NIMHANS 2002 PG ENTRANCE PAPER

Visit www.aippg.com for more pre pg papers

1. A 17 yr nonsmoking man presents with deep venous thrombosis and a pulmonary embolus. This is his second hospital admission for a similar presentation 1 yr ago. The patient has a family history for reccurent pulmonary emboli. The PTT remains normal after initiation of heparin therapy. Another dose of heparin produces similar results. The patient most likely has

a. von Willibrands disease

b. Antithrombin III deficiency

c. Antibodies against heparin

d. Protien C defect

2. All of the following are hypercoagulable conditions except

a. AT III deficincy

b. Protien C deficiency

c. Protien S defieciency

d. Anti Lupus anticoagulant deficiency

3. All of the following are responsible for internal rotation of shoulder joint except

a. Infraspinatus

b. Teres Major

c. Deltoid

d. Pectoralis Major

4. In a patient presenting with hoarseness of voice, inability to turn head to left against resistance was on examination found to have a swelling in the cervical region. The nerves affected in the lesion are

a. IX, XII XII

b. VII, X, XI

c. IX, X XI

d. V, X, XI

5. In undisplaced fracture of neck of femur the ideal treatment includes

a. Skeletal traction

b. Internal fixation

c. Femoral head prosthesis

d. Each of the above has similar prospects and results

6. A person skying on a slope falls and presents with pain in the wrist. On examination there is no deformity. The diagnosis is

a. Colles fracture

b. Scaphoid fracture

c. Trapezius dislocation

d. Lunate subluxation

7. A patient with Hb level 6 gms/dl, TLC -3500 and platelet count 50,000. The most probable diagnosis is

a. Leukemia

b. Multiple myeloma

c. Aplastic anemia

d. Megaloblastic anemia

8. Fresh frozen plasma is best given in which of the following situations

a. Post op bleeding

b. Elective endoscopy where PT has been found to have increased due to effect of coumarin

c. Bleeding due to thrombocytopenia

d. In burns patient

9. A patient presented with pulmonary embolism the treatment to be given is

a. Urokinase with fibrinolytics

b. IV heparin with continous infusion followed by coumarin for 4-5 months

c. Subcutaneous Heparin 5000 units

d. Warfarin with INR 1-1.5

10. In a patient post myocardial infarction developed atrial fibrillation. Subsequently the ECHO showed a mural thrombus. The management is by

a. Warfarin

b. Cardioversion

c. Digoxin

d. Propranolol

11 The first step on priority basis required in the management of status epilepticus is

a. IV Diazepam

b. IV phenytoin

c. Airway mainetenance

d. IV phenobarbitone

12. A patient develops mitral regurgitation following myocardial infarction. The likely cuase for this complication is

a. Infarction involving the valve

b. Rupture of chordae tendinae

c. Dilatation of the ventricle

d. Atrial fibrillation

13. A patient with congestive heart failure was started on digoxin and diuretics. He later presents with bradycardia and GIT upset and visual disturbances. His K+ was found to be 2.5. The reason for these features is

a. Left ventricular aneurysm

b. Digoxin toxicity

c. Viral gastroenteritis

d. Hypokalemia

14. Oculomotor nerve passes between which of the following

a. Superior cerebellar artery and posterior cerebral artery

b. Anterior inferior cerebellar artery and middle cerebral artery

c. Anterior inferior cerebellar artery and posterior cerebellar artery

d. Posterior cerebral artery and anterior communicating artery

15. In a patient with complete median nerve palsy the function totally lost is

a. Flexion

b. Abduction

c. Adduction

d. Opposition

16. Supracondylar fracture is associated most commonly with which of the following nerve lesions

a. Ulnar nerve

b. Radial nerve

c. Median nerve

d. Posterior interossios nerve

17. In Dupytrens contracture true is

a. It is due to acute tenosynovitis

b. The treatment is total excision of the palmar fascia

c. The mainstay of treatment is steroids and physiotherapy

d. The little finger is rarely involved

18. Infection from flexor pollicis longus sheath would most likely spread to

a. 2nd digit

b. 3rd digit

c. 4th digit

d. 5th digit

19. A 60 year old patient came with 4 episodes of massive bleeding per rectum. On examination the abdomen is soft and there is no tenderness, with bowel sounds being normal. The most likely diagnosis is

a. Diverticulitis

b. Carcinoma rectum

c. Heamorroids

d. Peptic ulcer disease

20. In intestinal obstruction true is

a. Closed loop obstruction is to be treated as an emergency

b. Long tubes used to treat obstruction are now outdated and not used in modern practice

c. A delay in operation in a patient with partial loop obstruction is not beneficial as compared to an early operation

d. In strangulated obstruction the events occur so fast that fluid and electrolyte disturbances do not occur at the time of presentation

21. A patient was found to have flushing and episodes of hypotension. Ultrasound scan showed multiple small nodular lesions in the liver. The patient was found to have carcinoid syndrome. The site from which the tumor has most likely arisen from is

a. Small intestine

b. Apendix

c. Descinding colon

d. Ascending colon

22. A patient presented with headache and episodes of hypertension. In between the episodes he was found to be normal. His urinary VMA levels were found to be raised. The diagnosis is

a. Carcinoid syndrome

b. Pheochromocytoma

c. Small cell carcinoma

d. Adissons disease

23. A patient on colonoscopy was found to have tubular adenoma which was removed. The pathology report suggested that the adenoma was found to extend upto the muscularis mucosae. The management now includes

a. Fulguration at the site of the polypectomy

b. Sigmoid colectomy

c. Observation

d. Left hemicolectomy

24. True regarding anaerobic infection is

a. Anaerobic bacteria are present in the skin and mucosae

b. If properly cultured then bacteroides account for 20% of cases causing peritonitis

c. Penicillin is ineffective in the treatment of anaerobic infections

25. True regarding subphrenic abscess is

a. Subphrenic abscess is most common following stomach surgery

b. It is most commonly seen following biliary tract surgery

c. As the subphrenic space is surrounded by the falciform ligament and other hepatic ligament anteriorly the subphrenic space is best approached through the bed and 12th rib

d. It occurs most commonly following hepatic abscess rupture

26. A patient was operated 2 months back and at that time a midline inscicion was used. Now he requires a second operation and this the ideal incision to be used now is

a. A fresh transverse incision

b. The scar of the previous incision is excised and the same incision is used

c. The same incision used without excision of old scar

d. A paramedian incision is to be used

27. In a trauma patient presenting to the casualty the fluid to be given initially is

a. Normal saline

b. Ringers Lactae

c. Dextrose 5%

d. Blood

28. Most common complication in varicose vein surgery is

a. Echymosis

b. Deep vein thromosis

c. Recurrence of varicosity

d. Venous ulcer

29. Infection draining the index finger goes to

a. Thenar space

b. Mid palmar space

c. Ulnar bursa

d. Radial bursa

30. True regarding akathasia is

a. Treatment is by anticholinergics

b. Patient wanders away from home

c. Presents with hallucinations

d. Behavioral therapy is required

31 Most common complication in colles fracture is

a. Malunioin

b. Non union

c. Sudecks osteodystrophy

d. Rupture of extensor pollicis

32. Regarding testicular torsion all of the following are true except

a. Is to be differentiated from acute epididymitis

b. Immediate management is mainly medical and surgery indicated later

c. Billaterality common

d. May not present with dysuria

33. In Webers syndrome true is

a. Lesion is in pons

b. Associated with 3rd nerve palsy

c. Hemiplegia on ipsilateraal side of lesion

d. Immediate surgery is the treatment

34. A child suffered through trauma and had to undergo splenectomy for splenic injury and blood loss. The further management includes all of the following except

a. Continous pencillin treatment

b. Continous aspirin to prevent coagulation

c. The parents are advised of the possible complications the child is prone for

d. Repeated evaluation for potential complications

35. True regarding mammography is

a. 2 rads of exposure is given each time hence it is not generally preferred

b. It can detect small lesions which are not palpable clinically

c. It can accurately diagnose carcinoma

d. Not very useful as a screening tool

36 . A patient presented with epidoses of flushing and hypotension. His urinary 5HIAA levels were found to be increased. The diagnosis is

a. Pheochromocytoma

b. Carcinoid syndrome

c. Adissons disease

d. SIADH

37. True regarding the large intestine is

a. The rectum is partly retroperitoneal and partly free

b. The ascending colon and descending colon are retroperitoneal

c. The transverse colon is largely extraperitoneal

d. The whole of colon is supplied by the vagus

A I P P G .C O M [ P R E P G ENTRANCE SITE WITH LATEST AIIMS,ALL INDIA, PGI etc PAPERS]

38. The vagus nerve supplies the large intestine closest upto

a. Hepatic flexure

b. Splenic flexure

c. Ceacum

d. Rectosigmoid junction

39. True about histology of large intestine is

a. The outer longitudinal and inner circular muscle are complete

b. The pilcae circularis form the haustra

c. The mucous cells line only the ascending colon

40 True about the pancreas is

a. The uncinate process is just ventral to where the splenic and the superior mesenteric vein unite

b. Duct of santorinin is ventral to the duct of wirsung

c. The two ducts rarely unite to form common entry into the duodenum

d. The main blood supply to the pancreas is from the splenic artery

41. Which of the following is true

a. The right gastric artery arises from the common hepatic artery

b. Ligation of the splenic artery causes infarction of the greater curvature of the stomach

c. Gastroepiploiec arteries arise from gastrodoudenal and splenic arteries

d. The lesser cuvature gets its blood supply mainly from the short gastric vessels

42. A smoker presented with altered sensorium. His blood osmolality was found to be 240 and urine osmolality 340. His Na+ is 122 meq/L. The diagnosis is

a. Diabetes insipidus

b. SIADH

c. Renal tubular acidosis

d. Cerebellar degeneration

43. A patient came with history of fall and on examination there was tenderness between the extensor pollicis longus and brevis. The likely lesion is

a. Scaphoid #

b. 1st metacarpal #

c. Lower end of radius #

d Trapezoid #

44. A child when playing had cat scratches over his hand. After 2 days he developed lymphadenopathy. Which group of the lymphnodes are involved if the scatches are over the region where the cephalic vein penetrates into the deeper fascia.

a. Deltopectoral group

b.Lateral group

c. Clavipectoral group

d. Central group

45 Inability to abduct left eye with LMN fascial palsy on same side. The lesion is in

a. Left pons

b. Right pons

c. CP angle tumor

d. Cerebellar lesions

46. In a patient with burns

a. Carbon monoxide is highly toxic to the pulmnory tract

b. Early tracheostomy is indicated because it is difficult to to pass tube through inflamed pharynx

c. The laryngeal edema can occur as late as 48 hours

47 In a patient presenting odynophagia with oral thrush the chest xray was found to be normal. The CD4 count was found to be 2400. The next step in management is

a. Fluconazole

b. Acyclovir

c. Endoscopy with biopsy of lesion

d. IV amphotericin B

48. Pulmonary fibrosis is caused by all of the following except

a. Clindamycin

b. Nitrofurantoin

c. Methysergide

d. Amidarone

49. A drug which causes parkinsonism and is not to be used in patients with this type of disease is

a. Methysergide

b. Haloperidol

c. Riluzole

d. Phenytoin

50. In a child with hernia on the right side the management is

a. High ligation of the lesion is done

b. The distal sac needs to be excised as it can develop hydrocele

c. Opposite side needs to be explored as bilaterality is common

d. X ray of the abdomen is useful for diagnosis

51. In a patient with subclavian steel syndrome true is

a. The flow of blood in the vertebral arteries is normal

b. The BP is decreased on the ipsilateral side

c. The patients commonly present with cluadication features

d. The patients commonly present with neurological features

52 In a patient with cervical disc prolapse the management includes

a. Immediate restrictive excercises

b. Skeletal traction and manipulation

c. Immediate surgery to prevent neurological complications

d. Medical management only

53. True regarding lymphatics is

a. Arise just below the derrnis

b. Flow is because of pulsation of arteries and muscular contractions

c. RBC's and WBC's are not seen in the lymphatic flow

d. These are valveless

54. Vitamin D deficiency is caused by all of the following except

a. Cirrhosis

b. Celiac sprue

c. Hypoprotienemia

d. CRF

55. True regarding osteosarcoma is

a. Pain is 1st due to pathologic fractures

b. 10% arise from pagets disease

c. Spread is mainly by lymphatic route

d. Most common site is Diaphysis of femur

56. True about follicular carcinoma is

a. Discrete capsule excludes carcinoma

b. Multicentricity same as in papillary carcinoma

c. Spreads more to distal sites then to the regional lymphnodes

d. FNAC is very useful in making a diagnosis

57 In a 3yr child fever with nuchal rigidity and other signs of meningitis is most likely caused by which of the following

a. Gram negative bacilli

b. Gram positive bacilli

c. Gram positive cocci

d. Gram negative cocci

58. In a patient with eye opening to pain , no motor and verbal response the GCS score is

a. 3

b. 4

c. 5

d. 6

59. In a lady presenting with preeclampsia all of the following drugs can be used in treatment except

a. Labetalol

b. Methyl dopa

c. Enalapril

d. Hydralizine

60. In trauma to chest the region of aorta most commonly injured is

a. The site of origin of the aorta

b. The descending aorta where it is passing though the diaphragm

c. The arch just distal to the attachment of the ligamentus arteriosis

d. Ascending aorta

61. Drug of choice in the treatment of onchocerciasis is

a. DEC

b. Ivermectin

c. Ketoconazole

d. Cotrimoxazole

62. Most common complication following splenectomy is

a. Left lower lobe atelectasis

b. Wound dehiscence

c. Pneumococcal septicemia

d. Deep vein thrombosis

63. True regarding aortic aneurysm is

a. The mortality in emergency operation is less then 10%

b. The size does not correlate with chances of rupture

c. Renal infarction is common in surgery for rupture

d. Thoraxic aneurysms have better prognosis

64. Full thickness graft is indicated in

a. Deep burns

b. Burns over large areas

c. Fascial regions for cosmetic effect

d..Over the back

65. TSH secreted from the pituitary gland is under control by

a. TRH and T3 ,T4

b. Releasing factors same as those of cortisol

c. Releasing factors bypass neurohypophysis to act on the anterior pituitary

d. TRH only

66. In a patient with thrombotic Thrombocytopenia all of the following are seen except

a. Anemia

b. Neurologic features

c. Thrombocytopenia

d. Coomb's positive

67. In a 32 weeks preterm baby the X ray showed diffuse opacities bilaterally. The diagnosis is

a. Congenital cystic lungs

b. RDS

c. Diaphramatic hernia

d. Tracheo-esophageal fistula

68. All of the following are true regarding hyaline membrane disease except

a. Corticosteroids will prevent the disease

b.Artificial surfactant will decrease features

c. More common in females

d. PEEP is used in the treatment

MULTIPLE CHOICES

a. 1 and 3 are correct

b. 1 and 2 are correct

c. 1,2 and 4 are correct

d. 1, 2,3,4 are correct

69. Complications of chicken pox include

1. Pancreatitis

2. Pneumonia more in children then in adults

3. Proliferative glomerulonephritis

4. Encephalitis

70. Non metastatic complications of carcinoma lung include

1. Myasthenia gravis

2. Cerebellar dysplasia

3. Polyneuropathy

4. SIADH

TRUE FALSE MODE

Answer as true or false for each option

1. In Normal distribution curve

a. Is bell shaped , symmetrical and on the x axis

b. Occurs only in normal people

c. Median=mode=mean

2. Regarding mean, median and mode

a. Mode-nominal value

b. Mean -is sensitive to extreme values

c. Median - is not sensitive to extreme values

3. Categorical values are

a. Age

b. Weight

c. Gender

4. Atypical antipshycotics are

a. Clozapine

b. Olanzapine

c. Metrizamide

5. Regarding Pick's disease

a. Neurofibrillary tangles are seen

b. Posterior 2/3rd temporal lobe atrophy accurs

c. Sparing of caudate lobe and putamen

6. About Prion disease correct are, it is

a. Fatal familial insomnia

b. Lewy body disease

c. Lyme's disease

7. Sleep in the elderly true is

a. REM sleep decreased to 5 %

b. Stage 4 sleep increased

c. Sleep cycle unlatered

8. True about treatment of menorrhagia is

a. Naproxen

b. Traneaxamic acid

c. Diazoxide

9. In clinical trials true are

a. Step I: animal trial

b. Step II: trial in healthy volunteers

c. Step III: concerns drug marketing

10. The correct matches are

a. Arsenic - blue gum's line

b. Manganese- parkinsonism

c. Asbestos - lung carcinoma

11. Correct matches are

a. Aspergillosis- cell mediated cytotoxicity

b. Serum sickness- immune mediated reaction

c. Erthroblastosis - cell mediated immunity

12. About dopamine receptors true is/are

a. D1 recptors are auto receptors

b. D2 D5 mediate through adenyl cyclase

c. D4 receptors act via kinase

13. True about mechanism of action of drugs is

a. Erythromycin -attaches to ribososme and inhibits DNA replication

b. Rifampicin- inhibits DNA dependent RNA polymerase

c. Vancomycin acts on cell wall

14. Left shift of oxygen dissociation curve occurs due to

a. Increased temperature

b. Metabolic acidosis

c. Chronic hypoxia

15. True about akathesia is

a. Most common complication of SSRI use

b. Anticholinergics are used for treatment

c. Wanders away from home

16. Correctly matched choices are

a. Lady Macbeth - Obsessive compulsive disease

b. Othello- Delusional jealousy

c. Helmet- Multiple personality

17. Prolactin is inhibited by

a. Serotonin

b. Estrogen

c. Oxytocin

18. Regarding post traumatic stress disorder true is

a. Anxiety is a feature

b. Occurs after days after stress

c. Hallucinations are a prominent feature

19.True about feautures in catotonic schizophrenia is/are

a. Echolalia

b. Anhedonia

c. Ambitendency

20. Complications in anorexia nervosa include

a. Esophagitis

b. Ammenorrhea

c. Osteoporosis

21. EEG changes seen correctly matched are

a. Hypsarrhythmia's- CJ disease

b. Absent seizures- 3 Hz spike and dome pattern

c. Infantile seizures- focal lateralized slow wave discharges

22. In histolopathology findings correctly matched are

a. Dysplasia- change of histology from one form to another

b. Anaplasia - complete change of cells

c. Metaplasia- involving basement membrane

23. Drugs with acetyl cholinesterase activity used in alziemers disease are

a. Donezepil

b. Galamatine

c. Piracetam

24. MRI is contraindicated in

a. IUD device

b. 3rd trimester pregnancy

c. Pace maker implants

25. Diseases which can lead to dementia

a. Syphillis

b. Gonorrhea

c. Prion disease

26. Cryptococcus meningitis true is

a. Cryptococcal memningitis is more common then crypticoccal pneumonia

b. Leucopenia is a distinct feature

c. Ketoconazole is used in treatment

27. Correctly matched stains used include

a. Giemsa-Pneumocystis carinii

b. Mucicarmine- leishmaniaisis

c. Warthin starry- H.Pylori

28. Enlarged tongue is seen in

a. Hypothyroidism

b. Trisomy 21

c. XII th nerve palsy

29. Blindness can occur due to

a. Toxoplasmosis

b. Cysticercosis

c. Oncocerciasis

30. True about carotid artery stenosis is

a. Bruit relates to severity

b. Lesion more common in external carotid artery

c. Surgery is most commonly performed

31.About abdominal aneurysm is

a. Size relates to chances of rupture

b. Usually asymptomatic till rupture

c. 30 day mortality in emergency operation is less then 10%

32. True about bladder carcinoma is

a. Painless heamturia is most common symptom

b. Alcohol consumption is a predisposing factor

c. >90% are squamous cell carcinoma

33. Second messengers are

a. Inositol P

b. DAG

c. PLC

34. In Nicotine addiction the treatment is

a. Nicotine nasal spray

b. Diazepam

c. Naltrexone

35. Alcohol craving is decreased by

a. Disulfiram

b. Acomprosite

c. Naltrexone

36. MDMA

a. Ecstasy is another name for it

b. It's a cocaine congener

c. Cuases parkinsonism like syndrome

37. A 3 year old child can

a. Hop on one foot

b. Copy a square

c. Match as per shape

38. Hallucination is seen in

a. Delusional syndrome

b. Delirium

c. Mania

39. Regarding ovarian neoplasm true is

a. Most common from epithelium

b. Most commonly benign

c. Germ cell tumors are mostly malignant

40. In HIV vaccines that can be given are

a. Measles

b. Oral typhoid vaccine

c. Hepatitis A vaccine

41. True about Fragile X syndrome is

a. Father to son transmission

b. CGG repeats

c. Mental retardation present

42. Regarding Meiosis true is

a. Do not occur in X and Y chromosome

b. Halves the diplopiod number

c. It is longer in males then females

43. Mendalian theory cannot explain

a. Polygenic inheritance

b. Genetic linkages

c. Autosomal recessive inheritance

44. Diseases with trinucloetide repeats occurs in

a. Friedricks ataxia

b. Alzheimers disease

c. Fatal familial insomnia

45. Babinski's reflex is weak in

a. Hypothyroidism

b. Parkinsonism

c. Disc herniation

46. True are

a. Cerebellar nystagmus are gaze evoked nystagmus

b. Sea saw nystagmus is associated with homonymous heminaopia

c. Down beat nystagmus - is seen in brianstem herniation

47. In vestibular dysfunction causing dizziness

a. It is continous

b. More on moving head

c. Worsens on lying down

48. True about ASPERGERS syndrome is

a. Language development delayed

b. Retts syndrome is more common in boys

c. Treatment is mainly behavioral therapy

49. True about memory is

a. Riding tricycle is-implicit memory

b. Mathemetical calculation is episodic memory

c. Naming is declerative memory

50. Correctly matched are

a. Stalking-deUamberlauts syndrome

b. Frued- Caapgras syndrome

c. ***- Cotards syndrome

51. Regarding medical ethics

a. Primus non onre means patient comes first

b. Res ipsa laquire means the thing speaks for itself

52. In trichotillomania features seen are

a. Nail biting

b. Associated with alopecia

c. Antipsychotics are used in treatment

53. Restless leg syndrome true is

a. Feautures are more common in day time

b. Legs are restless in the day

c. Treatment is dopaminergic medications

54. Large pulmonary embolism can present as

a. Bradycardia

b. Decreased JVP

c. Syncope

55. True regarding succinyl choline is

a. Succinyl choline has increased activity in pseudocholinesterase dysfunction

b. Causes increase in IOT

c. Is a competitive muscle relaxant

56. True about muscle relaxants are

a. Vecuronium is a depolarizing agent

b. Mivacurium is shortest acting non depolarizing agent

c. Succinyl choline causes phase 2 block

57. Correctly matched are

a. Koch-Germ theory

b. Halsted- heart transplant

c. Pastuer -chicken pox vaccine

58. Correctly matched are

a. Gluconeogenesis- Cortisol

b. Hepatic glycogenesis- insulin

c. Hepatic glygenolysis- growth hormone

59. Treatment of hyperkalemia is

a. Sodium bicarbonate and calcium gluconate

b. Glucose and insulin

c. Na+ K+ exchange resin

60. Treatment in rapid cyclers is

a. Valproate

b. Carbamazpine

c. Phenytoin

61. Correctly matched are

a. Erythema multiforme- orf

b. Erythema marginatum - lymes disease

c. Erythema induratum- Syphillis

62. True about Schizophrenia in female is

a. Insidious in onset in females

b. Occurs later in life in females

c. Poorer prognosis

63. OCD in female patients is

a. Depressive episode is more in men

b. Bipolar more in females

c. Duration of depression more in females

64. Kline Levine syndrome true is

a. Hyposexuality

b. Polyphagia

c. Due to frontal lobe excision

65. In frontotemporal lesion true is

a. Intact memory

b. Speech disturbance

c. Primitive reflexes

66. In benign intracranial hypertension

a. Treatment is needed in all cases

b. Mostly asymptomatic

c. CT shows diffuse opacities

67. In accommodation reflex

a. Sphincter muscle of iris dilates

b. Lens curvature increases

c. Cilliary muscles relax

68. As per revised national tuberculosis programme

a. Chest xray is valued as most diagnostic

b. HIV status is taken as separate category

c. Treatment are supervised on daily basis

69. Pottasium sparing diuretics are

a. Tiamterine

b. Ethacrinic acid

c. Metrizamide

70. In trichotillomania features seen are

a. Nail biting

b. Associated with alopecia

c. Treatment is by antipsychotics