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Model Test Keys-16-3-2013

1.A 2.B 3.A 4.D 5.A 6.C 7.C 8.A 9.B 10.A 11.D 12.B

13.C 14.D 15.A 16.C 17.C 18.B 19.B 20.C 21.A 22.D 23.C 24.D

25.A 26.A 27.D 28.D 29.A 30.B 31.C 32.B 33.A 34.A 35.C 36.A

37.C 38.D 39.A 40.D 41.B 42.B 43.A 44.A 45.A 46.D 47.C 48.B

49.B 50.B 51.A 52.B 53.C 54.A 55.D 56.C 57.A 58.C 59.A 60.C

61.B 62.B 63.D 64.B 65.D 66.A 67.B 68.A 69.D 70.C 71.C 72.D

73.D 74.B 75.C 76.D 77.C 78.C 79.A 80.D 81.A 82.A 83.B 84.B

85.B 86.A 87.B 88.C 89.A 90.B 91.C 92.A 93.C 94.C 95.A 96.B

97.A 98.B 99.D 100.B

Model Test Keys-17-3-2013

1.B 2.B 3B 4C

5 A. The patella deviates to the lateral side due to unopposed constraction of the vastus lateralis.

6A 7A 8A

9 D. The lateral cutaneous nerve of thigh, a branch of lumbar plexus gets contribution from L1 and L2
segments of the spinal cord. It innervates the lateral aspect of thigh. It descends along the lateral
border of the psoas major muscle and enters the thigh after passing deep to the fascia iliaca and the
inguinal ligament. Sometimes the nerve is incorporated within the substance of the fascia iliaca and
placed in a fibrous tunnel of the inguinal ligament. Irritation of this nerve in the fibrous tunnel produces
pain along the lateral aspect of thigh. This is known as Meralgia parasthetica. Freeing the nerve from
the fibrous tunnel will relieve the symptoms. While doing laproscopic surgery for inguinal hernia,
accidental damage to the nerve in the triangle of pain (a non-anatomical triangle described by the
laproscopic surgeons) can cause pain and tingling sensation in the area of its innervation.

10B

11A. This is a condition known as "foot drop" and indicates that the muscles in the anterior
compartment of the leg, that dorsiflex the foot at the ankle joint, have lost their nerve supply. The
nerve supplying this compartment is the superficial fibular nerve, which is a branch of the common
fibular nerve.

12.D. The valves in the perforating veins ensure unidirectional blood flow from the superficial veins to
the deep veins. Following damage to the valves, the direction of blood flow is reversed resulting in
engorgement of superficial veins.

13C. The dorsalis pedis artery is the continuation of the anterior tibial artery distal to the extensor
retinaculum. The dorsal midline of the foot is a routine location at which to evaluate the quality of
blood flow by compressing the dorsalis pedis artery against the tarsal bones.

14A 15C 16.E 17.D 18.C 19.D

20.D From the supraspinous fossa of scapula, the tendon of the supraspinatus muscle passes
laterally under the acromion to be attached to the greater tubercle of humerus. Therefore, an injury to
this tendon could cause pain during abduction of the arm. Note that the supraspinatus abducts the
arm mainly in the initial stage of abduction. It is commonly involved in rotator cuff injury. The tendon is
separated from the arch and the deltoid muscle by the subacromial bursa. Therefore, inflammation of
this bursa (subacromial bursitis) also makes abduction of the arm painful.

21.B Injury to the upper trunk of brachial plexus usually results from excessive separation of the neck
and shoulder, which may be seen in violent stretching of an infants neck during delivery. B, C & D
can produce injury to the lower part of brachial plexus due to sudden upward pulling of the upper limb
(B & C) and compression of the lower trunk by a cervical rib.
22.A 23.B

24.E Carpal tunnel syndrome is caused by the compression of the median nerve as it passes through
the carpal tunnel in the wrist. This patient's history is classic for this problem. As the median nerve
innervates the thenar muscles in the hand, opposition of the thumb would be impaired or absent. All
other movements listed can be produced by muscles in the forearm (abduction, flexion, and
extension) or by muscles innervated by other nerves (adduction).

25.A

26.E The posterior circumflex humeral artery is a branch of the third part of the axillary artery. It
accompanies the axillary nerve through the quadrangular space. The artery contributes to the
collateral blood supply around the shoulder. The artery and nerve are often damaged by fracture of
the surgical neck of the humerus.

27.B The serratus anterior muscle is responsible for holding the scapula against the posterior thoracic
wall. Loss of function of this muscle causes the scapula to "wing," or move away from the posterior
thoracic wall. The serratus anterior muscle is innervated by the long thoracic nerve. This nerve
passes through the axilla on the lateral thoracic wall, superficial to the serratus anterior muscle.
Surgery in the axilla can damage this nerve

28.D

29.D The inability to extend the fingers indicates an injury to the radial nerve.

30.A The thoracodorsal nerve innervates the latissimus dorsi muscle. This muscle extends, medially
rotates, and adducts the arm.

31.A 32.B 33.C 34.C 35.A 36.C 37.A 38.C 39.D 40.D 41.A 42.D 43.A

44.A 45.B 46.D 47.C 48.B 49.B 50.B 51.B 52.C 53.A 54.D 55.D 56.B

57.C 58.C 59.C 60.D 61.C 62.B 63.C 64.A 65.A 66.B 67.C 68.A 69.D

70.C 71.C 72.B 73.A 74.D 75.C 76.A 77.D 78.A 79.B 80.B 81.B 82.C

83.D 84.B 85.B 86.A 87.C 88.A 89.A 90.A 91.D 92.B 93.D 94.A

95.B 96.D 97.A 98.B 99.A 100.B


MODEL TEST KEYS-23-3-2013

1.C 2.B 3.D 4.A 5.B 6.D 7.D 8.B 9.B 10.B 11.A 12.C

13.B 14.C 15.C 16.B 17.C 18.C 19.D 20.B

21.Ans: A

Tests for syphilis can be divided into tryponemal (specific) & nontreponemal (nonspecific) tests.
Specifc treponemal tests remain positive even after successful treatment.

22.Ans: C

Donovaniosis or granuloma inguinale is caused by Calymmatobacterium granulomatis. The


conditionis characterised by the presence of Donovan bodies, measuring 1.5 x 0.7 in large,
mononuclear (Pund) cells and the stratum malpighii. Donovan bodies are Gram-negative
intracytoplasmic cysts filled with deeply staining bodies that may have a safety-pin appearance.

23.Ans: B

Rabies is characterised by encephalitis.

Pathology: Macroscopic examination of the brain shows intense edema and vascular congestion. On
microscopic examination there is widespread neuronal degeneration and an inflammatory reaction
that is most severe in the brainstem. The basal ganglia, spinal cord, and dorsal root ganglia may
also be involved
24.Ans: B

In individuals with AIDS, majority of cases of toxoplasma infections are believed to be a reactivation
of old or pre existing infection. Hence routine quantitative tests for IgM antibody are usually negative
and IgG titres are low ( 1: 256, IFA). More sophisticated methods suc as IgM capture or IgG avidity
may reveal an acute response.

Fewer than 3% of patients have no demonstrable antibody to Toxoplasma at diagnosis of


encephalitis.

25.Ans: B

Antibody excess is known as prozone phenomenon and antigen excess is known as post zone
phenomenon.

26.Ans: A

In Europe and Asia, the first neurologic sign is characteristically radicular pain, which is followed by
the development of CSF pleocytosis (calledmeningopolyneuritis, or Bannwarth's syndrome);
meningeal or encephalitic signs are frequently absent.

.27.D 28.D 29.B 30.B 31.B 32.D 33.B 34.A 35.A 36.C 37.A 38.D 39.B

40.C 41.D 42.A 43.C 44.A 45.A 46.A 47.D 48.D 49.A 50.A 51.B 52.A

53.C 54.A 55.D 56.B 57.B 58.B 59.C 60.C 61.C 62.C 63.D 64.D 65.A

66.B 67.D 68.C 69.B 70.D 71.C 72.B 73.A 74.B 75.B 76.A 77.D 78.A

79.B 80.C 81.A 82.B 83.C 84.D 85.B 86.B 87.B 88.A 89.C 90.A 91.B
92.A 93.D 94.C 95.B 96.C 97.A 98.B 99.A 100.B
MODEL TEST-KEYS-24-3-2013
1.D
Types of wound healing
a. Primary intention
b. Secondary intention
c. Tertiary intention/ Delayed primary intention

Clean surgical wounds heal by first intention.


Untidy wounds left alone heal by second intention causing ugly scar.
Skin grafting and delayed primary/secondary closure are examples of third intention healing.
2.C.Elasticity never becomes normal.

3. Ans A.There is no scar in fetal wounds.

4.A

5.D

6 Ans A.

Drug of choice is Vancomycin.

Quinupristin, Linezolid and Clindamycin are also useful.

7 Ans D.
After the 4th day.
Fever within 48 hours is usually due to resp infection.
3rd day UTI, Thrombophlebitis,

8.E

Systolic BP is taken into consideration.

SSSI (Superficial Surgical Site Infection) means infected wound


SIRS (Systemic Inflammatory Response Syndrome) Bodys response to an infected wound
MSOF ( Multiple System Organ Failure) is the end stage of uncontrolled infection.

9.Ans E.
Clostridium difficile.
Antibiotic associated diarrhoea is the simplest form.
Metronidazole and oral vancomycin are useful for treatment.

10. Ans. B:
Occurs in Tertiary stage. Hypersensitivity reaction.

Condylomas and eruptions occur in secondary stage and contain plenty of organisms

11. Ans E.
Gluconeogenesis increases.
Muscle breakdown increases.
Urinary N increases.
Acute Phase protein (CRP) increased.

Insulin increases but insulin action decreases due to high increase of diabetogenic factors.
Parathormone and thyroxine decrease.

12. Ans. A:

Cases posted for operation are restricted from oral fluids.

Post operatively, sufficient fluid is not given.

I.V. dextrose corrects water depletion (Not normal saline).

Symptom is thirst. Nobody should be thirsty

13 A. ( Bailey ).Sequestration of ECF.

14 Ans D

15 Ans D.
NaCl also has acidic pH.
Contains less Na.
RL is hypo-osmolar.

Acidosis doesn't occur.


Lactate is converted to bicarbonate.
For replacement of nasogastric tube loss best is NaCl

Ringer lactate is useful in acidosis.


Lactate is converted to Bicarbonate.

16. Ans. D: All others are Reactionary bleed.

MCC of secondary bleed is infection.

Cancers infiltrating blood vessels also cause secondary. Peptic ulcer bleed is secondary.

Primary bleed occurs during surgery,

Reactionary within 24 hours,

Secondary by 7th day.


17.B

18 Ans A

19 Ans E:Pulmonary artery catheterisation.

20. Ans. D:

Verified by catheterization.

In anaesthetized patient, A is answer.

21.E

22. Ans C.
Major transfusion reaction (mismatch) is usually due to clerical error.
O ve blood can be transfused without cross match in a dire emergency.

23.C

24 Ans E

25. Ans. C: Glycogen reserve lasts for only 24 hrs.


Muscle glycogen is more than liver glycogen:
Muscle proteins are used for gluconeogenesis.
After some days of starvation, brain can utilize ketone bodies.

26. Ans. C: Mechanism not clear. Osmotic effect is proposed. Infective etiology also suggested.
Avoiding enteral feeds can lead to bacterial translocation in gut.

27. Ans. D:

TPN also useful in Radiation enteritis, prolonged ileus, perioperative wt loss, and in cancer to
improve general condition for surgery. (Not useful in advanced cancers)

Psychiatric disturbances
( Anorexia nervosa) will lead to non co-operation and treatment cannot continue

28.Ans E

29 Ans A.
Acrodermatitis enteropathica.
EFA deficiency can also produce skin changes.

30. D

RED; Critical. Life-threatening unless action is taken within minutes.

YELLOW; Urgent. Action as quickly as possible. Eg. Pneumothorax, Long bone fracture.

GREEN : Can wait


BLACK; Dead or looks uninvolved.

31. D

32.B.Minimum total score is 3.

33 E

34C

Vascular.
Arterial Diseases.

35 A.
This is usually ignored.
They present with calf muscle claudication.
Affects distal arteries. Tibial vessels are affected
36 Ans D.Takayasu disease.

37. ANS D Good collaterals through lumbar artery and cruciate anastomosis.

Impotence Due to bilateral internal iliac occlusion

38 Ans A

39.D
Left side of heart in 95 % cases.
Atrial fibrillation and acute MI are the usual predisposing causes.

40. A.To prevent propagation of thrombus

41.D.Acute IHD is an indication

42 C
Usually iatrogenic- Canulation for invasive procedures.
Most common peripheral true aneurysm is Popliteal.

43. C.:First step in management of Dissecting aneurysm is antihypertensives.

44. Ans E
majority are asymptomatic.
Detected on USG abdomen for some other indication.

45. Ans E

46.Ans E

47. Ans E

48. Ans : A This is useful for sclerotherapy of piles


49 E.
20 % chance of recurrence even in best centers.
MCCompli. of stripping is echymosis.

50. Ans E:Less than 15%

51.A 52.C 53.A 54.C 55.C 56.D 57.C 58.C 59.C 60.A 61.B 62.C
63.C

64.A 65.D 66.A 67.C 68.A 69.B 70.D 71.C 72.B 73.B 74.D 75.B
76.C

77.A 78.D 79.B 80.B 81.B 82.B 83.A 84.D 85.B 86.C 87.D 88.A 89.B

90.C 91.A 92.A 93.D 94.A 95.C 96.B 97.B 98.C 99.B 100.C

Model Test Keys-30-3-2013


1.A 2.B 3.C 4.B 5.A 6.D 7.B 8.B 9.A 10.C 11.D 12.B

13.D 14.B 15.D 16.A 17.D 18.A 19.C 20.D 21.A 22.A 23.D 24.A

25.D 26.B 27.D 28.C 29.B 30.A 31.D 32.C 33.B 34.C 35.B 36.B

37.C 38.A 39.B 40.C 41.D 42.A 43.D 44.B 45.B 46.C 47.D 48.A

49.D 50.C 51.C 52.D 53.B 54.A 55.A 56.C 57.C 58.B 59.B 60.C

61.C 62.D 63.B 64.D 65.A 66.D 67.A 68.A 69.C 70.A 71.A 72.C

73.D 74.B 75.C 76.A 77.B 78.B 79.C 80.A 81.D 82.B 83.D 84.B

85.B 86.A 87.A 88.A 89.B 90.D 91.B 92.A 93.B 94.A 95.A 96.D

97.C 98.C 99.A 100.A

Model Test Keys-31-3-2013


1.D 2.B 3.C 4.A 5.D 6.A 7.B 8.C 9.C 10.D 11.A 12.D

13.B 14.B 15.B 16.C 17.A 18.B 19.D 20.B

21.Ans: A

Antibodies to M protein antigens are protective.

Nephritogenic strains: M types 2, 42, 49, 56, 57 and 60 affecting skin

M types 1, 4, 12 and 25 affecting throat


Penicillin resistance is almost unheard among GAS.

22.Ans: D

E.histolytica, E.dispar and E.moshkovskii are 3 morphologically identical species prevalent.

Granuloma cutis results from spontaneous rupture of amoebic liver abscess through the parietes and
skin gets secondarily infected with trophic forms ofE.histolytica

23.Ans: C

ETEC is the most common cause of travellers diarrhea. The Labile toxin (LT) produced by ETEC
resembles cholera in every respect. They do not invade the intestinal mucosa.

24.Ans: A

Incubation period of emetic form of Bacillus cereus food poisoning is 1-6 hrs and diarrhoeal form is 8-
16 hrs.

25.Ans: B

Restriction modification system in bacteria consists of restriction endonuclease + methylase enzyme

26.C 27.A 28.B 29.C 30.D 31.D 32.A 33.D 34.B 35.D 36.A 37.A 38.A

39.D 40.A 41.C 42.C 43.D 44.C 45.C 46.B 47.A 48.C 49.D 50.C 51.B

52.B 53.C 54.A 55.B 56.B 57.C 58.A 59.E 60.C 61.B 62.C 63.D 64.A

65.D 66.A 67.D 68.D 69. C 70. A 71. D 72. D 73. C 74. C 75. B 76. D 77. C

78.B 79. A 80. A 81.D 82. D 83.B 84.C 85.B 86.C 87.A

88. Answer D Only Flexor digitorum profundus


89. Answer D In cases with prostatic weight more than 100gm the ideal option will be open
haemorrhoidectomy

90.C

91. Answer: A she is having all features of Cholangitis (Reynold pentad) Treatment is immediate
extraction of stone .ERCP is the method of Choice.

92.B 93.C 94.A 95.A 96.C 97.C 98.A 99.A 100.A

Model Test Keys-6-4-2013


1.B 2.C 3.A 4.A 5.D 6.C 7.B 8.D 9.B 10.B 11.C 12.C

13.A 14.D 15.B 16.A 17.C 18.D 19.B 20.B 21.B 22.C 23.D 24.A

25.C 26.D 27.B 28.C 29.D 30.B 31.A 32.C 33.B 34.B 35.D 36.B

37.A 38.C 39.C 40.B 41.C 42.D 43.B 44.A 45.B 46.D 47.C 48.A

49.C 50.A 51.B 52.D 53.A 54.D 55.B 56.A 57.C 58.B 59.A 60.D

61.C 62.A 63.A 64.C 65.C 66.D 67.D 68.C 69.A 70.C 71.C 72.C

73.B 74.D 75.A 76.C 77.A 78.C 79.D 80.B 81.A 82.A 83.C 84.C

85.C 86.C 87.D 88.B 89.A 90.D 91.A 92.A 93.D 94.B 95.D 96.C

97.B 98.D 99.B 100.B

Model Test Keys-7-4-2013

1.C 2.D 3.C 4.C 5.B 6.C 7.A 8.B 9.D 10.D 11.C 12.D

13.A 14.B 15.C 16.D 17.D 18.C 19.B 20.A 21.D 22.A 23.A 24.C

25.B 26.C 27.B 28.D 29.A 30.C 31.A 32.D 33.C 34.C 35.B 36.B

37.B 38.D 39.D 40.C 41.D 42.D 43.B 44.D 45.B 46.C 47.A 48.A
49.D 50.A 51.C 52.A 53.D 54.D 55.D 56.B 57.C 58.C 59.B 60.C

61.D 62.C 63.A 64.C 65.B

66.Ans: D

Pontiac fever is an acute, self-limiting, flu-like illness with an incubation period of 2448 hrs.
Pneumonia does not develop.

The role of neutrophils in immunity appears to be minimal: neutropenic patients are not predisposed
to Legionnaires' disease. Although L. pneumophila is susceptible to oxygen-dependent microbiologic
systems in vitro, it resists killing by neutrophils.

67.Ans: B

C.trachomatis is sensitive to sulfonamides whereas C.pneumoniae and C.psittaci are resistant.


Approximately 40% of NGU is attributed to Chlamydiae. Glycogen inclusions are present only
inside C.trachomatis.

68.Ans: A:Produce short chain FA that control intestinal epithelial cell differentiation.

69.Ans: A:Choices B, C and D helps in the identification of GAS or Strp.pyogenes.

70.Ans: B

B.globigii sterilization control forethylene oxide

B.stearothermophilus - sterilization control forautoclave

Cl.tetani spores - sterilization control forhot air oven

71.A 72.D 73.D 74.A 75.B 76.D 77.C 78.A 79.A 80.C 81.A 82.B 83.A
84.A 85.A 86.A 87.A 88.B 89.C 90.A 91.B 92.A 93.D 94.A 95.A 96.D

97.C 98.C 99.C 100.A

Model Test Keys-20-4-2013

1.B 2.C 3.C 4.A 5.D 6.D 7.B 8.D 9.C 10.B

11. Ans.d

Catalepsy (a form of catatonia) is a disorder of muscle tone in which uncomfortable positions can be
maintained for a long time. It is a feature of schizophrenia. Cataplexy is the sudden loss of motor tone
associated with the sleep disorder narcolepsy. Mannerisms are intentional movements which are
inappropriate

12.E 13.B 14.C 15.B 16.D 17.A 18.D 19.B 20.C 21.A 22.C 23.D 24.B

25.C 26.A 27.B 28.B 29.B 30.C 31.B 32.A 33.A 34.D 35.B 36.B 37.C

38.D 39.B 40.A

41. Ans: A.The most likely pathogen causing this picture is Stre.pyogenes.

42. Ans: D:All members of genus Bacillus are motile except B.anthracis.

43.B 44.D

45. Ans: D

Clinical findings, nonmicrobiologic laboratory tests, and chest radiography are not useful for
differentiating M. pneumoniae pneumonia from other types of community-acquired pneumonia. They
lack cell wall, hence Gram staining not useful.Culture not recommended for routine diagnosis as it
takes several weeks. PCR allows rapid, specific diagnosis earlier in the course of clinical illness. The
diagnosis can also be established by serologic tests for IgM and IgG antibodies to M. pneumoniae in
paired (acute- and convalescent-phase) serum samples; enzyme-linked immunoassay is the
recommended serologic method.

The combination of PCR of respiratory tract secretions and serologic testing constitutes the most
sensitive and rapid approach to the diagnosis of M. pneumoniaeinfection

46.C 47.B 48.C 49.A 50.C 51.C 52.B 53.A 54.B 55.B 56.C 57.A 58.C

59.B 60.B 61.C 62.D 63.C 64.A 65.D 66.C 67.A 68.B 69.C 70.B 71.B

72.A 73.C 74.C 75.C 76.B 77.A 78.C 79.A 80.B 81.B 82.A 83.A 84.A

85.A 86.C 87.A 88.A 89.A 90.B 91.A 92.B 93.E 94.A 95.B 96.D 97.D

98.B 99.D

100.B. Delusions if present in Delirium are fleeting .So among the options here, delirium would be the
best choice.

Model Test Keys-27-4-2013

1.C 2.B 3.B 4.D 5.D 6.A 7.D 8.B 9.C 10.C 11.A 12.D

13.C 14.A 15.B 16.C 17.B

18. Ans: D.EBV is transmitted by saliva and requires close intimate oral contact.

19. Ans: A
Bacteroides are normal inhabitants of the bowel. Normal stools contain 1011 B.fragilis organisms per
gram.

20. Ans: C

Dimorphic fungi include: Blastomyces, Paracoccidioides, Histoplasma, Sporothrix, Coccidioides and


Penicillium marneffi.

21. Ans: C 22. Ans: A

23.A 24.A 25.B 26.B 27.A 28.C 29.D 30.C 31.A 32.D 33.B 34.A 35.A

36.A 37.A 38.A 39.A 40.B 41.A 42.B 43.D 44.B 45.C 46.B 47.C 48.D

49.C 50.D 51.B 52.C 53.D 54.C 55.B 56.D 57.A 58.D 59.B 60.D 61.C

62.A 63.A 64.A 65.C 66.A 67.C 68.C 69.A 70.C 71.C 72.D 73.B 74.C

75.C 76.D 77.E 78.C 79.A 80.C 81.A 82.A 83.B 84.D 85.A 86.D 87.A

88.D 89.B 90.C 91.D 92.A 93.C 94.C 95.B 96.C 97.A 98.A 99.B 100.D

Model Test Keys-28-4-2013


1.D 2.C 3.D 4.C 5.A 6.A 7.D 8.A 9.D 10.A 11.A 12.C

13.D 14.B 15.B 16.D 17.D 18.B 19.A 20.C 21.A 22.B 23.D 24.C

25.C 26.A 27.D 28.A 29.D 30.B 31.C 32.A 33.A 34.B 35.D 36.A

37.C 38.A 39.D 40.D 41.D 42.C 43.C 44.C 45.B 46.D 47.A 48.B

49.D 50.A 51.D 52.A 53.C 54.B 55.C 56.C 57.D 58.C 59.C 60.D

61.B 62.D 63.D 64.D 65.D 66.B 67.B 68.C 69.C 70.C 71.C 72.D

73.A 74.A 75.C 76.C 77.C 78.D 79.C 80.D 81.C 82.A 83.B 84.D

85.B 86.B 87.A 88.C 89.B 90.B 91.A 92.A 93.D 94.C 95.D 96.D
97.C 98.B 99.D 100.D