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    Dr. Paresh Koli
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    AIPGMEE 2006 Rapid Review cover

    Anatomy

    1. Popliteus is an intra-articular tendon.

    2. Signs of stellate ganglion block includes meiosis, nasal congestion and conjunctival redness.

    3. A woman could not extend her right hand above her head after I&D procedure in right posterior triangle of neck for an abscess. It implies an injury to spinal part of accessory nerve.

    4. Middle meningeal artery is direct branch of internal maxillary artery.

    5. In adults, spinal cord normally ends at lower border of L1.

    6. Lymphatic drainage of cervix occurs by parametrial, obturator and external iliac lymph nodes.

    7. Components of white pulp of spleen includes periarteriolar lymphoid sheath, B cells and antigen presenting cells.

    8. Polar bodies are formed during Oogenesis.

    Physiology

    1. Normal range of serum osmolality is 270-285 mOsm/L.

    2. Most afferent fibers from lateral geniculate nucleus terminate in primary visual cortex in Layer 4.

    3. Blobs of visual cortex are associated with Colour processing.

    4. Parvocellular pathway from lateral geniculate nucleus to visual cortex, carries signals for detection of Color vision, shape and fine details.

    5. Maintenance of posture in normal adult human being depends upon integrity of reflexes.

    6. 1st reflex response to appear as spinal shock wears off in humans is withdrawal reflex.

    7. Hyperkinetic features of Huntington’s disease are due to loss of GABAergic and cholinergic system.

    8. Cell bodies of orexinergic neurons are present in lateral hypothalamic area.

    9. Tubuloglomerular feedback is mediated by sensing NaCl concentration in macula densa.

    10. Primary driving force for countercurrent multiplier system is reabsorption of Na+ in thick ascending limb.

    11. Organs involved in calcium homeostasis includes kidneys, skin and intestine but not lung.

    12. Calcitonin is secreted by Thyroid gland.

    13. Testosterone production is mainly contributed by Leydig cells.

    14. Ovulation is primarily caused by preovulatory surge of LH.

    15. Developmental events which depends on production of maternal and fetal glucocorticoid includes induction of thymic involution, production of surfactant by Type II alveolar cells and functional thyroid.

    16. Pancreatic juice has very high pH.

    17. In a pilot experiencing negative G, cerebral arterial pressure will rise.

    18. In humans, least useful physiological response to low environmental temperature is Piloerection.

    Biochemistry

    1. During phagocytosis metabolic process called respiratory burst involves activation of Oxidase.

    2. Ligand receptor complex dissociates in endosome because of the acidic pH of the vesicle.

    3. Specialized mammalian tissue in which fuel oxidation serves not to produce ATP but to generate heat is Brown adipose tissue.

    4. Human plasma lipoprotein containing highest percentage of triacylglycerol by weight is Chylomicrons.

    5. Valine is a homologous substitution for isoleucine in a protein sequence.

    6. Proteins fold into compact structures which associate to form homo or hetero dimers. This refers to Quaternary structure of proteins.

    7. Comparison of amino acid sequence of Cytochrome C from different species shows many random variation.

    8. Most important factor to be conserved in a protein for its function is the Ligand binding residues.

    9. Fibrous proteins are involved in maintaining shape of a cell or in formation of matrices in the body.

    10. Amino acids that are converted into succinyl-CoA includes Methionine, Isoleucine and Valine.

    11. Amino acid which serves as a carrier of ammonia from skeletal muscle to liver is Alanine.

    12. Long and short arms of chromosomes are designated respectively as q and p arms.

    13. Euchromatin is the region of DNA that is relatively uncondensed.

    14. Microsatellite sequence is short sequence (2-5) repeat DNA.

    15. Mitochondrial DNA is closed circular.

    16. tRNA has highest percentage of modified base.

    17. Sigma (σ) subunit of prokaryotic RNA polymerase specifically recognizes promoter site.

    18. Complementary sequence to 5’ TTAAGCTAC 3’ is 5’ GTACGCTTAA 3’.

    19. During replication of DNA, DNA Polymerase III polymerizes the Okazaki fragments.

    20. Cell types which contains enzyme telomerase which protects length of telomeres at end of chromosomes are Germinal, Hematopoietic and Tumor.

    21. Base substitution mutations can have molecular consequences which includes changes one codon for an amino acid into another codon for that same amino acid, codon for one amino acid is changes into a codon for another amino acid and codon for one amino acid is changed into a translation termination codon.

    22. Methods which can be used to detect point mutation in β globin gene causing sickle cell anaemia includes polymerase chain reaction with allele specific oligonucleotide hybridization, southern blot analysis and DNA sequencing.

    23. Vitamin B12 acts as co-enzyme to Homocysteine methyltransferase.

    24. Enzymes regulated by calcium or calmodulin includes Adenylate cyclase, Glycogen synthase and Guanylyl cyclase.

    25. A common feature of all serine proteases is presence of Ser-His-Asp catalytic triad at the active site.

    Pathology

    1. Normal cellular counterparts of oncogenes are important for promotion of cell cycle progression, inhibition of apoptosis and promotion of nuclear transcription.

    2. Intestinal metaplasia is most significant risk factor for development of gastric carcinoma.

    3. When carcinoma of stomach develops secondarily to pernicious anemia, it is usually situated in the Fundus.

    4. Acinic cell carcinoma of salivary gland arise most often in Parotid salivary glands.

    5. With regards to malignant behavior of leiomyosarcoma, the most important criterion is the number of mitoses per high field.

    6. Comedo DCIS most likely results in a palpable abnormality in the breast.

    7. Immunohistochemical markers positive in neoplastic cells of granulocytic sarcoma are CD43, myeloperoxidase and lysozyme.

    8. Mantle cell lymphoma are positive for CD, CD5 and CD43.

    9. Neointimal hyperplasia causes vascular graft failure as a result of hypertrophy of smooth muscle cells.

    10. In subendocardial infarction are multifocal in nature,it often results from hypotension or shock and epicarditis is not seen.

    11. Percentage of pulmonary emboli that proceeds to infarction is approximately 5-15%.

    12. Finish type of congenital nephritic syndrome occurs due to gene mutations affecting Nephrin protein.

    Microbiology

    1. If blood culture in special laboratory media was positive for gram negative short bacilli which was oxidase positive, likely organism is Brucella spp.

    2. 5 days after flea bite a boy developed fever and axillary lymphadenopathy. Staining method which would help in identification of the suspecting pathogens is Wayson staining.

    3. Mycobacterium kansasii can cause a disease indistinguishable from tuberculosis.

    4. VDRL reactive mother gave birth to an infant, risk of transmission can be determined by TPHA test on serum sample of mother, VDRL on paired serum sample of infant and mother and time interval between treatment of mother and her delivery.

    5. Patient with chills and fever after louse bite 2 weeks before, rashes all over body, delirium and subsequently went into coma. Provisional diagnosis is of vasculitis due to Rickettsial infection was made. Causative organism could be Rickettsia prowazekii.

    6. Diseases associate with Epstein barr virus infection includes infectious mononucleosis, nasopharyngeal carcinoma and oral hairy leukoplakia.

    7. Giardiasis can lead to malabsorption syndrome.

    8. Vitreous aspirate from a case of metastatic endophthalmitis on culture yields gram positive round to oval cells, 10-14 microns in size, Aspirate on gram staining shows the presence of pseudohyphae, most likely aetiological agent is Candida.

    Pharmacology

    1. When a drug is evaluated for its usefulness in controlled conditions, it is termed as a trial signifying Efficacy.

    2. Misoprostol is a prostaglandin E1 analogue.

    3. Phosphodiesterase is inhibited by aminophylline.

    4. Bisphosphonates acts by decreasing osteoclast mediated resorption of bone.

    5. Verapamil causes constipation.

    6. Benzodiazepines of choice in elderly and those with liver disease includes Lorazepam, Oxazepam and Temazepam.

    7. Benzodiazepines have active metabolites, decrease nocturnal gastric secretion and extensively metabolized by CYP enzymes.

    8. Ethosuximide is used in treatment of Absence seizure.

    9. Concomitant administration of clonazepam with Sodium valproate can precipitate absence status.

    10. Drugs interfering with folic acid metabolism includes Phenytoin, Phenobarbitone and Primidone.

    11. Common side effect with Fluoxetine therapy is loose stools.

    12. Effects of Clozapine includes granulocytopenia, seizure and sedation.

    13. Most common side effect with treatment with haloperidol is Akathisia.

    14. Antibacterials acting by cell wall synthesis includes Carbapenems, Monobactams and Cephamycins.

    15. Brinzolamide is contraindicated in patients with allergy to sulfonamides.

    16. Therapeutic effects of Penicillin G includes bacterial meningitis, syphilis and anthrax.

    17. Cloxacillin is an antipseudomonal penicillin.

    18. A diabetic patient with cellulitis from methicillin resistant Staphylococcus aureus can be treated with Vancomycin, Teicoplanin and Linezolid.

    19. Mycophenolate mofetil is a prodrug, is a selective uncompetitive and reversible inhibitor and it selectively inhibits lymphocyte proliferation.

    20. Protease inhibitors includes Nelfinavir, Saquinavir and Ritonavir.

    21. Nevirapine is a non-nucleoside reverse transcriptase inhibitor.

    22. Pre-treatment evaluation for lithium therapy should include serum creatinine.

    23. Treatment of lithium toxicity includes treating dehydration, ingestion of polystyrene sulfonate and hemodialysis.

    Forensic Medicine

    1. Spalding’s sign occurs after death of fetus in uterus.

    2. Scab or crust of abrasion appears brown between 2-3 days. Barberio’s test is used to detect semen.

    3. Medical qualifications awarded by institutions outside India and recognized by MCI are registered in 2nd schedule of Indian Medical Council Act 1956.

    4. Fingerprint Bureau was first established in India.

    PSM

    1. Physical quality of life index is measured by Infant mortality, life expectancy at age 1 and latency.

    2. Standardization allows comparison to be made between 2 different population, for direct standardization, age specific rates of study population are applied to that of the standard population and for indirect standardization, age specific rates of standard population are applied to that of study population.

    3. Major purpose of randomization in a clinical trials is to ensure groups are comparable on baseline characteristics and reduce selection bias in allocation to treatment.

    4. Purpose of double blinding in clinical trials is to avoid observer and subject bias.

    5. In randomized control trial (RCT) baseline characteristics of intervention and control groups should be similar, investigator’s bias minimized by double blinding and drop outs from trial should be excluded from analysis.

    6. Apolipoproteins are most strongly associated with coronary heart disease.

    7. Under National programme for control of blindness, school teachers are supposed to conduct vision screening of school students.

    8. According to WHO definition, blindness is visual acuity <3/60 in the better eye with best correction.

    9. As per the 1986-89 NPCB survey, prevalence of blindness in India (at visual acuity <6/60 in better eye) is 1.49%.

    10. Most common cause of ocular morbidity in India is Cataract.

    11. According to World health report 2000, India’s health expenditure is 5.2% of GDP.

    12. Indian (economic) real GDP growth for the year 2003 is 7.8.

    13. Transplantation o human organs act was passed by Government of India in 1994.

    14. Extra energy allowances needed per day during pregnancy is 300 Kcals.

    15. Premium of the ‘Community based Universal health insurance scheme’ launched during 2003-04 ranges from Rs. 1/day poor and individual to Rs. 2/day for a family of seven.

    Medicine

    1. Megaloblastic anemia due to folic acid deficiency is commonly due to inadequate dietary intake.

    2. In >50 age group myelodysplastic syndromes (MDS) are most common.

    3. 58-year-old woman with backache, recurrent chest infections for 6 months, develops sudden weakness of legs and urinary retention, Hb 7.3 gm/dL, Ca 12.6 mg/dL, Phosphate 2.5 mg/dL, alkaline phosphatase 100 mg/dL, serum albumin 3 gm/dL, globulin 7.2 gm/dL and urea 178 mg/dL. Most likely diagnosis is Multiple myeloma.

    4. Major criteria for diagnosis of multiple myeloma includes plasmacytoma on tissue biopsy, bone marrow plasmacytosis >30% and M spike >3 g% for IgG > 2 g% for IgA.

    5. B cell prolymphocytic leukemia patients differ from those with B cell chronic lymphocytic leukemia in having a shorter survival.

    6. Primary effusion lymphoma generally presents in elderly patients, it is often associated with HHV-8 and patients are commonly HIV positive.

    7. Patient with leukemia on chemotherapy develops acute right lower abdominal pain associated with anemia, thrombocytopenia and leukopenia. Clinical diagnosis is Neutropenic colitis.

    8. Major complications of massive transfusion includes hypothermia, hypomagnesemia and hypocalcemia.

    9. Risk factors for atherosclerosis includes increased waist-hip ratio, hyperhomocysteinemia and decreased HDL levels.

    10. Due to hyperkalemia there could be prolonged PR interval, prolonged QRS interval and ventricular asystole.

    11. Features seen in cardiac tamponade includes pulsus paradoxus, electrical alternans and right ventricular diastolic collapse on echocardiogram.

    12. Mitral valve prolapse transmission may be as an autosomal dominant trait, value leaflets characteristically show myxomatous degeneration and disease is one of common cardiovascular manifestations of Marfan syndrome.

    13. Sudden cardiac death may occur in dilated cardiomyopathy, hypertrophic cardiomyopathy and eisenmenger’s syndrome.

    14. Salmonella typhi is one of the least likely cause of infective endocarditis.

    15. Mycotic aneurysm is an aneurysm infected because of both intravascular and extravascular infection.

    16. Smoking is generally not associated as a risk factor with Bronchiolitis obliterans organizing pneumonia.

    17. Binge eating is not a common feature of Anorexia nervosa.

    18. Upper GI bleeding is most common presenting symptom of non-cirrhotic portal hypertension.

    19. Among colonic polyps Juvenile polyp is not pre-malignant.

    20. Drug induced lupus can be identified by Anti-histone antibodies.

    21. Anticentromere antibodies are most commonly associated with CREST syndrome.

    22. Presence of anti-Saccharomyces cerevisiae antibody is a surrogate marker of Crohn’s disease.

    23. Renal artery stenosis may occur in atherosclerosis, fibromuscular dysplasia and Takayasu’s arteritis.

    24. Joint erosion is a feature of Rheumatoid arthritis, Psoriasis and Multicentric reticulohistiocytosis but not in SLE.

    25. Causes of osteoporosis includes hypogonadism, hyperthyroidism and hyperparathyroidism.

    26. Feature of hypocalcemia includes polyuria, depression and vomiting.

    27. Most common location of hypertensive intracranial hemorrhage is basal ganglia.

    28. Common cause of subarachnoid hemorrhage is Aneurysm.

    29. Phenylpropanolamine has been associated with hemorrhagic shock.

    30. Most common type of glial tumors is Astrocytoma.

    31. Brain abscess in cyanotic heart disease is commonly located in Parietal lobe.

    32. Clinical finding of extramuscular involvement excludes diagnosis of polymyositis.

    33. Girl consumed barium carbonate with suicidal intent and complains of generalized weakness. Most common electrolyte is Hypokalemia.

    Surgery

    1. Most common malignancy found in Marjolin’s ulcer is Squamous cell carcinoma.

    2. Prognosis of rhabdomyosarcoma is likely to be poor if the site of tumor is Extremities.

    3. Fine needle aspiration cytology is not suitable for diagnosing Aneurysmal bone cyst.

    4. Thyroglossal cyst frequently causes anterior midline neck masses in 1st decade of life, cyst is located within ccm of midline and swelling moves upwards on protrusion of tongue.

    5. Mixed tumor of salivary glands are most common parotid gland.

    6. Most important prognostic factor in breast carcinoma is Stage of tumor at the time of diagnosis.

    7. In lobular variety of breast carcinoma, biopsy of opposite breast should be considered.

    8. Angiosarcoma may occur in residual breast or overlying skin following wide local excision and radiotherapy for mammary carcinoma.

    9. In inflamed pelvic appendix, inflamed ovaries and stone in pelvic ureter referred pain may be felt along the inner side of right thigh.

    10. Apart from Escherichia coli, other most common organism implicated in acute suppurative bacterial peritonitis is Bacteroides.

    11. Patient of post-cholecystectomy biliary stricture had undergone ERCP and developed acute cholangitis 3 days later. Most likely organism is Escherichia coli.

    12. Stones in common bile duct can present with Charcot’s triad, are suggested by a bile duct diameter >6 mm of ultrasound and ERCP, sphincterotomy and balloon clearance is now standard treatment.

    13. Biliary stricture developing after laparoscopic choice cystectomy usually occurs at upper part of common bile duct.

    14. Modalities which can be used for in situ ablation of liver secondaries includes cryotherapy, alcohol and radio-frequency.

    15. Most common cause of gastric outlet obstruction in India is cancer stomach.

    16. Treatment of choice for management of carcinoma of anal canal is combined radiotherapy and chemotherapy.

    17. Drugs forming ‘Triple therapy’ immunosuppression for post-renal transplant patients are Cyclosporine, azathioprine and Prednisolone.

    18. Testicular tumours are bilateral in up to 10% cases.

    19. Allen’s test is useful in evaluating Integrity of palmar arch.

    20. Most common cause of acquired arteriovenous fistula is Penetrating trauma.

    21. Dacron vascular graft is Textile synthetic.

    22. Saphenofemoral fistula is not a preferred site for planning vascular access for maintenance hemodialysis.

    23. Most preferred approach for pituitary surgery as present time is Trans-sphenoidal.

    24. Component of Glasgow coma scale includes eye opening, motor response and verbal response and does not include pupil size.

    25. Total score in Glasgow coma scale of a conscious person is 15.

    Obstetrics and Gynaecology

    1. LH is raised in polycystic ovarian syndrome.

    2. In polycystic ovarian disease there is elevated LH hormone, can cause infertility and may be associated with abnormal glucose tolerance test.

    3. 15-year-old female with primary amenorrhea, breasts are Tanner 4 but no axillary or pubic hair. Most likely diagnosis is Testicular feminization syndrome.

    4. Treatment for a case of virilizing adrenal hyperplasia is Cortisone.

    5. In carcinoma of cervix risk of metastasis to ovary is least.

    6. Investigation of choice in a 55-year-old postmenopausal woman who has presented with postmenopausal bleeding is Fractional curettage.

    7. In A suspected case of ovarian cancer, imaging workup is required for detection of adnexal lesion, characterization of lesion, staging and assess respectability.

    8. Wertheim’s hysterectomy has highest incidence of ureteric injury.

    9. 40-year-old woman with profuse vaginal discharge, no discharge from cervix on examination. Diagnosis of bacterial vaginosis can be made on findings such as abundance of gram variable coccobacilli, absence of Lactobacilli and presence of clue cells.

    10. Most common cause of tubal block in India is TB.

    11. Mechanism of action of oral contraceptives includes inhibition of ovulation, prevention of fertilization and interference with implantation of fertilized ovum.

    12. Levonorgestrel releasing intrauterine system can be used as hormone replacement therapy, it is useful for treatment of endometrial hyperplasia and irregular uterine bleeding can be problem initially.

    13. Mechanisms which cause reduced risk of upper genital tract infection in users of progestin releasing IUDs includes reduced retrograde menstruation, thickened cervical mucus and decidual changes in endometrium.

    14. Emergency contraceptives prevents pregnancy by delaying/inhibiting ovulation, inhibiting fertilization and preventing implantation of fertilized egg.

    15. Prenatal diagnosis at 16 weeks of pregnancy can be performed using amniotic fluid, maternal blood and chorionic villi.

    16. Anencephaly can be diagnosed in 1st trimester ny ultrasound.

    17. Best way to diagnose Trisomy-21 during 2nd trimester of pregnancy is Amniocentesis.

    18. TB lares up most commonly in a pregnant women during puerperium.

    19. Dermoid cyst in ovary is most prone to undergo torsion during pregnancy.

    20. Tumors commonly known to increase during pregnancy includes pituitary adenoma, meningioma and neurofibroma but not glioma.

    21. Folic acid deficiency is most commonly seen in a pregnant mother who is on phenytoin therapy for epilepsy.

    22. Primigravida with 32 weeks gestation with acute pain in abdomen for 2 hours, vaginal bleeding and decreased fetal movements. She should be managed by immediate cesarean section.

    23. Macrosomia, twin pregnancy and hydramnios during pregnancy increase the risk of postpartum hemorrhage (PPH).

    24. Indicators of impending uterine rupture during labour includes fetal distress and fresh bleeding PV.

    Paediatrics

    1. A normally developing month old child should be able to stand alone, play peek a boo and pick up a pallet with thumb and index finger.

    2. A child with 3rd percentile height, normal growth velocity and chronological age more than skeletal age. Most likely diagnosis is Constitutional delay in growth.

    3. Features of prematurity in a neonate includes no creases on sole, abundant lanugo and empty scrotum.

    4. Principal mode of heat exchange in an infant incubator is by Convection.

    5. Characteristics of autism includes repetitive behaviour, delayed language development and severe deficit in social interaction.

    6. In down’s syndrome there could be hypothyroidism, ventricular septal defects and Brushfield’s spots.

    7. Caudal regression in a newborn is specific for maternal insulin dependent diabetes mellitus.

    8. Requirement of K+ in a child is 1-2 mEq/kg.

    9. Na+ content of ReSoMal (rehydration solution for malnourished children) is 45 mmol/L.

    10. Most common etiological agent for acute bronchiolitis in infancy is Respiratory syncytial virus.

    11. In mumps, meningoencephalitis can precede parotitis.

    12. Earliest indicator of response after starting iron in 6-year-old girl with iron deficiency is increased reticulocyte count.

    13. Late onset hemorrhagic disease of newborn is onset occurring at 4-12 week of age, intracranial hemorrhage can occur and intramuscular vitamin K prophylaxis at birth has a protective role.

    14. Tetralogy of Fallot includes ventricular septal defect, right ventricular hypertrophy, pulmonary stenosis and overriding aorta.

    15. Blalock and Taussig shunt is done between Aorta to pulmonary artery.

    16. Left atrium is enlarged in VSD, aortopulmonary window and PDA but not in ASD.

    17. 1 month old boy with failure to thrive, features of congestive heart failure, femoral pulses feeble as compared to brachial. Most likely clinical diagnosis is Coarctation of aorta.

    18. Most important determinants of prognosis in Wilms tumor are the stage of disease and histology.

    19. Neuroblastoma is malignant tumor of childhood that metastasizes to bones often.

    20. Process underlying differences in expression of a gene, according to which parent has transmitted is called Anticipation.

    21. A child with a small head, minor anomalies of face including thin upper lip, growth delay and developmental disability can have a chromosomal syndrome, teratogenic syndrome and mendelian syndrome.

    22. Affected male infant born to normal parents could be an example of an autosomal recessive disorder, a polygenic disorder and a vertically transmitted disorder.

    23. Father has a disorder and 1 of 3 children also has same disorder but mother is normal than most likely pattern of inheritance in this case is Autosomal dominant.

    Orthopaedics

    1. Ideal treatment of bilateral idiopathic clubfoot in a newborn is manipulation by mother.

    2. Development dysplasia (DDH) of hip, is more common in women, oligohydramnios is associated with higher risk of DDH and hourglass appearance of capsule may prevent a successful closed reduction.

    3. In brachial plexus injury, Erb’s palsy causes paralysis of abductors and external rotators of shoulder, In Klumpke’s palsy, and Horner’s syndrome may be present on ipsilateral side and Histamine test is useful to differentiate between preganglionic and postganglionic lesions.

    4. ‘Rugger Jersey Spine’ is seen in renal osteodystrophy.

    5. Simple bone cyst is least likely to present as an eccentric osteolytic lesion.

    6. Exotosis occurs at the growing end of bone, it is covered by cartilaginous cap and malignant transformation may occur.

    7. Brown tumors are seen in Hyperparathyroidism.

    8. Osteosarcoma is radioresistant.

    9. Expansile lytic osseous metastases are characteristics of primary malignancy of Kidney.

    Ophthalmology

    1. Afferent component of corneal reflex is mediated by Trigeminal nerve.

    2. Average distance of fovea from temporal margin of optic disc is 2 disc diameter.

    3. Retina receives its blood supply from central retinal artery, retinal arteries and plexus of Zinn and Haller arteries.

    4. Magnification obtained with a direct ophthalmoscope is 15 times.

    5. SAFE strategy is recommended for the control of Trachoma.

    6. Nystatin is drug of choice for treatment of corneal ulcers caused by filamentous fungi.

    7. Brimonidine can cause drowsiness.

    8. Acetazolamide is not used topically for treatment of open angle glaucoma.

    9. Gentamicin can cause macular toxicity when given intravitreally.

    10. A case of NIDDM with h/o diabetes for 1 year should have an ophthalmic examination as early as possible.

    11. Most common cause of vitreous hemorrhage in adults is Diabetes.

    12. Typically bilateral inferior lens subluxation is seen in Homocystinuria.

    13. In juvenile rheumatoid arthritis it is contraindicated to put intraocular lens after cataract surgery.

    14. Macular dystrophy is a recessive condition.

    15. In phthisis bulbi calcification of lens is common, sclera is thickened and size of globe is reduced.

    16. Most common retrobulbar orbital mass in adults is cavernous hemangioma.

    17. Optic glioma has a peak incidence in 1st decade, it arises from oligodendrocytes and is associated with type I neurofibromatosis.

    18. Most common 2nd malignant tumor in survivors of retinoblastoma is Optic glioma.

    ENT

    1. Postero superior retraction pocket, if allowed to progress, will lead to sensorineural hearing loss.

    2. 30-year-old male with attic cholesteatoma of left ear with lateral sinus thrombophlebitis. Procedure of choice is canal wall down mastoidectomy.

    3. Brainstem evoked response audiometry (BERA) is the investigation of choice is assessing hearing loss in neonates.

    4. Ossicular disruption with intact tympanic membrane causes maximum hearing loss.

    5. Sensorineural deafness may be feature of distal renal tubular acidosis, Bartter syndrome and Alport syndrome.

    6. During inspiration the main current of airflow in a normal nasal cavity is through middle part of cavity in middle meatus in a parabolic curve.

    7. 5-year-old scheduled for tonsillectomy has running nose, temperature 37.5o C and dry cough on day of surgery. So they should cancel surgery for 3 weeks and patient to be on antibiotics.

    8. Laryngocele arises as a herniation of laryngeal mucosa through Thyrohyoid membrane.

    Dermatology

    1. Patient had 7 irregular hyperpigmented macules on trunk, multiple small hyperpigmented macules in axillae and groins since early childhood. Most appropriate investigation to support the diagnosis is slit lamp examination of eye.

    2. Pterygium of anil is characteristically seen in Lichen planus.

    3. 24-year-old unmarried woman has multiple nodular cystic, pustular and comedonal lesions on face, upper back and shoulders for 2 years. DOC is Isotretinoin.

    4. 45-year-old farmer has itchy erythematous pustular lesions on face, neck, ‘V’ area of chest, dorsum of hands and forearms for 3 years. Lesions are severe in summer and improve by 75% in winters. Most appropriate test for diagnosis is Patch test.

    5. 6 month old had itchy erythematous papules and exudative lesions on scalp, face, groins and axillae for 1 month and vesicular lesions on palms. Most likely diagnosis is Scabies.

    6. In Actinic keratosis, Parakeratosis most frequently occurs.

    Anaesthesia

    1. Indications of endotracheal intubation includes maintenance of a patent airway, to provide positive pressure ventilation and pulmonary toilet.

    2. Doxacurium has the maximum duration of action.

    3. Atracurium is muscle relaxant of choice in renal failure.

    4. Streptomycin cannot be used with d-tubocurarine.

    5. Procaine belongs to ester group of local anaesthetics.

    6. Sevoflurane is inhalational agent of choice for induction of children.

    7. Halothane sensitizes myocardium to catecholamines.

    8. Etomidate is an intravenous anaesthetic, it inhibits cortisol synthesis and causes pain at site of injection.

    9. Halothane, isoflurane and suxamethonium could trigger malignant hyperthermia but thiopentone cannot.

    10. Propofol is best suitable for day care surgery.

    11. Pethidine is used for treatment of postoperative shivering.

    12. Agents used to provide induced hypotension during surgery includes sodium nitroprusside, hydralazine and esmolol but not mephentermine.

    13. Pain relief for 2 month old infant who has undergone major surgical procedure can be done by intravenous narcotic in low dosage.

    Radiology

    1. Helium ion has maximum ionization potential.

    2. Radioisotopes used as systemic radionuclide includes P32, St89 and Sm153.

    3. P32 emits βparticles.

    4. I131 is used in treatment of differentiated thyroid cancer.

    5. Non-ionizing radiation is used in USG, Thermography and MRI.

    6. Bone scan given maximum radiation exposure to the patient.

    7. Ideal timing of radiotherapy for Wilms tumor after surgery is within 10 days.

    8. One of the most radiosensitive tumor is Dysgerminoma.

    9. Coarctation of aorta causes rib notching on chest radiograph.

    10. Objective sign of identifying pulmonary plethora in a chest radiograph is diameter of descending right pulmonary artery >16 mm.

    11. Procedure of choice for evaluation of an aneurysm is Arteriography.

    12. Most sensitive imaging modality to detect early renal tuberculosis is Intravenous urography.

    13. Most accurate investigation for assessing ventricular function is Echocardiography.

    14. Most important sign of significance of renal artery stenosis on an angiogram is the presence of collateral.

    15. MR imaging in multiple sclerosis will show lesions in white matter.

    Psychiatry

    1. Loosening of association is an example of Formal thought disorder.

    2. Late onset, marriage and acute onset are associated with better prognosis in schizophrenia.

    3. Intense nihilism, somatization and agitation in old age are hallmark symptoms of involutional melancholia.

    4. Mutism and akinesis in a person who appears awake and even alert is best described as Stupor.

    5. Bright light treatment is most effective in treatment of seasonal affective disorder.

    6. Rivastigmine and Donepezil are drugs used predominantly in management of Dementia.

    7. Pavlov’s experiment is an example of Classical conditioning.

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