Anatomy

1. Pectineus, Adductor magnus and Biceps femoris are composite muscles.

2. Digastric muscles are Muscle fibers in the ligament of Treitz, Omohyoid and Occipitofrontalis.

3. In lungs bronchial arteries supply the bronchopulmonary tree till respiratory bronchioles.

4. Skin overlying the region where a venous cutdown is made to access the great saphenous vein is supplied by femoral nerve.

5. Pathway of sperm is Straight tubules -> Rete testis -> Efferent tubules.

6. Inferior mesenteric vein is found in relation to paraduodenal fossa.

7. Artery to ductus deferens is a branch of Superior vesical artery.

8. Tributary of cavernous sinus includes Superior petrosal sinus, Inferior petrosal sinus and superficial middle cerebral vein.

9. Diploid veins are valveless, are present in cranial bones and have a thin wall lined by a single layer of endothelium.

10. Lacrimal bone does not contribute to nasal septum.

11. Cranial nerves containing somatic efferents includes IIIrd, IVth and VIth nerves.

12. Facial colliculus is seen in pons.

13. Mesencephalic nucleus of vagus nerve is the nucleus of Masseteric reflex.

Physiology

1. Lewis triple response is mediated by Histamine.

2. Histamine is found in Mast cells, it increases gastric acid secretion and it is related to arousal and blood pressure.

3. Secretin increases bicarbonate rich secretion, inhibits gastric acid secretion and causes contraction of pyloric sphincter.

4. Site where myosin heads bind to actin in skeletal muscles are covered by Tropomyosin.

5. Sarcoglycan, Dystrophin and Dystroglycan are sarcolemmal proteins.

6. Factor XIII causes cross linking and stabilization of clot.

7. Blood within vessels does not clot normally because vascular endothelium is smooth and coated with glycocalyx.

8. Blood pressure measured by a sphygmomanometer is higher than intra-arterial pressure.

9. Vagal stimulation decreases rate of contraction of heart, noradrenaline increases force of contraction and denervated heart has more heart rate.

10. Spermatogenesis occurs at temperature lower than core body temperature.

11. Fallopian tubes are lined by ciliated epithelium.

12. Flow of lymph from lower limb is increased by massage of foot.

13. Moderate exercise does not change cerebral blood flow.

14. Fine touch is transmitted by dorsal tract/ posterior column.

Biochemistry

1. HMP pathway does not generate ATP.

2. Muscle glycogen is incapable of contributing directly to blood glucose.

3. Phosphorylase B is maintained in an inactivated state by insulin.

4. Chaperones assist in folding of other proteins.

5. Proteins are sorted by Golgi bodies.

6. Trypsin inhibitors includes alpha-1 antitrypsin, alpha-1 antiproteinase and egg white.

7. Apoprotein A activates LCA, Apoprotein C1 activates lipoprotein lipase and Apoprotein C2 activates lipoprotein lipase.

8. Type III hypertriglyceridemia is associated with an increase in chylomicrons.

9. Okazaki fragments are formed during synthesis of dsDNA.

10. Folic acid is water soluble vitamin.

11. Vitamin K is required for carboxylation of clotting factors.

12. Ionised calcium is active form of calcium.

13. Neutral molecules are transported by simple diffusion.

Pathology

1. Reactive oxygen intermediates are released by NADPH oxidase.

2. Delayed prolonged leakage following tissue is due to direct effect of the injuring agent.

3. Bradykinin causes pain.

4. Langerhans cell, dendritic cells and B cells are antigen presenting cells.

5. Hemodialysis associated amyloid is due to deposition of beta 2 microglobulin.

6. ‘Sis’ oncogene is a growth factor.

7. P53 antigen is located on chromosome 17, arrests cell cycle at G1 phase and is a kD protein.

8. HMB is an immunohistological marker for Melanoma.

9. Specific marker for synovial sarcoma is t (x; 18).

10. CD15 and CD30 are characteristic markers for Hodgkin’s lymphoma.

11. Rosettes are characteristic in Retinoblastoma.

12. In malignant hypertension there are Petechial haemorrhages on cortical surface, fibrinoid necrosis of arterioles and intimal concentric thickening.

13. Crescentic glomerulonephritis may be seen in Post streptococcal glomerulonephritis (PSGN), Henoch Schonlein Purpura (HSP) and anti-basement membrane disease.

14. Non-proliferative glomerulonephritis includes focal segmental glomerulonephritis (FSGN), membranous glomerulonephritis and amyloidosis.

15. Finnish type of congenital nephritic syndrome occurs due to gene mutations in Nephrin protein.

16. Plasmacytoma, Askins tumor and Chloroma re malignant tumors.

17. Differential expression of same gene depending on parent of origin is referred to as Genomic imprinting.

18. Rh factor is a Glycoprotein antibody.

19. Graft vs host disease (GVHD) occurs when host is immunocompromised, is also called as Runt disease and a common cause is stem cell transplantation.

20. Superantigens bind T cells irrespective of antigenic specificity of the PCR, binds directly to both MHC II and T cell receptor causing T cell activation and binds directly to lateral aspect of T cell receptor.

21. Ferruginous bodies are commonly seen in Asbestosis.

22. Degeneration of basement membrane is mediated by Metallo proteinase.

Microbiology

1. Prions are most resistant to antiseptics.

2. Staphylococcus saprophyticus causes UTI in women.

3. Micrococci are oxidase positive.

4. Pneumococci are encapsulated.

5. Capsular hyaluronic acid of Streptococcus pyogenes has cross reactivity to synovium of human’s tissues.

6. Common species of enterococci are E. faecalis and E. faecium, Enterococci are cause for peritonitis and are a cause for intra-abdominal abscess.

7. V. cholerae O139 have clinical manifestations similar to O1 El Tor strain, it was 1st discovered in Chennai and epidemiologically indistinguishable from O1 El Tor strain.

8. Pneumocystis jiroveci may be associated with pneumatocele, usually diagnosed by sputum examination, often associated with CMV infection and causes disease only in immunocompromised patients.

9. Prions are infectious proteins.

10. H5N1 is best described as Bird flu virus.

11. Causes of biliary obstruction includes clonorchis, ascaris and fasciola.

Pharmacology

1. Phase II in a clinical trial is done to assess Therapeutic efficacy.

2. Therapeutic index is a measure of a drug’s Safety.

3. ED50 is a measure of potency.

4. Pralidoxime acts by reactivation of cholinesterase.

5. Ipratropium bromide is contraindicated in Urinary retention.

6. Tiotropium is used for treating asthma.

7. Drugs which may be used in relieve urinary spasms after urological procedures includes Darifenacin, Oxybutynin and Tolterodine.

8. Use of Ergotamine is contraindicated in IHD.

9. Clomiphene citrate binds estrogen receptor and prevents negative feedback at hypothalamus.

10. Flumazenil is a Diazepam antagonist.

11. Drugs used in anxiety includes SSRIs, Clonazepam and buspirone.

12. Cell wall synthesis is inhibited by Amoxicillin, Penicillin G and Cefotetan.

13. Piperacillin is an antipseudomonal penicillin.

14. Penicillin-G is active against gram positive organisms, Probenecid given along with Penicillin G increases its duration of action and it acts by inhibition of cell wall synthesis.

15. Resistance to Methicillin in MRSA is produced as a result of alteration in Penicillin binding proteins (PBP) is primarily transmitted via plasmids.

16. Tetracyclines may lead to discolouration of teeth, are a common cause of superinfections and may precipitate liver damage.

17. Streptomycin, Gentamicin and Polymyxin B are nephrotoxic.

18. Drug of choice for prophylaxis in diphtheria is Erythromycin.

19. Cotrimoxazole, Ciprofloxacin and Ceftriaxone can be given in enteric fever.

20. Drug of choice for treatment of Neurosyphilis is Procaine penicillin G.

21. Ciclopiroxolamina, Ketoconazole and undecylenic acid are antifungal agents.

22. Bleomycin is an anti-tumor peptide.

23. Paclitaxel acts by stabilisation of tubulin.

24. Leucovorin is given with Methotrexate.

25. Tacrolimus can lead to Neurotoxicity, diabetes and Hirsutism.

26. Imiquimod is used in genital warts.

27. Cytochrome P450, Methylation and hydroxylation and their reactions are involved in metabolism of Xenobiotics.

Forensic Medicine

1. Throttling is not a cause of death due to suffocation.

2. Fracture of hyoid bone and thyroid cartilage with neck muscle bruising suggests a diagnosis of Strangulation.

3. Fracture of Hyoid bone, thyroid cartilage and cricoid cartilage along with extensive bruising of neck muscles suggests a diagnosis of Manual strangulation.

4. Lugol’s iodine test is done for detecting vaginal cells from accused in a case of rape.

5. Mechanism of induction of labor with use of abortion stick is by stimulation o uterine contraction.

6. False negative hydrostatic test in a live born foetus may be seen in Atelectasis.

7. Corporal Basal index is useful for determination of sex.

8. Endrin is an example of a polychlorinated hydrocarbons.

9. Yellow fatty liver is a characteristic of poisoning with Phosphorus.

10. Mercury poisoning may cause colitis that resembles diphtheritic colitis.

11. Middle aged man from west Bengal presents with paraesthesia of hands and feet, hyperkeratosis of palms, lines on his nails and rain drop pigmentation. Most likely causative toxin is Arsenic.

12. Alkalinisation of urine may be done in cases of Barbiturates.

PSM

1. Iceberg phenomenon differentiates apparent and inapparent cases.

2. Interviewer’s bias can be reduced by allowing equal interview time.

3. Strength of association, dose response relationship and specificity of association are criterias suggesting causality in non-communicable disease.

4. MMR vaccine is contraindicated in pregnancy.

5. Booster doses are not required when live vaccines are administered, single dose gives lifelong immunity and live vaccine contains both major and minor antigens.

6. Completed family size may be estimated by Total fertility rate.

7. Most common cause of maternal mortality in India is Obstetric hemorrhage.

8. As per RCH, community center is a 1st referral unit.

9. Nutritional surveillance is a diagnostic approach, assessment involves precise measurement of weight and height and assessment is done by trained persons.

10. RDA is decided by a panel of experts and is based on scientific research, it is often higher than recommended minimum requirement and it is based on estimated average requirement (EAR).

11. Highest amount of saturated fatty acid is seen in Palm oil.

12. Psychrometer is used to measure humidity.

13. Plague, Japanese encephalitis (JE) and Tuberculosis (TB) are zoonosis.

14. Soil forms an important reservoir for Coccidioidomycosis, Anthrax and Tetanus.

15. Soft tick transmits Relapsing fever.

16. Isolation is strictly recommended for pneumonic plague.

17. Measles has high secondary attack rate, only one strain causes infection and infection confers lifelong immunity.

18. Yaws is caused by T. pertenue, has cross immunity with syphilis and cannot be differentiated serologically from T. pallidum.

19. Dharmendra’s index and Jopling’s classification deals with Leprosy.

20. IMCi initiative was taken to prevent morbidity and mortality from malaria, malnutrition and otitis media.

21. KAP studies in India were first used to study family planning.

22. Most common occupational cancer in India is Skin cancer.

23. Delphi method involves the formation of a term to undertake and monitor a Delphi on a given subject and selection of one or more panels to participate in exercise. Customarily, the panelists are experts in area to be investigated and 1st round in Delphi method involves development of a questionnaire.

24. Standard deviation is a measure of Deviation from mean value.

Medicine

1. Patient with macroglossia, loss of tongue papilla, Hb 11.5 and MCV 100. next step of investigation is b12 estimation.

2. Megaloblastic anemia should be treated with both folic acid and vitamin B12 because folic acid alone causes improvement of hematological symptoms but worsening of neurological symptoms.

3. Most appropriate investigation for a 40-year-old woman presenting with anemia, jaundice and spherocytosis is Coomb’s test.

4. Ring sideroblasts are characteristically seen in megaloblastic anemia, myelodysplasia and paroxysmal nocturnal hemoglobinuria.

5. Hemolysis is G6PD deficiency may be caused by primaquine, Chloroquine and Quinine.

6. IgM antibody is Cold agglutinin.

7. Patient with RCC on erythropoietin. Erythropoietin use may be associated with increased hematocrit, increased hemoglobin and eliminated need for transfusion.

8. Most common blood transfusion reaction is febrile non-hemolytic reaction.

9. Poor prognosis in AML is indicated by monosomy 7.

10. DIC is seen in M3 type of AML.

11. All-trans-retinoic acid is used in treatment of acute promyelocytic leukemia (PML).

12. Drug of choice for chronic myeloid leukemia (CML) is Imatinib.

13. Torsades des pointes may be caused by Quinidine.

14. Drug of choice for supraventricular tachycardia is Verapamil.

15. Young athlete died of sudden cardiac arrest after athletic activity. Post mortem finding revealed interventricular septal hypertrophy. Most probable diagnosis Hypertrophic obstructive cardiomyopathy (HOCM).

16. Diffuse esophageal spasm is best diagnosed by Manometry.

17. 30-year-old woman with non-progressive dysphagia for both solids and liquids. The characteristic finding on barium swallow that will confirm probable diagnosis is multiple sacculations and pseudodiverticulum (Corkscrew esophagus).

18. Young male HBsAg positive and HBeAg negative, liver enzymes normal. Next step in management is serial monitoring.

19. Acute pyelonephritis and uncomplicated UTI may be differentiated by WBC cast, concentrating defect and antibody to Tamm Horsfall protein.

20. Suprapubic aspiration is best method of urine collection associated with least contamination.

21. Coloured urine is seen in Rifampicin, Nitrofurantoin and Pyridium.

22. MEN I syndrome is most commonly associated with Gastrinoma.

23. Cushing’s disease is associated with increased ACTH and increased cortisol.

24. Conn’s syndrome is most commonly associated with cortical adenoma.

25. Causative agent for rheumatoid arthritis is Mycoplasma.

26. Antiphospholipid syndrome (APS) is associated with recurrent abortions, venous thrombosis and pulmonary hypertension.

27. In hereditary hemochromatosis arthropathy involving small joints of hands may be seen, skin pigmentation is a frequent presentation and Hypogonadism may be seen.

28. 24-year-old male presents with abdominal pain, rashes, palpable purpura and arthritis. Most probable diagnosis is Henoch Schonlein Purpura (HSP).

29. Thymoma is associated with Myasthenia gravis.

30. Crohn’s disease may be caused by Clostridium difficile.

31. 25-year-old male with h/o chronic diarrhea. Pathological examination reveals cryptitis and crypt abscess. Likely diagnosis is Ulcerative colitis.

32. Histopathological findings in Whipple’s disease includes marked increase in number of macrophages, dilatation of lymphatics in mucosa and lipids deposition in mucosa.

33. Dying back neuropathy is seen in diabetic neuropathy, arsenic neuropathy and porphyria.

34. Likely causes of meningitis in elderly includes Listeria monocytogenes, Streptococcus pneumoniae and Gram-negative bacteria.

35. Pick’s body in Pick’s disease is Tau protein.

36. Biondi ring tangles (BRT) are found in CHoroid plexus cells.

37. Features of extramedullary tumours includes early corticospinal signs and paralysis, root pain or midline back pain and abnormal CSF.

38. Clinical features of Conus medullaris syndrome includes plantar extensor, sacral anaesthesia and lower sacral and coccygeal involvement.

39. Diffuse axonal injury (DAI) is caused by shearing force, predominant white matter haemorrhages in basal ganglia and corpus callosum and most common at junction of grey and white matter.

40. Pain, swelling and osteoporosis are seen in chronic regional pain syndrome.

Surgery

1. Vicryl, catgut and polydioxanone are absorbable sutures and polypropylene is non-absorbable.

2. Breach of platysma is used to define Penetrating neck injury.

3. Decision regarding surgery in a case of hemothorax due to blunt trauma chest should be based on hemodynamic status.

4. Male patient with blunt trauma abdomen is hemodynamically stable. Next line of management is further imaging of abdomen.

5. Young patient with massive injury to proximal duodenum, head of pancreas and distal common bile duct. Procedure of choice in this patient should be Pancreaticoduodenectomy (Whipple’s operation).

6. Landmarks for facial nerve during parotid surgery include digastric muscle, tragal pointer and retrograde dissection of distal branch.

7. Abbe-Estlander Flap is used for Lip.

8. Most common histological type of thyroid carcinoma is the papillary type.

9. Complications of Hemithyroidectomy includes wound hematoma, recurrent laryngeal nerve palsy and external branch of superior laryngeal nerve palsy.

10. 25-year-old female complains of discharge of blood from single duct is her breast. Most appropriate treatment is Microdochectomy.

11. Most common tumor in posterior mediastinum is Neurofibroma.

12. For a patient with ITP with platelet count 50,000 and is being planned for splenectomy Best time for platelet infusion in this patient would be after ligating splenic artery.

13. 45-year-old woman with symptoms of acute Cholecystitis, on USG a solitary gallstone of size 1.5 cm seen. After controlling of symptoms with medical management next most appropriate step is laparoscopy cholecystectomy immediately.

14. A woman with symptoms of flatulent dyspepsia was started on proton pump inhibitor which controlled her symptoms. Next step should be to wait and watch.

15. Chronic alcoholic with abdominal pain radiating to back that responds to analgesics. On evaluation pancreatic duct was found to be dilated and stones noted in tail of pancreas. Most appropriate management is medical management.

16. For a patient undergone a prolonged and complicated pancreatic surgery for chronic pancreatitis. Most preferred route for supplementary nutrition in this patient would be Feeding Jejunostomy.

17. Segments of liver to left of attachment of the falciform ligament are segments 2 and 3.

18. Volvulu is more common in psychiatric patients, sigmoid volvulus is more common than caecal volvulus and volvulus of caecum is managed by conservative methods.

19. Anal fissure is best diagnosed by history and superficial clinical examination.

20. Nigro’s regimen is a regimen for anal canal neoplasm, it incorporates chemotherapy with radiation as an alternative to surgery and it has advantage of preserving continence.

21. 30-year-old male with sudden onset swelling and pain over right hemiscrotum, on examination scrotum is tender and reddened. Probable diagnosis is torsion, right testis is likely to ride high in scrotal compartment and if torsion is confirmed treat with antibiotics and analgesics and perform corrective surgery immediately.

22. Ureteric colic due to stone is caused by increased peristalsis of ureter o overcome obstruction.

23. Epispadias is associated with Chordae.

24. Trans-rectal USG in evaluation of carcinoma prostate is most useful for taking guided biopsy.

25. For a newborn child who has not passed meconium for 48 hours, diagnostic procedure of choice is Contrast enema.

26. For a newborn baby with absent anal orifice and meconium, most appropriate management is transverse colostomy.

Obstetrics and Gynaecology

1. In complete mullerian duct aplasia, fallopian tubes, uterus and vagina are likely to be absent.

2. First sign of puberty in girls is Breast budding.

3. Least failure in sterilization occurs with unipolar cautery.

4. Isthmo-isthmic anastomosis is associated with maximum chance of recanalization during surgery for reversal of tubal ligation.

5. SSRIs have shown best results for premenstrual syndrome.

6. For a woman with fluctuant non-tender swelling at introitus, best treatment is Marsupialisation.

7. Salpingitis/ Endosalpingitis is best confirmed by hysteroscopy + Laparoscopy.

8. In Androgen insensitivity syndrome patients have an XY genotype, short vaginal may be present and ovaries are absent.

9. Virus associated with cancer cervix is HPV.

10. Squamous cell carcinoma is common at squamocolumnar junction, postcoital bleeding is a common symptoms and HPV 16 and 18 are associated with high risk of carcinogenesis.

11. Ideal treatment for a 55-year-old woman with simple hyperplasia of endometrium with atypia is simple hysterectomy.

12. Conditions diagnosed by Chorionic villous biopsy includes Down’s syndrome, Phenylketonuria and Sickle cell anemia.

13. In Doppler studies of umbilical circulation changes in flow velocity waveforms of umbilical artery may be important in clinical management of high risk pregnancies, normal pregnancy shows a characteristic decrease in systolic/ Diastolic (S/D) ratio with advancing gestational age and maternal smoking leads to an increase in S/D ratio.

14. SLE, Rh incompatibility and Syphilis are known to cause recurrent abortions.

15. Interventions included in active management of IIIrd stage of labour includes administration of a uterotonic within 1 minute of delivery and immediately clamping cutting and ligation of cord and controlled cord traction.

16. Induction at term is indicated in hypertension, diabetes mellitus and renal disease.

17. Contraindications of vaginal delivery after previous cesarean section includes previous classical CS, no vaginal delivery in past and puerperal infection in previous pregnancy.

18. Risk factors for Placenta accreta includes previous LSCS scar, previous curettage and previous myomectomy.

19. Tocolytic agents include Ritodrine, Salbutamol and Isoxsuprine.

20. Drugs useful in management of PPH includes Misoprostol, Oxytocin and Ergotamine.

21. Labetalol is DOC for severe preeclampsia.

22. Calcium supplements are recommended for a pregnant woman on Heparin.

23. Breast infection during lactation can lead to abscess formation for which and I & D may be required.

24. HIV is associated with minimal teratogenic risk to fetus.

25. For a pregnant mother presenting with h/o delivery of a previous child with ocngenital adrenal hyperplasia (CAH), best management protocol for current pregnancy is to start dexamethasone as soon as pregnancy is confirmed.

Paediatrics

1. Gomez classification is based on 50th centile Boston standards, between 75-89% implies mild malnutrition and this classification has prognostic value for hospitalization of children.

2. Most common cause for short stature is constitutional.

3. Very LBW preterm baby is on ventilator for respiratory distress. Baby presents with clinical features of necrotizing enterocolitis with perforation. Most appropriate management is peritoneal drainage.

4. Probiotics are found to be beneficial in Necrotizing enterocolitis.

5. Child with massive hepatomegaly and hypoglycemia and no improvement in blood glucose on administration of Glucagon. Probable diagnosis is Von Gierke disease.

6. Bicuspid aortic valve is most commonly associated with coarctation of aorta.

7. Right sided aortic arch is most strongly / commonly associated with truncus arteriosus.

8. PDA is common heart lesion in rubella, hypoxia and immaturity are important in maintaining patency and treatment is closure of defect by ligation and division of ductus.

9. 7 1/2 year old child with cough, mild stridor is started on oral antibiotics, child showed initial improvement but later developed wheeze, productive cough and mild fever. X-ray shows hyperlucency and PFT shows an obstructive curve. Most probable diagnosis is Bronchiolitis obliterans.

10. Uncomplicated pregnancy and delivered baby develops severe respiratory distress within a few hours of birth, results of routine culture were negative and chest venogram revealed normal heart shadow and in reticulonodular infiltrates radiating from hilum. ECHO findings normal. Family history reveals similar clinical course and death of a male and female sibling at 1 month and 2 months of age. Most likely diagnosis is Neonatal alveolar proteinosis.

11. 6-year-old child with recurrent episodes of gross hematuria for 2 years is likely to have IgA nephropathy.

12. Kawasaki’s disease is associated with coronary artery aneurysm in upto 25% of untreated cases.

13. In 21 alpha hydroxylase deficiency, is most common cause of congenital adrenal hyperplasia (CAH) in children, in it affected women present with ambiguous genitalia and affected men present with precocious puberty.

14. Commonest type of seizure in newborn is Subtle.

15. Symptomatic neonatal CNS involvement is most commonly seen in Rubella and Toxoplasmosis intrauterine infections.

16. CNS involvement is most commonly associated with CMV and Toxoplasmosis congenital intrauterine infections.

17. In cerebellar astrocytomas in paediatric group are usually low grade tumours, tumors have a good prognosis and are more commonly seen in 1sy and 2nd decades.

18. Probable diagnosis for cyst in a child which is located at and associated with vertebral defects is Neurenteric Cyst.

19. For nocturnal enuresis lowest relapse rate is seen in treatment with Bell alarm systems.

20. Resistant plasmodium falciparum malaria in pediatric age group should be treated by Clindamycin.

Ophthalmology

1. WHO definition of low vision in children is visual acuity 6/18 to 6/60 in better eye with best correction.

2. Most common cause of ocular morbidity in India is Refractive error.

3. Major function of major intrinsic protein 26 (MIP-26) is transport of water in lens.

4. Metalloproteinase, Sialoprotein associated with rods and cones (SPARC) and tissue inhibitor of metalloproteinases (TIMP) are seen in interphotoreceptor matrix.

5. Final common pathway for horizontal gaze involves Abducens nucleus.

6. Von Recklinghausen disease is associated with Glaucoma, optic nerve glioma, neurofibroma of lids and anterior chamber angle malformation.

7. Sarcoidosis is associated with Band keratopathy.

8. Intractable secondary glaucoma is seen in diffuse iris melanoma.

9. Persistent primary hyperplastic vitreous (PHPV) is associated with Patau syndrome.

ENT

1. For a newborn with bilateral microtia and external auditory canal atresia, corrective surgery is usually performed at 5-7 years of age.

2. In cochlear implants electrodes are most commonly placed at Oval window.

3. 70-year-old man with loss of sensation in external auditory meatus (Heidelberg’s sign positive), likely diagnosis is Vestibular schwannoma.

4. 70-year-old with hearing loss, tinnitus, conductive hearing loss, dull tympanic membrane on right side, 3×3 lymph node enlargement in posterior triangle of neck and tympanogram revealing Type B wave. Most likely diagnosis is nasopharyngeal malignancy.

5. Diagnostic criteria of Allergic fungal sinusitis includes areas of high attenuation on CT scan, allergic eosinophilic mucin and Type I hypersensitivity.

6. 30-year-old woman with singing, vocal abuse and gastroesophageal reflux develops nodules at junction of anterior 1/3rd & middle 1/3rdn of her vocal cords. Treatment of choice is Speech therapy and PPI.

Orthopaedics

1. Autologous bone graft is commonly taken from iliac crest.

2. In ‘Low radial nerve palsy’ there is loss of nerve supply to extensor carpi radialis brevis and extensor pollicis brevis and loss of sensation over 1st dorsal web space.

3. Tuberculous osteomyelitis is a type of secondary osteomyelitis, sequestrum is uncommon in it and inflammation is minimal.

4. Coronary ligament of knee are ligaments connecting the menisci to tibia.

5. On getting up from sitting position medial rotation of femur on a fixe tibia takes place.

6. In acute knee injuries with swelling & hemarthrosis with muscle spasm, Lachman’s test is most sensitive to detect anterior cruciate ligament.

7. Blood supply of anterior cruciate ligament (ACL) is primarily derived from middle genicular artery.

8. In tears in inner zone, meniscectomy will be more suitable option than meniscal repair.

9. HIv patients on protease inhibitors with limitations of abduction and internal rotation of hip. Most probable diagnosis is Avascular necrosis (AVN) of femur 56 year old Type II diabetic with complain of swelling in left ankle with effusion but only minimal pain, X-ray shows severe osteopenia with bone destruction , extensive osteophytosis and loose bodies. Management in patient includes resting & splinting, aspiration & compression and ankle arthrodesis.

10. Pollicization can be best described as Thumb reconstruction.

Skin

1. Male with patchy loss of hair on scalp, eyebrows and beard, h/o rapid greying of hair in a few areas. Likely diagnosis is Alopecia areata.

2. 40-year-old female with persistent oral ulcers followed by multiple flaccid bullae on trunk and extremities, intercellular IgG deposits in epidermis and suprabasal; split with acantholytic cells. Probable diagnosis is Pemphigus vulgaris.

3. Heterosexual man presents with multiple non-indurated painful ulcers with undermined edges and enlarged lymph nodes 5 days after exposure. Most likely diagnosis is Chancroid.

4. DOC for pregnant woman in 2nd trimester with pustular psoriasis is Prednisolone.

5. DOC for type II Lepra reaction is Steroids.

Anaesthesia

1. Train of four fade is a characteristic feature of Non-depolarizing block.

2. Propofol does not trigger malignant hyperthermia, its commercial preparations contains egg and it is a suitable agent for day care surgery.

3. Sevoflurane is less cardiodepressant than isoflurane.

4. Desflurane has lower blood-gas partition coefficient than sevoflurane.

5. Sevoflurane has a higher MAC than isoflurane.

Radiology

1. Photoelectric effect can be best described as an interaction between low energy incident photon and outer shell electron.

2. Allergic reactions to radiological contrast agents are anaphylactic reactions.

3. Most radiosensitive phase of cell cycle is G2M.

4. Tc99m-DTPA is used to measure GFR.

5. Flaring of anterior ends of ribs is characteristically seen in Rickets.

6. Inferior rib notching is seen in Coarctation of aorta.

7. Earliest radiological sign of pulmonary venous hypertension in chest X-ray is Cephalization of pulmonary vascularity.

8. Earliest sign of left atrial enlargement is posterior displacement of oesophagus.

9. Most common features of Aortitis on chest x-ray is calcification of ascending aorta.

10. Investigation of choice for detection and characterization of interstitial lung disease is HRCT.

11. Best radiographic view for fracture of C1, C2 vertebrae is odontoid view.

12. Diagnostic feature of ileocecal TB on barium follow through includes pulled up contracted angle, widening of ileocecal angle and stricture involving terminal ileum.

Psychiatry

1. Term ‘Dementia precox’ was coined by Kraepelin.

2. 25-year-old woman with chest pain, sweating, restlessness, dyspnoea and palpitation, Enzyme analysis and x-ray are normal and she becomes asymptomatic with supportive measures. Probable diagnosis is Panic attack.

3. Clinical features of post-traumatic stress disorder (PTSD) includes flashbacks, hyper arousal and emotional numbing.

4. 2 months after knowing son is suffering from leukaemia, 45-year-old father presents with sleep deprivation, lethargy headache and low mood. Interacts reasonably well with others but has absented himself from work. Most probable diagnosis is Adjustment disorder.

5. 30-year-old with erectile dysfunction has normal investigations. Next step should be Oral Sildenafil citrate trial.

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