Dnb/Aipgmee Model Test 1

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    Defective dystrophin; less severe than Duchenne's

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    • Gilbert's syndrome
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    • Reiter's syndrome
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Dnb/Aipgmee Model Test 1 - Quiz
About This Quiz

FREE MODEL TEST FOR STUDENTS PREPARING FOR DNB/AIPGMEE
No of questions;200 Time:180 mins
Contains image based questions
After completion of test a report complete with answers and explanation will be sent to your e-mail id.

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  • 2. 

    Acute gastric ulcer associated with severe burns

    • Owl's eye

    • McBurney's sign

    • Curling's ulcer

    • Virchow's node

    Correct Answer
    A. Curling's ulcer
    Explanation
    Curling's ulcer is a type of gastric ulcer that occurs as a complication of severe burns. It is caused by a decrease in blood flow to the stomach lining due to burn-induced hypovolemia. This leads to the formation of ulcers in the stomach. The term "Owl's eye" refers to an appearance seen in certain viral infections, "McBurney's sign" is associated with appendicitis, and "Virchow's node" refers to a lymph node enlargement in the left supraclavicular region that is often associated with abdominal malignancies.

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  • 3. 

    Clinical manifestations of Listeria monocytogenes infec­tion include

    • Meningitis

    • Primary bacteremia

    • Endocarditis

    • All of the above

    Correct Answer
    A. All of the above
    Explanation
    Listeria monocytogenes causes meningitis. Findings in CSF are similar to findings in other types of purulent meningitis; a relative lymphocytosis is seen in 25% to 40% of cases. Patients may present with primary bacteremia without evidence of central nervous system infection. Listeria can cause endocarditis, with either normal or abnormal valves. These listerial infections are more common in immunosuppressed patients, specifically patients using chronic steroid therapy, renal transplant pa¬tients, and cancer patients. If a pregnant woman experiences bacteremia, transplacental infection can occur, leading to stillbirth or spontaneous abortion.

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  • 4. 
    diagnose this? - ProProfs

    diagnose this?

    • Adenoma sebaceum

    • Rhinophyma

    Correct Answer
    A. Adenoma sebaceum
    Explanation
    Tuberous sclerosis, adenoma sebaceum. Small erythematous papules on the nose and cheeks of a child representing angiofibromata.

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  • 5. 

    Which of the following is a water soluble vitamin?

    • Folic acid

    • Vitamin A

    • Vitamin k

    • Linolenic acid

    Correct Answer
    A. Folic acid
    Explanation
    Review:Biochemistry

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  • 6. 

    24 year old patient has been diagnosed with androgen-insensitivity syndrome. The patient is likely have all of the following signs EXCEPT

    • An XY chromosome complement

    • Menstruation’

    • Female external genitalia

    • Heterosexuality

    Correct Answer
    A. Menstruation’
    Explanation
    genetic male with androgen-insensitivity (testicular feminization) syndrome has the sexual phenotype of a female. Because there is a genetic defect, the somatic cells do not respond to androgen, and masculinization does not take place prenatally. In adults with andro¬gen-insensitivity syndrome, breast development occurs as a result of testicular estrogen secretion. However, menstruation does not occur because there is no uterus. Individuals with androgen-insensitivity syndrome are usually heterosexual with respect to their sexual pheno¬type (i.e., they have sexual interest in men).

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  • 7. 

    A young man with hypercholesterolemia is rushed to the hospital with crushing chest pain radiating to his left arm and a probable heart attack. Which of the following treatments should be considered?

    • Heparin infusion

    • Thrombin infusion

    • Fibrinogen infusion

    • Tissue plasminogen activator infusion

    Correct Answer
    A. Tissue plasminogen activator infusion
    Explanation
    Many enzymes interact to regulate blood clotting. Plasmin is activated by proteolytic cleavage of its zymogen, plasminogen. The activating protease is called tissue plasminogen activator (tPA). Plasmin hydrolyzes fibrin clots to form soluble products and is used to dissolve clots in coronary arteries that cause myocardial infarction. Platelets, thrombin, and fibrinogen promote clotting through the intrinsic pathway and would be contraindicated in myocardial infarction. Platelets form a plug at the site of bleeding and bind prothrombin to facilitate its conversion to thrombin. Fibrinogen is the substrate acted on by thrombin to yield the fibrin mesh of blood clots. Heparin is a mucopolysaccharide that terminates clot formation by interfering with a number of steps in the coagulation cascade. Heparin inhibits the formation of clots, but cannot dissolve clots that have already formed.

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  • 8. 

    The gaps between segments of DNA on the lagging strand produced by restriction enzymes are rejoined/sealed by.

    • DNA Ligases

    • DNA Helicase

    • DNA topoisomerase

    • DNA phosphorylase

    Correct Answer
    A. DNA Ligases
    Explanation
    Review:Biochemistry

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  • 9. 

    Which of the following drugs demonstrate zero order kinetics :­

    • Enalapril

    • Bendrofluazide

    • Atenolol

    • Phenytoin

    Correct Answer
    A. Phenytoin
    Explanation
    Pharmacokinetics: metabolism
    The questions which commonly arise in the MRCP with respect to drug metabolism are usually concerned with zero-order kinetics and acetylator status .
    Zero-order kinetics
    Drugs exhibiting zero-order kinetics
    • Salicylates
    • Heparin
    • Ethanol
    • Phenytoin ………………. SHE Presents 0 order
    Acetylator status
    50% of the UK Population are deficient in hepatic N-acetyltransferase
    Drugs affected by acetylator status
    • Procainamide
    • Hydralazine
    • Dapsone
    • Isoniazid
    • Sulfasalazine ……… PHD IS

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  • 10. 

    Which is the earliest sign of hyperkalemia? 

    • Peaked T-wave

    • Peaked P waves

    • Shortened QRS

    • Peaked U-waves

    Correct Answer
    A. Peaked T-wave
    Explanation
    ECG changes seen in hyperkalemia include:
    • Peaked T-wave (earliest)
    • Flattened P-wave
    • Prolonged PR interval (first-degree block)
    • Widened QRS complex
    • Sine wave formation
    • Ventricular fibrillation.

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  • 11. 

    Which disease disseminates rapidly in immunosuppressed pa­tients.

    • Kaposi's sarcoma

    • Ewing's sarcoma

    • Osteogenic sarcoma

    • Chondrosarcoma

    Correct Answer
    A. Kaposi's sarcoma
    Explanation
    Kaposi's sarcoma is described as an indolent disease affecting elderly men and responding well to local therapeutic intervention. The disseminated form of the disease is now seen more frequently in severely immunologically compromised patients, such as AIDS patients. Ewing's sarcoma does respond well to chemotherapy and radiation, but it may be difficult to diagnose without sophisticated immunohistochemical techniques. The clinical course of ontogenic sarcoma has been dramatically altered by the effectiveness of chemotherapy in combination with surgical techniques, which has enabled patients to avoid amputation in many cases.

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  • 12. 

    Oseltamivir the drug available for the treatment of ' Ava in flu' belongs to which pharmacological class?

    • Reverse transcriptase inhibitor

    • Hemagglutinase inhibitor

    • Neuraminidase inhibitors

    • Ribonuclease inhibitor

    Correct Answer
    A. Neuraminidase inhibitors
    Explanation
    Oseltamivir and Zanamivir are two drugs of neuraminidase inhibitor group which are known to reduce the severity and duration of illness caused by avian influenza. Oseltamivir is given 75 mg orally bid for 5 days, to be started within 48 hours of symptom onset. Zanamivir is to be given by inhalation

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  • 13. 

     Initial treatment in a management of trauma

    • Airway

    • IV fluids

    • Fracture stabilasation

    • Do not shift

    Correct Answer
    A. Airway
    Explanation
    The initial treatment in the management of trauma is to ensure a clear airway. This is because maintaining a patent airway is crucial for the patient's survival and oxygenation. Without a clear airway, the patient may not be able to breathe properly, leading to hypoxia and potential respiratory arrest. Therefore, establishing and maintaining an open airway is the first priority in trauma management.

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  • 14. 

    The most common opportunist isolated from patients with AIDS 

    • M. kansasii

    • M. avium-intracellulare complex

    • M. bovis

    • M. fortuitum-chelonae complex

    Correct Answer
    A. M. avium-intracellulare complex
    Explanation
    The Mycobacterium avium-intracellulare complex (sometimes referred to as the Mycobacterium avium complex or MAC) is the most common bacterial infec¬tion in AIDS patients in the United States. Histori¬cally, it was a relatively uncommon cause of human infection, and disease was usually restricted to the pulmonary region.
    Mycobacterium avium-intracellulare is often widely disseminated in AIDS patients, especially when the CD4+ lymphocyte count falls below 100/!J.l. In some patients, hundreds of thousands of organisms per milli¬liter of blood are present.
    The organisms are present in birds (pigeon drop¬pings) and other animals, water, and soil. Inhalation or ingestion of the organisms by a debilitated individ¬ual can result in its colonization of the respiratory or gastrointestinal tracts, respectively. After an initial episode of bacteremia and spread into tissues, persis¬tent bacteremia and extensive tissue invasion may oc¬cur. Clinical manifestations include fever, night sweats, weight loss, diarrhea, and abdominal pain. Many organs can be involved, including the lungs, lymph nodes, bone, pericardium, skin, and brain.
    Mycobacterium avium-intracellulare is almost always resistant to the first line of drugs used for tuberculosis. Unfortunately, there is no rapid or reliable method for testing drug susceptibility for these organisms. Clarithromycin or azithromycin combined with eth¬ambutol is often used for initial therapy. 'Rifabutin may be used prophylactically to reduce the risk for bacteremia and decrease the severity of symptoms.
    Mycobacterium kansasii is an opportunistic organism
    That cause pulmonary and systemic disease in debilitated individuals. Mycobacterium bovis is considered a pathogen. When inhaled, it causes disease that is virtu¬ally indistinguishable from tuberculosis. These orga¬nisms are no longer prevalent in the United states. An attenuated strain is used in the bacille Calmette Guérin (BCG) vaccine for immunization against tu¬berculosis. Mycobacterium fortuitum-chelonae complex rarely causes disease in humans. The organisms have been occasionally isolated from porcine valves im¬planted during cardiac surgery. Mycobacterium scrofu¬laceum may cause cervical lymphadenitis in children and has been isolated from adults with chronic lung disease.

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  • 15. 

    All of the following substances are produces of arachidonic acid metabolism EXCEPT

    • Leukotrienes

    • Thromboxane

    • Endothelin

    • Prostacyclin

    Correct Answer
    A. Endothelin
    Explanation
    Arachidonic acid metabolism proceeds via three path¬ways. The cyclooxygenase pathway, which is inhibited by aspirin and other nonsteroidal antiinflammatory drugs, leads to the formation of prostaglandins, prosta¬cyclin, and thromboxanes. The lipooxygenase pathway leads to the formation of leukotrienes, whereas the cytochrome P 450 monooxygenase pathway produces lipoxins and other products. Endothelin is a 21 amino ¬acid peptide that is produced by vascular endothelium and has potent vasoconstrictive properties.

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  • 16. 

    MHC antigen is present on:   

    • Chromosome VI

    • Chromosome XII

    • Chromosome X

    • Chromosome XXI

    Correct Answer
    A. Chromosome VI
    Explanation
    • each cell expressing them displays several different The major histocompatibility complex (MHC) contains at least 128 functional genes, more than 20% of which have functions in immunity, and is the most gene-dense region of the human genome.
    • It is also the region with the most disease associations: most, if not all, autoimmune diseases are associated with genes in the MHC, reflecting the central role of MHC molecules in focusing immune responses.
    • For historical reasons, human MHC molecules are known as HLA, for human leukocyte antigen, and mouse as H-2, for histocompatibility 2, with the different genes indicated by letters.
    • The MHC genes are traditionally divided into three classes: the MHC class I and class II genes, which encode the antigen-presenting MHC molecules; and the class III genes, a miscellany of genes encoding some molecules with important immune functions and others with no known immune function.
    • The gene encoding b2-microglobulin lies outside the MHC, on a different chromosome.
    • All the other genes encoding chains of the class I and class II MHC molecules are present in several different copies within the MHC, and MHC molecules.
    • This is important for ensuring sufficient diversity to bind peptides from a wide range of microorganisms, an issue we discuss in more detail below. The peptide antigen-presenting MHC molecules are known as classical MHC molecules.
    • There are also structurally related molecules of both classes that do not function in the presentation of peptide antigens to T cells: these are known as non-classical MHC molecules. The nonclassical MHC class II molecules (DM and DO in human) regulate peptide loading onto classical
    MHC class II molecules
    A notable distinction between classical and non-classical MHC molecules that bears on their different functions is the polymorphism of the classical MHC molecules.

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  • 17. 
    diagnosis? - ProProfs

    diagnosis?

    • Corns

    • Dermatomyopathy

    Correct Answer
    A. Corns
    Explanation
    Corns: Corns generally occur on the tops and sides of the toes. A hard corn is a small patch of thickened, dead skin with a packed center. A soft corn has a much thinner surface and usually occurs between the 4th and 5th toes. A seed corn is a tiny, discrete callous that can be very tender if it's on a weight-bearing part of the foot. Seed corns tend to occur on the bottom of the feet, and some doctors believe this condition is caused by plugged sweat ducts.

    Calluses: Calluses can develop on hands, feet, or anywhere there is repeated friction -- even on a violinist's chin. Like corns, calluses have several variants. The common callus usually occurs when there's been a lot of rubbing against the hands or feet. A plantar callus is found on the bottom of the foot.

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  • 18. 
     SUDDEN & PAINLESS vision loss is seen in  - ProProfs

     SUDDEN & PAINLESS vision loss is seen in 

    • Acute congestive glaucoma

    • CRVO

    • chronic simple glaucoma

    • Corneal ulceration

    Correct Answer
    A. CRVO
    Explanation
    SUDDEN & PAINLESS:CRAO, CRVO, vitreous hemorrhage, retinal detachment, central serous retinopathy, optic neuritis
    SUDDEN & PAINFUL: Acute congestive glaucoma, corneal ulceration, chronic simple glaucoma

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  • 19. 

    DNA replication occurs in which phase of the eukaryotic cell cycle?

    • M phase

    • S phase

    • G0 phase

    • G1 phase

    Correct Answer
    A. S phase
    Explanation
    . In eukaryotes, DNA replication occurs in the S phase of the cell cycle. Cells undergo mitosis or cell division in the M phase. The G1 phase follows mitosis, but precedes DNA replication. The G2 phase follows repli¬cation and precedes mitosis. Non-dividing cells are said to have entered the Go phase.

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  • 20. 
    bunions most commonly affect ? - ProProfs

    bunions most commonly affect ?

    • Men

    • Women

    Correct Answer
    A. Women
    Explanation
    Bunion: A bunion is a localized painful swelling at the base of the big toe (the great toe). The joint is enlarged (due to new bone formation) and the toe is often misaligned. It is frequently associated with inflammation. It can be related to inflammation of the nearby bursa (bursitis) or degenerative joint disease (osteoarthritis).
    Bunions most commonly affect women. Ballet dancers are prime candidates for bunions. Tight-fitting shoes and high heels can contribute to bunions.
    The treatment of bunions includes rest, a change in shoes, foot supports, medications or surgery.

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  • 21. 

    Patient 50 year old comes with weakness and lethargy for 5-6 months. On examination he is found anemic and occult blood in stools is positive. What is the next best investigation for him?

    • Colonoscopy

    • Ba meal

    • Ba enema

    • CT abdomen

    Correct Answer
    A. Colonoscopy
    Explanation
    Colonoscopy is the accurate & most widely used modality to evaluate the large bowel in pts
    with occult bleeding

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  • 22. 

    Paroxysmal nocturnal hemoglobinuria

    • Senile plaques

    • Reinke crystals

    • Red urine in the morning

    • Councilman bodies

    Correct Answer
    A. Red urine in the morning
    Explanation
    Red urine in the morning can be explained by the condition called hematuria, which is the presence of red blood cells in the urine. This can occur due to various reasons such as urinary tract infections, kidney stones, or bladder infections. It is important to consult a healthcare professional to determine the underlying cause and receive appropriate treatment.

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  • 23. 

    Which enzyme is defective in Refsum’s disease 

    • Phytanic acid oxidase

    • Succinate thiokinase

    • Malonate dehydrogenase

    • Thiophorase

    Correct Answer
    A. Phytanic acid oxidase
    Explanation
    Ref: Harrison’s 17th edition, chapter 379
    Refsum Disease
    This is an autosomal recessive hypertrophic neuropathy caused by defective oxidation of phytanic acid, a branched-chain fatty acid found in dairy products, beef, lamb, and fish. The onset is in late childhood or adolescence, with a slowly progressive course of a sensorimotor demyelinating neuropathy with sensorineural deafness, cerebellar ataxia, and anosmia. Retinitis pigmentosa presenting as night blindness often precedes the onset of neuropathy. Thickened skin (ichthyosis), syndactyly and shortening of the fourth toe, cardiomyopathy, and cataracts are other features. CSF protein is typically elevated. Abnormally high plasma and urinary levels of phytanic acid are diagnostic. Although a diet low in phytanic acid may prevent the onset of some of the complications, compliance with this diet is usually poor. Plasma exchange and dialysis may be helpful for episodes of worsening

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  • 24. 

    Previously healthy 60-yrs-old man undergoes a corneal transplant. Three months later, he is profoundly demented, demonstrates myoclonic jerks on exam, and has an EEG that shows periodic bursts of electrical activity superimposed on a slow background. Which of the following is this patient’s most likely diagnosis?

    • Wilson’s disease

    • Multi-infarct dementia

    • Creutzfeldt-Jakob Disease

    • Epilepsy

    Correct Answer
    A. Creutzfeldt-Jakob Disease
    Explanation
    Creutzfeldt -Jakob disease is a neu¬rodegenerative disease caused by a transmissible infectious agent, the prion. Most cases are iatrogenic, following transplant of infected corneas or use of contaminated neurosurgical instruments. Familial forms, following an autosomal dominant pattern of inheritance, represent 5 to 15% of cases. Patients show a very rapid cognitive deterioration, myoclonic jerks, rigid¬ity, and ataxia. Death follows within a year. An intermittent periodic burst pattern (periodic complexes) is the characteristic EEG finding. Epilepsy causes spike and wave patterns on EEG, and may cause postseizure mem¬ory loss and disorientation (in generalized, tonic-clonic seizures) or a depersonalization syndrome (in temporal lobe epilepsy or other focal seizure disorder), but would not be expected to cause dementia, continu¬ous myoclonic jerks on exam, or an EEG that shows periodic bursts of elec¬trical activity superimposed on a slow background. Pseudo dementia is the term used in patients with major depression who exhibit impaired atten¬tion, perception, problem solving, or memory. The cognitive decline is often more precipitous than in demented patients. Patient history often reveals past major depressive episodes. Although the actual memory impairment is modest in these patients, the subjective complaint is high.

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  • 25. 

    Histogram is used to describe:

    • Quantitative data of a group of patients

    • Qualitative data of a group of patients

    • Data collected on nominal scale

    • Data collected on ordinal scale

    Correct Answer
    A. Quantitative data of a group of patients
    Explanation
    Review:SPM-STATISTICS-

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  • 26. 

    Plasma factor VIII is stabilized by

    • Von Willebrand factor

    • Factor IX

    • Prothrombin

    • Glycoprotein Ib

    Correct Answer
    A. Von Willebrand factor
    Explanation
    Circulating factor VIII is bound to von Willebrand factor, which stabilizes factor VIII. In addition, von Willebrand factor is important to the binding of platelets to injured vessel walls, and it enhances platelet-platelet interactions. The hemostatic defect in p3fiellls with yon WillelJr3t1.d disease results perinodally from impaired interactions of platelets with vessel walls.

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  • 27. 

    All of the following symptoms are commonly seen in the patient with major depressive disorder except

    • Insomnia

    • Poor concentration

    • Decreased appetite with weight loss

    • Amnesia

    Correct Answer
    A. Amnesia
    Explanation
    A depressed mood and a loss of interest or pleasure are the key symptoms of depression. Approxi¬mately 65% of all depressed patients have suicidal ideation, and 10% to 15% of patients commit suicide. Most depressed patients have loss of energy, insomnia, decreased appetite, and weight loss. Anxiety is also a common symptom of depression. Other vegetative symptoms include abnormal menses and decreased interest and performance in sexual activities. The changes in food intake and rest can aggravate coexisting medical illnesses such as diabetes, hypertension, chronic obstructive pulmonary disease, and heart disease. Amnesia is not a symptom of depression.

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  • 28. 

    A patient has huge hepatomegaly with episodes of hypoglycemia in between meals and no change after glucagon and epinephrine. Diagnosis?

    • Von Gierke disease

    • Cori’s disease

    • Pompe’s disease

    • . Mc Ardle’s disease

    Correct Answer
    A. Von Gierke disease
    Explanation
    • von Gierke disease is a type I glycogen storage disease due to a defect in glucose-6-phosphatase in liver, kidney and intestinal mucosa.
    • The patients develop hypoglycemia and lactic acidosis during the neonatal period but more commonly present at 3–4 months of age with hepatomegaly and hypoglycemia.
    • These children may have doll-like facies with fat cheeks, relatively thin extremities short stature, and a protuberant abdomen that is due to massive hepatomegaly.
    • The hallmarks of the disease are hypoglycemia, lactic acidosis, hyperuricemia and hyperlipidemia.
    • The diagnosis of type I disease can be suspected on the basis of clinical presentation and abnormal plasma lactate and lipid values. In addition, administration of glucagons or epinephrine causes little or no rise in blood glucose but increases lactate levels significantly. A definitive diagnosis, however, requires a liver biopsy to demonstrate a deficiency of glucose-6-phosphatase.
    • The primary treatment goal is prevention of hypoglycemia and the secondary metabolic derangements by frequently feeding foods high in glucose or starch (which is readily digested to glucose).
    • To compensate for the inability of the liver to provide sugar, the total amount of dietary carbohydrate should approximate the 24 hour glucose production rate. The diet should contain approximately 65–70% carbohydrate, 10–15% protein, and 20–25% fats.
    • At least a third of the carbohydrates should be supplied through the night, so that a young child goes no more than 3–4 hours without carbohydrate intake. In the last 30 years, two methods have been used to achieve this goal in young children:
    1. Continuous nocturnal gastric infusion of glucose or starch and
    2. Night-time feedings of uncooked cornstarch.
    • An elemental formula of glucose polymer, and/or cornstarch can be infused continuously through the night at a rate supplying 0.5–0.6 g/kg/hr of glucose for an infant, or 0.3–0.4 for an older child. This method requires a nasogastric or gastrostomy tube and pump.
    • Cornstarch is an inexpensive way to provide gradually digested glucose.
    One tablespoon contains nearly 9 g carbohydrate (36 calories).
    Although it is safer, less expensive, and requires no equipment, this method does require the parents to arise every 3–4 hours to administer the cornstarch. A typical requirement for a young child is 1.6 g/kg every 4 hours.

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  • 29. 

    All of the following are findings of patients with schizo­phrenia except

    • Lateral and third ventricle enlargement

    • Deficits in smooth-pursuit eye movements

    • Increased incidence of abnormally slow electroen¬cephalogram tracings

    • Cerebellar dysfunction

    Correct Answer
    A. Cerebellar dysfunction
    Explanation
    Studies using CT have consistently shown that the brains of patients with schizophrenia have lateral and third ventricular enlargement and some degree of reduction in cortical volume. Disorders of smooth visual pursuit and the disinhibition of saccadic eye movements are commonly seen in patients with schizophrenia. Electroencephalographic studies of patients with schizophrenia indicate that a high number have abnormal records, increased sensitivity to activation procedures, decreased a-activity, and increased 7- and 8-activity. No studies have shown impaired cerebellar functioning.

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  • 30. 

    45 year old male patient complains that he is often tired and has a headache almost every morning His wife says that her sleep is disturbed because of the patient’s loud snoring. Physical examination reveals leg edema. Hypertension, and cardiac arrhythmia. From which disorder is this patient most likely suffering?

    • Sleep wake schedule disorder

    • Obstructive sleep apnea

    • Narcolepsy

    • Delayed sleep phase syndrome

    Correct Answer
    A. Obstructive sleep apnea
    Explanation
    In obstructive sleep apnea, airway obstruction results in snoring as well as failure to breathe during the night. The resulting anoxia causes frequent awaken¬ings during the night so that the patient feels tired in the morning. Decreased oxygen availability may result in leg edema, hypertension, morning headaches, car¬diac arrhythmias, and stroke in patients with obstruc¬tive sleep apnea.

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  • 31. 

    3 yrs old child is brought to the emergency room by his parents after they found him having a generalized seizure at home. The child’s breath smells of garlic, and he has bloody diarrhea, vomiting, and muscle twitching. Which poison is it likely that this child has encountered?

    • Thallium

    • Lead

    • Arsenic

    • Carbon monoxide

    Correct Answer
    A. Arsenic
    Explanation
    Acute arsenic poisoning from ingestion results in increased permeability of small blood vessels and inflammation and necrosis of the intestinal mucosa; these changes manifest as hemorrhagic gastroenteritis, fluid loss, and hypotension. Symptoms include nausea, vomiting, diarrhea, abdominal pain, delirium, coma, and seizures. A garlicky odor may be detectable on the breath. Arsenic is found in herbal and homeopathic remedies, insecticides, rodenticides, and wood preservatives, and it has a variety of other industrial applications.

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  • 32. 

    Mental retardation has affected several generations of a family. Only male family members manifest this condition. In general, it appears that the severity of mental retardation has increased with each passing generation. By which of the following mechanisms is this genetic condition most likely to be produced?

    • Trinucleotide repeat mutation

    • Frameshift mutation

    • Missense mutation

    • Point mutation

    Correct Answer
    A. Trinucleotide repeat mutation
    Explanation
    This is fragile X syndrome, a condition in which there are 250 to 4000 tandem repeats of the trinucleotide sequence CGG. In general, the more repeats, the worse is the disease or the earlier the onset in conditions caused by trinucleotide repeats. The trinucleotides' are dynamic: be¬cause their size increases during oogenesis the male off¬spring have more severe disease compared with, for exam¬ple, their grandfathers. With a frameshift mutation, one, two, or three nucleotide base pairs are inserted or deleted. The protein transcribed is abnormal. A missense mutation results from a single nucleotide base substitution. Resultingin an abnormal protein being elaborated. Abnormalities of mitochondrial DNA are transmitted on the maternal side.

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  • 33. 

    PAIR stands for:­

    • Percutaneous angiography and imaging radiology

    • ) Per abdominal intense radiotherapy

    • Percutaneous aspiration, infusion and respiration

    • Percutaneous air infused radiography

    Correct Answer
    A. Percutaneous aspiration, infusion and respiration
    Explanation
    PAIR - Percutaneous aspiration of hydatid cyst, infusion of scolicidal drugs and then respiration is used as a minimally invasive procedure for treatment of hydatid cyst

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  • 34. 

    What will be the BMI of a male whose weight is 89 kg and height is 172 cm :       

    • 27

    • 30

    • 33

    • 36

    Correct Answer
    A. 30
    Explanation
    Body mass index = -----------------
    Height2 (m)

    89 kg
    = ------------------- = 30.07
    (1.72)2 M

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  • 35. 

    Which of the following leads to facial nerve palsy?  

    • Transverse fracture of temporal bone

    • Longitudinal fracture of temporal bone

    • Flat part fracture of temporal bone

    • Always associated with CSF leak

    Correct Answer
    A. Transverse fracture of temporal bone
    Explanation
    • Transverse
    • Longitudinal
    • Mixed
    Facial palsy is seen more often in transverse fracture. CSF leak is more commonly associated with longitudinal fracture.

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  • 36. 

    Eighty-five percent of aggressive lymphomas exhibit which cell type?

    • Follicular small cleaved cell lymphoma

    • Diffuse small lymphocytic lymphoma

    • Diffuse large cell lymphoma

    • Adult T -cell leukemia-lymphoma

    Correct Answer
    A. Diffuse large cell lymphoma
    Explanation
    In non-Hodgkin's lymphoma, the primary determinant of prognosis remains the grade of the tumor. High-grade lymphomas remain potentially curable; low-grade lymphomas are not curable, but they may have a much more indolent clinical course.

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  • 37. 

    Baby born at term develops abdominal distention in the fist week of life. Meconium ileus is diagnosed. Subsequently the infant has persistent steatorrhea and fails to develop normally. Which of the following laboratory test findings is most likely related to the infant’s underlying disease:

    • Decreased serum thyroxine level

    • Positive HIV serology

    • Elevated sweat chloride

    • Increased urine homovanillic acid level

    Correct Answer
    A. Elevated sweat chloride
    Explanation
    The findings are typical for cystic fibrosis, which is an inherited defect in chloride transport. Cretinism from hypothyroidism results in impaired CNS and skeletal devel¬opment. A baby with congenital HIV infection may have a variety of infections. The increased urine homovanillic acid is a failure of neuroblastoma. a mass lesion that could also cause bowel obstruction but not meconium ileus. Neonatal jaundice has a variety of causes including the inherited disorder called galactosemia.

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  • 38. 

    It has been noted that infants placed on extremely low-fat diets for a variety of reasons often develop skin problem and other symptoms. This is most often due to which of the following?

    • Lactose intolerance

    • Glycogen storage diseases

    • Antibody abnormalities

    • Deficiency of fatty acid desaturase greater than 9

    Correct Answer
    A. Deficiency of fatty acid desaturase greater than 9
    Explanation
    Infants placed on chronic low-fat formula diets often develop skin problems, impaired lipid transport, and eventually poor growth. This can be overcome by including linoleic acid to make up 1 to 2 % of the total caloric requirement. Essential fatty acids are required because humans have only 4 5 6 and 9 fatty acid desaturase. Only plants have desaturase greater than 9. Consequently, certain fatty acids such as arachidonic acid cannot be made "from scratch" (de novo) in humans and other mammals. However, linoleic acid, which plants make, can be converted to arachidonic acid. Arachidonate and eicosapentaenoate are 20-carbon prostanoic acids that are the starting point of the synthesis of prostaglandins, thromboxanes, and leukotrienes

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  • 39. 

    International prognostic index” for lymphoma includes the following prognostic factors except:

    • (A). Age of patient and performance status

    • (B). Number of extranodal sites involved

    • (C). Albumin and Hemoglobin levels

    • (D). Serum LDH levels

    Correct Answer
    A. (C). Albumin and Hemoglobin levels
    Explanation
    International Prognostic Index for NHL

    Five clinical risk factors:
    Age ≥60 years
    Serum lactate dehydrogenase levels elevated
    Performance status ≥2 (ECOG) or ≤70 (Karnofsky)
    Ann Arbor stage III or IV
    >1 site of extranodal involvement
    Patients are assigned a number for each risk factor they have
    Patients are grouped differently based upon the type of lymphoma
    For diffuse large B cell lymphoma:
    0, 1 factor = low risk: 35% of cases; 5-year survival, 73%
    2 factors = low-intermediate risk: 27% of cases; 5-year survival, 51%
    3 factors = high-intermediate risk: 22% of cases; 5-year survival, 43%
    4, 5 factors = high risk: 16% of cases; 5-year survival, 26%
    For diffuse large B cell lymphoma treated with R-CHOP:
    0 factor = very good: 10% of cases; 5-year survival, 94%
    1, 2 factors = good: 45% of cases; 5-year survival, 79%
    3, 4, 5 factors = poor: 45% of cases; 5-year survival, 55%

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  • 40. 

    A 45-year-old alcoholic man with a history of blackouts when intoxicated presents with fever, chills, and cough productive of putrid, foul-smelling sputum. On physical examination the patient appears inebriated. He is febrile with a temperature of

    • Spontaneous pneumothorax

    • Bronchogenic carcinoma

    • Lung abscess

    • Pleural effusion

    Correct Answer
    A. Lung abscess
    Explanation
    The answer is c. (Fauci, 14/e, pp 1437.1440.) The signs and symptoms of lung abscess
    include a history of loss of consciousness due to seizure, alcoholism, or illicit drug use. Patients
    complain of several days or weeks of malaise and fever while t

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  • 41. 

    A newborn is suffering from CHF, not improving on treatment. He has a bulging anterior fontanelle with a bruit heard on auscultation. On trans fontanelle USG, a hypoechoic midline mass is seen with dilated lateral ventricles. Most probable diagnosis is?

    • Arachnoid cyst

    • Vein of Galen malformation

    • Medulloblastoma

    • Encephalocele

    Correct Answer
    A. Vein of Galen malformation
    Explanation
    Two internal cerebral veins join to form vein of Galen which receives tributaries from the superior surface of cerebellum, quadrigeminal area and the pineal bodies.
    The vein of Galen malformation is the most common A V malformation in neonates. It causes high output cardiac failure, developmental delay and seizures.
    It is present in posterior fossa and on USG, appears as a hypoechoic lesion.

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  • 42. 

    Treatment of choice for stab injury caecum

    • Caecostomy

    • Ileo-transverse anastomosis

    • Transverse colostomy

    • Sigmoid colostomy

    Correct Answer
    A. Ileo-transverse anastomosis
    Explanation
    Ileo-transverse anastomosis is the treatment of choice for stab injury to the caecum. This procedure involves connecting the ileum, the last part of the small intestine, to the transverse colon, which is part of the large intestine. This allows for the continuity of the digestive tract and maintains normal bowel function. Caecostomy, transverse colostomy, and sigmoid colostomy are not the preferred treatments for stab injury to the caecum.

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  • 43. 

    Patient sustains a knife wound through the right fouth intercostals space, 7 cm to the right of the sternum. The area most likely penetrated by the knife is the 

    • Right upper lobe of the lung

    • Right middle lobe of the lung

    • Right lower lobe of the lung

    • Right atrium of the heart

    Correct Answer
    A. Right middle lobe of the lung
    Explanation
    The right border of the heart is approximately 1 to 2 cm to the right of the right border of the sternum; therefore, the knife probably did not hit the heart. The middle lobe of the right lung extends from the level of the fourth costochondral junction to the level of the fifth intercostal space. The middle lobe is most likely at the level of the fourth intercostal space.

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  • 44. 

    Which type of collagen is most important is most important in wound healing

    • Type III

    • Type V

    • Type VII

    • Type XI

    Correct Answer
    A. Type III
    Explanation
    Type I collagen is the major component of extracellular matrix in skin. Type III, which is also normally present in skin, becomes more prominent and important during the repair process

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  • 45. 

    Anakinra is a?

    • TNF-Alpha neutralizing drug

    • Anti CD20 drug

    • Immuno suppressive drug

    • IL-1 receptor antagonist

    Correct Answer
    A. IL-1 receptor antagonist
    Explanation
    Anakinra is an interleukin-1 (IL-1) receptor antagonist. Anakinra blocks the biologic activity of naturally occurring IL-1, including inflammation and cartilage degradation associated withrheumatoid arthritis, by competitively inhibiting the binding of IL-1 to the Interleukin-1 type receptor, which is expressed in many tissues and organs. IL-1 is produced in response to inflammatory stimuli and mediates various physiologic responses, including inflammatory and immunologic reactions. IL-1 additionally stimulates bone resorption and induces tissue damage like cartilage degradation as a result of loss of proteoglycans. In patients with rheumatoid arthritis the natural IL-1 receptor antagonist is not found in effective concentrations in synovium and synovial fluid to counteract the elevated IL-1 concentrations in these patients.
    Anakinra is not considered a 'Disease-modifying antirheumatic drug' (DMARD) but rather a 'Biological Response Modifier' (BRM) because its able to selectively target the pathologic element of the disease.

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  • 46. 

    Ohngren's line is from?

    • Medial canthus to angle of mandible.

    • Medial canthus to alveolar process.

    • Lateral canthus to angle of mandible

    • Lateral canthus to alveolar process.

    Correct Answer
    A. Medial canthus to angle of mandible.
    Explanation
    • An imaginary plane is drawn extending between medial canthus of eye and the angle of mandible.
    • Growths situated above this plane (supra structural) have a poorer prognosis than those below it (infra structural).

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  • 47. 

    Most common cause of Lemierre’s disease? 

    • Staphylococcus aureus

    • Fusobacterium necrophorum

    • H. influenzae type B

    • Beta hemolytic streptococci

    Correct Answer
    A. Fusobacterium necrophorum
    Explanation
    Postanginal septicemia (Lemierre's disease) is a rare anaerobic oropharyngeal infection caused predominantly by Fusobacterium necrophorum. The illness typically starts as a sore throat (most commonly in adolescents and young adults), which may present as exudative tonsillitis or peritonsillar abscess. Infection of the deep pharyngeal tissue allows organisms to drain into the lateral pharyngeal space, which contains the carotid artery and internal jugular vein. Septic thrombophlebitis of the internal jugular vein can result, with associated pain, dysphagia, and neck swelling and stiffness. Sepsis usually occurs 3–10 days after the onset of sore throat and is often coupled with metastatic infection to the lung and other distant sites. Occasionally, the infection can extend along the carotid sheath and into the posterior mediastinum, resulting in mediastinitis, or it can erode into the carotid artery, with the early sign of repeated small bleeds into the mouth. The mortality rate from these invasive infections can be as high as 50%. Treatment consists of IV antibiotics (penicillin G or clindamycin) and surgical drainage of any purulent collections. The concomitant use of anticoagulants to prevent embolization remains controversial but is often advised.

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  • 48. 

    Gram negative rod is isolated from th sputum of a 22-year old woman who is hospitalized with cystic fibrosis. Laboratory test show that the bacterium is an aerobic non fermenter that is highly resistant to numerous antibiotics. The organism is most likely 

    • Escherichia coli

    • Klebsiella pneumoniae

    • Mycoplasma

    • Pseudomonas aeruginosa

    Correct Answer
    A. Pseudomonas aeruginosa
    Explanation
    Pseudomonas aeruginosa is an aerobic, gram-negative rod that does not ferment glucose or any other sugar; thus, it is known as a "nonfermenter." The organisms colonize within the respiratory tract of patients with cystic fibrosis and other chronic respiratory tract dis¬eases. Respiratory diseases caused by the organisms range from relatively benign tracheobronchitis to se¬vere necrotizing bronchopneumonia.
    P. aeruginosa is a ubiquitous, opportunistic patho¬gen. In addition to its involvement in the respiratory tract, it is associated with other nosocomial infections. In debilitated individuals, it can cause bacteremia, particularly in patients with diabetes, extensive burns, hematologic malignancies, or neutropenia; endocardi¬tis; and urinary tract infections. Ear infections caused by the organisms include external otitis ("swimmer's ear") and malignant external otitis.
    P. aeruginosa is hardy and can grow in environments that are often hostile to other bacteria. It has few nutritional requirements and survives extremes of temperature. In hospotals it can often be isolated from respiratory therapy equipment, sinks, water, bed pans, and floors.
    Escherichia coli and Klebsiella pneumoniac ferment glucose, and Mycoplasma pneumoniae and Mycobacte¬rium species are not gram-negative rods.

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  • 49. 

    CAP in Lac operon is an example of .

    • Positive regvulator

    • Negative regulator

    • Constitutive expression

    • Attenuation.

    Correct Answer
    A. Positive regvulator
    Explanation
    Review:Biochemistry

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  • Aug 31, 2023
    Quiz Edited by
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  • Nov 16, 2013
    Quiz Created by
    Fmgs India

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