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UPSC CMS 2007 Paper 1
UPSC CMS 2007 Examination Paper 1

Mcqs contributed by Ashish Kumar Sinha

1. A five-year-old girl presents with fever and conjunctivitis. Physical examination is significant for oral erythema and fissuring along with a generalized maculopapular rash and cervical lymphadenopathy. What is the most likely diagnosis?
(a) Henoch-Schnolein purpura
(b) Polyarteritis nodosa
(c) Kawasaki disease (ANS)
(d) Takayasu arteritis

2. The following can be associated with fatty liver except
a) Amiodarone
(b) Zidovudine
(c) Sodium valproate
(d) Chlorpropamide (ANS)

3. Which one of the following is not associated with a high reticulocyte count?
(a) Acute bleed
(b) Haemolytica anemia
(c) Megaloblastic anemia (ANS)
(d) Response to treatment in nutrition/
deficiency anemia

4. A young boy presents with failure to thrive. Biochemical analysis of a duodenal aspirate after a meal reveals a deficiency of enteropeptidase (enterokinase). The levels of which one of the following digestive enzymes would be affected?
(a) Amylase
(b) Pepsin
(c) Lactose
(d) Trypsin (ANS)

5. Regarding falciparum malaria, consider the following statements:
1. The mortality rises steeply when the proportion of infected erythrocytes increases above 3 per cent.
2. The patient may develop hypoglycemia even when not treated with quinine.
Which of the statements given above is/are correct?
(a) 1 only
(b) 2 only
(c) Both 1 and 2 (ANS)
(d) Neither 1 nor 2

6. The features of organophosphorus poisoning include the following except
(a) Fasciculations
(b) Pulmonary oedema
(c) Epileptic seizures
(d) Mydriasis (ANS)

7. The salicylate intoxication in adults usually causes the following except
(a) Severe respiratory alkalosis
(b) Mixed metabolic acidosis-respiratory alkalosis
(c) Pure high anion gap metabolic acidosis
(d) Hyperchloremic metabolic acidosis (ANS)

8. The Schilling test is performed to determine the cause of
(a) Lactose malabsorption
(b) Fatty acid malabsorption
(c) Amino' acid malabsorption
(d) Cobalamin malabsorption (ANS)

9. I-receptors. Which are responsible for rapid shallow breathing are located in
(a) Thoracic cage and lung
(b) Carotid artery
(c) Alveolo-capillary junction (ANS)
(d) Respiratory muscles

10. Pansystolic murmur at apex with soft first heart sound is the key sign of which one of the following?
(a) Aortic regurgitation
(b) Mitral regurgitation (ANS)
(c) Ventricular septal defect
(d) Atrial septal defect

11. Which is the most common micro organism known to cause tropical pyomyositis ?
a) Streptococcus viridans
(b) Staphylococcus albus
(c) Klebsiella pneumoniae
(d) Staphylococcus aureus (ANS)

12. Consider the following statements:
1. In leptospirosis, the incubation period ranges from 2 to 20 days.
2. In leptospirosis, urine may show microscopic haematuria.

Which of the statements given above is/are correct?
(a) 1 only (b) 2 only
(c) Both 1 and 2; (ANS) (d) Neither 1 nor 2

13. What is' the treatment of choice for benign tertian malaria?
(a) Sulfamethoxazole-pyrimethamine
(b) Quinine
(c) Mefloquine
(d) Chloroquine (ANS)

14. Match list-I with list –II and select the correct answer using the code given below the lists:
List – I List-II
(Infection) (Therapeutic agent)
A. Candidiasis 1. Ganciclovir
B. Syphilis 2. Ciprofloxacin
C. Typhoid 3. Penicillin
D. CMV retinitis 4. Fluconazole
Code:
a. A B C D
1 3 2 4

b. A B C D
1 2 3 4

c. A B C D (ANS)
4 3 2 1

d. A B C D
4 2 3 1


15. Which one of the following is an antiemetic with minimal CNS side effects?
a. Ondansetron (ANS)
b. Chlorpromazine
c. Metoclopramide
d. Prochlorperazine

16. Regarding vitamin K, which one of the following statements is correct?
a. It is a water soluble vitamin
b. Its body-stores can last more than 8 years
c. Its routine prophylaxis in newborn children is recommended to prevent early haemorrhagic disease (ANS)
d. It is the treatment of choice in patients with acute severe haemoptysis

17. Which one of the following is the most appropriate clinical tests to confirm the iron-deficiency anaemia?
a. Red blood cell indices
b. Serum ferritin level (ANS)
c. Bone-marrow examination
d. Urinary iron clearance

18. A two old child presents with persistent diarrhoea, acidic stools and presence of one percent of reducing substance in the fresh stools. What is the most probable diagnosis?
a. Cystic fibrosis
b. Lactose intolerance (ANS)
c. Rotavirus induced diarrhoea
d. Intestinal tuberculosis

19. With reference to leprosy, consider the following statements:
1. In lepromatous leprosy, lepromin , test is always positive.
2. Polyclonal hypogammaglobinemia is a common feature of lepromatous leprosy.
3. Secondary amyloidosis may occur in long-standing lepromatous leprosy.

Which of the statements given above are correct?
(a) 1, 2 and 3 (b) 1 and 2 only
(c) 1 and 3 only (d) 2 and 3 only (ANS)

20'. With reference to Polyarticular juvenile rheumatoid arthritis" consider the following statements:
1. It is more common in girls.
2. Five or more joints are affected within the first six months of onset.
3, Uveitis occurs in 95% patients.
4. Rheumatoid factor may be negative.,

Which of the statements given above are correct?
(a) 1 and 4 only (b) 1, 2 and 4 (ANS)
(5} 2, 3 and 4 (d) 2 and 3 only

21. Koebner's phenomenon is seen in
(a) Lupus, vulgaris
(b) Lupus erythematosis
(c) Psoriasis (ANS)
(d) Eczematous dermatitis

22. Consider the following clinical features:
1. Impaired judgement
2. Impaired memory
3. Alteration of personality
4. Clouding of consciousness
Which of the above are characteristic of dementia?
a) 1 and 2 only
(b) 1, 2 and 3 only (ANS)
(c) 3 and 4 only
(d) 1, 2, 3 and 4

23. which one of the following is not a feature of catatonic schizophrenia?
(a) Negativism
(b) Automatic obedience
(c) Catalepsy (ANS)
(d) Cataplexy

24. Which one of the following is the investigation of choice for suspected deep vein thrombosis of the lower extremity?
(a) Radioactive labeled fibrinogen uptake
(b) Ascending contrast phlebography
(c) D-dimer estimation
(d) Duplex ultrasonography (ANS)

25. What is the most common initial manifestation of increased intracranial pressure in a patient' with head injury?
(a) Change in the level of consciousness (ANS)
(b) Ipsilateral pupillary dilatation
(c) Retching and vomiting
(d) Bradycardia

26. An evidence that splenectomy might benefit a patient with idiopathic thrombocytopenic purpura includes which of the following?
(a) A significant enlargement of the spleen
(b) A high reticulocyte count
(c) Patient's age less than five years
(d) An increase in platelet count on corticosteroid therapy(ANS)

27. Which one of the following ligaments contains splenic artery?
(a) Gastrosplenic ligament
(b) Splenocolic ligament
(c) Splenorenal ligament (ANS)
(d) Splenophrenic ligament

28. The segmental division' of liver into eight segments is based on
(a) Hepatic veins alone
(b) Portal vein alone
(c) Hepatic veins and common hepatic artery
(d) Hepatic veins and portal vein (ANS)

29. What is the most common surgical complication following Whipple procedure?
(a) Disruption of pancreatic anasto mosis (ANS)
(b) Biliary peritonitis
(c) Disruption of gastric anastomosis
(d) GI bleeding

30. Injury to which one of the following nerves leads to winging of scapula?
a. Thoracodorsal nerve
b. Axillary nerve
c. Long thoracic nerve (ANS)
d. Radial nerve

31. Consider the following statements:
Venacaval opening of the diaphragm situated at the level of T 8 transmits:
1. Inferior vena cava
2. Vagus nerve
3. Branches of the right phrenic nerve
4. Thoracic duct

Which of the statements given above are correct?
(a) 1 and 2 (b) 2 and 3
(c) 1 and 3 (ANS) (d) 1 and 4

32. Vascular complications of acute pancreatitis include the following except
(a) Splenic vein thrombosis
(b) Splenic artery aneurysm
(c) Gastroduodenal artery aneurysm
(d) Middle colic artery thrombosis (ANS)

33. With reference to Hirschsprung's disease, which one of the following statements is correct?
(a) It is initially treated by colostomy (ANS)
(b) In the neonatal period, it is best confirmed by barium enema
(c) It is associated with high incidence of genito-urinary tract anomalies
(d) It is characterized by the absence of ganglion cells in the transverse colon

34. Which one of the following nerves is injured in anterior dislocation of shoulder?
(a) Radial nerve
(b) Axillary nerve (ANS)
(c) Median nerve
(d) Ulnar nerve

35. What is the most common complication of fracture of the ischio-pubic ramus of pelvic bone?
(a) Rupture of urinary bladder
(b) Rupture of prostatic urethra
(c) Rupture of membranous urethra (ANS)
(d) Injury to penile urethra

36. Non-cardiac causes of raised central venous pressure include the following except .
(a) Abdominal compartment syndrome. (ANS)
(b) Tension pneumothorax
(c) Positive pressure ventilation
(d) Hypervolemia

37. Consider the following:
1. Arginine
2. Nucleotides (RNA and DNA)
3. Fatty acids
4. Glutamine
Which of the above immuno-nutrients are required more in the conditions of stress?
(a) 1 and 3 only(ANS) (b) 2 and 4 only
(c) 1, 2 and 3 only (d) 1, 2, 3 and 4

38. Sprain of the ankle joint results from an injury to
(a) Deltoid ligament
(b) Spring ligament
(c) Posterior talofibular ligament
(d) Anterior talofibular ligament (ANS)

39. 'Anterior drawer sign' is positive in
(a) Medial meniscus injury
(b) Anterior cruciate ligament injury (ANS)
(c) Lateral collateral ligament injury
d) Lateral meniscus injury

40. What is the most important aspect of management of bum injury in the first 24 hours?
(a) Fluid 'resuscitation (ANS)
(b) Dressing
(c) Escharotomy
(d) Antibiotics'

41. Abdominal compartment syndrome is characterised by the following except
(a) Hypercarbia and respiratory acidosis
(b) Hypoxia due to increased peak inspiratory pressure
(c) Hypotension due to decrease in venous return
(d) Oliguria due to ureteric obstruction (ANS)

42. Which one of the following surgical procedures is considered to have a clean contaminated wound?
(a) Elective open cholecystectomy for cholelithiasis (ANS)
(b) Herniorrhaphy with mesh repair
(c) Lumpectomy with axillary node dissection
(d) Appendectomy with walled off abscess


43. Split skin grafts in young children should be harvested from
(a) Buttocks b) Thigh (ANS)
(c) Trunk (d) Upper limb

44. A 25-year old female presents with pyrexia for ten days, develops acute pain in periumbilical region spreading all over the abdomen. What would be the most likely cause?
(a) Perforation peritonitis due to intestinal tuberculosis
(b) Generalised peritonitis due to appendicular perforation
(c) Typhoid enteric perforation and peritonitis (ANS)
(d) Acute salpingo-oophoritis with peritonitis

45. Match List I with List II and select the correct answer using the code given below the Lists:
List – I List- II
(Carcinoma) ( Characteristic)
A. Seminoma testis 1. Hormone dependent
B. Carcinoma prostate 2. Does not spread by lymphatics
C. Basal cell carcinoma 3. Prognosis depends on
thickness
D. Malignant melanoma 4. Highly radiosensitive
Code:
a. A B C D (ANS)
4 1 2 3

b. A B C D
4 2 1 3

c. A B C D
3 1 2 4

d. A B C D
3 2 1 4


Directions:
The following 3 (three) items consist of two statements, one labelled as the' Assertion (A)' and the other as 'Reason (R)'. You are to examine these two statements carefully and select the correct answer using the code given below.
(a) Both A and R are individually true and R is the correct explanation of A .
(b) Both A and R are individually true but R is not the correct explanation of A
(c) A is true but R is false
(d) A is false but R is true

46. Assertion (A) : If Perthes test is positive, surgery is
Absolutely contraindicated in varicose vein
Of leg.
Reason (R) : Perthes test confirms perforator
incompetence.
Answer: C


47. Assertion (A) : Raloxifene is a drug used in the
treatment of breast carcinoma.
Reason (R): It is preferred over tamoxifen since it
has less incidence of thromboembolism.
Answer: C


48. Assertion (A) : Femoral hernia is more likely to become
strangulated than inguinal hernia.
Reason (R) : Femoral hernia is more common in
females and gets neglected more often.
Answer: B

49. Of the various modalities used in the treatment of life-threatening effects of hyperkalemia, which one of the following has the most rapid onset of action?
(a) Hemodialysis
(b) Sodium bicarbonate infusion
(c) Insulin and glucose infusion
(d) Intravenous calcium gluconate (ANS)

50. A patient presents with acute gastroenteritis in a dehydrated state. Which of the following conditions is highly suggestive of pre-renal renal failure?
(a) Urinary sodium> 40 m mol;
Urine osmolality < 350 m osm/L
(b) Urinary sodium> 40 m mol;
Urine osmolality> 500 m osm/L
(c) Urinary sodium < 20 m mol; (ANS)
Urine osmolality> 500 m osm/L
(d) Urinary sodium < 20 m mol;
Urine osmolality < 350 m osm/L ,

51. Chronic renal failure with inappropriately high haemoglobin levels may be seen with:
a. Hypertensive nephropathy
b. Ischemic nephropathy
c. Diabetic nephropathy
d. Polycystic renal disease (ANS)

52. Regarding rheumatoid arthritis, which one of the following statements is correct?
a. NSAIDs are helpful in controlling the disease process
b. Corticosteroids, on long term basis, are to be given in all cases
c. DMARDs should be given early and preferably in combinations (ANS)
d. Every patient of rheumatoid arthritis has a positive rheumatoid factor

53. Consider the following sites of lesion in brain:
1. Lateral geniculate body
2. Optic radiation
3. Optic tract
4. Optic chiasma
Which of the above can result r in homonymous hemianopia?
(a) 1, 2 and 4 (b) 2, 3 and 4
(c) 1 and 4 only (d) 1, 2 and 3 . (ANS)

54. What is the typical feature' of nerve entrapment in the carpal tunnel syndrome?
(a) Symptoms diminish by wrist flexion
(b) Pain worsens at night (ANS)
(c) Erythema present in the cutaneous distribution of median nerve
(d) Motor symptoms precede sensory symptoms

55. Which one of the following is not a feature of Gullain Barre syndrome?
(a) Albumino-cytological dissociation
(b) Transient bladder disturbances
(c) Areflexia
(d) Babinski plantar response (ANS)

56. In a patient with ischaemic stroke, intravenous recombinant tissue plasminogen activator has mainly been found to be useful during the initial
(a) 3 hours(ANS) (b) 6 hours
(c) 12 hours (d) 24 hours

57. Consider the following:
1. Malnutrition
2. Lithostatin (pancreatic stone protein) deficiency
3. Cassava tuber
4: Oxidant stress (heightened cytochrome P-450 activity)
Which of the above produce tropical calcific pancreatitis (fibrocalculous pancreatic diabetes) ?
(a) 1, 2 and 3 only (ANS)
(b) 2, 3 and 4 only
(c) I and 4 only
(d) 1, 2, 3 and 4

58. The prognosis in reduced or unreduced fractures involving epiphyseal plate is very poor if the fracture line
(a) runs along the epiphyseal plate
(b) extends into epiphysis
(c) crushes the epiphyseal plate (ANS)
d) crosses the epiphyseal plate

59. A green stick fracture
(a) occurs mainly in the elderly
(b) is a fatigue fracture
(c) is a spiral fracture of long bone
(d) is a fracture where part of cortex is intact and part is crumpled(ANS)

60. With reference to varicocele, which one of the following is not true of it?
(a) Varicosity of cremastric veins (ANS)
(b) Left side is affected usually
(c) Feels like a bag of worms
(d) May lead to infertility


61. Steering wheel injury on chest of a young man reveals multiple fractures of ribs and paradoxical movement with severe respiratory distress. X-ray shows pulmonary contusion on right side without pneumothorax or haemothorax. What is the initial treatment of choice?
(a) Immediate internal fixation
(b) Endotracheal intubation and mechanical ventilation (ANS)
c) Thoracic epidural analgesia and °2 therapy
(d) Stabilization with towel clips


62. Which one of the following gastro intestinal disorders predisposes to urolithiasis?
(a) Peutz-Jeghers’ syndrome
b) Short bowel syndrome (ANS)
(c) Familial polyposis coli
(d) Ulcerative colitis

63. Amaurotic cat's eye reflux is typical of
(a) Papilloedema
(b) Papillitis
(c) Retinoblastoma (ANS)
(d) Retinitis pigmentosa

64. Cobble-stone conjunctiva is a feature of
(a) Viral conjunctivitis
(b) Spring catarrh (ANS)
(c) Fungal conjunctivitis
(d) Tubercular conjunctivitis

65. In acute sinusitis, the sinus most often involved in children is
(a) Maxillary (ANS) (b) Sphenoid
(c) Ethmoid (d) Frontal

66. The clinical manifestation of cauda equina lesion include the following except
(a) Urinary retention (ANS)
(b) Radicular pain
(c) Dermatomal sensory loss
(d) Extensor plantar reflexes

67. Following blood transfusion, non cardiogenic pulmonary oedema may sometimes occur because of
(a) RBC incompatibility
(b) Antigen-antibody mechanism involving human leucocyte antigen
(c) Platelet surface antigen reaction
(d) Antibody to IgA in donor plasma

68. What is the most frequent tooth to be impacted?
(a) Lower third molar (ANS)
(b) Upper third molar
(c) Lower canine
(d) Upper premolar

69. Fogarty's catheter is used, for
(a) Drainage of urinary bladder
(b) Parenteral hyperalimentation
(c) Removal of embolus from blood vessels (ANS)
(d) Ureteric catheterization

70. Consider the following conditions:
1. Central diabetes insipidus
2. Uncontrolled diabetes mellitus
3. Mannitol infusion
4. Post-obstructive diuresis

Which of the above result in solute diuresis?
(a) 1 and 2 only (b) I, 2 and 3
(c) 2, 3 and 4 (ANS) (d) 1, 3 and 4

71. Match List I with List II and select the correct answer using the code given below the Lists:
List-I List-II
(Finding in urine ( Disease)
examination)
A. red cell casts 1. Nephrotic syndrome
B. Microscopic hematuria 2. Chronic renal failure
C. Proteinuria 3. Polycystic kidney
D. Broad cell casts 4. Glomerulonephritis
Code:
a. A B C D (ANS)
4 3 1 2

b. A B C D
4 1 3 2

c. A B C D
2 3 1 4

d. A B C D
2 1 3 4

72. A young male with acid peptic disease receives three units of blood for upper gastrointestinal bleeding. Two months later he presents with .fever, malaise and tender hepatomegaly. His serum bilirubin is normal and the liver enzymes are elevated - ALT 800 IU/L and AST 600 IU/L.
Which of the following are the likely infections in this case?
1. Hepatitis A
2. Hepatitis B
3. Hepatitis C
4. Hepatitis E
5. Cytomegalo virus
Select the correct answer using the code given below:
(a) 1, 2 and 3 (b) 2, 3 and 4
(c) 2, 3 and 5 (ANS) (d) 1 and 4

73. Celiac sprue causes syndrome due to
(a) Coliform infection of small bowel
(b) Lactase deficiency
(c) Hypersensitivity to dietary gluten (ANS)
(d) Ischaemia of celiac artery

74. Match List I with List II and select the correct answer using the code given below the Lists:
List I List- II
(Type of anaemia) (Cause)
A. Macrocytic anaemia 1. Iron deficiency
B. Microcytic anaemia 2. Hypothyroidism
C. Haemolytic anaemia 3. Vitamin B12 deficiency
D. Megaloblastic anaemia 4. Alpha methyl dopa
Code:
a. A B C D
3 1 4 2

b. A B C D
3 4 1 2

c. A B C D (ANS)
2 1 4 3

d. A B C D
2 4 1 3

75. Gastric erosions are likely to be associated with the following conditions except
(a) Pernicious anaemia (ANS)
(b) Cor pulmonale
(c) Polycythemia rubra vera
(d) Hepatic cirrhosis

76. With reference to the treatment of chronic Hepatitis B infection, consider the following drugs:
1. Lamivudine
2. Alpha interferon
3. Ribavirin
4. Acyclovir
Which of the above drugs are useful in the treatment of chronic Hepatitis B infection?
(a) 1 and 2 only (ANS)
(b) 1 and 3 only
(c) 2 and 3 only
(d) 1, 2, 3 and 4

77. Cavitating pulmonary lesions can be seen in the following except
(a) Sarcoidoses (ANS)
(b) Tuberculosis
(c) Carcinoma of lung
(d) Histoplasmosis

78. Which one of the following is not likely to be associated with pulmonary fibrosis?
(a) Coal miners' lung
(b) Primary sclerosing cholangitis (ANS)
(c) Primary biliary cirrhosis
(d) Ankylosing spondylitis

79. The following agents may be used as prophylaxis in high altitude pulmonary edema except
(a) ACE inhibitor
(b) Acetazolamide
(c) Nifedipine
(d) Digoxin(ANS)

80. With reference to right ventricular myocardial infarction, consider the following statements:
1. It may occur along with inferior wall myocardial infarction.
2. The ECG shows ST segment elevation in right precordial leads.
3. Prognosis in right ventricular infarction is better than the left ventricular myocardial infarction.
4. The treatment may include intra venous fluid challenge.

Which of the statements given above are correct?
(a) 1, 2 and 3 only
(b) 2, 3 and 4 only
(c) 1 and 4 only (ANS)
(d) 1, 2, 3 and 4

81. Regarding rheumatic heart disease, consider the following statements:
1. Rheumatic carditis is a pancarditis.
2. Carey-Coombs munnur is a delayed systolic munnur heard during the course of acute rheumatic fever.
3. Mitral regurgitation is the most common manifestation of acute rheumatic carditis.
Which of the statements given above is/are correct?
(a) 1 only (b) 1 and 2
(c) 2 and 3 (d) 1 and 3 (ANS)

82. Which one of the following does not cause pulsus paradox us ?
(a) Severe aortic regurgitation (ANS)
(b) Cardiac tamponade
(c) Constrictive pericarditis
(d) Acute severe bronchial asthma

83. Match List I with List II and select the correct answer using the code given below the Lists:
List-I List- II
(Heart sound) (Disease)
A. Loud S1 1. Valvular pulmonary stenosis
B. Loud S2 2. Atrial septal defect
C. Soft S2 3. Mitral stenosis
D. Wide and fixed S2 4. Pulmonary arterial
Hypertension
Code:
a. A B C D (ANS)
3 4 1 2

b. A B C D
3 1 4 2

c. A B C D
2 4 1 3

d. A B C D
2 1 4 3

84. Ghon's complex is not characterized by
(a) Hilar lymph nodes
(b) Pleural effusion(ANS)
(c) Prominent draining lymphatics
(d) Subpleural focus

85. Which one of the following is the drug of choice in the case of ventricular tachycardia in myocardial infarction?
(a) Xylocard (ANS)
(b) Digitalis
(c) Quinidine
(d) Disopyramide

86. What is the most common opportunistic infection in AIDS?
(a) Tuberculosis (ANS)
(b) Cryptococcosis
(c) Pneumocystitis carinii
(d) Histoplasmosis

87. In chronic Hepatitis B infection, which one of the following markers is indicative of active viral replication and the corresponding risk of disease transmission?
(a) HBe antigen (ANS) (b) HBs antigen
(c) Anti-HBe (d) Anti-HBs

88. Match list-I with list-II and select the correct answer using the code given below the lists:
List-I List-II
(Type of hyperlipidemia) (Features)
A. Hyperchylo- 1. Palmer plane xanthoma
micronaemia)
B. Hyperbetalipo- 2. Subcutaneous extensor
Proteinaemia tendon xanthoma
C. Typer III hyperlipo- 3. Eruptive xanthoma over
Proteinaemia buttocks
D. Familial LPL 4. Tryglyceride level above
Deficiency mg%

Code:
a. A B C D
3 1 2 4

b. A B C D
3 2 1 4

c. A B C D
4 1 2 3

d. A B C D (ANS)
4 2 1 3


89. Tetany may be a feature of the following' except
(a) Hyperventilation
(b) Hypokalaemic alkalosis
(c) Hypoinagnesaemia
(d) Hyponatraemia (ANS)

90. With reference to non-ketotic; hyperglycemic, hyperosmolar coma, consider the following statements:
1. It is common in second and third decade of life:
2. It is typically seen in Type I diabetes mellitus.
3. Blood sugar is usually above 500 mg/dl.
Which of the statements given above.' is/are correct?
(a) 1 and 2 only
(b) 3 only
(c) 2 and 3 only
(d) 1, 2 and 3

91. In a patient suspected to be suffering from vesicoureteric. Reflux, which one of the following radiological investigations may confirm the diagnosis?
(a) Intravenous urography
(b) Micturating cystourethrography (ANS)
(c) Pelvic ultrasound
(d) Antegrade pyelography

92. During the treatment of chronic myeloid leukemia, cytogenetic remission is least likely to occur with which one of the following modalities of treatment?
(a) Hydroxyurea (ANS)
(b) Imatinib mesylate
(c) Interferon-alpha
(d) Bone marrow transplantation.

93. Pancytopenia may occur in the following except
(a) Megaloblastic anaemia
(b) Severe iron-deficiency anaemia (ANS)
(c) Hypoplastic anaemia
(d) Paroxysmal nocturnal haemoglo binuria

94. A patient of rheumatic heart disease with mitral stenosis and atrial fibrillation is on oral warfarin. On one OPD visit, his INR is found to be 6. What is the action to be taken?
(a) Stop warfarin, and review (ANS)
(b) Stop warfarin, and administer protamine sulphate
(c) Stop warfarin, and administer fresh frozen plasma
(d) Stop warfarin, and administer intramuscular vitamin K

95. Which antipsychotic drug may cause severe agranulocytosis?
(a) Clozapine (ANS) (b) Olanzapine
(c) Pimozide (d) Risperidone

96. Which one of the following is not autosomal recessive?
(a) Adult polycystic kidney disease (ANS)
(b) Cystic fibrosis of pancreas
(c) Homocystinuria
(d) Mucopolysaccharidosis

97. Match List I with List II and select the correct answer using the code given below the Lists:
List-I List-II
(Poison) (Antidote)
A. Benzodiazepine 1. D-Penicillamine
B. Copper sulphate 2. Flumazenil
C. Opiates 3. N-acetyl cysteine
D. Paracetamol 4. Naloxone
Code:
a. A B C D
2 4 1 3

b. A B C D (ANS)
2 1 4 3

c. A B C D
3 4 1 2

d. A B C D
3 1 4 2


98. Estimation of plasma cholinesterase levels may be helpful in the management of which one of the following poisonings?
a Datura
B Barbiturate
C Organophosphours (ANS)
D opium

99. Antinuclear antibodies are present in what presence of cases of SLE ?
A 50 %
B 70%
C 80%
D More than 90% (ANS)

100. A 40 year old male patient is hospitalized with huge splenomegaly marked sternal tenderness and a total leucocyte count of 85000 per cubic millimeter and metamyelocytes which one of the following drugs is best indicated for his disease ?
a. Cyclophospyamide
b. Chlorambucil
c. Melphalan
d. Hydroxyurea (ANS)

101 Which of the following is a potent stimulus for the production of erythro-poietin?
A. Alpha interferon
B. Interkeukin-3
C. Hypoxia (ANS)
D Hypercarbia

102 Among the following one is not a good dietary source of iron?
A . Liver
B. Jaggery
C. Fish
D. Milk (ANS)

103 A man who had under gone total mastectomy remains well for five year then he develops anemia. What is ate most likely cause of this anemia?
A. protein deficiency
B. Zinc deficiency
C. Folic acid deficiency
D. Vitamin B 12 deficiency (ANS)

104 Loeffler s syndrome is characterized by
A. Transient migratory pulmonary infiltration (ANS)
B Fibrosis in the pulmonary apices
C Fibrosis in the base of one or both lungs
D Miliary mottling

105 The level of which on of the flowing hormones is likely to increase after hypothalamic ablation ?
A. Growth hormone
B. Prolactin (ANS)
C. FSH
D. ACTH

106 The post exposure prophylaxis against rabies repress a course of five doses of human diploid cell derived rabies vaccine these shpts are given on
A . Days 0,1, 4, 10, and 30
B Days 0, 3,7, 14, and 30 (ANS)
C Days 0,7, 14,, 21 and 28
D Days 0, 4, 14,, 24 and 30

107 Haemolysis in G 6 PD ( glucose 6- posthaste dehydrogenises ) deficiencies may be induced by the following except
A. Primaquin
B . Phenacetin
C Pronenecid
D Penicillin (ANS)

108 In India, what is the most common cause of unilateral lymph edema of lower limb?
A . Lymphedema
B Carcinoma of penis with metastasis nodes
C Filariasis (ANS)
D tubercular lymphadenopathy

109 Etipathpgenesis of diabetic foot include the following except.
A Myelopathy
B Osteoarthropathy (ANS)
C microangiopathy
D Infection

110. Protein metabolism after truma is characterized by the following except
A Increased liver gluconegenesis (ANS)
B inhibition of skeletal muscle break down by interleukin I and tumor necroses factor
C Increased urinary nitrogen loss
D Hepatic synthesis of acute phase reactants

111. Carcinoma of lip is characterized by the following except that
A . 90% of The lip cancers occur on the lower lip
B the most common site of origin is the vermilion border
C 2 CM X 2 2 CM Cell carcinomas can be treated by V shaped excision and primary closure
D Since lymph nodded mutates are common of ten a radical dissection of neck is mandatory. (ANS)

112. A 40 year old man presented with a flat 1 cm x 1 cm scaly, otchy back mole on the front of thing examinations did not revel any
Inguinal lymphadenopathy the best course of managements would be
A FNAC of the lesion
B Incision biopsy
C Excisional biopsy (ANS)
D wide excision with inguinal lymphadenctomy

113. Tumors of anterior mediastinum include the following except
A. Thymoma
B Lymphoma
C Germ cell tumor
D Schwanoma (ANS)

114 Extensive surgical debridement decompression of amputation may be indicated in the following clinical setting except.
A Progressive synergistic gangrene
B Acute Thrombophlebitis (ANS)
C acute hemolytic streptococcal cellulite
D Acute thabdonuplysis

115. Which one of the following bacteria is classified as facultative anaerobe?
A. Pseudomonas
B. Bactericides
C. Escherichia (ANS)
D. Clostridium

116. Regarding Ludwig ahgina consider the following statement:
1 It is characterized by cellulites usually if odobtogenic origin.
2 It involves the submandibular sublingual and submittal spaces.
which of the statements given above is are correct ?
A 1 only
B 2 only
C Both 1 and 2 (ANS)
D Neither 1 nor 2

117. Sutured surgical wound, the process of epothelialization is completed within .
A 24 Hours
B 48 hours (ANS)
C 72 hours
D 96 hours

118. The reference to duodenal ulcers consider the following statement:
1 They occur most often in the second part of duodenum
2 infections with H pylori and NSAID induced injury account for maturity of duodenal ulcers
3. Malignant duodenal users are extremely rare .
4. Eradication of H Pylori has greatly reduced the recurrence rates in duodenal ulcers.
A 1, 2 and 3 only
B 2,3 and 4 only (ANS)
C 1 and 4 only
D 1,2,3, and 4

119. A Patient present with hemoptysis copious sputum and tram lines (abnormal air bronchogram ) pattern on the chest X –ray what is the most likely diagnosis ?
A. Lung abscess
B. Pulmonary embolism with infraction
C. Bronchiectasis (ANS)
D. Carcinoma of lung

120. Peripheral eosinophile is not a characteristic feature of
a Hypersensitive (ANS)
b Allergic aspergillus’ s
c Tropical eosinophilia
d Loeffler Syndrome



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