2012 www.drpawan.webs.com pawan 1/17/2012 AIPG 2012 159 QUES(wel framed) AND ANSWERS WITH 4 OPTIONS by www.drpawan.webs.com (CAN BE DOWNLOADED) join this website for get updated 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 B.ERYTHROMYCIN C. D. 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 c. 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 a) cAMP ANS 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 Ref 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. 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 alone...". 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 prolapse". Benefits for men www.drpawan.webs.com join this website for get updated 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. 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' Incontinence 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 a) FANCONI ANEMIA ANS 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 a) DTPA b) DMSA ANS 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 D.manometry 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 c) CSOM 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? a) LUMINOL SPRAY 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 c) TSH ANS d) GHRELIN 63) mitochondria involved in a/e 1fatty acid synthesis ANS 2chromosome 3 fatty acid redn 4protin 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 c d 67) All cause Conduction Deafness Except? a. menieres disease ( Hydrops) b. otosclerosis. c. serous OTitis Media d. 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 diagnosis? a. SCFE b. c. d. 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 Diagnosis? 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.... d. 72) . Proximal Segment of Scaphoid Fracture goes into AVN Due To? a. REtrograde Blood Supply to Scaphoid b. c. d. 73) . Tuberculosis Bone Is due to? a. Hematogenous Spread b. Lymphatic Spread. 74) Deep ant. chamber with scar on limbus with 10D lens: 1.Aphakia 2.Pseudophakia 3.post dislocation lens 75) Q most resistant to disinfectants and antiseptics: 1.spore 2.prions 3.bacteria 4.virus. 76) mosquito- culex anap aedes commonly transmits? a.JE B.YF C.filariasis 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 B.heriditary C.congenital 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 www.drpawan.webs.com join this website for get updated 80) . Blood group A will have which genotype? A. OO B. AO C. AB C. BO 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 REF: 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 D.SLE 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? A. OO B. AO ANS C. AB C. BO 98) 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 fragment 99) ans.c 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 repeat 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. http://www.ornl.gov/sci/techresources/Human_Genome/faq/compgen.shtml 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. COVALENTLY-CONNECTED TERTIARY DOMAINS 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 [http://swissmodel.expasy.org] Best option is Tertiary structure 106) Which of the following amino acid can have o-glycoxylation linkage in oligosachride molecule A.Asparagine B. glutamine C. serine D. cysteine Ans Serine THERE ARE THREE MAJOR CLASSES OF GLYCOPROTEINS 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 glycosylphosphatidylinositolanchored (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 ABSTRACT 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 sites.[http://nar.oxfordjournals.org/content/29/18/3705.full] 108) Which of the following proteins cannot be phosphorylated using protein kinase in prokaryotic organisms A.Aspargine B.Cysteine C.Serine D.Methionine ANS Reference 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. Reference PROTEIN STRUCTURE 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. Source Department of Internal Medicine, University of Essen, Germany. [REMOVED] Abstract 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] 111) 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 CONSIDERATIONS FOR USE 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 a 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 c. d. 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: http://mohfw.nic.in/NRHM/asha.htm http://mohfw.nic.in/NRHM/RCH/guidelines/ASHA_guidelines.pdf 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 involved. 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. http://www.wbhealth.gov.in/nrhm/ASHA%20Implementation%20Guidelines.pdf 4. ROLE OF ANMs: Be the main link between ASHA, Health system and PRI Provide on the job support to the ASHA 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 concerned 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 ASHA. ANM will take the leadership in organizing village health camps along with ASH hence ans is d not c 118) 119) child involved in repetitve tasks, no communication? A.Autism... ANS B.ADHD 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 C. 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. Treatment 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. Discussion 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 increases. 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 edition] 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 Ketogenesis 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 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 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) 124) Least likely to develop endocarditis? a.vsd b.asd c.mr d.ar 125) Scholastic performance impeded by all except ? A.ADHD 126) B.PIC 127) immune complex shoes what protein structure? A.primary B.secondary C.tertiary D.quarternary 128) Spleen is a common site for metastasis from A. Pancreatic Ca B. Stomach Ca C. Ovarian Ca D. endometrial Ca 129) . pyrogenic cytokinin, a/e: 1. il-6 2. il-18? 3. tnf 4.inf-a 130) design effect is used for??? 1. Stratified sampling 2. Simple random sampling 3. Cluster sampling ANS 4. Systematic sampling 131) 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 132) definite method of identifying gene functn? Western blot southern blot productn of transgenic animals productn of knock out animals 133) 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 134) difference between 20% and 10% lipid solution of lipids all except? A. Less hyper triglyceridemia B. Less hpyer cholesterolemia C. less energy supplied D.? 135) 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 136) 209. Which of these is not a cause of increased MCV and normal MCH ? A. Aplastic bone marrow B. Thalasemia C. Vit B12 deficiency D. 137) 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 138) 139) Which muscle relaxant causes pain on injection ? A. Succinyl choline B. Vecuronium C. Rocuronium D. 140) Retinoblastoma most commonly metastasize by? A. Hematogenous route B. Lymphatic C Optic nerve D. Direct extension 141) . 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 B. PCP C. cocaine D. 142) which of these is the most common tumor in a fetus? A. Wilms tumor B. Neuroblastoma C. D. 143) 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. 144) Which of these causes Central retinal arterial occlusion ? A. Orbital mucormycosis B. Cytomegalovirus virus retinitis C. Diabetes mellitus D. ? 145) 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 D. 146) drug efficacy between 2 drugs compared in which phase of trial? A. Phase 1 B. Phase 2 C. Phase 3 D. Phase 4 147) which tumor erupting from nasal neuro epithelium ? A. B. astrocytoma C. glioma D. 148) Repeated transcranial magnetic stimulation of brain is done in a) Depression b) Resistant schizophrenia c) OCD d) Acute psychosis 149) 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 C. 150) 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 151) There is no conduction deficit in electro physiological studies in ? A.Diffuse motor neuropathy B. leprosy C.AIDP ANS 152) extensor plantar, ankle and knee reflex absent ? A.Friedrichs ataxia B. 153) Not useful in MRSA ? A.Cefaclor, B.ciprofloxacin, C. vancomycin repeat 154) Hb values, mean is 10 gm/dl. sample size - 100 , SD 1. Wat is the standard Error ? A.0.1, ANS B.10... REPEAT 155) Sexual function controlled by which part of hypothalamus ? A.Supraoptic, B.paraoptic,C. posterior hypoth, D.lat hypothal 156) 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 157) basal exudates, infarcts, hydrocephalus? A.TB meningitis. ANS... B.VIRAL MENINGITIS 158) Cordotomy done to relieve pain in right lower limb . Wat kind ? A.Right spinothalamic tract, B.left spinothalamic tract ANS.... REPEAT 159) which part of the brain must be stimulated using...... in Parkinsonism ? A.Substantia nigra ANS ,B. putamen, ... 160) mean blood sugar of d. patient 105, range for 95% confidence limit? A.85-125,ANS B. 65-100, 161) child with recurrent infection by bac havin polysaccaride capsule, what assay to b done: IgA, A.IgG1, B.IgG2 C.IgA D. IgG2 162) least common presentation in multiple myeloma ? A.hyperviscosity ANS B. anemia C.bone pains, D. infections 163. Drug of choice in IBS (constipation type) A.LUBIPROST ANS 164.scholastic performance impeded by all except ? A.ADHD B.PICA 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 pneumoperitoneum 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 www.drpawan.webs.com join this website for get updated TO BE CONTINUE…….
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