Appg 2008 questions with explanations

   Appg 2008 questions with explanations

1. What is the action of anterior fibres of deltoid ?

a flexion

b lateral rotation

c flexion and medial rotation

d extension and lateral rotation

2. Which is not lined by stratified nonkeratinised squamaous

epithelium ?

a hypopharynx and laryngopharynx

b oesophagus

c cornea

d tympanic membrane

3. Which of the following is not supplied by posterior division

of obturator nerve?

a obturator externus

b obturator internus

c adductor magnus

d both a and c

4. Which of the following is true about the starting course

azygous vein course

a superior venecava

b posteriorly to inferior venecava

c anterior lumbar vein

d none

5. Which of the following is not present at birth ?

a mastoid tip

b mastoid antrum

c ethmoidal labrynth

d endolymphatic sinus

6. Which is the critical temperature of nitrous oxide ?

a -118 ºC

b - 88ºC

c 26ºC

d 36.5ºC

7. Which of the following is not an amino steroid derivative ?

a alcuronium

b vecuronium

c pancuronium

d pipecuronium

8. What is the time gap given in train of four ?

a 10 sec

b 20 sec

c 40 sec

d 60 sec

9. Which of the following presents as follicular pink scaly rash

of chronic type with palmoplantar involvement ?

a pitryiasis rosea

b pitryiasis alba

c pitryrias capitis

d pitryriasis rubra pilaris

10. Which of the following presents as chronic winter rash in

woman ?

a asteatotic eczema

b statis eczema

c atopic dermatitis

d nummular eczema

11. Which of the following presents as keratin plug without

opening ?

a comedone

b nodule

c cyst

d milia

12. Which of the following is not a type of lesion in leprosy

a hypopigmented patch

b vesicle

c nodule

d raised plaque

13. Which of the following is not the cause of charcots joint ?

a leprosy

b syringomyelia

c diabetes mellitus

d psoriasis

14. Which of the following is called catamite ?

a Passive victim of sodomy anybody

b passive victim of sodomy young boy

c both

d none

15. What is transvestism ?

a Wearing clothes of opposite sex to be known as of

opposite sex

b wearing clothes of opposite sex for sexual gratification

c contact with another person to obtain sexual satisfaction

d none

16. Contributory negligence is a defence in ?

a civil negligence

b criminal negligence

c ethical negligence

d none

17. Which of the following is true about pneumothorax except

a radiolucency of underlying lung with no bronchial

markings

b shift of lung to hilum

c full radio opacity of underlying lung

d moderate ventilation of underlying lung

18. Which of the following is not true about MRI ?

a MRI is useful in locating small lesions

b CT is better than MRI in bone lesions

c MRI is better for calcified lesions

d none

19. 1 Curie equals to

a 3.7 M becqueral

b 37 M becqueral

c 3.7 G b

d 37 Gb

20. Biological half life of radioactive substance in organ

depends upon

a initial radioactivity

b substance half life

c effective half life

d metabolism of organ

21. Which of the following is beneficial in Electroconvulsive

therapy ?

a Bilateral induction of symmetrical generalised seizures

b Induction of memory disturbances

c use of anaesthetic agents

d pulse oxymeter use

22. When extracellular potassium is increased from 4 meq to 10

meq what will happen

a resting membrane potential becomes more negative

b increase in conductance of sodium

c increase in conduction of potassium

d Na+ K+ ATpase will be stopped

23. 5 percent dextrose is ?

a hypotonic b isotonic

c normotonic d hypertonic

24. What is electromyogram ?

a stimulation of muscle through nerve

b stimulation of muscle without nerve

c direct recording of electrical activity from muscle

d recording motor nerve conduction

25. Guardian of genome

a p53 b bcl2

c bcl1 d BRCA

26. Gene is ?

a codon

b anticodon

c cistron

d okazaki fragment

27. Which of the following is not the presentation of

obstructive sleep apnea

a day time somnlence

b nocturia

c impotence

d resp. insufficiency

28. Pimozide belongs to

a thioxanthines

b phenothiazines

c buprenorhine group

d diphenyl group

29. Which of the following drug is contraindicated in

pregnancy and lactation ?

a mebendazole

b albendazole

c metronidazole

d none

30. Which drug causes gynaecomazia ?

a ketoconazole

b fluconazole

c aspirin

d diltiazem

31. Which of the following untrue about wilson disease?

a increased ceruloplasmin

b excessive deposition of copper in the liver

c high urinary excretion of copper

d excessive absorption of copper from small intestine

32. Which of the following condition S4 is absent ?

a pulmonary stenosis

b mitral stenois

c systemic hypertension

d pulm. hypertension

33. In which of the following conditions pulsus paradoxus

absent in cardiac tamponade ?

a obesity b pregancy

c MS d AR

34. Sternocleidomastoid atrophy seen in

a spinal muscular atrophy

b olivopontocerebellar atrophy

c myotonic dystrophy

d duchenes muscular dystrophy

35. Krukenberg spindle present in ?

a corneal endolethium

b retina

c lens

d ciliary body

36. Photopsia seen in ?

a choroiditis

b retinitis

c retinal detachment

d all

37. Laser trabeluoplasty done in ?

a open angle gluacoma

b closed angle glaucoma

c angle closure glaucoma

d all

38. Power of Intra ocular lens is determined by ?

a keratometry

b retinoscopy

c ophthalmoscopy

d gonioscopy/Biometry

39. Brown reflex deposition seen in mercury poisoning in ?

a anterior cornea

b posteror cornea

c anterior lens

d posterior lens

40. Precocious puberty caused by all except ?

a testicular feminisation

b albrights syndrome

c testicular tumours

d brain tumours

41. Rosette cataract seen in ?

a ocular trauma

b diabetes

c wilsons

d none.

42. Which of the following disease has consistent symptoms of

tinittus ?

a menieres disease

b CSOM

c otosclerosis

d mastoiditis

43. Which of the following is not related to lateral sinus

thrombosis ?

a greisinger sign

b tobey ayer test

c gradenigo syndrome

d none

44. Recently found association of bells palsy ?

a HSV

b herpes zoster

c EBV

d varicella

45. Sodium chromoglygate used in ?

a phlyctenular conjunctivitis

b vernal conjunctivitis

c mucopurulent conjunctivitis

d membranous conjunctivitis

46. Most common site of cholesteatoma ?

a prussaks space

b hypotympanum

c antram

d none

47. Quinsy related to ?

a paratonsillar fossa

b peritonsillar fossa

c crypta magna

d none

48. External carotid artery is ligated at ?

a above the origin of sup thyroid artery

b below the origin of sup thyroid artery

c at the bificuration of common carotid artery

d at the origin of ascending palatine artery

49. A boy presents with unilater purulent foetid discharge from

nose?

a foreign body

b polyp

c allergic rhintis

d all

50. Which is false about natal teeth ?

a always present at birth

b 2 incisors of mandibular teeth

c severe root resorbtion problems associated

d not removed

51. What is the most common organism causing spinal epidural

abscess ?

a staph aureus

b streptococcus

c bacteriods

d H .influenza

52. What is the deformity seen in fixed adduction of hip ?

a apparent shortening

b apparent lengthening

c true shortening

d true lengthening

53. 10 year old boy presents with pain in the hip with flexion

adduction problem, cause ?

a perthes disease

b transcervical fracture of neck

c TB hip

d Transient hip

54. Which is not secreted by stomach ?

a lipase

b pepsinogen

c HCl

d all

55. Which part of brain most often contused in RTA ?

a frontal

b parietal

c occipital

d temporal

56. Which of the following is not a barrier method ?

a centchroman

b Today

c barrier

d none

57. Which of the following associated with endometrial

cancer?

a metropathica haemorrhagica

b dysgermniona

c fibroid

d all

58. Which is not true about CTEV ?

a equinus of talus

b varus of heel

c shortened tendo achilles

d triple arthrodesis is optimal treatment

59. Most common cause of fracture of neck of talus ?

a fall from height

b plantar flexion

c dorsi flexion

d inversion

60. Which is false about turners syndrome ?

a mental retardation

b digital deformities

c web neck

d short stature

61. False about klinefelters ?

a most common syndrome of sex gene involvement

b most common cause of Hypothalamic hypogonadotropic

failure is males

c mental retardation common

d serum FSH levels are consistently high

62. Most common cause of perisent diarrhea in children ?

a rota virus

b E coli

c Cholera bantti

d Salmonella

63. In which of the following conditions oxygen delivery is

least to muscles ?

a Person inhaling 100 percent oxygent at the top of mount

everest

b Marathon runner at sea level

c person with carbon monoxide poisoning

d none of the above ( this option none of the above was also

there )

64. Hb o2 dissociation curve to left by ?

a increase pH

b Increased PCO2

c Increased 2.3. DPG

d Exercise

65. Blood flow to brain is not influenced by ?

a paco2

b po2

c cerebral circulation

d systemic circulation

66. Which of the following is least in protein quality ?

a gelatin

b lactalbumin

c albumin

d cashewnut protein

67. Which of the following is K channelopathy ?

a episodic ataxia 1

b familial hemiplegic migraine

c myotonia

d paramyotonia

68. Which of the following is not true about berry aneurysms ?

a rupture leading to SAH

b most common in post circulation

c associated with polycystic kidney disease

d are usually asyptomatic

69. Untrue about aneurysm in brain ?

a SAH

b intraventricular haemorrhage

c papilledema

d vasospasm

70. Which is most commonly deficient in TPN ?

a zinc

b chromium

c selinium

d magnesium

71. What type of RBC seen in chronic renal failure ?

a microcytic

b macrocytic

c normocytic

d none

72. Most common cause of thyrotoxicosis in childhood?

a toxic nodular goitre

b toxic adenoma

c graves disease

d thryotoxicosis factitia

73. Least plasma halflife ?

a dehydroepiandrostendione

b aldosterone

c norepinephrine

d dapsone

74. Assocatied with conns syndrome ?

a low plasma renin

b low aldosterone

c both

d none

75. Not associated with barterrs syndrome ?

a hypokalemia

b recurrent weakness

c hypertension

d none

76. Most common presentation in endemic goitre ?

a hypothryoidism

b adenoma

c diffuse goitre

d all

77. Which of the following is not malignant ?

a adenolymphoma

b adenoid cystic carcinoma

c acinic cell carcinoma

d none

78. Which of the following is associated with destruction of

valves ?

a acute infective endocarditis

b libman sach’s endocarditis

c rheumatic Heart disease

d all

79. Which of the following is not the cause of Myocardial

infarction ?

a coxsackie B

b lead poisoining

c SLE

d none

80. Which of the following is dimorphic fungi ?

a sporothtrix schenki

b cryptococcus

c trichophyton

d candida albicans

81. What is the size of particle is rapid sand filter ?

a 0.1 mm b 0.2

c 0.5 d 0.4 to 0.7 mm

82. What is diagnosed by xenodiagnosis ?

a chagas

b malaria

c kala azar

d malaria

83. Whip test is used for ?

a candida

b gardenella

c trichomonas

d LGV

84. No need to treat partner in ?

a trichomonas

b gardenella

c herpex genitalis

d candida

85. Most common cause of primary adrenal insufficiency in

india ?

a autoimmune b TB

c HIV d all

86. Which is false about crytpogenic TB ?

a age < 40 years

b weight loss

c definite diagnosis by liver and bonemarrow biopsy

d anorexia

87. Which is not associated with ANCA ?

a PAN

b wegeners

c HSP

d Microscopic polyangitis

88. Most common employed sterisation technique ?

a pomeroys

b madlener

c irving

d uchida

89. Pill given in lactation ?

a minipill

b combined pill

c both

d none

90. Chorangioma of placenta associated with ?

a oligo hydramnios

b polyhydramnios

c premature labour

d IUGR

91. Drug of choice in eclampsia ?

a magnesium sulphate

b ACE inhibitors

c ringer lactate

d all

92. Ligament used to maintain anteversion ?

a triangular ligament

b uterosacral ligament

c broad ligament

d round ligament

93. Which is not germ cell tumour ?

a dysgerminoma

b brenners tumour

c clear cell tumour

d mucinous tumours

94. Most common type of choledochal cyst ?

a type 1 b type 2

c type 3 d type 6

95.Process by which an individual gradually aquires culture

and becomes a member of a social group is called ?

a socialization

b accultration

c Socialism

d custom

96. Not used in Health planning ?

a increasing demands for resources

b analysis of health situation

c assessment of Resources

d fixing priorities

97. What is not true about cross sectional study ?

a also called prevalance study

b tells etiology

c shows pattern of disease

d tells prevalance

98. What is not true about point source epidemic ?

a plateau phase

b no secondary waves

c explosive epidemic

d only one peak

99. Strain used for measles ?

a edmonston b ra 27/3

c 17 d d none

100. Which is not true about cephalohaematoma ?

a not limited by sutures

b swelling subsides in 3 months

c caused by periosteal injury of skull

d none

101. Most common causes of perinatal mortality ?

a birth injury

b intra uterine infection

c birth asphyxia

d LBW

102. Not seen in small for date babies ?

a hypoglycemia

b polycythemia

c intracranial bleed

d hypocalcemia

103. Diffence of LCIS from invasive carcinoma ?

a age > 40 years

b incidental detected

c bilateral

d histology similar to invasive

104. Which is not having underlying malignancy ?

a paget disease of bone

b paget disease of nipple

c paget disease of vulva

d paget disease of anal region

105. Which is not true about PBC ?

a no increase in risk of hepatocellular carcinoma

b OFTEN ASYPTOMATIC

c elevated IgM

d positive antimitochondrial antibody

106. String sign of kantor seen in ?

a chrons discose

b ulcerative colitis

c both

d none

107. Claw sign seen in ?

a intussception b volvulus

c both d none

108. Treament of hydatid cyst ?

a excision of cyst

b percutaneous drainage

c conservative managment

d none

109. Most common site of intra peritoneal abscess ?

a morrison’s pouch

b omental bursa

c pelvic region

d left subhepatic pouch

110. Complete Rx of intussception indicates ?

a free passage of barium in the terminal ileum

b passage of faceus and flatus along with barium

c improvement of clinical condition

d none

111. Which is false about hydrocele ?

a almost always fluid is transudate

b get above the swelling

c testis is separate from swelling

d obscures inguinal hernia

112. Functional brace not used in ?

a fracture neck of femur

b fracture shaft of femur

c fracture shaft of tibia

d fracture shaft of humerus

113. Which of the following is incorrect about scaphoid?

a most common carpal bone injured

b non union is complication

c avascular necrosis of distal part is there

d x rays to be taken successively after 2 weeks

114. What is true about dequervan tenovaginitis ?

a involvement of extensor pollicis brevis and abductor

pollicis longus

b pain and swelling over ulnar styloid process

c inflammation of adductor liongus

d all

115. What is incorrect about supra condylar fracture of

humerus ?

a extension type is common

b radial nerve is injured

c cubitus valgus is most common complication

d all

21 October 2008 RECEPTOR

116. Mechanism of action of mini pill ?

a rendering cervical mucus thick

b inhibiting ovulation

c both

d none

117. Incorrect about internal os of cervix ?

a hegar dilators used

b most common cause of first trimester abortion

c both

d none

118. latent period in primigravida is ?

a 2 hours

b 6 to 8 hours

c 10 to 12 hours

d 14 to 16 hours

119. Most reversible method of sterilisation ?

a mini lap

b pomeroys method

c laparoscopic sterilisation

d hysteroscopic sterilisation

120. Maltese cross ( Tetrads ) in RBC seen in ?

a babesia b entamoeba

c malaria d syphilis

121. Which is incorrect about cystic hygroma ?

a brilliantly translucent

b radiotherapy

c sclerotherapy with bleomycin

d sclerotherapy with actinomycin

122. Which of the following is not the cause of macrocytic

anaemia ?

a orotic aciduria

b abetalipoproteinemia

c lesh nyhan disease

d transcobalamine deficiency

123. Not the cause of neonatal seizures ?

a pyridoxine deficiency

b hypokalemia

c hypoxia

d none

124. Anti Avidin is

a biotin

b thiamine

c pyridoxine

d folic acid

125. Which is incorrect about Burkitts lymphoma ?

a High mitotic activity

b High Apoptotic cell death

c small nuclei proliferation

d none

126. Serious complication of bacterimic shock ?

a causes shock lung

b decrease peripheral resistance

c increase cardiac output

d decrease cardiac output

127. Calcium channel blocker showing affinity to cerebral

vessels ?

a nimodipine

b verapamil

c diltiazem

d all

128. Chromosome associated with familial polyposis colon ?

a chromosome 5

b chromosome 6

c chromosome 11

d chromosome 13

129. Which of the following is the cause of break of glomerular

basement membrane sometimes and sub epithelial

deposits in electron microscopy?

a membranous glomerulonephritis (MGN)

b focal glomerular sclerosis

c rapidly progressive glomerulonephritis (RPGN)

d minimal change (MCD)

130. Which of the following is not the branch of maxillary

branch of internal carotid artery ?

a inferior alveolar

b middle meningeal

c anterior tympanic

d posterior tympanic

131. Which of the following is untrue about calcium

homeostastis in chronic renal failure ?

a secondary hyperparathryoidism

b primary hyperparathyroidism

c multiple myeloma

d none

132. What is column of bertini in kidney ?

a renal tumour

b Tongue like papillary projection

c caliculus

d none

133. Skeletal muscle most sensitive to tubocurarine ?

a muscles of respiration

b muscles of limb

c muscles of jaw and larynx

d all

134. Which is not true about VVF ?

a amenorrhea

b hydronephrosis

c uraemia

d all

RECEPTOR October 2008 22

135. Which of the following leads to cyclical haematuria ?

a vesico uterine fistula

b VVF

c Rectovaginal fistula

d all

136. Which is correct about this ?

a Sperm production is cyclical

b Continous GnRH secretion is essential

c sertoli cells are important for mitotic and meiotic activity

d secretion of testosterone from leydig cells depends upon

FSH

137. What is the stage of ovarian cancer with b/l with capsule

intact, no ascites ?

a IA b IB

c IC d II

138. What is epicolic node ?

a node draining colon

b adjacent to aorta

c epitracheal node

d none

139. A boy draws triangle but not diamond shape age is ?

a 3 years

b 4 years

c 5 years

d 6 years

140. Which of the following is not included in Human

developmental index ?

a Infant mortality rate

b percapita income

c life expectancy at birth

d Education

141. Most common presentation of Meckels diverticulum ?

a Lower GI bleeding

b upper GI bleeding

c diarrhorea

d abdominal pain

142. Bulging fissure in lung is due to infection ?

a Mycoplasma

b Klebsiella

c TB

d pnemococcus

143. Which deficiency is seen in alcoholic with dementia ?

a Thiamine b B 6

c B12 d folic acid

144. Which microorganism is responsible for classical

presentation of hydrocephalus, chorio retinitis ,

intracerebral calcification ?

a Toxoplasmosis

b Rubella

c measles

d CMV

145. Which defect is not detected by amniocentesis ?

a cystic fibrosis

b phenyl ketonuria

c downs syndrome

d none

146. What is the drug of choice of antiepilepsy in porphyria ?

a phenytoin

b phenobarbitone

c valproate

d Clonazepam

147. Which type of porphyria is transmitted as Autosomal

recessive ?

a AIP

b PCT

c congenital erythropoietic porphyria

d variegate porphyria

148. What is aseptic autolysis called ?

a Decomposition

b adipocere

c mummification

d none

149. What is the mechanism of abruption of SVT by carotid

massage ?

a decrease sympathetic discharge

b increase parasympathetic discharge to SA node

c increase parasympathetic discharge to conducting system

from SA to AV node

d ventricular depolarisation

150. Which of the following cast has no significance ?

a Hyaline cast

b RBC

c protien

d WBC

151. What is the range of proteinuria is microalbuminuria ?

a 30 to 300 mg/d

b 10 to 100 mg/d

c 3 to 30 mg/d

d 1 to 10 mg/d

152. Which semicircular canal is stimulated with cold water ?

a lateral scc

b posterior scc

c anterior scc

d medial

153. Which of the following is associated with renal stones ?

a tiagabine

b zonasimide

c lamivudine

d acyclovir

23 October 2008 RECEPTOR

154. In which of the following conditions acetazolamide is not

used ?

a epilepsy

b cirrhosis

c meningitis

d all

155. Which of the following is not the presentation of Extrinsic

allergic alveolitis ?

a Bronchial asthma and wheeze

b B/L reticulo nodular shadows

c Headache

d myalgia

156. Band shaped keratopathy seen in ?

a JRA b RA

c SLE d DLE

157. Which of the following is incorrect about Dubin Johnson

syndrome ?

a alkaline phosphatase is elevated

b autosomal recessive condition

c conjugated hyperbilirubinemia

d benign condition

158. Systolic murmur in TOF is due to ?

a VSD

b pulm stenosis

c ASD

d none

159. Which glycogen storage disease doesn’t affect muscles ?

a type 1

b type 2

c type 3

d type 4

160. Cholelithiasis is due to all except ?

a obesity

b excessive haemolysis

c high protein diet

d pregnancy

161. Which is the characteristic lesion of pregnancy ?

a vitiligo

b pemphigus

c tinea versicolor

d chloasma

162. A person recently exposed to sex 14 days back presents

with painless granulomatous ulcer with everted edges ?

a primary chancre

b chancroid

c LGV

d Donovanosis

163. Which type of clostridium tetani has no flagella ?

a type 1 b type 2

c type 4 d type 6

164. Specific congenital abnormality associated with DM ?

a caudal regression syndrome

b VSD

c ASD

d TOF

165. Fibrates acts by reducing ?

a chylomicrons

b VLDL

c LDL

d HDL

166. Shortest acting benzodiazipine ?

a midazolam

b lorazepam

c diazepam

d clonazepam

167. Severity of Aortic stenosis is determined by ?

a Late ejection systolic murmur

b ST -T changes

c LV HYPERTROPHY with displaced apex

d none

168. mRNA codes for which tail ?

a poly A b poly U

c poly C d poly G

169. Which of the following has propensity to metastasize

through lymph nodes ?

a alveolar rhabdomyosarcoma

b osteosarcoma

c both

d none

170. Which of the following is poor prognosis factor in

malnutrition ?

a dermatosis b hepatomegaly

c emaciation d all

171. Extended ESI benefit are all except ?

a news paper establishments

b non power 18 employees

c non power < 18 employees

d small power 10 to 18 employees

172. Which of the following is not seen due to mutiple

myeloma ?

a amyloidosis

b proximal tube defect

c light chains

d none

173. Which of the follwoing condition is treated by Sacral

colpoplexy ?

a stress incontinence

b rectovaginal fistula

c retroverted uterus

d vault prolapse

RECEPTOR October 2008 24

174. Not a contraindication for external cephalic version ?

a breech presentation

b obstructed labour

c oligohydramnios

d first baby of twin pregnancy

175. Not a leading cause of DIC in pregnancy ?

a Prolonged pregnancy

b abrubtio placenta

c heart disease

d IUP

176. Engaging diameter in brow presentation ?

a mentovertical

b occipiti.posterior

c mento-anterior

d mento-posterior

177. A blunt trauma to chest with Bp 80/50 pulse rate 100 /mt

with jugular vein distention ?

a cardiac tamponade

b pneumothorax

c arrythymias

d MI

178. Which of the following doesn’t change pH of stomach ?

a sucralfate

b H2 blocker

c omeprazole

d ranitidine

179. Toxicity associated with haemodialysis ?

a Aluminium

b magnesium

c calcium

d potassium

180. What is rider walker coefficent ?

a Efficacy in comparision to phenol

b sterilisation technique

c amount of phenol used for disinfection

d all

181. Which of the following doesn’t cause diarrhoea ?

a diabetes

b hypercalcemia

c hyperthyroidism

d IBD

182. Which is not true about otosclerosis ?

a conductive deafness

b non progressive deafness

c autosomal dominant

d flouride is therapeutic

183. Which of the following is not associated with fulminant

hepatic failure ?

a herpes simplex

b paramyxovirus

c infectious mononucleosis

d all

184. Oral hairy leukoplakia caused by ?

a Ebstein barr virus b CMV

c HIV d HZV

185. Contact period of chlorination ?

a 1 hour

b 30 minutes

c 1 1/2 hour

d 2 hours

186. Which of the following is not associated with vibrio

cholera ?

a Haemolytic uraemic syndrome

b rice water stool

c dehydration

d none

187. Which of the following is not absorbable suture ?

a catgut

b polyamide

c polygalactyl

d polyester

188. Prognosis of breast carcinoma is best determined by ?

a oestrogen/progesterone receptors

b Axillary lymph node status

c clinical assessment

d CT

189. Sudden painless vision loss in a patient with myopia ?

a Retinal detachment

b Central retinal artery occlusion (CRAO)

c diabetes

d optic atrophy

190. Most common site of Tuberculosis of genital tract ?

a endometrium

b ovary

c fallopian tube

d cervix

191. Which of the following conditions disappear

spontaneously in first year of life ?

a port wine stain

b Naevus flammeus

c cavernous haemangioma

d strawberry haemangioma

192. Which of the following is true about prostate cancer

screening ?

a Digital screening along with PSA is additive

b Prostate cancer is common among young males

c Tumor markers are diagnosed

d Bleeding per rectum in earliest manifestation of disease

25 October 2008 RECEPTOR

193. Which of the following is associated with Normal anion

gap metabolic acidosis ?

a cholera

b Diabetic keto acidosis

c starvation

d vomiting

194. Gynaecomastia not seen in ?

a Myxedema

b Thyrotoxicosis

c leprosy

d ketoconazole therapy

195. Discordant twin complication in multiple pregancy is due

to ?

a Twin Twin transfusion syndrome

b dizygotic twins

c fetus papyraceous

d monoamniotic twins

196. Distressing Complication after modified radical

mastectomy ?

a lymphedema

b axillary vein thrombosis

c seroma

d death

197. Hyperosmolar agents in glaucoma acts by ?

a Increasing aqueous outflow

b Decreasing vitreous volume

c Decrease aqeous production

d facilitate uveoscleral outflow

198. Most common cause of death due to burns in early period

is ?

a sepsis

b Hypovolemic shock

c both

d none

199. Initial management of dacrocystitis is ?

a syringing

b topical antibiotics

c massaging

d none

200. Which of the following is not a anthropozoonosis ?

a Rabies

b plague

c dracunculosis

d anthrax

1. (C) Flexion and medial rotation

(Ref. BDC/I/4th ed. Pg – 96)

· Ant. fibres flexors and medial rotators of the arm

· Post. fibres Ext and L. rotators of arm

· Acromial fibres are powerful abductors of the arm at the

Sh. joint from 15º–90º.

2. (D) Tympanic membrane

(Ref. IB Singh Histology 2nd e Pg. 66, 70, 277, 291)

The mucous membrane of TYMPANIC MEMBRANE is lined by an

epithelium which may be cuboidal or squamous. It is said that

the mucosa over the upper part of the tympanic membrane may

have patches of ciliated columnar epithelium, but this is not borne

out by EM studies.

3. (B) obturator internus

(Ref. BDC vol. II, 3rd ed.)

Obturator nerve L2 through L4 Medial compartment

anterior divisions of thigh (gracilis,

adductor longus, adductor brevis,

anterior portion of adductor

magnus)

Superior gemellus and obturator internus muscle are supplied

by Nerve to superior gemellus and obturator internus which are

branches from posterior divisions of L5 through S2.

4. (B) Posterior to inferior vena cava

(Ref. BDC 4th ed. Vol. I– 213 and Vol. II – 274)

· The azygos vein may arise from the posterior surface of IVC

near the renal veins, or from the right renal vein, or may be

formed by the union of right ascending lumbar vein and

the right subcostal vein.

5. (A) Mastoid tip

(Ref. Langman’s Medical Embryology pg. 409)

Most postnatal mastoid growth occurs in a lateral and posterior

direction, with a fully developed mastoid and styloid process not

appearing until the child is about age 3.

6. (D) 36.5 degree C

(Ref. Short Textbook of Anaesthesia by Ajay Yadav 2nd ed. Pg. 59)

8. (A) 10 seconds

(Ref. Anaesthesia secretes Fig. 13-2; Pg. 88-96)

Train of four (TOF)

TOF stimulation is the most common modality used to assess

degree of non-depolarising neuromuscular blockade. Four stimuli

are delivered at a frequency of 2 Hz (1 every 0.5 second), and the

ratio of the amplitude of the fourth to the first response in a train

(T4:T1 ratio) estimates the degree of block.

9. (D) Pitryiasis Rubra Pilaris

PRP is characterized by widespread small follicular acuminate

pinkish yellow scaling papules that coalesce to form patches of

various sizes distributed symmetrically with palmo plantar

keratoderme.

10. (A) Asteatotic eczema

Asteatotic eczema

=

Winter eczema, Eczema craquele

· Asteatotic eczema is a complication of xerosis

· It is due to decreased surface skin topid.

11. (D) Milia

A milium is a 1-2 mm superficial white to yellow keratin containing

epidermal cysts.

12.(B) Vesicle

13. (D) psoriasis

(Ref. CMDT – 862)

Charcot joint = Newrogeric arthropathy

Causes: Tabes dorsalis, diabetic neuropathy, syringomyelia, spinal

cord injury, Leprosy.

14. (B) Passive victim of sodomy young boy

(Ref. N. Reddy, 25th Ed. Pg – 357)

· In Sodomy when the passive agent is an adult it is called

gerontophilia

· When the passive agent is child it is known as catamite.

15. (B) Wearing cloths of opposite sex for sexual gratification

(Ref. N. Reddy 25th Ed. Pg – 361)

7. (A) Alcuronium

(Ref. Short Textbook of Anaesthesia by Ajay Yadav 2nd ed. Pg. 88)

CLASSIFICATION OF NDMR

· Steroidal compounds

· Benzylisoquinoline compounds

Steroidal Compounds Benzylisoquinoline Compounds Others

Pancuronium d-tubocurare Gallamine

Pipecuronium Metocurine Alcuronium

Vecuronium Atracurium

Rocuronium Mivacurium

Rapacuronium Doxacurium

5W89

APPG -2008

Answers

27 October 2008 RECEPTOR

· A transvestite is a person whose whole personality is

dominated by the desire to be identified with the opposite

sex

· It is usually found in the males who obtain sexual pleasure

by wearing female dress.

16. (B) criminal negligence

(Ref. Reddy FMT 23rd ed. Pg. 31, 32; Textbook of FMT by Parikh 6th

ed. Pg. 1.46)

Contributory negligence is a common law defence to a claim or

action. It applies to a situation where a plaintiff claimant has,

through their own negligence, caused or contributed to the injury

they suffered. For example where a pedestrian crosses a road

carelessly and is hit by a driver who is also driving carelessly.

Grievous hurt is punishable under section—IPC 320.

Perjury means giving wilful false evidence by a witness while

under oath, the witness is liable to be prosecuted for perjury

and the imprisonment may extend to seven years. This falls

under which section of IPC → 193 of Indian Penal Code.

Section 302 of Indian penal code is for → Murder.

17. (C) full radioopacity of underlying lung.

(Ref. Grainger diagnostic Radiology 4th ed. Pg. 334)

Typical sites and signs of pneumothorax evident in the supine

position include a sharply defined lucency outlining the

mediastinum medially and the ‘deep sulcus sign’ at the lung bases.

The thin line of the visceral pleura may not be visualized and the

only clue may be increased and featureless lucency over the

diaphragm, cardiac apex and fat pad.

18. (C) MRI is better for calcified lesions.

Disadvantages of MRI:

1. Longer time of acquisition

2. Claustrophobia.

3. Metal is absolutely contraindicated.

4. Costly.

5. Calcification is best detected by CT, not by MRI.

19. (A) 3.7 Mega Becquerel

(Ref. Grainger and Allison’s Diagnostic Radiology 4th Ed.)

· The SI units of activity is the becquerel (symbol Bq) equal

to one nuclear transformation per second. 3.7 × 1010

becquerels equal 1 curie (Ci) exactly.

20. (D) metabolism of organ

(Ref. Grainger and Allison’s Diagnostic Radiology 4th Ed. Pg. 239,

240)

The biological halflife; time taken for a radionucleotide to

metabolise will depend upon its chemical form and upon the

organ under consideration. As a general rule, the ideal

radiopharmaceutical should have an effective half-life (obtained

by combining the physical and biological half-lives) of the same

order as the time between administration of the radionuclide and

completion of the study.

21. (C) Use of anaesthetic agents

(Ref. Schatzberg’s psychiatry 2nd ed. pg 528–538.)

· The majority of patients requiring ECT will need

Anaesthesia ; therefore, interactions could conceivably

occur between the psychotropic drugs, ECT and the

anaesthetic agents utilized.

22. (C) increase in conductance of potassium

(Ref. Ganong physiology 21st ed. Figure 1–30)

Most K+ channels are tetramers, with each of the four subunits

forming part of the pore through which K+ ions pass. Structural

analysis of a bacterial voltage-gated K+ channel indicates that each

of the four subunits have a paddle-like extension containing four

charges. When the channel is closed, these extensions are near

the negatively charged interior of the cell

23. (B) Isotonic

• Dextrose 5 per cent is an isotonic solution that supplies

calories without electrolytes. It is useful in the

postoperative period when sodium excretion is reduced. It

is also valuable when the salt requirements of a patient

needing much fluid have been satisfied on a particular day.

Prolonged administration of 5 per cent dextrose solution

alone is liable to result in hyponatraemia, and may cause

thrombosis of the vein used;

24. (C) direct recording of electrical activity from muscle

(Ref. Harrison’s internal medicine 16th ed. pg. 2506–2507)

Electrodiagnosis

· EMG involves recording for electrical potentials from a

needle electrode in muscle both at rest and during

voluntary contraction of the muscle.

Electromyography is used -

· in back pain

· in constipation,

· in muscle disease,

· in peripheral neuropathy,

· in radiculopathy.

25. (A) p53

(Ref. Ganong 21st ed. 27; Harper’s biochemistry 27th ed. 346-347)

p53 (Policeman of human genome)

26. (C) Cistron

(Ref. Harper’s Biochemistry 26th ed. 376 )

The cistron is the smallest unit of genetic expression. The cistron

is the genetic unit coding for the structure of the subunit of a

protein molecule, acting as it does as the smallest unit of genetic

expression.

27. (C) Impotence

(Ref. Harrison medicine 16th ed. Pg. 427)

In sleep apnea syndrome, there may occur loss of libido, but

impotence is not known to occur.

28. (D) Diphenyl group

(Ref. KDT, 6th Ed. Pg – 425)

Pimozide is a Heterocyclic drug

29. (C) Metronidazole

(Ref. KDT, 6th Ed. Pg – 909)

Metronidazole, Albendazole, Mebendazole are contraindicate in

pregnancy.

30. (A) Ketoconazole

(Ref. KDT, 6th Ed. Pg – 763)

· Ketoconzaole decreases androgen production from testes

and it displaces testosterone from protein binding sites.

Gynaecomestia, loss of hair and libido and oligospermia

are manifestations.

RECEPTOR October 2008 28

31. (A) Increased ceruloplasmin

(Ref. MDT, Pg – 677)

· Serum ceruloplasmin, the plasma copper carrying protein

is low

· Increased urinary copper excretion

· Low serum ceruloplasmin levels

32. (B) Mitral stenosis

(Ref. Harrison’s Principles of Internal Medicine 16th Edition. Pg.

1308)

The fourth heart sound (S4)

· The fourth heart sound (S4)is a low-pitched, presystolic sound

produced in the ventricle during ventricular filling; it is

associated with an effective atrial contraction and is best

heard with the bell piece of the stethoscope.

· The sound is absent in patients with atrial fibrillation.

33. (C) MS

° Paradoxical pulse occurs not only in cardiac tamponade but

also in approximately one-third of patients with constrictive

pericarditis. This physical finding is not pathognomonic of

pericardial disease because it may be observed in some cases

of hypovolemic shock, acute and chronic obstructive airways

disease, and pulmonary embolus.

34. (C) Myotoric dystrophy

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg.

2351)

· The clinical expression of myotonic dystrophy varies widely

and involves many systems other than muscle.

· Affected patients have a typical “hatchet-faced appearance

due to temporalis, masseter, and facial muscle atrophy and

weakness.

· Frontal baldness is characteristic of men with the disease.

· Neck muscles, including flexors and sternocleidomastoids,

and distal limb muscles are involved early.

35. (C) Lens

(Ref. Basak’s Ophtahlmology 2nd ed. Pg. 112)

MELANIN Pigment dispersion syndrome Corneal

(Krukenberg’s spindle) Endothelium

36. (C) Retinal detachment

(Ref. Parson’s disease of eye 20th ed. Pg. 321)

Retinal detachment can remain asymptomatic for a long time. In

the stage of acute posterior vitreous detachment, the patient will

notice flashes of light (photopsia) and floaters, black points that

move with the patient’s gaze.

37. (A) Open angle glaucoma

(Ref. Lang, Ophthalmology pg. 261)

o Laser burns in the trabecular meshwork cause tissue

contraction that widens the intervening spaces and improves

outflow through the trabecular meshwork.

38. (D) Gonioscopy / Biometry

(Ref. Khurana ophthalmology 4th ed. 196)

CALCULATION OF IOL POWER (BIOMETRY)

· ‘SRK’ formula i.e P = A – 2.5L – 0.9K, is the most common

method of determining IOL power.

· The USG machine equipped with A-scan and IOL power

calculation software is called “Biometer”.

39. (C) Anterior lens

40. (A) Testicular feminisation

(Ref. Harrison’s Principles of Internal Medicine 16th Edition Pg.

2202; Table 326-1)

41. (A) Ocular trauma

(Ref. Khurana, Pg – 373)

Rosette cataract is the most typical form of concussion

cataract.

42. (A) Menieres disease

43. (C) Gradenigo syndrome

(Ref. Dhingra 3rd Ed, Pg – 103)

Gardenigo syndrome is the triad of

(a) VIth N Palsy

(b) Retro-orbital pain

(c) Persistant ear discharge

44. (A) HSV

45. (B) Vernal Kerato Conjunctivitis

(Ref. Khurana, 3rd Ed., )

VKC is considered a hypersensitivity reaction to some exogenous

allergen (IgE mediated mechanism).

46. (A) Prussaks space

Prussak’s space lies medial to pars flaccida, lateral to the neck of

malleus and above the lat. Process of malleus.

47. (B) Peritonsillar fossa

48. (A) Above the origin of sup. thyroid artery

49. (A) Foreign body

(Ref. Bhargava, 166)

· Rhinolith is a concretion in the nose formed around foreign

body, blood or inspissated pus.

· Concretion is due to deposition of calcium carbonate and

calcium phosphate.

· Unilateral, foul smelling, blood stained discharge.

· It is removed under General anaesthesia.

50. (C) Severe root resorption problems associated

(Ref. Nelson Textbook of Pediatrics 17th edition 1206)

NATAL TEETH

· Natal teeth are observed in approximately 1 in 2,000 newborn

infants; usually there are two in the position of the mandibular

central incisors.

· Natal teeth are present at birth, whereas neonatal teeth erupt

in the 1st month of life.

· Attachment of natal/neonatal teeth is generally limited to the

gingival margin, with little root formation or bony support.

· They may be a supernumerary or a prematurely erupted

primary tooth.

· Natal/neonatal teeth may occasionally result in pain and

refusal to feed and at times may produce maternal discomfort

because of abrasion or biting of the nipple during nursing.

51. (A) staph. aureus

29 October 2008 RECEPTOR

62. (B) E coli

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg. 879; TABLE 134-1)

52. (A) Apparent shortening

(Ref. Clinical orthopaedic examination by Ronald McRae 5th ed. Pg.

178)

In apparent shortening, the limb is not altered in length, but

appears short as a result of adduction contracture of the hip, which

has been compensated for by the tilting of the pelvis.

53. (A) Perthes disease

(Ref. Maheswari, Pg – 269)

· Perthes disease is an osteochondritis of epiphysis of the

femoral head

· The disease occurs commonly in boys in the age group of

5-10 years

· Limitation of abduction and internal rotation and

shortening.

54. (A) Lipase

55 . (A) Frontal

· Frontal and temporal lobes are most often contused in RTA.

56. (A) Centchroman

57. (A) Metropathica haemorrhagica

58. (D) Triple arthrodesis is optimal treatment

Triple arthrodesis is performed after the age of 12 years because

before this the bodies are cartlagening and it is difficult to achieve

fusion.

59. (C) Dorsi flexion

60. (A) Mental retardation

61. (B) most common cause of Hypothalamic

hypogonadotropic failure is males

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg.

2215; Table 328-1.)

66. (A) Gelatin

67. (A) Episodic ataxia I

(Ref. Harrison medicine 16th ed. 2339, 2363, 2536)

______________________________________________

Disease Pathology

-----------------------------------------------------------------------------

1.Spinocerebellar ataxia 1 - trinucleotide repeat (cac)

Expansion in gene.

2.Episodic ataxia type 1 - k channel gene mutations.

3.Hypokalemic periodic - l-type ca++ channelopathy.

Paralysis

4.Hyperkalemic periodic - point mutation sodium

Paralysis channel.

5.Malignant hyperthermia - mutation in ryanodine

receptor gene.

6.Myotonia - mutation in cl- channel

gene.

—————————————————————————

68. (B) most common in posterior circulation

(Ref. Harrison’s principles of internal medicine 16th ed. 2388)

Approximately85% of aneurysms occur in the anterior circulation,

mostly on the circle of Willis. About 20% of patients have multiple

aneurysms, many at mirror sites bilaterally. As an aneurysm

develops, it typically forms a neck with a dome.

69. (C) Papilledema

(Ref. Harrison’s principles of internal medicine 16th ed. 2388)

70. (A) Zinc

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg.

420; TABLE 63-8 )

Pathotype Clinical Syndrome(s) Defining Molecular Trait Responsible Genetic Element

EAEC/DAEC Traveler’s diarrhea, Aggregative/diffuse Chromosomal or plasmid associated

Persistent diarrhea adherence adherence genes

63. (C) Person with carbon monoxide poisoning

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg.

600)

Carbon monoxide has a higher affinity for hemoglobin than does

oxygen; it can replace oxygen and diminish O2 delivery.

64. (A) increase pH

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg.

210)

A shift to the right of the curve indicates a greater unloading of

oxygen.

A shift to the left, conversely, indicates less unloading but slightly

more oxygen loading in the lungs.

65. (B) PO2

(Ref, Ganong Physiology 22nd ed. 616)

CEREBRAL BLOOD FLOW is dependent on-Cerebral Metabolic

rate, CO2, and Cardiac output.

71. (C) Normocytic

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg.

1658)

· A normocytic, normochromic anemia attributable to CRD is

observed beginning at stage 3 CRD and is almost universal

at stage 4.

72. (B) Toxic adenoma

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg.

2116)

Graves’ disease rarely begins before adolescence and typically

occurs between 20 and 50 years of age, but it also occurs in the

elderly.

Multinodular goiter (MNG) occurs in up to 12% of adults. MNG is

more common in women than men and increases in prevalence

with age.

RECEPTOR October 2008 30

73. (C) Norepinephrine

74. (C) Both

(Ref. HARRISON’S PRINCIPLES OF INTERNAL MEDICINE - 16th Ed.

2039)

CONN’S SYNDROME

Conn’s syndrome is primary hyperaldosteronism due to:

o Aldosterone producing adrenal cortical adenoma (50%)

o Bilateral idiopathic adrenal hyperplasia - idiopathic

hyperaldosteronism (40%)

o Aldosterone secreting carcinoma

75. (C) Hypertension

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg.

1698)

· Hypokalemia, metabolic alkalosis, and normal to low blood

pressure are the clinical findings characteristic of Bartter’s

syndrome.

76. (C) Diffuse goitre

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg.

2120)

Worldwide, diffuse goiter is most commonly caused by iodine

deficiency and is termed endemic goiter when it affects 5% of the

population. In nonendemic regions, sporadic goiter occurs, and

the cause is usually unknown.

77. (A) Adenolymphoma

(Ref. Bailey 22nd ed. 475, 23rd ed. Ed. 659; robbins 5th ed. 570)

NEOPLASTIC SALIVARY GLAND LESIONS

Benign

1. Pleomorphic adenoma (mixed parotid tumor)

2. Adenolymphoma (Warthin’s tumors)

3. Hemangioma in children

4. Lymphangioma in children

5. Intermediate

6. Mucoepidermoid tumors

7. Acinic cell carcinoma

8. Oncocytoma

Malignant

1. Adenoid cystic carcinoma

2. Adenocarcinoma

3. Squamous cell carcinoma

78. (B) Libman Sack’s endocarditis

LSE (Libman-Sacks endocarditis) has small or medium-sized

vegetations on either or both sides of the valve leaflets.

79. (B) Lead poisoning

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg.

1413)

Myocarditis, i.e., cardiac inflammation, is most commonly the

result of an infectious process. Myocarditis may also result from a

hypersensitivity to drugs or may be caused by radiation,

chemicals, or physical agents.

80. (B) Cryptococcus neoformans

(Ref. Ananthanarayan Microbiology 6th Ed, 574)

81. (D) 0.4 to 0.7 mm

(Ref. Park PSM 19th ed. 524)

82. (A) Chagas disease

(Ref. Harrison’s Principles of Internal Medicine 16th Edition 1200)

Xenodiagnosis is successful in 50% of patients with chronic

Chagas’ disease.

83. (B) Gardenella

(Ref. Shaw 13th Edition 129)

84. (?)

We have to treat both the Partners.

85. (B) TB

(Ref. Harrison’s Principles of Internal Medicine 16th Edition Pg.

2141)

· Addison’s disease results from progressive destruction of the

adrenals, which must involve 90% of the glands before

adrenal insufficiency appears.

· The adrenal is a frequent site for chronic granulomatous

diseases, predominantly tuberculosis but also histoplasmosis,

coccidioidomycosis, and cryptococcosis.

· In early series, tuberculosis was responsible for 70 to 90%

of cases, but the most frequent cause now is idiopathic

atrophy, and an autoimmune mechanism is probably

responsible.

· Specific adrenal antigens to which autoantibodies may be

directed include 21-hydroxylase (CYP21A2) and side chain

cleavage enzyme.

86. (A) age < 40 years

87. (C) HSP

(Ref. Harrison’s Principles of Internal Medicine 16th Edition 2002)

ANCA are antibodies directed against certain proteins in the

cytoplasmic granules of neutrophils and monocytes. These

autoantibodies are present in a high percentage of patients with

certain systemic vasculitis syndromes, particularly Wegener’s

granulomatosis and microscopic polyangiitis, and in patients

with necrotizing and crescentic glomerulonephritis.

Antineutrophil Cytoplasmic Antibodies

• cANCA = Wegener’s;

• pANCA = Churg-Strauss + others

Other causes of positive ANCA (usually pANCA)

inflammatory bowel disease (UC > Crohn’s)

connective tissue disorders: RA, SLE, Sjogren’s

autoimmune hepatitis

88. (A) Pomeroy’s method

(Ref. Textbook of Gynecology by Shaw 13th ed. 236)

Tubal ligation and resection (removal) of a portion of the

fallopian tube is the most frequent method of blocking the

tubes. This involves tying a segment of tube and removing it.

There are many variations of this technique. The tubal ligation

procedure described by Dr. Ralph Pomeroy a century ago is

most commonly used today.

89. (A) Minipill

90. (B) Polyhydramnios

91. (A) Mag. sulphate

92. (B) Uterosacral ligaments

(Ref. Novak’s Gynecology Chapter 5)

31 October 2008 RECEPTOR

The uterosacral ligaments, which provide support to the cervix

and upper vagina and interdigitate with fibers from the cardinal

ligament near the cervix

93. (B) Brenners tumour

94. (A) Type I

(Ref. Oxford Textbook of Surgery 2nd edition pg. 654)

CHOLEDOCHAL CYST

Cystic dilatation may affect any part of the biliary system; five

patterns have been described.

· Type 1, a cystic or fusiform dilatation of the common bile

duct, is the most common (82 per cent).

· Type 2 (3 per cent) is a supraduodenal diverticulum of the

common bile duct.

· Type 3 (5 per cent) is a diverticulum of the intraduodenal

bile duct, or choledochocele.

· Type 4 (9 per cent) consists of multiple cysts: type-4A cysts

affect both the intrahepatic and extrahepatic bile ducts,

while type-4B cysts affect the extrahepatic duct only.

· Type 5 (1 per cent) describes cysts of the intrahepatic bile

ducts. These may be solitary or multiple, and this type includes

Caroli disease. They can vary in size from 2 cm in diameter to

giant cysts and the wall is composed of fibrous tissue that

may be up to 1 cm thick.

95. (A) Socialization

(Ref. PARK PSM 19th ed. 537)

Process by which an individual gradually acquires culture and

becomes a member of a social group is called socialization.

96. (A) Increasing demands for resources

97 . (A) Also called prevalence study

(Ref. PARK PSM 19th ed. 67)

Simplest form of observational study based on single exam of

population at one point of time – the results of which can be

projected on the whole population. It is also known as “prevalence

study”.

98. (A) Plateau phase

(Ref. Park PSM 18th ed.58; Ref. above for explanation)

Point source” epidemics (single exposure):

• Exposure to disease agent is brief and simultaneous; all

cases develop within one incubation period

• Curve has usually one peak.

• Epidemic tends to be explosive, there is clustering of cases

within a narrow interval.

• Epidemic curve rises and falls rapidly, with no secondary

waves,

• E.g., food poisoning, Bhopal gas tragedy (methyl

isocyanide).

99. (A) Edmonston

100. (A) Not limited by sutures

101. (C) Birth asphyxia

(Ref. Park psm 19th ed. 450, 421)

Perinatal Mortality Rate:

Late foetal deaths (28 weeks gestation and more +

early neonatal deaths (first week) in one year

= ———————————————————— x 1000

Live births in the same year

The most common causes of perinatal mortality is birth asphyxia.

102. (C) Intracranial bleed

(Ref. Nelson pediatrics 17th ed. 552 TABLE 86.2-2)

Problems of IUGR (SGA) Infants

• Intrauterine fetal demise

• Perinatal asphyxia

• Meconium aspiration syndrome

• Hypoglycemia

• Hypothermia

• Polycythemia

• Reduced oxygen consumption/hypothermia

• Dysmorphology Syndrome anomalads, chromosomalgenetic

disorders, oligohydramnios-induced deformations,

TORCH infection

• Other problems include pulmonary hemorrhage and those

common to the gestational age–related risks of prematurity

if born at less than 37 wk..

103. (D) Histology similar to invasive

(Ref. Shaw’s gynecology 14th ed. 369)

104. (A) Pagets disease of bone

(Ref. Bailey and Love 24th ed. 656)

105. (A) No increase in risk of HCC

(Ref. Bailey and Love 24th ed.)

PRIMARY BILIARY CIRRHOSIS (PBC)

· As with PSC, the presentation of patients with PBC is often

hidden with general malaise and lethargy prior to the

development of clinical jaundice or the finding of abnormal

liver function tests.

· The condition is largely confined to females.

· Diagnosis is suggested by the finding of circulating antismooth

muscle antibodies and, if necessary, is confirmed by

liver biopsy.

· It is slowly progressive with deterioration in liver function

resulting in lethargy and malaise.

· It may be complicated by the development of portal

hypertension and the secondary complications of ascites and

variceal bleeding.

· The mainstay of treatment is liver trans-plantation, which

should be considered when the patient’s general condition

starts to deteriorate with inability to lead a normal lifestyle.

106. (A) Chrons disease

(Ref. Bailey and Love 24th ed. 1123)

RADIOLOGY OF CHRON’S DISEASE

· Barium enema will show similar features to those of

colonoscopy in the colon.

· The best investigation of the small intestine is small bowel

enema.

· This will show up areas of delay and dilatation characterising

partial obstruction. The involved areas tend to be narrowed,

irregular and sometimes, when a length of terminal ileum is

involved, there may be the “string sign of Kantor”.

107. (A) Intusuception

(Ref. Bailey and Love 24th ed. 1068)

· A barium enema may be used to diagnose the presence of

an ileo-colic or colocolic form (the claw sign) but would be

negative for the ileo-ileal variant in the presence of a

competent ileocaecal valve.

RECEPTOR October 2008 32

108. (A) Excision of the cyst

(Ref: Bailey and Love, short practice of surgery - 23rd edition -986)

• The effective treatment of hydatid cyst(s) in the lung is

complete excision of the cyst(s) with maximum preservation

of the lung parenchyma.

109. (C) Pelvic region

(Ref. Bailey and Love 24th ed. 1012)

PELVIC ABSCESS

• The pelvis is the commonest site of an intraperitoneal

abscess because the vermiform appendix is often pelvic in

position and also the Fallopian tubes are frequent sites of

infection.

110. (A) Free passage of barium in the terminal ileum

(Ref. Bailey and Love 24th ed. 1068)

· In difficult cases the little finger may be gently inserted into

the neck of the intussusception to try and separate adhesions

(Cope’s method).

111. (C) Testes is separate from swelling

(Ref. Short cases of surgery by S das pg. 314; Bailey and Love 24th

ed. 1278)

HYDROCELE

Hydroceles are almost invariably translucent and it is possible

to ‘get above the swelling’ on examination of the scrotum.

(surgical Das mentions as a rule testis cannot be felt separately as

the fluid of hydrocele surrounds the body of the testis)

112. (A) Fracture neck of femur

113. (C) Avascular necrosis of distal part is there

(Ref. Maheswari, 3rd Ed.)

Common sites of Avascular Necrosis:

1. Head of the femur

2. Proximal pole of scaphoid

3. Body of Talus

114. (A) Inv. of extensor pollices brevis and abductor pollices

(Ref. Maheswari, Pg – 257)

It results from the inflammation of the common sheath of

abductor pollicis longus and extensor pollicis brevis tendons.

115. (C) Cubital valgus is most common complication

(Ref. Maheswari, Pg – 85)

· Cubitus varus is the common complication of supracondylar

fracture

· Cubitus valgus deformity is the completion of fracture of

lateral condyle of humerus.

116. (A) Rendering cervical mucus thick

117. (B) Most common cause of first trimester abortion

The most common cause of first trimester abortion is

chromosomal anomalies.

118. (B) 6 to 8 hours

119. (C) laparoscopic sterilisation

(Ref. Lippincott - Novak’s Gynecology 13ed. Table 10.10. ; Shaw’s

gynecology 13th ed. 238)

Least failure rate is seen with Unipolar coagulation of

laparoscopic sterilization.

120 (A) Babesia

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg. 1233)

Dividing within RBCs, B. microti can form four daughter parasites

attached by strands of cytoplasm; these “tetrad” forms are seen

infrequently in human blood films but are a distinguishing feature

121. (A) Brilliantly translucent

(Ref. Bailey and Love 24th ed. 778)

· As a result of the intercommunication of its many

compartments, the swelling is soft and partially compressible,

it visibly increases in size when the child coughs or cries, but

the characteristic that distinguishes it from all other neck

swellings is that it is brilliantly translucent.

122. (C) Lesch Nyhan disease

(Ref. Harrison’s Principles of Internal Medicine 16th Edition ed. 601)

123. (B) Hypokalema

Causes of neonatal seizures

· Hypoxic-ischemic encephalopathy (HIE)

· Intracranial hemorrhage:

· Metabolic causes:

· Infections:

· Developmental defects:

· Miscellaneous: These causes include polycythemia maternal

narcotic withdrawal, drug toxicity (e.g. theophylline,

doxapram), local anesthetic injection into scalp and

phacomatosis (e.g. tuberous sclerosis, incontinentia

pigmentii).

124. (A) Biotin

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg. 407)

125. (B) High Apoptotic cell death

(Ref. Robbin’s pathology 7th ed. Figure 14-14 )

Burkitt lymphoma: numerous pale tingible body macrophages

are evident, producing a “starry sky” appearance.

At high power, tumor cells have multiple small nucleoli and high

mitotic index. The lack of significant variation in nuclear shape

and size lends a monotonous appearance.

126. (A) Causes shock lung

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg. 1608)

Septic shock is caused by the systemic response to a severe

infection

127. (A) Nimodipine

128. (A) Chromosome 5

(Ref. Harrison’s Principles of Internal Medicine 16th Edition 528)

Polyposis coli is associated with a deletion in the long arm of

chromosome 5 (including the APC gene) in both neoplastic

(somatic mutation) and normal (germline mutation) cells..

129. (A) Membranous Glomerulonephritis

(Ref. Robbin’s pathology 7th ed. Table 20-6)

130. (D) Posterior tympanic

131. (B) Primary hyperparathyrodism

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg. 1656)

· The pathophysiology of bone disease due to secondary

hyperparathyroidism is related to abnormal mineral

metabolism.

o (1) Decreased GFR leads to reduced inorganic phosphate

(PO4 3) excretion and consequent PO4 3_ retention,

33 October 2008 RECEPTOR

o (2) retained PO4 3_ has a direct stimulatory effect on PTH

synthesis and on cellular mass of the parathyroid glands,

o (3) retained PO4 3_ also indirectly causes excessive

production and secretion of PTH through lowering of ionized

Ca2_ and by suppression of calcitriol (1,25-

dihydroxycholecalciferol) production, and

o (4) reduced calcitriol production in CRD results both from

decreased synthesis due to reduced kidney mass and from

hyperphosphatemia. Low calcitriol levels, in turn, lead to

hyperparathyroidism via both direct and indirect

mechanisms.

132. (C) Caliculus

(Ref. Grainger & Allison’s Diagnostic Radiology, 4th Ed. Pg. 1560)

Partial duplication may be associated with hypertrophy of the

septal cortex (hypertrophied column of Bertin). In this

developmental abnormality the septal cortex is enlarged and

gives the impression of a mass lesion between the upper and

middle caliceal groups. It is one type of pseudotumour.

133. (C) Muscles of jaw and larynx

(Ref. Goodman Gillman Pharmacology 9th ed. 565)

· When an appropriate dose of a competitive blocking agent

is injected intravenously in human beings, motor weakness

progresses to a total flaccid paralysis.

134. (A) Amenorrhoea

(Ref. Lippincott - Novak’s Gynecology 13ed. Chapter 22)

135. (A) Vesico uterine fistula

136. (C) Sertoli cells are important..

(Ref. Ganong Physiology 21st ed. Chapter 23; Fig. 23-22)

In response to LH, some of the testosterone secreted from the

Leydig cells bathes the seminiferous epithelium and provides the

high local concentration of androgen to the Sertoli cells that is

necessary for normal spermatogenesis.

137. (B) IB

138. (A) Node draining colon

(Ref. Schakelford textbook of surgery Fig. 1-12)

· The lymphatic drainage of the colon and rectum is illustrated,

showing that the lymph nodes are distributed around the

arterial supply to the large intestine.

· Four tiers of nodes are recognized:

o Paracolic,

o Epicolic,

o Intermediate, and

o Principal lymph nodes.

139. (C) 5 years

(Ref. Nelson - Textbook of Pediatrics 17th ed. 34; and . OP Ghai

Paediatrics 6th ed. 48)

140. (A) Infant mortality rate

141. (A) Lower GI bleeding

(Ref. Bailey and Love 24th ed. 1159)

MECKEL’S DIVERTICULUM

· In order of frequency, these symptoms are as follows.

o Severe haemorrhage, caused by peptic ulceration. The blood

is passed per rectum, and is maroon in colour. Although the

patient may vomit, the vomit does not contain blood. There

is rarely any pain and sometimes the bleeding precedes

perforation. An operation is required for serious progressive

gastrointestinal bleeding. When no lesion in the stomach or

duodenum can be found the terminal 150 cm of ileum should

be carefully inspected.

Intestinal obstruction.

142. (B) Klebsiella

143. (A) Thiamine

(Ref. Pg. Harrison’s Principles of Internal Medicine 16th Edition pg.

404, TABLE 61-1)

144. (A) Toxoplasmosis

(Ref. Nelson Textbook of Pediatrics 17th edition pg. 569)

145. (B) Phenyl ketonuria

(Ref. Nelson Textbook of Pediatrics 17th edition ed. 384)

· Amniocentesis, the transabdominal withdrawal of amniotic

fluid during pregnancy for diagnostic purposes, is frequently

performed to determine the timing of the delivery of fetuses

with erythroblastosis fetalis or the need for fetal transfusion.

· The amniotic fluid may be directly analyzed for amino acids,

enzymes, hormones, and abnormal metabolic products, and

amniotic fluid cells may be cultivated to permit detailed

cytologic analysis for prenatal detection of chromosomal

abnormalities and DNA-gene or enzymatic analysis for the

detection of inborn metabolic errors.

· Analysis of amniotic fluid may also help in identifying neural

tube defects (elevation of alpha fetoprotein), adrenogenital

syndrome (elevation of 17-ketosteroids and pregnanetriol),

and thyroid dysfunction.

146. (C) Valproate

(Ref. Nelson Textbook of Pediatrics 17th edition 515)

147. (C) Congenital erythropoietic prophyria

(Ref. Harper 27th Ed, Pg – 285)

In general, the porphyrias are inherited in the autosomal

dominant manner, with the exception of congenital erythropoieic

prophyria, which is inherited in recessive mode.

148. (A) Decomposition

149. (B) Increase parasympathetic discharge to SA node

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg.

1347)

TREATMENT OF PSVT

· In patients without hypotension, vagal maneuvers,

particularly carotid sinus massage, can terminate the

arrhythmia in 80% of cases.

· If these maneuvers are unsuccessful, adenosine (12 mg

intravenously) is the agent of choice.

· Beta blockers may also be used to slow or terminate the

tachycardia but are agents of second choice.

· Digitalis glycosides have a slower onset of action and should

not be used for acute therapy.

· When these drugs fail to terminate the tachycardia, or when

the tachycardia is recurrent, atrial or ventricular pacing via a

temporary pacemaker inserted pervenously may be used to

terminate the arrhythmia. However, if severe ischemia and/

or hypotension is caused by the tachycardia, (DC)

cardioversion should be considered.

150. (A) Hyaline cast

151. (A) 30 to 300mg/d

RECEPTOR October 2008 34

159. (A) Type I

(Ref. Nelson Textbook of Paediatrics 17th ed. 470; Harper’s Biochemistry 26th ed. Pg. 152 )

GLYCOGEN STORAGE DISEASES.

152. (A) Lateral scc

(Ref. Bhargava 5th Ed, 36; Dhingra 3rd Ed. 55)

CALORIE TEST (HALLPIKE TEST)

· To test vestibular function by stimulating the Labyrinth by

water of 300C (cold) and 440C (hot).

· Position of patient: Head raised to 300 from horizontal in

supine position to bring horizontal semicircular canal in

vertical position.

· Inference : Nystagmus produced (COWS).

153. (B) Zonasimide

154. (B) Cirrhosis

155. (A) Bronchial asthma and wheeze

156. (A) JRA

(Ref. Parson’s 20th ed. Pg. 201-202)

After many years of chronic inflammation of the anterior chamber

(chronic uveitis and keratitis) with shrinkage of the eyeball or in

patients with juvenile polyarthritis, calcific deposits occur in

Bowman’s layer, causing a transverse zone of opacification in the

region of the palpebral fissure.

157. (A) Alkaline phosphatase is elevated

(Ref. Robbins and Cotran pathologic basis of disease 7th edition

887-888; table 18-4)

DUBIN-JOHNSON SYNDROME

· It results from a hereditary defect in hepatocellular excretion

of bilirubin glucuronides across the canalicular membrane.

· The defect is due to absence of the canalicular protein, the

multidrug resistance protein 2 (MRP2; located on

chromosome 10q24), that is responsible for transport of

bilirubin glucuronides and related organic anions into bile.

· The liver is darkly pigmented owing to coarse pigmented

granules within the cytoplasm of hepatocytes.

· Electron microscopy reveals that the pigment is located in

lysosomes, and it appears to be composed of polymers of

epinephrine metabolites, not bilirubin pigment.

· The liver is otherwise normal.

· Apart from chronic or recurrent jaundice of fluctuating

intensity, most patients are asymptomatic and have a normal

life expectancy.

158. (B) Pulmonary stenosis

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg.

1310)

The so called systolic ejection murmurs, which are often crescendodecrescendo

in shape, and occur when blood is ejected across

the aortic or pulmonic outflow tracts.

Water Nystagmus

Cold (300C) Opposite Side

Warm (440C) Same Side

Glycogenosis Name Cause of Disorder Clinical Presentation Characteristics

Type I Von Gierke’s disease Deficiency of glucose- Growth retardation, hepatomegaly, Liver cells and renal tubule

6-phosphatase hypoglycemia; elevated blood cells loaded with glycogen.

lactate, cholesterol, triglyceride, Hypoglycemia, lacticacidemia,

ketosis, hyperlipemia.

and uric acid levels

160. (C) High protein diet

161. (D) Chloasma

(Ref. Oxford Textbook of Medicine 4th edition Chapter 13.13)

· Pigmentary changes and pigmented lesions

There is darkening of the nipples, genitalia, and linea alba.

The unsightly and sometimes psychologically distressing

facial pigmentation of melasma (chloasma) affects many

women, is worse with sunlight, and can be reduced by the

use of high protection factor (SPF 25) UVB and UVA sun

screens. Pigmented naevi can increase in number, size, and

pigmentation. Melanoma may occur and is associated with a

poor prognosis in pregnant women. Any rapidly changing,

irregularly shaped, or irregularly pigmented mole should be

biopsied to exclude a dysplastic naevus or melanoma.

162. (D) Donovanosis

163. (D) Type 6

164. (A) Caudal regression syndrome

(Ref. Textbook of obstetrics D C Dutta 6th ed. 303, 304)

Sacral agenesis may be expected in 1% of offspring of diabetic

mothers. In 16% of cases of caudal regression syndrome, the

mother is diabetic; rarely, the father is diabetic instead. The

syndrome appears sporadically but is 100 times more common

in one sib of twin births.

165. (B) VLDL

166. (A) Midazolam

Midazolam is parenterally shorter acting drug.

35 October 2008 RECEPTOR

167. (C) LV HYPERTROPHY with displaced apex

(Ref. Harrison’s Principles of Internal Medicine 16th Edition 1398)

· In patients with AS, Operation should, if possible, be carried

out before frank LV failure develops; at this late stage, the

aortic valve pressure gradient declines as the stroke volume

and ejection fraction decline.

168. (A) Poly A

(Ref. Harper’s Illustrated Biochemistry 26th edition pg. 309, 355,

365)

· The protein-synthesizing machinery begins translating the

mRNA into proteins beginning downstream of the 5' or

capped terminal.

· The other end of most mRNA molecules, the 3'-hydroxyl

terminal, has an attached polymer of adenylate residues 20–

250 nucleotides in length. The specific function of the poly(A)

“tail” at the 3'-hydroxyl terminal of mRNAs is not fully

understood, but it seems that it maintains the intracellular

stability of the specific mRNA by preventing the attack of 3'-

exonucleases.

169. (A) Alveolar rhabdomyosarcoma

(Ref. Robbin’s pathology-7th edn-1322)

170. (D) All

(Ref. Harrison’s Principles of Internal Medicine 16th Edition )

171. (D) Small power 10 to 18 employees

172. (B) Proximal tube defect

(Ref. Harrison’s Principles of Internal Medicine 16th Edition pg.

656)

173. (D) Vault prolapse

(Ref. Novak’s Gynaecology 13ed.Chapter 90)

· Colpopexy A different procedure is required for younger

women and for women who wish to retain sexual function.

For these women, the condition can be managed

transvaginally or transabdominally. With the transvaginal

approach, vaginal eversion is corrected by suturing one or

both sides of the vaginal apex (usually the right side) to the

sacrospinous ligament with one or two sutures—a

transvaginal sacrospinous colpopexy.

174. (D) First body of twin pregnancy

(Ref. Textbook of Obstetrics D.C. Dutta 6th Ed. 380)

Contraindications to external cephalic version:

a) Preeclampsia (severe)

b) Post caesarean section

c) Placenta previa or history of bleeding in early months

d) Pelvic contraction

e) Previously known congenital malformation of uterus

f ) Specially valuable baby.

g) Multiple Pregnancies

h) Fetal causes (hydrocehalic after coming head, hyperextended

head, and dead fetus).

175. (A) Prolonged pregnancy

(Ref. Textbook of obstetrics D.C. Dutta 6th ed. 628)

Causes of DIC during pregnancy:

· Abruptio placentae

· Amniotic fluid embolism

· Chorioamnionitis

· Dextran infusion

· Eclampsia and pre-eclampsia (severe)

· Hydatidiform mole

· HELLP syndrome

· IUD

· Instillation of intra-amniotic hypertonic saline

· LSCS

· Pyelonephritis in pregnancy

· Shock

· Septic abortion

176. (A) Mentovertical

177. (A) Cardiac tamponade

(Ref. Harrison’s medicine 16th Ed.1416)

So, tachycardia, hypotension, and distended IJV in a case of blunt

trauma abdomen, is s/o cardiac tamponade.

Cardiac tamponade

Features

· raised JVP, with an absent Y descent - this is due to the limited

right

ventricular filling

· tachycardia

· hypotension

· muffled heart sounds

· pulsus paradoxus

· Kussmaul’s sign (much debate about this)

· ECG: electrical alternans

178. (A) Sucralfate

(Ref. Harrison’s Principles of Internal Medicine 16th Edition 1754)

179. (B) Magnesium

(Ref. Harrison’s Principles of Internal Medicine 16th Edition ed.

1664)

180. (A) Efficacy in comparision to phenol

181. (B) Hypercalcemia

(Ref. Harrison’s Principles of Internal Medicine 16th Edition

TABLE 35-3)

182. (B) Non progressive deafness

(Ref. Bhargava ENT 6th ed. 76; PL Dhingra 3rd Ed.114)

183. (C) Infectious mononucleosis

(Ref. Harrison’s Principles of Internal Medicine 16th Edition 1047;

1834)

Most cases of Infectious Mononucleosis are self-limited. Deaths

are very rare and most often are due to central nervous system

complications, splenic rupture, upper airway obstruction, or

bacterial superinfection.

184. (A) EBV

· Hairy Leukoplakia is caused by the EB virus

· Hairy Leukoplakia is commonly seen as a white lesion on

the lateral aspect of tongue.

185. (A) 1 hour

186. (A) HUS

187. (D) Polyester

RECEPTOR October 2008 36

188. (B) Axillary lymph node status

(Ref. Bailey and Love 24th ed. 820)

189. (A) Retinal detachment

(Ref. Lange Ophathalmology pg. 432)

MYOPIA

· The risk of retinal detachment is increased in myopia.

However, it does not increase in proportion to the severity of

the myopia. Because of the increased risk of retinal

detachment, patients with myopia should be examined

particularly thoroughly for prodromal signs of retinal

detachment, such as equatorial degeneration or retinal tears.

Therefore, examination of the fundus with the pupil dilated

is indicated both when the first pair of eyeglasses is

prescribed and at regular intervals thereafter.

189. (C) Central retinal artery occlusion

190. (C) Fallopian tube

191. (D) Strawberry hemangioma

192. (A) Digital screening along with PSA is additive

(Ref. Harrison’s principles of internal medicine 17th ed. Table 78-3)

· The most common prostate cancer screening modalities are

DRE and serum prostate-specific antigen (PSA) assay.

193. (A) Cholera

(Ref. Harrison’s principles of internal medicine - 16th edition – 264,

table 42-3, table 42-4)

194. (A) Myxedema

(Ref. Harrison’s principles of internal medicine 17th ed. Figure 340-

5)

· Gynecomastia refers to enlargement of the male breast.

· It is caused by excess estrogen action and is usually the result

of an increased estrogen/androgen ratio.

· True gynecomastia is associated with glandular breast tissue

that is >4 cm in diameter and often tender. Glandular tissue

enlargement should be distinguished from excess adipose

tissue: glandular tissue is firmer and contains fibrous-like

cords.

195. (A) Twin Twin transfusion syndrome

(Ref. Danforth obstetrics pg. 556)

196. (A) Lymphedema

(Ref. Bailey and Love 24th ed. 840)

· More often lymphedema is a result of treatment, either

surgical excision of draining lymph nodes and/or

radiotherapy.

· Lymphedema following treatment for breast carcinoma is the

commonest example, but fortunately this is decreasing in

incidence as surgery for the condition has become more

conservative.

· Lymphedema may occur after radical mastectomy (up to

60 per cent), modified radical mastectomy (up to 20 per

cent), local excision with either axillary node clearance or

radiotherapy (less than 5 per cent), and local excision with

axillary node clearance and radiotherapy (up to 40 per cent).

197. (B) Decreasing vitreous volume

198. (B) Hypovolemic shock

(Ref. Bailey and Love 24th ed. 267)

Burns shock occurs as a result of rapid plasma loss from the

damaged tissues, causing hypovolaemia. When 25 per cent or

more of the body surface area is burnt, a generalised capillary

leakage may result in gross hypovolaemia in the first 24 hours.

Endotoxaemia due to infection makes matters worse and large

volumes of colloidal and crystalloid fluids are required for

resuscitation.

199. (C) Massaging

(Ref. Basak’s ophthalmology 2nd ed. 281)

The primary treatment of uncomplicated nasolacrimal

obstruction is a regimen of nasolacrimal massage, usually 2–3

times a day, accompanied by cleansing of the lids with warm water.

Topical antibiotics are used for significant mucopurulent drainage.

Most cases of congenital nasolacrimal duct obstruction resolve

spontaneously, 96% before 1 yr of age.

200. (C) Dracunculosis