pgaiims-Fort-Worth-Star-Telegram

Q: Which of the following is not associated with RCC:

(a) Polycythemia
(b) Amyloidosis
(c) Cushing's syndrome
(d) Hypertension.



                                                                                                   A: c. Cushing's..

Q: Survival in unresectable GB Ca is:

(a) 4-6 months
(b) 8-10 months
(c) 1 year
(d) 12-24 months.



                                                                                                   A: a. 4-6 months

Q: Mangled Extremity Severity Score includes all except:

(a) Shock
(b) Ischemia
(c) Neurogenic injury
(d) Energy of injury.



                                                                                                   A: c. Neurogenic...

Q: The technique of lap cholecystectomy was first described by:

(a) Erich Muhe
(b) Philip Moore
(c) Kurt Semm
(d) Eddie reddick



                                                                                                   A: a. Erich Muhe

Q: Not true about mucinous cystadenoma pancreas:

(a) Microcystic adenoma
(b) Lined by columnar epithelium
(c) Pre malignant
(d) Focus of ovarian stroma in it.



                                                                                                   A: a. Microcystic ...

Q: In a male after lap cholecystectomy, specimen shows Ca gall bladder stage T1a. Appropriate management is:

(a) Conservative and follow up
(b) Extended cholecystectomy
(c) Excision of all port sites
(d) Radiotherapy.


                                                                                                   A: c. Excision of...

Q: Best test to diagnose GERD and quantify acid output is:


(a) Esophagogram
(b) Endoscopy
(c) Manometry
(d) 24 hr pH monitor


                                                                                                   A: d. 24 hr pH

Q: Most common site of cholangiocarcinoma:

(a) Distal biliary duct
(b) Hilum
(c) Intrahepatic duct
(d) Multifocal.



                                                                                                   A: b. Hilum

Q: Gleason score, all are true except:

(a) Used for grading prostate cancer
(b) Scores range from 1- 10
(c) Higher score, poorer prognosis
(d) Helps in planning management.



                                                                                                   A: b. Scores....

Q: Most common cause of acute mesenteric ischemia is:

(a) Arterial thrombosis
(b) Venous thrombosis
(c) Embolism
(d) Non- occlusive disease.



                                                                                                   A: c. Embolism

Q: Treatment of medullary Ca thyroid:

(a) Surgery and radiotherapy
(b) Radiotherapy and chemo
(c) Surgery only
(d) Radioiodine ablation.



                                                                                                   A: Surgery only

Q: Which of the following statements about Pancreatic Ca is not true:

(a) Mutation in P 53 gene is associated in 75% of cases
(b) Hereditary pancreatitis significantly increases the risk
(c) Median survival in locally advanced ( stage III) disease is 3-6 months
(d) Five year survival after curative pancreatico-duodenectomy is 15-20%.



                                                                                                   A: c. Median....

Q: Risk factors for malignant change in an asymptomatic patient with a gall bladder polyp on USG include all except:

(a) Age > 60 yrs
(b) Rapid increase in polyp
(c) Size of polyp >5 mm
(d) Asso gall stones.


                                                                                                   A: c. Size of....

Q: Non progressive contraction of esophagus are:

(a) Primary
(b) Secondary
(c) Tertiary
(d) Quartenary.



                                                                                                   A: d. Quartenary

Q: Most important prognostic factor for colorectal ca:

(a) Site of lesion
(b) Tumor size and characteristics
(c) Age of patient
(d) Lymph node status.



                                                                                                   A: d. Lymph node

Q: A 3 week old patient presenting with vomiting and failure to thrive found to have pyloric stenosis. What should be the next step of management:

(a) Emergency pyloromyotomy
(b) Fluid resuscitation maybe delayed
(c) Correction of electrolyte disturbances
(d) Cardiopulmonary resuscitation.


                                                                                                   A: c. Correction....

Q: On abdominal USG, gall bladder shows diffuse wall thickening with hyperechoic nodules at neck and comet tail artefacts, the most likely diagnosis:

(a) Adenomyomatosis
(b) AdenoCa of GB
(c) Xanthogranulomatous cholecystitis
(d) Cholesterol crystals.


                                                                                                   A: a. Adenomyoma...

Q: Gold standard investigation for recurrent GIST:

(a) MRI
(b) MIBG
(c) USG
(d) PET CT



                                                                                                   A: d. PET CT

Q: Which of the following is the terminal group of lymph node for colon:

(a) Paracolic
(b) Epicolic
(c) Preaortic
(d) Ileocolic



                                                                                                   A: c. Preaortic

Q: Most protective against Ca Colon:

(a) High fibre diet
(b) Low fat diet
(c) Low selenium diet
(d) Low protein diet.



                                                                                                   A: a. High fibre

Q: BRCA 1 gene is located on chromosome:

(a) 13
(b) 11
(c) 17
(d) 22



                                                                                                  A: c. 17

Q: Which of the following is not true about FAP:

(a) AR inheritance
(b) Screening done by sigmoidoscopy
(c) Polyps develop in late adulthood
(d) Epidermal cysts & osteomas may occur.



                                                                                                   A: a. AR inheritance

Q: Gold standard test for insulinoma:

(a) 72 hr fasting test
(b) Plasma insulin levels
(c) C-peptide levels
(d) Low glucose levels < 130 mg/dl.



                                                                                                   A: a. 72 hr .....

Q: Which of the following would be the best treatment for a 2cm thyroid nodule in a 50yr old man with FNAC revealing it to be a papillary carcinoma:

(a) Hemithyroidectomy
(b) Total thyroidectomy with left sided modified neck dissection.
(c) Near total thyroidectomy with radiotherapy
(d) Hemithyroidectomy with modified neck dissection.


                                                                                                   A: b. Total.....

Q: All of the following genes maybe involved in Ca colon except:

(a) APC
(b) beta Catenin
(c) K ras
(d) Mismatch repair genes.



                                                                                                   A: b. Beta catenin

Q: A 50 yr old male with obstructive symptoms. Biopsy of stomach reveals GIST. Most appropriate marker:

(a) CD 34
(b) CD 117
(c) CD 30
(d) CD 10



                                                                                                   A: b. CD 117

Q: Hashimoto's thyroiditis- true are a/e:

(a) Follicular destruction
(b) Increase in lymphocytes
(c) Oncocytic metaplasia
(d) Orphan Annie eye nuclei.



                                                                                                   A: d. Orphan ....

Q: All are true regarding mesothelioma except:

(a) Bilaterally symmetrical
(b) Associated with asbestos exposure
(c) Histopathology shows biphasic pattern
(d) Occurs in late middle age.



                                                                                                   A: a. Bilaterally....

Q: Which of the following is true:

(a) Colloid goitre mostly presents as hyperthyroidism
(b) Thyroid storm, the clinical features are primarily due to increased thyroxine
(c) Excess calcium intake can lead to hyperthyroidism
(d) Goitre more than 5 percent of population is endemic goitre.



                                                                                                   A: d. Goitre more....

Q: Which is NOT true about femoral artery canulation:

(a) Common femoral artery is canulated
(b) Single wall puncture is indicated in those with normal coagulation profile
(c) Femoral artery is catheterised at medial third of femoral head
(d) Seldinger technique is used both for femoral artery and vein.



                                                                                                   A: b. Single wall....

Q: False about hepatic duct:

(a) Left hepatic duct formed in umbilical fissure
(b) Caudate lobe drains only left hepatic duct
(c) Right hepatic duct formed by V and VII segments
(d) Left hepatic duct crosses IV segment.



                                                                                                   A: b. Caudate lob...

Q: Ductus dependent blood flow is required for all of these congenital heart diseases except:

(a) Persistent truncus arteriosus
(b) Hypoplastic left heart syndrome
(c) Pulmonary stenosis
(d) TGA with intact septum.


                                                                                                   A: a. Persistent....

Q: A child is admitted on 7th day of life with severe respiratory distress and shock. He was discharged 2 days back healthy. What could be the probable diagnosis:

(a) Large VSD
(b) Hypoplastic left heart syndrome
(c) Ebstein anomaly
(d) AP window defect.



                                                                                                   A: b. Hypoplastic...

Q: International prognostic index for lymphomas includes the following prognostic factors except:

(a) Stage of disease
(b) No: of extralymphatic sites involved
(c) LDH
(d) Hemoglobin and albumin


                                                                                                   A: d. Hemoglobin...

Q: A study under Australian collaborative trial on steroid use in neonates showed:

(a) No difference between placebo and steroid
(b) Steroids to children cause behavioural worsening
(c) Steroids to children cause reduction in head circumference
(d) Steroids to children cause neurosensitivity degradation.



                                                                                                   A: b. behavioural...

Q: In a child with respiratory distress, failure to thrive, the sweat chloride levels were estimated to be 35 meq/l and 41 meq/l. What is the next best to do:

(a) Nasal transmembrane potential difference
(b) DNA analysis of F 508 mutation
(c) CT chest
(d) 72 hour fecal fat estimation.


                                                                                                   A: a. Nasal .....

Q: Hypoplasia of limbs and scarring is due to:

(a) Varicella
(b) Herpes simplex
(c) Rubella
(d) Toxoplasmosis.



                                                                                                   A: a. Varicella....

Q: A pregnant lady had no complaints but mild cervical lymphadenopathy in first trimester. She was prescribed spiramycin, but she was non-compliant. Baby was born with hydrocephalus and intracerebral calcification. Which of these is a likely cause:

(a) Rubella
(b) Toxoplasmosis
(c) CMV
(d) Herpes.


                                                                                                   A: Toxoplasmosis

Q: A 3.5 male infant born at term after an uncomplicated pregnancy and delivery develops respiratory distress shortly after birth and requires mechanical ventilation. The chest radiograph reveals a normal cardiothymic silhouette but a diffuse ground glass appearance to the lung fields. Surfactant replacement fails to improve gas exchange. Over the first week of life, the hypoxemia worsens. Results of routine culture and echocardiographic findings are negative. A term female sibling died at 1 month of age with respiratory distress. Which of the following is the most likely diagnosis:

(a) TAPVC
(b) Meconium aspiration
(c) Neonatal pulmonary alveolar proteinosis
(d) Disseminated herpes simplex infection.



                                                                                                   A: c. Neonatal....

Q: A 4 week old female child with normal genitalia presents to the emergency department with severe dehydration, hyperkalemia and hyponatremia. The measurement of blood levels of which of the following will be helpful:

(a) 17 hydroxy progesterone
(b) Renin
(c) Cortisol
(d) Aldosterone.


                                                                                                   A: d. Aldosterone

Q: Which of the following is not a feature of juvenile idiopathic arthritis:

(a) Rheumatoid arthritis
(b) Spikes of high fever
(c) Uveitis
(d) Raynaud's phenomenon.



                                                                                                   A: d. Raynaud's...

Q: A 5-yr old boy presents with pubic hair development. He is tall and has increased pigmentation of his genitalia and phallic enlargement. Blood pressure is 130/90 mm of Hg. Measurement of which of the following hormones would most likely be diagnostic:

(a) Increased 17 beta hydroxy progesterone
(b) Increased cortisol
(c) Increased aldosterone
(d) Increased 11 deoxy cortisol.


                                                                                                   A: d. Increased 11...

Q: A 2 month old infant is presented with failure to thrive, recurrent emesis, hepatosplenomegaly and adrenal insufficiency. Adrenal calcification is noted radiologically. The most likely diagnosis is:

(a) Adrenal hemorrhage
(b) Wolman's disease
(c) Pheochromocytoma
(d) Addison's disease.


                                                                                                   A: b. Wolman's ....

Q: All of the following statements about congenital rubella are true except:

(a) IgG persists for more than 6 months
(b) IgM antibody is present at birth
(c) Most common anomalies are hearing and birth defects
(d) Increased risk of congenital malformation if infection occurs after 16 weeks.



                                                                                                   A: d. Increased....

Q:  A previously healthy 6 week old female infant is found unresponsive in her crib. In the emergency department, she is noted to be well developed and well nourished with normal blood pressure and appearance of the genitalia, but with increased pigmentation of her skin. Blood glucose level is 30 mg/dl. The most likely diagnosis is:

(a) CAH due to 21 hydroxylase deficiency
(b) Familial glucocorticoid deficiency
(c) Cushing syndrome
(d) Insulinoma.


                                                                                                   A: b. Familial gluco..

Q: A child comes with steroid resistant nephrotic syndrome secondary to FSGS, not responsive to methylprednisolone. what next should be given:

(a) Oral cyclophosphamide
(b) Oral cyclosporine
(c) Oral mycophenolate
(d) IV cyclophosphamide.


                                                                                                   A: b. Oral cyclospo..

Q: Which of the following about cystic fibrosis is not true:

(a) Autosomal recessive
(b) Abnormality in CFTR which leads to defective calcium transport
(c) Mutation in cystic fibrosis transport regulator
(d) Decrease in ENaC activity.



                                                                                                   A: b. Abnormality...

Q: Most common organism associated with cystic fibrosis:

(a) Pseudomonas aeuroginosa
(b) Burkholderia cepacia
(c) Pleisomonas
(d) Aeromonas.



                                                                                                   A: a. Pseudo....

Q: A male child with Fanconi syndrome with nephrocalcinosis has a variant of Dent's disease. All are true except:

(a) Hypercalciuria
(b) Proteinuria
(c) Similar presentation in father
(d) Rickets.


                                                                                                   A: c. Similar....

Q: A patient develops sudden palpitation with HR 150/min, regular. What could be the cause:

(a) PSVT
(b) Sinus tachycardia
(c) Ventricular tachycardia
(d) Atrial flutter with block.


                                                                                                   A: a. PSVT

Q: Cause of alpha thalassemia:

(a) Deletion of alpha genes
(b) Deletion of beta genes
(c) Excess of alpha genes
(d) Single AA substitution in alpha chain.



                                                                                                   A: a. Deletion...

Q: All are congenital myopathies except:

(a) Central core myopathy
(b) Centronuclear myopathy
(c) Z band myopathy
(d) Nemalin myopathy.



                                                                                                   A: c. Z band....

Q: Horner's syndrome, all are true except:

(a) Miosis
(b) Anhydrosis
(c) Hyperchromatic iris
(d) Apparent exophthalmos.



                                                                                                   A: d. Apparent....

Q: Thrombotic event is seen in all of the following except:

(a) PNH
(b) DIC
(c) ITP
(d) Heparin induced thrombocytopenia.



                                                                                                   A: c. ITP

Q: Pulsatile liver and ascites is found in:

(a) TR
(b) PS
(c) MR
(d) MS



                                                                                                   A: a. TR

Q: Positive hepatojugular reflex is found in all of the following conditions except:

(a) Tricuspid regurgitation
(b) Right heart failure
(c) Decreased after load
(d) Increased capillary bed pressure.



                                                                                                   A: c. Decreased....

Q: Berry aneurysm- defect lies in:

(a) Degeneration of internal elastic lamina
(b) Deposition of mucoid material in media
(c) Degeneration of media.
(d) Disturbance in vessel wall.



                                                                                                   A: c. Degeneration...

Q: A 14 yrs old girl on exposure to cold has pallor of extremities, followed by pain and cyanosis. In later ages of life, she is prone to develop:

(a) Systemic lupus erythematosis
(b) Scleroderma
(c) Rheumatoid arthritis
(d) Histiocytosis.


                                                                                                   A: b. Scleroderma.

Q: A 9yr old girl has difficulty in combing hairs and climbing upstairs since 6 months. She has Gower's sign positive and maculopapular rash over metacarpophalangeal joints. What should be the next appropriate investigation to be done:

(a) ESR
(b) RA factor
(c) Creatine kinase
(d) Electromyography.


                                                                                                   A: c. Creatine kinase

Q: A girl presented with severe hyperkalemia and peaked T waves on ECG. Most rapid way to decrease serum potassium level:

(a) Calcium gluconate iv
(b) Oral resins
(c) Insulin + glucose
(d) Sodium bicarbonate.


                                                                                                   A: c. Insulin +.....

Q: Which of the following about atherosclerosis is true:

(a) Intake of unsaturated fatty acid is associated with decreased risk.
(b) Thoracic aorta involvement is more severe than abdominal aorta
(c) Extent of lesion in veins is same as that in arteries.
(d) Hypercholesterolemia does not always increase the risk of atherosclerosis per se.


                                                                                                   A: a. Intake of...

Q: Reperfusion is useful for:

(a) Stunned myocardium
(b) Hibernating myocardium
(c) Non ischemic viable myocardium
(d) Mixed ischaemic viable myocardium



                                                                                                   A: b. Hibernating...

Q: In congenital dystrophic variety of epidermolysis bullosa, mutation is seen in the gene coding for:

(a) Laminin 4
(b) Collagen type 7
(c) Alpha 6 integrin
(d) Keratin 14.


                                                                                                   A: b. Collagen....

Q: Cardiac polyp means:

(a) Acute infarct
(b) Cardiac aneurysm
(c) Benign tumour
(d) Fibrinous clot.



                                                                                                   A: d. Fibrinous...

Q: CD4 is not important for which of the following:

(a) Antibody production
(b) Cytotoxicity of T cells
(c) Memory B cells
(d) Opsonisation.



                                                                                                   A: b. Cyto....

Q: Infraclavicular lesion of tuberculosis is known as:

(a) Ghon's focus
(b) Puhl's focus
(c) Assman's focus
(d) Simmon's focus.



                                                                                                   A: c. Assman's...

Q: A 7 year old girl is brought with complaints of generalized swelling of body. Urinary examination reveals grade 3 proteinuria and presence of hyaline and fatty casts. She has no history of hematuria. Which of the following statements about her condition is true:

(a) No IgG deposits or C3 deposition on renal biopsy
(b) Her C3 levels will be low
(c) IgA nephropathy is the likely diagnosis
(d) Alport's syndrome is the likely diagnosis.


                                                                                                   A: a. No IgG depo....

Q: A 45 years male died four days after MI and autopsy showed transmural coagulative necrosis. Which of the following microscopic features will be seen on further examination:

(a) Fibroblasts and collagen
(b) Granulation tissue
(c) Neutrophilic infiltration
(d) Granulomatous inflammation.


                                                                                                   A: c. Neutro....

Q: Common histological finding in benign hypertension:

(a) Proliferative endarteritis
(b) Necrotizing arteriolitis
(c) Hyaline arteriosclerosis
(d) Cystic medial necrosis



                                                                                                   A: c. Hyaline....