nimset 2014 questions

NIZAM’S INSTITUTE OF MEDICAL SCIENCES Punjagutta, Hyderabad – 500 082, A.P., India.

Set: A

NIMSET2014

Question Booklet

Entrance Examination for Admission to

Post Graduate courses (MD/MS)

16 February 2014 Marks 150 Time: 2 hrs:30 min

Please verify whether the number printed on this question booklet

corresponds to your hall-ticket number

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Select the one that is most appropriate and darken the corresponding

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Q1. The following disorder/ disorders come under somatoform autonomic dysfunction.

1) Cardiac neurosis 2) Bulimia nervosa 3) Irritable bowel syndrome 4) Mania

A) Only 1, 2 and 3 are correct

B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct

Q2. The type of surgical knot shown in the picture is

A) Reef knot B) Granny knot C) Surgeon's knot D) Half-hitch knot Q3. Which of the following plain radiographic feature is not true about malignant solitary pulmonary nodule?

A) Size > 4 cm favours the diagnosis B) Growth doubles in about 6 months C) Calcification rules out malignant mass D) Rounded appearance is not always suggestive of malignancy

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Q4. A 13 year old girl is brought to Emergency department with complaints of colicky pain of lower abdomen and retention of urine since few hours. The attendants give history of similar pain one month ago, which subsided spontaneously after 2 days. Examination shows a girl of average height and weight with well developed secondary sexual characters. Per abdominal examination, shows a supra pubic swelling and local examination of external genitalia shows a bluish membrane bulging through the introitus. The most probable diagnosis is

A) Torsion of ovarian cyst B) Appendicular abcess C) Loculated ascites D) Imperforate hymen Q5. Shown below is a schematic presentation of post-mortem changes represented by curve numbers (1, 2, 3)

Which one of the following represents the correct depiction of curves 1, 2 and 3 respectively

A) Decomposition, body temperature, rigor mortis B) Rigor mortis, body temperature, decomposition C) Body temperature, rigor mortis, decomposition D) Rigor mortis, decomposition, body temperature Q6. A patient's serological report reveals HBsAg positive, HBeAg Negative, Anti HBe

positive, anti HBcIgM negative, HBV DNA quantitative 19,00,000 IU/ml. The diagnosis based on serology is

A) Chronic HBsAg carrier wild type B) Chronic HBsAg carrier with acute exacerbation C) Chronic HBsAg carrier with pre core mutation D) HBV related acute viral hepatitis

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Q7. True statement/statements regarding nerve recovery in a peripheral nerve injury

1. Sunderland third and fourth degree injuries have less predictable recovery than first degree 2. Failure of Tinel's sign to advance suggests a fourth or fifth degree injury and the need for early exploration 3. Denervation potentials by the third week in Electromyography (EMG) excludes neurapraxia 4. In neurapraxia, Tinel's sign is positive

A) Only 1, 2 and 3 are correct B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct Q8. The site/ sites affected in Ludwig's angina

1. Site 1 2. Site 2 3. Site 3 4. Site 4



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Q9. Regarding 'Anemia of chronic disease',which of the following statements is/are true? 1. Impaired iron utilization occurs 2. Associated with reduction of proliferation of erythroid precursors

3. RBCs may be normocytic, normochromic or microcytic hypochromic 4. Characterised by decreased iron stores in tissue macrophages

A) Only 1, 2 and 3 are correct B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct Q10. Example/examples of liquefactive necrosis include

1. Caseation in tuberculosis 2. Pyogenic abscess 3. Myocardial infarct 4. Hypoxic death of cells in CNS

A) Only 1, 2 and 3 are correct B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct Q11. Antifungal agent used as first line treatment of invasive Aspergillosis: A) Fluconazole B) Voriconazole C) Caspofungin D) Itraconazole Q12. A 23 year old woman experienced watery diarrhea , nausea ,vomiting and

abdominal cramps 6 hours after eating in a local restaurant. The most likely organism causing her disease is?

A) Vibrio cholera B) Yersinia entercolitica C) Staphylococcus aureus D) Clostridium difficile

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Q13. Oral pulmonary vasodilators is/are 1) Bosentan 2) Teprostinil 3) Sildenafil 4) Enalapril

A) Only 1, 2 and 3 are correct B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct Q14. A 42 year old gentleman sustained injuries to right shoulder and was diagnosed as

posterior dislocation of shoulder. Which one of the following abnormalities is usually seen

A) Arm is kept in abducted posture B) Fixed medial rotation of the arm C) Shortening of the arm D) Absent radial pulse Q15. Dosulepin belongs to which of the following group of Anti-Depressant drugs. A) Selective serotonin receptor inhibitors B) Mono amine oxidase inhibitors C) Tricyclic antidepressants D) Selective norepinephrine reuptake inhibitors Q16. A 36 year old man presents to the Emergency department after a hit by a two

wheeler to his right leg. He complains of severe pain in his right leg and on examination he is not able to actively dorsiflex and evert the foot, but is able to do plantar flexion. The nerve most likely to be injured is

A) Anterior Tibial Nerve.

B) Posterior Tibial Nerve C) Common Peroneal nerve D) Sciatic nerve

Q17. Which of the following developmental milestones is not normally attained by the

age of 10 months? A) Stable head control

B) Making a tower of 6 cubes C) Sitting without support D) Rolling over

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Q18. Regarding propofol pharmacokinetics compared to thiopentone, in brief procedures

Assertion: Recovery from propofol anaesthesia takes longer than thiopentone Reason: Propofol has a shorter context sensitive half time

A) Both Assertion and Reason are true, and Reason is the correct

explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct

explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

Q19. Patients with C5 to C9 complement deficiencies are most likely susceptible to

which of the following infections?

1. Pneumococcal infection 2. AIDS 3. Histoplasmosis 4. Meningococcal infection

A) Only 1, 2 and 3 are correct B) Only 1 and 3 are correct

C) Only 2 and 4 are correct D) Only 4 is correct Q20. One of the best known large prospective studies which has played a major role in

establishing the nature of coronary heart disease (CHD) risk factors and their relative importance is

A) Framingham study B) The Stanford three community study C) The North Kerelia project. D) MRFIT Q21. Regarding phonasthenia,

Assertion: On indirect laryngoscopy, vocal cords lie in cadaveric position Reason: Easy fatiguability of thyroarytenoids and interarytenoids is present

A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

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Q22. After acute blood loss resulting in hemodilution and lowering of hematocrit,

Assertion: There is leucocytosis Reason: There is compensatory release of adrenergic hormones which mobilizes

granulocytes from the intravascular marginal pool



C) Assertion is true but Reason is false D) Assertion is false, but Reason is true

Q23. Shown below is a graphical representation of adaptation of different receptors. The

receptors 1, 2, 3 respectively are

A) Hair, muscle spindle, joint B) Muscle spindle, joint, hair C) Muscle spindle, hair, joint D) Joint, muscle spindle, hair

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Q24. Treatment options for patients with Staghorn calculi include

1. Percutaneous Nephrolithotripsy 2. Retrograde intrarenal surgery 3. Extracorporeal shockwave lithotripsy 4. Anatropic Nephrolithotomy


B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct Q25. A 15-year old boy presented with history of fever, loose motions. His renal

parameters were found to be deranged. The blood picture revealed anemia and thrombocytopenia. The peripheral smear picture is depicted below. The likely diagnosis would be

A) Henoch Schonlein purpura B) Hereditary spherocytosis C) Idiopathic thrombocytopenic purpura D) Hemolytic uremic syndrome Q26. Which of the following drug/drugs act by inhibiting the formation of microtubular

protein

1. Vincristine 2. Colchicine 3. Vinblastine 4. Paclitaxel



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Q27. Regarding management of papillary thyroid cancer,

Assertion: Total thyroidectomy is preferred over hemithyroidectomy. Reason: Multiple foci may be present in both lobes.

A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion.

B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion.

C) Assertion is true, but Reason is false. D) Assertion is false, but Reason is true.

Q28. On day 28 of the menstrual cycle in a 25 year old female, there is menstrual

bleeding that lasts for a few days. She has had these regular cycles for many years. Which of the following processes is most likely happening in the endometrium just before the onset of bleeding?

A) Apoptosis

B) Liquefactive necrosis C) Coagulative necrosis D) Increased mitosis Q29. The surgical instrument shown in the picture is a general purpose retractor used for

holding open wounds, such as in an open appendicectomy. It is named after:

A) De Bakey B) Daever

C) Langenbeck D) Morris Q30. The need for vitamin B12 and folic acid in the formation of red blood cells is primarily

for their effects on A) Synthesis and release of erythropoietin from the kidney B) Absorption of iron from the gut C) DNA synthesis in the bone marrow D) Hemoglobin formation in the red blood cell

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Q31. A 21-year old female, presented with a right-sided ovarian mass. On gross

examination, the mass was a unilocular cyst measuring 7X5X3 cm. It contained hair and cheesy, sebaceous material. The histopathology revealed

A) Serous cystadenoma B) Mature cystic teratoma C) Brenner tumour D) Dysgerminoma Q32. Regarding laboratory monitoring of coagulation in patients receiving low-molecular

weight heparins (LMWH)

Assertion: Coagulation monitoring is unnecessary in most patients Reason: LMWH have better bioavailability and longer half-life




Q33. True statement/statements regarding Macula lutea

1) Area of retina rich in cones. 2) Central 1.5mm of macula is called foveola 3) It lies 2 disc diameters temporal to optic disc 4) It corresponds to the area where optic nerve fibres exit the globe

A) Only 1, 2 and 3 are correct B) Only 1and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct

Q34. MELD Score for predicting prognosis of patient with liver disease includes which

of the following parameter A) Serum creatinine

B) Serum Albumin C) ALT Level D) Hepatic Encephalopathy

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Q35. The axillary lymph nodes described surgically as level 2 are located

A) Behind the pectoralis minor muscle B) Between pectoralis major and minor muscles C) At the upper border of pectoralis minor muscle D) Below the lower border of pectoralis minor muscle Q36. The classic triad of hemobilia is A) Malena, pain abdomen, fever B) Upper gastrointestinal bleed, jaundice and fever C) Pain abdomen, upper gastrointestinal bleed, jaundice D) Fever, jaundice, pain abdomen Q37. Consolidation of which lobe of the lung silhouettes the right heart border

A) Right upper lobe B) Right middle lobe C) Lingular lobe D) Right lower lobe Q38. Regarding the early (blastomere stage) embryonic cell divisions

Assertion: The size of the early embryo remains unchanged after each cleavage division

Reason: The blastomere size decreases with each successive division




Q39. Which of the following statements is/are true regarding Hemophilia A?

1. Patients typically have a prolonged PT & APTT 2. Caused by mutations in factor VIII 3 .Presents with easy bruising and hemorrhage; petechiae are characteristically seen 4. Inherited as an X-linked recessive trait affecting mainly males and homozygous

females A) Only 1, 2 and 3 are correct B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct

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Q40. The bone lesions in the radiographs shown below, respectively, are

A) Unicameral Bone Cyst, Aneurysmal Bone Cyst and Osteochondroma B) Aneuysmal Bone Cyst, Unicameral Bone Cyst and Osteochondroma C) Unicameral Bone Cyst, Aneurysmal Bone Cyst and Osteoclastoma D) Aneuysmal Bone Cyst, Unicameral Bone Cyst and Osteoclastoma Q41. In a village of 3000 people, 150 suffered from viral encephalitis in one year. The

number of deaths in that one year in that region was 60 in which 15 were due to viral encephalitis. The proportional mortality rate due to viral encephalitis is

A) 40%

B) 10% C) 5% D) 25%

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Q42. A 35 year old patient who was recently diagnosed to have retroviral disease with a

CD4 count of 150 cells/cu.mm and started on HAART, came with the complaints of fever, cough with scanty amounts of whitish sputum and a sharp retrosternal chest pain on deep inspiration. Chest Xray was normal, ABG showed a PaO2 of 60 mmHg and serum showed raised lactate dehydrogenase. The treatment regimen should include

1. Trimethoprim/sulphamethoxazole 2. Aerosolized pentamidine 3. Corticosteroids 4. Leucovorin

A) Only 1, 2 and 3 are correct B) Only 1and 3 are correct

C) Only 2 and 4 are correct D) Only 4 is correct Q43. True statement/statements regarding neurocardiogenic syncope

1. More common in young females 2. Incontinence may occur during syncope 3. Prolonged fatigue is common after the event 4. Short duration of premonitory symptoms <5 seconds is common

A) Only 1, 2 and 3 are correct B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct Q44. Regarding antibiotic therapy for infections due to Staphylococcus aureus

1. The antibiotics of choice for penicillin resistant isolates are penicillinase resistant penicillins.

2. Daptomycin is indicated for the treatment of respiratory tract infections due to Staphylococcus aureus.

3. Vancomycin is the drug of choice for the treatment of MRSA infections. 4. Vancomycin is more effective than β-lactams against methicillin sensitive

isolates of Staphylococcus aureus. A) Only 1, 2 and 3 are correct. B) Only 1and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct

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Q45. Given below is a schematic representation of radiographic appearance of an ankle

injury sustained while playing soccer.

The type of injury most likely to be associated with the findings

A) Vertical compression injury B) Adduction injury C) Abduction injury D) Dorsiflexion injury

Q46. True statement/statements regarding "hostile witness"

1. Is declared hostile based on the suggestion of the lawyer who has summoned the witness

2. Perjury by hostile witness is not punishable 3. Can be cross examined by the same side lawyer 4. Oath need not be taken

A) Only 1, 2 and 3 are correct B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct Q47. A young male presents with severe pain in the thigh that is worse at night and

relieved by salicylates. The radiograph of femur shows a small focal lucent lesion with surrounding sclerosis. The most likely diagnosis is

A) Osteosarcoma B) Aneurysmal bone cyst C) Osteoid osteoma D) Fibrous dysplasia

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Q48. With regard to Myelodysplastic Syndromes (MDS), which of the following statements is not true

A) Belong to a group of clonal stem cell disorders B) Low risk of transformation to AML C) Hypercellular marrow at diagnosis

D) Characterised by varying degrees of dyspoiesis in erythroid, myeloid and megakaryocytic lineages

Q49. Regarding, Parkinson’s disease,

Assertion: Cog wheel rigidity is characterised by a series of brief relaxations or "catches" as the extremity is passively moved

Reason: There is difficulty in initiating movement




Q50. An example for an atavistic type of epiphysis is A) Trochanters of femur B) Metacarpals C) Ends of long bones as fibula and tibia D) Coracoid process of scapula Q51. A six years old boy complains of pain in the right hip of 6 months duration, causing

him to limp while walking. He has restricted abduction and internal rotation of right hip. Most likely diagnosis is

A) Tuberculosis of hip B) Old posterior dislocation of hip C) Perthes' disease D) Slipped capital femoral epiphysis Q52. A patient on Amitryptiline for depression developed constipation after 3 weeks.

This side effect is classified as A) Hypersensitivity effect B) Toxic effect C) Collateral effect D) Steven Johnsons syndrome

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Q53. True statement/ statements regarding the three drugs X, Y and Z depicted in the

figure below

1) Maximal efficacy of drug Y is more than that of drug Z 2) Potency of drug X is more than that of drug Z 3) Potency of drug Z is more than that of drug X 4) Both drug Z and drug X have the same efficacies


B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct Q54. Lesion/lesions related to a malignant process

1. Actinic keratosis 2. Keratoacanthoma 3. Lentigo maligna 4. Seborrheic keratosis

A) Only 1, 2, and 3 are correct B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct

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Q55. Regarding perioperative prophylaxis for short class II (National Research

classification of operative wounds and rate rates of wound infection) surgeries less than 2 hrs,

Assertion: Only a single dose of antibiotic is required Reason: There is no evidence that administration of postoperative doses of

antimicrobials provides additional benefit




Q56. A female child aged 5 years was brought after ingestion of a button battery of a toy. Radiograph revealed that the foreign body was located in the stomach and was measuring less than 2 cm. The child was asymptomatic. The most appropriate next step in the management is

A) Laporoscopic surgery B) Urgent endoscopic removal C) Wait for symptoms of obstruction and then intervene D) Open surgical removal Q57. A person commits any crime under post hypnotic trance

Assertion: He is held responsible for his criminal act Reason: One can not be hypnotised against his will


explanation for the Assertion B) Both Assertion and Reason are true, and Reason is not the correct

explanation for the Assertion C) Assertion is true but Reason is false D) Assertion is false but Reason is true

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Q58. Regarding the presentation depicted in the figure below

Assertion: There is no mechanism for normal delivery Reason: Fundal height is less than expected for the period of gestation




Q59. A 50 year old chronic alcoholic came with features of confusion, ataxia, nystagmus

and external ophthalmoparesis. The biochemical test which can prove the diagnosis is

A) Serum methylmalonate level B) Serum VitB12 level C) RBC folate level D) RBC transketolase level Q60. Massive transfusion in previous healthy adult male can cause hemorrhage due to

A) Increased tPA B) Dilutional thrombocytopenia C) Vitamin K deficiency D) Decreased fibrinogen

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Q61. A person brought by police under Narcotic Drugs and Psychotropic Substances Act, is found to be having jet black tongue and teeth. It is suggestive of person being habitual user of

A) Heroin B) Tobacco C) Cocaine D) Arsenic Q62. Which of the following is not a radiographic feature of osteo arthritis? A) Diminution of joint space. B) Sub chondral cysts C) Osteophyte formation D) Diffuse rarefaction. Q63. Figures 1, 2 and 3 shown below schematically represent different types of

signalling mechanisms in cell growth.

Which one of the following correctly represents the autocrine, paracrine and endocrine signaling mechanisms respectively

A) Figure 3, figure 1, and figure 2 B) Figure 3, figure 2, and figure 1 C) Figure 1, figure 2, and figure 3 D) Figure 2, figure 3, and figure 1

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Q64. What is the abnormality seen in the following karyotype?

A) Down syndrome B) Turner syndrome C) Fragile X syndrome D) Klinefelter syndrome Q65. Regarding Hangman's fracture:

Assertion: It is a traumatic spondylolisthesis of C2/3 resulting from bilateral C2

pedicle fractures Reason: It is a flexion injury

A) Both Assertion and Reason are true and Reason is the correct

explanation for Assertion B) Both Assertion and Reason are true and Reason is not the correct

explanation for Assertion C) Assertion is true but Reason is false D) Assertion is false but Reason is true

Q66. The time of appearance of which of the following centre of ossification roughly

coincides with viability of foetus A) Calcaneus B) Clavicle C) Maxilla D) Talus

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Q67. A patient aged 30 years presented to emergency department after experiencing

syncopal attack. He had several such episodes in the past several years, but he never sought medical evaluation for them. Family history revealed that his elder brother died suddenly with ventricular tachycardia at the age of 35 years. The ECG pattern in V1,V2 and V3 is shown below.

The most likely diagnosis is

A) Wolff-Parkinson-White syndrome B) Torsades-de pointes C) Brugada syndrome D) Apical myocardial aneurysm

Q68. Serotyping of Pneumococci may be carried out by

A) Elseck's test B) Nagler reaction C) Quellung reaction D) Sereny test

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Q69. Show below is a single-breath nitrogen washout curve with changes in nitrogen concentration of expired gas during expiration. The point at which airways in the dependent regions of the lung start closing is

A) Point 1 B) Point 2 C) Point 3 D) Point 4

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Q70. Shown below is the histology of small intestine depicting the crypts of Lieberkuhn. The cells 1, 2 and 3 labeled in the figure are represented correctly by which one of the following sequences

A) Progenitor, goblet, absorptive B) Absorptive, goblet, progenitor C) Progenitor, absorptive, goblet D) Goblet, progenitor, absorptive Q71. Shown below is the schematic representation of section through one of the turns of cochlea. Sound vibrations from foot plate of stapes at the oval window enter which part indicated by numbers

A) Part 1 B) Part 2 C) Part 3 D) Part 4

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Q72. Which of the following statements is/are true regarding T cell dependent antigens

1. Directly stimulate antibody production by B cells 2. Do not stimulate cytokines 3. Do not bind to the surface Ig on B cells 4. Requires a co-stimulatory signal to activate B cells

A) Only 1, 2 and 3 are correct B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct Q73. A six day old neonate is brought to the paediatrician with complaints of vaginal

bleeding .The ideal line of management is

A) Emergency MRI scan B) Serum prolactin levels assessment C) Examination under anaesthesia to know the cause of bleeding

D) Reassure the parents that no treatment is required and the bleeding will subside by itself.

Q74. Regarding infants born to diabetic mothers:

Assertion: Infants born to diabetic mothers are at an increased risk for developing neonatal hypoglycaemia.

Reason: Maternal hyperglycemia leads to reduced fetal insulin production.




Q75. Endotoxins produced by Gram negative bacteria are

1. Highly antigenic 2. Active only in very large doses 3. Actively secreted by cells and diffuse into surrounding 4. Toxicity is not completely neutralised by the homologous antibodies

A) Only 1, 2 and 3 are correct B) Only 1 and 3 are correct C) Only 2 and 4 are correct D) Only 4 is correct

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Q76. Regarding polio vaccination:

Assertion: IPV (inactivated polio vaccine) is safe in patients with immunodeficiency. Reason: IPV does not cause vaccine-associated paralytic poliomyelitis.

A) Both Assertion and Reason are true and Reason is the correct explanation for the Assertion.

B) Both Assertion and Reason are true but Reason is not the correct explanation for the Assertion.

C) Assertion is true but Reason is false. D) Assertion is false and Reason is true.

Q77. Which of the following statements regarding idiopathic focal segmental glomerulosclerosis is false?

A) Selective proteinuria B) Higher incidence of hematuria C) IgM and complement 3 deposits in sclerotic segment D) Does not respond to steroid therapy

Q78. Sister Joseph's nodule in gastric cancer is due to spread of cancer by:

A) Direct spread B) Lymphatic spread C) Transperitoneal spread D) Blood-borne spread

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Q. 79

. In the figure above the cells depicted in (A) are irreversibly converted to type (B). True statement/statements regarding this process 1. It is an adaptive process with the changed phenotype better able to withstand the stress 2. Associated with decrease in cell number and organ size 3. May predispose to malignant transformation 4. These changes are transmitted to the offspring


Q80. A 30 year old lady with myopia presented with complaints of transient flashes of

light in the nasal field of right eye over 15 days, followed by increasing numbers of 'floaters' -muscae volitantes and veil like appearance with loss of vision in right eye of 2 days duration. The most likely diagnosis is

A) Rhegmatogenous retinal detachment B) Acute uveitis C) Macular degeneration D) Keratoconus

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Q81. Shown below are the dose response curves for two drugs (drug 1 & drug 2)

Assertion: Compared to drug 1, drug 2 has narrow therapeutic ratio Reason: The curve for adverse effect is steeper for drug 2




Q82. The imaging investigation of choice for diagnosis of ectopic pregnancy is

A) Hysterosalpingography B) Computerised Tomography Scan C) Transvaginal sonography D) Plain X-Ray of pelvis

Q83. A farmer who had spent most of his 63 years on the land developed an ulcerated

pearly plaque on one nostril commonly called the rodent ulcer. He is most likely suffering from which of the following disease.

A) Seborrheic keratoses B) Solar keratoses C) Basal cell carcinoma D) Bowen's disease

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Q84. Regarding Factor V Leiden:

Assertion: Factor V Leiden increases the risk of venous thrombotic disease Reason: Factor V Leiden is resistant to inactivation by APC complex

A) Both Assertion and Reason are true and Reason is the correct explanation for Assertion

B) Both Assertion and Reason are true and Reason is not the correct explanation for Assertion


Q85. A woman with preterm premature rupture of membranes has reported at 32 weeks

of gestation. Her pulse, temperature and blood cell counts were within normal range. The most appropriate management strategy would be

A) Start induction B) Give antibiotics, steroids and observe C) Immediate caesarian section D) Start amnioinfusion

Q86. Menorrhagia not associated with any genital tract abnormalities and general or

endocrinological diseases is called

A) Cryptomenorrhea B) Oligomenorrhea C) Dysfunctional Uterine Bleeding D) Metrorrhagia

Q87. A 30 year old female presented with shortness of breath and hemoptysis. There is history of swelling of right leg 1month ago and the ECG shows a S1Q3T3 pattern. A chest radiograph shows a triangular, pleurally based opacity in the right mid zone with an ipsilateral effusion. Which investigation would be most helpful in clinching the diagnosis?

A) Ventilation-perfusion scan B) CT pulmonary angiogram C) Conventional pulmonary angiogram D) High resolution CT scan

Q88. Gold standard investigation for fistula in ano is:

A) Endo anal ultrasound B) MRI C) Fistulography D) Computerized tomography

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Q89. Regarding Sickle cell disease,

Assertion: Infants do not become symptomatic till they reach 5-6 months of age Reason: Infants tend to have high hemoglobin values


B) Both Assertion and Reason are true, and Reason is the not the correct explanation for assertion

C) Assertion is true but Reason is false D) Assertion is false but Reason is true

Q90. A patient developed posterior interosseous nerve paralysis following open reduction

and internal fixation (ORIF) with a dynamic compression plate (DCP) through dorsal (Thompson) approach of proximal 3rd shaft of radius fracture. On examination, the patient is most likely to have

1. Loss of extension at metacarpophalangeal (MCP) joints 2. Loss of wrist extension 3. Loss of thumb extension 4. Patchy sensory loss on the dorsum of hand around anatomical snuffbox


Q91. Which of the following is not a distention medium in Hysteroscopy?

A) Nitrous-Oxide B) Carbondioxide C) Saline D) Dextrose

Q92. Which one of the following structures contains the ovarian artery, vein and nerve

A) Round ligament B) Infundibulopelvic ligament C) Uterosacral ligament D) Cardinal ligament

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Q93. Erythropoietic porphyrias include/includes

1) Erythropoietic protoporphyria 2) Porphyria cutanea tarda 3) Congenital erythropoietic porphyria 4) Acute intermittent porphyria


Q94. The amino-acid sequence of alpha subunit of HCG (human chorionic gonadotropin)

is structurally similar to

1. FSH 2. LH 3. TSH 4. PRL


Q95. ASHA scheme is associated with

A) ICDS B) Rural health mission C) 20 points programme D) Minimum needs programme

Q96. A young lady presents with pink flat topped polygonal papules with whitish lace work pattern on its surface on the anterior aspect of her forearms and wrists. The most likely diagnosis is,

A) Psoriasis B) Urticaria C) Lichen planus D) Taenia cruris

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Q97. The articular surfaces of bones, forming a synovial joint are covered by hyaline cartilage in

A) Sterno-clavicular joint B) Acromio-clavicular joint C) Proximal tibio-fibular joint D) Tempero-mandibular joint

Q98. Regarding initial treatment of Wilson's disease presenting with neurological symptoms

Assertion: D-Pencillamine should be avoided Reason: It causes bone marrow suppression




Q99. Regarding Hereditary Spherocytosis

Assertion: The spherocytes disappear after splenectomy Reason: There are intrinsic defects in the red cell membrane making the cells less deformable and vulnerable to splenic sequesteration and destruction

A) Both Assertion and reason are true, and Reason is the correct

explanation for assertion B) Both Assertion and reason are true, and Reason is not the correct

explanation for assertion C) Assertion is true, Reason is false D) Assertion is false, but Reason is true

Q100. Which of the following is true regarding the layers of retina?

A) The internal limiting membrane seperates the inner nuclear layer from the inner plexiform layer

B) The nerve fibre layer comprises the axons of ganglion cells C) The outer plexiform layer consists of synapses between bipolar cells

and ganglion cells D) The retinal pigment epithelium is innermost layer of retina

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Q101. Regarding complications of blood transfusion, Assertion: Post transfusion purpura develops 5 to 10 days after transfusion. Reason: Antibodies in the donor's blood destroy the megakaryoctes in recipients' bone marrow.


explanation for Assertion B) Both Assertion and Reason are true and Reason is not the correct

explanation for Assertion C) Assertion is true but Reason is false. D) Assertion is false but Reason is true

Q102. Regarding frontalis sling procedure in congenital ptosis,

Assertion: It is contraindicated in the absence of Bell's phenomenon Reason: Bell's phenomenon is responsible for post-operative aesthetic look in ptosis patients


explanation for Assertion B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true

Q103. Lead affects which two enzymes in the porphyrin synthesis:

A) ALA dehydratase and uroporphyrinogen I synthase B) ALA dehydratase and Ferrochelatase C) ALA synthatase and ALA dehydratase D) ALA synthatase and Ferrochelatase

Q104.Following leutinising hormone(LH) surge, ovulation occurs in

A) 10-12 hours B) 12-24 hours C) 24-36 hours D) 36-48 hours

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Q105. In pedigree drawing what does this symbol indicate?

A) Siblings B) Monozygotic twins C) Dizygotic twins D) Consanguineous couple

Q106. The type of malignant melanoma which has the least metastatic potential is

A) Superficial spreading melanoma B) Nodular melanoma C) Lentigo malignant melanoma D) Acral lentigious melanoma

Q107. For a study a sample was built by initially dividing the population into age groups 21-30 yrs, 31-40 years, 41-50 years, 51-60 years, 61-70 years and above 70 years. From each group subjects were selected using a random number table. This sample is called:

A) Systematic random sample B) Stratified random sample C) Hemi random sample D) Simple random sample

Q108. Regarding Malaria

Assertion: Plasmodium Vivax malaria is characterized by long term relapses Reason: The latent erythrocytic stage lasts for several years

A) Both Assertion and Reason are true, and Reason is the correction explanation for the assertion

B) Both Assertion and Reason are true, and Reason is not the correction explanation for the assertion


Q109. Which one of the following represents the correct sequence of development of hair cycle

A) Anagen, catagen, telogen, early anagen B) Catagen, anagen, telogen, early anagen C) Telogen, catagen,early anagen, anagen D) Early anagen, telogen, catagen, anagen

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Q110. What will be the BMI of a male whose weight is 86.7 kg and height is 170 cm

A) 27 B) 30 C) 33 D) 36

Q111. Which one of the following features about warts is incorrect

A) Warts are cutaneous neoplasms caused by human papilloma virus (HPV) B) Filiform warts are typically seen on face, neck and skinfolds C) Topical therapy with liquid nitrogen, laser, keralolytics results in

cure D) Malignant transformation is rare

Q112. Corpora aranacea are calcareous deposits detectable in which of the following structures.

A) Pineal gland B) Anterior lobe of pituitary gland C) Hypothalamus D) Posterior lobe of pituitary gland

Q113. Regarding Hypermetropia,

Assertion : Latent divergent squint often develops in moderate hypermetropia Reason : Proper focusing of distant objects also need constant accommodation




Q114. Regarding mammography, Assertion: Sensitivity of this investigation decreases with age. Reason: The breast becomes less dense with age.




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Q115. Identify the disease in which patients accumulate phytanic acid.

A) Zellweger syndrome B) Refsum's disease C) Faber's disease D) Niemann-Pick disease

Q116. True statement/statements regarding nausea and vomiting associated with neuraxial block

1. Primarily related to gastrointestinal hyperperistalsis caused by unopposed parasympathetic activity. 2. Atropine is effective. 3. This hyperperistalsis is advantageous in providing excellent surgical conditions because of contracted gut. 4. Intramucosal pH is lower in epidural analgesia than with systemic analgesia.

A) Only1, 2 and 3 are correct. B) Only 1 and 3 are correct C) Only 2 and 4 are correct. D) Only 4 is correct

Q117. Regarding barbiturates

Assertion: They can lead to failure of effectiveness of oral contraceptive pills Reason: They are hepatic microsomal enzyme inducers




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Q118. A 15 year old girl came with complaints of paraesthesias of both lower limbs with mild memory disturbances of 1 year duration. Her peripheral smear showed the following abnormality

What is the possible diagnosis

A) Chronic myeloid leukemia B) Pernicious anemia C) Acute myeloid leukemia D) Bacterial infection

Q119. Which of the following is/are true about hereditary colorectal cancer?

1. The risk of colorectal cancer is 100% in patients with Familial Adenomatous Polyposis syndrome 2. Females with Hereditary Non Polyposis Colon Cancer Syndrome have a 30- 50% lifetime risk of developing endometrial cancer. 3. The mean age of diagnosis of colorectal cancer in Hereditary Non Polyposis Colon Cancer syndrome is around 44 years. 4. If there are no adenomas on colonoscopy by the age of 20 years, Familial Adenomatous Polyposis syndrome is unlikely.


Q120. A synthetic RNA having the sequence of CCCCCC… (Poly C) will give a protein having poly ______.

A) Alanine B) Phenyl alanine C) Glycine D) Proline

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Q121. Regarding incidence and prevalence

Assertion: Prevalence can increase even if incidence is constant Reason: Prevalence depends on both incidence and duration of illness

A) Both Assertion and Reason are true and Reason is the correct explanation for Assertion

B) Both Assertion and Reason are true and Reason is not the correct explanation for Assertion

C) Assertion is true but Reason is false D) Reason is true but Assertion is false

Q122. Inherited deficiency of Aldolase A and Pyruvate kinase causes

A) Essential fructosuria B) Galactosemia C) Hereditary fructose intolerance D) Hemolytic anemia

Q123. Side effect/effects of lithium therapy

1. Hypocalcemia 2. Neutrophilia 3. SIADH 4. Hypothyroidism


Q124. A person working as a driver for a long time drives automatically. This type of memory is classified as

A) Episodic memory B) Working memory C) Semantic memory D) Implicit memory

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Q125. Regarding sterilization and disinfection of surgical instruments

Assertion: Steam sterilization is preferred over chemical disinfection with a high level disinfectant (provided the instruments are heat stable). Reason: Steam Sterilization results in the complete elimination or destruction of all forms of microbial life including spores.


explanation for Assertion. B) Both Assertion and Reason are true and Reason is not the correct

explanation for Assertion C) Assertion is true but Reason is false D) Assertion is false but Reason is true

Q126. Which one of the following drugs is dopamine antagonist

A) Bromocriptine B) Esmolol C) Metoclopramide D) Clonidine

Q127. True statement/statements regarding treatment of metabolic alkalosis

1. Infusion of 0.9% saline will increase serum chloride and decrease serum bicarbonate. 2. Acetazolamide administration causes renal bicarbonate wasting. 3. Infusion of [H+] in the form of ammonium chloride or arginine hydrochloride. 4. Dialysis against a low-chloride and high-bicarbonate dialysate.

A) Only 1, 2 and 3 are correct. B) Only 1 and 3 are correct. C) Only 2 and 4 are correct. D) Only 4 is correct.

Q128. A 40 year old patient on routine examination showed microscopic hematuria. He neither had hypertension nor proteinuria. His serum electrolytes and GFR was normal. Ultrasound scan of abdomen was normal. On further examination of his relatives his son and his father had asymptomatic microscopic hematuria. The most likely diagnosis is

A) Henoch Schonlein purpura B) Alport syndrome with COL4A5 gene mutation C) Fibromuscular dysplasia of renal arteries D) Thin glomerular basement membrane (GBM) disease

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Q129. True statement/statements regarding histological structure of complete hydatidiform mole

1. Hydropic degeneration and swelling of villous stroma 2. Malformed fetus 3. Absence of blood vessels in the swollen villi 4. Hypertrophy of amniotic membrane


Q130. A patient presented with pneumonia and had a chest radiograph. This showed

absence of the clavicles, 13 pairs of ribs and a narrowed thorax. What is the underlying condition?

A) Stokes-Adams syndrome B) Sprengel's shoulder C) Kartagener's syndrome D) Cleidocranial dysostosis

Q131. To study "the value of a certain lung-function test recorded for men of the same

age group in a number of different occupational categories" the appropriate statistical method is

A) Regression analysis B) Univariate analysis C) Bivariate analysis D) Analysis of variance (ANOVA)

Q132. Regarding clinical feature of carcinoma of breast Assertion: Dimpling of skin over breast occurs Reason: Malignant cells in cancer breast tether the ligament of Cooper




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Q133. Which of the following tumors occurs predominantly in children and exclusively in the cerebellum?

A) Meningioma B) Primary CNS lymphoma C) Oligodendroglioma D) Medulloblastoma

Q134. Benign tumours of nasal cavity include/includes

1) Chondrodermatitis nodularis chronica helicis 2) Olfactory neuroblastoma 3) Squamous cell carcinoma 4) Ringertz tumour


Q135. Regarding Codman's triangle,

Assertion: It is seen in osteosarcoma Reason:It is formed by the tumor cells infiltrating into the periosteum




Q136. True statement/statements regarding the pathology of rhinoscleroma

1. Mikulicz cells and Russel bodies are diagnostic 2. Caused by gram positive bacillus 3. Starts in the nose and extends down the airway 4. Acute inflammatory disease


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Q137. Blisters seen in staphylococcal scalded skin syndrome are the expression of

A) Local production of exfoliative toxins B) Secondary infection with streptococci C) Toxin related distant disease D) A hypersensitive reaction to the drugs

Q138. The common malignancy associated with HIV infection is

A) Sqamous cell carcinoma B) Non Hodgkins lymphoma C) Renal cell carcinoma D) Osteosarcoma

Q139. As per the Bayes theorem, in a diagnostic test, the post test likelihood of the disease depends on which of the following characteristics

1. Sensitivity of the test 2. Frequency of the test being done 3. Specificity of the test 4. Serendipity


Q140. Which of the following receptor is deficient in familial hypercholesterolemia?

A) LDL (Apo B 100) receptor B) Class B scavenger receptor C) ATP-binding cassette transporter A1 D) VLDL receptor

Q141. Regarding the pathology of myocardial infarcts, 1) Left circumflex coronary artery is more commonly involved than the left anterior descending coronary artery 2) Dark mottling of the myocardium may first be noted at 4-12 hours after the infarct 3) A well-formed scar is noted within 1 week of infarct 4) It is possible to highlight the area of infarct with triphenyltetrazolium chloride


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Q142. The term "Aspermia" means:

A) No sperms in semen B) Low sperm count C) No semen D) No motile sperms

Q143. Which one of the following is not an ovarian cause of virilisation

A) Arrhenoblastoma B) Hilus cell tumour C) Polycystic ovary D) Postnatal adrenogenital syndrome

Q144. The appearance in the radiograph below is suggestive of

A) Scurvy B) Rickets C) Hemophilia D) Leukemia

Q145. A patient’s plasma osmolarity was 280mOsm/L, urine osmolarity was 140mOsm/L, with a urine flow rate of 2ml/min, then the free water clearance is

A) 3 ml/min B) -2ml/min C) 0.5ml/min D) 1ml/min

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Q146. Glasgow coma scale includes evaluation of which of the following

1. Eye opening 2. Motor response 3. Verbal response 4. Pupillary light reaction

A) Only 1, 2and 3 are correct B) Only 1and 3 are correct C) Only 2and 4 are correct D) Only 4 is correct

Q147. In the diagram of HIV cycle given below, the drugs acting at step 1, 2 and 3 respectively are

A) Enfuvirtide, Elvitegravir, Darunavir B) Darunavir, Elvitegravir, Enfuvirtide C) Elvitegravir, Enfuvirtide, Darunavir D) Darunavir, Enfuvirtide, Elvitegravir

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Q148. The following is/are used in the treatment of opioid dependence/ withdrawal.

1) Lofexidine 2) Clonidine 3) Naltrexone 4) Atenolol


Q149. A young adult female with severe acne had several episodes of chest wall

clavicular pain and inflammatory joint symptoms. She also had X-ray evidence of osteosclerosis of several vertebrae and clavicles. What other skin rash is she at high risk of?

A) Erythema nodosum B) Heliotrope rash C) Palmoplantar pustulosis D) Psoriasis

Q150. "Pulse polio vaccination" program is an example of which one of the following preventive strategies

A) Primary prevention B) Primordial prevention C) Secondary prevention D) Tertiary prevention

nimset 2014 questions

Education

correct c

correct b

decomposition d rigor

rigor mortis b rigor

hbsag positive

body temperature q6

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