Genodermal disease | PGI May 2017 Preparations MCQ

Genodermal disease that can cause skin malignancy are 

A. Xeroderma pigmentosa 
B. Neurofibromatosis 
C. Actinic keratosis 
D. Porphyria cutanea tarda
E. None of the above

Ans. (A) Xeroderma pigmentosa;
• Xeroederama pigmentosa is a rare autosomal recessive neurocutaneous disorder in addition to
skin lesions, patients may show:-
- Progressive mental deterioration, microcephaly, ataxia, peripheral neuropathy, spasticity,
choreoathetosis, Hypogonadism and nerve deafness.
• Inheritable conditions a/w skin cancer
- Albinism
- Xeroderma pigmentosum
- Congenital nevus.
- BCC nevus syndrome
• Actinic keratosis is a premalignant skin lesion.
• Neurofibromatosis can undergo malignant changes to sarcoma & CNS tumours.

Balanoposthitis | PGI May 2017 Preparations MCQ

Recurrent Balanoposthitis seen in.: 

A. DM 
B. Herpes simplex 
C. Smoking 
D. Alcohol 
E. Bad hygiene

Ans. (A) Diabetes Mellitus.
• Inflammation of the glans penis is called Balanitis and that of mocous surface of prepuce is called prosthitis. Inflammation of both prepuce and blans is called Balanoprosthitis (BP)
• Causes:
TRAUMATIC :

- Zip fasteners,
- Pin pricks excoriations,
- Teeth bite (during sex-play)
- Self infliction (Psychological).
IRRITANT:

-  Retained smegma and urine in the prepuceal sac,

- Contact dermatitis to condom, vaginal spermicidal gelly, various creams used as sexual stimulant, podophylin used for venereal warts.

- Fixed drug cruptions — Tetracycline, sulfonamides phenylbutazone, paracetamol, carbamazepine.
INFECTION :

- M.C. cause of BP is candida albicans (21% cases).

- Others—Bacteroides, Gardnerella vaginalis, Trichomonal, Gonococcal, Mycoplasma fermenters, Grp. B. Hemolytic streptococcus.
MISC

- Syphilis, Chancroid, Donovanasis, LGV, Herpes genitalis.
• DM causes recurrent balanoposthitis

Indications for ECT | PGI May 2017 Preparations MCQ

Indications for ECT are 

A. Paranoid schizophrenia 
B. Depression with suicidal tendency 
C. Catatonic schizophrenia 
D. Neurotic depression 
E. Depression in involutional stage

Ans. (B) Depression with suicidal tendency ;(C) Catatonic schizophrenia
• First and most important indication of ECT is major severe depression with suicidal tendencies.

• Other indications

- Severe catatonia

- Severe psychosis (Schizophrenia or Mania)
• Indication of ECT in depression (Major)
- Suicidal tendencies

- Poor intake of food and fluids

- With psychotic feature
- With melanocholia

- Unsatisfactory response to drugs
- When speedier recovery needed. 

TRUE regarding prions | NEET Based MCQ

Which of the following is TRUE regarding prions? 

A. It contains nuclear material 
B. They are infectitious proteins 
C. Immunogenic 
D. DNA particle

Ans. B. (They are infectitious proteins)

Explanation

• Prions are proteinaceous infectious particles without any detectable nucleic acids, resistant to heat, UV rays and nucleas. and sensitive to proteases. They have the ability to convert the normal non-infectious form of protein in question in::

infectious prion form.

• Prion conversion is accompanied by a change in functional status of protein that allows a cell or organism to be in tso - ferent phenotypic states in which it respectively harbors the normal or the prion form of the particle.

• Prions are responsible for several fatal neurodegenerative disorders known as transmissible spongiform encephalopathies or prion diseases. In these conditions secondary or tertiary structure of a protein is altered.

• They are causative agents of[MCQ]

a. Kuru and Creutzfeldt-Jacob disease

b. Scrapie and Bovine spongiform encephalopathy (mad cow disease)

Apple jelly nodules | NEET Based MCQ

Apple jelly nodules are seen in: 

A. Syphilis 
B. Lupus Vulgaris 
C. CSOM 
D. Menier’s disease

Ans. B. Apple jelly nodules are seen in Lupus Vulgaris.

• Apple jelly nodules are characteristic papular lesions of lupus vulgaris detected on diascopy.
• Apple jelly nodules are small, sharply defined reddish brown papules of gelatinous consistency seen in lupus vulgaris.
Lupus vulgaris:
• It is skin TB with no underlying active focus.
• Form of cutaneous TB common in children and young adults.
• Feature is indurated plaque, annular in shape.
• Heals with scarring, Blanching with glass slide (diascopy) reveals grey or green foci (Apple jelly nodules).
Scrofulodema: is skin TB secondary to involvement of underlying structure e.g. joint, lymph node.
Tuberculosis Verrucosa cutis: TB bacillus here is inoculated into skin and seen in TB patient,
Pathologists, Veterinary surgeons.
Tuberculosis cutis orifacialis: TB of orifices as oral cavity, anal canal, urogenital tract.
**Tuberculids don’t denote true TB but explain hypersensitivity reaction to Mycobacteruim tuberculosis.**

Griesinger’s sign | NEET Based MCQ

Griesinger’s sign is seen in: 

A. Cerebellar abscess 
B. Lateral sinus thrombosis 
C. Otitic hydrocephalus 
D. Meningitits

Ans. B. Griesingers sign is seen in Lateral sinus thrombosis

Tenderness and edema over mastoid (Griesinger’s sign) are pathgnomonic of lateral sinus thrombosis. (LST) 

• Classic symptoms of LST include a “picket fence” fever pattern; chills; progressive anemia (especially with beta-hemolytic strep); and, symptoms of septic emboli, headache and papiledema may indicate extension to involve the cavernous sinus. 

• The Toby-Ayer test is measured by monitoring the CSF pressure during a lumbar puncture. No iriaease in CSF pressure during external compression of the internal jugular vein on the affected side, and an exaggerated response on the patent side, is suggestive of LST. 

• Since the introduction of antibiotics, some authors have noted that a high percentage of cases are due to chronic rather than acute cases of otitis media; however this finding has not been consistent in all reports. Teenagers and young adults are more commonly affected in modern reports whereas younger children were reported in higher numbers in earlier series. In the pre-antibiotic era, 

Most common cause of unilateral offensive nasal discharge | NEET Based MCQ

The most common cause of unilateral offensive nasal discharge in a child is: 

A. Enlarged adenoid 
B. Maxillary sinusitis 
C. Foreign body in the nose 
D. Nasaldiphtheria

Ans. C. The most common cause of unilateral offensive discharge nasal discharge in a child is foreign body in the nose
- Most are self inserted by the child.
- Organic matter presents with early, purulent nasal discharge.
- Inorganic bodies remain inert.
- In case of cooperative child, retrieval by forceps is done.
- In severe cases, extraction under general Anesthesia is done.

Noise induced vertigo | NEET Based MCQ

Noise induced vertigo is seen in: 

A. Tympanosclerosis 
B. Labyrinthine fistula 
C. CSOM 
D. Meniere’s disease

Ans. D. Noise induced vertigo is seen in Menniere’s disease.                  

Mennieres Disease is characterized by:
Deafness, vertigo and tinitus and noise induced vertigo is seen in Meuniere’s disease.
Meniere’s Disease
A disorder characterized by recurrent prostrating vertigo, sensory hearing loss, and tinnitus, associated with generalized dilation of the membranous labyrinth (endolymphatic hydrops). The attacks of vertigo appear suddenly and last from afew to 24 h, and subside gradually. The attacks are associated with nausea and vomiting. The patient may have a recurrent feeling of fullness or pressure in the affected ear, and hearing in that ear tends to fluctuate but progressively worsens over the years. The tinnitus may be constant or intermittent and mau be worse before, after or during an attack of vertigo. Although usually only one ear is affected both ears are involved in 10 to 15% of patients.
In Lermoyez’s variant of Meniere’s disease, hearing loss and tinnitus precede the first attack of vertigo by months or years, and the hearing may improve with the onset of the vertigo.

Inquest Based MCQ | NEET Based MCQ

If death occurs in a jail, the inquest is done by 

A. Police 
B. Magistrate 
C. Medical Officer 
D. Coroner


Ans. B. Magistrate
 Magistrate’s Inquest: This is conducted by a District magistrate, sub-divisional Magistrate, or any other Executive Magistrate, especially empowered by the State Government, such as Collector, Deputy Collector or Tahsildar (Executive Magistrates).
>Magistrate’s Inquest is done in case of
• Death in prison,
• In police custody, and while under police interrogation,
• Death due to police firing,
• Dowry deaths, and
• Exhumation

Conduct money | NEET Based MCQ

Conduct money is given to 

A. money given to doctor for performing autopsy 
B. Witness in civil court 
C. Doctor in criminal court 
D. Reward for good conduct of doctor

Ans. B. Witness in civil court

Conduct money:
> It is the fee offered to paid to the witness in civil cases, at the tie of serving the summons to meet the expenses for attending the court.
>in criminal cases, no fee is paid to the witness. He must attend the court and give evidence because of the interest of the state in securing justice otherwise he will be charged in contempt of court.
How ever in criminal cases, the doctor can claim the conveyance charges and daily allowances.

Drugs used for ovulation induction | PGI May 2017 Preparations

Drugs used for ovulation induction 

A. Clomiphene citrate 
B. Danazol 
C. Cyproterone acetate 
D. Tamoxifen
E. Mefenemic Acid

Ans.  (A) Clomiphene citrate ; (D) Tamoxifen 
• The following drugs are used either single or in combination for induction of ovulation
— Stimulation of ovulation
• Clomiphene citrate (CC)
•FSH
•HCG
•GnRH
• GnRH analogues
— Reduction of level of:
• Androgen = Dexamethasone
• Prolactin = Bromocriptine
— Substitution therapy
•Hypothyroidism — Thyroid extract
•Diabetes mellitus Antidiabetic drugs.
• Tamoxifen is an anti-oestrogen, can be used where the patient is intolerant to clomiphene.
• Cyclofenil is a compound structurally similar to diethyl stilbestrol. It has got anti-oestrogenic property and it produces abundant thin, elastic cervical mucous which facilitate sperm penetration. The indications are same as that of clomiphene.
• Cyproterone acetate is an anti-androgenic progestogen. The compound blocks the hormone action at the receptorlevel. It decreases 5c reductase activity of reduces LH secretion.
It is used in idiopathic hirsutism or hyperandrogenic state.

Cervical CA surgery | PGI May 2017 Preparations MCQ

During cervical CA surgery to prevent the complication asthe vault prolapse, should be treated with 

A. Total Hysterectomy 
B. Vaginal hysterectomy 
C. Subtotal hysterectomy 
D. Abdominal Hysteroctomy
E. Supportive treatment.

Ans. (A) Total Hysterectomy ; (D) Abdominal Hysteroctomy
• Vault prolapse is a special term variously applied to the following several different conditions
— Enterocele
— Prolapse of the vaginal vault (or inversion of vagina) after hysterectomy.
— Collapse of the supports around the upper vagina and uterus which allows these organs to slide: Nulliparous prolapse is commonly of this type.
• Vault prolapse in more likely to occur after subtotal than after total hysterectomy despite the fact that the latter involves division of more elements of the transverse cervical ligaments. But it does leave more fibrosis and the scar tissue might have a supporting role. If cervix.is not removed it may act like the apex of an intussusception and encourage the vault to invert.
• Vaginal hysterectomy is alleged to be more commonly followed by vault prolapse than is abdominal.

Egg shell” calcification | PGI May 2017 Preparations MCQ

Egg shell” calcification is seen in 

A. Bronchiolitis 
B. Silicosis
C. Ca. bronchus 
D. Sarcoidosis 
E. Histoplasmosis

Ans. (B) Silicosis; (D) Sarcoidosis
• Egg cell calcification is peripheral rim calcification of lymphnodes. It is seen in
— Silicosis- Seen approximatly 5% of silicotics. Predominantly hilar lymphnodes may also be observed in anterior or posterior mediastinal lymphnode.
Sarcoidosis-about 5% pt of sarcoidosis present as egg cell calcification.
— Other causes of egg shell calcification
(i) following radiotherapy : appear 1-9 yrs. post radiation.

(ii)Pneumoconiosis- in 1% cases 

Features of cholecystitis on USG | PGI May 2017 Preparations MCQ

True about features of cholecystitis on USG 

A. Thick fibrosed gallbladder wall 
B. Stone impacted at neck of gall bladder 
C. Perigallbladder halo 
D. Increased vascularity
E. None of the above.


Ans. (A) Thick fibrosed gallbladder wall ; (B) Stone impacted at neck of gall bladder
• Ultrasound demonstrate in hepato biliary system
— Gall stones, biliary calculi
—. Size of gal bladder
— Thickness of gall-gladder
— Size CBD
— Stones in billary tree.
• It demonstrate calculi in G.B. in 90 to 95% of cases and specificity — 82%, sensitivity-67%(for USG) 

Prions | NEET Based MCQ

Which of the following is TRUE regarding prions? 

A. It contains nuclear material 

B. They are infectitious proteins 

C. Immunogenic 

D. DNA particle

Ans. B. (They are infectitious proteins) 

Explanation 

• Prions are proteinaceous infectious particles without any detectable nucleic acids, resistant to heat, UV rays and nucleas. and sensitive to proteases. They have the ability to convert the normal non-infectious form of protein in question in::

infectious prion form. 

• Prion conversion is accompanied by a change in functional status of protein that allows a cell or organism to be in tso - ferent phenotypic states in which it respectively harbors the normal or the prion form of the particle.

• Prions are responsible for several fatal neurodegenerative disorders known as transmissible spongiform encephalopathies or prion diseases. In these conditions secondary or tertiary structure of a protein is altered. 

• They are causative agents of^[MCQ]

a. Kuru and Creutzfeldt-Jacob disease

b. Scrapie and Bovine spongiform encephalopathy (mad cow disease)

Pneumocystis jirovecil | AIIMS Based MCQ

Which of the following is TRUE regarding Pneumocystis jirovecil? 

A. Occurs only in immune-compromised individuals.

B. Sputum examination is very helpful in diagnosis 

C. Usually associated with CMV infection 

D. Always associated with pneumatocele

Ans. B. (Sputum examination is very helpful in diagnosis) 

Explanation 

• P. jirovecii is the species found in humans, while P cariniiis the most common species found in rats. How frequently, we read P. carinii as affecting immunocompromised humans in routine microbiology books! Actually, it is P. jirovecii.

• P. jirovecii causes opportunistic pneumonia infection in young immunocompromised adults.

• Pneumocystis may be associated with CMV, but not usually

• A definitive diagnosis requires the demonstration of P cariniiin the lung in addition to clinical signs and symptoms of the infection. Methods for obtaining organisms include bronchoalveolar lavage, tracheal aspirates, transbronchial biopsy, bronchial brushings, percutaneous transthoracic needle aspiration, and open lung biopsy. Induced sputum samples are useful if P. carinii is found, but the absence of the organism does not exclude the infection.

• The epidemic infantile form of P carinii interstitial plasma cell. Pneumonitis is seen predominantly in infants between 3 and 6 mo of age. The onset is subtle with tachypnea and 101° fever, progressing to intercostal suprasternal, and infrasternal real flaring, and cyanosis. In the sporadic form of P carinii,pneumonitis occurring in children and adults with underlying immunodeficiency, the onset is usually abrupt with fever, tachypnea, dyspnea, and cough progressing to nasal flaring and cyanosis.

Note: 

• Pneumatocele are seen in staphylococcal infection, pneumocystic disease, past traumatic (laceration), after treatment of metastasis).

• Risk factors of pneumocystic disease are

— Immunocompromized patients (HIV), primary immunodeficient diseases, patients on immuno-suppressive therapy. Premature malnourished infants (immunodeficient).

Adult hemoglobin appears in fetus at thegestational | PGI May 2017 Preparations MCQ

Adult hemoglobin appears in fetus at thegestational age of (in weeks) 

A. 5th 
B. 10th 
C. 15th 
D. 20th 
E. 25th

 Ans. (E) 25th
• Haematopoiesis is demonstrated in the embryonic phase in the yolk sac by the 14^thday. By 10^thweek, the liver becomes the major site,, and after that gradually bone marrow become the major site of red cell production.
• Between the 5-8weeks, the embryo manufactures some additional haemoglobin : Hb Gower-1, Hb Gower-2 and Hb Portland. At 10-11 wks. HbF (Fetal Hb) predominate.

* From 24 weeks onwards adult type of hemoglobin appears in fetus. But during first half, hemoglobin is fetal type (α₂v₂) and at term about 75-80% of total hemoglobin is fetal type.
• Cord blood level of Iron, ferritin, vit. B₁₂, folic acid are higher than maternal blood.
HbF   : α₂β₂
HbF   : α₂γ₂

HbA₂  :  α₂θ₂

Hydramnios | PGI May 2017 Preparations MCQ

All are associcated with hydramnios except 

A. Premature labour
B. Gestational diabetes
C. Renal agenesis.
D. Increasedamniotic fluid.
E. PROM

Ans.  (C) Renal agenesis
• Renal agenesis is associated with oligohydramnios.
- In Polyhydramnios, amniotic fluid is more than 2 liters.

---- Polyhydramnios is associated with gestational diabetes and premature labour.
The causes of Polyhydramnios divided into :
1. Foetal anomalies :
--- Anencephaly

- Open spina bifida
- Oesophageal or duodenal atresia
-- Facial clefts and neck mass.

- Hydrops fetalis.
II. Placental causes :
- Chorioangioma of placenta.
III. Multiple pregnancy :
Hydramnios is more common in uniovular twins, usually affects the second sac.

IV. Maternal causes :
- Diabetics
- Renal disease.
• Amnion nodosum — is a condition in which there is failure of secretion by the cells of amnion covering the placents  causes oligohydramnios.

CIN-II positive on pap’s smear | PGI May 2017 Preparations MCQ

Patient with CIN-II positive on pap’s smear, next step will be 

A. Repeat pap’s smear 
B. Cone biopsy 
C. Colposcopic directed biopsy 
D. Punch biopsy
E. Start chemotherapy

Ans. (C) Colposcopic directed biopsy :
* Cone biopsy is done when there is discrepancy between cytology and colposcopy

* Hystrectomy is done if there is persistent CIN-II.

* If-CIN-I, then PAP smear is repeated

Note :The sequence of performing tests are
- PAP Smear
- COLPOSCOPY (and biopsy directed by COLPOSCOPY) :any discrepancy or incomplete visualisation of the lesion.
- CONE. BIOPSY
• As pap smear is positive, next step is to visualise the abnormal areas under coploscopy and to take biopsy under guidance of it (abnormality in PAP smear).

Pseudomonas | Crack AIIMS, NEET 2017 with NIME MCQs

Which of the following drug is effective in pseudomonas infection? 

A. Piperacillin 
B. Amoxicillin 
C. Oxacillin 
D. Vancomycin

Ans. A. (Piperacillin)
Explanation:
Antipseudomonal antibiotics
A. Carbenicillin:
The special feature of this penicillin congener is its activity against Pseudomonas aeruginosa and indole-positive proteus which are not inhibited by penicillin G or aminopenicillins. It is less active against Salmonella, E. coli, and Enterobacter, while Klebsiella and Gram-positive cocci are unaffected by it. Pseudomonas strains are less sensitive to carbenicillin in some areas, especially when inadequate doses have been used.
• Carbenicillin is neither penicillinase-resistant nor acid resistant, it is inactive orally and is excreted rapidly in urine (Ph 1 hour). It is used as sodium salt in a dose of l—2 g IM or l—5 g IV every 4—6 hours. At the higher doses, enough sodium may be administered to cause fluid retention and CHF in patients with borderline renal or cardiac function.
High doses have also caused bleeding by interfering with platelet function. This appears to result from perturbation of agonist receptors on platelet surface.
• The indications for carbenicillin are serious infections caused by pseudomonas or proteus, e.g., burns, urinary tract infection, and septicemia; but piperacillin is now preferred. It may be used together with gentamicin, but the two should not be mixed in the same syringe.
B. Ticarcillin
• It is more potent than carbenicillin against pseudomonas, but other properties are similar to it.
C. Piperacillin
• This antipseudomonal penicillin is about 8 times more active than carbenicillin. It has good activity against Kiebsiella and is used mainly in neutropenic immunocompromised patients having serious Gram-negative infections, and in burns. Elimination half life is 1 hour.  Concurrent use of gentamycin or tobramycin is advised.
Antimicrobial agents active against Pseudomonas aeruginosa
• Antipseudomonal penicillins

o Piperacillin
o Piperacillin/tazobactam
o Meziocillin
o Ticarcillin
o Ticarcillin/clavulanatc

• Antipseudomonal cephalosporins

o Ceftazidime
o Cefoperazone
o Cefepime

• Carbapenems

o Imipenem/cilastatin

o Meropenem
• Monobactams

o Aztreonam
• Aminoglvcosides

o Tobramycin

o Gentamicin

o Amikacin
• Fluoroquinolones

o Ciprofloxacin

o Levofloxacin
• Other Agents

oPolymyxin B

o Colistin 

Penicillin | Crack AIIMS, NEET 2017 with NIME MCQs

Which of the following is true about penicillin 

A. Can be given orally 
B. Main mechanism of action is cell wall synthesis 
inhibition 
C. Probenecid given with penicillin G increases its 
duration of action
D. Effective against gram-positive bacteria


Ans. A. (Can be given orally)
Explanation
• Antibacterial spectrum: Penicillin G is a narrow spectrum antibiotic; activity is limited primarily to Gram-positive bacteria and few others.
• Penicillin G is acid labile destroyed by gastric acid. So it is not given orally
• The pharmacokinetics of penicillin G is dominated by very rapid renal excretion; about 10% by glomerular filtration and the rest by tubular secretion.
• Tubular secretion of penicillin G can be blocked by probenecid; higher and longer lasting plasma concentrations are achieved.
• Penicillin act by inhibiting cell wall synthesis.
• They are bactericidal drugs.
• Spectrum of activity of PnG is narrow
• It is primarily active against Gram-positive bacteria
• It is usually inactive against Gram-negative bacteria
• Gram-negative cocci (Gonococci and Meningococci) are sensitive to it
• Bacteroides fragilis, mycobacterium TB are resistant rickettsia, chlamydia, protozoa, fungi, viruses are totally insensitive.

Treatment of choice for neurosyphillis | Crack AIIMS, NEET 2017 with NIME MCQs

Which of the following drug not effective in treatment of typhoid? 

A. Amikacin 
B. Co-trimoxazole 
C. Ciprofloxacin 
D. Ceftriaxone

Ans. A. (Amikacin)
Explanation:
Antibiotic Therapy Options for Typhoid Fever
Antibiotic                                             Dosage
First line
Ciprofloxacin                       500 mg PO bid for 10 days
Ceftriaxone                                          1-2gm IV or IM for 10—14 days

Alternative (NARST)
Azithromycin                       1 g PO days for 5 days
Ciprofloxacin                       10 mg/kg PO bid for 10 days 

T.B. larynx | PGI May 2017 Preparations MCQ

True about T.B. larynx: 

A. Turban’ epiglottis 
B. Odynophagia 
C. Cricoarytenoid fixation 
D. Ulceration of arytenoids 
E. Paralysis of vocal cord

Ans. (A) Turban epiglottis ; (B) Odynophagia; (D) Ulceration of arytenoids:
• Tuberculosis of larynx is always secondary to pulmonary TB, mostly affecting males in middle age gp. Tubercle bacilli reach the larynx by bronchogenic or haematogenous routes.
• It affects — interarytenoid fold, ventricular bands, vocal cords and epiglottis in order (post. part> ant. part)
• C/F:- Weakness and hoarseness of voice, pain, odynophagia, dysphagia.
• Laryngeal examination shows
— Vocal cord Hyperaemia, ulceration giving mouse nibbled appearance. Arytenoids ulceration, granulation tissue.
— Interarytenoid region Granulation tissue, superficial ragged ulceration and swelling that gives rnamillated appearance.
— Epiglottis Pseudoedema — the ‘turban epiglottis’
— Swelling of ventricular bands and aryepiglottic folds.
—Marked pallor of surrounding muscosa. 

Cholesteaotoma | PGI May 2017 Preparations MCQ

True about cholesteaotoma is/are 

A. It is a benign tumour 
B. Metastasize to lymphnode 
C. Contains cholesterol 
D. Erodes the bone 
E. Malignant potential

Ans. (D) Erodes the bone
• Theterm cholesteatoma is a misnomer, becasue it neither contains cholesterol crystals nor is it a tumor. This is a sac or a pocket in the middle car cleft lined by keratinised squamus epithelium and contains desquamated concentric sheets of keratin.
• Mechanism of its formation : (a) By retraction pocket formation and (b) by immigration of squamous epithelium from deeper part of the canal usually through a marginal perforation.
• The cholesteatoma sac may undergo following pathological changes
— Spontaneous healing
— Secondary infection
— The granulation tissue on the outside of the sac produces lysozymes and this gradually erodes the ossicles, eardrum, and mastoid bone.
• The nature of cholesteatoma is usually benign and does not have any malignant potential nor it metastasizes. 

Nerve supply of tympanic membrane | PGI May 2017 Preparations MCQ

Nerve supply of tympanic membrane 

A. Auriculotemporal NV 
B. Auricular br. of vagus 
C. Occipital NV 
D. Great auricular NV 
E. Glossopharyngeal NV

Ans. (A)  Auriculotemporal ; (B) Auricular branch of vagus; (E) Glassopharyngeal N
• Onthe outer surface of tympanic membrane, the anteroinferior part is supplied by the auriculotemporal nerve, and the posterosuperior part by the auricular branch of the vagus nerve.
• On the inner surface, it is supplied by the tympanic branch of the glassopharyngeal nerve through tympanic plexus.
• The auricle and external meatus are supplied by branches of the Vth, IXth and Xth cranial nerves. The medial or posterior surface of the auricle is supplied by fibres of the great auricular nerve (C2 and C3) and the lesser occipital nerve (C2). 

Vestibular function | PGI May 2017 Preparations MCQ

Vestibular function is tested by 

A. Galvanic stimulation 
B. Acoustic reflex 
C. Fistula test 
D. Impedance audiometry 
E. Cold caloric test

Ans. (A) Galvanic test ; (C) Fistula test ; (E) Cold caloric test
• Fistula test: is done by pressing the tragus and alternately relasing it or by compression of air by Siegle’s speculum. Positive test is indicated by vertigo and nystagmus and signifies presence of fistulous communication between middle ear and labyrinth. Negative test signifies absence of fistula and fastula with dead labyrinth.
• Galvanic test is the only vestibular test which helps in differentiating an end organ lesion from that of vestibular nerve.
• Impedence Audiometryprovides a quick objective resistance measurement of tympanic membrane and middle ear and their compliance to sound pressure transmission.
• Acoustic reflex: is based on the fact that a loud sound, 70-100 dB above the threshold of hearing of a particular ear, causes bilateral contraction of the stapedial muscles which can be detected by tyrnpanometry. It is an objective test for
— Rough estimation of hearing ability
— Detection of non-organic hearing loss (Malitigerers)
— Demonstration of recruitment
— Localization of lesion of the facial nerve
— Assessment of hearing in neonates and children

Drugs is not used for H. pylori treatment | Crack AIIMS, NEET 2017 with NIME MCQs

Which of the following drugs is not used for H. pylori treatment? 

A. Oxytetracycline 
B. Bismuth compounds 
C. Amoxicillin 
D. Omeprazole

Ans. D. 

• Omeprazole is not an anti H. Pylori drug

Drugs used against H. Pylori are
• Amoxicillin
• Clarithromycin
• Tetracycline
• Metronidazole /Tinidazole
• Bismuth subsalicylate
Monotherapy has failed in treatment of H. Pylori infections. Hence, multidrug regimens given for 7-14 days are generally used. 

Antibiotic acts by inhibiting cell wall synthesis | Crack AIIMS, NEET 2017 with NIME MCQs

Which antibiotic acts by inhibiting cell wall synthesis? 

A. Erythromycin 
B. Tetracycline 
C. Lomefloxacin 
D. Cefepime

Ans. D. Cefepime
Antibiotics inhibiting cell wall synthesis: Penicillins, cephalosporins, Cycloserine, Vancomycin, Bacitracin,
Imipenen, Aztreonam.
Inhibiting protein synthesis;
Acting on 50S RNA - chloramphenicol, clindamycin, Erythromycin
Acting on 30S RNA - Tetracycline, Aminoglycosides
Puromycin is a tRNA analogue which inhibits translaton in eukaryotic cell.
Alteration in cell membrane function: Polymyxin, Colistin, Bacitracin.
Amphotericin B, Nystatin,
Interfere with DNA function - Rifampicin, 

Differential diagnosis of Simple bone cyst | PGI May 2017 Preparations MCQ

ASD is seen in a/e :

A. Turners synd. 
B. Ellisvan crevald synd. 
C. Down’s synd. 
D. Halt-oram synd. 
E. TAR synd

Ans. (A) Turner’s synd. : 

In the following syndrome, ASD seen-
- Syndrome Cardiovascular manifestation
- ELLIS-Van Creveld Syndrome >Single osteum or atrial septal defect
- TAR Syndrome: ASD, TOF
- Holt-oram syndrome- ASD
- Downs syndrome- ASD, VSD 

SSPE (subacute sclerosing panencephalitis) | PGI May 2017 Preparations MCQ

Differential diagnosis of Simple bone cyst are:

A. Giant cell tumour 
B. Non ossifying fibroma 
C. Dermtofibroma
D. Fibrous dysplasia 
E. Eosinophilic granuloma.

Ans. (A) Giant cell tumour; (B) Non-ossifying fibroma ; (D) Fibrous dysplasia; (E) Eosinophillic granulonia
• D/D of simple solitary bone cyst
-GCT
- Aneurysmal bone cyst
- Fibrous dysplasia
- Eosinophillic granuloma

Branchiolitis in children | PGI May 2017 Preparations MCQ

Which of the following is/are true about branchiolitis in children?

A. Caused by respiratory syncytial virus 
B. Hyperinflation of the chest 
C. Pleural effusion 
D. May lead to bronchial asthma later in life 
E. Lymphopenia is seen

Ans. (A) Caused by respiratory syncytial virus ; (B) Hyperinflation of the chest
(D) May lead to bronchial asthma later in life 

Bronchiolitis is most commonly caused by Respiratory syncytial virus.
• Chest X-ray shows hyperinflation and infiltrates, diaphragm is pushed down.
• The relationship of acute bronchiolitis to bronchial asthma in later life has been observed in about one-fourth of the cases of acute bronchiolitis. Bronchial asthma is more likely with personal or family history of an allergic illness.
leukocyte countis normal or slightly e1evated.

8 yr. old boy with undescended testis | PGI May 2017 Preparations MCQ

8 yr. old boy with undescended testis, your concern to ask for operation is due to 

A. Cosmetic reasons 
B. Infertility 
C. Risk of malignancy 
D. Impotence
E. Abdominal pain

Ans. (B) Infertility ; (C) Risk of malignancy : 

• Early orchidopexy reduces the risk of primary germ cell tumours of testis 

There is no reliable statistics as to whether orchidopexy diminishes the liability of malignancy. However.it does improve the prospect of early diagnosis. [LB 24th-1404]

• Orchidopexy decreases the risk of neoplasia when performed before 10 years of age. 

• The definite histological changes occur in an undescended testis by age of 6 yrs.

• Orchidopexy should be done before child goes to school 5 yrs. of age.

After 16 years, irrevesible, destructive changes occur, halt, the spermtogenesis, limit the androgen production to half the normal output. After 6 years, the percentage of successful operation falls in undescended testis. 

— By the age of five years, both the testes should be in the scrotum. After that age the germinal epithelium is increasingly at risk, and lack of descent by puberty is associated with infertility. Therefore orchidopexy before puberty may prevent infertility. 

Considering the above points, it is better to do orchidopexy for reasons 

— Risk of malignancy and Infertility 

Osteogenesis imperfecta | PGI May 2017 Preparations MCQ

True about osteogenesis imperfecta 

A. Autosomal dominant 
B. Known as marble bone disease 
C. Blue sclera.
D. Associated with otosclerosis 
E. Defect in collagen I

Ans. (A) Autosomal dominant ; (C) Blue Sclera ; (D) Associated with Otosc1erosis(E) Defect in collagen-I

• Features of osteogenesis Imperfecta 

- Autosomal dominant. 

- Progressivehearing loss, osteosclerosis & positive family history.

- Defect in type I Collagen. 

- Multiple fracture/Skeletal fragility 

- A/W Blue Sclera, dental abnormality. 

• Osteopetrosis is also known as Marble bone disease.