Mudit 2004

1. After radical mastectomy there was injury to the long thoracic nerve. The integrity of the nerve can be tested at the bedside by asking the patient to:

2. An inhaled foreign body is likely to lodge in the right lung

3. While exposing the kidney from behind, all of the following nerves are liable to injury except

4. Infection/inflammation of all of the following causes enlarged superficial inguinal lymph nodes except

5. The intricately and prodigiously looped system of veins and arteries that lie on the surface of the epididymis is known as:

6. The movement at the following joint permits a person to look towards the right or left

7. The first costochondral joint is a

8. The articuiar cartilage is characterized by all of the following features except

9. All of the following are catagorised as secondary lymphoid organs except

10. Which of following is the feature of Y chromosome?

11. The Couinaud's segmental nomenclature is based on the position of the

12. During acclimatization to high aititude all of the following take place except

13. One interm calculated the concentration of O, in blood as 0.0025 ml/ml of blood. Considering atmospheric pressure as 760mmHg, how much approx. O2 tension could have been in the blood?

14. Patients having acute cardiac failure do not show oedema, because

15. During the cardiac cycle the opening of the aortic valve takes place at the

16. Sertoli cells have receptors for:

17. The enzyme associated with the conversion of androgen to oestrogen in the growing ovarian follicle

18. Before the onset of puberty, the GnRH neurons are under the inhibitory control of:

19. In which of the following form the Anti diuretic hormone (ADH) is circulated in plasma:

20. The main excitatory neurotransmitter in the CNS is:

21. The force of muscle contraction can be increased by all of the following except

22. A newly posted junior doctor had difficulty in finding out base deficitl/excess for blood in a given patient. An experienced senior resident advised a quick method to determine acid base composition of blood based on PCO2 Which of the following is the likely method he suggested to predict acid base composition of blood?

23. Shine-Dalgarno sequence in bacterial mRN

24. RNA polymerase does not require

25. A segment of a eukaryotic gene that is not represented in the mature messenger RNA is known as:

26. An enzyme that makes a double stranded DNA copy from a single stranded RNA template molecule is known as

27. Which of the following can be a homologous substitution for valine in hemoglobin?

28. The transmembrane region of protein is likely to have

29. Which of the following group of proteins assist in the

30. Proteins targeted for destruction in eukaryotes are covalently linked to

31. Which of the following is a membrane bound enzyme that catalyzes the formation of cyclic AMP from ATP?

32. Which of the following substances acts to increase the release of Ca from endoplasmic reticulum?

33. A small Ca 2 binding protein that modifies the activity of many enzymes and other proteins in response to changes of Ca2 concentration, is known as

34. A person on a fat free carbohydrate rich diet continues to grow obese. Which of the following lipoproteins is likely to be elevated in his blood?

35. A middle aged woman on oral contraceptives for many years, developed neurological symptoms such as depression, irritability, nervousness and mental confusion. Her hemoglobin level was 8g/dl Biochemical investigations revealed that she wasexcreting highly elevated concentrations of xanthurenic acid in urine. She also showed high levels of triglycerides and cholesterol in serum All of the above findings are most probably related vitamin B6 deficiency caused by prolonged oral contraceptive use except

36. Which of the following elements is known to influence the body's ability to handle oxidative stress?

37. In which of the following conditions the level of creatinine kinase-1 increases?

38. A young man finds that every time he cats dairy products he feels very uncomfortable, His stomach becomes distended He develops gas and diarrhea frequently. These symptoms do not appears when ho eats foods other than dairy products. Which of the following is the most likely enzyme in which this young man is deficient?

39. Cytochrome C of the bacteria has 50% identity of amino acid sequence with that of human. Which of the following is the most conserved parameter in these two proteins

40. Alpha helix and Beta pleated sheet are examples of:

41. A genetic disorder renders fructose 1,6-biphosphatase in liver less sensitive to regulation by fructose 2,6-bi phosphate. All of the following metabolic changes are observed in this disorder except:

42. Xerodema pigmentosum is produced as a result of a defect in:

43. To which of the following family of chemicalmediators of inflammation, the Lipoxins belong?

44. Which of the following is a procoagulation protein?

45. Which of the following is an antiapoptotic gene?

46. The most abundant glycoprotein present in basement membrane is:

47. To which of the following events is 'good' outcome in neuroblastoma associated

48. Which of the following gene defect is associated with development of medullary carcinoma of thyroid?

49. Males who are sexually under developled with rudimentary testes and prostate glands, sparse pubic and facial hair, long arms and legs and large hands & feet are likely to have the chromosome complement of

50. Kinky hair disease is a disorder where an affected child has peculiar white stubby hair, does not grow, brain degenration is seen and dies by age of two years. Mrs A is hesitant about having children because her two sisters had sons who had died from kinky hair disease Her mother's brother also died of the same condition. Which of the following is the possible mode of inheritence in her family?

51. Which of the following is an automsomal dominant metabolic disorder?

52. Which is the most common cytogenetic abnormality in adult myelodysplastic syndrome (MDS)?

53. All of the following statements about Hairy cell leukaemia are true except:

54. All of the following are the good prognostic feature for Hodgkin's disease except

55. A 60 year old male presented with acute chest pain of 4 hours duration. Electrocardiographic examination revealed new Q wave with ST segment depression. He succumed to his illness within 24 hours of admission. The heart revealed presence of a transmural haemorthagic area over the septum and anterior wall of the left ventricle. Light microscopic examination is most likely to reveal

56. Serum C3 is persistently low in the following except

57. All of the following are associated with low complement levels except

58. Splenic macrophages in Gaucher's disease differ from those in ceroid histiocytosis by staining positive for

59. A 70 year old male who has been chewing tobacco for the past 50 years presents with a six months history of a large, fungating, soft papillary lesions in the oral cavity. The lesion has penetrated into the mandible.Lymph nodes are not palpable. Two biopsies taken from the lesion proper show benign appearing papillomatosis with hvperkeratosis and acanthosis infiltrating the adjacent tissue. The most likely diagnosis is:

60. The blood in the vessels normally does not clot because

61. Which of the following statements is true about hapten?

62. A 20 year old man presented with hemorthagic colitis. The stool sample grew Escherichia coli in pure culture. The following serotype of E.coli is likely to be the causative agent

63. Which of the following toxins acts by inhibiting protein synthesis

64. A microbiologist wants to develop a vaccine for prevention of attachment of diarrhoeagenic E. coli to the specific receptors in the gastro-intestinal tract. All of the following fimbrial adhesions would be appropriate vaccine candidates except

65. Toxins are implicated as the major pathogenetic mechanism in all of the following bacterial diarrheas except

66. A man, after skinning a dead animal, developeda pustule on his hand. A smear prepared from the lesion showed the presence of Gram positive bacilli in long chains which were positive for McFadyean's reaction. The most likely actiological agent is

67. A farmer presenting with fever off and on for the past 4 years was diagnosed to be suffering from chronic brucellosis. All of the following serological tests would be helpful in the diagnosis at this state except:

68. Regarding gas gangrenc one of the following is correct:

69. A 30 year old woman with a bad obstetric history presents with fever. The blood culture from the patient grows gram-positive small to medium coccobacilli that are pleomorphic, occurring in short chains. Direct wet mount from the culture shows tumbling motility. The most likely organism is

70. A 20 years old male patient presents to the STD clinic with a genital ulcer. The gram stain of the smear from ulcer shows gram negative coccobacilli. The most appropriate media for culture would be

71. The most sensitive method for detecting cervical Chlamydia trachomatis infection is

72. Epstein Barr (EB) virus has been implicated in the following malignancies except

73. Laboratory diagnosis of viral respiratory tract infections can be established by all of the following tests except

74. All of the following statements are true regarding poliovirus except:

75. A young pregnant woman presents with fulminant hepatic failure. The most likely aetiological agent is:

76. All of the following clinical features are associated with Enteroviruses except

77. Which of the following statements is true regarding ARBO viruses:

78. A highly ionized drug

79. In which of the following phases of clinical trial of drug ethical clearance is not required?

80. Sympathomimetic drugs are useful in the therapy of all of the following conditions except;

81. Which one of the follwing statements about biguanides is not true?

82. All of the following statements about an alpha glucosidase inhibitor are true except

83. All of the following Anticancer agents cause bone marrow depression except:

84. All of the following are advantages of using Raloxifen over estrogen in post menopasual women except?

85. Which of the following does not bind to GABA receptor chloride channels?

86. A 60 year old man with rheumatic mitral stenosis with atrial fibrillation is on therapy for a fast ventricular rate. While on treatment, he developed a regular pulse of 64/min. The most likely drug being administered was:

87. Which of the following is not an adverse effect of chronic amiadarone therapy

88. A patient of peptic ulcer was prescribed ranitidine and sucralfate in the moning hours. Why is this combination incorrect

89. All the following statements regarding interactions of levodopa are correct except

90. Drug implicated for prolonging QT interval in a premature baby is

91. Which of the following actions is ascribed to delta type of opoid receptors?

92. Morphine can be used in all the following conditions except

93. Which of the following statements is not true regarding sulfonamides

94. A post operative patient developed septicemia and was empirically started on combination chemotherapy by a new resident doctor. However, when the patient did not respond even after 10 days of antibiotics treatment, the review of the charts was done. It was found that the resident doctor had started the combination of antibiotics which was mutually antagonistic in action. Which one of the following is the most likely combination that was given?

95. Which of the following fluoroquinolones does not require dose adjustment in a patient with creatinine clearance of <50mg/min?

96. Which of the following Antimicrobials has Antipseudomonal action

97. A 30 year old pregnant woman developes tuberculosis Which of the following antitubercular drugs should no be used

98. Patients suffering from multidrug resistant tuberculosis can be treated with all the following drugs except

99. All of the following are hormonal agents used against breast cancer except

100. Which is the most active single chemotherapeutic agent in the treatment of Leiomyosarcoma?

101.Clinically significant drug interaction occurs between pyridoxine and all the following drugs except

102. Which of the following statements is not true about Tacrolimus?

103. BAL is useful in treating poisoning due to all except?

104.A convict whose family or relations were not known and no biological sample was available with jail authorities, escaped from the jail. A dead body resembling the convict was found in nearby forest, but due to mutilation of face, identity could not be established. The positive identity that he is the same convict who escaped from jail can be established by

105.The cephalic index of Indian population is between

106.A 25 year old person sustained injury in right eye. He developed right corneal opacity following the injury Left eye was already having poor vision. Corneoplasty of right eye was done and vision was restored. Medicolegally such injury is labelled as:

107.Deep blue colour of hypostasis is seen in death due to poisoning by

108.In which of the following conditions postmortem caloricity may be seen in death due to

109 Contre-coup injuries are seen in:

110. Disputed maternity can be solved by using the following tests except

111. Hydrogen peroxide is used in all of the following chemical tests for blood except

112.A person was brought by police from the railway platform. He is talking irrelevant. He is having dry mouth with hot skin, dilated pupils, staggering gait and slurred speech. The most probable diagnosis is

113.A middle aged man presents with paraesthesia of hands and feet. Examination reveals presence of 'Mees' lines in the nails and rain drop pigmentation in the hands.

114.Which of the following is the most reliable method of estimating blood alcohol level?

115.A 39-year old carpenter has taken two bottles of liquor from the local shop. After about an hour he develops confusion, vomiting and blurring of vision. He has been brought to the emergency out patient. He should be given:

116. A 34 years old rickshaw puller has been using heroin for the past ten years. One evening his family members found him unconscious. He was brought to the casualty. On examination he had tachycardia, shallow breathing, constricted pupils. His blood pressure was 100/70 mm of Hg. He had brisk bilateral deep tendon reflexes. The planter reflexes were flexor on both sides. Which of the following is the best treatment for him?

117.A study began in 1970 with a group of 5000 adults in Delhi who were asked about their alcohol consumption. The occurrence of cancer was studied in this group between 1990-1995. This is an example of

118.All of the following are used as proxy measures for incubation period except:

119.A 3 % year old child has not received primary immunization. Which of the following is the best vaccination advice to such a child?

120.The following statements are true about DPT vaccine except

121.A 37 weeks pregnant woman attends an antenatal clinic at a Primary Health Centre. She has not had any antenatal visit till now. The best approach regarding tetanus immunization in this case would be to

122.A child aged 4 months was brought to a health worker in the sub center with complaints of cough and fever On exanunation, there was chest indrawing and respiratory rate was 45 per minute. Which of the following is best way to manage the child?

123.The most appropriate test to assess the prevalence of tuberculosis infection in a community is

124.According to International Health Regulations, there is no risk of spread of yellow Fever if the Aedes aegypti index remains below

125.All of the following are the mode of transmission of leprosy except?

126.All of the following statements about leprosy are true except

127.A 10 month old child weighing 8kg has Bitot spots in both eyes. Which of the following is the most appropriate schedule to prescribe vitamin A to this child ?

128. The current recommendation for breast feeding is that

129. The following statements about breast milk are true except:

130.The following statements are true about Intrauterine devices (IUD) except

131.The National Population Policy of India has set the following goals except

132.Essential component of RCH Programme in India include all of the following except:

133."Five clean practices" under strategies for elimination

134. Dietary changes advocated by WHO for prevention of heart diseases include all of the following except:

135.Multi-purpose worker scheme in India was introduced following the recommendation of

136.If cach value of a given group of observations is multiplied by 10 the standard deviation of the resulting observations is:

137.If the systolic blood pressure in a population has a mean of 130mmHg and a median of 140mmHg, the distribution is said to be

138.The table below shows the screening test results of

139. If prevalence of diabetes is 10%, the probability that three people selected at random from the population will have diabetes is:

140.If the grading of diabetes is classified as mild moderate" and "severe" the scale of measurement used is

141. The usefulness of a screening test' in a community depends on its

142.Disseminated intravascular coagulation (DIC) differs from thrombotic thrombocytopenic purpura. In this reference the DIC is most likely characterized by:

143.A 5 year old girl came with history of progressively increasing pallor since birth and hepatosplenomegaly Which of the following is the most relevant test for achieving diagnosis

144.Elevated serum ferritin, serum iron and percent transferrin saturation are most consistent with the diagnosis of

145.Bone marrow transplantation can be used as a treatment for all except

146.All of the following statements are true about sickle cell disease except

147.All of the following are seen in cardiac temponade except

148. In hematuria of glomerular origin the urine is characterized by the presence of all of the following except:

149.Polycystic disease of the kidney may have cysts in all of the following organs except

150.A 40 year old man presented with painless hematuria Bimanual examination revealed a ballotable mass over the right flank. Subsequently right nephrectomy was done and mass was seen to be composed of cells with clear cytoplasm. Areas of hemorrhage and necrosis were frequent. Cytogenic analysis of this mass is likely to reveal an abnormality of

151. Which of the following is the drug of first choice for Non-Gonococcal Urethritis ?

152.An HIV patient complains of visual disturbances Fundal examination shows bilateral retinal exudates and perivascular haemorrhages. Which of the following viruses are most likely to be responsible for this retinitis

153. Which one of the following is true regarding HIV infection:

154. Which of the following is not a nucleoside reverse transcriptase inhibitor?

155.A known sputum positive pulmonary tuberculosis patient currently on INH, rifampicin, pyrizinamide and ethambutol is found to be HIV positive. His CD4 count was 100 L and viral load was more than 50,000 copies/ml. Which of the following antiretroviral drug should be avoided:

156.HBAIC level in blood explains

157.A 45-year old woman visited her physician with

158.The best marker to diagnose thyroid related disorder is:

159. The occurrence of hyperthyroidism following administration of supplemental iodine to subjects with endemic iodine deficiency goiter is known as

160.All of the following are true about amiadarone induced thyroid dysfunction except?

161.A 28 year old lady has put on weight (10 kg over a period of 3 years), and has oligomenorthoca followed by amenonohoca for 8 months. The blood pressure is 160/100 mm of Hg. Which of the following is the most appropriate investigation?

162. Which of the following is the carliest manifestation of Cushing 's syndrome?

163.Retardation of skeletal maturity can be caused by all except

164.A 21 year old woman presents with complaints of primary amenorthoea. Her height is 153 cms, weight is 51 kg. She has well developed breasts. She has no pubic or axillary hair and no hirsuitism. Which of the following is the most probable diagnosis?

165.A 30 year old woman presented with secondary amenorrhoea for 3 years along with galactorrhoea. The most likely cause of her symptoms would be

166.A 55-year old man who has been on bed rest for the past 10 days, complains of breathlessness and chest pain. The chest x-ray is normal. The next step in investigation should be

167.A 20 year old women presents with bilateral conductive deafness, palpable purpura on the legs and hemoptysis. Radiograph of the chest shows a thin walled cavity in left lower zone. Investigations reveal total leukocyte count 12000/mm, red cell casts in the urine and serum creatinine 3mg/dL. What is the most probable diagnosis?

168.An 18 yr old boy presents with digital gangrene in third and fourth fingers for last 2 weeks. On examination the blood pressure is 170/110 mm of Hg and all peripheral pulses were palpable. Blood and urine examinations were unremarkable. Antinuclear antibodies, antibody to double stranded DNA and antineutrophil cytoplasrmic antibody were negative. The most likely diagnosis is

169.A woman is admitted with complains of low-grade fever of 6 wecks duration. Chest radiograph reveals bihilar adenopathy with clear lung fields. All of the following investigations will be useful in differential diagnosis except:

170.An 80 year old asymptomatic woman was detected to have a monoclonal spike on serum electrophoresis (IgG levels 1.5 g/dl). Bone marrow revealed plasma cells of 8%. The most likely diagnosis is:

171.A 12 year old girl with tremors and emotional lability has a golden brown discoloration in Descemet's membrane. The most likely diagnosis is:

172.The following is not a feature of Alzheimer's disease

173.All of the following can cause neuropathies wit predominant motor involvement except

174. Which of the following viruses is not a common cause of viral encephalitis?

175.A young male develops fever, followed by headache, confusional state, focal seizures and right hemiparesis. The MRI pertormed shows bilateral frontotemporal hyperintense lesion. The most likely diagnosis is

176.Which of the following brain tumors does not spread via CSF ?

177.A 15 year old boy with epilepsy on treatment with combination of valproate and phenytoin has good control of seizures. Levels of both drugs are in the therapeutic range. All of the following adverse effects can be attributed to valproate except

178.Persistant vomiting most likely causes

179.All are true regarding idiopathic edema of women except:

180.In patients with cirrhosis of the liver the site of obstruction in the portal system is in the

181.In Budd Chiari syndrome, the site of venous thrombosis is

182.The short bowel syndrome is characterized by all of the following except

183.Estimation of the following hormones is useful while investigating a case of gynaecomastia except:

184.Biopsy from a mole on the foot shows cytologic atypia of melanocytes and diffuse epidermal infiltration by anaplastic ells, which are also present in the papillary and reticular dermis. The most likely diagnosis is

185.Chronically lymphadenopathy limb is predisposed to all of the following except

186.First treatment of rupture of varicose veins at the ankle should be

187.A young man with pulmonary tuberculosis presents with massive recurrent hemoptysis. For angiographic treatment, which vascular structure should be evaluated first

188.A 60 year old male was diagnosed as carcinoma right lung. On CECT chest there was a tumor of 5x5 cm in upper lobe and another 2x2 cm size tumor nodule in middle lobe. The primary modality of treatment is

189.Thoracic extension of cervical goiter is usually approached through

190.Pancreatitis, pituitary tumor and pheochromocytoma may be associated with

191.A 20 year old male presented with chronic constipation, headache and palpitations. On examination he had marfanoid habitus, neuromas of tongue, medullated cormeal nerve fibers and nodule of 2x2 cm size in the left lobe of thyroid gland. This patient is a case of:

192.The most common histologic type of thyroid cancer is

193.The commonest site of oral cancer among Indian population is

194.The most common malignant tumor of adult males in India is

195.The most common site of intestinal obstruction itn gallstone ileus is

196. Which of the following types of pancreatitis has the best prognosis?

197. Injection sclerotherapy is ideal for the following:

198 For a rectal carcinoma at 5cm from the anal verge the best acceptable operation is:

199.All of the following are significant risk factors for colonic carcinoma in an adenomatous polyp except

200.A 55 year old male presented with painless terminal hematuria. Cystoscopic examination revealed a solitary papillary tumor. Histopathological examination of completely resected tumor is suggestive of grade III transitional cell carcinoma with no muscle invasion. Further management of this patient is best done by

201.Unilateral undescended testis is ideally operated around

202.Which of the following is not an important cause of hyponatremia?

203. Which one of the following preservatives is used while packing catgut suture ?

204.Which of the following is not an indication of radiotherapy in Pleomorphic adenoma of parotid:

205.All of the following are ultrasonographic fetal growth parameters except

206.Which of the following is the investigation of choice in a pregnant lady at 18 weeks of pregnancy with past history of delivering a baby with Down's syndrome

207.Mr. and Mrs. Annadurai have a 2 month old baby suffering with Down's syndrome. Karyoiype of Mrs Annadurai shows translocation variety of Down syndrome. Which of the following investigations will you advise to the parents before the next pregnancy?

208. Which of the following tests on maternal serum is most useful in distinguishing between open neural tube defects and ventral wall defects in a fetus?

209.Screening by using maternal serum alpha fetoproteins helps to detect all of the following except

210.Antiprogesterone compound RU-486 is effective for inducing abortion if the duration of pregnancy is

211.A case of 35 week pregnancy with Hydramnios and marked respiratory distress is best treated by:

212.Anti-D prophylaxis should be given in all of the following conditions except:

213. The consequences of Rh incompatibility are not serious during first pregnancy because:

214. Which of the following tests is most sensitive for the detection of iron depletion in pregnancy?

215.A 37 year multipara construction labourer has a blood picture showing hypochromic anisocytosis. This is most likely indicative of:

216.All of the following may be used in pregnancy associated hypertension except

217.Which of the following is not an indication for Antiphospholipid antibody testing

218.All of the following conditions are risk factor for urinary tract infections in pregnancy except

219.Which of the following perinatal infections has the highest risk of fetal infection in the first trimester

220.A pregnant mother at 32 weeks gestation presents in

221.All of the following drugs are effective for cervical ripening during pregnancy except

222. Which of the following conditions is most likely to be associated with a vaginal pH of 4?

223.The most appropriate method for collecting urine for culture in case of Vesicovaginal fistula is

224.A case of obstructed labour which was delivered by caesarian section complains of cyclical passage of menstrual blood in urine. Which is the most likely site of fistula?

225. Which of the following is the most likely diagnosis in a 27 year old obese woman presenting with oligomenorrhoea, infertility and hirsuitism?

226.A fifty year old woman, presenting with bilateral solid ovarian tumors, has ascitis. Upper gastro-intestinal endoscopy reveals an ulcerative growth in pyloric region of stomach. The most likely diagnosis is

227.Choice of adjuvant treatment for endometrial carcinoma stage IA, grade I is

228.A two month old child is able to:

229. Webbing of neck, increased carrying angle, low posterior hair line and short fourth metacarpal are characteristics of:

230.Ataxia telangicctasia is chracterised by all of the following except:

231 .А 10 year old boy has a fracture of femur. Biochemical evaluation revealed Hb 11.5 gm/dL and ESR 18 mm 1st hr. Serum calcium 12.8 mg/dL, serum phosphorus 2.3 mg/dL, alkaline phosphate 28 KA units and blood urea 32 mg/dL. Which of the following is the most probable diagnosis in his case?

232.A nine month old boy of Sindhi parents presented to you with complaints of progressive lethargy, irritability

233.A 5 year old child presents with history of fever off and-on for past 2 weeks and petechial spots all over the body and increasing pallor for past 1 month. Examination reveals splenomegaly of 2 cms below costal margin. The most likely diagnosis is:

234.A five day old, full term male infant was severely cyanotic at birth. Prostaglandin E was administered initially and later ballooned atrial septosomy was done which showed improvement in oxygenation. The most likely diagnosis of this infant is

235.In which of the following a 'Coeur en Sabot' shape of

236.An infant develops cough and fever. The X-ray examination is suggestive of bronchopneumonia. All of the following viruses can be the causative agent except

237.In neonatal cholestasis, if the serum gamaglutamyl transpeptidase (gamma GTP) is more than 600 IU/L the most likely diagnosis is

238. The neonatal kidney achieves concentrating ability equivalent to adult's kidney by

239.All of the following are neural tube defects except

240.All are features of absence seizures except:

241.A 10 month old child presents with two weeks history of fever, vomiting and alteration of sensorium Cranial CT scan reveals basal exudates and hydrocephalus, The most likely etiological agent is

242.For which of the following diseases is enzyme replacement therapy available?

243. Duchenne Muscular Dystrophy is a disease of

244.Bacterial meningitis in children (2 months-12 years of age) is usually due to the following organisms except

245.All of the following are essential features of attention deficit hyperactivity disease (ADHD) except:

246.A 25 year old woman had premature rupture of membranes and delivered a male child who became lethargic and apneic on the 1st day of birth and went into shock. The mother had a previous history of abortion 1 year back. On vaginal swab culture growth of ß-haemolytic colonies on blood agar was found. On staining these were found to be gram positive cocci. Which of the following is the most likely etiological agent?

247.The most common agent associated with neonatal bacterial meningitis is

248. Haemophilus influenzae has been isolated from the CSF of a two year old boy suffering from meningitis. The strain is beta-lactamase producing and resistant to chloramphenicol. The most appropriate antimicrobial in such a situation is:

249.An army recruit, smoker and 6 months into training

250.In some old fractures, cartilaginous tissue forms over the fractured bone ends with a cavity in between containing clear fluid. This condition is called as

251.Aseptic loosening in cemented total hip replacement, occurs as a result of hypersensitivity response to

252.In fracture of the olecronon, excision of the proximal fragment is indicated in all of the following situations except

253.Tuberculosis of the spine commonly affects all of the following parts of the vertebra except

254.All of the following can be the complications of a malunited Colles fracture except

255. The management of fat embolism includes all of the following except

256.Management plan for osteogenic sarcoma of the lower end of femur must include

257.Maximum density of goblet cells is seen in

258.A 10 year old boy presents with severe itching of the eye and a ropy discharge. His symptoms aggravate in summer season. Most likely diagnosis is?

259. Arlt's line is seen in

260. Which of the following will be the most important adjuvant therapy in a case of fungal corneal ulcer

261.Polychromatic lusture is seen in:

262.A two week old child presents with unilateral cataract. Which of the following statement represents the best management advice

263. Which prominent ocular manifestation is associated with Marfan's syndrome:

264. Lanatoprost used topically in glaucoma primarily acts

265.A two months old child presents with epiphora and regurgitation. The most probable diagnosis is

266. "Photo dynamic therapy" is used in the eye for the following disease:

267.All are ocular emergencies except

268. The most common condition of inherited blindness due to mitochondrial chromosomal anomaly is

269.All of the following can cause a white pupillary reflex except:

270. In right middle ear pathology Weber's test will be:

271. Meniere's disease is characterized by

272.Fordyce's (Spots) Granules in Oral Cavity arise from:

273.Which of the following locations show collection of pus in quinsy

274. Which of the following statements best represents Bell's paralysis

275.A 30 year old male had severely itchy papula-vesicular lesions on extremities, knees, elbows and buttocks for one year. Direct immunofluorescence staining of the lesions showed IgA deposition at dermoepidermal junction. The most probable diagnosis is:

276.A 5 year old male child has multiple hyperpigmented macules over the trunk. On rubbing the lesion with the rounded end of a pen, he developed urticarial wheal, confined to the border of the lesion. The most likely diagnosis is

277.A 25 year old man presents with recurrent episodes of flexural eczema, contact urticaria, recurrent skin infections and severe abdominal cramps and diarrhoea upon taking sea foods. He is suffering from

278. Which of the following volatile anaesthetic agents should be preferred for induction of anaesthesia in children

279. Which of the following is the best indication for propofol as an intravenous induction agent?

280.A patient undergoing caesarean section following prolonged labour under subarachnoid block developed carpopedal spasm. Lignocain was used as anesthetic agent. The most likely diagnosis is

281.A 25 year old male with roadside accident underwent debridement and reduction of fractured both bones right forearm under axillary block. On the second postoperative day the patient complained of persistert numbness and paresthesia in the right forearm and hand. The commonest cause of this neurological dysfunction could be all of the following except:

282.When a patient develops supraventricular tachycardia with hypotension under general anaesthesia, all of thoe following treatments may be instituted except:

283.A patient is suspected to have vestibular schwanoma The investigation of choice for its diagnosis is

284.In scurvy' all the following radiological signs are seen except

285.On radiography widened duodenal"C" loop with irregular mucosal pattern on upper gastrointestinal barium series is most likely due to

286. Which of the following is the most penetration beam?

287.The radiation tolerance of whole liver is

288. In which malignancy postoperative radiotherapy is minimally used?

289. Which of the following is not a CT scan feature of acute pancreatitis

290 Which of the following is the classic CT appearance of an acute Subdural hematoma

291.The first investigation of choice in a patient with suspected subarachnoid haemorrhage should be

292. Radio isotopes are used in the following techniques except

293.Signs of organic brain damage are evident on:

294.Miss B, a 27 year old nurse had extracurricular interest in trekking and painting. She broke up relationship with her boy friend. Two months later she lost interest in her hobbies and was convinced that she would not be able to work again. She thought life was not worth living and has consumed 60 tablets of phenobarbitone to end her life. She is most likely suffering from

295.A 25-year old house wife came to the Psychiatry out patient department (OPD) complaining that her nose was longer than usual. She felt that her husband did not like her because of the deformity and had developed relationship with the neighbouring girl. Further she complained that people made fun of her. It was not possible to convince her that there was no deformity Her symptoms include

296.A 40-year old man presents to casualty with his regular and heavy use of alcohol for ten years and morning drinking for one year. The last alcohol intake was three days back. There is no history of head injury or seizures. On examination, there is no icterus, sign of hepatic encephalopathy or focal neurological sign. The patient had coarse tremors, visual hallucinations and had disorientation to time. Which of the following is the best medicine to be prescribed for such a patient?

297.A 30 year old unmarried woman from a low socio economic status family believes that a rich boy staying in her neighbourhood is in deep love with her. The boy clearly denies his love towards this lady. Still the lady insists that his denial is a secret affirmation of his love towards her. She makes desperate attempts to meet the boy despite resistance from her family. She also develops sadness at times when her effort to meet the boy does not materialize. She is able to maintain her daily routine. She however, remains preoccupied with the thoughts of this boy. She is likely to be suffering

298.The Non-REM (NREM) sleep is commonly associate

299-A 16 year old boy does not attend school because of the fear of being harmed by school mates. He thinks that his classmates laugh at and talk even scared of going out to the market. He is most likely suffering from

300-A 41 year old woman working as an Executive Director is convinced that the management has denied her promotion by preparing false reports about her competence and have forged her signature on sensitive documents so as to convict her. She files a complaint in the police station and requests for security. Despite all this she attends to her work and manages the household. She is suffering from