Early expanding stage | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

At present India is going through the following phase of demographic cycle 

A. High stationary 
B. Early expanding 
C. Late expanding 
D. Low stationary

Ans. C. Late expanding 

First Stage (High stationary):This is characterised by a high birth rate and a high death rate which cancel each other & the population remains stationary.
- India was in this stage till 1920.
Second Stage (Early expanding):The death rate begins to decline, while the birth rate remains unchanged.
- Many countries in South Asia and Africa are in this phase. Birth rates have increased in some of these countries possibly as a result of improved health conditions.
Third Stage (Late expanding):The death rate declines still further, and the birth rate tends to fall.
- The population continues to grow because births exceed deaths. India has entered this phase.
- In number of developing countries (e.g., China, Singapore) birth rates have declined rapidly. 

Which of the following cannot be done by 3yrs old child | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Which of the following cannot be done by 3yrs old child 

A. Draw a triangle 
B. Draw a circle 
C. Can arrange 9 cubes 
D. Can go up and down 
E. Stands on one foot for 5 second

Ans.  (A) Draw a triangle ; (E) Stands on one foot for 5 second
• The developmental milestones of a 3 years old child are
(i) Motor development.:
— Climbs stairs in a co-odinated manner, with alternate feet going up the stair case. Child is able to climb up or down by age of 2 years.
— Rides a tricycle
— Makes a broad jump, Jumps in place
— Stand momentarily on one foot.
(ii) Language development:
— Telling a story
— The child has a fairly good vocabulary of about 250 words.
— Uses plurals
(iii) Fine motor and adaptive behaviour:
— Holds a crayon with finger
— Copies and draws a circle
—Dress and undress himself completely
— Often successfully buckles his shoes.
— Makes a tower of 9-10 cubes
— Makes a 3 cube bridge.
(iv) Personal and social development
— Knows gender
— Gives first and last name

A child can copyor draws –

• a horizontal line or vertical line at 2 years
• a circle by 3 years
• a cross (plus) by 4 yrs
• titled cross (multiplication sign) by 5 years
• a rectangle by 4 years
• a triangle by 5 years
 The child can stand on one foot for 5 seconds by 4 years. 

Infant with blood in stools, mass in abdomen | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Infant with blood in stools, mass in abdomen, diagnosis is 

A. Intussusception 
B. Volvulus 
C. Idiopathic abdominal epilepsy 
D. Hirschsprung’s disease
E. Physiological.

Ans. (A) Intussusception : 
• Intussusception in infants present with acute intestinal obstruction — abdominal pain, stools are stained with blood like CURRANT JELLY, abdominal mass.
So, the probable diagnosis according to the question is intussusception.
• Volvulus — pain abdomen, distension but no bloody stool.
• Hirschsprung’ s disease - No bloody stool.
• Idiopathic abdominal epilepsy-an unusual cause of recurrent abdominal pain. The patient may have prodrome. Abnormalities on EEG can be identified but may not be seen in single study. 

Upper airways of neonate | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

True about upper airways of neonate 

A. Cricoid is narrowest part 
B. Laryngx extend from C4 to C6 
C. Epiglottis is big & omega shaped 
D. All of the above.
E. None of the above.

Ans.  (C) Epiglottis is big & omega shaped :
• Larynx lies opposite to 2nd, 3rd and 4th cervical vertebra at birth. It descends from basiocciput during fetal life at six weeks.
At 6 yrs :itis opposite the 5^th cervical vertebra.
At puberty: it is opposite the 6th cervical vertebra
In Adult :from C₃ to C₆.
• Epigloltis is less rigid, and folded longitudinaly at the free lateral edges, although base is broad. Growth proceeds, chondrification stiffens epiglottis, longitudinal fold opens. So cartilage become omega shaped, persists throughout the childhood.

* Narrowest area of larynx is subglotis in neonate while cricoid in adult. 

Physiological jaundice in neonate | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

True about physiological jaundice in neonate 

A. Occurs in first 6 hrs. of delivery 
B. Unconjugated hyperbilirubinemia 
C. Neurological sequele are common 
D. Best treated by phototherapy 
E. Starts on 2nd day of life

Ans. (B) Unconjugated hyperbilirubinemia ; (E) Statrs on 2nd day of life :

Characterisitcs of physiological jaundice in newborn
— Jaundice appears on 2nd or 3rd day.
— Peak level of bilirubin (maximum 12 mg/dl) on 4^th/5^th day.
--- Icterus disappears by 7-14 days.

— In premature babies, level becomesmaximumto 15 mg/dl on 5-7th day and disappears by 14 days to a month.
--- Usually unconjugated fraction of bilirubin is raised.
— Level of declining bilirubin 2 mg/day occurs in phase-II

---- It resolves spontaneously. 

Ischemic heart disease | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Ischemic heart disease is associated with

A. LDL 
B. VLDL 
C. HDL 
D. Chylomicrons

Ans. A. LDL
- Very Low-Density Lipoprotein (VLDL) has also been shown to be associated with premature atherosclerosis. It is more strongly associated with peripheral vascular disease (E.g., intermittent claudication) than with CHD.
- LDL Cholesterol is directly associated with IHD.
- VLDL cholesterol is associated with premature Atherlosclerosis; it is more strongly associated with peripheral vascular disease.

- HDL is protective against development of CHD.
- Total cholesterol /HDL ratio < 3.5 is the clinical goal of CHD prevention.

Tetanus MCQ | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

All of the following statements are incorrect regarding tetanus except?

A. Active immunisation is possible 
B. Patient is unconscious during spasms 
C. Symptoms are caused by endotoxins 
D. Clostridium tetani can be cultured from CSF

Ans. A. Active immunisation is possible
>Active immunization: Tetanus is best prevented by active immunization withtetanus toxoid. It stimulates the production of the protectiveantitoxin.
> The aim should be to vaccinate the entirecommunity and ensure a protective level of antitoxinapproximately 0.01 IU/ ml serum throughout life.

> All personsshould be immunized regardless of age. 

Carcinoma breast | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Incidence of Carcinoma breast is more common in 

A. Multiparous women 
B. Alcoholic women 
C. Nulliparous women 
D. Women who smokes cigarettes


Ans. C. Nulliparous women
> PARITY: MacMahon, et al in their international case-control study found that the risk of breast cancer is directly related to the age at which women bear the first child.
An early first, full-term pregnancy seems to have a protective effect. Those whose first pregnancy is delayed to their late thirties are at a higher risk than multiparous women.
Unmarried women tend to have more breast tumours & married single women & nulliparous women also had same risk.

Pancreatic Ca | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

True about pancreatic Ca 

A. M.C. symptom is pain 
B. Ca head of pancreas causes obstruction of both pancreatic and billiary duct 
C. Smoking predisposes
D. Long term DM is a potent risk factor.
E. Family H/O familial adenomatous polyposis syndrome

Ans. (A) M.C. Symptom is pain; (B) Ca head of pancreas causes obstruction of both pancreatic and billary duct; (C) Smoking predisposes; D. Long term DM  is a potent risk factor.

• Pancreatic cancer has the following risk factors:-
Male Sex
— Blacks > whites
— Age>50 yrs.
—Cigarette smoking Most consistent risk factor. Whether due to direct carcinogenic effect of tobacco metabolites on the pancreas or an as yet undefined exposure that occurs more
frequently in cigarette smokers is uncertain.
— Chronic pancreatitis
— Long standing DM
— Obesity
Mutation in k-ras gene and pio4
• Alcohol abuse or cholelithiasis are not risk factors nor is it associated with coffee consumption.
• In Familial adenomatous polyposi,s (FAP), polyps are found in large intestine and is not a/w any other malignancies.

Marjolins ulcer | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

True about Marjolins ulcer 

A. Develops in long standing sear 
B. Sq cell ca develops 
C. Slow growing lesion 
D. Also know as Baghdad sore 
E. Common in Black races

Ans . A.  Develops in long standing scar; (B) Sq cell Ca develops; (C) Slow growing lesion.
• Marjolin’s ulcer is the name given to a squamous cell carcinoma which arises in a chronic
benign ulcer or scar. The commonest ulcer to become malignant is long standing venous ulcer
The scar which may show malignant change is the scar of an old burn.
• The special features are :Slow growing malignant lesion, probably due to less vascularity.
— Edge of such an ulcer is not raised and everled
— They are less malignant than a typical squamous cell Ca.
• Baghdad sore or oriental sore or Delhi boil is caused by Leishmania Tropica.

Dietery factors associated with colon carcinoma | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Dietery factors associated with colon carcinoma 

A. High fiber 
B. Low fiber 
C. Smoked fish 
D. High fat intake 
E. Japanese are common to develop Ca colon

Ans. B. Low fiber ; (C) Smoked fish; (D) High fat intake ; (E) Japanese are common to develop Ca colon :

Dietary risk factors for colorectal Ca,
— Diet rich in fat and red meat -                           — low fiber diet.
• Colorectal Ca has increased in Japan since that ration has adopted a more western diet.
• Animal Fats : Ingestion of animal fats — increased proportion of anaerobes in the gut microflora which leads to conversion of normal bile acids to carcinogens. This provocative hypothesis is supported by several reports of increased amounts of fecal anaerobes in the stools of pts of colonic Ca.
• Some studies suggest that certain elements of the diet protect against the development of neoplasia.
Selenium, dithiothiones, thioester’s, terpenes and carotenoids might act as anticarcinogensby reducing free oxygen radicals in the colon at the muscosal surface,
• Fiber:-An increase in dietary fiber may lower the incidence of Ca in pts who have a high fat diet.
Dietary fiber —increases the intestinal transit time — Reduction of the exposure of colonic mucosa to potential carcinogen and dilution of these carcinogens because of enhanced fecal bulk.
• The role of fiber in colorectal Ca is controversial. Because, a diet low in fiber can lead to chronic constipation and diverticulosis. If a low-fiber diet were a significant risk factor in colorectal Ca, individuals with diverticulosis should be at higher risk for developing colorectal Ca ; This is not the case.
• According to the National Research Council, interim guidelines for diet recommendation for prevention of colorectal Ca are
—Fat in the diet from 40-30% of total caories,
— increased consumption of fiber containing foods.
—* Limit salt-cured, smoked foods.
—* Limit food additives show to be potential carcinogens,
 — Establish research protocals for direction of mutagen in foods.
— Limit alcohol consumption.

histopathological features of Extra hepatic Biliary Atresia | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Which of the following are histopathological features of Extra hepatic Biliary Atresia 

A Bile lakes 
B. Hepatocyte ballooning degeneration 
C. Marked bile duct proliferation 
D. Fibrosis of hepatic duct 
E. Parenchymal cholestasis.

Ans. A. Bile lakes ; (C) Marked Bile duct proliferation ; (D) Fibrosis of hepatic duct
(E) Parenchymal cholestasis : 

Histologically florid feature of extrahepatic biliary obstruction are:
— Marked bile ductular proliferation, containing inspissated bile and lakes of extravasated bile.
— Portal tract oedema and fibrosis
Parenchymal cholestasis

Transitional cell carcinoma of bladder | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Transitional cell carcinoma of bladder is associated with 

A. Schistosomiasis 
B. Naphthylamine 
C. Smoking 
D. Tuberculosis of bladder
E. None

Ans. A. Schistosomiasis ; (B) Naphthylamine ; (C) Smoking :
• Exposure to schistosoma haematobium causes both squamous (70%) and transitional cell
(30%) carcinoma. Other causes are aniline dyes exposure.

• 2-naphthylamine is also carcinogenic.

Traumatic injury of the hip | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

In traumatic injury of the hip 

A. Anterior dislocation is common
B. Posterior dislocation is common 
C. Avascular fracture is common 
D. Visceral, injury usually associated with fracture femur 
E. Open reduction is always necessary

Ans.  (B) Posterior dislocation is common:
• In injuries about hip:-

1. Fracture of femur of neck
2. Dislocation of hip
3. Avulsion fracture of lesser  trochanter.

• There are three main types of dislocations of hip
(i) Posterior dislocation (the commonest)
(ii) Anterior dislocation
(iii) Central fracture-dislocation 

Non Ossifying Fibroma | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

True about non ossifying fibroma is-

A. Eccentric in position (metaphysis) 
B. Can present at 30 to 40 yr. age group 
C. Multinucleated giant cells are seen on histopathology.
D. True bone tumor 
E. Commonly presents as pathological

Ans.  (A) Eccentric in position (metaphysis);  (C) Multinucleated giant cells are seen on histopathology.

• Both Fibrous Cortical defects and Non-ossifying Fibroma occur, in first and 2nd decades, of life, & presents as developmental defects rather than neoplasm.
• Fibrous cortical defects are asymptomatic detected on X-ray and undergoes spontaneous resolution.
•Non-ossifyirg fibroma may present with pathological fracture also.
• Both of them produce sharply demarcated radiolucencies that are surrounded by a thin zone of sclerosis.

ZES (gastrinoma) | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

True about ZES (gastrinoma) 

A. Gastrin levels > 1000 ng/l 
B. BAO (Basal acid output) > 15 meq/hr 
C. Somatostatin is inhibitor of HCL secretion 
D. Omeprazole is helpful 
E. Secretin increases gastrin secretion in Zollinger Ellison Syndrome

Ans. (A). Gastrin levels> 1000 ng/l ; (B) BAO (Basal acid output)> 15 meq/hr;
(C) Somatostatin is inhibitor of HCL secretion ; (D) Omeprazole is helpful (E) Secretin increases gastrin secretion in zollinger Ellison Syndrome 

• Most patients with Zollinger Ellison syndrome have
— Fasting hypergastrinemia (> l000ng/L)
— Increased basal gactric output (> 15 meq/hr)
—Secretin increases gastrin secretion
• Proton pump inhibitor like orneprazole is helpful.
• Somatostatin is inhibitor of HCl secretion.

Zygoma | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Zygoma presents with 

A. Cheek swelling 
B. Trismus 
C. Epistaxis 
D. Dental malocclusion 
E. Diplopia


Ans.  (A) Cheek swelling ; (B) Trismus ; (E) Diplopia :
Fracture zygoma presents with
— Flattening of malar prominence.
— Step deformity of infraorbital margin.
— Diplopia due to entrapement of inferior rectus.
— Periorbital emphysema.
— Anaesthesia in distribution of infraorbital nerve.
• Soft tissue swelling may occur due to fracture. 

Xenobiotics enzymes | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Xenobiotics does not involve which of the following enzymes? 

A. Hydroxylation 
B. Cytochrome oxidase 
C. Cytochrome P450 
D. Methylation

Ans. B. (Cytochrome oxidase)

Explanation

• This enzyme is the final component of electron transport chain.
• Xenobiotics are metabolized by monooxygenase like cytochrome P450.
• These enzymes carry out hydroxylation, deamination, dehalogenation, desulfuration, and epoxidation.
• Peroxygenation and reduction. All these reactions comprise of phase 1.
• In phase 2, the above metabolites are made water soluble. 

Antifungal drug | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Which of the following is not an antifungal drug? 

A. Ketoconazole 
B. Undecylenic acid 
C. Ciclopirox 
D. Clofazimine

Ans. D. (Clofazimine)
Explanation:
Classification of antifungals
Antibiotics
• Polyenes: Amphotericin B, Nystatin, Hamycin, and Natamycin
• Heterocyclic benzofuran: Griseofulvin
• Antimetabolite: Flucytosine
Azoles
• Imidazoles (topical): Clotrirnazole, Econazole, Miconazole, Oxiconazole, and Ketoconazole
• Triazoles (systemic): Fluconazole, itraconazole, and Voriconazole
• Allylamine: Terbinafine
o Other topical agents: Tolnaftate, Undecylenic acid, Benzoic acid, Ciclopirox olamine, Butenafine, and Sodium Thiosulfate 

Antibiotic that inhibits protein synthesis | AIIMS Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Antibiotic that inhibits protein synthesis is 

A. Doxycycline 
B. Nitrofurantoin 
C. Cephalosporin 
D. Penicillin

Ans. A. (Doxycycline)
Explanation: Mechanism of action of various antibiotics
• Inhibit cell wall synthesis: Penicillin’s, Cephalosporins, Cycloserine, Vancomycin, and Bacitracin.
• Cause leakage from cell membranes:Polypeptides—polymyxins, Colistin, and Bacitracin. Polyenes—Amphotericin B, Nystatin, and Hamycin.
Inhibit protein synthesis: Tetracyclines, Chloramphenicol, Erythromycin, Clindamycin, and Linezolid.
• Cause misreading of mRNA code and affect permeability:Aminoglycosides—Streptomycin and Gcntamycin.

• Inhibit DNA gyrase:Fluoroquinolones, Ciprofloxacin. and others.
• Interfere with DNA function: Rifampin, Metronidazoic,
• Interfere with intermediary metabolism: Sulfonamides, sulfones, PAS, trimethoprim, pyrimethamine, ethambutol.

Painless lower GI bleed in a child | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Painless lower GI bleed in a child is seen in

A. Meckle’s diverticulum 
B. Rectal polyp 
C. Anal fissure 
D. Ac. Appendicitis
E. None of the above

Ans. A. Meckle’s diverticulum ; (B) Rectal polyp :
• Painless lower GI bleeding in a child is seen with :
— Rectal polyp
— Meckel’s diverticulum
—Piles secondary to vascular malformation 

* In Meckel’s diverticulum, haemorrhage occurs almost below 10 yrs and invariably results from peptic ulceration of ileal mucosa adjacent to the meckel’s diverticulum, lined with gastric mucosa. Diagnosis established by isotope scanning with technetium-99.

• Though piles occur in all ages but uncommon below 20 yrs.
• Bleeding due to anal fissure associated with severe pain.

Stomach carcinoma | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

True about stomach carcinoma 

A. Weight loss is commonest feature 
B. Secondaries are most commonly seen in peritoneum & omentum 
C. Lymphatic & hematogenous spread are rare 
D. Barium meal is diagnostic 
E. Radioresistant

Ans. E.Radioresistant
• Early gastric corcinoma is usually asymptomatic. As tumour becomes extensive, patient may complain of upper abdominal discomfort, post-prandial fullness. Anorexia and with slight nausea is very common but not the usual complaining symptom. Weight loss may eventually be observed.
• Gastric carcinoma is spread by

— Local                                — Lymphatic
— Haematogenous                — Peritoneal seedling
•A double contrast-radiography is the simplest diagnostic procedure for the evaluation. However, recommendation is gastroscopic biopsy and brush cytology.
Radiotherapy and chemotherapy has little to offer in the way of palliation Treatment of Ca Stomach.is primarily surgery. M.C. Surgery for Ca Stomach is radical subtotal gastrcctorny.
Role of Neo-adjuvent therapy is less well established.
* Virchows gland is supraclavicular lymphy node metastasis from stomach.

* Location of lymphoma is submucosal in stomach.
* Surgical removal (complete) with resection of adjucent lymph nodes offers only chance of cure. 

Enterocutaneous fistula | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

True about enterocutaneous fistula 

A. High output fistula drains 500 ml/day 
B. Malignancy is most common cause 
C. Fluid &electrolyte loss can occur 
D. No skin damage
E. Fluid and electrolyte imbalance does not occur

Ans. C. Fluid & electrolyte loss can occur
• Causes of enterocutaneous fistula
— Following operation of gangrenous appendicitis and draining of appendicular abscess
— Malignancy (carcinoma colon)
— Tubercular enteritis.
• Type of enterocutaneous fistula
—Those with high output > 1 liter /day.

--- Those with low output < 1 liter /day.
• Features

• Discharge
• Excoriation of skin [speciallyfrom duodenum]
• Fluid and electrolyte imbalance e.g. hypokalemia

Predisposing factors for carcinoma oesophagus | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Predisposing factors for carcinoma oesophagus are: 

A. Tylosis 
B. Plummer vinson syndrome 
C. Reflux esophagitis 
D. Lye stricture
E. Cigarette smoking

Ans. A. Tylosis ;(B) Plummer vinson syndrome; (C) Reflux esophagitis ; (D) Lye stricture : (E) Cigarette smoking

Aetiological Factors associated with Oesophageal carcinoma
— Excess alcohol consumption — Plummer vinson syn.
— Cigarette Smoking
— Other ingested carcinogens

—? Dietary deficiencies of molybdenum, Zinc, Nitrates (converted to Nitrites), Smoked opiates

— ? Celiac sprue
—Fungal toxins in pickled vegetables

— Chronic gastric reflux (i.e. Barret’s esophagus)
—Mucosal damagefrom physicalagents foradeno carcinoma
—Hot tea
—Lye ingestion
—Radiation induced stricture
—Chronic achalasia

Methicillin resistant staphylococci | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Which of the followings is not correct regarding methicillin resistant staphylococci? 

A. MRSA indicates resistance to all beta-lactarnases 
B. MRSA resistance is beta-lactamase independent 
C. it is plasmid dependent 
D. At 37°C resistance is more expressed


Ans. B. (MRSA resistance is beta-lactamase independent)
Explanation:
• Methicillin: It is highly penicillinase resistant but not acid resistant, hence must be injected. It is also an inducer of penicillinase production.
• MRSA have emerged in many areas. These are insensitive to all penicillinase-resistant penicillins and to other betalactams as well as to erythromycin, aminoglycosides, tetracyclines, etc. The MRSA have altered PBPs which do not bind penicillins.
• The drug of choice for these organisms is vancomycin/linezolid, but ciprofioxacin can also be used.
• Staph. aureus(MRSA) are not resistant to Gram-negative beta-lactamases.

Hemolysis in G6PD deficiency | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Hemolysis in G6PD deficiency is caused by all of the following EXCEPT 

A. Quinine 
B. Chioroquine
C. Primaquine 
D. Pyrimethamine

Ans. D. (Pyrimethamine)
Explanation
• “Antimalarials such as primaquine increase red blood cell fragility in individuals with G6PD deficiency leading to profound hemolytic anemia.”
Both chloroquine and quinine occasionally cause hemolysis in some G6PD patients. Under pyrimethamine hemolysis in G6PD has not been mentioned unlike the other drugs. 

Nephrotoxic drug | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Which of the following is a nephrotoxic drug? 

A. Streptomycin 
B. Ciprofloxacin 
C. Piperacillin 
D. Cefotaxime

Ans. A. (Streptomycin)
Explanation: Common properties of aminoglycoside antibiotics
• All are used as sulfate salts, which are highly water soIuble solutions are stable for months.
• They ionize in solution; are not absorbed orally; distribute only extracellularly; do not penetrate brain or CSF.
• All are excreted unchanged in urine by glomerular filtration.
• All are bactericidal and more active at alkaline pH. They act by interfering with bacterial protein synthesis.
• All are active primarily against aerobic Gram-negative bacilli and do not inhibit anaerobes.
• There is only partial cross resistance among them,
• They have relatively narrow margin of safety.
• All exhibit ototoxicity and nephrotoxicity.

Absolute contraindications of heart transplantation | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Absolute contraindications of heart transplantation: 

A. HIV infection 
B. Age> 60 years 
C. Irreversible pulmonary hypertension 
D. Significant pulmonary vascular disease 
E. Malignancy

Ans. A. HIV infection ; (C) Irreversible pulmonary hypertension ; (E) Malignancy

• Absolute contraindication of heart transplantation are
— Active infection (or HIV)
— Irreversible pulmonary hypertension
— Malignancy
— Other life threatening illness

* Age> 60 yrs, significant pulmonary vascular damage are relative contra-indications.

Raised AFP | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Raised AFP is seen in 

A. PCKD 
B. Cystic hygroma 
C. Gastroschisis 
D. Chromosomal trisomies 
E. Hepatitis

Ans. A. PCKD ; (B) Cystic hygroma ; (C) Gastroschisis; E. Hepatitis

• AFPis higher than normal in
— Liver and germ cell tumour                           — Recent or impending fetal demise
— Gastroschisis                                                   --- Fetal renal damage
— Cirrhosis, hepatitis
* In chromosal trisomies, its value is decreased.

• Extremely high level of AFP is specific for fetal congenital anomalies like meningomyelocele, PCKD, cystic hygroma and Gastroschisis

Operation of biliary duct obstruction in newborn | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Better prognostic factors for operation of biliary duct obstruction in newborn are 

A. No passage of bile 
B. size of ductule >200 micron 
C. Weight of baby >3 kg 
D. Preterm baby 
F. Age of 8 weeks

Ans. B. Size of ductule >200 micron ;(C) Weight of baby> 3 kg; (E) Age of 8 weaks :
• The factors influencing the outcome of billiary tract surgery are (i) Age of patient — better when operation is performed before the age of 8 weeks.
(ii) Microscopic stage of billiary tree: Patients with ductules greater than 200 micron diameter have good prognosis.

• A baby with adequate weight withstand the better surgical procedure.
• Prognosis also depends upon
— Extent of hepatic fibrosis.
— Presence of cholangitis.

Amoebic liver abscess | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

True about amoebic liver abscess

A. Frequently associated with diarrheal presentation 
B. Most common in right lobe of liver 
C. Can rupture into pleural cavity 
D. Almost never respond to metronidazole
E. Commonpresentationin left lobe of liver

Ans. B. Most common in right Lobe liver; (C) Can rupture into pleural cavity
• Extraintestinalinfection of E. histolytica most often involves the liver, right-side being the commonest.
* Althoughinitial site of infection is colon,fewer than one third of patients with amoebic abscess have active diarrhoea, so diarrhoea in notmost frequent. Most important features are rt, quadrant pain (upper), fever, weight-loss, hepatomegally.
• Pleuro-pulmonary involvement occurring in 20-30% of pts is the most frequent complication of amoebic liver abscess.
• Metronidazole is drug of choice. More than 95% of patients respond dramatically to metronidazole therapy.

Non-absorbable sutures | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

All of the following are non-absorbable sutures except:-

A. Vicryl 
B. Catgut 
C. Polyethylene 
D. Polyacramide 
B. Polypropylene

Ans. A. Vicryl; (B). Catgut
• Sutures -
A) Absorbable

* Catgut, collagen

* Homopolymer of glycolide

• Copolyrners of glycolide and lactide (vicryl)

B) Nonabsorbable
*  Polyster
* Polyamide
*Polypropylene, polyethlene
* Steel
*Silk
• Cotton, linen.

Premalignant | PGI Nov 2017 Preparations MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

All are premalignant except 

A. Adenomatous polyps 
B. Juvenile polyps 
C. Familial polyposis coli. 
D. Peutz-jegher synd.
E. Lynch syndrome


Ans. B. Juvenile polyps ;(D)Peutz-jegher synd
• The premalignant conditions for colon carcinoma are
— Familial adenomatous polyposis
— Adenomatous polyp
— Lynch syndrome
-— Turcot’s syndrome
— Gardner’s syndrome
• Malignant potential is rare in peutz-jeghers syndrome and juvenile polyposis

Antitumor drug | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Which antitumor drug is not an alkylating agent? 

A. Cyclophosphamide 
B. 5-FU 
C. Busulfan 
D. Melphalan

Ans. D.
Alkylating agents are electrophhle molecules that react with electron rich atoms to form covalent bond.
Examples: Cyclophosphamide, Ifosfamide
• Mechlorethoamine
• Dacarbazine
• Thiotepa
• Carmustine
• Chlorambudil
• Procarbazine
• Busulphan
• Temezolamide
• Cisplatin, Carboplatin and oxiliplatin
Mech. of action: These agents form reactive intermediates that covalently modify bases in DNA. In addition they can activate apoptosis.
Major site of action within DNA is N7 portion of guanine.

Common toxicities: Myelosuppression, alopecia, gonadal dysfunction, pulmonary fibrosis, mucositis, second neoplasm (esp leukemia):
5-FU is an antimetabolite:
• It is a pyrimidine antagonist
• Converted in body to 5-fdUMP which inhibits thymi dylate synthetase, resulting in inhibition of DNA synthesis through: “thymine less death”
• In addition it gets incorporated into RNA causing single stranded break.
Toxicity: Mucositis, Diarrhoea, Myebosuppression, Hand foot syndrome. 

Hypercoagulable syndrome | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Which anticancer drug causes hypercoagulable syndrome? 

A. 5-FU 
B. L-asparaginase 
C. Melphalan 
D. Carmustine


Ans. B.
Side-effects of L-Asparaginase:
Hypersensitivity reaction manifested by fever, chills, nausea and vomiting, urticaria, bronchospasm, respiratory failure and hypotension; increased risk of both clotting and bleeding as a result of alterations in various clotting factors:
pancreatitis, and neurological toxicity

Syndrome of Inappropriate ADH secretion (SIADH) | NEET Based MCQ

NIME Next Batch PGI Quest in Delhi from 10 August to 20 August

Which of the following chemotherapy agent can cause syndrome of Inappropriate ADH secretion (SIADH)? 


A. Vincristine 
B. Vinblastine 
C. Dacarbazine 
D. Cyclophosphamide

Ans. A. Vincristine 
Causes of SIADH:
Neoplasms:
Carcinoma - lung, duodenum, pancreas, ovary, Mesothelioma, Branchial adenoma, Carcinoid, Ewing sarcoma
Head trauma
Infections- Pneumonia
                Abscess (lung or brain)
                Cavitation (aspergillosis)
                TB (lung or brain)
                Meningtis (Bacterial or viral)

Encephalitis
                AIDS
Vascular:
Cerebrovascular occlusions, hemorrhage, Cavernous sinus thrombosis
Neurologic:
CBS, MS, ALS, Delirium tremens, Hydrocephalus, Psychosis, Peripheral neuropathy.
Metabolic:
Acute intermittent prophyria
Pulmonary:
Asthma
Pneumothorax
Positive pressure ventilation
Drugs:.
Vasopressin or Desmopressin
Chlorpropamide

Vincristine, Cyclophosphamide
Carbamazepine
Phenothiazines
TCAs
MACIs
SSRIs