Adduction of hand at wrist | PGI Nov 2017 Preparations MCQ

Adduction of hand at wrist is done by 

A. Flexor carpi radialis 
B. Flexor carpi longus 
C. Flexor digitorum profundus 
D. Extensor carpi ulnaris 
E. Flexor digitorum superficialis

Ans. D. Extensor carpi ulnaris :
• Adduction of wrist is done by
—  Flexor Carpi ulnaris.
— Extensor Carpi ulnaris.

* Flexor digitorum superficialis is main flexor of proximal interphaangeal joints : while flexor digitorium profundus is flexor of distal IP joints and main gripping muscle of hand,
• Abductors of hand at wrist joint are :
(i) Flexor carpi radialis,
(ii) the extensor carpiradial is longus and brevis, and
(u) abductor pollicis longus and the ext pollicis brevis 

Blood supply of sigmoid colon | PGI Nov 2017 Preparations MCQ

Blood supply of sigmoid colon is by 

A. Middle colic A 
B. Marginal a 
C. Left colic A 
D. Sigmoid A
E. Right colic artery

Ans. B. Marginal A ; (D) Sigmoid A :
• Blood supply of sigmoid colon is from
— Marginal artery (of Sudeck)
— Sigmoid artery
• The marginal Ais arterial arcade situated along the concavity of colon formed by anastomosis in between arteries -- ileocolic, Rt. colic, midd1e colic, left colic and sigmoid arteries. It is closest to colon in its descending and sigmoid parts.
• Sigmoid A is 2-3 in no, branch of inferior mesenteric A : supply transverse and descending colon. 
• Left colic A ;.a..branch. of inferior mesenteric A : supply transverse and descending colon.
• Middle colic A :br. of superiormesenteric A : supply transverse colon. 

Lateral border of cubital fossa | PGI Nov 2017 Preparations MCQ

Lateral border of cubital fossa is formed by 

A. Pronator teres 
B. Brachioradialis 
C. Supinator 
D. Brachialis 
E. Biceps

Ans. B. Brachioradialis:
Boundaries of cubital fossa
• Laterally— Medial border of brachioradialis
• Medially— Lateral border of pronator teres.
• Base represented by an imaginary line joining the two epicondyles of humerus and is directed upwards.
• Apex — Meeting point of the medial and lateral border and is directed downwards

Normotensive patient with normal hemoglobin suffered massive blood loss | NEET Based MCQ

A normotensive patient with normal hemoglobin suffered massive blood loss. Which of the following findings will not be seen in that patient? 

A. Increased PCV 
B. Increased MCV
C. Thrombocytosis 
D. Reticulocytosis

Ans. A. (Increased PCV)

Explanation
Different features of hemolytic anemias are as follows:

General examination:-                                     Jaundice/ pallor

Physical findings:-                                             Splenomegaly

Hemoglobin:-                                                      From normal to severely reduced

MCV, MCH:-                                       Usually increased

Reticulocytes:-                                    Increased

Bilirubin:-                                            Increased/mostly unlaryngated

LDH:-                                                    Increased 
Hepatoglobin:-                                    Reduced to absent

In case of blood loss within about 2 to 3 days after acute hemorrhage, reticulocytes will increase in the blood and reach a maximum 7 to 10 days after the hemorrhage has been controlled. Reticulocyte counts of 20% may be achieved. Internal bleeding may result in a rise in unconjugated bilirubin and a fall in serum haptoglobin. 

Transvaginal Ultrasonography | PGI Nov 2017 Preparations MCQ

On transvaginal ultrasonography:

A. The ventricular system within the head is visible at 8 weeks.
B. The head is not distinguishable from the body until 12weeks.
C. Physiological herniation of the umbilicus is seen at 9 weeks.
D. In early pregnancy, the ovaries will be seen to contain smallprimordial follicles.
E. In pregnancy, free fluid in the pouch of Douglas is not anormal finding.

Ans. A, C, D

1. CORRECT. As are the limb buds

2. WRONG. This occurs at 7 weeks

3. CORRECT. At this stage it is also possible to see the knees,elbows, crossed legs, stomach and choroid plexus. At 10 weeks,the heart chambers, bladder and kidneys are visible

4. CORRECT. As in the non-pregnant state, but one ovary isusually seen to contain one larger cystic structure, the corpus

luteal cyst

5. WRONG. A small amount of free fluid may be seen within thepouch of Douglas in normal pregnancy.

Newborn with APGAR score of 2 at 1 min & 6 at 5 min | PGI Nov 2017 Preparations MCQ

Newborn with APGAR score of 2 at 1 min & 6 at 5 min. has respiratory distress & mediastinal shift. Probable diagnosis is 

A. Congenital adenomatoid lung disease 
B. Pneumothorax 
C. Diaphragmatic hernia 
D. Transient tachypnea of newborn 
E. HMD

Ans.  (C) Diaphragmatichernia
• Apgar score at 1 minute is not so significant but at 5 minutes is significant and further point for reference. As the score is 6, below normal, with respiratory distress and mediastinal shift indicates — congenital diaphragmatic hernia.
• Pneumothorax causes sudden deterioration of respiratory distress, as such not in the history.

• Transient techypnea of new born, onset first 24 hrs of life, but techypnea, respiratory distress is minimal.

* Hyaline membrane disease, congenital-adenomatous long disease doesn’t produces mediastinal shift.

Cellulitis of lower limb | PGI Nov 2017 Preparations MCQ

True about cellulitis of lower limb

A. Infection of skin & subcutaneous tissue 
B. Fever & malaise are common 
C. Margins are distinct 
D. External wound always present 
E. Involved site is red & hot

Ans. A. Infection of skin & subcutaneous tissue ; (B) Fever & malaise are common (C) Margins are distinct ; (E) Involved site is red & hot :
• Cellulitis is an acute inflammatory condition of skin and subcutaneous tissue characterised by localized pain, erythema, swelling and heat.
• Systemic signs are common with chills, fever and rigors along with signs of inflammation

• External wound is not always present.
* It is non-suppurative. 

Mantoux | PGI Nov 2017 Preparations MCQ

True about mantoux is 

A. False negative in fulminant diseases 
B. If once done, next time it is always positive 
C. Results are given in terms of positive & negative 
D. Indurations given in terms of length & breadth. Always indicate active TB infection
E. None of the above

Ans. A. False negative in fulminant diseases:
• False neg. Mantoux is found in Fulminant disease.
• Mantoux test is used to detect disease hypersensitivity to tubercular antigens. The results of the test are read as reactions (induration) in inn the horizontal transverse diameter of induration. An induration of: <6 mm is considered negative.

8-9 mm : doubtful
> 10 mm :taken as positive
It DOES NOT prove th the person is SUFFERING from the active disease.
. It doesn’t distinguish between active and latent infection.
. Tuberculin sensitivity slowly wanes with time. A repeat test may appear to be negative. However, a repeat test may exert BOOSTER EFFECT so that, another tuberculin test after 1-2 wks. later will be strong positive (> 20 mm) test.

A 60 yrs old pt presenting with dysphagia | PGI Nov 2017 Preparations MCQ

A 60 yrs old pt presenting with dysphagia of 6 wks thiration with solid foods now can swallow only liquids. Investigations done to diagnose her are-

A. CxR 
B. Ba Swallow. 
C. Endoscopy 
D. USG 
E. CT Scan.

Ans A.  CXR ; (B) Ba- swallow (C) Endoscopy (D) USG ; (E) CT-Scan.
Progressive dysphagia and weight loss of short duration are initial symptoms in vast majority
of the cases of esophageal carcinoma. Dysphagia initialy for solid foods and gradually progressive to semisolids and liquids suggestive of Ca esophagus.
Esophagoscopy is the preferred investigation as it can visualise the tumour and biopsy can be
done for definite diagnosis.
• Ba-swallow is helpful for diagnosis ;irregular filling defects are seen in oesophagus.
• Chest CT scan — to detect extent of the tumour to mediastinum and para aortic lymph nodes.
• A 60 yrs old patient with H/o dysphagia initially to solids & gradually to liquids is a case of Ca esophagus.

Otitis media with effusion in a child | PGI Nov 2017 Preparations MCQ

Following statements are true about otitis media with effusion in a child 

A. Immediate myringotomy is done 
B. Type B tympanogram 
C. The effusion of middle ear is sterile 
D. Most common cause of deafness in a child in day care patients.
E. None of the above.


Ans. (B) Type B tympanogram; (C) The effusion of middle ear is sterile; (D) Most common cause of deafness in a child in day care patients
• Otitis media with effusion or secretory otitis media or mucoid otitis media or glue ear is an
insidious condition characterized by accumulation of non-purulent effusion in the middle ear
cleft.
oThe effusion is often thick and viscid but may be thin and serous and is nearly always sterile
• The disease commonly affects school going children, 5-8 yrs of age.
• C/F- Hearing loss is the presenting and sometimes the only symptom
- Delayed and defective speech
- Mild ear aches
• Diagnosis
Otoscopy- Dull opaque TM with loss of light reflex -decreased mobility of TM
- Hearing tests Conductive hearing loss of 20-40 dB.
- Clouding of mastoid air cells in X—ray mastoids.
- Type—B tympanogram.
• Treatment: In secretory otitis media, Myringotomy is done for aeration of middle ear (grommet insertion) & removal of secretions.

Statements about mycosis fungoides | NEET Based MCQ

All of the following statements about mycosis fungoides are true EXCEPT 

A. It is the most common form of cutaneous lymphoma 
B. Pautriers microabscess 
C. Indolent course and easily amenable to treatment 
D. Erythroderma seen and spreads to peripheral circulation

 Ans. C. (Indolent course and easily amenable to treatment)

Explanation
Mycosis fungoides is also known as cutaneous T-cell lymphoma. This lymphoma is more often seen by dermatologists. Median age is mid fifties, more common in males and in blacks. It is an indolent lymphoma with patient often having several years of eczematous or dermatitic skin lesions before the diagnosis is finally established. In advanced stages, the lymphoma can spread to lymph nodes and visceral organs. Patients with this lymphoma may develop generalized erythroderma and circulating tumor cells, called Sezary syndrome. Rare patients with localized early stage mycosis fungoides can be cured with radiotherapy, often total skin electron beam irradiation. More advanced disease has been treated with topical glucocorticoids, topical nitrogen mustard, phototherapy, psoralen with ultraviolet, an electron-beam irradiation (PUVA), interferon, antibodies, fusion toxins, and systemic cytotoxic therapy.

Features of bronchioalveolar carcinomas lung | NEET Based MCQ

All of the following are features of bronchioalveolar carcinomas lung except: 

A. Lepidic spread 
B. Some variants carry better prognosis than 
adenocarcinomas 
C. Mucinous variants are TTF- 1 positive and 
CK-20 negative
D. Metastatic adenocarcinomas are TTF-l negative and CK-20 positive

Ans. C. Lepidic spread (spread along surfactant) is the commonest mode of spread of bronchio-alveolar carcinomas, but they have low metastatic potential and lymphatic spread, therefore carry better prognosis as compared to adenocarcinomas. Metastatic adenocarcinomas are differentiated from primary adenocarcinoma by 2 markers, ie, TTF-1 (thyroid transcription factor-1) and CK-20. Primary adenocarcinomas are TTF-l positive and CK-20 negative, the only exception is mucinous variant of bronchioalveolar carcinomas which behave like metastatic adenocarcinomas

Sporulation in bacteria | NEET Based MCQ

Sporulation in bacteria occurs in which one of the following growth phase? 

A. Lag phase 
B. Stationary phase 
C. Log phase 
D. Phase of decline

Ans. B. Stationary Phase

Phases of Bacterial growth cycle:

1. During lag phase, bacteria adapt themselves to growth conditions. It is the period where the individual bacteria are maturing and not yet able to divide. During the lag phase of the bacterial growth cycle, synthesis of RNA, enzymes and other molecules occurs.
2. Exponential phase (log phase or the logarithmic phase) is a period characterized by cell doubling. The number of new bacteria appearing per unit time is proportional to the present population.
3. During stationary phase, the growth rate slows as a result of nutrient depletion and accumulation of toxic products. This phase is reached as the bacteria begin to exhaust the resources that are available to them. This phase is a constant value as the rate of bacterial growth is equal to the rate of bacterial death Sportulation occurs here.
4. At death phase, bacteria rim out of nutrients and die.

Acute viral hepatitis | PGI Nov 2017 Preparations MCQ

Acute viral hepatitis is characterised by 

A. Piece meal necrosis 
B. Zonal necrosis 
C. Focal necrotic spot 
D. Liver is enlarged and bile stained 
E. Bridging necrosis.

Ans. B. Zonal necrosis ; (C) Focal necrotic spot ; (D) Liver enlarged with bile stained
— In acute viral hepatitis, liver is slightly enlarged, soft and greenish. Following pathologic changes are seen:-

— Ballooning degeration of hepatocytes.

— Some hepatocytes become necrotic and forms eosinophilic councilman body or acidophilic body.

—Dropout necrosis, where some hepatocytes undergo lysis.
Focal necrosis; this type of necrosis involves small group of hepatocytes irregularly distributed in hepatic lobules. Piece meal necrosis and bridging necrosis is seen in chronic active hepatitis.

Conn’s syndrome | PGI Nov 2017 Preparations MCQ

True about conn’s syndrome 

A.↑K 
B.↓K 
C. Proximal myopathy 
D.↑ed plasma renin activity 
E. Edema

Ans. B. ↓K+ ;(C) Proximal myopathy:
• Conn’s syndrome is primary hyperaldosteronism characterised by
— Diastolic hypertension without edema.
— Hypokalemia and metabolic alkalosis.
— Hyposecretion of renin (i.e. low plasma renin activity).
— Hypernatremia.
— Proximal myopathy due to hypokalemia.
— Hypomagnesemia.
— Polyuria, polydipsia.
— Renal failure (15%), Proteinuria (50%).
— Elevated plasma and urine aldosterone levels.

Feature of AML | NEET Based MCQ

Which of the following is not a feature of AML? 

A. Retinoic acid is used in treatment 
B. 15/17 translocation may be seen 
C. CD 15/34 both seen in same cell 
D. Associated with disseminated intravascular coagulation (DIC)

Ans. C. (CD 15/34 both seen in same cell)

Explanation
Tretinoin (45 mg/kg per day orally until remission is documented) plus concurrent anthracycline chemotherapy appears to be among the safest and most effective treatments for APL (acute promyelocytic leukemia). Unlike patients with other types of AML, patients with this subtype benefit from maintenance therapy with either tretinoin or chemotherapy. AML FAB M3 is now designated acutepromyelocytic leukemia (APL), based on the presence of either the t(l5; 17) (q22q12) cytogenetic rearrangement or the PML/RARu product of the translocation. Similar examples exist with a variety of other balance translocations and inversions, including the t(8;2 1), t(9; 11), t (6;9) and mv (16).

Various physicalfindings are as follows:

• Ecchymosis and oozing from IV sites (DIC, possible acute promyelocytic leukemia)

• Fever and tachycardia (signs of infection)

• Papilledema, retinal infiltrates, cranial nerve abnormalities (CNS leukemia) poor dentition, dental abscesses

• Gum hypertrophy (leukemic infiltration, most common in monocytic leukemia)

• Skin infiltration or nodules (leukemia infiltration MC in monocytic leukemia

• Lymphadenopathy, splenomegaly, hepatomegaly

• Back pain, lower extremity weakness (spinal granulocytic sarcoma, most likely in t(8;21) patients 

Autoimmune hemolytic anemia | NEET Based MCQ

Autoimmune hemolytic anemia is associated with malignancy of 

A. T cell 
B. B cell 
C. Pre-Tcell 
D. Pre-Tcell

Ans. B. (B cell type)

Explanation
The diagnosis of typical B-cell CLL should be considered in a patient presenting with an autoiminune hemolytic anemia or autoimmune thrombocytopenia. The evaluation of a new patient with typical B-cell CLL/small lymphocytic lymphoma will include many of the studies that are used in patient with other non-Hodgkin’s lymphomas, In addition, particular attention needs to be given to detecting immune abnormalities such as autoimmune hemolytic anemia, autoimmune thrombocytopenia. 

Absolute finding of bone marrow biopsy | NEET Based MCQ

Which of the following is the absolute finding of bone marrow biopsy? 

A. Acute leukemia 
B. Megaloblastic anemia 
C. Hairy cell leukemia 
D. Thalassemia

Ans. C. (Hairy cell leukemia)

Explanation
In hairy cell leukemia, the malignant cells appear to have “hairy” projections on light and electron microscopy and show a characteristic staining pattern with tartarate-resistant acid phosphatase. Bone marrow is typically not able to be aspirated, and biopsy shows a pattern of fibrosis with diffuse infiltration by the malignant cells. 

Pancytopenia with cellular marrow | NEET Based MCQ

Pancytopenia with cellular marrow is a feature of 

A. PNH 
B. G6PD deficiency 
C. Acquired aplastic anemia 
D. Thalassemia

Ans. A. (PNH)

Explanation
It is the most consistent blood finding in anemia, which may range from mild to moderate to very severe. The anemia is usually normo-macrocytic, unremarkable red cell morphology; if MCV is high, it is usually largely accounted for by reticulocytosis, which may be quite marked (upto 20%, or upto 400,000/µL). Neutropenia and/or thrombocytopenia may or may not be present. In conjugated, bilirubin is mildly or moderately elevated, LDH is typically markedly elevated, and haptoglobin is usually undetectable. Hemoglobin urea may be overt in a random urine sample. The bone marrow is usually cellular with marked to massive erythroid hyperplasia, often with mild to moderate dyserythropoietic features. At some stage of the disease the marrow may become hypocellular or even frankly aplastic. 

Hypertrophic pyloric stenosis | PGI Nov 2017 Preparations MCQ

Hypertrophic pyloric stenosis, true about 

A. Common in females. 
B. Present after 3-5 wks of birth 
C. USG can’t diagnose. 
D. Alkalosis. 
E. Surgery is the TOC

Ans.  (B) Present after 3-5 wks of birth; (D) Alkalosis; (E) Surgery is the TOC.
• Congenital hypertrophic pyloric stenosis can be diagnosed by
- USG:- Most sensitive test, identifies when the muscle thickness >4mm & the length of the pylorus is >16mm.
- Contrast upper abd.
• Surgery is the treatment of choice. Preferred operative treatment is “Fredet — Ramstedt
Pyloromyotomy” which should be undertaken after corretion of hydration & electrolytes.

Predisposing factor of Testicular germ cell tumor | PGI Nov 2017 Preparations MCQ

Predisposing factor of Testicular germ cell tumor 

A. Cryptorchidism.
B. Testicular feminization syndrome. 
C. Klinefelter’s syndrome. 
D. Radiation. 
E. Trauma

Ans.  (A) Cryptorchidism. (B) Testicular Feminization syndrome; (C) Klinefelter’s syndrome

• Predisposing factors of testicular germ cell tumors are
- Cryptorchidism
- Testicular Feminization Syndrome
- Testicular dysgenesis - Klinefelter syndrome
- Exposure to environmental oestrogens.
- Development of Cancer in one testis is a/w markedly increased risk of neoplasia in the contralateral one.
-Testicular trauma is a coincidence only. This may not precipitate a testicular tumor, but brings to the attention of the patient

Iliac horn MCQ | PGI Nov 2017 Preparations MCQ

Iliac horn’ is seen in 

A. Achondroplasia 
B. Muco-polysaccharodosis 
C. Nail patella syndrome 
D. Tuberous sclerosis in posterior horn
E. None of the above.

Ans. (C) Nail patella syndrome :
• ‘Iliac horn’ is seen in Nail patella syndrome.
• NPS:- It an autosomal dominant trait characterised by multiple osseous abnormalities primarily affecting elbows and knees, nail dysplasia, absence of Patella and nephropathy.

Bony spine arises from posterior aspect of iliac horn.

Phase II clinical trial | NEET Based MCQ

True about phase II clinical trial is 

A. Large number of patients are included 
B. Therapeutic efficacy 
C. Toxicity 
D. Safety

Ans. D. (Therapeutic efficacy)
Explanation

Phase I (Pen label/Non blind)
• Done on normal volunteers; who are with renal and hepatic impairment
• It determines human pharmacology and safety and tells about safety, biological effects, metabolism, kinetics, metabolism and drug interactions
• Ethical approval is required
Phase II (Single/Double blind)
• Done on selected patients
• it determines therapeutic exploration and dose ranging and tells about therapeutic efficacy, dose range metabolism and kinetics
• Ethical approval is required
Phase III (Double blind)
• Done on large sample.of selected patients
• It determines therapeutic confirmation and tells about the safety and efficacy
• Ethical approval is needed
Phase IV
• Patients are given drugs for their treatment
• it determines post marketing surveillance and tells about the adverse reactions, patterns of drug utilization and other indications are thus discovered
• No ethical approval is required

Major stimulant(s) of acic secretion| | PGI Nov 2017 Preparations MCQ

At a cellular level, the major stimulant(s) of acid secretion by the gastric parietal cell is/are: 

A. Histamine 
B. Prostaglandin E2 
C. Acetyicholine 
D. Gastrin 
E. Norepinephrine

Ans. a, c, d

The three major stimulants of acid secretion by the parietal cell are acetylcholine, gastrin, and histamine. Acetylcholmne is released from cholinergic nerve endings in close proximity to parietal cells and binds to. muscarinic receptors. Cholinergic stimulation of panetal cells is coupled to hydrolysis of membrane-associated lipids (termed phosphatidylinositides) and leads to increases in intracellular calcium. Histamine is released from mast cells in the lamina propria and reaches parietal cells by diffusion. Histamine occupies H2 receptors that may be selectively blocked by agents such as cimetidine. Histamine stimulation of parietal cell acic secretion is mediated by a cyclic AMP-dependent pathway. Gastrin is delivered to the fundic mucosa by the systemic circulation from its source in the antrum and duodenum. Like acetylcholine, gastrin causes increases in membrane phosphoinositol turnover and increases intracellular calcium.

Activation of parietal cells by acetylcholine, gastric or histamine can be blocked by somatostatin. Local release of somatostatin is physiologically important in modulating postprandial gastric acid secretion Prostaglandin E2 and its synthetic derivatives are potent inhibitors of histamine-stimulated acid secretion.

Dietary Antioxidant | PGI Nov 2017 Preparations MCQ

Which of the following is/are a dietaryantioxidant(s)?

A. Vitamin C 
B. Lipoic acid
C. Vitamin K 
D. Beta-carotene
E. Vitamin E

Ans. A,B,D,E

Dietary antioxidants include the micronutrients vitamin C, vitamin E, beta-carotene and the polyphenols. Beta-carotene and vitamins E and C have been well studied, possess strong antioxidant activities and are well absorbed, with a relatively high bioavailability. On the other hand, the polyphenols are a complex family of molecules, ubiquitous in plants, and include the flavonoids and phenolic acids.Commonly occurring flavonoids are quercetin derivatives (onion, apple), catechins (tea), anthocyanins (berries) and hesperitin derivatives (citrus fruits), while commonly occurring phenolic acids are caffeic acid, occurring in many fruit and vegetable and chlorogenic acid (coffee).

Protein metabolism | PGI Nov 2017 Preparations MCQ

True regarding Protein metabolism:

A. Proteins contain about 40 per cent nitrogen
B. Chains containing >100 amino acid residues are calledproteins
C. Proteins yield 4 calories per gram absorbed
D. During pregnancy, there is a rise in the plasmaconcentration of triglycerides
E. During pregnancy, there is a rise in the plasmaconcentration of albumin

Ans.  B. D

A. WRONG. Protein on average is composed of 16 per centnitrogen and 84 per cent of carbon, hydrogen and sulphurcombined.

B. CORRECT. Peptide chains contain 2–10 amino acid residues,while polypeptide chains contain >10 to over 100 amino acidresidues.

C. WRONG. The yield is 4 kcal per gram absorbed.

D. CORRECT.

E. WRONG. In the case of pre-eclampsia, where the liver isaffected, there is a further fall in albumin concentration.

Regional anaesthesia | PGI Nov 2017 Preparations MCQ

Regional anaesthesia:

A. Bupivacaine is the drug most widely used inepidural anaesthesia.
B. Epidural block is very useful in the management ofpatients with antepartum hemorrhage.
C. Spinal anaesthesia may be complicated bymaternal respiratory difficulties.
D. Epidural anaesthesia may lead to a higher rate offorceps delivery.
E. Headache is more common in epidural than spinalanaesthesia.

Ans.  A, C, D

A. True. It is usually used at strength of 0.25 per cent, although higher concentrations may be used.

B. False. It is contra-indicated in ante-partum haemorrhage due to the dual risk of hypotension, but is useful in the management of pre-eclampsia.

C. True. If the spinal block rises to too high a level.

D. True. Due to relaxation of the levator ani, it takes longer for the fetal head to descend and rotate after full dilatation.

E. False.