fri Jan 26, 2007 04:23 am Dear Nanu, You have correctly pointed out the mistake. We shall fix it very soon. With regards, Netmedicos

bhavu Total Posts: 41	Posted: Fri Jan 26, 2007 05:40 am dear netmedicos. the mistake pinted out by nanu has been corrected only in your ranking rest all ranking are still accroding to aiims pattern.

nanu Total Posts: 228	Posted: Fri Jan 26, 2007 05:55 am all are still same. no correction had been made including mine. it will take time.

bhavu Total Posts: 41	Posted: Fri Jan 26, 2007 06:02 am nanu i didn,t mean you.i meant netmedicos marks.see it.

nanu Total Posts: 228	Posted: Fri Jan 26, 2007 06:07 am ok, i got it wrong. sorry. good nite.

Admin Total Posts: 890	Posted: Fri Jan 26, 2007 08:11 am Dear All, Now the ranks of everyone has been correctly updated using AIPGME (+4) instead of AIIMS (+3) ranking system. If there is any error please let us know. With regards, Netmedicos

bhavu Total Posts: 41	Posted: Fri Jan 26, 2007 02:57 pm dear netmedicos, waiting for more questions eagerly. beacause this time when there is so much confusion about paper being easy/tricky you are doing great job atleast this effort will give us some idea. i hope many people will take part sp the sample size increases beaucause i think this time no body is sure of being in the list.

bhavu Total Posts: 41	Posted: Fri Jan 26, 2007 03:52 pm for caudal anesthesia contraindicated in infant/children 1.morphine 2. fantanyl 3.sufantanyl 4. ???? regardin caudal anesthesia answer is confirmed morphine. see mudit khnna 2001 question 286. refrence lee 12th edi 509,510. kdt 5th edi 423 kdt: infannts and elderly are more suceptible to the respiratory depresseent action of morphine. lee:morphine should not be used in infants specially those less than 6 months of age. morphine is also not commonly recommended in older children (3 to 10 years) of age

Admin Total Posts: 890	Posted: Fri Jan 26, 2007 07:56 pm Dear Bhavu, First of all, thanks for appreciation. We are going through all the questions to ensure accuracy as much as possible, and this is taking time to update the questions. We shall try to update the rank projector completely today. With regards, Netmedicos

bhavu Total Posts: 41	Posted: Fri Jan 26, 2007 09:55 pm thanks netmedicos, eagerly waiting for updated version of this rank projector with all the questions.

bhavu Total Posts: 41	Posted: Fri Jan 26, 2007 09:57 pm i think in cluster sampling question was all except.

Admin Total Posts: 890	Posted: Fri Jan 26, 2007 10:12 pm updated cluster sampling question

bhavu Total Posts: 41	Posted: Sat Jan 27, 2007 12:24 am dear netmedicos, there is another mistake, the percentage is begin calculated now is out of 600 marks(aiims patten 2003) but it should be out of 1200 (in all india 3004)

Admin Total Posts: 890	Posted: Sat Jan 27, 2007 12:31 am More Questions have been updated in RankProjector. With regards, Netmedicos

Admin Total Posts: 890	Posted: Sat Jan 27, 2007 12:46 am Dear Bhavu, We have now corrected the error. The percentages are now being calculated out of 1200. Thanks for pointing out the error. With regards, Netmedicos

bhavu Total Posts: 41	Posted: Sat Jan 27, 2007 12:50 am thanks, netmedicos. now the system is fool proof. just waiting for new questions. keep up the great work.

bhavu Total Posts: 41	Posted: Sat Jan 27, 2007 02:35 am Patients with ALL are divided into 3 prognostic groups. Good risk includes (1) no adverse cytogenetics, (2) age younger than 30 years, (3) WBC count of less than 30,000/mL, and (4) complete remission within 4 weeks. Intermediate risk does not meet the criteria for either good risk or poor risk. Poor risk includes (1) adverse cytogenetics [(t9;22), (4;11)], (2) age older than 60 years, (3) precursor B-cell WBCs with WBC count greater than 100,000/mL, or (4) failure to achieve complete remission within 4 weeks. refrence https://www.emedicine.com/med/topic3146.htm so precursor b cell or pre b cell have poor prognosis. andfemale have definatley good prognosis. so answer if leukemia should be pre b cell

nanu Total Posts: 228	Posted: Sat Jan 27, 2007 02:36 am Q48) Centrineuraxial (spinal or epidural) anaesthesia is contraindicated in all except ? A) Platelets < 80,000 B) Patient on aspirin C) Patient on oral anticoagulants D) Patient on I.V. Heparin Verified Correct Ans: Platelets < 80,000 NETMEDICOS THE ANS TO THIS QUESTION SHOULD BE either 'B'or 'D' after reading the following text. so it is not a verified answer. Give your views guys. REFERENCE--Prophylaxis of Venous Thromboembolism Section 7: Spinal and epidural block 7.1 Efficacy in prophylaxis of VTE in surgical patients A meta-analysis of RCTs of spinal/epidural block versus general anaesthesia reported reduction in postoperative morbidity and mortality (including VTE).65 Evidence level 1+ [A] Spinal or epidural anaesthesia may be preferred to general anaesthesia where appropriate and feasible. 7.2 Risk of vertebral canal haematoma when combined with pharmacological prophylaxis of VTE The increasing use of pharmacological prophylaxis for VTE has raised concerns amongst anaesthetists that spinal or epidural block may be followed by an increased risk of vertebral canal haematoma. Most cases of vertebral canal haematoma occur spontaneously, at an estimated incidence of only one per million population per year,146 often associated with disordered coagulation,147 which is also one of the major causal factors in the cases reported after spinal/epidural block.148 Although this is a rare complication, its serious nature requires that some precaution is taken to minimise its incidence.149 Advice on the use of spinal/epidural block in patients receiving pharmacological prophylaxis for thromboembolism has been published.150 Technical difficulty during instrumentation of the vertebral canal is an associated factor, with epidural block (especially with catheter insertion) carrying a greater risk than spinal anaesthesia. Catheter removal is also a time of risk.148 The skill and experience of the anaesthetist may therefore be important. In 1997-98 American reports documented over 40 cases of vertebral canal haematoma occurring within a five year period in patients receiving the LMW heparin, enoxaparin.40,41 Most followed spinal or epidural block, although a few followed diagnostic lumbar puncture. The report also confirmed the risk factors identified in the earlier review:148 epidural catheters carried the highest risk at both removal and insertion. However, this is in direct contrast to the European experience, where, although enoxaparin has been available for much longer, only two cases of vertebral canal haematoma have been reported. In a further study, the incidence of vertebral canal haematoma after spinal or epidural block in patients receiving enoxaparin was estimated at 1 in 2,250,000 in Europe, but at 1 in 14,000 in the United States.151 The main factor contributing to this variation was the difference in the recommended dose of enoxaparin used: 40mg once daily, starting 12 hours before surgery for high risk European patients, compared with 30mg twice daily, starting one hour after surgery for American patients. In the European patients, the peak effect of the drug (occurring at four - six hours post-administration) would be past at the time of block administration, minimising risk. In the American patients, although there would be no effect at the institution of a block, the long half life of enoxaparin (10-12 hours) could lead to accumulation, producing an overt effect on coagulation and leading to bleeding at the time of catheter removal.152 7.2.1 ORAL ANTICOAGULANTS (see section 3. Full anticoagulation is an absolute contraindication to spinal or epidural block. Most authorities recommend that the INR be 1.5 or lower for institution of a block or removal of a catheter.153,154,155 In most cases, the patient with a higher INR who is to undergo major elective surgery will have it delayed so that coagulation can revert to normal. Management is as outlined elsewhere6,156 (see also SIGN guideline on perioperative transfusion).157 7.2.2 UNFRACTIONATED HEPARIN (see section 3.4) Thromboprophylaxis with low-dose subcutaneous heparin (5,000 IU 8-12 hourly or 7,500 IU 12-hourly) does not usually prolong the APTT and large numbers of patients have received spinal or epidural block without sequelae.158 However, a transient elevation of the APTT may occur159 and some anaesthetists prefer not to institute spinal or epidural block within 4-6 hours of a dose, and to administer heparin after institution of the block.150 Similar considerations apply to catheter removal. The platelet count should be checked before the block is instituted or the catheter removed if the patient has been receiving any heparin preparation for more than a few days, to exclude heparin-associated thrombocytopenia (see section 3.4.5). 7.2.3 LOW MOLECULAR WEIGHT HEPARINS Evidence suggests that standard European dosing regimens (e.g. enoxaparin 20-40mg once daily) are not associated with any increased risk as long as the block is instituted, or the catheter removed, 10-12 hours after drug administration. A first dose can be given immediately after block administration or catheter removal.160 7.2.4 ANTIPLATELET AGENTS (ASPIRIN) There is little or no evidence that aspirin increases risk,160 although interactions with other agents such as heparins or warfarins may occur.149 7.2.5 RECOMMENDATIONS [D] When instituting spinal/epidural block prior to elective surgery, epidural catheter removal or diagnostic lumbar puncture, the following precautions should be taken: o Aspirin: proceed normally, but remember interactions o UFH: proceed normally but exercise caution + or administer 4-6 hours before block + or delay first dose until after block performed or until after surgery o LMWH: administer 10-12 hours before block o Warfarin: if INR <1.5 proceed normally + if INR >=1.5 delay surgery or consider alternative anaesthetic or anaesthetic technique if surgery is urgent. [tickbox] When there is difficulty or bleeding during the block procedure it is essential that this is recorded and greater vigilance ensured during the postoperative period. It may also be advisable to omit or delay the next dose of thromboprophylactic agent. [tickbox] If perioperative pharmacological prophylaxis is to be omitted altogether in a patient who would normally receive it, a mechanical method should be used instead. [tickbox] In patients requiring emergency surgery who have already received a thromboprophylactic drug, the agent used, the dose, and the time interval since the last administration should be noted and related to recommendations above. [tickbox] Any decision should be based on the balance of risks and benefits, will often require discussion with the patient, and should be documented fully. 2nd REFERENCE-Epidural Anaesthesia Dr Leon Visser, Dept. of Anesthesiology, University of Michigan Medical Center, Ann Arbor, Michigan, USA * Introduction * Factors affecting epidural anaesthesia * Indications * Physiological effects of epidural blockade * Contradictions * Epidural management and choice of drugs * Epidurals and Anticoagulants * Complications and side effects * Anatomy of the Epidural Space * Further Reading * Technique of Epidural Anaesthesia Introduction Epidural anaesthesia is a central neuraxial block technique with many applications. The epidural space was first described by Corning in 1901, and Fidel Pages first used epidural anaesthesia in humans in 1921. In 1945 Tuohy introduced the needle which is still most commonly used for epidural anaesthesia. Improvements in equipment, drugs and technique have made it a popular and versatile anaesthetic technique, with applications in surgery, obstetrics and pain control. Both single injection and catheter techniques can be used. Its versatility means it can be used as an anaesthetic, as an analgesic adjuvant to general anaesthesia, and for postoperative analgesia in procedures involving the lower limbs, perineum, pelvis, abdomen and thorax. [Top]0 Indications General Epidural anaesthesia can be used as sole anaesthetic for procedures involving the lower limbs, pelvis, perineum and lower abdomen. It is possible to perform upper abdominal and thoracic procedures under epidural anaesthesia alone, but the height of block required, with its attendant side effects, make it difficult to avoid significant patient discomfort and risk. The advantage of epidural over spinal anaesthesia is the ability to maintain continuous anaesthesia after placement of an epidural catheter, thus making it suitable for procedures of long duration. This feature also enables the use of this technique into the postoperative period for analgesia, using lower concentrations of local anaesthetic drugs or in combination with different agents. Specific uses * Hip and knee surgery. Internal fixation of a fractured hip is associated with less blood loss when central neuraxial block is used. The rate of deep venous thrombosis is reduced in patients undergoing total hip and knee replacement, when epidural anaesthesia is used. * Vascular reconstruction of the lower limbs. Epidural anaesthesia improves distal blood flow in patients undergoing arterial reconstruction surgery. * Amputation. Patients given epidural anaesthesia 48-72 hours prior to lower limb amputation may have a lower incidence of phantom limb pain following surgery, although this has not been substantiated. * Obstetrics. Epidural analgesia is indicated in obstetric patients in difficult or high-risk labour, e.g. breech, twin pregnancy, pre-eclampsia and prolonged labour. Furthermore, Caesarean section performed under central neuraxial block is associated with a lower maternal mortality owing to anaesthetic factors than under general anaesthetic. * Low concentration local anaesthetics, opioids, or combinations of both are effective in the control of postoperative pain in patients undergoing abdominal and thoracic procedures. Epidural analgesia has been shown to minimise the effects of surgery on cardiopulmonary reserve, i.e. diaphragmatic splinting and the inability to cough adequately, in patients with compromised respiratory function, such as those with chronic obstructive airway disease, morbid obesity and in the elderly. Epidural analgesia allows earlier mobilization, reduces the risk of deep venous thrombosis, and allows better cooperation with chest physiotherapy, preventing chest infections. * Thoracic trauma with rib or sternum fractures. Adequate analgesia in patients with thoracic trauma improves respiratory function by allowing the patient to breathe adequately, cough and cooperate with chest physiotherapy. [Top] Contraindications Absolute * Patient refusal * Coagulopathy. Insertion of an epidural needle or catheter into the epidural space may cause traumatic bleeding into the epidural space. Clotting abnormalities may lead to the development of a large haematoma leading to spinal cord compression. * Therapeutic anticoagulation. As above * Skin infection at injection site. Insertion of the epidural needle through an area of skin infection may introduce pathogenic bacteria into the epidural space, leading to serious complications such as meningitis or epidural abscess. * Raised intracranial pressure. Accidental dural puncture in a patient with raised ICP may lead to brainstem herniation (coning). * Hypovolaemia. The sympathetic blockade produced by epidurals, in combination with uncorrected hypovolaemia, may cause profound circulatory collapse. Relative * Uncooperative patients may be impossible to position correctly, and be unable to remain still enough to safely insert an epidural. * Pre-existing neurological disorders, such as multiple sclerosis, may be a contraindication, because any new neurological symptoms may be ascribed to the epidural. * Fixed cardiac output states. Probably relative rather than absolute. This includes aortic stenosis, hypertrophic obstructive cardiomyopathy (HOCM), mitral stenosis and complete heart block. Patients with these cardiovascular abnormalities are unable to increase their cardiac output in response to the peripheral vasodilatation caused by epidural blockade, and may develop profound circulatory collapse which is very difficult to treat. * Anatomical abnormalities of vertebral column may make the placement of an epidural technically impossible. * Prophylactic low dose heparin (see discussion below) [Top] Epidurals and anticoagulants (see also page 7 ) * Full oral anticoagulation with warfarin or standard heparin (SH) are absolute contraindications to epidural blockade. * Partial anticoagulation with low molecular weight heparin (LMWH) or low dose warfarin (INR <1.5) are relative contraindications. * Minihep (low dose standard heparin (SH), 5,000units bd s/c is not associated with an increased risk of epidural haematoma. Wait for 4 hours after a dose before performing epidural. Minihep/SH should not be given until 1 hour following epidural injection. These guidelines also apply for removal of epidural catheters. * LMWH (<40mg enoxaparin and dalteparin): allow 12hr interval between LMWH administration and epidural; this also applies to removal of epidural catheters. * NSAID's (including aspirin) do not increase the risk of epidural haematoma. * Intraoperative anticoagulation using 5000units i/v heparin following epidural/spinal injection appears safe, but careful postoperative observations are recommended. Bloody tap or blood in epidural catheter is controversial. Some teams delay surgery for 12hr, others (if pre-op coagulation normal) delay i/v bolus of heparin for 1hour. * Fibrinolytic and thrombolytic drugs: avoid epidural block for 24 hrs, check clotting prior to insertion. * Thrombocytopaenia: epidurals are relatively contraindicated below platelet count of 100,000/mm3. * An epidural haematoma should be suspected in patients who complain of severe back pain a few hours/days following any central neuraxial block or with any prolonged or abnormal neurological deficit (including. sensory loss, paraesthesiae, muscle weakness and disturbance of bladder control and anal sphincter tone). A high index of suspicion is required, with early orthopaedic or neurosurgical referral for decompression of the haematoma. Even with early recognition, the morbidity of this condition is still very high. [Top] Anatomy of the epidural space (figure 1) The epidural space is that part of the vertebral canal not occupied by the dura mater and its contents. It is a potential space that lies between the dura and the periosteum lining the inside of the vertebral canal. It extends from the foramen magnum to the sacral hiatus. The anterior and posterior nerve roots in their dural covering pass across this potential space to unite in the intervertebral foramen to form segmental nerves. The anterior border consists of the posterior longitudinal ligament covering the vertebral bodies, and the intervertebral discs. Laterally, the epidural space is bordered by the periosteum of the vertebral pedicles, and the intervertebral foraminae. Posteriorly, the bordering stuctures are the periosteum of the anterior surface of the laminae and articular processes and their connecting ligaments, the periosteum of the root of the spines, and the interlaminar spaces filled by the ligamentum flavum. The space contains venous plexuses and fatty tissue which is continuous with the fat in the paravertebral space. [Top]

bhavu Total Posts: 41	Posted: Sat Jan 27, 2007 02:38 am no nanu it is verified answer see lee 11th edition spinal anesthesia topic it is clearly stated that aspirin is contraindicated. yes the book specifically mention this.

bhavu Total Posts: 41	Posted: Sat Jan 27, 2007 02:40 am in epidural anesthsia they write same contraindication as spinal.

nanu Total Posts: 228	Posted: Sat Jan 27, 2007 03:01 am I have latest 13th edition of lee. it is cle1arly written 'ASPIRIN ALONE OR NSAIDS WITHOUT ADDITIONAL FACTORS ARE CONSIDE1RE1D SIGINIFICANT FACTORS FOR DE1VELOPMENT OF SPINAL HAEMATOMA AFTER CENTRAL NEURAXIAL ANESTHESIA. so aspirin is c.i. only if their are drug interactions or low platelet count. PLATELET COUNT OF <50,0000 AS A C.I. is given only in ajay yadav which cant not be relied upon. warfarin is a definite c.i. Heparin having a half life of only 1-2 hrs. and it forms a part of many operations for thromboprophylaxis it can be given with a safe interval of 12 hrs. before block. this is what 13 edition lee says. ans. is not confirmed.

nanu Total Posts: 228	Posted: Sat Jan 27, 2007 03:04 am Q51) Good prognostic factors in childhood leukemia are all except ? A) Common ALL subtype B) pre-B ALL C) Hyperploidy D) Female gender Expected Correct Ans: Female gender CORRECT ANS IS B) pre-B ALL REFERENCE--Cytomorphologic differentiation of common acute lymphoblastic leukemia from other immunologic subtypesPMID: 3901644 [PubMed - indexed for MEDLINE] 1.Of the subtypes of acute lymphoblastic leukemia (ALL), the "common" subtype (c-ALL) bears the best prognosis. 2. Copyright (c) 2006-2007, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved. Overview : Identification of significant risk factors in a patient helps in selecting the optimum treatment protocol for that patient, permitting a more or less aggressive approach as needed. Parameters: (1) age (2) initial white blood cell count (3) sex (4) race (5) cytogenetics (6) immunophenotype (7) FAB morphology ( organomegaly (9) mediastinal mass (10) lymphadenopathy (11) hemoglobin (12) LDL (13) platelet count (14) serum immunoglobulins (15) rapidity of leukemic cytoreduction on induction therapy (16) response to initial course of induction chemotherapy Parameter Finding Prognosis age < 12 months very poor 12-23 months poor (?) 2 - 10 years good > 10 years poor initial white blood cell count > 200,000 per µL very poor > 50,000 per µL poor < 10,000 good sex females good males poor race Blacks poor cytogenetics hyperdiploidy (> 50 chromosomes) good hypoploidy poor t (8;14) very poor (induction failure and early relapse) t (9;22) (Philadelphia chromosome) very poor (induction failure and early relapse) t (4;11) poor (induction failure and early relapse) dicentric translocation involving short arms of 9 and 12 good t (1;19) and pre-B immunophenotype (not early pre-B) poor MLL gene rearrangement in infants very poor immunophenotype early pre-B cell (no cytoplasmic immunoglobulin) good pre-B cell (cytoplasmic immunoglobulin) poor mature B cell very poor T cell poor myeloid markers present poor FAB morphology L3 poor L2 poor L1 good mediastinal mass present poor organomegaly hepatomegaly poor splenomegaly poor lymphadenopathy present poor hemoglobin level LDH platelet count serum immunoglobulins low IgM poor low IgG and/or IgA poor rapidity of leukemic cytoreduction on induction therapy residual leukemia on day 14 of induction therapy poor response to initial course of induction chemotherapy failure to achieve complete remission poor where: • The relationship between initial WBC count and prognosis is linear and continuous, with the prognosis inversely related to the count. • The worse prognosis in males is related to testicular relapse and the higher rate of T cell ALL. • The worse prognosis in Blacks is associated with an increased frequency of very high initial white blood cell counts, mediastinal mass, and L2 morphology. • Mediastinal mass, hepatomegaly, splenomegaly and lymphadenopathy reflect high initial tumor burden and correlation with the initial WBC count. • > 1,000 blasts per µL one week after preliminary treatment with glucocorticoids and intrathecal methotrexate is a poor prognostic finding (Arico et al)

gitak Total Posts: 17	Posted: Sat Jan 27, 2007 06:46 am THE Q was which of the following is teratogenic in pregnancy NOT C/I as given here.

gitak Total Posts: 17	Posted: Sat Jan 27, 2007 06:52 am REGARDING ANTIEPILEPTICS question no.50 i mentioned in previous post.

bhavu Total Posts: 41	Posted: Sat Jan 27, 2007 04:35 pm gitak it was which of the following is not teratogenic. because other wise phenytoin--- fetal hydantoin syndrome valporate -- neural tube defect so rest all are teratogenic. and so answer has to be phenobarbitone.

Admin Total Posts: 890	Posted: Sat Jan 27, 2007 04:45 pm Updated most of the answers.

bhavu Total Posts: 41	Posted: Sat Jan 27, 2007 08:51 pm dear netmedicos, eagely waiting for next updation.

Admin Total Posts: 890	Posted: Sat Jan 27, 2007 09:23 pm Updating now.

bhavu Total Posts: 41	Posted: Sun Jan 28, 2007 03:56 pm next set of questions please.

Admin Total Posts: 890	Posted: Sun Jan 28, 2007 05:24 pm Dear Bhavu, We regret the delay due to network connection problem. We have fixed it and now the questions are being updated rapidly. With regards, Netmedicos

bhavu Total Posts: 41	Posted: Sun Jan 28, 2007 05:42 pm dear netmedicos, question no101 was not actuall there actual question was which of the following is prodrug?? 1.aprin 2.dipyridamol 3. 4. now regaring 3rd and 4th option many people are saying ticlopiding and clopidogrel but i am not sure because asprin ticloiding and clopidogrel all are prodrugs.

Admin Total Posts: 890	Posted: Sun Jan 28, 2007 06:55 pm Dear Bhavu, We have taken a note of the correction suggested by you. We shall first update all the questions so that you all can have an idea of the expected ranks. After that we will start corrections. If you suggest to correct first, we can do that also, let us know. With regards, Netmedicos

bhavu Total Posts: 41	Posted: Sun Jan 28, 2007 09:05 pm it is absouletly fine.if you first updal all athe questions.

bhavu Total Posts: 41	Posted: Sun Jan 28, 2007 09:05 pm it is absouletly fine.if you first updal all athe questions.

bhavu Total Posts: 41	Posted: Sun Jan 28, 2007 09:21 pm thanks for updation. so 190 is completed, just 110 to go.

bhavu Total Posts: 41	Posted: Sun Jan 28, 2007 09:38 pm in question 202 one of the option was sharps. and that was the answer refrence park. chapter hospital and waste management

bhavu Total Posts: 41	Posted: Sun Jan 28, 2007 10:07 pm for question 219. polycythemia queestion answer is pancreatic carcinoma. because hypernephroma causes polycythemia. refrence harrison

bhavu Total Posts: 41	Posted: Sun Jan 28, 2007 10:40 pm thanks netmedicos. just 50 to go.keep it up

Admin Total Posts: 890	Posted: Sun Jan 28, 2007 11:41 pm Dear Bhavu, 13 more to go, we shall update try to update them as soon as we sort them out. Correction for Polycythemia Q has been done. With regards, Netmedicos

bhavu Total Posts: 41	Posted: Sun Jan 28, 2007 11:43 pm wow!! thanks netmedicos. it is a mammoth jon you have accomplished. now just a final winning shot is remaining.

bhavu Total Posts: 41	Posted: Sun Jan 28, 2007 11:48 pm but netmedicos, i have updated my answers.so no problem with mine.but other people who have not updated the answers. all their question which they have not yet updated are counted wrong. i think until they update those it should be considerd as not attempted.

Admin Total Posts: 890	Posted: Sun Jan 28, 2007 11:53 pm Dear Bhavu, We have traced this error just now and have fixed it. Thanks for pointing it. IT HAS NOW BEEN FIXED With regards, Netmedicos

bhavu Total Posts: 41	Posted: Sun Jan 28, 2007 11:56 pm some questions which are not included ALL the following is true for promyelocytic except 1.ass with DIC 2.translocation 15.17 3.retinoids are used for treatment. 4. cd marker cd15 and 34 positive answer 4 The conversion of short term memory to long term memory occurs in a.Frontal cortex b.Hippocampus c.Amygdale ???(b)harrison16e/2394-95 : ganong20e/259

bhavu Total Posts: 41	Posted: Sun Jan 28, 2007 11:58 pm . What is the diff between sexual maturity in boys n girls at puberty a.inc inhibin b.spurt of fsh Any ref ! .Oxygenases all are true except- a.incorporates 1 atom of O2 molecule b.incorporates both the atoms of molecular O2 c.required for reactions like hydroxylation d. ???/ (d) HARPER 25e/134 (ch 13) ; first 3 options r true Nesiritide is a a)Brain natriuretic peptide answer a

bhavu Total Posts: 41	Posted: Mon Jan 29, 2007 12:01 am SIADH is a side effect of a.5FU b.vincristine c.bleomycin d.gemcitabine (b) harrison�s16/e 477

bhavu Total Posts: 41	Posted: Mon Jan 29, 2007 12:05 am . RANDOMISATION IS DONE TO a. to remove selection bias b. so that groups are comparable c.? d.? (b)

gitak Total Posts: 17	Posted: Mon Jan 29, 2007 03:58 am breast milk lactose;62&protein;11 whereas cow milklactose;50&protein;33 REF;PARK 18ed;Page-398.

gitak Total Posts: 17	Posted: Mon Jan 29, 2007 05:00 am bhavu' 4th option in Q Of oxygenase was carboxylation reaction.

bhavu Total Posts: 41	Posted: Mon Jan 29, 2007 05:14 am may be gitak.you are right i do not remember i marked b in that question and that is wrong i know.

Admin Total Posts: 890	Posted: Mon Jan 29, 2007 05:41 am 4th option Updated Gitak...

bhavu Total Posts: 41	Posted: Mon Jan 29, 2007 03:33 pm regarding clonidine question no. 137 answer should be c praszocine antagonise its action. kdt 5th edi page 509 clealy mention that prasocine has no effect on presyaptic alpha-2 receptors. plus page 510 mentions that part of effect of clonidine is due to increase vagal tone (mentioned in the bracket) so option of parasypathetic tone seem to right. ans answer should be c

bhavu Total Posts: 41	Posted: Mon Jan 29, 2007 03:43 pm another question that is missed question 298.206.child has started mouthing objects , shows likes/dislikes, and has not developed stranger anxiety... age?? a.3 months b.5 months c. 7 months d.9 months (b) ghai/33

bhavu Total Posts: 41	Posted: Mon Jan 29, 2007 03:45 pm question 283 actually was Not used in controlling heart rate intraoperatively a.PROPANOLOL b.procainamide c.verapamil d.ESMOLOL answer is procainamide. refrence leementions rest of the 3 drugs to use to control heart rate. it doesnot mention b

Admin Total Posts: 890	Posted: Mon Jan 29, 2007 03:45 pm Updated

bhavu Total Posts: 41	Posted: Mon Jan 29, 2007 06:42 pm 2 question remaining are 298.child has started mouthing object,shows likes/dislikes and does not developed stranger anxiety age a.3months b. 5 months c.7 months d. 9 months answer b. ghai 33 299.most common site of metastasis of choriocarcinoma a.lung b.vagina c. d. answer lung. refrence shaws please update this 2 question that makes 299 questions. just 1 remaining i think that was something about e coli. cap a etc but i do not remember as i had left that question. plase update these 2 questions netmedicos.

Admin Total Posts: 890	Posted: Mon Jan 29, 2007 10:08 pm Updated

ramana Total Posts: 6	Posted: Tue Jan 30, 2007 02:29 am i wud just like to update the correct answer for the drug contraindicated for caudal anaesthesia in paediatrics... the ans is MORPHINE as correctly suggested.morphine is a less lipid soluble drug and so will not bind to spinal cord..and will ascend up to the CNS and cause delayed resp.depression which is the most feared complication in paediatric anaesthesia.the other drugs (fentanyl,sufentany) are lipid soluble and will binfd to the neurons in the spinal cord.

gitak Total Posts: 17	Posted: Tue Jan 30, 2007 03:14 am in Q of tuberculid the ans has to be lichen scrofulosorum.REF;NEENA KHANNA Page-197.

gitak Total Posts: 17	Posted: Tue Jan 30, 2007 03:19 am moro's reflex disappears by 12 wks.REF;OP GHAI ed;5th page-125.

gitak Total Posts: 17	Posted: Tue Jan 30, 2007 03:35 am in PNH granulocytopenia&thrombocytopenia&dificient thrombocytopenia.Also BM is normocellular.REF;HARRISON'S ed;16 page-616. In g6pd only picture of hemolytic anemia appear.p-611.

gitak Total Posts: 17	Posted: Tue Jan 30, 2007 03:40 am i like to correct its deficient hematopoiesis.

Admin Total Posts: 890	Posted: Tue Jan 30, 2007 06:19 am Dear Gitak, Updated correct answers for - 1) tuberculide 2) moro's reflex What do you mean by - in PNH granulocytopenia&thrombocytopenia&dificient thrombocytopenia.Also BM is normocellular.REF;HARRISON'S ed;16 page-616. In g6pd only picture of hemolytic anemia appear.p-611. Let us know your answer for this PNH question. With regards, Netmedicos

ramana Total Posts: 6	Posted: Tue Jan 30, 2007 01:51 pm hey net medicos, u peope r doing wonnerful job and am sure every year thousands of PG aspirants will be benefitted by ur work.The MOCKTESTS and RANKPROJECTOR is really really wonnerful.just go on and on and on......

addu Total Posts: 42	Posted: Wed Jan 31, 2007 01:58 am hello netmedicos u r doing great job. i would like to make 1 correction.in aipg q about PNH it was asked that which 1 of the following has pancytopenia with hypercellular marrow and to that q ans was PNH........don't exactly remember the other options.but it was this 1 for sure.

Admin Total Posts: 890	Posted: Wed Jan 31, 2007 03:54 am Updated Addu

ponnu Total Posts: 116	Posted: Wed Jan 31, 2007 05:41 am I think Addu is right. That wasnt an exact repeat of AIIMS question.AIIMS que was all except. Best indicator of nutritional status of a child. Wasnt that a repeat from AIIMS? and the answer in speed is Rate of increase of height and weight.The choices given in your key is different. Pontine stroke was palatal palsy an option? Question of genomics is not thats given in your paper. Anybody remember the correct question? Betablocker question had except in it. All are nonselective beta blockers without additional action except?labetelol, cartiolol, carvedilol, forgot the 4th option. both labetelol and carvedilol has addtl axion dats alpha blocking action. So whats the answer. or am i interpreting the question in a wrong way? somebody pls help wid this Heterotopic calcification, I found this from a website https://www.emedicine.com/pmr/topic52.htm Serum alkaline phosphatase (AP) level can detect early onset of HO, since it is a marker of osteoblastic and osteogenic activity HO is heterotopic ossification. So i think alp is the ans. somebody confirm AML Which is NSE negative? M3 confirmed. Read the following link: https://www.med-ed.virginia.edu/courses/path/innes/wcd/myeloid1.cfm Acute Erythroblastic Leukemia - FAB M6-The blasts are MPO negative, but often positive for NSE Acute Promyelocytic Leukemia (APL) - FAB M3 Staining: The cells are MPO and chloroacetate esterase (CAE) positive, but generally negative for NSE (NSE positive in 25%). Eventhough they've given M3 is NSE in positive in 25 % cases M6 is OFTEN positive for NSE.Thank god so M3 is the answer. Wonderful AIIMS people to ask such questions!!!! Which is a prodrug?What were the choices? Its not that given in your paper. and ticlopidine and clopidogrel are both prodrugs. but both were not there. aspirin was there. Chlamydia psittaci all except? It causes NGU was an option i think and isnt that the answer? Most common cause of post menopausal bleeding in india? isnt it carcinoma endometrium? Cluster sampling,What were the options? I asked my SPM professor. She said its a rapid method. and sample size is usually small. Random sampling any sample size can be there. Following hemorrhage which doesnt happen? Isnt the answer increase PCV? Reticulocytosis can occur after hemorrhage right? was the question immediately after hemorrhage? anyway PCV won increase right? S4? S4 is due to atrial contraction, not ventricular filling. Ans is either it can be heard by human ears or frequency more than 20. i dont know Findings in DIC all except? There was an option saying decreased PT. I think thats the answer. PT won decrease. Fibrinogen may increase. Thats what i could gather from many sites

ponnu Total Posts: 116	Posted: Wed Jan 31, 2007 05:54 am Criteria for MDP. Ans is mania plus anxiety i think. Depression alone is a criteria given in Ahuja Which is not a cavernous branch? Ophthalmic artery is a cavernous branch. As given in a greys anatomy website. i forgot the other choices All can be incinerated except? there was an option waste sharp. And my friend said its given in new ed park that waste sharp should not be incinerated. about cytotoxics theyve given in the chart that incineration wont be fully effective. That doesnt mean it SHOULD not be incinerated And you havent added the question on papiloedema? sorry i dont remember the question or the answer. Leukotriene receptor antagonist question was asked twice.Wid montelukast and zafirlukast as answers i think Youve repeated the BCYE question twice. i think it ws asked only once. About randomisation isnt the answer given in mudit khanna to prevent selection bias? And peripheral neuropathy i think its stavudine. thats what i felt from googling. sorry, not sure. somebody pls help Birth anoxia also causes basal ganglia calcification. so whats the answer?

ponnu Total Posts: 116	Posted: Wed Jan 31, 2007 05:58 am one dermat pg told me leprosy usually don affect female genital organs. and since ovary has a higher temp least chance is for ovary. she told her professor asked her that question once and this was the ans he said!!

Admin Total Posts: 890	Posted: Wed Jan 31, 2007 06:33 am Dear Ponnu, As the questions are from recalls, so there are likely to be some errors. We would like other users to point out the mistakes too, keeping in mind your corrections, so that we can correct the recalled questions, options and answers. With regards, Netmedicos

nanu Total Posts: 228	Posted: Wed Jan 31, 2007 06:34 am yes ponnu about DIC question u are right. i dont remember the exact q. but i also marked the one with dec. PT option. Fibrinogen level can be normal,dec. or inc. in chronic DIC. PT is always elevated. reference- Disseminated intravascular coagulation A primer for primary care physicians Harry L. Messmore Jr, MD; William H. Wehrmacher, MD WEB EXCLUSIVE / MARCH 2002 / POSTGRADUATE MEDICINE Table 2. Clinical and laboratory findings in DIC Acute DIC Clinical findings * Multiple bleeding sites * Ecchymoses of skin, mucous membranes * Visceral hemorrhage * Ischemic tissue Laboratory abnormalities * Coagulation abnormalities: prolonged prothrombin time, activated partial thromboplastin time, thrombin time; decreased fibrinogen levels; increased levels of FDP (eg, on testing for FDP, D dimer) * Platelet count decreased as a rule but may be falling from a higher level yet still be normal * Schistocytes on peripheral smear Chronic DIC Clinical findings * Signs of deep venous or arterial thrombosis or embolism * Superficial venous thrombosis, especially without varicose veins * Multiple thrombotic sites at the same time * Serial thrombotic episodes Laboratory abnormalities * Modestly increased prothrombin time in some patients * Shortened or lengthened partial thromboplastin time * Normal thrombin time in most patients * High, normal, or low fibrinogen level * High, normal, or low platelet count * Increased levels of FDP (eg, on testing for FDP, D dimer) * Evidence of molecular markers* (eg, thrombin-antithrombin complexes, activation markers on platelet membranes, prothrombin fragment F1+2)

nanu Total Posts: 228	Posted: Wed Jan 31, 2007 06:43 am Regarding bipolar iilness-- Diagnostic Criteria For Bipolar I Disorders Bipolar I Disorder, Single Manic Episode 1. Presence of only one Manic Episode and no past Major Depressive Episodes. Note: Recurrence is defined as either a change in polarity from depression or an interval of at least 2 months without manic symptoms. 2. The Manic Episode is not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. Bipolar I Disorder, Most Recent Episode Hypomanic 1. Currently (or most recently) in a Hypomanic Episode. 2. There has previously been at least one Manic Episode or Mixed Episode. 3. The mood symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 4. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. Bipolar I Disorder, Most Recent Episode Manic 1. Currently (or most recently) in a Manic Episode. 2. There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode. 3. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. Bipolar I Disorder, Most Recent Episode Mixed 1. Currently (or most recently) in a Mixed Episode. 2. There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode. 3. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. Bipolar I Disorder, Most Recent Episode Depressed 1. Currently (or most recently) in a Major Depressive Episode. 2. There has previously been at least one Manic Episode or Mixed Episode. 3. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. Bipolar I Disorder, Most Recent Episode Unspecified 1. Criteria, except for duration, are currently (or most recently) met for a Manic, a Hypomanic, a Mixed, or a Major Depressive Episode. 2. There has previously been at least one Manic Episode or Mixed Episode. 3. The mood symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 4. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. 5. The mood symptoms in Criteria A and B are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

nanu Total Posts: 228	Posted: Wed Jan 31, 2007 06:45 am One question was on bacitracin senstivity and one on optochin senstivity.

nanu Total Posts: 228	Posted: Wed Jan 31, 2007 06:49 am question was-Factor present in final common complement pathway ? a. C2 B. C3 C. C4 D. C5 THERE WAS NO C3b OPTION. Ans has to be C3 and not C5 Final common pathway starts at C3 and not C5 though C3b is present intially in altenate pathway. given in harrison and all sites.

bhavu Total Posts: 41	Posted: Wed Jan 31, 2007 02:06 pm opthalmic artey is not cavenous brance it is cereberal branch. just see bd chaurasia

ponnu Total Posts: 116	Posted: Wed Jan 31, 2007 03:43 pm bhavu, yeah i checked chaurasya. its given as cerebral branch thank god. but just to make sure anybody who has access to greys wil u pls check? and nanu, so the answer is depression alone?

ponnu Total Posts: 116	Posted: Wed Jan 31, 2007 04:09 pm About complement question they've given in Harrison Page 1915 THE 3 PATHWAYS OF COMPLEMENT ACTIVATION ALL CONVERGE ON THE FINAL COMMON TERMINAL PATHWAY. and in the next page they've given a figure in which C5 to C9 is marked as the terminal pathway. Kindly read that and give your opinion. I'm confused myself

nanu Total Posts: 228	Posted: Wed Jan 31, 2007 04:25 pm ya answer is C5 agreed.

nanu Total Posts: 228	Posted: Wed Jan 31, 2007 04:36 pm Q42) Which of this is not true about Vibrio cholerae ? A) Nonhalophilic B) Can be grown in ordinary media C) Can survive outside the body D) Ans can not be 'B'. its clearly written in anatnarayanan in vibrio chapter under cultural characreistics-"VIBRIO GROWS WELL ON ORDINARY MEDIA" A is true abd C is the ans. option C explained by amit/ashish somewhr. dont remember D option.

ponnu Total Posts: 116	Posted: Wed Jan 31, 2007 04:45 pm Youre right. So 1 down

gitak Total Posts: 17	Posted: Thu Feb 01, 2007 03:50 am In diagnosis of mood disorder MANIA WITH ANXIETY is not a factor. REF;NIRAJ AHUJA Page-74.

gitak Total Posts: 17	Posted: Thu Feb 01, 2007 03:57 am IN pnh pancytopenia occurs during aplastic crisis &BM is normocellular.so it can't be the ans.HERE ANSWER IS G6PD .see HARRISON'S 16 ed;page-616&611

gitak Total Posts: 17	Posted: Thu Feb 01, 2007 04:08 am as addu has pointed out there was no except in Q on PNH then answer is PNH but in the Q here EXCEPT IS GIVEN so accordingly ans is G6PD.SO NETMEDICOS please either correct the question or the answer.

Admin Total Posts: 890	Posted: Thu Feb 01, 2007 03:19 pm Dear Gitak, PNH question updated. With regards, Netmedicos

Admin Total Posts: 890	Posted: Thu Feb 01, 2007 03:29 pm Dear Gitak, Question on Bipolar Disorder has been updated. With regards, Netmedicos

Admin Total Posts: 890	Posted: Thu Feb 01, 2007 03:38 pm Dear Nanu, Vibrio Cholera Question has been updated. With regards, Netmedicos

gitak Total Posts: 17	Posted: Thu Feb 01, 2007 04:10 pm waste sharps is not given in option here so netmedicos kindly give it in the options .then it will be the answer.

Admin Total Posts: 890	Posted: Thu Feb 01, 2007 09:42 pm Dear Gitak, Option - Waste sharps, has been added. With regards, Netmedicos

mughal Total Posts: 2	Posted: Sat Feb 03, 2007 12:22 pm netmedicos virus infected cells are specifically killed by cytotoxic t cell whereas nk cells are nonspecific killers and question asked about specific killers

Admin Total Posts: 890	Posted: Sun Feb 04, 2007 06:50 am Dear Mughal, We are waiting for confirmation of the answer for this question on Virus infected cells. With regards, Netmedicos

mughal Total Posts: 2	Posted: Sun Feb 04, 2007 12:24 pm netmedicos diagnostic isotope of choice is i123 and not i131 check bailey 24th pg 779. also primordial germ cell arises from endoderm and not mesoderm,check any embryology book. also PROTEIN+GLYCAN[THAT IS CHODRITIN SULPHATE,DERMATAN SULPHATE]= PROTEOGLYCAN[AGGRECAN ,DYSGLYCAN ETC.]AND HENCE CHONDRITIN SULPHATE IS A {GAG} AND NOT PROTEOGLYCAN IN FACT GAG ISA A PART OF PROTEOGLYCAN. CHECK HARPER AND SINCE QUESTION ASKED EXCEPT AND HENCE 4TH IS THE OPTION. ALSO T/T OF CHOICE FOR CARDIOGENIC SHOCK +MI IS PRIMARY ANGIOPLASTY AND NOT IABP AS IT IS A STABALISING PROCEDURE AND NOT THE TREATMENT. CHECK HARRY AND CMDTAND QUESTION ASKED ABOUT T/T OF CHOICE AND NOT TEMPORARY STABALISING PROCEDURE.

addu Total Posts: 42	Posted: Mon Feb 05, 2007 04:06 pm about Q 6........chlamydia pssitacci true except there was 1 option as it causes non gonnococcal urethritis......which i marked as ans in examination not sure abt the option of inclusion conjunctivitis whether it was there or not. somebody pls confirm.

addu Total Posts: 42	Posted: Mon Feb 05, 2007 04:09 pm Q16..nonspecific esterase seen in all except a. AML M3 b. AML M4 c. AML M5 d. AML M6 this was the exact q for sure

gitak Total Posts: 17	Posted: Tue Feb 06, 2007 03:01 am addu, i think you r right this was exact Q on NSE.

addu Total Posts: 42	Posted: Tue Feb 06, 2007 07:01 am ans to germ cell orgin is endoderm. in inderbeer singh's embroyology its clearly written that primordial germ cells are derived from walls of yolk sec from where they migrate to the developing gonads and yolk sec is made of cells of endodermal origin.

addu Total Posts: 42	Posted: Tue Feb 06, 2007 07:46 am for q no.256 4th option was immediately after delivery (CO is maximum)which i have marked as answer.

devil2908 Total Posts: 1	Posted: Fri Feb 09, 2007 05:50 pm hi there was a question regarding metastasia and matrix metalloprotiensaes if my memory goes right

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