AIPGMEE QUERIES

RESPIRATORY MEDICINE NEPHROLOGY PATHOLOGY FMT GUT SURGERY PEDIATRIC SURGERY GENERAL SURGERY PHARMACOLOGY ENT PEDIATRICS MICROBIOLOGY PHARMACOLOGY PSYCHIATRY BIOCHEMISTRY

RESPIRATORY MEDICINE
1. A Lady come with complain of hemoptysis. CxR normal. Next best Investigation Bronchoscopy or HRCT Can u explain protocol? In somebooks bronchoscopy given and in some HRCT. According to harrison flowchart, i think it shd be bronchoscopy but i'm confused. 2. Ca lung metastasite most commonly to Brain / Liver / Adrenal / Bone Diff answer in all books but i found adrenal >50% in robbins, but some books says liver/brain. 3. Pancoast tumor is AdenoCa / Squmous Ca 4. Type 1 Respiratory Failure Normal PCOo2 & less PO2 Decreased PCO2 & less PO2 5. Sequestration of lung best diagnosed by CT scan / Angiography What to mark is best asked and wht if definitive

NEPHROLOGY
1. 60 yr old DM & HT male patient with secondary prostatism admitted for prostetectomy developed MI. Now Treatment -Finasteride -Terazocin

-Both 2. CNS manifestation in CRF caused by all except hypocalcemia hyponatremia Hyperosmolality Acidosis 3. Macroproteinuria <350 <400 <500 <350 >500 4. Kidney normally doesnt allows transglomerular passage of B2 microglobulin lysozyme Ig Microglobulin 5. Most specific marker of renal function Cr. Clearance Inulin clearance S.Creatitinine Blood Urea 6. Most Rapid onset of action in t/t of hyperkalemia Insulin + Glucose IV Ca gluconate Hemodialysis Resin Similar question For lifethreatening hyperkalemia, Most Rapid onset of action in t/t of hyperkalemia?

PATHOLOGY
1. How many bands can we find In SCA homozygous & how many in normal individual? 2/1? I'm confused as HbA2 in normaland HbF in SCA homozygous are lower, then will it show in bands or only one band?

2. 21yr old female presents with anemia and mild hepatospleenomegaly. Hb 5gm% H/O single blood transfusion till now. Diagnosis Thalesemia intermedia or AIHA 3. Lab diagnosis for chronic myeloproliferative disorder all except Chromosomal evaluation B.M. aspiration Flow cytometry Determination of RCM 4. Most common cause of post transfusion hepatitis HBV / HCV 5. Serum Ferritin decreased in all except IDA Vit C deficiency Liver Disease Hypothyroidism 6. Case was given with feaure of ET. Features of CNS involvement [thrombosis] were given. Drug of choice hydroxyurea anagrelide IFN alpha Radioactive PO4 7. Cross matching necessary in all except Cryoprecipitate/SDAP Different books have given different answer with valid references. ??? 8. DNA analysis by all except Lymphocyte Fibroblast Monocyte Amniocyte 9. Chromosomal study best to use following nucleated cell Lymphocyte Polymorphs Fibroblasts Epithelial cell 10. All are chromosomal anomalies except Hemophilia Hypoplastic left heary syndrome

1. 9 month old Sindhi boy with c/o lethargy, severe pallor since 6 months. Hb 3.8, mcv 58fl mch 19.4pg. Osmotic fragility normal. Target cells & normoblasts. Xray shows expansion of bonemarrow. Likely diagnosis IDA / Hb D disease

Thus question was asked in weekly test & answer was Hb D disease & in all mcq books answer is IDA with explaination that Hb D disease won't cause severe anemia. Can u explain what to write plz?

2. 3 yr old child with ALL. Hyperdiploidy , preB type. WBC count 12,000. Radiological evaluation shows only mediastinal mass. Which of following will be most likely of concern treating oncologist Child's age Mediastinal mass WBC count Hyperdiploidy

I think answer should be mediastinal mass as all other option are good prognosis. This question was told in pediatric lecture & sir mostly told answer was age but I'm not sure as in Surat connection was disconnected for few min that time. Can u plz tell answer & if age, y?

3. 8 yr old boy with h/o swollen gland in neck & groin for 6 months, increasing cough for 2 weeks & fever spl at night & some wt loss. O/E nontender supraclavicular , axillary , inguimal LNpathy, otherwise normal. No hepatospleenomegaly. Next appropriate step Biopsy of node Trial of ATT CBC, DC Chest Xray

4.Acid phosphatase stains

B cell T cell Monocytes Myelocyte

5.Acid phosphatase is specific to which cells Same options as above

6.Coagulative necrosis (aiims 97) Tb Gangrene Which one to select from both?

7. Most common ovarian tumor in post menopausal women Dysgerminoms Thecoma Brenner Serous cystadenoma

1. Most common cause of post transfusion hepatitis HBV / HCV

2. MC cause of HCC HBV/HCV

3 Most common ovarian tumor in post menopausal women

Dysgerminoms/Thecoma/Brenner/Serous cystadenoma

I checked in Robbins but couldn't find.

Other pathology queries

1.Acid phosphatase is specific to which of following T lymphocyte/ monocytes / ?? Other??

2. How many bands on Hb electrophoresis in HbSS ? Sickle cell disease homizygous 1/2

FMT
Padmashree award winner sportsperson if arrested need sign document of -1st class magistrate -President of INDIA What is legal permissible level of alcohol (max) for driving in India 30/50

GUT SURGERY
1. Most Characteristic feature of schistosomiasis Pseudotubercle

Sandypatch ? ? 2. Renal collor to prevent spread of malignancy IVC / Renal Vein / Aorta / Renal Artery 3. B/L VUR in >1 yr old child, t/t Injection of bulking agent / B/L ureteral reimplantation Some books mention, first 2 trial of injection of bulking agent then reimplantation.. but answer is reimplantation in all books??? 4. 60 yr, hematuria, TCC bladder T1N1M0. Best Mx TUR TUR & intravesical chemoimmunotherapy Total Cystectomy & pelvic LNectomy Systemic chemotherapy 5. 60 yr old DM & HT male patient with secondary prostatism admitted for prostetectomy developed MI. Now Treatment -Finasteride -Terazocin -Both

PEDIATRIC SURGERY
1. 6 ur old child has urinary retension & constipation. Most probable diagnosis Malignant sacral teratoma / ant sacral menengimyelocele One book says sacral teratoma malignant variety can present at later age & sacral meningimyelocele cause incontinence due LMN and no retention Otherbook says teratoma against age.. ??? 2. Mimp prognostic factor for wilm's tumor Size/histology/stage Checked in diff books, done says stage , some histology. Which one to follow? 3. 3 yr old boy presents with fever, dysuria, gross hematuria. O/E suprapubic area which is dull on percussion. Urinalysis reveals RBC but no proteinuria. This patient is suffering from UTI / posterior urethral valve ? -If gross hematuria not given then, what's answer? 4. Childhood cholelithiasis is seen in

Hurler syndrome Mucopolysacharidosis Neumann pick's disease Autoimmune hepatitis 5. Child come with bag & mask ventilation. Intubation done. CxR shows right sided deviation of mediastinum with scaphoid abdoman. Pulse impulse shifted to right, next step? Remove ET tube Put nasogastric tube Can u tell proper management steps orderly in such condition? Bcz always mcq is same but they change option. If they give following 3 option which one to select Remove ET & reattmpt Confirm position of ET (e.g. End tidal co2) Put nasogastric tube & if only remove ET given, not reattemt as in above question

GENERAL SURGERY
1. Free skin graft rejected on muscle fat dermis deep fascia 2. Prognosis of multiple melanoma depends on grade spread histology metastasis 3. Please tell Site for FTG in descending order diff. option combination in diff mcqs Axilla/Groin/Eyelid Which is most common and least commom? 4. Diuretic given or not given in eletrical burn? 5. Least useful in extensive burns Dextran/ Blood / NG intubation / RL 6. Cold water t/t in burn, disadvantage Infection Pain Exudation

None 7. Hypotension in gas gangrene best treated by RL / NS / Blood Explaination?? 8. What is follman balanitis [kerala '03] 9. Septic shock in pt treated for colonic necrosis. low bp & low u/o. Tx iv fluid only / iv fluid + dopamine Very confusing as in H'son it's given that vasopressor/inotropic only if patient doesnt responds to iv fluids while in schwartz it's given both if septic shock. ?? 10. Assesment of nutritional status, status of muscle protein indicated by midarm circumfirence S.Albumin Triceps skin fold thinkness Hb level 11. Indication of thoracotomy all except Pulmonary contusion massive pneumothorax 12. Most important in patient with borderline pulmonary function requiring lung resection Amount of non-functioning removal Amount of functioning lobe removal Experienced Surgical team Elevated pulmonary artery pressure 13. True regarding traumatic pneumothorax immediate ICD CT to confirm pulmonry leak sealed immdiate needle aspiration 14. Int.Oblique ,External Oblique & Trans.Abd. retracted laterally in Laproscopy Spigelian hernia Classic renal approach 15. 6 ur old child has urinary retension & constipation. Most probable diagnosis Malignant sacral teratoma / ant sacral menengimyelocele One book says sacral teratoma malignant variety can present at later age & sacral meningimyelocele cause incontinence due LMN and no retention Otherbook says teratoma against age..

??? 16. Removal of L1 in sympethectomy Impotence sterility retention of urine causalgia i think both a & b shd be answer,,single most apprx answer? 17. Popliteal pulse difficult to feel bcz it's not superficial it doesnt cross prominent bone Both Weak pulsaton one book says b only and other a+b..both hae diff ref. ? 18. nerve sacrifised in parotid surgery fascial auriculotemporal cervicofascial buccal 18. All can be seen in early post op period except? Hypokalemia/ Hyponatremia it's written in book that increase ADH post op so Na conserved so less Na, but K lost, so it shd be hyponatremia isnt it?

PHARMACOLOGY
1. Not a front line antiHT atenolol / amlodipine IN CMDT 2010, it's given betablocker not first line line, CCB are first line. is it true ? i havent found in any other book.. 2. Urgent t/t of procainamide toxicity Ca chelation Nitroprusside Sodium Lactate

KCL 3. Biochemical action of digitalis decrease Ca uptake by SR increase ATP synthesis Increase extracellular Ca level Block Na/Ca exchange 4. DOC for petitmal seizure Valproate / Ethosuximide I've found valproate in some pharmac books, but in all medicine or pedia books , both mentioned and valproate only if atypical absence seizure. ?? 5. Neuroleptic malignant syndrome caused by Domperidone Amantidine In h'son domperidone is given in table but answer amantidine in amit-aashish mcq books..?? Amantidine withdrawl can cause NMS, but in option amantidine, then what can be answer? I'm much confused.

ENT
1. In retropharnygeal abscess with trismus, t/t immediate drain antibiotic 2. child with 3 days history of URTI, presents with stridor which decrease on lying down. Diagnosis Laryngotrachrobronchitis Retropharyngeal abscess Acute epiglotitis FB aspiration Another option in other book Retropharyngeal abscess Laryngomalacia FB aspiration Acute epiglotitis

3. MC sign of acute mastoiditis sagging of canal wall or tenderness 4. MC tumor of EAC exostosis/osteoma??

PEDIATRICS
1. You are asked to evaluate infant born vaginally 3 hours previously to mother with only complication poorly controlled diabetis. Nursing staff noticed infant breathing abnormally, o/e cyanosis, irregular laboured breathing, decreased breath sound on right, decrease tone on right arm, you provide o2 & ordet CxR which is normal. Which of following is likely to confirm your diagnosis Nasal wash for viral culture Fibrooptic bronchodcopy Chest CT Chest USG I'm not getting diagnosis even. Plz explain diagnosis & Investigation. 2. 5 yr old male known case of nephrotic syndrome had 4 relapse in last 1 yr. Responded to prednisolone on each occasion. He presents in relapse. After ruling out infection, initial treatment would be A.Low dose alternate day prednisolone B.Alternate day prednisolone with levimasole C.Daily prednisolone 2mg/kg/day in divided doses until urine protein trace or nil for 3 consecutive days followed by further therapy D.Combination of cyclophosphamide with cyclosporine Answer in solution is c but in frequent relapse there should be answer a?? Printing mistake or it is right. Plz explain.

===== following was asked in neonate exam & also in notes.

1. Child come with bag & mask ventilation. Intubation done. CxR shows right sided deviation of mediastinum with scaphoid abdoman. Pulse impulse shifted to right, next step?

Remove ET tube Put nasogastric tube

Can u tell proper management steps orderly in such condition? Bcz always mcq is same but they change option.

If they give following 3 option which one to select

Remove ET & reattmpt Confirm position of ET (e.g. End tidal co2) Put nasogastric tube

& if only remove ET guven, not reattemt as in above question

2. 3 yr old child with ALL. Hyperdiploidy , preB type. WBC count 12,000. Radiological evaluation shows only mediastinal mass. Which of following will be most likely of concern treating oncologist Child's age Mediastinal mass WBC count Hyperdiploidy

I think answer should be mediastinal mass as all other option are good prognosis. This question was told in lecture & sir mostly told answer was age but I'm not sure as in Surat connection was disconnected for few min that time. Can u plz tell answer & if age, y?

1. Screening for congenital hypothyroidism , what's latest guidelines? Cord blood at birth or heel pad 3 days later/ else? 2. Cause of seizure in a new born after 16 hours of birth, 3.8kg born to diabetic mother Hypocalcemia/hypoglycemia? 3. Drug of choice in petitmal epilepsy / absence seizure Valproate or ethosuximide if both given in option 4. 8 yrs old boy , routine checkup 1,00,000 cc/ml ecoli on urine culture on mid stream clean catch void, child is asymptomstic, next line of management No treatment or Treat as acute uti NNPD article mention klebsiella in both extra & intramural birth as most common cause of neonatal sepsis, but not as early or late onset. What we have to mark if question on early onset?

5. Most common cause of vasculitis in children Kawasaki disease/ HSP I found in ghai, Kawasaki , rest all book HSP. But in mcq which one to mark? Mist common in India / world? Is Kawasaki most common in india? 6. Mimp prognostic factor for wilm's tumor Size/histology/stage Checked in diff books, done says stage , done histology. Which one to follow? 7. 6 ur old child has urinary retension & constipation. Most probable diagnosis Malignant sacral teratoma / ant sacral mrnengimyrlicele One book says sacral teratoma malignant variety can present at later age & sacral meningimyelocele cause incontinence due to LMN(cauda equina) leison not retention. Other book says age against sacral teratoma & meningomyelocele is answer. ??? 8. Most common cause of pneumonia in India/worldwide 2M to 2 yrs(HiB/pneumococcus), 2 yrs - 20yrs(Pneumococvus/Mrningococcus) 9. child with 3 days history of URTI, presents with stridor which decrease on lying down. Diagnosis Laryngotrachrobronchitis Retropharyngeal abscess Acute epiglotitis FB aspiration

Another option in other book Retropharyngeal abscess Laryngomalacia FB aspiration Acute epiglotitis 10. 3 yr old boy presents with fever, dysuria, gross hematuria. O/E suprapubic area which is dull on percussion. Urinalysis reveals RBC but no proteinuria. This patient is suffering from UTI / posterior urethral valve. Explaination? 11. 3yr old boy is brought to the casulity by his mother with progressive shortness of breath for 1 day. H/o bronchial asthma. On examination, child is blue, gasping, unresponsive. What will you like to do first? Intubate Administer 100% O2 by mask Ventilate with bag & mask Administer nebulized salbutamol 12. A blue newborn presents with cyanosis. CxR oligemic lung field & normal sized heart. Likely diagnosis Pulmonary atresia / TOF 13. Child presents with c/o oliguria, abd distention, diarrhoea. O/E deep jaundice, 4cm hepatomegaly. Conjugated billirubin 38mg/dl & urinary urobillnogen & bile pigments present. Hb 4mg/dl , S.creatinine 3mg/dl. Which of following is least useful for diagnosis Leptospiral antibody level Serum ceruloplasmin Reticulocyte count G-6PD level in blood 14. Developmental examination should be further evaluated in child of 12 weeks if he Doesn't vocalize Doesn't hold head at 90 degree 15. All true for Gilbert syndrome except Mild conjugated hyperbilirubinemia Autosomal dominant Normal liver histology Normal liver function In Harrison table, it's given diconjugated > conjugated in Gilbert, & AR mainly. I'm confused if it's unconjugated hyperbilirubinemia than how diconjugated form more & vice versa. 16. Childhood cholelithiasis is seen in Hurler syndrome Mucopolysacharidosis Neumann pick's disease

Autoimmune hepatitis 17. 1.5kg child born at 32wks LSCS presents with moderate respiratory difficulty (RR > 70/min) most appropriate management CPAP Mechanical ventilation Warm O2 Surfactant & ventilation 18. Most common cause of sepsis within 2month in India E.Coli Coagulase positive staphylococcus aureus Klebsiella not given in option & in NNPD after it, staph aureus f/b ecoli given but coagulase positive or negative not mention. ???? If early onset(<72hour) sepsis asked then which organism? 19. Child come with bag & mask ventilation. Intubation done. CxR shows right sided deviation of mediastinum with scaphoid abdoman. Pulse impulse shifted to right, next step? Remove ET tube Put nasogastric tube Can u tell proper management steps orderly in such condition? Bcz always mcq is same but they change option. If they give following 3 option which one to select Remove ET & reattmpt Confirm position of ET (e.g. End tidal co2) Put nasogastric tube & if only remove ET guven, not reattemt as in above question 20. 1.5 kg child born at 32wk LSCS presents with moderate respi diffulty(RR 70/min), management Surfactant& mech ventilation CPAP 21.All associated with AML except Downs syndrome Klinfelter syndrome Turner syndrome Patau syndrome In h'son patau is given in cause while in wintrobe hematology turner is given.which one is rare now?? 22. Term infant hasn't passed meconium fir 48 hours. Distension of abdoman & emesis since one day. Most appropriate investigation

Manometry Lower bowel contrast enema 23. 3kg full term infant on examination found pale. Mother A positive & baby O positive. HCT 3 months reticulocyte count 5%. Likely cause of anemia ABO incompatibility Fetomaternal transfusion Answer was F-M transfusion but I'm confused as fetus is O+ve then how it'll cause anemia? Can it cause by other mechanism or printing mistake in question?

MICROBIOLOGY
1. Highest concentration of carbohydrate in which Ig? IgG/IgM? 2. Binary (secondary) exposure to antigen result in sudden increase in IgG / IgM In secondary response also IgM is first Ab?? 3. Commonest IgG with maximum individual variation IgG1/2/3/4 4. Ag recognition on surface of Ag processing cell is by T cell recognition Ag Fc portion of Ig FAB portion of Ig Cell surface Ag I think it shd be FAB but answer in mcq book is Fc?? 5. Immunoglobulin found in B lymphocyte IgA IgE IgD IgG Aren't all Ig found in b cell? 6. Opsonization is by

IgM/IgG In Robbins Fc of IgG written, anantnarayan IgM>IgG while in NMS immunology IgG, which one to follow?? 7. C3 convertase in C4B2B or C4B2A? I've 7th basic Robbins & old anantnarayan , both says C4B2A but in jawetz & IAMS notes C4B2B??

PHARMACOLOGY
1.A diabetic female on INH & Rifampicin for TB developed DVT. She was started warfarin but PT not raised. Next step Increase dose of warfarin Switch to ethambutol for rifampicin Use LMW heparin Replace warfarin with acecoumarin 2. Therapeutic blood range of theophyline in mcg/ml 5-10 5-15 5-20 Confusion between 5-15 & 5-20 as some book mention 5-15 in asthma & some 1020 & >20 toxic.?? KDT figure is Aldo in between? 3. Heparin therapy is monitoring by PT BT CT All of above aPTT isn't in option. In mcq book, answer is CT with katzung pn 598 ref, but I'm not getting it. ?? 4. Antipeptic ulcer drug that can be given safe in CRF Al hydroxide

Mg Hydroxide Sucralfate None 5. Drug of choice in theophyline poisoning Cortisone Propranolol Thyroxine Phenytoin Same question with 4th option phenobarbitone instead of phenytoin Plz explain both answer & management of theophyline poisoning. 6. Which PG keep ductus arteriosus patent & which is used to keep duct patent? In some books, it's given pge2 & pgi2 keep it patent & then they write pge1 & pgi2 used to keep ductus patent. Is it right? Pge2 keep patent & pge1 given to keep patent? Same thing for peptic ulcer, misoprodtol PGE1 used & normally PGE2 & PGI2 decrease acid secretion & increase mucous production. 7. Which of following statement mostly apply characteristics of ibuprofen vis a vis other NSAIDs It's less effective in migraine compared to other NSAIDs It's more effective in dysmenorrhea than other NSAIDs It's less effective than other NSAIDs in t/t of food hypersensitivity Like other NSAIDs, it can cause aseptic meningitis. Can u explain all option? 8. 60 yr old DM & HT male patient with secondary prostatism admitted for prostetectomy developed MI. Now Treatment -Finasteride -Terazocin -Both 9. Which of following drug shouldn't be given in pt with acute angle closure glaucoma Pilocarpine Clozapine Fluphenazine Duloxetine Clozapine & fluphenazine both have anti Ch. & duloxetine is SNRI so all can cause mydriasis, which one to choose then?

10. Histamine blocker in stomach act through Decrease cAMP in stomach Increase cAMP in stomach Decrease IP3 in stomach Increase IP3 in stomach Does is mean h2 blocker-decrease ip3, isn't it? Or H3-->H1 smooth muscle?? So decrease cAMP? 11. Plz tell location of various intracellulat receptor - nuclear & cytoplasmic As diff mcq book, diff location for vitaminD , androgen & estrogen,progesterone. 12. cAMP is second messanger for all except Thyroxine Insulin LH FSH I'm confused between insulin & thyroxine. 13. All of following cross plasma membrane except Epinephrine Thyroxine Androstenedione Methydopa I'm confused between a & d. 14. Old man come with MI & arrhythmia. Anti arrhythmic drug choosen has narrow TI. Minimum toxic conc is 1.5 times minimum therapeutic conc. Half life 6hr. It's essential to maintain plasma conc above minimum therapeutic level to prevent lethal arrhythmia. Most app disingenuous regimen Once daily Twice daily Four times daily Constant IV infusion Confused in last 2 options. 15. Drug having t1/2 of 12 hour & loading dose 600mg. For constant level in blood, what would be BD dose? 100mg 600mg 300mg 1200mg

16. What will be maintainance dose for oral administration of drug every 8hrly if calculated dose rate were 20mg/hr & bioavailability were 0.5? 40mg 110mg 75mg 320mg 17. Imatinab MOA Block action of chimeric fusion protein of BCR-ABL Competitive inhibition of ATP binding site Aren't both options correct? 18. Which of following chemotherapeutic agent a/w secondary leukemia (AIIMS-M06) Cisplatin Etoposide Both cause leukemia, then which one to choose? 19. All of following reason increase drug toxicity in elderly except Decreased volume of distribution Increased receptor sensitivity Confused with these 2 option as Vd for lipid soluble increase & water soluble increase & receptor sensitivity increase & decrease for different receptor as in katzung, what to choose between both? Vd increase or decrease both increase toxicity? 20. Interstitial nephritis is seen in all except Isoniazid Betalactamase inhibitors Isoniazid is given in some ref in cause & betslactamase inhibitor itself doesn't cause interstitial nephritis isn't it- beta lactam antibiotic cause it- then which option to choose? All mcq book give different answers. 21. DOC for Chloroquine resistant uncomplicated P.Falciparum malaria & DOC for severe complicated P.Falciparum malaria? According to Harrision & PSM also (not sure) it's Artesunate & in KDT it's quinine?? 22. Please tell safe drugs in pregnancy for ChQ resistant / sensitive & complicated / uncomplicated malaria in descending order MCQ Karnataka 07 DOC for ChQ resistant malaria in pregnancy Quinine

SD+TMZ Mefloquin Artemisin 23. DOC for generalized anxiety disorder BZD/SSRI Some books mention it was BZD but now SSRI, but mostly in all mcq books it's BZD?? Plz tell latest DOC. 24. Which drug produce dramatic response in type 2 lepra reaction - (MH-05) Thalidomide Steroid Clofazimine Dapsone Confusion between thalidomide & steroid. 25. In patient on cisplatin, which diuretic is preferred Mannitol Acetazolamide Thiazide Furosemide Some ref write loop diuretic, some mannitol. 26. Which diuretic cause hypercalcemia & renal stone formation - UP 07 Spironolavtone Chlorthiazide Mannitol Furosrmide Is this question wrongly framed bcz thiazide cause hypercalcemia but used in renal stone as decrease Ca excretion according to kdt 27. All true about phenytoin except Anti seizure activity closely resembles plasma conc. Doesn't depress CNS Cerebellar degeneration on long term administration. 28. Can u tell list of drugs to be stopped before how many days of surgery? 29. All of these uses cAMP as second messenger except (AIIMS-N-09) Dopamine Vasopressin 30. AntiTNF not used in RA with HIV RA with Hepatitis B

31. COX2 function Cell adhesion Cell migration Cell proliferation Cell differentiation 32. Increase prolactin associated with Increased estradiol Increased libido Increased FSH Increased testosterone

PSYCHIATRY
1. Best therapy to teach daily life skill to mentally challenged child CBT Contingency Cognitive reconstrubction Self reconstruction 2. A man taking 20 cigarettes daily started coughing, his family suggested quit smoking & he's ready but he think quitting smoking will make him irritable. Best health planning model followed is Cost & survival Persuasion Precontemplatiom & preparation Belief 3. Which isn't included in personality triat? Sensation seeking Problem solving Openness to experience Neuroticism 4. 20 yrs female c/o nausea, vomiting & pain in leg. Physical examination & investigation normal. Most probable diagnosis Somatization pain disorder Conversion disorder

Generalized anxiety disorder Somatization disorder 5. 30 old male erectile dysfunction first line of evaluation Sidenafil citrate test Carvernosometry Penile colour dopplar test Intercavernous inj of papaverine 6. 30 yr old male presents with erectile dysfunction. Basic screening unremarkable. The next step in evaluation/management shd be Oral sildenafil trial Cavernosometry Dopplar study Neurological testing 7. Which of following excludes painful stimuli from awareness Repression Reaction formation Projection Rationalization 8. Organic mental disease is indicated by incoherence Delusion Flight of ideas Perservation of speech 9. PGI Question Which is appropriate in a case of schizophrenia Low socioeconomic group In adolescents Common in primitive society Affluent society influence incidence 10. Characteristic Symptom of organic psychosis Hallucination Delusion Transient delusion Anxiety 11. DOC for rapid cycling MDP & DOC for Li resistant MDP Carbamazepine /Valproate 12. In korsakoff psychosis all seen except Loss of remote memory Loss of intellectual function but preservation of memory

Lack of insight, unable to understand disability Reversible state Confusion between a,c,d 13. Not seen in korsakoff psychosis Clear consciousness Hallucination 14. Suggestibility is increased following intake of Barbiturate Cannabis Alcohol All of above 15. Fear least commonly seen in Anxiety neurosis Hypochondriasis Paranoid schizophrenia Depressive psychosis 16. Fugue state seen in Schizophrenia Hysteria Epilepsy All of above Should it none of above?? 17. Please tell Age wise phobia. Phobia typically develops at age of 8 yr Thanatophobia Animal phobia Fear of darkness Fear of contamination 18. TOC for OCD Behaviour therapy Drug therapy Both 19. True about social phobia Irrational Fear of situation Irrational fear of activities 20. Peptic ulcer is uncommon in Obsessive compulsives Schizophrenia Depressives Alcoholics

21. Delusion is Comprehensible Reasonable None Both 22. A boy attempts suicide & brought to the doctor/private practitioner, next step Infom police Not required to inform Reffer to psychiatrist 23. Fixation of hysteria is Phallic Genital 24. DOC for night terror Clonazepam/Imipramine 25. Patient's death in childhood responded by all except Idealization Denial of death Mourning Unconscious identification Is it D? 26. Which drug is used to bring back large number of memories for events just before a traumatic event Ketamine Thiopentone Piracetam Vitamin B1 27. All are features of hallucinations except? a)it is independent of will of observer b)sensory organs are not involved. c)it is as vivid as that in a true sense perception. d)it occurs in absence of a perceptual stimulus. All of the following are true about hallucinations except? a)it is as vivid as sense perception. b)it is independent of the will of the observer. c)occurs in inner subjective space. d)it occurs in the absence of perceptual stimulus Can u summerize positive point for hallucination? Confusion with following 3 lines, please tell if these are right/wrong -It is as vivid as true perception

-Sensory organ not involved -Occurs in inner subjective space --Hypothesis of Schizophrenia Skew-skism Breeder hypotgesis, drift hypothesis --Risk factor for suicide , specially in endogenous depression - old age is good or bad? Across on 656 --MC substance of abuse & MC used ilicit drug Cannabis/tobacco --D/D anhedonia, avolition, apathy, amotivation -defination --D/D of body dysmorphic disorder vs hypochondriasis vs somatic delusion disorder --D/D between schizophrenia vs Delusional disorder Q AI-2000 across pn 625 --D/D Grief Vs psychosis --D/D grief vs psychosis Stressor alone or other features too?

BIOCHEMISTRY
1. All of the following techniques can be used to detect mutative changes except RFLP DNA sequencing Hetero Duplex Migration Analysis Whole Genome Amplifucation D.Whole genome amplification. This is a technique used for amplification of DNA. It is not useful for the detection of mutative changes. Areas where whole genome amplification (WGA) is necessary

include molecular cloning, single cell analysis, and genome-wide analysis of single nucleotide polymorphisms (SNP). In this technique, primers attach randomly to the template adding complementary base pairs to one strand, while displacing the other DNA strand. Primary products initiate secondary priming on the displaced DNA strand and continue displacing to create multiple branches. If the initial sample of genomic DNA is high quality, it can be amplified one million-fold while maintaining accurate loci and allele representation. Phi29 DNA is a high processivity polymerase (processivity refers to the average number of bases the polymerase adds to a DNA strand being synthesized before the polymerase detaches from the template nucleic acid), which is used for WGA. Heteroduplex migration analysis, also called conformation sensitive gel electrophoresis (CSGE), reveals the presence of mutations, by altered electrophoretic mobility of a double-stranded DNA fragment, that contains one or more mismatched bases (heteroduplex) versus one that is perfectly matched (homoduplex). Heteroduplexes usually tend to migrate more slowly than homoduplexes during electrophoresis. The ability of this technique to detect polymorphisms is relatively good, & the presence of a single nucleotide polymorphism in a fragment as large as600bp can be detected. ===== 3. Can u tell I'm Sickle cell anemia homozygous individual how many bands seen on electrophoresis? 1/2 In patho lecture, sir told that in India & some other countries, more HbF is seen, so double band, in western countries 1 band. But in books, it's written 1 only. ??? 1. In a homozygous individual, having sickle cell disease(HbSS), electrophoresis at both alkaline and acidic pH shows a single large band in the HbS position, with smaller bands at the HbA2 and HbF positions. In HbS trait, electrophoresis shows bands in the A and S positions. ====== 9. Prenatal diagnosis of hemophilia DNA sequence polymorphism Linkage analysis Microarray Cytogenetic/cytometry analysis

Prenatal diagnosis of hemophilia is done by linkage analysis. A linkage map is a genetic map of a species or experimental population that shows the position of its known genes or genetic markers relative to each other in terms of recombination frequency, rather than as specific physical distance along each chromosome. Linkage mapping is critical for identifying the location of genes that cause genetic diseases. A genetic map is a map based on the frequencies of recombination between markers during crossover of homologous chromosomes. The greater the frequency of recombination (segregation) between two genetic markers, the farther apart they are assumed to be. Conversely, the lower the frequency of recombination between the markers, the smaller the physical distance between them. Genetic maps help researchers to locate other markers, such as other genes by testing for genetic linkage of the already known markers. Restriction fragment length polymorphisms (RFLPs) within or close to the factor VIII locus are very useful for genetic linkage analysis. Such RFLPs allow a mutant allele to be tracked in a family, segregating haemophilia A even when, as is usually the case, the precise mutation causing failure to synthesise factor VIII is unknown. To date two markers tightly linked to the factor VIII locus have been described, one of which is highly polymorphic and therefore informative in most kindreds. A significant crossover rate, however, does not make diagnosis absolute. Three intragenic RFLPs have been defined, which, taken together, are informative in about 70% of women, providing virtually deterministic genetic diagnosis. ==== 12. Which of following is correct Chemouminescence is energy emitted when electron comes from high energy state to low energy state Bioluminescence is energy emitted by photon Phosphorence is energy emitted following radiation absorbed Electrochemiluminscence is energy emitted by photons Phosphoresence is energy emitted following radiation Correct option: chemiluminescence is the emission of light when an

electron returns from an excitedor high energy level to a lower energy level. The excitation event is caused by a chemical reaction and involves the oxidation of an organic compound like luminol, isoluminol, acridinium esters or luciferin, by an oxidant (hydrogen peroxide, oxygen etc); light is emitted from the excited product formed during oxidation. Bioluminescence is a special form of chemiluminescence found in biological system. Luciferase and aequorin are examples of biological catalyst. Electrochemiluminescence differs in that, here, the reactive species that produce the chemiluminescent reaction, are electrochemically generated from stable precursors on the surface ofan electrode. A ruthenium, tris(bipyridyl) chelate is most commonly used. Phosphorescence is the luminescence produced by certain substances after absorbing radiant energy or other types of energy. ===== 15. Does melting leads to denaturation of DNA? DNA denaturation, also called DNA melting, is the process by which double-stranded deoxyribonucleic acid unwinds and separates into single-stranded strands through the breaking of hydrogen bonding between the bases. Both terms are used to refer to the process as it occurs when a mixture is heated, although "denaturation" can also refer to the separation of DNA strands induced by chemicals like urea.

Answers to questions from Dr Vitrag, Surat.

1. D.Whole genome amplification. This is a technique used for amplification of DNA. It is not useful for the detection of mutative changes. Areas where whole genome amplification (WGA) is necessary include molecular cloning, single cell analysis, and genome-wide analysis of single nucleotide polymorphisms (SNP). In this technique, primers attach randomly to the template adding complementary base pairs to one strand, while displacing the other DNA strand. Primary products initiate secondary priming on the displaced DNA strand and continue displacing to create multiple branches. If the initial sample of genomic DNA is high quality, it can be

amplified one million-fold while maintaining accurate loci and allele representation. Phi29 DNA is a high processivity polymerase (processivity refers to the average number of bases the polymerase adds to a DNA strand being synthesized before the polymerase detaches from the template nucleic acid), which is used for WGA. Heteroduplex migration analysis, also called conformation sensitive gel electrophoresis (CSGE), reveals the presence of mutations, by altered electrophoretic mobility of a double-stranded DNA fragment, that contains one or more mismatched bases (heteroduplex) versus one that is perfectly matched (homoduplex). Heteroduplexes usually tend to migrate more slowly than homoduplexes during electrophoresis. The ability of this technique to detect polymorphisms is relatively good, & the presence of a single nucleotide polymorphism in a fragment as large as600bp can be detected.

3. In a homozygous individual, having sickle cell disease(HbSS), electrophoresis at both alkaline and acidic pH shows a single large band in the HbS position, with smaller bands at the HbA2 and HbF positions. In HbS trait, electrophoresis shows bands in the A and S positions. 9. Prenatal diagnosis of hemophilia is done by linkage analysis. A linkage map is a genetic map of a species or experimental population that shows the position of its known genes or genetic markers relative to each other in terms of recombination frequency, rather than as specific physical distance along each chromosome. Linkage mapping is critical for identifying the location of genes that cause genetic diseases. A genetic map is a map based on the frequencies of recombination between markers during crossover of homologous chromosomes. The greater the frequency of recombination (segregation) between two genetic markers, the farther apart they are assumed to be. Conversely, the lower the frequency of recombination between the markers, the smaller the physical distance between them. Genetic maps help researchers to locate other markers, such as other genes by testing for genetic linkage of the already known markers.

Restriction fragment length polymorphisms (RFLPs) within or close to the factor VIII locus are very useful for genetic linkage analysis. Such RFLPs allow a mutant allele to be tracked in a family, segregating haemophilia A even when, as is usually the case, the precise mutation causing failure to synthesise factor VIII is unknown. To date two markers tightly linked to the factor VIII locus have been described, one of which is highly polymorphic and therefore informative in most kindreds. A significant crossover rate, however, does not make diagnosis absolute. Three intragenic RFLPs have been defined, which, taken together, are informative in about 70% of women, providing virtually deterministic genetic diagnosis. 12. Correct option: chemiluminescence is the emission of light when an electron returns from an excitedor high energy level to a lower energy level. The excitation event is caused by a chemical reaction and involves the oxidation of an organic compound like luminol, isoluminol, acridinium esters or luciferin, by an oxidant (hydrogen peroxide, oxygen etc); light is emitted from the excited product formed during oxidation. Bioluminescence is a special form of chemiluminescence found in biological system. Luciferase and aequorin are examples of biological catalyst. Electrochemiluminescence differs in that, here, the reactive species that produce the chemiluminescent reaction, are electrochemically generated from stable precursors on the surface ofan electrode. A ruthenium, tris(bipyridyl) chelate is most commonly used. Phosphorescence is the luminescence produced by certain substances afterabsorbing radiant energy or other types of energy. 15. DNA denaturation, also called DNA melting, is the process by which double-stranded deoxyribonucleic acid unwinds and separates into singlestranded strands through the breaking of hydrogen bonding between the bases. Both terms are used to refer to the process as it occurs when a mixture is heated, although "denaturation" can also refer to the separation of DNA strands induced by chemicals like urea.