aiims november 2002 answers explanations pg paper solutions pre pg entrance::aippg.com

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1) Which activity will be difficult to perform for a patient with an anterior cruciate deficient joint?

1. Mastoidectomy
2. Medical Management
3. Underlay myringoplasty
4. Insertion of ventilation tube

1. Caldwell Luc Operation
2. Intranasal Polypectomy
3. Corticosteroids
4. Wait and Watch

4) The cough response caused while cleaning the ear canal is mediated by stimulation of

1. The V Cranial Nerve
2. Innervation of external ear canal by C1 C2 .
3. The X Cranial Nerve
4. Branches of VII Cranial nerve

5) A 38 year old gentleman reports of decraesed hearing in right ear for the past 2 years. On testing with a 512 Hz tuning fork the Rinne's test (without masking)is negative on the right ear and positive on left ear. With the weber'a test being percieved as louder in the left ear. The patient most likely has

1. Right conductive hearing loss
2. Right sensorineural hearing loss
3. Left sensorineural hearing loss
4. Left conductive hearing loss

1. Allergy is an etiological factor
2. Occur in first decade of life
3. Are Bilateral
4. Are often associated with bronchial asthma

Ans 2 [ Ref CMDT Allergic polyps can be associated with ASTHMA, they occur in 2nd decade-Dhingra]

7) Foetal hydronephrosis is diagnosed in mother at 34 weeks of gestation. The amniotic fluid is nornal \. Which of the following is the most appropriate management.

1. Fetal intervention to decompress hydronephrotic kidney
2. Premature termination of pregnancy followed by pyeloplasty
3. Delivery at term followed by radiological examination
4. Delivery at term followed by pyeloplasty

8) A 2 year old boy has Vitamin D refractory Rickets. Investigations show serum calcium to 9 mg/ dl, phosphate 2.4 mg/ dl , alkaline phosphatase 1040 IU . Parathyroid hormone level and bicarbonate levels are normal. The most probable diagnosis is

1. Distal Renal Tubular Acidosis
2. Hypophosphatemic Rickets
3. Vitamin D dependent rickets
4. Proximal Renal Tubulat acidosis

9) Neurological complications of meningitis include all of the following except:

1. Seizures
2. Increases intracranial pressure
3. Cerebral hematoma
4. Subdural effusions

10) The gold standard for definative diagnosis of extrahepatic biliary atresia is

1. Per operative Cholangiography
2. hepatobiliary scintigraphy
3. Alkaline Phosphatase Level
4. Liver Biopsy

11) The lenght of feeding tume to be inserted for transpyloric feeding is measured from the tip of

1. Nose to umblicus
2. Ear lobe to umblicus
3. Nose to knee joint
4. Ear lobe to knee joint

1. Stratum germinavatum
2. Stratum granulosum
3. Stratum lucidum
4. Stratum corneum

13) In pediatric advanced life support intraosseous access for drug fluid administration is recommended for pediatric age of

Ans 3 [ Prashant , Banglore] [Nelson - "Intraosseous infusion is an easily achieved alternative to an IV line when vascular access is essential and a peripheral IV live cannot be rapidlt placed in children 6yrs or younger]

14) A 3 yr old boy is brought to casualty by his mother with progressive shortness of breath for 1 day. The child has a history of bronchial asthma. On examination, the child is blue gasping and unresponsive. What will you do first

1. Intubate
2. Administer 100% oxygen by mask
3. Ventilate with bag and mask
4. Administer nebulized salbutamol

15) A 5-yr old child presents with confusion, increased salivation, lacrymation, fasiculations, miosis, tachycardia and hypertension. Which of the following poisons can cause these manifestations.

17) All of the following statements regarding malignant potential of colorectal polyps are true except

1. Polyps of familial polopyosis coli could undergo malignamt change
2. Pseudepolyps of ulcerative colitis has high risk of malignancy
3. Villous adenoma is associated with high risk of malignancy
4. Juvennile polyps has little or no risk

18) A patient presents with respiratory symptoms ie: cough, hemoptysis and glomerulonephritis. His c-ANCA levels in serum d to have been raised. The mosty likely diagnosis is

1. Goodpastures Syndrome
2. Classic Polyarteritis Nodosa
3. Wegners Granulomatosis
4. Kawasaki syndrome

Ans (2) P-16 Is tumour supression gene involved in devlopment(robbins), PTEN is phosphatase tensin gene involved in Breast , prosrate, tomours, FMR - 1 is familial mental retardation gene involved IN FRAGILE X SYNDROME. Also ref LANGMAN EMBRYOLOGY 8th ED which implicates HOMEOBAX = HOX GENES IN syndactly / polydactly and other things.[Maniks, Chennai; ]

20) All of the following familial syndromes are associated with the devlopment of pheocromocytomas EXCEPT

1. Sturge Weber Syndrome
2. Von Recklinghausen Disease
3 MEN Type II b
4. Prader Villi Syndrome

1. Inhibition of enzymes involved in heme biosynthesis
2. Binding of lead to transferrin, inhibiting transport of iron
3. Binding of lead to cell membrane of erythroid precursors
4. Binding of lead to ferretin inhibiting their breakdown into hemosiderin

1. Dilatation of endoplasmic reticulum
2. Dissociation of ribosomes from rough endoplasmic reticulum
3. Flocculent densities in mitochondria
4. Mylein figures

1. Radiant energy is absorbed by water
2. Hydrogen peroxidase is formed by Myeloperoxidase
3. Ferrous ions are converted into ferric ions
4. Nitric oxide is converted into peroxynitrite anion

24) Familial amyloidotic polyneuropathy is due to amyloidosis of nerves caused by deposition of

1. Amyloid associated protein
2. Mutant calcitonin
3. Mutant transthyretin
4. Normal transthyretin

1. Sinusoids of red pulp
2. White pulp
3. Pencilliary artery
4. Splenic trabeculae

26) A 42 year old man was referred with a 2 week history of fever, weakness, bleeding gums. Peripheral smear showed pancytopenia. The bone marrow examination revealed 26 % blasts, frequently exhibiting Auers rods, and mature myeloid cells. An occasional neutrophil with pelger huet anamoly was also noted

1. Acid phosphatase
2. Nonspecific esterase
3. Myeloperoxidase
4. Toulidine Blue

Ans
This is typical Myleodysplasttic syndrome: RAEB -T
Features 20-29% blasts in bone marrow, 5-29% blasts in peripheral blood, Auer rods in myeloblasts or other cells of the neutrophil cell line, Auer rods present in 70% of cases, Ringed sideroblasts may be numerous, Hypercellular marrow in 80-90% of cases.

1. Rickets
2. Hyperparathyroidism
3. Atheromatous plaque
4. Vitamin A intoxication

1. Gauchers Disease
2. Niemann Pick Disease
3. Tay Sachs Disease
4. Downs syndrome

29) Aschoff Bodies in Rheumatic heart disease show all the following features except
1. Anitschkow cells
2. Epitheloid cells
3. Giant cells
4. Fibrinoid necrosis

1. Diffuse pulmonary interstitial fibrosis
2. Fibrous pleural thickening
3. Emphysema
4. Calcific pleural plaques

31) Which of the following statements is true regarding drugs used in parkinsonism

1. Amantidine causes ankle oedema
2. Levodopa is particularly effective in reducing tremor
3. Amantidine is more effective then levodapa
4. Antimuscarinics are effective in drug induced parkinsonism

Ans 1 [ Manicks, Stanley Med College] [ Choice 4 seems to be true but only "CENTRAL ANTIMUSCARINCS" are effective in drug induced parkinsonism. Amantidine also causes livedo reticularis, levodopa reduces hypokinesia and rigidity first and lastly tremor. Amantidine action is faster than levodopa but less effective]

32) Prostaglandlins (PGs) have effects on a variety of tissues. The different prostaglandlins may have different effects. Which of the following is not a correct statement.

1. The human arteriolar smooth muscle is relaxed by PGE 2 and PGI 2, where as TXA 2 and PGF 2 alpha cause vasoconstriction.
2. PGE 1 and PGI 2 inhibit platelet aggregation, where as TXA2 facilitate aggregation.
3. PGE 2 has marked oxytosic action while PGF 2 alpha has tocolytic action
4. PGE 2 is a bronchodilator where as PGF 2 alpha is a bronchoconstrictor

1. Multiply by binary fission
2. Are sensitive to Beta lactam group of antibiotics
3. can grow in cell free culture media
4. require sterols for growth

36) Rapid induction of anaesthesia occurs with which of the following inhalational anaesthetics

40) Whuich of the following gas is used to decrease pulmonary artery pressure in adults

43) Which of the following is the treatment of choice of for cryptococcal meningitis

44) The lymphocytopenia seen a few hours after administration of a large dose of prednisolone to a patient with lymphocytic leukemia is due to :

1. Massive lymphocyte apoptosis
2. Bone marrow depression
3. Activation of cytotoxic cells
4. Stimulation of Natural killer cell activity

1. It is hyperpolarized
2. It is refractory
3. It is not self propogating
4. The condition is always orthodromic

48) A 10 Deg Centigrade decrease in temperature causes decrease in cerebral metabolic rate by

Ans (4)
Ref Lee With each one degree fall in temperature cerebral metaboism is reduced by 6-7%. Also fall in temp leads to rise in serum potassium & acidosis

49) The laboratort report shows values of gonadotropin and ovarian values of the blood sample taken on day 20 of the menstrual cycle of a young woman . Whether her cycle was ovulatory or not may be validly assesed by the reported serum levels of

50) Which of the following is NOT a usual feature of right middle cerebral artery territory infarct

51. A 5 year old child id scheduled for strabismus(squint) correction.induction of anesthesia is uneventful . after conjuctival incision as the surgeon grasps the medial rectus ,the anesthesiologist looks at the cardiac monitor . why do think he did that ?

                1. he wanted to check the depth of anaesthesia.
                2. he wanted to be sure that the blood pressure did not fall
                3. he wanted to see if htere was an oculocardiac reflex.
                4. he wanted to make sure there were no ventricular dysrhythmias which normally accompany incision.

52. A 55 year old male accident victim in casualty urgently needs blood . the blood bank is unable to determine his ABO group , as his red cell group and plasma group , do not match . emergency transfusion of patient should be with

                1. RBC corresponding to his red cell group and colloids /crystalloid.
                2. whole blood corresponding to his plasma group .
                3. O positive RBC and colloids /crystalloid.
                4. AB negative whole blood .

53. Although more than 400 blood groups have been identified , hte ABO group system the ABO group system remains the most important in clinical medicine because

                1. it was the first blood group system to be discovered
                2. it has four different blood groups A, B ,AB ,O(h).
            3. ABO(h) antigens are present in most body tissues and fluids .
                4. ABO(h) antibodies are invariably present in plasma when persons RBC lacks the corresponding antigen.

54. The neurons may get irreversibly damaged if exposed to significant hypoxia for

55. A 41 year old woman presented with a history of aches and pains all over the body and cannot sleep because of the illness and has lost her appetite as well .she has lack of interest in work and doesn’t like to meet friends and relatives .she denies feelings of sadness . her most likely diagnosis is :

                1. somataform pain disorder .
                2. major depression .
                3. somatization disorder .
                4. dissociative disorder .

                1. panic disorder .
                2. schizophrenia .
                3. mania
                4. reactive psychosis

57. A 25 year ald man with a psychotic illness , was treated with haloperidol 30 mg/day. on the third day he developed pacing , and inability to sit still at one place. the medication likely to be helpful is:

                1. phenyoin
                2. propanolol
                3 .methyl phenidate
                4. trihexyphenedyl

58. A 65 yr . old male is brought to the outpatient clinic with one yr. illness characterized by marked forgetfulness , visual hallucinations , suspiciousness , persojnilty decline , poor self care and prgressive deterioration in his condition . his mini mental status examination (MMSE) score is 10 . his most likely diagnosis:

                1. dementia
                2. schizophrenia
                3. mania
                4. depression

59. A 16 yr . old girl was brought to the psychiatric emergency after she slashed her wrists to commit suicide . on the enquiry her father revealed that she had made several such attempts of wrist slashing in the past , mostly in response to trivial fights in her house. further she had marked fluctuations in her mood with a pervasive pattern of unstable interpersonal relationship. the most probable diagnosis is :

                1. border line personlity disorder
                2. major depression
                3. histronic personality disorder
                4. adjustment disorder

60. High resolution CT of the lung is a specialized CT techinque for greater detail of lung parenchyma and it utilizes:

                1. special lung filters
                2. thick collimation
                3 bone algorithm for image reconstruction
                4. large field of view

61. The folloiwng is not in the diffrential diagnosis of an anterior mediastinal mass:

                1. teratoma
                2. neurogenic tumour
                3. thymoma
                4. lymphoma

                1. acute ureteral obstruction .
                2. systemic hypertension .
                3. severe hydronephrosis.
                4. dehydration.

63. Which of the following imaging modality is most sensitive to detect early renal tuberculosis :

                1. IV urography
                2. ultrasound .
                3. computed tomography
                4. MRI

64. A young man with TB presents with massive recurrent hemoptysis . for angiographic treatment which vascular structure should be evaluated first :

                1. pulmonary artery .
                2. bronchial art.
                3. pulmonary v.
                4. sup. vena cava

65. Which of the following imaging modalities is most sensitive for evaluation of extra adrenal pheochromocytoma ?

                1. USG
                2. CT
                3. MRI
                4. MIGB scan

66. A 15 yr. old 10-12 partial complex seizures per day in adequate 4 drug anti epileptic regime . he had h/o repeated high grade fever in childhood . MRI for epilepsy protocol normal brain scan . what should be the best non invasive strategy to make a definite dx. so that he can be prepared to undergo epilepsy surgery?

                1. interictal scalp EEG
                2. video EEG
                3. interictal 18 F- FDG PET
                4. video EEG with ictal 99 m Tc- HMPAO brain SPECT

                1. G1
                2. S
                3. G2
                4. M

                1.elecron beam strikes the nucleus of the atom
                2. elecron beam strikes the anode
                3. elecron beam reacts with the electromagnetic field
                4. elecron beam strikes the cathode.

69. Eight yr. old boy presents with swelling in left eye of 3 months duration. examination revealed proptosis of left eye with preserved vision . right eye is normal . CT scan revealed intraorbital extra conal mass lesion .biopsy revealed embryonal rhabdomyosarcoma . metastatic work up was normal. the standard line of treatment is:

                1. chemotherapy only
                2. wide local incision .
                3. enucleation
                4. chemotherapy & radiotherapy

                1. cortical
                2. nuclear
                3. posterior subcapsular
                4. zonular

Ans (4) Even less area catract in post subcapsular region involves large area of vision as rays of light have converged as they pass through lens. Nuclear causes loss of vision in later later stages, cortical is usually cuneiform type which does not interfere in vision. [POST.SUBCAPSULAR CATARACT IS DISABLING B'CAUSE ITS IN THE OPTICAL AXIS NEAR THE POST. POLE.HENCE DAYLIGHT VISION IS DISABLED.] DR Prashant V N.

71. The standard sutureless catarct surgery done with phaco emulsification and foldable IOL has an incision of:

                1. 1mm - 1.5mm
                2. 2mm -2.5mm
                3. 3mm - 3.5mm
                4. 3.5mm - 4mm

Ans 3 [ 3.2 mm is correct answer also - The size of the phacoprobe within the silicone sleeve is 2.8mm and so the incision cannot be less than 2.8mm .Hence answer is 3-3.5 mm. Refer Peyman, Sanders , Goldberg: Principles and practice of Opthalmology Vol 1 Chapter 7 Pg-622 DR Ruchika Sahay.]

72. A one yr. old child having leucocoria was detected to be haivng a unilateral , large retinoblastoma filling half the globe . current therapy would involve :

                1. enucleation
                2. chemotherapy followed by local dyes
                3. direct lase ablation using photo dyanamic cryotherapy
                4. scleral radiotherapy followed dy chemotherapy

73. A 2 yr. old presented with leucucoria in the right eye since 2 months . on examination , a total retinal detachment was present in the same eye. ultrasound B scan revealed a heterogenous subretinal mass with calcification , associated with a retinal detachment . the most likely clinical diagnosis is :

                1. coats disease
                2. retinoblastoma
                3. toxocariasis
                4. retinal tuberculoma

74. A 60 yr. old man presented with watering from his left eye since one year . syringing revealed a patent drainage system. rest of the ocular eaxmination was normal . a provisional dx. of lacrimal pump failure was made. confirmation of this dx. would be :

                1. dacryoscintigraphy
                2. dacryocystography
                3. pressure syringing
                4. canaliculus irrigation test

75. While working in the neonatal ICU your team delivers a premature infant at 27 wks. of gestatoin and weighing 1500 gms. how soon will you request fundus examination by an opthalmologist

                1. immediately
                2. 3-4 weeks after delivery
                3. at 34 weeks gestational age
                4. at 40 weeks gestation period

Ans 3 [ In prematures less than 28 weeks and those weighing less than 1500 gm {or those weighing more than 1500 gm and unstable} we check fundus at 6 weeks. Normal neonatal examination is done at 4-6 weeks. Here since child is less than 28 weeks to diagnose retinopathy of prematurity we examine child at 6 weeks = 33 weeks of gestational age ~~ 34 weeks]

76. A friend of yours has a spectacle correction of -6.0 and -8.0. he telephones you one morning and tells that he has started seeing some opacities floating in front of his eyes and that his vision has decreased slightly over the last few days. as an intern in the ophthamology section , what would you do?

                1.reassure
                2. refraction and prescribe a new spectacle
                3. direct ophthamoscopy
                4. indirect ophthalmoscopy

77. A 30 year old male presents with a history of injury to the eye with a leaf 5 days ago and pain , photophobia and redness of the eye for 2 days. what would be the most likely pathology?

                1.anterior uveitis
                2. conjuctivitis
                3. fungal corneal ulcer
                4. corneal laceration

Ans 3 [ Key word is Injury with vegetable matter, Pain points towards ulcer, Fungal corneal ulcer does have some signs though less.In other words fungal corneal ulcer does not have a totally asymptomatic presentation.The answer could have been corneal laceration but then the presentation would have been acute not after 5 days]

78. The most likely diagnoss in a new born who has radio- opaque shadow with an air -fluid level in the chest along in the chest along with hemivertebra of the 6th thorasic vertebra on plain x-ray is

                1.congenital diaphragmatic hernia
                2. esophageal duplication cyst
                3. bronchogenic cyst
                4. staphylococcal pneumonia

79. Failure to pass meconium within 48 hrs of birth in a new born with no obvious external abnormality should lead to suspicion of

                1. anal arterisia
                2. congential pouch colon
                3. congential aganglionosis
                4. meconium ileus

                1. hypochloremic alkalosis
                2. hyperchloramic alkalosis
                3. hyperchloramic acidosis
                4. hypochloramic acidosis

81. In neonatal cholestasis , if serum gama- alutamyl - trnaspeptidase is more than 600 IU/L the most likely diagnosis is:

                1. neonatal hepatitis
                2. choledochal cyst
                3. hypothyrodism
                4. biliary atresia

Ans 4 [ In liver obstruction alkaline phosphate is increased îîî, concurrent increase in GGTP indicates that alkaline phosphate source is in liver; in other words Gamma-GTP helps in differentiating liver / bone source of ALP]

82. These ventral spinal rootlets are more prone to injury during decompressive operations because they are shorter and exit in more horizontal direction:

                1. C5
                2. C6
                3. C7
                4. T1

Ans (1). The ventral spinal rootlets are more horizontal and shorter at upper levels.

                1. sup. saggital sinus
                2. inf. saggital sinus
                3. straight sinus
                4. transverse sinus

Ans 1 Arachnoid villi are more numerous in superior saggital sinus; CSF is absorbed from villi.

84. The term post traumatic epilepsy refers to seizures occuring ::::
                1. within moments of head injury
                2. within 7 days of head injury
                3. several wks. to months after head injury
                4. many yrs. after head injury

                1. cisplastin based chemotherapy followed by radical radiotherapy
                2. abdominoperineal resection
                3. radical radiotherapy
                4. radical radiotherapy followed by mitomycin C based chemotherapy

86. All of the following are indications for surgery in gastric lymphomas except:

                1. bleeding
                2. perforation
                3. residual disease following chemotherapy
                4. intractable pain

87. A 22 yr old man presents with a solitary 2 cm space occupying lesion of mixed echogenicity in the right lobe of the liver on USG .the rest of the liver is normal . which of the following tests s/b done:

                1. ultrasound guided biopsy of the lesion
                2. hepatic scintigraphy
                3. hepatic angiography
                4. contrast enhanced CT scan of the liver

                1. isopropyl alcohol
                2. colloidal iodine
                3. glutaraldehyde
                4. hydrogen peroxide

89. Ramkumar a 70 yr. old hypertensives male was admitted in the intensive care unit with transmural anterolateral myocardial infarction . his condition was stable till 5th day of admission , when he developed a pericardial friction rub and pleuritic chest pain which persisted despite narcotic and steroid therapy . on the 7th morning he suddenly developed marked hypotension . on exam. there was distension of jug. veins , accompanied with electromechanical dissociaion . most likely , the patient had developed :

                1. severe acute mitral regurgitaion
                2. vent. septal rupture
                3. rt. vent . rupture
                4. ext. cardiac rupture

90. A young motorist suffered injuries in a major road traffic accident . he was diagnosed to have fracture of left humerus. he was also having fractures of multiple ribs anteriorly on both sides . on examination , the blood pressure was 80/60 mm hg , and heart rate was 140/minute. the patient was agitated , restless, and tachypnic. jugular viens were distended. air entry was adequate in both the lung fields. heart sounds were barely audible. Femoral pulses were weakly palpable but distilly no pulsation could be felt . on priority basis , the immediate intervention would be

                1. rapid blood transfusion
                2. urgent paricardial tap
                3.Intercostal Drainage on both sides
                4. Fixation of left femur and repair of femoral artery

Ans 2 [ Cardiac tamponade - if blood loss was heavy no distention of juglar veins- hypovolemia]

91. 35 year old farmer consulted a local medical pratitioner for recurrent attacks of chest pain . his elder brother had similar complaints and had died suddenly at the age of 40 yrs. the farmer was advised to take nitroglycerine sublingually at the time of pain . however, the patient finds that the intensity of pain is increased by nitroglycerine.mostprobably he is suffering from

                1. subacute bacterial endocarditis involving the aortic valve.
                2. hypertrophic obtructive cardiomyopathy
                3. degenerative mitral regurgitation
                4. chronic type a dissection of aorta

92. 30 year old man presents with pain on the right flank and hematuria. a cect abdomen reveals a large 8*8 cm sized solid mass in the right kidney and a 3*3 cm solid mass occupying the upper pole of the left kidney. the most appropriate surgical treatment for this patient is

                1. bilateral radial nephrectomy
                2. right radial nephrectomy and biopsy of the mass from opposite kidney
                3. right radial nephrectomy and left partial nephrectromy
                4. right radial nephrectomy only

93. 40 year old male patient is brought to the emergency room with a stab injury to the chest. on exam. pt. is found to be hemodynamically stable. the neck veins are engorged and the heart sounds are muffled .the foll. statements are true about this patient except:

                1. cardiac tamponade is likely to be present .
                2. immediate emrgency room thoracotomy s/b done
                3. echo should done to confirm pericardial blood .
                4.the entry wound should sealed with an occlusive dressing

               1. they constitute 90 - 95 % of all primary testicular tumours
               2. seminoma is the MC tumour developing in patients with cryptochid testes
               3. alpha - fetoprotien is markedly raised in all germ cell tumours .
               4. high inguinal orchidectomy is the initial surgical procedure

95. A 25 yr. old male presents to the emergency department following a road traffic accident .on examination there is pelvic fracture and blood at the urethral meatus .the foll. is true about this pt. except:

                1. the ant. urethera is most likely the site of injury
                2. retrograde urethrography s/b done after the patient is stabilized
                3. foley catheter m/b carefully passed if RGU is normal
                4. rectal exam. may reveal a large pelvic hematoma with the prostate displaced superiorly

                1. pts.present with complaints of painful erection.
                2. the condition affects adolescent males
                3 the condition associated with dupuytrens contracture of the tendons of the hand
                4. spontaneous regression occurs in 50% of the cases

                1. 25 % of the patients.
.               2. 50 % of the patients.
                3. 75 % of the patients.
                4. 100 % of the patients.

                1. strep. pyogenes
                2. strep. faecalis
                3. strep. viridans
                4. microaerophillic streptococci

                1. myohemoglobinuria.
                2. massive crushing of muscles
                3. acute tubular necrosis
                4. bleeding diasthesis

100. A 25 yr . old young woman has recurrent episodes of headache and sweating .her mother had renal calculi and died after having a neck mass . the P/E reveals thyroid nodule but not clinical sign of thyrotoxicosis . before performing thyroid surgery , the surgeon should order:

                1. measurment of thyroid hormones .
                2. serial determinations of serum calcium , phosphorus , protein and alkaline phosphatase
                3. 24- hrs. urine test for 5- hydroxy - indoleacetic acid excretion
                4. serial 24 - hr. test for catecholamines , metanepharines and vanillylmandelic acid excretion

101)During surgery for aortic arch aneurysm under deep hypothermic circulatory arrest which of the following anaesthetic agent administered prior to circulatory arrest that also provides cerebral protection.

102) A 6 year old boy is scheduled for examination of eye under anaesthesia. The Father informed that for the past 6 months the child is developing progressive weaknes of both legs. His elder sibling had dies at age 14 years. Which drug would you definately avoid during anaesthetic management.

1. It has high incidence of Cardiovascular side effects
2. It has short duration of neuromuscular block
3. In usual doses dose adjustment is not required in kidney disease
4. It has high lipophillic property

105) A 10 yr old child presented with headache, vomiting, gait instablity and diplopia. On examination he had papilloedema and gait ataxia. The most probable diagnosis is

1. Hydrocephalus
2. Brain stem Tumour
3. Supraseller tumour
4. Midline posterior fossa tumour

Ans 4 [In posterior fossa tumour-
i) Raised Intra cranial pressure causing -headache, vomiting,diplopia
ii)Ataxia
Hydrocephalus may be the answer but that is also caused by such a tumour] Dr Rohit Mathur

106) The most recent advance in non invasive cardiac output monitoring is use of

1. PA catheter
2. Thermodilution technique
3. Echocardiography
4. Electrical impedence cardiograph technology

107)While carrying a heavy suitcase. the downward dialocation of glenohumeral joint is resisted by the following muscles except:

108) A 19 yr old boy fell from the motor bike on his shoulder. The doctor diagnosed him as a case of Erb's paralysis. The following signs and symptoms will be observed except

1. Loss of abduction at shoulder joint
2. Loss of lateral rotation
3. Loss of pronation at radioulnar joint
4. Loss of flexion at elbow joint

109) A 4 1/2 year girl child always had to wear warm socks even in summer season. On physical examination, it was noticed that she had high blood pressure and her femoral pulse was weak as compared to radial and carotid pulse. A chest radiograph showed remarkable notching of ribs along their lower borders. This was due to :

1. Femoral artery thrombosis
2. Co archtation of aorta
3. Raynauds Disease
4. Takayasu's arteritis

110) A 40-year old man was repairing his wooden shed on sunday afternoon. By afternoon, he felt that the hammer was getting heavier and heavier. He felt pain in lateral side of elbow and also found that squeezing water out of sponge hurt his elbow. Which of the following muscles are most likely involved.

1. Biceps Brchii and supinator
2. Flexor digitorum superficialis
3. Extensor carpi radilis longus and brevis
4. Triceps brachii and anconeus

111) A 16 year old girl failed in her final examination. Disgusted with life, she cut across the front of her wrist at the flexor retinaculum. She was rushed to hospital. the surgeon noticed that the cut was superficial. All of the following structures would have been damaged except

1. Ulnar nerve
2. Median nerve
3. Palmar cutaneous branch of median nerve
4. Superficial branch of radial artery

112) In dislocation of the jaw, displacement of the articular disc beyond the TM joint results from spasm of excessive contraction of the following muscle

113) Following surgical removal of a firm nodular cancer swelling in the right breast and exploration of the right axilla, on examination thepatient was found to have a winged scapula. This occurred due to injury to the

1. Subscapular Muscle
2. Coracoid process of scapula
3. Long thoracic nerve
4. Circumflex scapular artery

114) A 49-year-old man suffering from carcinoma of prostate was X rayed. He showed areas of sclerosis and collapse of T 10 and T 11 vertebra in X ray. the spread of this cancer to the above vertebrae was through

1 Sacral canal
2. Lymphatic vessels
3. internal vertebral plexus of veins
4. Superior rectal veins

Ans 3 See references [ Human Genome project, earlier thought to be 100 000--- now only 30 000 genes What Does the Draft Human Genome Sequence Tell Us?
By the Numbers: The human genome contains 3164.7 million chemical nucleotide bases (A, C, T, and G).
The average gene consists of 3000 bases, but sizes vary greatly, with the largest known human gene being dystrophin MCQat 2.4 million bases.
The total number of genes is estimated at 30,000 to 35,000 much lower than previous estimates of 80,000 to 140,000 that had been based on extrapolations from gene-rich areas as opposed to a composite of gene-rich and gene-poor areas. Almost all (99.9%) nucleotide bases are exactly the same in all people.
The functions are unknown for over 50% of discovered genes. ] This was also reported in science journal , BBC news.
{HARRISON AND HARPER give the answer as 100 000 but CMDT 2002 in genetics chapter 1st page says 30-35000 genes}

116) Which of the following would distinguish hydrocephalus due to aqueductal stenosis when compared to that due to dandy walker phenomenon

1. Third ventricle size
2. Posterior fossa volume
3. Lateral ventricular size
4. Head circumference

117) In henoglobin, the innate affinity of Heme for carbon mono oxide is diminished by the presence of

118) Substrate concentration used for determining the activity of an enzyme having Km= x µm will be

Ans 1 [Michaelis constant Km is numerically equal to the substrate concentration when reaction velocity is half of Vmax maximum velocity, therefore conc is 2 x µm]

119) The Antibiotic that inhibits protein synthesis by premature chain termination and which structurally resembles amino acyl T RNA is

120) In post-hepatic jaundice, the concentration of conjugated bilirubin in the blood is higher than that of unconjugated bilirubin because.

1. There is in increased rate of destrucyion of red blood cells.
2. The unconjugated bilirubin is trapped by the bile stone produced in the bile duct.
3. The conjugation process of bilirubin in liver remains operative without any interference.
4. The UDP- glucuronosyl-transferase activity is increased manifold in obstructive jaundice.

121) If a biochemical test gives the same reading for a sample on repeated testing, it is inferred that the measurement is:

Ans (1) [ Dr Pyari, Thrissur ; Azhlagu,Chennai : HARPER says that repeatablity of test is precision and getting results within reference range is accuracy]

122) An alpha helix of a protein is most likely to be disrupted if a missense mutation introduces the following armino acid within the alpha helical structure:

Ans 4 [Glycine and proline introduce a bend in structure of protein, hence alpha helix disrupted, DR Santosh K]

123) During gluconeogenesis reducing equivalents from mitochondria to the cytosol are transported by:

1. Chromatography on a carboxymethyl (CM) cellulose column.
2. Iso-electric focusinhg.
3. Get filtration chromatography.
4. Chromatography on a drethylaminoethyl (DEAE) cellulose coloumn.

1. Sensitivity increases but specificity decreases.
2. Specificity increases but sensitivity decreases.
3. Both sensitivity and specificity increase
4. Both sensitivity and specificity decrease

129) The preferred public health approach to control non-communicable diseases is:

1. Shift the population curve of risk factors by a population based approach.
2. Focus on high risk individuals for reducation of risk.
3. Early diagnosis and treatment of indentified cases.
4. Individualdisease based vertical Programmes.

130) All of the following statements about rheumatic fever/heart disease epidemiology in India are true except:

1. Its prevalence varies between 2 to 11 per 1000 children aged 5-16 years.
2. Mitral regurgiration is the commonest cardiac lesion seen.
3. It occurs equally in females and males.
4. Rheumatic fever occurs in about 2% of streptococal sore throats.

1. It should be stored in deep freezer.
2. Exposureto direct sunlightr when in use should be avoided
3. Store stocks are needed for three months at PHC level.
4. Half used vials should not he put back into the cold chain after the session.

132) In Community Needs Assessment approach as a part of the Reproductive & Child Health activities are set at the level of:

Ans (4)Acc to Park , Fixation of targets and allocation of resources for RCH is done at DISTRICT LEVEL.[ Pramod, KIMS]

133) A randomized trial comparing the efficacy of two drugs showed a difference between the two with a p value of <0.005. In reality, however the two drugs do not differ. This therefore is an example of:

1. Type I error (alpha error).
2. Type II error (beta error).
3. 1 - œ (alpha)
4. 1 - ß

134) The National Population Policy 2001 aims to achieve net reproduction rate of 1 by the year:

135) As per the World Health Organisation guidelines, iodine deficiency disorders are endemic in a community if the precalence of goiter in school age children is more than:

137) The drug of choice for chemoprophylaxis in contacts of a patient of pneumonic plague is:

138) In the grading of Trachoma, Trachomatou. Inflammation-follicular is defined as the presence of:

1. Five or more follicles in the lower tarsal conjunctiva.
2. Three or more follicles in the lower tarsal conjunctiva.
3. Five or more follicles in the upper tarsal conjunctiva.
4. Three or more follicles in the upper tarsal conjunctiva.

Exp :Ocular MORBIDITY CAUSES Trachoma > Refractive error >Vit A deficiency > Ocular Injury
The question says "ocular morbidity". "Morbidity" is "any departure, subjective or objective from a state of physiological well-being".Its not "Blindness", the commonest cause of which is "Cataract". Certainly there are more people with specs that there are with cataract.
If the question had stated children Then TRACHOMA( NOT IN CHOICE) > VIT A DEFICIENCY > Refractive Error. MCQ

140) According to the National Programme for Control of Blindness (NPCB) survey (1986-89), the highest prevalence of blindness in India IS IN:

141) In a case-control study of a suspected association between breast cancer and the contraceptive pill, all of the following are true statements except:

1. The control should come from a population that has the same potential for breast cancer as the cases.
2. The control should exclude women known to be taking the pill at the time of the survey.
3. All the controls need to be healthy.
4. The attributable risk of breast cancer resulting from the pill may be directly measured.

1. Is the best measure of disease frequency in etiological studies.
2. Can only be determined by a cohort study.
3. Is the number of new cases in a defined population.
4. Describes the balance between incidence, mortality and recovery.

AIIMS NOVEMBER 2002 QUESTIONS WITH SUGGESTED ANSWERS AND EXPLANATIONS EXCLUSIVE AIPPG FEATURE FREE! If you are not at AIPPG you are missing something!

AIIMS NOVEMBER 2002 QUESTIONS WITH SUGGESTED ANSWERS AND EXPLANATIONS EXCLUSIVE AIPPG FEATURE FREE!
If you are not at AIPPG you are missing something!