AIIMS nov 1999 questions with answers
mail
corrections/questions/answers at contribute@aippg.com
1.
If
a missile enters the body just above the pubic ramus through the anterior
abdominal wall, it will most likely pierce which of the following
structures
a.Abdominal aorta
b.Left renal vein c.Urinary bladder d.Spinal cord
Ans: (c)
Ref: Snell page 309(6th ed). Also
the abdominal aorta splits at L4 and the spinal cord ends at L1.
2.
Which
of the following is not a boundary of the Koch's triangle a.Tendon of Todaro b.Limbus fossa ovalis c.Coronay sinus d.Tricuspid valve ring
Ans: (b)
Ref: Gray's Anatomy p644(35th
ed)
3.
Which
of the following aminoacids is associated with increased risk of Myocardial
infarction a.Methionine b.Homocysteine c.Ornithine
d.Valine
Ans: (b)
Ref: Harrison 14th ed. p1348
and table 242-1
4.
Kalloo
65 years presents with complaints of abdominal pain. On examination there was
distension of abdomen and the stools were maroon colored. He gives a past
history of Cerebro vascular accident and Myocardial infarction. What would be
the probable diagnosis
a.Ulcerative colitis
b.Crohn's disease
c.Acute mesenteric ischemia
Ans: (c)
Ref: Harrison p1652
5.
Which
of the following ECG changes is least likely in a patient with left
pneumothorax
a.Inversion of Twave b.Left axis deviation c.Small R wave d.Electrical alternans
Ans:(b)
Ref:Harrison p1240."Right
axis deviation seen in condition such as right ventricular
overload,infarction
of lateral wall of left ventricle, dextrocardia, left pneumothorax or left
posterior
fascicular block.
6.
A
patient presents 12 hours following a Myocardial infarction. Which of the
following enzymes will be elevated at this period [1] a.Lactate dehydrogenase b.Serum Glutamate Oxalo
acetate Transferase c.Creatinine Phospho Kinase d.Myoglobin
Ans:(c)
Ref:Davidson 18th edn p 260
7.
Which
of the following features denote a contraindication for surgical resection in a
case of carcinoma lung
a.Malignant pleural effusion
b.involvement of visceral pleura
c.Hilar lymphadenopathy
d.Consolidation of one lobe
Ans:(a)
Ref:CMDT 2000, Chap 12,
p312.Harrison Table 90-5
8.
Lalloo
50 years, a chronic smoker, presents with history of hemoptysis. He was having
trunkal obesity and hypertension. He had an elevated ACTH level
which was not suppressible with high dose dexamethasone. What would be
the most probable diagnosis
a.Bilateral adrenal hyperplasia
b.adrenal adenoma
c.pituitary tumor
d.ectopic ACTH producing lung
cancer
Ans:(d)
Ref:Harrison p2044, table 332-5
9.
When
the following aminoacids are separated by running them on agarose gel, at pH 7,
which one of them will migrate slowest to the anodic end a.Glycine b.Valine
c.Aspartic acid d.Lysine
Ans:?d
Ref:accoding to a similar
question in NMS Step !
10.
While
bathing a 6 month old child, his mother noted that there was a swelling in the
abdomen towards the left side. On examination there was an abdominal mass,
which showed calcification near the left kidney. What is the most probable
diagnosis
a.Lymphoma
b.Leukemia
c.Neuroblastoma
d.Renal cell carcinoma
Ans:(c)
Ref:
11.
A
G2P1+0+0, Diabetic mother presents at 32 weeks of
pregnancy. She gives a history of full term fetal demise during her last
pregnancy. Her sugar is now controlled and the child is stable. What is the
best plan of action
a.Await spontaneous
delivery b.Induce at 38 weeks c.Induce at 40 weeks d.Cesarian section at 38
weeks
Ans:(a)
Ref:DewHurst's OBG 6th edition,
p205
12.
Which
of the following is an absolute indication for Cesarian section in pregnancy
associated with heart disease a.Pulmonary stenosis b.Coarctation of Aorta c.Eisenmenger syndrome d.Ebstein's anomaly
Ans:(b)
Ref:Dutta, p298
13.
Basanti,
23 year old pregnant women presents with features of dilated cardiomyopathy.
Which of the following drugs you will not give to treat her
a.Digoxin b.ACE
Inhibitors c.Diuretics d.vasodilators
Ans:(b)
Ref:Due to the teratogenecity of
the ACE inhibitors
14.
The
?9 month old child of a diabetic mother presents with tachypnea and
hepatomegaly. Echo cardiography of the heart showed normal cardiac morphology
with asymmetric septal hypertrophy. Which of the following you will give to
treat this child a.Digoxin b.Frusemide c.Propranolol d.Isoptin
Ans:(c)
Ref:Harrison p1331
15.
Under
the National Polio Eradication Program, a case of Acute Flaccid Paralysis is
confirmed as Polio, under the following circumstances except a.If a case is lost to follow up b.If a case could not be
confirmed because the patient died before that
c.If a wild strain of polio virus is isolated from stool d.If a
patient develops paralysis 30 days after diagnosis of AFP
Ans:(d)
Ref:Park p156
16.
What
is the number of FRU units per district a.01-- 03 b.04 -- 06 c.07 --
09 d.10 -- 12
Ans:(d)
Ref: Park page 308. Its given as
6-12 in addition to the district hospital. So we feel d is a better choice
17.
Child
of Vasanthi, was weaned from breast milk on the fifth day and was given sugar
cane juice. The child developed hypoglycemia and hepatomegaly. Biochemical
examination showed hypophosphatemia and reducing substances in urine. The child
is probably suffering from which of the following enzyme deficiencies a.Aldolase B b.Fructokinase c.Glucose 6 Phosphatase d.Beta Galactosidase
Ans:(a)
Ref:Harrison p2209, Nelson 16th
edition, p407
18.
Sex
ratio in India according to the 1991 Census is a.929 b.972 c.934 d.1012
Ans:(a)
Ref:Park, p314
19.
Calculate
the median from the following values
1.9, 1.9, 1.9, 2.1, 2.4, 2.5, 2.5, 2.5, 2.9 a.1.2 b.1.9 c.2.25 d.2.5
Ans:(c)
Ref:Refer Park
20.
Which
of the following is not spread by Aedes mosquito a.Dengue fever b.Chickungunya
c.Japanese Encephalitis
d.Yellow fever
Ans:(c)
Ref:Refer any micro text book
21.
Median
weight of 100 children was 12kgs. The Standard Deviation was 3. Calculate the
percent coefficient of variance
a.25% b.35% c.45% d.55%
Ans:(a)
Ref:It is calculated as Standard
Deviation/Mean. So it is 3x100/12 = 25% See p436 of Mahajan's text book of
preventive medicine
22.
All
of the following are random sampling methods except a.Simple
random b.Cluster
sampling c.Stratified
random d.Quota Sampling
Ans:(d)
Ref:Park p582
23.
In
a group of persons taking part in a controlled trial of an antihypertensive
drug, the Blood Pressures were measured before and after giving the drug. Which
of the following tests will you use for comparison a.paired t test b.F test c.t test d.Chi square test
Ans:(a)
Ref:Refer any statistics book,
you will get the explanation
24.
Widmark's
formula is used for measurement of blood levels of a.Benzodiazepines
b.Barbiturates c.Alcohol
Ans:(c)
Ref:Refer text book of Forensic
Medicine by Reddy
25.
Cherry
red color in post mortem staining is a feature of poisoning with
a.Nitrites
b.aniline c.Phosphorus d.Carbon Monoxide
Ans:(d)
Ref: Refer text book of Forensic
Medicine by Reddy
26.
Elevated
levels of cyanide is seen in death due to which of the following a.Cold b.Scald c.Starvation d.Thermal burns
Ans:(d)
Ref: Refer text book of Forensic Medicine by Reddy
27.
Kalloo
45 years old, having a 10 year history of alcoholism, presents with complaints
of confusion, ataxia, ophthalmoplegia and peripheral neuropathy. What is the
most probable diagnosis a.Wernicke's encephalopathy b.Korsakoff's psychosis c.Delerium tremens d.Alcoholic hallucinations
Ans:(a)
Ref:Harrison p2455
28.
Lalloo,
60 yrs of age, a known case of cirrhosis liver, presents with increased levels
of Alpha feto protein , hepatomegaly 3 cm below costal margin. USG showed
lesions involving the right lobe of the liver. What is the most probable
diagnosis a.Focal nodular
hyper plasia b.Hepato cellular
carcinoma c.Hepatic adenoma d.metastasis
Ans:(b)
Ref:Harrison p579-580
29.
What
is the most common mode of inheritance of von Williebrand's disease
a.Autosomal dominant
b.Autosomal recessive c.X linked recessive d.Co dominant
Ans:(a)
Ref:What
is the most common mode of inheritance of von Williebrand's disease
a.Autosomal dominant
b.Autosomal recessive c.X linked recessive d.Co dominant
Ans:(a)
Ref:Harrison p 733
30.
20
year old boy, presented with severe hematemesis. On examination there was no
hepatomegaly, mild splenomegaly present. On endoscopy esophageal varices were
seen. What is the most probable diagnosis a.Cirrhosis liver b.Budd Chiari syndrome c.Non cirrhotic portal fibrosis d.Veno occlusive disease
Ans:(c)
Ref:Harri p 1710
31.
What
is the most common cause for Budd Chiari syndrome a.Right ventricular failure b.PNH c.valve in hepatic
veins d.Nephrotic syndrome
Ans:(b)
Ref:Harrison p1709.Worldwide the
commonest cause is a membrane in the IVC(Anderson's pathology p1415,10th
edition)
32.
Which
of the following is not seen in Paroxysmal Nocturnal Hemoglobinuria a.Hypocellular bone marrow
b.Hemosiderinuria
c.Increased LAP score d.Pancytopenia
Ans:(c)
Ref:Harrison p670
33.
All
of the following are seen in polycythemia rubra vera except a.Increased Vit B12 binding
capacity (>900micromols/dL)
b.decreased LAP score
c.Leucocytosis
d.increased platelets
Ans:(b)
Ref:Harrison p681
34.
What
is the size of the microfilter used in blood transfusion sets a.50micro meters b.150 micro
meters c.170 micro
meters d.250 micro
meters
Ans:(c)
Ref:Clinical Practice of
Transfusion Medicine p323
35.
All
of the following are part of Manning's criteria except a.Fetal respiratory movements b.Non stress test c.Fetal body
movements d.Vibroacoustic stimulation
Ans:(d)
Ref: ObstetricsDutta p 115
36.
A
patient with choriocarcinoma, is not responding to the usual doses of
methotrexate. She is having jaundice. Which drug will you prefer for further
treatment
a.Actinomycin D
b.Cyclophosphamide
c.Cisplatin
d.Chlorambucil
Ans:(a)
Ref:ObstetricsDutta p 212
37.
Which
of the following is the most reliable indicator of Ectopic gestation a.No
gestational sac in USG b.Arias
Stella reaction c.Culdo
centesis showing blood in the posterior cul-de-sac d.Absence of the normal doubling of hCG levels
Ans:(a)
Ref: ObstetricsDutta p199
38.
A
22 year old lady present with pain in the right iliac fossa. On examination
there was tenderness and guarding . Which of the following should not be done
in this case
a.Put patient Nil
orally b.give
I.V.glucose c.Inj. Pethidine I.M. d.Plain X ray abdomen
Ans:(c)
Ref:Old Bailey p839
39.
A
child presents with history of blunt injury abdomen associated with splenic
trauma. On examination the child is stable. Which of the following is the
treatment of choice
a.Splenorrhaphy
b.Observation
c.Splenectomy
d.Arterial embolisation
Ans:(b)
Ref:Synopsis of Emergency pediatric Medicine p687, Nelson p1527
40.
Which
of the following is true about carcinoma colon a.Lesion on the left side of the colon
presents with features of anemia b.Solitary metastasis is liver
is not a contraindication for surgery
c.mucinous carcinoma has a good prognosis d.Duke's A stage should
receive adjuvant chemotherapy
Ans:(b)
Ref:Harrison p576
41.
A
patient with Hodgkin's lymphoma is having a single cervical lymphnode. Biopsy
showed lymphocyte predominant variant. Which of the following is the treatment
of choice a.Chemotherapy with
Radiotherapy b.Chemotherapy only c.Radiotherapy only d.No treatment
needed
Ans:(c)
Ref:Harrison p710
42.
Lalloo,
a 55 year old chronic smoker, presents with complaints of hoarseness of voice.
On examination there is a single enlarged painless lymphnode in the left
supraclavicular area. What is the next step to be done a.Excision biopsy of the node b.Laryngoscopy and Chest X ray
c.CT scan
d.Sputum for AFB
Ans:(b)
Ref:Harrison p550
43.
A
girl presents with complaints of melena. On examination there are pigmented
lesions involving her mouth and lips. Two of her sisters also had similar
complaints. Which of the following is the most probable diagnosis a.Kronchite
Canada syndrome
b.Puetz Jegher's syndrome c.Gardner's syndrome
Ans:(b)
Ref:Old Bailey p799
44.
30
year old Basanti presents with light brown lesions involving both her cheeks.
The lesions had never been erythematous. Which of the following is the most
probable diagnosis a.SLE b.Chloasma c.Air borne Contact Dermatitis
d.photodermatitis
Ans:(b)
Ref:Refer any skin text book
45.
All
the following malignancies are associated with HIV except a.Astrocytoma b.Non Hodgkin's lymhoma c.Gastric adenocarcinoma d.Kaposi's sarcoma
Ans:()
Ref:Sorry I could not find a
defnite answer, it could be Astrocytoma according to a book called Cancer
Medicine
46.
Babloo,
5 years, presents with small hypopigmented scaly macules on his cheek. Some of
his classmates also have similar lesions. Which of the following is the most
probable diagnosis a.Pityriasis alba b.Pityriasis
rosea c.Pityriasis versicolor d.Indeterminate leprosy
Ans:(a)
Ref:p258 Anderw's disease of
Skin, 9th edition.....a very good book
47.
A
11 month old child presents with complaints of respiratory distress. On
examination there is bilateral crepitations and wheezing . Which of the
following is the most likely cause a.pneumonia b.respiratory
syncitial virus c.adenovirus d.rhinovirus
Ans:(b)
Ref:Old Ghai p282
48.
A
patient presents with features suggestive of chronic pancreatitis. ERCP
examination showed "chain of Lakes" appearance. Which of the
following is the most appropriate management for this patient a.Side to side pancreatico
jejunostomy b.Distal pancreatic resection and
end to side anastomosis. c.Whipple's resection d.sphincterotomy
Ans:(?a)
Ref:According to Schwartz
pretest
49.
A
patient presents with a pancreatic pseudocyst 5cm in size, 3 weeks duration.
What is the best method to manage this case a.External drainage b.USG and follow
up c.cystogastrostomy d.Needle aspiration
Ans:(b)
Ref:Harrison p1746
50.
Kalloo,
25yrs, presented with a mass in the right iliac fossa. On laprotomy it was
found to be a carcinoid 2.5cms in diameter. What is the next step in
management
a.Segmental resection
b.Right hemicolectomy
c.Appendicectomy d.do yearly 5-HIAA
Ans:(b)
Ref:New Bailey p1092
51.
A
patient presents with head ache, intermittent claudication and dizziness. Which
of following may be the underlying cause a.Tetrology of Fallot b.Coarctaion of aorta c.Patent ductus
arteriosus d.Atrial septal
defect
Ans:(b)
Ref:Harrison p1306
52.
A
needle aspiration from the thyroid nodule of a patient with pituitary tumor and
pheochromocytoma shows which of the following a.Follicular carcinoma b.Medullary carcinoma c.Anaplastic carcinoma d.Papillary carcinoma
Ans:( )
53.
Kalloo
45 years presents with a swelling in the thyroid gland and a lymphnode in the
neck. Aspiration of the node shows amyloid material. What is the management of
choice for this patient a.
Hemithyroidectomy with neck dissection b.Total thyroidectomy with
neck dissection c.Total thyroidectomy with
neck irradiation d.Hemithyroidectomy
Ans:(b)
Ref:Harrison p2031
54.
A
patient presents with intermittent head ache. On examination there is
hypertension and a thyroid nodule. Which of
the following steps is to be taken next a.Urine HIAA levels b.Urine VMA and aspiration of the thyroid nodule
Ans:(b)
Ref:It is a case of MEN 2.
55.
Basanti,
40 yrs, underwent subtotal thyroidectomy. In the recovery room she developed
stridor. There was some staining of the wound with blood. Which of the following
is the least likely cause
a.Tracheomalacia
b.Bilateral recurrent nerve palsy
c.Hematoma formation d.Hypocalcemia
Ans:(d)
Ref:Probable explanation Old
Bailey p522. Most cases of hypocalcemia presents on days 2-5
56.
After
thyroidectomy, a patient developed a wound hematoma in the ward associated with
respiratory distress. Which of the following is the next best step to do a.Orotracheal intubation b.immediate opening of the wound c.observation d.Send the patient to the theatre
to remove the clots
Ans:(b)
Ref:Old Bailey p522
57.
A
post thyroidectomy patient presents with tingling and perioral paresthesia.
Serum calcium level was 7 mg/dL. Which of the following is the best line of
management
a.Oral vitamin D3 b.Oral vitamin D3 with
calcium c.I.V.calcium gluconate d.Observation
Ans:(c)
Ref:
58.
Bowel
does not get strangulated in which of the following a.Recto
uterine pouch b.Omental
bursa
c. Ileo-colic recess d.Para duodenal and peritoneal recess
Ans:(a)
Ref:Old Bailey p823
59.
Vocal
cord paralysis is due to involvement of which of the following nerves
a.External laryngeal b.Internal laryngeal c.Recurrent laryngeal d.Superior laryngeal
Ans:(c)
Ref:
60.
Vasanti,
28 year old, presents with complaints of tightness of fingers. There is also
history of dysphagia. Which of the following is the probable diagnosis a.Dermatomyositis b.Scleroderma c.Rheumatoid arthritis
Ans:(b)
Ref: Harrison p1892
61.
A
lady approaches a physician for contraceptive advice. On examination there were
two symmetrical ulcers on vulva, which were well defined with a firm base.
Which of the following is the most likely cause a.Syphilis
b.Chancre
c.Herpes d.Malignancy
Ans:(a)
Ref:
62.
Carcinoma
endometrium with involvement of inguinal nodes belongs to which stage a.StageI b.Stage II c.Stage III
d. Stage IV
Ans:(d)
Ref:Dewhurst's OBG p564
63.
Cone
biopsy is indicated in all the following conditions except a.Micro invasive carcinoma b.indefnite diagnosis on colposcopy c.CIN III d.Cervical metaplasia
Ans:(d)
Ref:Harrison p609
64.
Pap
smear from a lady shows CIN grade III.
Which of the following is the next step in management a.cone biopsy b.punch biopsy c.large loop
excision d.colposcopy directed biopsy
Ans:(d)
Ref:
65.
A
patient is diagnosed to have CIN II. She approaches you for advice. You can
definitely tell her the risk of lesion progressing to malignancy as
a.5% b.15% c.60% d.30%
Ans:( )
Ref: The progress rate for CIN
III is 18% by 10yrs and 36% by 20 yrs(Dew Hurst). So the answer could be 5%
66.
A
child presents with multiple permeating lesions involving all the bones in
body. Which of the following is the most probable diagnosis a.Neruoblastoma b.Histiocytosis X c.Metastasis from
osteosarcoma d.Metastasis
from Wilm's tumor
Ans:(b)
Ref:Robbin's page 685
67.
A
70 year old man presents with urinary retention and back pain. Which of the
following investigations is needed next a.Serum acid phosphatase b.Serum alkaline phosphatase c.serum electrophoresis d.serum calcium
Ans:(a)
Ref:
68.
Which
of the following is not seen after trans urethral resection of prostate a.Hyponatremia b.Hypernatremia c.Transient blindness d.convulsions
Ans:(b)
Ref:Old Bailey p978
69.
A
patient is having benign prostatic hyperplasia. He is having a blood pressure
of 180/110mmHg and a serum Creatinine of 3.5. Which of the following drugs is
not to be used to treat him a.Prazocin b.Enlapril c.Amlodipine
d.Metoprolol
Ans:(b)
Ref: Enlapril is excreted mainly
by kidney and Metoprolol mainly by liver. Patient's creatinine is high
70.
A
patient presents at 32 weeks of pregnancy with suspected antepartum hemorrhage.
Her blood pressure is 80/60mmHg. Which of the following is the next step in
management
a.Immediate cesarian section
b.careful observation c.blood transfusion
Ans:(c)
Ref:
71.
Scanty,
foul smelling, painless discharge from the ear is a characteristic feature of
which of the following lesions a.Acute otitis media b.otitis externa c.central perforation d.cholesteatoma
Ans:(d)
Ref: Text book of ENT by Dingra
72.
A
70 year old man presents with complaints of tinnitus. Which of the following is
the most probable diagnosis a.labrynthitis b.acoustic trauma c.ASOM d.acoustic
neurinoma
Ans:(d)
Ref:Text Book of ENT Scott
Brown, p3/21/10
73.
A
55 year old smoker presents with complaints of hemoptysis. On bronchoscopic
examination, there was a lesion in the distal trachea which was growing in to
the lumen. Which of the following is the most probable diagnosis a.Squamous
cell carcinoma b.adenoid cystic
carcinoma c.squamous papilloma d.Muco Epidermoid carcinoma
Ans:(a)
Ref:Robbin's 6th Edition p744
74.
After
hyperventilating for some time, holding the breath is dangerous since a.it can lead
on to CO2 narcosis
b.due to the lack of stimulation by CO2 anoxia can go into
dangerous levels c.decreased CO2 shift
the ODC to the left d.
alkalosis can lead on to tetany
Ans:(b)
Ref:
75.
Blood
gas measurements of a patient shows the following values pH 7.2 p CO2 80mmHg, pO2 46mmHg.
Which of the following could be the most probable diagnosis a.acute
asthma
b.acute exacerbation of COPD
c.ARDS d.severe pneumonia
Ans:(b)
Ref:
76.
Sulfur
granules in actinomycosis are composed of a.organisms b.Neutrophils and lymphocytes c.monocytes d.eosinophils
Ans:(a)
Ref:Harrison p991
77.
In
lipoprotein lipase deficiency which of the following is increased a.VLDL b.LDL c. HDL d.Chylomicrons
Ans:(d)
Ref:Harrison p 2142
78.
Lipid
lowering agents Statins, act in all the following ways except a.decreased hepatic cholesterol
synthesis
b.decreased LDL receptors
c.Inhibiting HMG Co-A reductase d.decreasing VLDL
Ans:(b)
Ref:Harrison p 2147
79.
Statin
induced myopathy is not exacerbated by which of the following drugs
a.Nicotinic acid
b.Enlapril c.Erythromycin d.Clofibrate
Ans:(b)
Ref:Harrison p 2147
80.
What
is the attitude of the lower limb following posterior dislocation of hip a.abduction,
flexion and internal rotation b.adduction, flexion and
internal rotation c.abduction flexion and
external rotation d.adduction
flexion and external rotation
Ans:(b)
Ref:
81.
A
child falls from a height and lands on his fully outstretched hands. On
examination there is pain and swelling over his right elbow. The probable
diagnosis is a.Fracture both bones
forearm b.Supra condylar fracture of
humerus
c.posterior dislocation of elbow. d.Fracture olecranon
Ans:(b)
Ref:
82.
A
man was diagnosed to have myositis ossificans progressiva at the age of 20
years. He died five years later. What is the most probable cause of death a.starvation and chest infection b.myocarditis c.hypercalcemia d.hyperphosphatemia
Ans:(a)
Ref:PostGraduate text book of
Clinical Orthopedics, p61
83.
A
patient is having a left tibial fracture which is on POP cast for two months.
Now he needs mobilization of a single crutch. On which side will you use this
crutch a.Any side b.left side c.right side
d.both sides
Ans:(?c)
Ref:
84.
A
10 year old child presents with a mass on his thigh which was found to be
arising from the diaphysis and involving the soft tissues. The child was having
fever also. What is the most probable diagnosis a.Osteosarcoma b.Ewing's sarcoma c.chondrosarcoma
d.malignant fibrous histiocytoma
Ans:(b)
Ref:Harrison p613
85.
Histology
of Ewing's sarcoma shows small round cells. These cells are filled with which
of the following a.Iron b.Fat c.Mucin d.Glycogen
Ans:(d)
Ref:Harrison p613
86.