2012 www.drpawan.webs.com pawan 1/17/2012

AIPG 2012
159 QUES(wel
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1) Thiazide used in t/t of a/e
a) Idiopathic hypercalceuria with nephrocalcinosis
b) Hyperlipidemia ANS
c) CCF
2) IPC prohibits the disclosure of the identity of victims in rape under
A) Section 225A
B) Section 226A
C) Section 227A
D) Section 228A ANS
3) Sham rage is seen in
a) Decerebrate animals
b) Decorticate animals ANS
c) Hypothalamic lesions
4) Doc for syphilis in pregnant lady
a) Penicillin ANS
5) Glasgow coma scale- Verbal Makes inappropriate words
a) 4
b) 3 ANS
c) 2
d) 1
6) pt. was infected with MRSA. All of the following can be given except
A) Cotrimoxazole
B) Ceflacor ANS
D) Ciprofloxacin
D) Vancomycin
7) In Japan, known as detergent suicide, a near-instant death achieved by mixing common
household chemicals into a poisonous cloud of gas
a. detergent effect of household chemicals
b. h2s ANS
d. production of poisonous gasses by mixing household chemicals Pancreas on CT shows
grape like clusters and dilated pancreatic duct
a) Ductectatic Mucinous Cystic Neoplasms ANS
8) Cholera toxin acts via secondary messenger
b) cGMP
c) Ca2+
d) IP3
9) Rheumatoid factor is
a) IgM antibody directed against IgG ANS
b) IgG antibody directed against IgM
10) Temozolamide is
a) Oral alkylating agent ANS
b) Antibiotic antitumor
Temozolomide is an oral alkylating agent used for the treatment of Grade IV
astrocytoma — an aggressive brain tumor, also known as glioblastoma multiforme — as well
as for treating melanoma, a form of skin cancer. Temozolomide is also indicated for relapsed
Grade III Anaplastic Astrocytoma and not indicated for, but as of 2011 used to treat
oligodendroglioma brain tumors in some countries, replacing the older (and less welltolerated) PCV (Procarbazine-Lomustine-Vincristine) regimen.
The agent was developed by Malcolm Stevens and his team at Aston University in
Birmingham, A derivative of imidazotetrazine, temozolomide is the prodrug of MTIC (3methyl-(triazen-1-yl)imidazole-4-carboxamide). It has been available in the US since August
1999, and in other countries since the early 2000s.
The therapeutic benefit of temozolomide depends on its ability to alkylate/methylate DNA,
which most often occurs at the N-7 or O-6 positions of guanine residues. This methylation
damages the DNA and triggers the death of tumor cells. However, some tumor cells are able
to repair this type of DNA damage, and therefore diminish the therapeutic efficacy of
temozolomide, by expressing an enzyme called O-6-methylguanine-DNA methyltransferase
(MGMT) or O-6-alkylguanine-DNA alkyltransferase (AGT or AGAT). In some tumors, epigenetic
silencing of the MGMT/AGT gene prevents the synthesis of this enzyme, and as a consequence
such tumors are more sensitive to killing by temozolomide. Conversely, the presence of MGMT
protein in brain tumors predicts poor response to temozolomide and these patients receive
little benefit from chemotherapy with temozolomide
11) Person with accident unable to abduct shoulder and flex at elbow due to
a) Shoulder dislocation
b) Medial cord injury
c) Lateral cord injury ANS
d) Upper trunk injury
12) Which fluoroquinolone shows the longest half-life?
a) Levofloxacin
b) Lomefloxacin
c) Grepafloxacin ANS
d) Moxifloxacin ANS
13) A Gram-negative marine bacterium causing ear infection
a) Vibrio cholera
b) Vibrio parahemolyticus
c) Vibrio alginolyticus ANS
d) Vibrio mimicus
14) Apixaban
a) Inhibits factor Xa ANS
B)tnf a inhibitor
C)anti platelet ref Apixaban (manufacturer's designation BMS-562247-01, tradename
Eliquis) is a compound being investigated as an anticoagulant. It is a direct factor Xa inhibitor.
It is presently undergoing phase III trials in the prevention of venous thromboembolism,
together with a number of related competing compounds, such as rivaroxaban.[1] It is being
developed in a joint venture by Pfizer and Bristol-Myers Squibb
15) Most common cause of Mobius Syndrome while pregnant is use of the drug
a) Misoprostol ANS
b) Thalidomide
16) In a case of repeated chalazion on upper eye lid, the biopsy was done. The most probable
diagnosis on histopathology
a) Sebaceous cell Ca ANS
b) Basal cell Ca
c) Squamous cell Ca
17) Median is Imp for all except
a) Blood pressure,
b) Survival Time,
c) Incubation Period,
d) Health Expenses ANS
18) Electromechanical systole
a) Q wave onset to peak S1
b) Q wave onset to peak S2 ANS
19) Dilator pupillae is supplied by
a) Postganglionic cervical sympathetic chain
b) Postganglionic parasympathetic neurons
20) All of the following are bactericidal except
a) Daptomycin
b) Tigecycline ANS
21) Langerhans histiocytosis
a) CD1a ANS
22) Individual intraoperative awareness is evaluated by
a) Pulse oximetry
b) Bispectral index ANS
c) Color Doppler
d) End tidal CO
23) A patient with BP 220/120, sudden death, pathological finding of kidney?
a) Petechial hemorrhage on cortex with normal size kidney
b) Small kidney with granular surface
c) Large edematous kidney with waxy surface ANS
d) Small contracted kidney with scars
24) Kegels exercise is advised
a) Immediately after delivery ANS
b) 3 months after delivery
c) 24 hrs. after delivery
ref --- Kegel exercise
A pelvic floor exercise, more commonly called a Kegel exercise (named after Dr. Arnold
Kegel), consists of contracting and relaxing the muscles that form part of the pelvic floor,
which are now sometimes colloquially referred to as the "Kegel muscles". Several tools exist to
help with these exercises, though many are ineffective. Exercises are usually done to reduce
urinary incontinence and aid with childbirth in women, and reduce premature ejaculatory
occurrences in men,as well as increase the size and intensity of erections.
The aim of Kegel exercises is to improve muscle tone by strengthening the pubococcygeus
muscles of the pelvic floor. Kegel is a popular prescribed exercise for pregnant women to
prepare the pelvic floor for physiological stresses of the later stages of pregnancy and vaginal
childbirth. Kegel exercises are said to be good for treating vaginal prolapse and preventing
uterine prolapse in women and for treating prostate pain and swelling resulting from benign
prostatic hyperplasia (BPH) and prostatitis in men. Kegel exercises may be beneficial in
treating urinary incontinence in both men and women.Kegel exercises may also increase
sexual gratification and aid in reducing premature ejaculation.Many actions that are controlled
by Kegel muscles include "holding in" urine or avoiding defecation. Reproducing these types of
muscle actions can yield stronger Kegel muscles.
A Kegel exerciser
Pelvic toning devices
A pelvic toning device (generically referred to as a Kegel exerciser, pelvic floor toner, pelvic
floor muscle toner or pelvic toner) is a medical or pseudo-medical device designed to help
women exercise their pelvic floor muscle and improve the muscle tone of the pubococcygeal or
vaginal muscle.
The original pelvic toning device was the perineometer invented by Arnold Kegel to facilitate
the measurement of the strength of the pubococcygeus muscle when it was resting and being
actively squeezed - sometimes referred to as the Kegel tone.
Unfortunately his device was a combination of rubber balloons and tubes that measured
pressure using a column of water. It was neither easy to use nor portable.
During the latter part of the 20th century a number of medical and pseudo-medical devices
were developed and launched onto the market. Some of these are used in a clinical setting,
but most are designed for women to use in the privacy of their own home.
Pelvic toning devices fall into a number of different types:
barbells, vaginal weights or cones designed to be held in the vagina. The action of
passively/actively retaining the device internally is supposed to improve muscle tone. Barbells
are made of smooth, polished solid stainless steel, cylindrical in shape, with a rounded bulge
at each end. They typically weigh one pound (454 g) and measure approximately 6¾ inches
(17.1 cm) in length with a diameter of one inch (2.5 cm) at the widest part. Being made of
stainless steel, vaginal barbells are nonporous and can be wiped clean with a cloth moistened
with mild soap and water.
electro-stimulation or TENS devices that administer an electrical current through an internal
probe. The current stimulates the adjacent muscles to twitch.
rubber resistance balls and indicators. These devices provide a nominal resistance to squeeze
against. An advantage of rubber bulb devices is that they provide visual feedback (via a
gauge) of how much pressure is being applied.
progressive resistance vaginal exercisers with springs are the only devices that meet all of
Kegel's criteria. They provide a biofeedback that the correct muscles are being engaged and
are capable of fulfilling the basic fundamentals of an exercise regime by applying a variable
and increasing resistive force to maximise the exercise effort.
Unfortunately there are a number of products on the market that have no impact at all on the
pubococcygeus muscle. If the PC muscle is not engaged then it is impossible to improve the
muscle tone or strengthen the muscle. Devices that are used externally, for example between
the thighs, may exercise the adductor muscle but do nothing for the pelvic floor.
Benefits for women
Factors such as pregnancy, childbirth, aging, being overweight, and abdominal surgery such
as cesarean section, often result in the weakening of the pelvic muscles. This can be assessed
by either digital examination of vaginal pressure or using a Kegel perineometer. Kegel
exercises are useful in regaining pelvic floor muscle strength in such cases.
Urinary incontinence
The consequences of weakened pelvic floor muscles may include urinary or bowel
incontinence, which may be helped by therapeutic strengthening of these muscles. A metaanalysis of randomized controlled trials by the Cochrane Collaboration concluded that "PFMT
[Pelvic floor muscle training] be included in first-line conservative management programs for
women with stress, urge, or mixed, urinary incontinence...The treatment effect might be
greater in middle aged women (in their 40s and 50s) with stress urinary incontinence
Pelvic prolapse
The exercises are also often used to help prevent prolapse of pelvic organs. A meta-analysis of
randomized controlled trials by the Cochrane Collaboration concluded that "there is some
encouragement from a feasibility study that pelvic floor muscle training, delivered by a
physiotherapist to symptomatic women in an outpatient setting, may reduce severity of
Benefits for men
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Though most commonly used by women, men can also use Kegel exercises. Kegel exercises
are employed to strengthen the pubococcygeal muscle and other muscles of the pelvic
diaphragm. Kegels can help men achieve stronger erections and gain greater control over
ejaculation.[5] The objective of this may be similar to that of the exercise in women with
weakened pelvic floor: to increase bladder and bowel control and sexual function'
Regarding postprostatectomy urinary incontinence, a meta-analysis of randomized controlled
trials by the Cochrane Collaboration found "conflicting information about the benefit of pelvic
floor muscle training for either prevention or treatment of urine leakage".
Sexual function
Kegel workouts can provide men with stronger erections.Research published in 2005 issue of
BJU International, have shown that pelvic floor exercises could help restore erectile function in
men with erectile dysfunction. There are said to be significant benefits for the problem of
premature ejaculation from having more muscular control of the pelvis. It is also possible that
strengthening the pelvic floor may allow some men to achieve a form of orgasm without
allowing ejaculation, and thereby perhaps reach more than one "climax" during sexual
activity.In men, this exercise lifts up the testicles, also strengthening the cremaster muscle, as
well as the anal sphincter muscles, as the anus is the main area contracted when a Kegel is
done. This is because the pubococcygeus muscle begins around the anus and runs up to the
urinary sphincter.
25) Doesn’t pass anterior to the ureter?
1. Terminal ileum
2. Vas deferens
3. Inferior epigastric artery
4. Genitofemoral nerve ANS
26) The appearance of cortical cataracts show up small linear opacities like "spokes of a wheel".
a) Lamellar cataract ANS
b) Punctate cataract
c) Cataract centralis pulverulenta
d) Coronary cataract
27) Dermatome of little finger
a) C6
b) C7
c) C8 ANS
d) T1
28) Congenital aplastic anemia
29) Erythematous lesions with Collarets of scales on trunk
a) Pityriasis rubra
b) Pityriasis rosea ANS
30) What is not a complication in fracture head of femur?
a) Shortening
b) Malunion ANS
c) Non union
31) Itchy lesion, linear IgA deposit in basilar membrane
a) Dermatitis herpetiformis
b) Chronic bullous disease of child ANS
32) Small vessels vasculitis seen in
a) giant cell arteritis
b) takayasu arteritis
c) PAN
d) Microscopic Polyangitis ANS
33) Sex ratio of children between 0-6 years
a) 914 ANS
b) 923
c) 940
d) 944
34) Man with asbestos exposure for 20 yrs with involvement of lower lobe and Comet tail sign
a) Round atelectasis ANS
b) Mesothelioma
35) Smallest AP diameter of skull in
a) Trignocepahaly
b) Brachycephaly ANS
c) Oxycepahly
d) Dolichocephaly
36) Renal scarring detect in infected kidney is detected by
37) Salmonella typhi - dose needed to infect human
a) 1 bacilli
b) 10 bacilli
c) 10^2 - 10^5 bacilli ANS
d) 10^8 – 10^10 bacilli
38) Drug induced osteomalacia
a) steroid
b) Heparin
c) Phenytoin ANS
39) anterior relation of ureter a/e
1- vas deferens
2- terminal ileum
3- iliocolic artery
4- genitofemoral nerve ANS
40) Investigation of choice in Hirschsprungs disease
A. rectal biopsy ANS
B.Barium enema
C.MR angiography
41) Type of hypersensitivity in myasthenia gravis
a) Type 1
b) Type 2 ANS
c) Type 3
d) Type 4
42) Pt. has external strabismus, ptosis and uniocular diplopia. It shows the involvement of
a) Trochlear
b) Occulomotor ANS
43) Agent is there in the environment but no transmission is taking place
A) Elimination
B) Control ANS
C) Eradication
d) Holoendemic
44) In Preeclampsia
a) GFR low ANS
b) GFR high
c) remains same
45) In ARDS
a) Diffuse alveolar damage ANS
46) IUCD not necessary to change after 3 - 5 yrs.
a) Cu 380A ANS
b) Cu 200
47) Which of the following is a cause of psychosis on a cocaine user?
A. tolerance
B. Withdrawal
C. regular intake
D. Reverse tolerance ANS
48) Functioning of a gene can be best demonstrated by
a) Western blotting
b) Southern blotting
c) Gene knock out ANS
d) Transgenic animals
49) Amylin is secreted by:
a) Alpha cells
b) Beta cells ANS
c) Gamma cells
d) Delta cells
ref Amylin, or Islet Amyloid Polypeptide
(IAPP), is a 37-residue peptide hormone secreted by pancreatic β-cells at the same time as
insulin (in the roughly 1:100 ratio of amylin to insulin)
Amylin functions as part of the endocrine pancreas and contributes to glycemic control. The
peptide is secreted from the pancreatic islets into the blood circulation and is cleared by
peptidases in the kidney. It is not found in the urine.
50) Porphyria with autosomal recessive inheritance
a) Congenital erythropoietic porphyria ANS
51) Least likely to cause infective endocarditis
a) Small VSD
b) Small ASD ANS
c) AS
d) AR
52) All Structures Are derivatives of pharyngeal arches except?
a) Tensor veli palatine.
b) LPS
c) Stapedius.
d) Palatine Tonsils ANS
53) All nerves supply the auricle except.
a) Greater Auricular
b) Lesser Occipital.
c) Tympanic Branch of glossopharyngeal ANS
d) Auricular branch of Xth nerve
54) Diabetic elderly male with painful lesion in external ear, bone erosion with facial nerve palsy
and resistant to antibiotics. Diagnosis
a) Malignant Otitis Externa ANS
b) Nasopharyngeal carcinoma
55) Disease spread by culex, anopheles and aedes globally
1) Malaria
2) Filaria ANS
3) Dengue
4) Yellow fever
56) 57) All cause Conduction Deafness Except?
a) Endolymphatic Hydrops ANS
b) Otosclerosis.
c) Serous Otitis Media
d) Suppurative otitis media
57) 58) All are mixed germ cell tumor except
a) Granulosa cell tumor ANS
b) Dysgerminoma
c) Endodermal sinus tumor
d) Choriocarcinoma
58)59) In active management of 3rd stage of labour, all are done except
a) Controlled cord traction
b) inj Methergine
c) inj Syntosin
d) Massage of uterus ANS
59) 60) Old blood stain is detected using?
b) Infrared rays ans
c) ultraviolet
60) 61) Common enzyme utilized in cholesterol and ketone synthesis
a) HMG Co-A synthetase ANS
b) HMG Co-A reductase
61) Lesion developed from Olfactory Mucosa?
a) Esthesionneuroepithelioma
62) In Kallman syndrome, which of the following is increased?
a) LH
b) FSH
63) mitochondria involved in a/e
1fatty acid synthesis ANS
3 fatty acid redn
64) person wid accident unable to abduct shlder nd flex at elbow due to
a.shoulder dislocatn
b.UPPER cord injry ANS
c.lat cord injry
d.post cord injry
65) Electromechanical point??
R wave to S1
Q wave to S2
66) LN enlargement seen in invovlment of a/e
a. Middle Ear Disease
b. Nasopharyngeal involvement
67) All cause Conduction Deafness Except?
a. menieres disease ( Hydrops)
b. otosclerosis.
c. serous OTitis Media
68) 12 yr old girl, rapid gain in height since last 11 months, inability to sit with legs crossed and
difficulty in squatting, on bending knee reaches same side axilla, whats the most probable
69) middle aged male comes wiyth shortening of leg by 7 cms, Hip in Flexion and External
Rotation, clinically hard mass palpable in lateral gluteus region, whats the most probable
a Post Dislocation.
b, Central Dislocation.
c. Grade 4 Dislocation.
d. Fracture of acetabulum with dislocation of Hip joint.
70) Inability to Abduct Shoulders and inability to flex elbow.. Most Likely Cause?
a. Shoulder Dislocation
b Lateral Cord Injury
c Anterior Trunk Injury.
d Medial Cord Injury
71) All Are True about SACH- ic10 Except?
a. Full Form is 'Solid Ankle Cushion Heel.
b. managed by ...
c. woody heel....
72) . Proximal Segment of Scaphoid Fracture goes into AVN Due To?
a. REtrograde Blood Supply to Scaphoid
73) . Tuberculosis Bone Is due to?
a. Hematogenous Spread
b. Lymphatic Spread.
74) Deep ant. chamber with scar on limbus with 10D lens:
3.post dislocation lens
75) Q most resistant to disinfectants and antiseptics:
76) mosquito- culex anap aedes commonly transmits?
77) O site for binding of oligosacharide is seen in which amino acid ?
A.Asparagine B. threonine C.serine
78) autosomal recessive inheritance in porphyria...
A.acute intermittent
D.porphyria cutanea tarda
79) Pt has external strabismus, ptosis and uniocular diplopia. Involvement of ?
A.Trochlear B. Occulomotos C. abducent
What causes increased triglycerides and lipid dystrophy?
1. Nevirapine
2. Lamivudine
3. Zidovudine
4. Ritonavir. ANS
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80) . Blood group A will have which genotype?
81) The occurrence of hyperthyroidism following administration of supplemental iodine to subjects
with endemic iodine deficiency goiter is known as:
A. Jod-Basedow effect
B. Wolff-Chaiokoff effect
82) Vision 2020 in India includes a/e
a) Cataract
b) Refractory error
c) Vitamin A deficiency
d) Diabetic retinopathy
83) AIDS related complex include
a. herpes zoster
b. opportunistic infection
c. generalized lymphadenopathy
d. cancer
84) Splenomegaly is not associated with
a. CML
b. Polycythemia vera
c. essential thrombocythemia
d. primary myelofibrosis
85) Side effects of thalidomide are all except
a) Myocarditis
b) Neuropathy
c) Sedation
d) Constipation
86) Which of the following is not a phase one reaction?
A) Oxidation
B) Reduction
C) Hydrolysis
D) Conjugation ans
87) In Immune complex formation, structure of protein involved is
A) Primary
B) Secondary
C) Tertiary
D) Quaternary ans
88) 12 yr. old girl with rapid gain in height since last 11 months has inability to sit with legs
crossed and difficulty in squatting. On bending, her knee reaches axilla of same side. What’s
the most probable diagnosis?
a. Slipped capital femoral epiphysis ANS
b. TB hip
c. perthes disease
d. coxa vera
89) The mitochondrial enzymes involved in metabolism of clopidogrel and PPI are
a. CYP3A4
b. CYP2C19 ANS
c. CYP 2A
d. CYP 2C20
ANS: b
Am J Gastroenterol 2010; 105:34–41; doi:10.1038/ajg.2009.638; published online 10
November 2009
Proton Pump Inhibitor and Clopidogrel Interaction: Fact or Fiction?
Clopidogrel users with decreased CYP2C19 function have less inhibition of platelet aggregation
and increased cardiovascular (CV) events. As PPI metabolism also involves CYP2C19, it was
hypothesized that competition by PPIs might interfere with clopidogrel's action
90) Lymphoma least commomly inA.ataxia telengiectasia,
B. comb
C.imm def
91) Which of the following hypoglycemic drug causes vit B12 deficiency
a) Exenatide
b) Rapaglinide
c) Gliptan
d) Metformin ANS
92) What will be the age of a child who can use 4-5 words including meaningful nouns & represent
his ideas mostly by non-verbal communication?
A) 15months
B) 18 months ANS
C) 24 months
D) 12 months
93) Least common presentation of multiple myeloma
a) Hyperviscosity ANS
b) Anemia
c) Bone pains
d) Infections
94) 45 yr male, with both upper limbs paralysed in childhood, now develops pain, fatigue in both
lower limbs. diagnosis?
a. post polio syndrome ANS
b. polymyositis
c. muscular dystrophy
d. neuropathy
95) The effect on sleep pattern if external source is removed
a) Will not change ANS
b) More than 24 hrs.
c) Less than 24 hrs.
d) Irregular
96) Mean hemoglobin of a sample of 100 pregnant women was found to be 10 mg % with
standard error of 1.0 mg %. The standard error of the estimate would be
a) .01
b) 0.1 ANS
c) 1.0
d) 10
97) Blood group A will have which genotype?
General Adaptation syndrome is seen in?
a) Depression
b) Anxiety
c) Panic attack
d) Stressful situation
ans .d
For Medical termination of pregnancy, the
consent is to be obtained from
a) Only husband b) Only wife c) Both husband and wife
d) Neither Husband nor wife
ans .b
100) Avascular necrosis of Scaphoid occurs in the
fracture proximal fragment because
a) Comminuted fracture
b) Articulates with radius c) Blood flow retrograde in Scaphoid d) Difficult to fix the proximal
101) Pyrogenic cytokines are all EXCEPT
a) IL 6
b) TNF alpha
c) IL 18 ANS
d) INF alpha
102) A clinician diagnosed a patient as having SLE
and ordered 6 tests. out of this 4 have come
positive and 2 are negative. TO determine the
probability of SLE what is required 1. Prior probability of SLE; sensitivity and
specificty of each test 2. Incidence of SLE and predictive value of each test
3. Incidence and prevalence of SLE
4. Relative risk of SLE in this patient
ans.a repeat so many times
103) Among the following which is the most
resistant to action of antiseptics?
1. Spore
2.prions ans
3. Bacteria
4. Virus
104) The function of a gene is determined by
a.southern blot
b.western blot
c.inserting in trangenic mice
d. inserting as a knock out gene ANS
Knockout : Remove complete or part of the gene from the genome
Knockin : inserting external elements in to the genome like GFP/RFP or LacZ
Transgenic : over expressing particular gene in in vivo, similar way like overexpressing
proteins in mammalian cells
When researchers isolate human genes with unknown functions, they can create knockout
mice with these genes and observe the results. Instead of creating merely the mouse
equivalent of the human gene, researchers are able to reproduce and express actual human
genes and their corresponding proteins in mice. Subsequent offspring will inherit not only the
instructions coded by their original mouse genome, but also the traits coded for by the
inserted human DNA. This helps researchers understand health and disease by observing how
genes work in cells.
Knockout mice have many benefits. They not only allow researchers to determine gene
function and understand diseases at the molecular level, but they also aid scientists in testing
new drugs and devising novel therapies.
Transgenic Mice
One of the simplest ways to study gene function in a mouse is exogenous expression of a
protein in some or all tissues. For this type of genetic modification, a new piece of DNA is
introduced into the mouse genome. This piece of DNA includes the structural gene of interest,
a strong mouse gene promoter and enhancer to allow the gene to be expressed and vector
DNA to enable the transgene to be inserted into the mouse genome
Currently, the phrase "transgenic mouse" generally refers to any mouse whose genome
contains an inserted piece of DNA, originating from the mouse genome or from the genome of
another species, and the term includes the standard transgenic mouse as well as a knockin or
knockout mouse http://www.cellmigration.org
According to my opinion Inserting as knock out gene is the best option
ans .d
Immune complex formation structure of protein involved is
105) In
a) Primary
b) Secondary
c) Tertiary ANS
d) Quaternary
Tertiary structure ,the immunoglobulin fold is the domain involved which is a tertiary
structure.Even though Ig Has more than one polypeptide chain .For its functional fulfillment
domain is needed which is a tertiary structure.
In this class of protein, domains are usually formed as modules covalently "strung together"
on a single polypeptide chain. The individual chains of antibodies are like this, strings of
immuno-globulin domains. However, light and heavy chains then combine to produce heteromultimers, which may even associate into higher complexes, as with IgM
Best option is Tertiary structure
106) Which of the following amino acid can have o-glycoxylation linkage in oligosachride molecule
B. glutamine
C. serine
D. cysteine
Ans Serine
Based on the nature of the linkage between their polypeptide chains and their oligosaccharide
chains, glycoproteins
can be divided into three major classes (Figure 47–1): (1) those containing an O-glycosidic
linkage (ie, Olinked),
involving the hydroxyl side chain of serine or threonine and a sugar such as N acetylgalactosamine
(GalNAc-Ser[Thr]); (2) those containing an N-glycosidic linkage (ie, N-linked), involving the
amide nitrogen of
asparagine and N -acetylglucosamine (GlcNAc-Asn); and (3) those linked to the carboxyl
terminal amino acid of a
protein via a phosphoryl-ethanolamine moiety joined to an oligosaccharide (glycan), which in
turn is linked via
glucosamine to phosphatidylinositol (PI). This latter class is referred to as
(GPI-anchored, or GPI-linked ) glycoproteins
107) Function of restriction II enzyme
A. Prevents protein folding
B. Removing formed DNA
C. Cleaves DNA at palindromic recognition site ANS
D. Negative supercoiling
Answer isRestriction enzymes Cut at Palindromic Sequences
Structure and function of type II restriction endonucleases
More than 3000 type II restriction endonucleases have been discovered. They recognize short,
usually palindromic, sequences of 4–8 bp and, in the presence of Mg2+, cleave the DNA within
or in close proximity to the recognition sequence. The orthodox type II enzymes are
homodimers which recognize palindromic
108) Which of the following proteins cannot be phosphorylated using protein kinase in prokaryotic
D.Methionine ANS
Phosphorylation is found most commonly on specific serine and threonine amino acid residues
in proteins, but it also occurs on tyrosine and other amino acid residues (histidine, aspartic
acid, glutamic acid) as well. In most cells, about 90% of the protein phosphorylation appears
on serine, 10% on threonine and ~0.05% on tyrosine residues. Therefore, protein-tyrosine
phosphorylation levels appear to be about 2000-times lower than protein-serine
phosphorylation levels and 200-times lower than protein-threonine phosphorylation levels. In
cells like activated platelets, tyrosine phosphorylation can be orders of magnitude higher
109) Keratin is present in both skin and nail .But skin is more flexible than nail. Reason ?
a. increased no of disulphide bonds ANS
b. decreased no of water molecules
c. increased Na content
d. increased hydrogen bonds
More the Disulphide bond More tensile the protein,Hence harder.So answer is Increased
Disulphide bond.
Nails are made of a protein called keratin, which is also found in skin and hair. The difference
is the sulfur content. Keratin contains an amino acid called cysteine. Cysteine contains the
sulfur atom. Two cysteines combine to form a disulfide bond. The number of these disulfide
bonds in the keratin is what makes the difference between skin, hair and nails. Lots of
disulfide bonds means very little flexiblity, like a nail. Fewer disulfide bonds results in more
flexibility, like hair and skin.
Nail Structure & Growth | eHow.com http://www.ehow.com/about_5246506_nail-structuregrowth.html#ixzz1j43l022I
110) Third
generation of thyroid function tests minimum value of assay TSH value is
a. .4 IU/ml
b . .04IU/ml
c. .004IU/ml
d. 004IU/ml
Utility of third generation thyrotropin assays in thyroid function testing.
Saller B, Broda N, Heydarian R, Görges R, Mann K.
Department of Internal Medicine, University of Essen, Germany. [REMOVED]
Determination of thyrotropin (TSH) by sensitive immunometric assays is currently judged as
the most sensitive and also most cost-effective first-line approach to thyroid function testing.
Further improvement of assay sensitivity has led to the description of third generation TSH
assays with a functional sensitivity in the range of 0.01 to 0.02 mU/l
Third generation TSH assays have become available with detection limits of about 0.01 mU/L.
Because of the considerably lower detection limit, these assays can reliably distinguish
between normal and hyperthyroid patients(Boulder Medical Center Journal)
These are the refernces I could collect.Please contribute more details
Extremely sensitive (fourth-generation) assays can detect TSH levels 0.004 mU/L, but, for
practical purposes, assays sensitive to 0.1 mU/L are sufficient[Harrison 18th editione book
Chapter 341]
The following method is not a method of estimation of total proteins
A biuret
B Bradford's
c. lowry's
d. bromocresol.green ANS
Bradford protein assay
The Bradford assay is very fast and uses about the same amount of protein as the Lowry
assay. It is fairly accurate and samples that are out of range can be retested within minutes.
The Bradford is recommended for general use, especially for determining protein content of
cell fractions and assesing protein concentrations for gel electrophoresis
BCG is a method to estimate albuminalone not total protein .So ans is Bromocresol Green
112) cytoplasmic
messenger RNA which of the following is true
a. mw equal to sn RNA
b. synthesized by nuclear DNA
I don’t get the other options.mRNA is synthesized from DNA
113) Which of the following porphyrias is not autosomal dominant
a. acute intermittent porphyrias
b. congenital erythrophytic porphyrias
c. porphyria cutanea tarda
d. hereditary porphyrias
Ans Congenital Erythropoeitic Porphyria
114) Commonest cause of keratitis in contact lens wearers
a) Acanthamoeba ANS
b) Staph aureus
c) Naeglaria
d) Herpes
115) How does Ebstein Barr Virus causes autoimmunity
A. Molecular mimicry
B. exposing sequestered antigens
C. antigenic cross reactivity
D. polyclonal B cell activity ANS
116) A man on provocation hit another man with a stick leading to formation of a bruise 3 X 3 cm
on his arm. Which of the following is correct for his punishment?
a. simple imprisonment 1 yr. with 1000 Rs fine
b. rigorous punishment for 6 months
c. simple imprisonment 2yr and 5000 fine
d. none ANS
117) Source
of training for ASHA
A. AWW and MPW
B. ANM and MPW
C. AWW and ANM ans
D. Medical Officer and ANM REF-Ministry of health website:
Selection Process
The selection of ASHAs would have to be done carefully. The District Health Society envisaged
under NRHM would oversee the process. The Society would designate a District Nodal Officer,
preferably a senior health person, who is able to ensure that the Health Department is fully
S/he would also act as a link with the NGOs and with other departments. The Society would
designate Block Nodal Officers, preferably Block Medical Officers, to facilitate the selection
process, organizing training for Trainers and ASHA as per the guidelines of the scheme.
Be the main link between ASHA, Health system and PRI Provide on the job support to the
ANM will meet ASHA one every fortnight and discuss the
activities undertaken and guide ASHA accordingly in case she
encounters any problem while implementing the programmes
ANMs will inform ASHA regarding the date and time of outreach
session o that she will be able to bring the beneficiaries to these
outreach sessions.
She will take help of ASHA to update the ECCR of the village
ASHA will be utilized to motivate pregnant mothers to take ANC
and other services available from the sub centre.
ANM will train ASHA on danger signals of pregnancy and labour
so that she can timely identify and help beneficiaries in getting
referred to the health facility.
ANM will ensure the supply of regular kits and medicines to the
ANM will take the leadership in organizing village health camps
along with ASH
hence ans is d not c
child involved in repetitve tasks, no communication?
A.Autism... ANS
120) One
year child is admitted with history of fever and cough had three episodes of bronchiolitis
prior now has large foul smelling hat stools which disorder may suspect
A. Cystic fibrosis
B. Maple syrup disease
D. Bilirubin conjugation defects
Answer is CysticFibrosis
Reference-Biochemical Case Histories [new chapter added in Harper 28th edition]
A 1-year-old girl, an only child of Caucasian background, was brought to the clinic at the
Hospital for Sick Childrenby her mother. She had been feverish for the past 24 h and was
coughing frequently. The mother stated that herdaughter had experienced three attacks of
"bronchitis" since birth, each of which had been treated with antibioticsby their family
physician. The mother had also noted that her daughter had been passing somewhat bulky,
foulsmellingstools for the past several months and was not gaining weight as expected. In
view of the history ofpulmonary and gastrointestinal problems, the attending physician
suspected that the patient might have CF,
although no family history of this condition was elicited.
Laboratory Findings
Chest x-rays showed signs consistent with bronchopneumonia. Culture of sputum revealed
predominantlyPseudomonas aeruginosa. Fecal fat was increased. A quantitative pilocarpine
iontopheresis sweat test wasperformed, and the sweat Cl– was 70 mmol/L (>60 mmol/L is
abnormal); the test was repeated a week later withsimilar results.
The child was given an appropriate antibiotic and referred to the cystic fibrosis clinic for
further care. Acomprehensive program was instituted to look after all aspects of her health,
including psychosocialconsiderations. She was started on a pancreatic enzyme preparation
(given with each meal) and placed on ahigh-calorie diet supplemented with multivitamins and
vitamin E. Postural drainage was begun for the thickpulmonary secretions. Subsequent
infections were treated promptly with appropriate antibiotics and with anaerosolized
recombinant preparation of human DNase that digests the DNA of microorganisms present in
therespiratory tract. At age 6 years, she had grown normally, had been relatively free of
infection for a year, wasattending school and making satisfactory progress. Serious chronic
cases of CF in which the lungs are severelycompromised are candidates for lung transplants,
although the effiacy of this treatment has been challengedrecently.
Research on gene therapy for CF is under examination (eg, using recombinant viruses
encoding the CFTRprotein). Another line of research is investigating whether small molecules
can be found for clinical use that helpabnormally folded CFTR molecules re-fold into at least
partially active molecules.
CF is a prevalent and usually serious genetic disease among whites in North America. It affects
approximately1:2500 individuals and is inherited as an autosomal recessive disease; about
one person in 25 is a carrier. It is adisease of the exocrine glands, with the respiratory and
gastrointestinal tracts being most affected. Adiagnostic hallmark is the presence of high
amounts of NaCl in sweat, reflecting an underlying abnormality inexocrine gland function (see
below). Pilocarpine iontophoresis has generally been used to allow collection ofsufficient
amounts of sweat for analysis. Iontophoresis is a process by which drugs are introduced into
the body (inthis case the skin) via use of an electrical current. Its use is diminishing as the
availability of specific genetic probes
The classic presentation of CF is that of a young child with a history of recurrent pulmonary
infection and signs ofexocrine insufficiency (eg, fatty, bulky stools due to a lack of pancreatic
lipase), as in the present case. However,the disease is clinically heterogeneous, which at least
partly reflects heterogeneity at the molecular level Approximately 15% of patients may have
sufficient pancreatic function to be classified as "pancreaticsufficient."
For reasons related to abnormalities in Cl– and Na+ transport the pancreatic ducts and the
ducts ofcertain other exocrine glands become filled with viscous mucus, which leads to their
obstruction. This mucus inalso present in the bronchioles, leading to their obstruction; this
favors the growth of certain bacteria (eg,Staphylocococu aureus and P aeruginosa ) that cause
recurrent bronchopulmonary infections, eventuallyseriously compromising lung function. In
turn, the pulmonary disease can lead to right ventricular hypertrophy andpossible heart
failure. Patients usually die of pulmonary infection or heart failure. In recent years,
morepatients have been living into their 30s and later, as the condition is now diagnosed
earlier and appropriatecomprehensive therapy started. Sometimes, problems due to lack of
pancreatic secretions can be present at birth,
the infants presenting with intestinal obstruction due to very thick meconium (meconium
ileus). Other patientsless severely affected, may not be diagnosed until they are in their teens
or later. CF also affects the genital tractand most males and many females are infertile
121) All except occurs on Decrease in liver glucose level :
a.inhibition of PFK2
b.Activation of Fructose 2,6bisphosphatase
c.increase in glucagon
d.increase in Fructose2,6bis phosphate ANS
When there is an abundant supply of glucose, the concentration of fructose 2,6-bisphosphate
increases, stimulating glycolysis by activating phosphofructokinase-1 and inhibiting fructose
1,6-bisphosphatase. In the fasting state, glucagon stimulates the production of cAMP,
activating cAMP-dependent protein kinase, which in turn inactivates phosphofructokinase-2
and activates fructose 2,6-bisphosphatase by phosphorylation. Hence, gluconeogenesis is
stimulated by a decrease in the concentration of fructose 2,6-bisphosphate, which inactivates
phosphofructokinase-1 and relieves the inhibition of fructose 1,6-bisphosphatase.[Harper 28th
Answer is increase in Fructose2,6bis phosphat e
122) After 12-24 hrs starvation,what will not happen?
A. Increase free fatty acid
B. increase ketone bodies.
C. decreased glycogen
D. decreased serum protiens. ANS
Table 16–2. Plasma Concentrations of Metabolic Fuels (mmol/L) in the Fed and Fasting States
Fed 40 Hours Fasting 7 Days Starvation
Glucose 5.5 3.6 3.5
Free fatty acids 0.30 1.15 1.19
Ketone bodies Negligible 2.9 4.5
Q. Common enzyme in cholestrol and ketone metabolism
a. HMG coA reductase
b HMG coA lyase
c HMG coA synthase
d. Thiolase
answer -HMG CoA Synthase
Cholesterol Synthesis
Acetoacetyl-CoA, which is the starting material for ketogenesis, also arises directly from the
terminal fourcarbons of a fatty acid -oxidation(Figure 22–7). Condensation of acetoacetyl-CoA
with another molecule of
acetyl-CoA by 3-hydroxy-3-methylglutaryl-CoA synthase forms 3-hydroxy-3-methylglutarylCoA (HMG-CoA)[Harper28th Chapter 22]Diagram 22-7
Expl-Acetoacetyl Co A is the starting material for ketogenesis..Acetyl CoA released by
Oxidation is added to the AcetoAcetyl Co A To Form HMG CoA.So Thiolasecannot be
considered a part of Ketogenesis according to Harper.
But many books says Acetyl CoA is the staarting material.But Harper doesnt.
By 12-24 hours the glycogen store is depleted ,So no point of decrease in glycogen after 24
hours.Eventhough I could not find decrease in serum Protein it is obvious that plasma protein
synthesis decrease in starvation.
123..After 12-24 hrs starvation,what will not happen?
A. Increase free fatty acid
B. increase ketone bodies.
C. decreased glycogen
D. decreased serum protiens. ANS
Table 16–2. Plasma Concentrations of Metabolic Fuels (mmol/L) in the Fed and Fasting States
40 Hours Fasting
7 Days Starvation
Free fatty acids
Ketone bodies
By 12-24 hours the glycogen store is depleted ,So no point of decrease in glycogen after 24
hours.Eventhough I could not find decrease in serum Protein it is obvious that plasma
protein synthesis decrease in starvation.
Least likely to develop endocarditis?
Scholastic performance impeded by all except ?
immune complex shoes what protein structure?
Spleen is a common site for metastasis from
A. Pancreatic Ca
B. Stomach Ca
C. Ovarian Ca
D. endometrial Ca
. pyrogenic cytokinin, a/e:
1. il-6
2. il-18?
3. tnf
design effect is used for???
1. Stratified sampling
2. Simple random sampling
3. Cluster sampling ANS
4. Systematic sampling
alcohol consumption amount was measured b4 and after an intervention program?
Test used 2 analyse significance of diff in amount of alcohol??
Paired T
Chi square
Unpaired T
Ans: paired T
definite method of identifying gene functn?
Western blot
southern blot
productn of transgenic animals
productn of knock out animals
Clozapin except
More potent block D2? greater than D1?
Blood level below 350 should be maintaines
shoud be stoppped at wbc<3000
Not used with Carbamazepine
difference between 20% and 10% lipid solution of lipids all except?
A. Less hyper triglyceridemia
B. Less hpyer cholesterolemia
C. less energy supplied
A young boy came with dyspnea and was found to have a mediastinal mass. which of
the following is known to produce mediastinal lymphadenopathy?
A. diffuse large B cell Lymphoma ANS
B. B cell rich T cell lymphoma
C. T cell rich B cell lymphoma
D. T cell ALL
209. Which of these is not a cause of increased MCV and normal MCH ?
A. Aplastic bone marrow
B. Thalasemia
C. Vit B12 deficiency
16YRS Macro adenoma is defined as being above what size
A. 1.5 cm
B 1 cm ANS
C. 2 cm
D. 2.5 cm
Which muscle relaxant causes pain on injection ?
A. Succinyl choline
B. Vecuronium
C. Rocuronium
Retinoblastoma most commonly metastasize by?
A. Hematogenous route
B. Lymphatic
C Optic nerve
D. Direct extension
. A young man living in a metropolitan city comes with abuse to a particular drug. He
says he Sees sounds and hears colours. What substance is he taking?
A. LSD ans
C. cocaine
which of these is the most common tumor in a fetus?
A. Wilms tumor
B. Neuroblastoma
newborn of diabetic mother with blood glucose levels 35 mg per 100ml. what should
be line of treatment.
a. fortified expressed breast milk
b. 10%dextose @10ml/kg b.wt. by oral route
c. 10%dextrose i.v.
Which of these causes Central retinal arterial occlusion ?
A. Orbital mucormycosis
B. Cytomegalovirus virus retinitis
C. Diabetes mellitus
D. ?
A 70 years old male after catarct surgery complained of diminished vision. On FFA
Petals of flower appearance was noticed and_____ whats the probable diagnosis ?
A. Cystoid macular edema
B. Central serous retinopathy
C. Endophthalmitis
drug efficacy between 2 drugs compared in which phase of trial?
A. Phase 1
B. Phase 2
C. Phase 3
D. Phase 4
which tumor erupting from nasal neuro epithelium ?
B. astrocytoma
C. glioma
Repeated transcranial magnetic stimulation of brain is done in
a) Depression
b) Resistant schizophrenia
c) OCD
d) Acute psychosis
Case control studies differ from cohort studies in
A. Case control does not measure the exposure in study and exposure group
B. cohort studies require long term exposure studies
after 12-24 hrs starvation, what will not happen?
1. Increase free fatty acid
2. increase ketone bodies.
3. decreased glycogen
4. decreased serum protiens. ANS
There is no conduction deficit in electro physiological studies in ?
A.Diffuse motor neuropathy
B. leprosy
extensor plantar, ankle and knee reflex absent ? A.Friedrichs ataxia B.
Not useful in MRSA ?
C. vancomycin repeat
Hb values, mean is 10 gm/dl. sample size - 100 , SD 1. Wat is the standard Error ?
A.0.1, ANS
B.10... REPEAT
Sexual function controlled by which part of hypothalamus ?
A.Supraoptic, B.paraoptic,C. posterior hypoth, D.lat hypothal
A person arrested for sodomy. Confesses tHat he is an active agent. Wat is not found
in him ?
A.Constriction in mid shaft
B. presence of smegma, ANS
C. tear in frenulum
basal exudates, infarcts, hydrocephalus?
A.TB meningitis. ANS...
Cordotomy done to relieve pain in right lower limb . Wat kind ?
A.Right spinothalamic tract,
B.left spinothalamic tract ANS.... REPEAT
which part of the brain must be stimulated using...... in Parkinsonism ?
A.Substantia nigra ANS
,B. putamen, ...
mean blood sugar of d. patient 105, range for 95% confidence limit?
B. 65-100,
child with recurrent infection by bac havin polysaccaride capsule, what assay to b
done: IgA, A.IgG1,
D. IgG2
least common presentation in multiple myeloma ?
A.hyperviscosity ANS
B. anemia
C.bone pains,
D. infections
163. Drug of choice in IBS (constipation type)
164.scholastic performance impeded by all except ?
165. the mitochondrial enzymes involved in
metabolism of clopidogrel and PPI are
a. CYP3A4
b. CYP2C10 ANS
c. CYP 2A
d. CYP 2C20
166. Best way to detect minimum
a) Erect abdomen
2) Supine
3) Right lateral decubitus with horizontal beam
4) Left lateral decubitus with horizontal beam ans
167. A child came with a lymph node and fine
needle confirmed it to be a papillary carcinoma
thyroid. He subsequently underwent total
thyroidectomy and functional neck dissection, what
should be the next step in the management?
A. Administer I131
B. Suppressive doses of thyroxin
C. scans to search for metastasis
D. CECT to see residual disease ans
168. A pt. on one regular medication, which should
be stopped before an abdominal surgery
A) statin
B) steroids
C) beta blockers
D) ACEI ans
169. All of the following are larvicidal except
a) Abate
b) Paris green
c) Malathion
d) Pyrethrum ans
170. In Alzheimer disease, neurofibrillary tangles are not seen in
a) Temporal lobe
b) Visual association areas
c) lateral geniculate body
d) Entorhinal cortex
171. Which of following is most common cause of bone fracture in India
A) Sarcoidosis
B) Paget’s disease
C) Nutritional deficiency
D) Steroids
172. Drug used in cerebral vasospasm
a) Nimodipine ans
b) Nifedipine
c) Amlodipine
d) Verapamil
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