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| rvimalchander Total Posts: 3 | Posted: Mon Feb 05, 2007 01:52 am UPSC 2007 Part-I 1. A five year old girl presents with fever and conjunctivitis. Physical examination is significant for oral erythema and fissuring along with a generalised maculopapular rash and cervical lymphadenopathy. What is the most likely diagnosis? (a) Henoch-Schnolein purpura (b) Polyarteritis nodosa (c) Kawasaki disease (d) Takayasu arteritis 2. The following can be associated with fatty liver except (a) Amiodarone (b) Zidovudine (c) Sodium valproate (d) Chlorpropamide 3. which one of the following is not associated with a high reticulocyte count? (a) Acute bleed (b) Haemolytica anaemia (c) Megaloblastic anaemia (d) Response to treatment in nutrition/deficiency anaemia 4. A young boy presents with failure to thrive. Biochemical analysis of a duodenal aspirate after a meal reveals a deficiency of enteropeptidase (enterokinase). The levels of which one of the following digestive enzymes would be affected? (a) Amylase (b) Pepsin (c) Lactose (d) Trypsin 5. Regarding falciparam malaria, consider the following statements: 1. The mortality rises steeply when the proportion of infected erythrocytes increases above 3 per cent. 2. The patient may develop hypoglycemia even when not treated with quinine. Which of the statements given above is/are correct? (a) 1 only (b) 2 only (c) Both 1 and 2 (d) Neither 1 nor 2 6. The features of organophosphorus poisoning include the following except (a) Fasciculations (b) Pulmonary oedema (c) Epileptic seizures (d) Mydriasis 7. The salicylate intoxication in adults usually causes the following except (a) Severe respiratory alkalosis (b) Mixed metabolic acidosis-respiratory alkalosis (c) Pure high anion gap metabolic acidosis (d) Hyperchloremic metabolic acidosis 8. The Schilling test is performed to determine the cause of (a) Lactose malabsorption (b) Fatty acid malabsorption (c) Amino' acid malabsorption (d) Cobalamin malabsorption 9. I-receptors. which are responsible for rapid shallow breathing are located in (a) Thoracic cage and lung (b) Carotid artery (c) Alveolo-capillary junction (d) Respiratory muscles 10. Pansystolic murmur at apex with soft first heart sound is the key sign of which one of the following? (a) Aortic regurgitation (b) Mitral regurgitation (c) Ventricular septal defect (d) Atrial septal defect 11. Which is the most common micro organism known to cause tropical pyomyositis ? (a) Streptococcus viridans (b) Staphylococcus albus (c) Klebsiella pneumoniae (d) Staphylococcus aureus 12. Consider the following statements: 1. In leptospirosis, the incubation period ranges from 2 to 20 days. 2. In leptospirosis, urine may show microscopic haematuria. Which of the statements given above is/are correct? (a) 1 only (b) 2 only (c) Both 1 and 2; (d) Neither 1 nor 2 13. What is the treatment of choice for benign tertian malaria? (a) Sulfamethoxazole-pyrimethamine (b) Quinine (c) Mefloquine (d) Chloroquine 14. Match list-I with list –II and select the correct answer using the code given below the lists: List – I List-II (Infection) (Therapeutic agent) A. Candidiasis 1. Ganciclovir B. Syphilis 2. Ciprofloxacin C. Typhoid 3. Penicillin D. CMV retinitis 4. Fluconazole Code: a. A B C D 1 3 2 4 b. A B C D 1 2 3 4 c. A B C D 4 3 2 1 d. A B C D 4 2 3 1 15. Which one of the following is an antietic with minimal CNS side effects? a. Ondansetron b. Chlorpromazine c. Metoclopramide d. Prochlorperazine 16. Regarding vitamin K, which one of the following statements is correct? a. It is a water soluble vitamin b. Its body-stores can last more than 8 years c. Its routine prophylaxis in newborn children is recommended to prevent early haemorrhagic disease d. It is the treatment of choice in patients with acute severe haemoptysis 17. Which one of the following is the most appropriate clinical tests to confirm the iron-deficiency anaemia? a. Red blood cell indices b. Serum ferritin level c. Bone-marrow examination d. Urinary iron clearance 18. A two old child presents with persistent diarrhoea, acidic stools and presence of one percent of reducing substance in the fresh stools. What is the most probable diagnosis? a. Cystic fibrosis b. Lactose intolerance c. Rotavirus induced diarrhoea d. Intestinal tuberculosis 19. With reference to leprosy, consider the following statements: 1. In lepromatous leprosy, lepromin , test is always positive. 2. Polyclonal hypogammaglobinemia is a common feature of lepromatous leprosy. 3. Secondary amyloidosis may occur in long-standing lepromatous leprosy. Which of the statements given above are correct? (a) 1, 2 and 3 (b) 1 and 2 only (c) 1 and 3 only (d) 2 and 3 only 20. With reference to Polyarticular juvenile rheumatoid arthritis" consider the following statements: 1. It is more common in girls. 2. Five or more joints are affected within the first six months of onset. 3, Uveitis occurs in 95% patients. 4. Rheumatoid factor may be negative., Which of the statements given above are correct? (a) 1 and 4 only (b) 1, 2 and 4 (5} 2, 3 and 4 (d) 2 and 3 only 21. Koebner's phenomenon is seen in (a) Lupus, vulgaris (b) Lupus erythematosis (c) Psoriasis (d) Eczematous dermatitis 22. Consider the following clinical features: 1. Impaired judgement 2. Impaired memory 3. Alteration of personality 4. Clouding of consciousness Which of the above are characteristic of dementia? (a) 1 and 2 only (b) 1, 2 and 3 only (c) 3 and 4 only (d) 1, 2, 3 and 4 23. which one of the following is not a feature of catatonic schizophrenia? (a) Negativism (b) Autom'atic obedience (c) Catalepsy (d) Cataplexy 24. Which one of the following is the investigation of choice for suspected deep vein thrombosis of the lower extremity? (a) Radioactive labelled fibrinogen uptake (b) Ascending contrast phlebography (c) D-dimer estimation (d) Duplex ultrasonography 25. What is the most common initial manifestation of increased intracranial pressure in a patient' with head injury? (a) Change in the level of consciousness (b) Ipsilateral pupillary dilatation (c) Retching and vomiting (d) Bradycardia 26. An evidence that splenectomy might benefit a patient with idiopathic thrombocytopenic purpura includes which of the following? (a) A significant enlargement of the spleen (b) A high reticulocyte count (c) Patient's age less than five years (d) An increase in platelet count on corticosteroid therapy 27. Which one of the following ligaments contains splenic artery? (a) Gastrosplenic ligament (b) Splenocolic ligament (c) Splenorenal ligament (d) Splenophrenic ligament 28. The segmental division' of liver into eight segments is based on (a) Hepatic veins alone (b) Portal vein alone (c) Hepatic veins and common hepatic artery (d) Hepatic veins and portal vein 29. What is the most common surgical complication following Whipple procedure ? (a) Disruption of pancreatic anasto mosis (b) Biliary peritonitis (c) Disruption of gastric anastomosis (d) GI bleeding 30. Injury to which one of the following nerves leads to winging of scapula? a. Thoracodorsal nerve b. Axillary nerve c. Long thoracic nerve d. Radial nerve 31. Consider the following statements: Venacaval opening of the diaphragm situated at the level of T 8 transmits : 1. Inferior vena cava 2. Vagus nerve 3. Branches of the right phrenic nerve 4. Thoracic duct Which of the statements given above are correct ? (a) 1 and 2 (b) 2 and 3 (c) 1 and 3 (d) 1 and 4 32. Vascular complications of acute pancreatitis include the following except (a) Splenic vein thrombosis (b) Splenic artery aneurysm (c) Gastroduodenal artery aneurysm (d) Middle colic artery thrombosis 33. With reference to Hirschsprung's disease, which one of the following statements is correct? (a) It is initially treated by colostomy (b) In the neonatal period, it is best confirmed by barium enema (c) It is associated with high incidence of genito-urinary tract anomalies (d) It is characterised by the absence of ganglion cells in the transverse colon 34. Which one of the following nerves is injured in anterior dislocation of shoulder? (a) Radial nerve (b) Axillary nerve (c) Median nerve (d) Ulnar nerve 35. What is the most common complication of fracture of the ischio-pubic ramus of pelvic bone? (a) Rupture of urinary bladder (b) Rupture of prostatic urethra (c) Rupture of membranous urethra (d) Injury to penile urethra 36. Non-cardiac causes of raised central venous pressure include the following except . (a) Abdominal compartment syndrome. (b) Tension pneumothorax (c) Positive pressure ventilation (d) Hypervolemia 37. Consider the following: 1. Arginine 2. Nucleotides (RNA and DNA) 3. Fatty acids 4. Glutamine Which of the above immuno-nutrients are required more in the conditions of stress? (a) 1 and 3 only (b) 2 and 4 only (c) 1, 2 and 3 only (d) 1, 2, 3 and 4 38. Sprain of the ankle joint results from an injury to (a) Deltoid ligament (b) Spring ligament (c) Posterior talofibular ligament (d) Anterior talofibular ligament 39. 'Anterior drawer sign' is positive in (a) Medial meniscus injury (b) Anterior cruciate ligament injury (c) Lateral collateral ligament injury d) Lateral meniscus injury 40. What is the most important aspect of management of bum injury in the first 24 hours? (a) Fluid 'resuscitation (b) Dressing (c) Escharotomy (d) Antibiotics' 41. Abdominal compartment syndrome is characterised by the following except (a) Hypercarbia and respiratory acidosis (b) Hypoxia due to increased peak inspiratory pressure (c) Hypotension due to decrease in venous return (d) Oliguria due to ureteric obstruction 42. Which one of the following surgical procedures is considered to have a clean contaminated wound? (a) Elective open cholecystectomy for cholelithiasis (b) Herniorrhaphy with mesh repair (c) Lumpectomy with axillary node dissection (d) Appendectomy with walled off abscess 43. Split skin grafts in young children should be harvested from (a) Buttocks b) Thigh (c) Trunk (d) Upper limb 44. A 25-year old female presents with pyrexia for ten days, develops acute pain in periumbilical region spreading all over the abdomen. What would be the most likely cause? (a) Perforation peritonitis due to intestinal tuberculosis (b) Generalised peritonitis due to appendicular perforation (c) Typhoid enteric perforation and peritonitis (d) Acute salpingo-oophoritis with peritonitis 45. Match List I with List II and select the correct answer using the code given below the Lists: List – I List- II (Carcinoma) ( Characteristic) A. Seminoma testis 1. Hormone dependent B. Carcinoma prostate 2. Does not spread by lymphatics C. Basal cell carcinoma 3. Prognosis depends on thickness D. Malignant melanoma 4. Highly radiosensitive Code: a. A B C D 4 1 2 3 b. A B C D 4 2 1 3 c. A B C D 3 1 2 4 d. A B C D 3 2 1 4 Directions: The following 3 (three) items consist of two statements, one labelled as the' Assertion (A)' and the other as 'Reason (R)'. You are to examine these two statements carefully and select the correct answer using the code given below. (a) Both A and R are individually true and R is the correct explanation of A . (b) Both A and R are individually true but R is not the correct explanation of A (c) A is true but R is false (d) A is false but R is true 46. Assertion (A) : If Perthes test is positive, surgery is absolutely contraindicated in varicose vein of leg. Reason (R) : Perthes test confirms perforator incompetence. 47. Assertion (A) : Raloxifene is a drug used in the treatment of breast carcinoma. Reason (R) : It is preferred over tamoxifen since it has less incidence of thromboembolism. 48. Assertion (A) : Femoral hernia is more likely to become strangulated than inguinal hernia. Reason (R) : Femoral hernia is more common in females and gets neglected more often. 49. Of the various modalities used in the treatment of life-threatening effects of hyperkalemia, which one of the following has the most rapid onset of action? (a) Hemodialysis (b) Sodium bicarbonate infusion (c) Insulin and glucose infusion (d) Intravenous calcium gluconate 50. A patient presents with acute gastroenteritis in a dehydrated state. Which of the following conditions is highly suggestive of pre-renal renal failure? (a) Urinary sodium> 40 m mol; Urine osmolality < 350 m osm/L (b) Urinary sodium> 40 m mol; Urine osmolality> 500 m osm/L (c) Urinary sodium < 20 m mol; Urine osmolality> 500 m osm/L (d) Urinary sodium < 20 m mol; Urine osmolality < 350 m osm/L , 51. Chronic renal failure with inappropriately high haemoglobin levels may be seen with: a. Hypertensive nephropathy b. Ischemic nephropathy c. Diabetic nephropathy d. Polycystic renal disease 52. Regarding rheumatoid arthritis, which one of the following statements is correct? a. NSAIDs are helpful in controlling the disease process b. Corticosteroids, on long term basis, are to be given in all cases c. DMARDs should be given early and preferably in combinations d. Every patient of rheumatoid arthritis has a positive rheumatoid factor 53. Consider the following sites of lesion in brain: 1. Lateral geniculate body 2. Optic radiation 3. Optic tract 4. Optic chiasma Which of the above can result r in homonymous hemianopia? (a) 1, 2 and 4 (b) 2, 3 and 4 (c) 1 and 4 only (d) 1, 2 and 3 . 54. What is the typical feature' of nerve entrapment in the carpal tunnel syndrome? (a) Symptoms diminish by wrist flexion (b) Pain worsens at night (c) Erythema present in the cutaneous distribution of median nerve (d) Motor symptoms precede sensory symptoms 55. Which one of the following is not a feature of Gullain Barre syndrome? (a) Albumino-cytological dissociation (b) Transient bladder disturbances (c) Areflexia (d) Babinski plantar response 56. In a patient with ischaemic stroke, intravenous recombinant tissue plasminogen activator has mainly been found to be useful during the initial (a) 3 hours (b) 6 hours (c) 12 hours (d) 24 hours 57. Consider the following: 1. Malnutrition 2. Lithostatin (pancreatic stone protein) deficiency 3. Cassava tuber 4: Oxidant stress (heightened cytochrome P-450 activity) Which of the above produce tropical calcific pancreatitis (fibrocalculous pancreatic diabetes) ? (a) 1, 2 and 3 only (b) 2, 3 and 4 only (c) I and 4 only (d) 1, 2, 3 and 4 58. The prognosis in reduced or unreduced fractures involving epiphyseal plate is very poor if the fracture line (a) runs along the epiphyseal plate (b) extends into epiphysis (c) crushes the epiphyseal plate d) crosses the epiphyseal plate 59. A green stick fracture (a) occurs mainly in the elderly (b) is a fatigue fracture (c) is a spiral fracture of long bone (d) is a fracture where part of cortex is intact and part is crumpled 60. With reference to varicocele, which one of the following is not true of it ? (a) Varicosity of cremestric veins (b) Left side is affected usually (c) Feels like a bag of worms (d) May lead to infertility 61. Steering wheel injury on chest of a young man reveals multiple fractures of ribs and paradoxical movement with severe respiratory distress. X-ray shows pulmonary contusion on right side without pneumothorax or haemothorax. What is the initial treatment of choice? (a) Immediate internal fixation (b) Endotracheal intubation and mechanical ventilation (c) Thoracic epidural analgesia and °2 therapy (d) Stabilization with towel clips 62. Which one of the following gastro intestinal disorders predisposes to urolithiasis? (a) Peutz-Jeghers’ syndrome b) Short bowel syndrome (c) Familial polyposis coli (d) Ulcerative colitis 63. Amaurotic cat's eye reflux is typical of (a) Papilloedema (b) Papillitis (c) Retinoblastoma (d) Retinitis pigmentosa 64. Cobble-stone conjunctiva is a feature of (a) Viral conjunctivitis (b) Spring catarrh (c) Fungal conjunctivitis (d) Tubercular conjunctivitis 65. In acute sinusitis, the sinus most often involved in children is (a) Maxillary (b) Sphenoid (c) Ethmoid (d) Frontal 66. The clinical manifestation of cauda equina lesion include the following except (a) Urinary retention (b) Radicular pain (c) Dermatomal sensory loss (d) Extensor plantar reflexes 67. Following blood transfusion, non cardiogenic pulmonary oedema may sometimes occur because of (a) RBC incompatibility (b) Antigen-antibody mechanism involving human leucocyte antigen (c) Platelet surface antigen reaction (d) Antibody to IgA in donor plasma 68. What is the most frequent tooth to be impacted? (a) Lower third molar (b) Upper third molar (c) Lower canine (d) Upper premolar 69. Fogarty's catheter is used, for (a) Drainage of urinary bladder (b) Parenteral hyperalimentation (c) Removal of embolus from blood vessels (d) Ureteric catheterization 70. Consider the following conditions: 1. Central diabetes insipidus 2. Uncontrolled diabetes mellitus 3. Mannitol infusion 4. Post-obstructive diuresis Which of the above result in solute diuresis? (a) 1 and 2 only (b) I, 2 and 3 (c) 2, 3 and 4 (d) 1, 3 and 4 71. Match List I with List II and select the correct answer using the code given below the Lists: List-I List-II (Finding in urine ( Disease) examination) A. red cell casts 1. Nephrotic syndrome B. Microscopic hematuria 2. Chronic renal failure C. Proteinuria 3. Polycystic kidney D. Broad cell casts 4. Glomerulonephritis Code: a. A B C D 4 3 1 2 b. A B C D 4 1 3 2 c. A B C D 2 3 1 4 d. A B C D 2 1 3 4 72. A young male with acid peptic disease receives three units of blood for upper gastrointestinal bleeding. Two months later he presents with .fever, malaise and tender hepatomegaly. His serum bilirubin is normal and the liver enzymes are elevated - ALT 800 IU/L and AST 600 IU/L. Which of the following are the likely infections in this case? 1. Hepatitis A 2. Hepatitis B 3. Hepatitis C 4. Hepatitis E 5. Cytomegalo virus Select the correct answer using the code given below: (a) 1, 2 and 3 (b) 2, 3 and 4 (c) 2, 3 and 5 (d) 1 and 4 73. Celiac sprue causes syndrome due to (a) Coliform infection of small bowel (b) Lactase deficiency (c) Hypersensitivity to dietary gluten (d) Ischaemia of celiac artery 74. Match List I with List II and select the correct answer using the code given below the Lists: List I List- II (Type of anaemia) (Cause) A. Macrocytic anaemia 1. Iron deficiency B. Microcytic anaemia 2. Hypothyroidism C. Haemolytic anaemia 3. Vitamin B12 deficiency D. Megaloblastic anaemia 4. Alpha methyl dopa Code: a. A B C D 3 1 4 2 b. A B C D 3 4 1 2 c. A B C D 2 1 4 3 d. A B C D 2 4 1 3 75. Gastric erosions are likely to be associated with the following conditions except (a) Pernicious anaemia (b) Cor pulmonale (c) Polycythemia rubra vera (d) Hepatic cirrhosis 76. With reference to the treatment of chronic Hepatitis B infection, consider the following drugs: 1. Lamivudine 2. Alpha interferon 3. Ribavirin 4. Acyclovir Which of the above drugs are useful in the treatment of chronic Hepatitis B infection? (a) 1 and 2 only (b) 1 and 3 only (c) 2 and 3 only (d) 1, 2, 3 and 4 77. Cavitating pulmonary lesions can be seen in the following except (a) Sarcoidoses (b) Tuberculosis (c) Carcinoma of lung (d) Histoplasmosis 78. Which one of the following is not likely to be associated with pulmonary fibrosis? (a) Coal miners' lung (b) Primary sclerosing cholangitis (c) Primary biliary cirrhosis (d) Ankylosing spondylitis 79. The following agents may be used as prophylaxis in high altitude pulmonary edema except (a) ACE inhibitor (b) Acetazolamide (c) Nifedipine (d) Digoxin 80. With reference to right ventricular myocardial infarction, consider the following statements: 1. It may occur along with inferior wall myocardial infarction. 2. The ECG shows ST segment elevation in right precordial leads. 3. Prognosis in right ventricular infarction is better than the left ventricular myocardial infarction. 4. The treatment may include intra venous fluid challenge. Which of the statements given above are correct? (a) 1, 2 and 3 only (b) 2, 3 and 4 only (c) 1 and 4 only (d) 1, 2, 3 and 4 81. Regarding rheumatic heart disease, consider the following statements: 1. Rheumatic carditis is a pancarditis. 2. Carey-Coombs munnur is a delayed systolic munnur heard during the course of acute rheumatic fever. 3. Mitral regurgitation is the most common manifestation of acute rheumatic carditis. Which of the statements given above is/are correct? (a) 1 only (b) 1 and 2 (c) 2 and 3 (d) 1 and 3 82. Which one of the following does not cause pulsus paradox us ? (a) Severe aortic regurgitation (b) Cardiac tamponade (c) Constrictive pericarditis (d) Acute severe bronchial asthma 83. Match List I with List II and select the correct answer using the code given below the Lists: List-I List- II (Heart sound) (Disease) A. Loud S1 1. Valvular pulmonary stenosis B. Loud S2 2. Atrial septal defect C. Soft S2 3. Mitral stenosis D. Wide and fixed S2 4. Pulmonary arterial Hypertension Code: a. A B C D 3 4 1 2 b. A B C D 3 1 4 2 c. A B C D 2 4 1 3 d. A B C D 2 1 4 3 84. Ghon's complex is not characterised by (a) Hilar lymph nodes (b) Pleural effusion (c) Prominent draining lymphatics (d) Subpleural focus 85. Which one of the following is the drug of choice in the case of ventricular tachycardia in myocardial infarction? (a) Xylocard (b) Digitalis (c) Quinidine (d) Disopyramide 86. What is the most common opportunistic infection in AIDS? (a) Tuberculosis (b) Cryptococcosis (c) Pneumocystitis carinii (d) Histoplasmosis 87. In chronic Hepatitis B infection, which one of the following markers is indicative of active viral replication and the corresponding risk of disease transmission? (a) HBe antigen (b) HBs antigen (c) Anti-HBe (d) Anti-HBs 88. Match list-I with list-II and select the correct answer using the code given below the lists: List-I List-II (Type of hyperlipidemia) (Features) A. Hyperchylo- 1. Palmer plane xanthoma micronaemia) B. Hyperbetalipo- 2. Subcutaneous extensor Proteinaemia tendon xanthoma C. Typer III hyperlipo- 3. Eruptive xanthoma over Proteinaemia buttocks D. Familial LPL 4. Tryglyceride level above Deficiency mg% Code: a. A B C D 3 1 2 4 b. A B C D 3 2 1 4 c. A B C D 4 1 2 3 d. A B C D 4 2 1 3 89. Tetany may be a feature of the following' except (a) Hyperventilation (b) Hypokalaemic alkalosis (c) Hypoinagnesaemia (d) Hyponatraemia 90. With reference to non-ketotic; hyperglycemic, hyperosmolar coma, consider the following statements: 1. It is common in second and third decade of life: 2. It is typically seen in Type I diabetes mellitus. 3. Blood sugar is usually above 500 mg/dl. Which of the statements given above.' is/are correct? (a) 1 and 2 only (b) 3 only (c) 2 and 3 only (d) 1, 2 and 3 91. In a patient suspected to be suffering from vesicoureteric. reflux, which one of the following radiological investigations may confirm the diagnosis? (a) Intravenous urography (b) Micturating cystourethrography (c) Pelvic ultrasound (d) Antegrade pyelography 92. During the treatment of chronic myeloid leukemia, cytogenetic remission is least likely to occur with which one of the following modalities of treatment? (a) Hydroxyurea (b) Imatinib mesylate (c) Interferon-alpha (d) Bone marrow transplantation. 93. Pancytopenia may occur in the following except (a) Megaloblastic anaemia (b) Severe iron-deficiency anaemia (c) Hypoplastic anaemia (d) Paroxysmal nocturnal haemoglo binuria 94. A patient of rheumatic heart disease with mitral stenosis and atrial fibrillation is on oral warfarin. On one OPD visit, his INR is found to be 6. What is the action to be taken? (a) Stop warfarin, and review (b) Stop warfarin, and administer protamine sulphate (c) Stop warfarin, and administer fresh frozen plasma (d) Stop warfarin, and administer intramuscular vitamin K 95. Which antipsychotic drug may cause severe agranulocytosis? (a) Clozapine (b) Olanzapine (c) Pimozide (d) Risperidone 96. Which one of the following is not autosomal recessive? (a) Adult polycystic kidney disease (b) Cystic fibrosis of pancreas (c) Homocystinuria (d) Mucopolysaccharidosis 97. Match List I with List II and select the correct answer using the code given below the Lists: List-I List-II (Poison) (Antidote) A. Benzodiazepine 1. D-Penicillamine B. Copper sulphate 2. Flumazenil C. Opiates 3. N-acetyl cysteine D. Paracetamol 4. Naloxone Code: a. A B C D 2 4 1 3 b. A B C D 2 1 4 3 c. A B C D 3 4 1 2 d. A B C D 3 1 4 2 98 . Estimation of plasma cholinesterase levels may be helpful in the management of which one of the following poisonings ? A Datura B Barbiturate C Organophosphours D opium 99. Antinuclear antibodies are present in what presence of cases of SLE ? A 50 % B 70% C 80% D More than 90% 100. a 40 year old male patient is hospitalized with huge splenomegaly marked sternal tenderness and a total leucocyte count of 85000 per cubic millimeter and metamyelocytes which one of the following drugs is best indicated for his disease ? a. Cyclophospyamide b. Chlorambucil c. Melphalan d. Hydroxyurea 101. Which of the following is a potent stimulus for the production of erythro-poietin ? A. Alpha interferon B. Interkeukin-3 C. Hypoxia D Hypercarbia 102. Among the following one is not a good dietary source of iron ? A . Liver B. Jaggery C. Fish D. Milk 103. A man who had under gone total mastectomy remains well for five year then he develops anemia. What is ate most likely cause of this anemia? (a) protein deficiency (b) Zinc deficiency (c) Folic acid deficiency (d) Vitamin B 12 deficiency 104. Loeffler s syndrome is characterized by A . Transient migratory pulmonary infiltration B Fibrosis in the pulmonary apices C Fibrosis in the base of one or both lungs D Miliary mottling 105. The level of which on of the flowing hormones is likely to increase after hypothalamic ablation ? A. Growth hormone B. Prolactin C. FSH D. ACTH 106. The post exposure prophylaxis against rabies repress a course of five doses of human diploid cell derived rabies vaccine these shpts are given on A . Days 0,1, 4, 10, and 30 B Days 0, 3,7, 14 , and 30 C Days 0,7, 14, ,21 and 28 D Days 0, 4, 14, ,24 and 30 107. Haemolysis in G 6 PD ( glucose 6- posthaste dehydrogenises ) deficiencies may be induced by the following except A. Primaquin B . Phenacetin C Pronenecid D Penicillin 108. In India , what is the most common cause of unilateral lymph edema of lower limb ? A . Lymphedema B Carcinoma of penis with metastasis nodes C Filariasis D tubercular lymphadenopathy 109 Etipathpgenesis of diabetic foot include the following except . A Myelopathy B Osteoarthropathy C microangiopathy D Infection 110. Protein metabolism after truma is characterized by the following except A Increased liver gluconegenesis B inhibition of skeletal muscle break down by interleukin I and tumor necroses factor C Increased urinary nitrogen loss D Hepatic synthesis of acute phase reactants 111. Ccarcinoma of lip is characterized by the following except that A . 90% of The lip cancers occur on the lower lip B the most common site of origin is the vermilion border C 2 CM X 2 2 CM Cell carcinomas can be treated by V shaped excision and primary closure D Since lymph nodded mutates are common of ten a radical dissection of neck is mandatory . 112. A 40 year old man presented with a flat 1 cm x 1 cm scaly , otchy back mole on the front of thing examinations did not revel any inguinal lymphadenopathy the best course of managements would be A FNAC of the lesion B Incision biopsy C Excisional biopsy D wide excision with inguinal lumphadenctomy 113. Tumors of anterior mediastinum include the following except A . Thymoma B Lymphoma C Germ cell tumor D Schwanoma 114 Extensive surgical debridement decompression of amputation may be indicated in the following clinical setting except . A Progressive synergistic gangrene B Acute Thrombophlebitis C acute hemolytic streptococcal cellulite D Acute thabdonuplysis 115. Which one of the following bacteria is classified as facultative anaerobe ? A. Pseudomonas B. Bactericides C. Escherichia D. Clostridium 116. Regarding Ludwig ahgina consider the following statement : 1 It is characterized by cellulites usually if odobtogenic origin. 2 It involves the submandibular sublingual and submittal spaces. which of the statements given above is are correct ? A 1 only B 2 only C Both 1 and 2 D Neither 1 nor 2 117. Sutured surgical wound , the process of epothelialization is completed within . A 24 Hours B 48 hours C 72 hours D 96 hours 118. the reference to duodenal ulcers consider the following statement : 1 They occur most often in the second part of duodenum 2 infection with H pylori and NSAID induced injury account for maturity of duodenal ulcers 3. malignant duodenal users are extremely rare . 4. Eradication of H Pylori has greatly reduced the recurrence rates in duodenal ulcers . A 1, 2 and 3 only B 2,3 and 4 only C 1 and 4 only D 1,2,3 , and 4 119. A Patient present with hemoptysis copious sputum and tram lines ( abnormal air bronchogram ) pattern on the chest X –ray what is the most likely diagnosis ? A. Lung abscess B. Pulmonary embolism with infraction C. Bronchiectasis D. carcinoma of lung 120. peripheral eosinophile is not a characteristic feature of a Hypersensitive b Allergic aspergillus’ s c Tropical eosinophilia d Loeffler Syndrome Part - II Directions: The following five (5) items consist of two statements, one labelled as the 'Assertion (A)' and the other as 'Reason (R)'. You are to examine these statements carefully and select the correct answers to these items using the code given below: Code: (a) Both A and R are individually true and R is the correct explanation of A (b) Both A and R are individually true but R is not the correct explanation of A (c) A is true but R is false (d) A is false but R is true 1. Assertion (A) : When ABO and Rh incompatibilities coexist, the baby is likely to have more severe haemolytic disease. Reason (R) Both ABO and Rh antibodies cause haemolysis of foetal red blood cells. 2. Assertion (A) : In category III contact with a cat or dog, both antirabies immunoglobulin and vaccine are given immediately. Reason (R) : It takes at least 30 days to achieve a maximum level of immunity after vaccination. 3. Assertion (A) : As long as baby is less than six months old, a woman can rely on exclusive breast-feeding alone for contraception unless she menstruates. Reason (R) : Exclusive breast-feeding alone is the only safe method of contraception during six months after delivery. 4. Assertion (A) : One of the pathological conditions of acquired coagulopathy is abruptio placentae. Reason (R) : In abruptio placentae, thromboplastin is liberated from the retroplacental clot and damaged decidua. 5. Assertion (A) : Hypocalcemia is more common among babies fed with cow's milk. Reason (R) : Cow's milk contains less concentration of calcium than that of human milk. 6. Guidelines for handling of / Biomedical Waste (Management and Handling) Rule, 1998 are laid down by a. Ministry of Social-Welfare b. Directorate of Medical Education and Research c. Ministry of Health and Family Welfare d. Ministry of Environment and Forests 7. Which one of the following is not a target disease under 'Vision 2020 : The Right to Sight'? a.) Refractive error b) Trachoma c) Corneal blindness (d) Diabetic retinopathy 8. What is Berkesonian bias? (a) Mis-classification bias b) Recall bias c) Selection bias (d) Non-response bias 9. The WHO definition for blindness is the inability of counting fingers in daylight at a minimum distance of (a) 3 feet (b) 6 feet (c) 3 metres (d) 6 metres 10. Which one of the following is the category 1 of biomedical waste in India? (a) Human anatomical waste (b) Microbiological and biotechnological waste (c) Discarded medicines and cytotoxic drugs (d) Animal waste 11. What is the average number of fleas of each species per rodent called? (a) General Flea Index b) Specific Flea Index c) Incidence of Flea Species (d) Flea Infestation Rate 12. Which one of the following is not a viral haemorrhagic fever? (a) Yellow fever b) Rocky Mountain spotted fever c) Kyasanur Forest disease (d) Dengue fever 13. What is the method of sampling in which the units are picked up at regular intervals from the universe? a) Simple random sampling b) Systematic random sampling c) Stratified random sampling (d) Snow- ball sampling 14. Match List-I with List-II and select the correct answer using the code given below the Lists List-I List-II (State) (Retinol as vitamin) A. Pregnancy 1. 600 mcg B, Lactation 2, 950 mcg C, Infant 3. 350 mcg D, Children (1-6 4. 400 mcg years age) Code: (a) A B C D 1 3 2 4 b) A B C D 4 2 3 1 (c) A B C D 4 3 2 1 d) A B C D 1 2 3 4 15. Which one of the following will be affected by inter-observer variation a) Sensitivity b) Predictive value of the positive test c) Specificity (d) Reliability 16. Intrauterine foetal growth retardation may be associated with the following except (a) maternal drug addiction b) maternal smoking (c) foetal viral infection (d) regular maternal aspirin intake 17. Face to pubes delivery is possible with which cephalic presentation? (a) Mento-anterior (b) Mento-posterior (c) Occipito sacral (d) Brow presentation 18. With reference to meningococcal meningitis, which one of the following statements is not correct? (a) Fatality in untreated cases is 60 percent (b) Disease spreads mainly by droplet infection (c). Treatment of cases has no significant effect on epidemiological pattern of disease (d) Mass chemoprophylaxis causes immediate drop in the incidence rate of cases 19. With reference to the epidemiology of Severe Acute Respiratory Syndrome (SARS), which one of the following statements is not correct? (a) Patient is most infectious during the first five days of illness (b) No evidence of mother to child transmission is observed (d) Children are rarely affected (d). No evidence of child to child 20. Consider the following diseases: 1. Trench fever 2. Q fever 3. Weil's disease 4. Brill-Zinsser disease Which of the above is / are caused by rickettsial infection? (a) 1 only (b) 2 and 3 only (c) 1, 2 and 4 only (d) 1, 2, 3 and 4 21. Which one of the following is not a strategy under Roll Back Malaria? (a) Strengthening of health system (b) Use of insecticide treated bed nets' (c) Anti-larval measures (d) Development of new antimalaria drugs 22. An epidemiological hypothesis should specify the following except a) population b) time response relationship c) Geographical trends d) Expected outcome 23. Under DOTS chemotherapy, which one of the following is not a correct dose for an adult patient weighing up to 60 kg? (a) Rifampicin 600 mg (b) Isoniazid 600 mg (c) Pyrazinamide 1500 mg (d) Ethambutol 1200 mg 24. What is the approximate penetrating ability of alpha particle radiation at tissue level? a) 0. 05 mm b) 0. 10 mm c) 1. 50 mm d) 2. 00 mm 25. The criteria for 'at risk' infant include the following except (a) Artificial feeding (b) Grade 11 malnutrition (c) Working mother (d) Birth order 4 and more 26. How is the Protein Energy Ratio (PER) in diet expressed as? (a) Energy in diet x 100 Protein in diet (b) Energy from protein x 100 Total energy from diet (c) Total protein in diet x 100 Total energy in diet (d) Total energy consumed x 100 Total protein consumed 27. In which one of the following conditions is sling operation done? (a) Multiparous prolapse (b) Nulliparous prolapse (c) Cystocoele. (d) Rectocele 28. Match List-l with List-II and select the correct answer using the code given below the Lists List-I List - II (Drug for induction (Daily dose) of ovulation) A. Clomiphene 1. 2.5 mg BDS B. Metformin 2. 50 mg OD C. Bromocriptine 3. 75 IU OD D. Gonadotrphin 4. 500 mg TDS a) A B C D 3 1 4 2 b) A B C D 3 4 1 2 c) A B C D 2 1 4 3 d) A B C D 2 4 1 3 29. The following conditions are associated with molar pregnancy except (a) Pregnancy induced hyper tension b) Thyrotoxicosis (c) Gestational diabetes (d) Hyperemesis gravidarum 30. The current imaging technique of choice for the diagnosis of hydatidiform mole is (a) computed tomography (b) ultrasonography (c) plain X-ray abdomen (d) magnetic resonance imaging 31. Poor prognostic factors in the management of cancer cervix are the following except (a) young age (b) well-differentiated squamous cell carcinoma (c) hydroureter (d) adenocarcinoma 32. Which one of the following drugs is not used in endometriosis? (a) Danazol (b) Progestins (c) GnRH agonists (d) Misoprostol 33. What is the most common ovarian tumour to undergo torsion? a) Mucinous cystadenoma b) Serous ,cystadenoma c) Dermoid d) Brenner tumour 34. Which one of the following is not a correct statement regarding the use of condom? (a) Air should be squeezed out of the tip (b) It should be tested by inflating (c) It should be unrolled on erect penis (d) K-Y Jelly may be used for lubrication 35. The levonorgestrel IUD prevents the pregnancy primarily by (a) suppressing ovulation (b) making endometrium unreceptive (c) making cervical mucus thick (d) 'making inflammatory changes within endometrium 36. The 'highest incidence of ectopic pregnancy amongst contraceptive users is observed with (a) Combined contraceptive pills (b) Cu-T intrauterine contraceptive device c) Progestasert intrauterine device (d) Lippes loop intrauterine device 37. Which one of the following is the most suitable situation for prescribing the progestin only pill? (a) Perimenopausal patients (b) Emergency contraception c) Lactational mother (d) Diabetic mother 38. The drug of choice for the treatment of chlamydial infection is (a) ampicillin (b) third generation cephalosporins c) metronidazole (d) doxycycline 39. Return to fertility is delayed after cessation of oral contraception by (a) 2 weeks (b) 3 weeks c) 4 weeks d) 6 weeks 40. Match List-I with List-II and select the correct answer using the code given below the Lists: List – I Type-II (type of vaccine) (Example) A. Purified protein antigen 1. Acellular pertussis vaccine B. Subunit 2. Hib vaccine C. Conjugated capsular 3. Hepatitis A vaccine Polysaccharide D. Inactivated whole cell 4. Influenza vaccine Code: a) A B C D 1 4 2 3 b) A B C D 1 2 4 3 c) A B C D 3 4 2 1 d) A B C D 3 2 4 1 41. Yearly data pertaining to deliveries and their outcome in a community is as follows: Total number of births : 12600 Total number of stillbirths : 114 Total number of deaths – (i) During first week after birth : 410 (ii) During second to fourth weeks after birth : 280 Which one of the following formulae is used to calculate perinatal mortality rate? (a) 114+410 x 1000 12600 (b) 114 + 410 + 280 x 1000 12600 (c) 114+410 x 1000 12600 -114 (d) 114 + 410 + 280 x 1000 12600 -114 42. Which of the following are the first incisors to erupt in an infant? a) Lower central (b) Lower lateral c) Upper central (d) Upper lateral 43. A 50-hour old full-term breast-fed newborn boy weighing 3100 g 'presents with clinically evident jaundice. Physical examination is otherwise normal, The total bilirubin is 11. 0 mg/ dl with a direct bilirubin of 0.4 mg/ dl. What would be the correct treatment? a) Continue breast feeds review after 48 hours b) Stop breast feeds and review after 24 hours c) Continue breast feeds and start blue-light phototherapy d) Arrange for a double-volume exchange transfusion 44. An infant can sit with leaning forward on his hands. He bounces actively when made to' stand. He laughs aloud and becomes concerned when the mother moves away. What is his most likely age? (a) 12 weeks b) 16 weeks (c) 22 weeks (d) 28 weeks 45. Birth weight of a baby doubles at the age of 5 to 6 months. At what age does his birth length double? (a) One year (b) Two years (c) Three years (d) Four years 46. Which one of the following is not a feature of combined immunodeficiency in children? (a) Decreased total immunoglobulin level (b) Neutropenia and eosinophilia (c) Defective T-cell function (d) Recurrent pulmonary infection 47. Which one of the following is not a pyridoxine dependent disorder? (a) Homocystinuria (b) Methyl-malonic-acidemia (c) Cystathioninuria (d) Xanthurenic aciduria 48. A four-year old child presents with mild fever, malaise, purpura, arthritis, abdominal pain and microscopic hematuria. What would be the most likely diagnosis? (a) Thrombasthenia (b) Idiopathic thrombocytopenic purpura (c) Systemic lupus erythematosus (d) Henoch-Schonlein purpura 49. Match List-I with List-II and select the correct answer using the code given below the Lists: List –I List-II (Drug taken by a (Adverse effect on foetus) pregnant woman) A. Sodium valproate 1. Supravalvular aortic stenosis B. Vitamin D 2. Cleft lip and palate C. Prednisolone 3. Deafness D. Chloroquine 4. Spina bifida Code: a) A B C D 3 1 2 4 b) A B C D 3 2 1 4 c) A B C D 4 1 2 3 d) A B C D 4 2 1 3 50. Straining and dribbling of urine in a male infant with recurrent urinary infection should lead to the suspicion of a) vesico-ureteric reflux b) posterior urethral valve c) pelvic ureteric junction obstruction d) phimosis 51. Which one of the following is an autosomal dominant type of genetic disorder? a) Colour-blindness b) Haemophilia c) Phenylketonuria d) Tuberous sclerosis 52. With reference to bronchiolitis, consider the following statements: 1. It is more common among boy. 2. RSV immunoglobulin does not have any role in acute episode. 3. It is common around the age of six months. 4. Mortality is high in it. Which of the statements above are given correct? a) 1 and 2 only b) 3 and 4 only c) 1, 2 and 3 only d) 1, 2, 3 and 4 53. A two-year old boy presented "with episodes of becoming dusky. On examination, there was central cyanosis and clubbing. There was no pallor, oedema or respiratory distress. The heart was normal sized with a parasternal heave. A systolic thrill was palpable over the left middle sternal border. First heart sound was normal and only the aortic component was audible in the second heart sound. Liver was not enlarged. What would be the most likely diagnosis? a) Congenital methemoglobinemia b) Eisenmenger syndrome c) Aortic stenosis d) Tetralogy of Fallot 54. What would be the minimum calorie requirement of a normal sedentary lactating mother of a eight month old baby? a. 1900 kcal b. 2100 kcal c. 2300 kcal d. 2600 kcal 55. A woman with Body Mass Index of 20 is a) undernourished b) normal c) overweigh d) obese 56. Which one of the following is not a test for pasteurized milk? (a) Methylene blue reduction test (b) Standard plate count (c) Coliform count (d) Phosphatase test 57. What is the percent of total energy ratio supplied by fish protein (PE% kcal)? a) 20 b) 40 c) 60 d) 80 58. With a birthrate of 30 per thousand, in a subcentre of 5000 population, what would be the number of pregnant women. a) 150 b) 155 c) 160 d) 165 59. Among the following, which one is the absolute contraindication .for combined oral contraceptive pills? (a) Diabetes mellitus b) Migraine c) Previous history of thromboembolism (d) Heart disease 60. Which one of the following is an ideal example of recurrent disinfection? (a) Boiling infected clothing for 30 minutes (b) Pasteurization of milk c) Autoc1aving of infected gloves and syringes (d) Disinfection of urine and sputum of patients with 5% cresol 61. systematic observation and recording of activities of one or more individuals at random interval is done in a) Systems analysis b) Network analysis (c) Work sampling d) Input-output analysis 62. Latent infection occurs in the following except: a) Mumps b) Herpes simplex c) Brill-Zinsser disease d) Ancylostomiasis 63. Which one of the following intervention studies on coronary artery disease did not observe significant changes in mortality or risk factor since the control group was not properly chosen? a. Stanford- three community study b. The north kerelia project c. Multiple risk factor intervention trial d. Lipid research clinic study 64. Consider the following statements : The features of cholera that differentiate it from food poisoning are 1. onset with purging 2. no nausea or retching 3. no tenesmus 4. leukocytosis Which of the statements given above are correct? a) 1, 2 and 3 only b) 2, 3 nd 4, only c) 1 and 4 only d) 1, 2, 3 and 4 65. What is the proportion of daily rate wages payable as periodic cash payment under Sickness Benefit of ESI Act? a) 5 of the average monthly wages 12 b) 7 of the basic monthly wages 12 c) 8 of the average daily wages 12 d) 10 of the average daily wages 12 66. A 32-year old woman with two live children was brought in emergency with the history of missed period for 15 days, spotting since 7 days and pain abdomen since 6 hours. Her pulse was 120 I min, pallor ++, systolic BP 80 mm of Hg. There was fulness and tenderness on per abdomen examination. Copper- T thread was seen through external os on per speculum examination. On p/v examination, cervical movements were tender, uterus was anteverted, bulky and soft. There was fulness in pouch of Douglas. She is most likely suffering from (a) pelvic inflammatory disease (b) missed abortion with infection (c) ruptured ectopic pregnancy (d) threatened abortion 67. Immediately after third stage, of labour in a case of full-term delivery, the fundus of the pterus is (a) at the level of Xiphisternum (b) at the level of umbilicus (c) just below the level of umbilicus (d) just above the symphysis pubis 68. Oxytocin sensitivity test is used to assess the (a) foetal well-being (b) period of gestation (c) cervical ripening (d) uterine response for induction 69. The Kleihauer test for detecting foetal erythrocytes is based on the fact that (a) adult erythrocytes are larger than those of foetus (b) HbA has higher oxygen affinity than HbF c) HbF is more resistant acid elution than HbA (d) HbA takes up erythrosin stain less than HbF 70. What is the most common type of conjoined twin? (a) Craniopagus (b) Thoracopagus (c) Ischiopagus (d) Pygopagus 71. \What is the treatment of choice of unruptured tubal pregnancy with serum beta hCG titre of 2000 IV/ml ? (a) Single dose of methotrexate (b) Variable doses of methotrexate (c) Expectant management (d) Laparoscopic salpingostomy 72. Which one of the following causes the greatest risk of ectopic pregnancy? (a) Pelvic inflammatory disease (b) Intrauterine contraceptive devices' use (c) Previous ectopic pregnancy (d) Previous medical termination of pregnancy 73. Consider the following statements: A woman suffering from gestational diabetes is likely to develop 1. PIH 2. Macrosomia (foetal) 3. IUD Which of the statements given above is / are correct? a) 1 and 2 only b) 2 only c) 1 and 3 only d) 1, 2 and 3 74. Which one of the following is not a sign of early pregnancy? (a) Goodell's sign (b) Hegar's sign (c) Cullen's sign (d) Palmer sign 75. Consider the following: 1. A reactive non-stress test 2. Absence of decelerations 3. A sinusoidal pattern Which of the above findings in an antepartum cardiotocography indicate foetal well-being? a) 1 and 2 only b) 2 and 3 only c) 1 and 3 only d) 1, 2 and 3 76. A 20-year old primigravida is admitted with full-term pregnancy and labour pains. At 4 : 00 AM she goes into active phase of labour with 4 cm cervical dilatation. Membranes rupture during p/v examination showing clear liquor. A repeat p/v examination after 4 hours of good uterine conditions reveals a cervical dilatation of 5 cm. What should be the next step in management? (a) Reassess after 4 hours (b) Immediate cesarean section (c) Oxytocin drip (d) Reassess for occipitoposterior position and cephalopelvic disproportion 77. Match List-I with List-II and select the correct answer using the code given below the Lists: List –I List-II (Condition of delivery) (Procedure of delivery) A. Hand prolapse 1. Lovset technique B. Placental 2. Decapitation C. Extended arms of 3. Brandt-Andrews procedure breech at delivery D. Deep transverse arrest 4. Vacuum extraction Code: a) A B C D 2 3 1 4 b) A B C D 2 1 3 4 c) A B C D 4 3 1 2 d) A B C D 4 1 3 2 78. A primigravida with full-term pregnancy in labour for one day is brought to casualty after dai handling. On examination, she is dehydrated, slightly pale; pulse is 100 minute, BP 120/80 mm Hg. Abdominal examination reveals a fundal height of 36 weeks, cephalic presentation, foetal heart absent, mild uterine contractions present. On p/v examination, cervix is fully dilated, head is at plus one station, caput with moulding present, pelvis is adequate. Dirty, infected discharge present. What would be the best management option after initial work-up? a) Cesarean section b) Oxytocin drip c) Ventouse delivery d) Craniotomy and delivery 79. Which one of the following is not an epithelial tumour of the ovary? a) Serous cystadenoma b) Brenner tumour c) Clear cell tumour d) Endodermal sinus tumour 80. An elderly multiparous woman with intrauterine foetal death was admitted with strong labour pains. The patient suddenly goes in shock with cyanosis respiratory disturbances and pulmonary oedema, The most likely clinical diagnosis is (a) Rupture of uterus (b) Congestive heart failure (c) Amniotic fluid embolism (d) Concealed accidental haemorrhage 81. G2 P1 A0 presents with full-term pregnancy with transverse lie in the first stage of labour. On examination, cervix is 5 cm dilated, membranes are intact and foetal heart sounds are regular. What would be the appropriate management in this case? a) Wait for spontaneous evolution and expulsion b) External cephalic version c) Internal podalic version d) Cesarean section 82. A patient has just delivered a live baby and is referred to in a state of shock. On abdominal examination, uterus is not felt. On pelvic examination, a mass is seen protruding through the vagina. What is the most likely diagnosis? a) Cervical fibroid polyp b) Third degree uterine prolapse c) Acute inversion of uterus d) Rupture of uterus 83. Following delivery, uterus becomes a pelvic organ after a) 2 weeks b) 4 weeks c) 6 weeks d) 8 weeks 84. Match list –I with list-II and select the correct answer using the code given below the lists: List-I List-II (Foetal tests) (Indications) A. Non-stress test 1. Neural tube defect B. Lecithin/ 2. Foetal well being sphingomyelin ratio C. Estimation of alpha- 3. Downs syndrome fetoprotein in liquor amni D. Triple test 4. Lung maturity Code: a) A B C D 2 1 4 3 b) A B C D 2 4 1 3 c) A B C D 3 1 4 2 d) A B C D 3 4 1 2 85. McDonald stitch is applied in the following condition except: a. Incompetent os b. Septate uterus c. Placenta previa d. Bad obstetrical history 86. On Doppler, the most ominous sign indication foetal compromise is: a. Increased pulsatility index in umbilical artery b. Increased systolic-diastolic blood flow ratio c. Increased cerebral artery flow d. Absent diastolic flow 87. Which one of the following medical disorders leads to delayed foetal lung maturity? a. Heart disease b. Diabetes c. Thalassemia minor d. Epilepsy 88. What is the incidence of chromosomal abnormality per 1000 live births? a. 1.6 b. 3.6 c. 5.6 d. 7.6 89. Which one of the following is the method in the context of health education in which four to eight qualified persons discuss a given problem in front of a large audience? a. Group discussion b. Panel discussion c. Symposium d. Brainstorming 90. As per WHO classification, what is the IQ score for moderate mental retardation? a. 20 – 34 b. 35 – 49 c. 50 – 60 d. 60 – 65 91. Absorption of vitamin A can be enhanced by giving the child a diet rich in: a. fat b. protein c. minerals d. carbohydrates 92. If a new sputum smear positive patient of tuberculosis continues to be smear positive at the end of intensive phase of category I treatment under DOTS, further management of this patient would be to . (a) start category treatment again (b) treat him as failure and start category II treatment under DOTS (c) continue the intensive phase of V treatment for one more month (d) start continuation phase under category I 93. What is the index for measuring operational efficiency of the Malaria Control Programme? (a) Annual Parasite Index (b) Annual blood examination rate (c) Slide Positive Rate (d) Infant Parasite Rate 94. Exposure to 90 db and 4000 Hz noise results in (a) auditory fatigue (b) temporary hearing loss (c) permanent hearing loss (d) rupture of tympanic membrane 95. Under National Cancer Control Programme, oncology wings were sanctioned to a) Regional Cancer Institutes b) District Hospitals c) Medical College Hospitals (d) Voluntary Agencies treating cancer patients 96. Which one of the following statements is not correct regarding National Leprosy Eradication Programme (NLEP)? (a) Multibacillary leprosy treatment is recommended for one year (b) Skin smear examination is done for classification into paucibacillary and multi bacillary c) Special Action Project for Elimination of Leprosy is for rural areas (d) Surveillance for two years for a treated case of paucibacillary leprosy to be carried out 97. Under Reproductive and Child Health (RCH) programme, which one of the following interventions is done only in selected districts? (a) Medical termination pregnancy at PHC level (b) High quality of training at all levels (c) Screening and treatment of RTI at district level (d) Transport facility for referral of pregnant women during emergency 98. Which one of the following is not a special incidence rate? (a) Attack rate (b) Secondary attack rate (c) Hospital admission rate (d) Standardized mortality rate 99. For the prevention of parent to child transmission of HIV, the NACO's recommendation is to give (a) nevirapine 200 mg in active labour to mother (b) nevirapine 200 mg, four hours after rupture of membranes, to mother (c) nevirapine 200 mg in active labour to mother and nevirapine 2 mg/kg weight to newborn 72 hours of delivery (d) syrup nevirapine 2 mg/kg body weight to newborn within 72 hours of birth 100. During Pomeroy's method of female sterilization, which portion of tube is ligated? (a) Isthmus (b) Ampullary (c) Isthmo-ampullary (d) Cornual 101. With reference to vasectomy, consider the following statements: 1. Non-scalpel vasectomy and conventional vasectomy have complication rates of 0.4% and 3% respectively. 2. When sperms are absent from two consecutive samples of semen, the vasectomy is considered complete for contraception. Which of the statements given above is / are correct? (a) 1 only (b) 2 only (c) Both I and 2 (d) Neither 1 nor 2 102. A 20-year old girl was raped around 13th day of her regular cycle. The best possible emergency contraception to be offered would be (a) centchroman tablets (b) Cu - T insertion (c). levonorgestrel tablets (d) ethinylestradiol tablets 103 . consider the following character istics of vaginal discharge . 1. Green and thick 2. PH < 4.5 . 3. Clue cells 4. Whiff test positive Which of the above characteristics are present in bacterial vagueness ? a. 1 and 3 only b. 2 and 3 only c. 1 and 4 only d. 3 and 4 only 104 Laparoscopic approaches are usually performed . A Immediately post – partum B > 4 week post – partum C > 6 week post – partum D any time 105 Ultrasound of 36 year old gravida reveals small grape like cystic structures without the evidence of complete hydatidiform mole id made further analysis is most likely to reveal that the a. genotype of the mole is 46XX and os completely paternal in origin . b. genotype of the mole is triploid c. hCG levels are , markedly decreased d. serum levels of alpha-fetoproteinsare elevated 106 . with reference to vagina , which one of the following statement is not correct? A . it has mucus secreting glands B it is supplied by uterine artery C it is lined by stratified squalors epithelium . D its posterior wall is covered by peritinium 107 with reference to syndromes approach in reproductive tract infection consider the following statements : 1. single drug can be used foe treatment 2. the diagnosis of exact disease is not relevant 3. the management is disease specific . 4. the is an important part of family health awareness campaign which of the statements given above are correct? A 1 and 2 only B 1 and 3 only C 2 and 4 only D 1 2 3 and 4 108. The risk of mongolism in a mother at the age of 20 year is 1: 3000. what would be this ratio when she is 45 year old A . 1: 6000 B . 1:3000 C . 1: 1040 D . 1: 50 109. Which one of the following is not a measure of dispersion ? A . Mean B . Range C. Mean deviation D . Standard deviation 110. Match list –1` with list II and select the correct answer using the code given below the lists List I List II ( IUD ) ( expulsion rate per 100 women year ) A CuT – T 200 1. 3.1 B. Progestasert 2.2.1 C. Nova –T 3.7.8 D. Multiload –375 4.5.8 Codes A A B C D 2 1 4 3 B A B C D 2 4 1 3 C A B C D 3 4 1 2 D A B C D 3 1 4 2 111. Which of the following vitamin deficiencies causes corneal vascularization, poor growth and photophobia? a. Riboflavin b. Pyridoxine c. Niacin d. Thiamine 112. Match List-I with list-II and select the correct answer using the code given below the list: List-I List-II (Congenital malformation ( Congenital heart defect) syndrome) A. Foetal alcohol syndrome 1. Bicuspid aortic valve B. Turner’s syndrome 2. Endocardial cushion defect C. Down’s syndrome 3. Pulmonary stenosis D. Congenital rubella syndrome 4. Ventricular septal defect Code: a) A B C D 3 2 1 4 b) A B C D 3 1 2 4 c) A B C D 4 2 1 3 d) A B C D 4 1 2 3 113. Which one of the following is a distinguishing feature of Edwards syndrome? a. Hypotonia b. Hypotelorism c. Holoprosencephaly d. Rocker bottom feet 114. With reference to classical phenylketonuria, consider the following statements: 1. Metal retardation is usually mild. 2. vomiting is usually severe 3. hypotonia and reduced tendon reflexes are present 4. convulsions may occur in 25% of cases. Which of the above are the features of classical phenylketonuria? a. 1, 2, and 3 only b. 1 and 3 only c. 2 and 4 only d. 1, 2, 3 and 4 115, Match list-I with list-II and select the correct answer using the code given below the lists: List-I Liost-II (Laboratory ( Disease conditions) investigation) A. Alkaline urine pH 1. Lactose intolerance B. Elevated sweat chloride 2. Renal tubular acidosis C. Reducing substance 3. Cystic fibrosis in urine D. Reducing substance 4. Galactosemia in stool Code a) A B C D 2 4 3 1 b) A B C D 2 3 4 1 c) A B C D 1 4 3 2 d) A B C D 1 3 4 2 116. Which one of the following is not a feature of proximal renal tubular acidosis? a. Growth failure b. Hypertonia c. Acidic urine d. Polyuria 117. Consider the following diseases: 1. Addison’s disease 2. hypervitaminosis A 3. Obesity 4. Hyperparathyroidism Which of the above are associated with pseudotumour cerebri? a. 1, 2 and 3 only b. 1 and 3 only c. 2 and 4 only d. 1, 2, 3 and 4 118. Which one of the following activities cannot be performed by a 7-month old infant? a. pivot b. cruise c. transfer objects d. enjoy mirror 119. The combined oral contraceptive pills decrease the risk of the following except: a. Endometrial cancer b. Ovarian cancer c. Breast cancer d. Ectopic pregnancy 120. What is the gestational age at which the maternal hCG levels are maximum in a normal pregnancy? a. 8 to 10 weeks b. 12 to 14 weeks c. 16 to 18 weeks d. after 20 weeks ANSWERS Part-I 1. (c) Kawasaki disease 2. (d) Chlorpropamide 3. (c) Megaloblastic anaemia 4. (d) Trypsin 5. (c) Both 1 and 2 6. (d) Mydriasis 7. (d) Hyperchloremic metabolic acidosis 8. (d) Cobalamin malabsorption 9. (c) Alveolo-capillary junction 10. (b) Mitral regurgitation 11. (d) Staphylococcus aureus 12. (c) Both 1 and 2 13. (d) Chloroquine 14. (c). A B C D 4 3 2 1 15. (a) Ondansetron 16. (c) Its routine prophylaxis in newborn children is recommended to prevent early haemorrhagic disease 17. (b) Serum ferritin level 18. (b) Lactose intolerance 19. (d) 2 and 3 only 20. (b) 1, 2 and 4 21. (c) Psoriasis 22. (b) 1, 2 and 3 only 23. (c) Catalepsy 24. (d) Duplex ultrasonography 25. (a) Change in the level of consciousness 26. (d) An increase in platelet count on corticosteroid therapy 27. (c) Splenorenal ligament 28. (d) Hepatic veins and portal vein 29. (a) Disruption of pancreatic anasto mosis 30. (c) Long thoracic nerve 31. (c) 1 and 3 32. (d) Middle colic artery thrombosis 33. (a) It is initially treated by colostomy 34. (b) Axillary nerve 35. (c) Rupture of membranous urethra 36. (a) Abdominal compartment syndrome. 37. (a) 1 and 3 only 38. (d) Anterior talofibular ligament 39. (b) Anterior cruciate ligament injury 40. (a) Fluid 'resuscitation 41. (d) Oliguria due to ureteric obstruction 42. (a) Elective open cholecystectomy for cholelithiasis 43. (b) Thigh 44. (c) Typhoid enteric perforation and peritonitis 45. (a) A B C D 4 1 2 3 46. Answer: C 47. Answer: C 48. Answer: B 49. (d) Intravenous calcium gluconate 50. (c) Urinary sodium < 20 m mol; Urine osmolality> 500 m osm/L 51. (d) Polycystic renal disease 52. (c) DMARDs should be given early and preferably in combinations 53. (d) 1, 2 and 3 . 54. (b) Pain worsens at night 55. (d) Babinski plantar response 56. (a) 3 hours 57. ? 58. (c) crushes the epiphyseal plate 59. (d) is a fracture where part of cortex is intact and part is crumpled 60. (a) Varicosity of cremestric veins 61. (b) Endotracheal intubation and mechanical ventilation 62. (b) Short bowel syndrome 63. (c) Retinoblastoma 64. (b) Spring catarrh 65. (a) Maxillary 66. (a) Urinary retention 67. (b) Antigen-antibody mechanism involving human leucocyte antigen 68. (a) Lower third molar 69. (c) Removal of embolus from blood vessels 70. (c) 2, 3 and 4 71. a. A B C D 4 3 1 2 72. (c) 2, 3 and 5 73. (c) Hypersensitivity to dietary gluten 74. (c) A B C D 2 1 4 3 75. (a) Pernicious anaemia 76. (a) 1 and 2 only 77. (a) Sarcoidoses 78. (b) Primary sclerosing cholangitis 79. (d) Digoxin 80. (d) 1, 2, 3 and 4 81. (d) 1 and 3 82. (a) Severe aortic regurgitation 83. a. A B C D 3 4 1 2 84. (b) Pleural effusion 85. (a) Xylocard 86. (a) Tuberculosis 87. (a) HBe antigen 88. d. A B C D 4 2 1 3 89. (d) Hyponatraemia 90. (b) 3 only 91. (b) Micturating cystourethrography |