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AIIMS NOV 2011 Recall Question Paper
1. An elderly man presented with fever and cough. Sputum examination revealed gram negative organisms that were grown on Buffered charcoal yeast extract agar. The organism involved is? 2. Not true about drug resistance mechanism? a. Most common mechanism is production of neutralizing substances b. If resistance is plasmid mediated, it is always transferred vertically c. Alteration of target in pneumococcal resistance d. Complete removal of target is cause of resistance to vancomycin a. 0.7% dexamethasone b. 0.7% betamethasone c. 0.3% triamcinolone d. 0.7% triamcinolone 4. Which of the following is used to prevent HIV transmission from an HIV positive 5. All of the following are required in PCR except 6. Isoenzyme have all the properties except- c. have equal affinity for target /Same quaternary structure d. Same classification/ same rate of work 7. Which among the following is an incorrect match? c. Suicide attempt – IPC 309/304-culpable homicide not amounting to murder 8. Receptor based drug design is helpful as a. It leads to very less lead compound b. Understanding the structure of receptor can enhance better target c. It is very easy and less time consuming 9. First step to produce insulin is to incorporate a. mRNA of beta pancreatic cell of humans b. DNA of beta pancreatic cell of humans c. mRNA of beta pancreatic cell of bacteria d. DNA of beta pancreatic cell of bacteria 10. The most common gene defect in idiopathic steroid resistant Nephrotic syndrome 11. Which of the following has LEAST chance of progression to multiple sclerosis b. Absence of oligoclonal antibodies in CSF 12. Investigation of choice for meningial carcinamatosis? 13. A patient presents with recurrent sinusitis, situs inversus and dextrocardia. Most a. Kartgener’s syndrome b. Horner’s Syndrome c. d. a. DBP + SBP/2 b. DBP + PP/3 c. SBP + PP/3 d. DBP + SBP +PP/3 15. Investigation of choice for zenker’s diverticulum 16. During starvation gluconeogenesis is dependent on? 17. Increased level of alanine in serum after fasting suggests : b. Reduced amino acid utilization from gluconeogenesis c. Break in continuity of plasma membrane so amino acids leaking out. 18. What is the probable diagnosis in a patient with a dilated pupil not responsive to 1% a. Post ganglionic parasympathetic edinger wesphal b. Post ganglionic sympathetic c. Occulomotor d. Trigeminal 20. Calcification around Foramen of Monro, with periventricular infiltrate, raised intracranial tension mass and below 3rd ventricle is seen in? 21. All of the following occur in Herpes zoster keratitis except? 22. In India, syndromic management is applicable for? 23. A man presents with a 6 month history of recurrent oral ulceration. He has yellowish ulcerations on his lip which are erythematous, with a central halo and nodular lesions on his shin. Diagnosis is : 25. Which of the following does not occur in a child exposed to cold climate? a. Shivering b. Flexion of body like a fetus c. Cutaneous vasoconstriction d. Production of noradrenalilne to release energy from brown adipose tissue 26. Socialised medicine all are true except a. Decreases competition among practitioners for patients d. Increases utilisation of health facilities 27. Psychoitic features are due to all except- 28. A patient with radiologically confirmed Reflux nephropathy develops 3+ proteinuria. What is the most probable cause of proteinuria in this patient? a. Membranoproliferative glomerulonephritis d. Rapidly progressive glomerulonephritis 29. Glomerular capillary flow all are true except- a. Glomerular oncotic pressure lower than filtrate b. Oncotic pressure of filtrate is same as the systemic oncotic pressure c. Constriction of efferent arteriole leads to increase in blood pressure d. Increase in filtration lead to increase in hematocrit 30. Evidence-based medicine (EBM) all are true EXCEPT- a. aims to apply the best available evidence gained from the scientific method b. the research paper is investigated by the tools qouted in research paper itself c. the opinion of medical professionals n researchers have given a least importance d. Evidence is formed from weak study and poor studies 31. If a thiazide diuretic is administered, the response in excretion seen within 24 hrs are- a. Decreased calcium, increased sodium and potassium b. Increase sodium and potassium, increase calcium c. Decrease potassium and increase sodium and calcium d. Not Recalled 33. Prophylaxis with Azithromycin is given in cases of trachoma when prevalence in a community is: a. Carboxypeptidase b. Zymogen c. Transaminase d. Elastase 34. Marker of bone formation is all except 35. A pt present with sudden b/l loss of vision with loss of light perception. The loss is more on right side. Pupillary reflex, optokinetic nystagmus are normal. Pt can touch to his finger on closing his right eye but not on closing lt. What is diagnosis? a. Optic neuritis b. Anterior ischaemic optic neuropathy c. CMV retinitis d. Functional visual loss a. Multiple cortical / system atrophy b. Spinocerebellar ataxia c. Corticobasal degeneration d. Supranuclear palsy 37. Which of the following is a marker for granulosa cell tumour? a. Alkaline phosphatase b. Inhibin c. CA 19-9 38. Not true about Alzheimer’s disease- a. Neurofibrillary tangles correlate with the degree of dementia c. Plaques increase with age d. Not Recalled 39. Alzheimer's disease is associated with all of these except: a. Acalculia b. Aphasia c. Apraxia d. Agnosia 40. A lady has a history of fall is unable to extend great toe. She also complains of pain in great toe, but with intact sensation. Disc prolapsed at what level? a. L4-L5 b. L1-L2 /S1-S2 c. L5-S1 d. L3-L4 41. A person had a fall from tree and has been unable to move both of his lower limbs and had no control over micturition. The dose of methylprednisolone in this condition is 42. All are seen in 3rd nerve palsy except a. Ptosis b. Diplopia c. Miosis d. Eye moves laterally 43. A patient develops delirium tremens after 4 days of abstaining from alcohol. In this state, he assaults his neighbor. Which of the following is true according to Indian Penal Code? a. He is not held responsible for the act b. He is partially responsible for the act 44. In a study in UK, it was found that there was more death due to asthma as compared to sale of drugs for asthma. This is an example of a. Ecological study b. Cohort c. Case reference d. Experimental 45. All are true regarding function of normal flora except- 46. All are true regarding primary hyperaldosteronism except d. High secretion of aldosterone inspite of reduced volume of fluid 47. Same amino acid is coded by multiple codons due to following - a. Degeneracy b. Frame shift mutation c. Transcription d. Mutation 48. poly (A) induced polypeptide synthesis will give rise to? 49. Technique used to compare a new lab test with a gold standard test is known as? b. Correlation analysis / Bland and Altman analysis 50. What percentage of endothelium is destroyed in keratoplasty/ Cell loss after descement’s stripping in automated endothelial keratoplasty 51. In acute inflammation endothelial cells retraction due to cytoskeleton re-organisation causes a. Immediate transient increase in permeability b. Delayed transient increase in permeability c. Early permanent increase in permeability d. Late permanent increase in permeability 52. Criteria for chloroquine retinopathy are all except- a. Mild stippling or mottling in the macular pigmentation b. Seen at a dose of >250mg/d or >3mg/kg c. >480g total dose d. Not Recalled 53. Which of the following therapy does not penetrate deep tissue? 54. A female patient was on hemodialysis developed carpel tunnel. It was found to be due to amyloidosis. What is the type of amyloid form synovial fluid? a. AA b. AL c. Beta2 microglobulin d. AL and AA b. Urinary osmolality > plasma osmolality 56. All are true regarding SIADH except- a. Serum Na can be as low as 125 b. Serum sodium is normal or slightly low c. Vaptans are new FDA approved drugs for its treatment d. Urine sodium is normal or slightly low 57. Flaying is seen in which type of lacerated wound? 58. Most common cause of Addison’s disease in India is- a. Tuberculosis b. Post partum c. Autoimmune d. HIV 59. If air is inspired forcefully maintenance of tidal volume is by? 60. Regarding LDL receptor all are true except. a. Clathrin coated receptor on cell membrane b. Present only in extrahepatic tissues/ Only present in peripheral organs c. . LDL is taken by endocytosis d. Increased cellular chloesterol downregulates the receptors 61. The transmitters –noradrenaline, adrenaline, dopamine, GABA and serotonin have a. Five pass gated Receptor /Two pass ligand receptor b. Four pass gated Receptor /One pass ligand receptor 62. Phagocytosis causes complement activation by a. C3b and Fc b. Receptor mediated endocytosis c. Not Recalled d. Not Recalled 63. Which of the following can help you to differentiate between epidermoid cyst and arachnoid cyst? 64. In a well fed state, carnitine shuttle in outer membrane of mitochondria is inhibited by? 65. Which of the following is used to test the efficiency of sterilization in an autoclave? 66. Regular drinking of which of the following can help prevent UTI? 67. A 6 year old boy presents with non blanching peticheal rashes all over the body. Biopsy shows perivascular neutrophillic infiltrate and IgA deposition. Which of the following is true? 68. Which of the following is not a direct somatoform disorder /specific somatoform disorder? 69. A 50 year old man with aortic stenosis is doing exercise for 11 minutes according to bruce protocol. Exercise had to be stopped due to fatigue. Regional pressure gradient is 60mmHg between the two sides of the aortic valve. What is the best management? 70. 65 years old patient presented to the emergency with high grade temperature and increased respiratory rate. He complained of pain in the chest and had developed cough with expectoration. His sputum was sent to the laboratory for gram straining which showed the presence of pus cells and gram positive cocci. The culture on the blood agar medium was also positive. Which of the following laboratory tests will help to differentiate the specific pathogen from the other commensal gram positive cocci? 71. A newborn presents with congestive heart failure, on examination has bulging anterior fontanellae with a bruit on auscultation. Transfontanellar USG shows a hypoechoic midline mass with dilated lateral ventricles. Most likely diagnosis is 72. A witness who changes his statement becomes hostile witness and is punishable under- 73. Adverse (deleterious) effect of hypothermia are all except: 74. Which of the following is not involved in protein synthesis? a. Ribosome b. Peptidyl transferase c. Aminoacyl tRNA d. RNA polymerase 75. If 4 nucleotide repeats code for a amino acid.what is no. of amino acid coded possible: 76. According to organ transplantation act 1994 what punishment for doctor if found guilty? 77. Drug used for non infectious uveitis in LUMINATE clinical trial program 80. Stack method for age estimation from the dental pattern is used in 81. A middle aged female presents with slowly progressive weakness of lower limbs, spasticity and recent onset hesitancy of micturition. On neurological examination there is evidence of dorsal myelopathy. MRI scan of spine reveals middorsal intradural/ subdural contrast enhancing mass lesion. Diagnosis is: 83. Recent direct thrombin inhibitor which can be used in stroke is 84. Normal functioning ovaries are found in - 85. In a patient presenting with hematuria and hypercalcuria, which of the following can be the associated finding - a. Fracture Femur b. Fracture Tibia c. Fracture Humerus d. Fracture Ulna 87. Intra-epidermal IgG is associated with? 88. A patient has the following lab test-BT=3, PT 15/14, APTT= 45/35, platelet count= 2.5 lacks, factor VIII= 60.The most probable diagnosis is 89. For which of the following conditions giving Prostaglandins is detrimental 90. Cricket player hit his base of right thumb while catching a ball. For which of the following muscle will you investigate further? c. Ulnar collateral ligament d. Volar plate 91. Patient complaining of pain and numbness in middle finger , index finger and thumb of right hand especially during night time. Which test is not done for evaluation of this condition? 92. A diabetic /Alcoholic presents with painless fixed 15 degree flexion deformity in the little finger. Management is 93. Ham's test positive with hemolytic anemia is seen in 94. Best treatment for kawasaki's disease is 95. A Child presents with meningomyelocoele. Investigation to be done is 96. All are true about myelopathies except 97. Girl presents with primary amenorrhea. On examination secondary sexual characters are present but uterus and ovary are absent. What is the probable diagnosis 98. In which of the following conditions ovary is functional 99. A patient with sudden bilateral acute severe vision loss more on the right eye. All other tests are normal. What is the probable diagnosis 100. Man with head injury, after 4 days periorbital and frontal ecchymosis , diagnosis 101. Most common complication after ieall pouch anal anastomosis for IBD is. 104. Which of the following if present is least likely to progress to multiple sclerosis c. B/L optic neuropathy/ blindness d. Not Recalled 106. Not a part of superficial perineal pouch: 107. Lateral most to the femoral hernial sac: 108. Anticoagulant of choice for coagulation test? 109. Most common organ to be affected in Post operative ileus: a. Stomach b. Duodenum c. Ileum d. Colon a.Aanterior part of palate b. Lateral wall of palate c. Medial wall of palate d. Posterior palate 111. Ossification centre first appears – a. End of 2nd month b. Beginning of 2nd month c. End of 3rd month d. Beginning of 3rd month 112. Type D personality were recently found to risk for a. Coronary artery disease b. Depression c. Personality disorder d. Schizophrenia a. Contrast nephropathy b.Drug induced nephropathy c. Atheromatous Plague d.Polynodosa 114. A 20 year old female presents with Hb-9, MCV- 50, ferritin-200, TIBC-294. What is the diagnosis? a. Iron deficiency b. Anemia of chronic disease c. Thalasemia major d. Thalasemia minor 115. WHICH OF THE FOLLOWING DOES NOT AFFECT THE HARDY WINBERG EQUATION? a. Small population b. Random mating c. Not Recalled d. Not Recalled 116. The following are components of Brown Sequard syndrome except: a. Ipsilateral extensor plantar response b. Ipsilateral pyramidal tract involvement c. Contralateral spinothalamic tract involvement d. Contralateral posterior column involvement 117. Structure passing via esophageal hiatus are all except a. Left vagus b. Right vagus c. Left phrenic d. Left gastric artery 118. Vision 2020, who which them does not form part of it WHO Unicef Orbis International Agency For Prevention of Blindness 119. Patient with proptosis and pain after 4 hrs of injury. Also bruise in left eye and frontal area. The diagnosis is a. Caverneous sinus thrombosis b. Internal carotid artery aneurysm c. Carotico cavernous fistula d. Sphenoid fracture 120. Down’s syndrome all are true except- a. Deleted 21 b. Trisomy 21 c. 45,XX,der(14;21)(q10;q10) d. 46,XX/47,XX,+21 121. A child with fever shows CD 10 positive; CD 19 positive; MPO positive; CD 117 positive; CD 3 negative; CD 33 negative; TC= 6000; Hb= 4.5; Platelet count= 20000. The most probable diagnosis is a. ALL b. AML c. Biphenotypuic d. Undifferentiated a. HIVI1 PROTEASE inhibitor b. HIV1 nucleosidase inhibitor c. HIV 1 integrase inhibitor d. HIV entry into cell 123. Which retinal layer is most resistant to radiation (a) RPE (b) Layers of rods and cones (c) Bipolar cell layer (d) Ganglion cell layer a. Bimatoprost b. Latanoprost c. Brimonidine d. Apraclonidine 125. In a patient with urethral syndrome, urine microscopy shows full of polymorph, but no bacteria. The most appropriate culture medium is? 126. First chemical barrier encountered for microorganism for common exposed sites a. Lysozyme b.Acidic ph c. Skin d.Glycogen 127. Yellow sclera and jaundice not seen from birth a.PNH b.G6PD c.SLE d. Hereditory spherocytosis 128. Least significant damage would occur in case of injury to : a. Celiac axis b. Renal artery c. Superior mesenteric artery d. Inferior mesenteric artery 129. In Spondylolisthesis which of this investigation is not useful a. CT scan b. MRI c. Lumbar region x-ray- AP view d. Lumbar region x-ray - lateral view 130. Proven case of renal papillary necrosis - what investigation on urine you would not do: a. Urine acidification test b. Sickling test c. TB-PCR - urine 131. A 75 yrs with focal seizures with normal renal function, Drug of choice is ? a. Valporate b.Pregbalin c.Levitriacetam d. Carbazepam 132. A person had infection due to gram positive organism treated with methicillin and then culture sensitivity shows resistance to it. Hence all can be given in MRSA except? a. Vancomycin b. Cotrimoxazole c. Cefaclor d. Ciprofloxacin 133. Heterotrophic ossification - most important investigation you would do for management: a. Alkaline phosphatase b. K+ c. Acid phosphatase d. Calcium 134. A surgeon with less experience of laproscopic cholecystectomy while doing lap surgery founds stone in common bile duct. What should he ideally do? a. Open cholecystectomy with choledocoduodenostomy b. Lap exploration of CBD and removal c. Lap removal of stone though bile duct d. Open exploration of CBD 135. All prevent delivery of after coming head of fetus except a. Extended head b. Hydrocephalus c. Placenta previa d. Incomplete dilation of cervix 136. A new born baby presented with blisters on skin and a shin on knee. Best investigation for diagnosis is- a. VDRL B.MANOUX on blister fluid c. TPI d. TPHA 137. Which of the following is not a limb girdle myopathy a.Sarcoglycanopathy b. Dystrophinopathy c. Calpainopathy d. Not Recalled b. FBS >125 and PPBS >199 c. HbA1c = 5.5% d.FBS more than 70 139. CV malformations are all of these except: a. Rheumatoid arthritis b. Ankylosing spondylitis c. Odontogenesis d. Basilar invagination 140. Not a pre malignant among the given is- a. PNH b. PCH c. Aplastic anemia d. Myelodysplastic 141. Mechanism of injury in ant shoulder dislocation – a. Abduction and external rotation b. Adductio0n and internal rotation c. Abduction and internal rotation d. Adduction and external rotation a. Patient feeling towards doctor b. Doctors feeling towards patient c. Not Recalled d. Not Recalled 143. For confirmation of DNA from autopsy sample is taken from 144. A 28 year female with infertility had been investigated with HSG reveled bilateral cornual block. Next best investigation to be done is – a. Tuboplasty b. IVF c. Hydrotubation d. Laprocscopy and hyseteroscopy 145. Karyotyping of fetus can be done from all except- a. Chronioc villous sampling b. Cordocentesis c. Amniocentesis d. Fetal skin biopsy 146. Xenon anesthesia all are true accept- a . Slow induction and emergence b. Non explosive c. Less cardiovascular side-effect d. Not Recalled. 147. A patient with history of trauma attended emergency with right renal hematoma. IVP shows descerblity on right kidney and left kidney normal uptake. Next line of management- a. Exploration of kidney b. Nephrectomy c. On table RUG d. Not Recalled a. competitive and reversible carbonic anhydrase inhibitor. b. non-competitive and reversible carbonic anhydrase inhibitor. c. competitive and irreversible carbonic anhydrase inhibitor. d. competitive and irreversible carbonic anhydrase inhibitor. 149. A patient had enlarged pituitary gland on MRI scan. His thyroid profile revieled increased TSH and T4 decreased. What may be the probabale cause? a. Primary hypothyroidism b. Pitutary tumor c. Pitutory throtrophic adenoma d. Not Recalled 150. Conversion of T4 to T3 is inhibited by all except- a.Propanolol b.Propyl thiouracil c.Amiodarone d. Methiimazole 151. A 16 yrs olf female has a solid content in USG finding with normal alpha fetoprotein, normal hCG, increased alkaline phosphatase . Most probable cause may be a.Dysgerminoma b.Teratoma. c.Endodermal sinus tumor d.Mucinous cystadenoma 152. A 18 year old female presented in infertility clinic with bilateral inguinal hernia; history reverel- Primary amenorrhea, but had normal secondary sexual characteristic with absent pubic hair. Most probable diagnosis is a. AIS b. Turner’s c. MRKH d. Mullerian duct agenesis a. Freeze to preserve clotting factor b. Rush to hospital in 2 hour c. Platelet rich plasma d. Activated by kaolin 154. Which of the following drug is used as Transcranial patch for Parkinsons disease a. Levodopa b. Rotigotine c. Selegiline d. Carbidopa 155. MRI appearance of cavernous angioma- a. Popcorn appearance b. Sun ray appearance c. Not Recalled d. Not Recalled a. Erectile dysfunction b. Ca prostate c. LUTs d. Metastatic RCC 157. A 30 yrs old executive complains of excessive sleepiness in daytime and lack of sleep at night. Once at a party his friends noticed of his sudden fall due to sleep. He may have a. Seizures b. Night mares c. Apnoea during sleep d. Not Recalled 158. A child presented with leaking menigiomyelocoele. Which of the following would be most appropriate for diagnosis? a. Wound swab and culture b. Blood culture c. Urine culture d. CBC 159. 40 mm gap between & tropocollagen is for which molecule so as to allow deposition in bone a.Calcium b. Iron c. Manganese d. Phosphorus 160. All changes occurs in pregnancy except – a. Increase in peripheral vascular resistance. b. Increase in stroke volume c. Increase in cardiac output d. Increase in blood volume 161. Hormone replacement therapy decreases all of the following except- a) Vaginal dryness b)Hot flushes C) Prevention of cardiovascular risk d)Prevention of osteoporosis a. Schizophrenia b. Hypochondriac disorder c. Body dysmorphic disorder d. Depression a. Mania and depression b. Hypomania and sub acute depression c. Hypomania and depression d. Mania and sub acute depression 164. Rheumatoid arthritis is best diagnosed by a. Anticitrulline antibody b. Ig G antibody c. Ig A antibody d. Ig M antibody 165. Acute pancreatitis severity associated with all except: 166. Suppose you are working in a remote PHC and you have to send a blood sample for estimation of blood glucose level, following agent is used – 167. A child presented with jaundice and history of passing clay colored stool. The following enzymes will be elevated except: 168. You have diagnosed a patient clinically as having SLE and ordered 6 tests. Out of which 4 tests have come positive and 2 are negative. To determine the probability of SLE at this point, you need to know: a. Prior probability of SLE; sensitivity and specificity of each test b. Incidence of SLE and predictive value of each test 169. A patient admitted to an ICU is on central venous line for the last one week. He is on ceftazidime and amikacin. After 7 days of antibiotics he develops a spike of fever an his blood culture is positive for gram positive cocci in chains, which are catalase negative. Following this, vancomycin was started but the culture remained positive for the same organism even after 2 weeks of therapy. The most likely organism causing infection is: 170. With reference to bacterioides fragilis the following statements are true, except: a. B. fragilis is the same frequent anaerobe isolated from clinical samples b. B. fragilis is not uniformaly sensitive to metronidazole c. The lipopolysaccharide formed by B. fragilis is structurally and functionally different from the conventional endotoxin d. Shock and disseminated intravascular coagulation are common in bacteroides a. Positive regulator b .Negative regulator c. Attenuation d. Constituted expression 172. All of the following regarding drug metabolism are correct EXCEPT- a. Calcium channel blockers-CYP3 b. Celiprolol- CYP2D6 c. Digitoxcin – p-gp d. Not Recalled 173. A new method of measuring Hb concentration was developed. The ten result of one sample are as follows-9.4, 10.4, 9.6, 10.8, 9.1, 12.1, 10.1, 9.8, 9.2 and 9.5. But the Hb level measured by standard colorimetry was 10.2. Thus this method has- a. low validity low reliability b. low validity and high reliability c. high validity and low reliability d. high validity and high reliability 174. Direct standardization is used to compare the mortality rates between two countries because of differences in: a. Cause of death b. Numerators c. Age distributions d. Denominators 175. Mother’s breast milk is essential for newborn .It also contain which of the following- 176. The complete amino acid sequence of the two polypeptide chains of insulin was studied and a Noble prize was awarded to- a. Frederick Sanger b. Banting and Best c. Not Recalled d. Not Recalled 177. Drug of choice of Congenital Adrenal Hyperplasia is a. Dexamethasone b. Betamethasone c. Hydrocortisone d. Predinsolone 178. A patient presents with LDL = 600 and TG= 140; which of the following may be present? a. Tender xanthomas b. Plantar xanthomas c. Tuberoeruptive xanthomas d. Lipemia retinalis 179. Gold standard study for clinical research is a. Randomised double blinded clinical trial b. Systemic meta-analysis c. Ecological study d. Retrepospective cohot study 182. A child presents with erythramatous and itching with redness of both the cheeks. There was history of sudden onset macule and papule. Mother has history of bronchial astham. Most probable diagnosis is b. Infections eczematoid dermatitis c. Drug eruption d.Psoriasis 183. All are inaccurate regarding forceps delivery except? a. The anteroposterior diameter of head should not be more than 15 degree to the axis b. The presentation should be vertex or mentoanterior c. The presenting part should be at at zero station d. Caput succedaneum is not a contraindication 184. Which among the following is not a ultrasound feature of Congenital Hypertrophic Pyloric Stenosis? 185. All are limb girdle dystrophies except? 186. If a doctor indulges in giving a false medical certificate to a patient, he is liable to be prosectuted under? 187. Universal definition of myocardial infarction includes all except? b. New abnormal wall motion with raised cardiac biomarkers d. Reperfusion leads to elevation of troponin levels in 5-7% 188. Which is the only drug effective in EDSS in multiple sclerosis? 189. A 4 month pregant lady on treatment with valproate regularly asked for your advice regarding taking the drug during pregnancy. What is the best course of action? a. Immediately taper off valproate and start lamotrigine c. Continue valproate with dose monitoring 190. All are inaccurate regarding forceps delivery except? a. The anteroposterior diameter of head should not be more than 15 degree to the axis b. The presentation should be vertex or mentoanterior c. The presenting part should be at at zero station d. Caput succedaneum is not a contraindication 191. All are true about oxygenase except? d. Help in carboxylation reaction of steroids 192. A young male who had a road traffic accident, presented with a non pulsatile retroperitoneal hematoma. On table intravenous urogram was done. Right kidney was not visualised. Left kidney showed immediate excretion of dye. What is next step in management? b. Explore proximal renal vessels, open Gerota’s fascia and explore kidney 193. All are true regarding vitamin D except- a. Hydroxylation occurs in liver b. 25 hydroxylation occur in kidney c. Vit d 400-600 is required in absence of sunlight d. Wilsons syndrome 194. Preleukemic conditions are all accept? 195. A 25 year old lady on treatment for rheumatoid arthritis has the following lab findings. Haemoglobin – 6g, MCV – 60fl,RBC= 2.5 lakhs, Ferritin – 200ng/ml. Transferrin – 298 mg/dl. Iron -=30 What is the probable diagnosis? 196. 17 year old female presented with a history of primary amenorrhoea. She had bilateral inguinal hernias. Secondary sexual characters were present. Pubic hair was absent. Which among the following is the most probable diagnosis? 197. Indications of glucose tolerance test in a pregnant woman are all except? 198. A 25 year old lady presented with fever of 1 month duration, ataxia and head ache. Brain imaging showed dilated ventricles with basal exudates. Which among the following is the most likely CSF finding? a. Lymphocytic pleocytosis, low sugar, high protein b. Lymphocytic pleocytosis, low sugar, low protein c. Lymphocytic pleocytosis, high sugar, low protein d. Neutrophilic pleocytosis, low sugar, high protein 199. Drug not used in multiple sclerosis? 200. Most Common site of cholangiosarcoma a.Intrahepatic bile duct b.Origin of cystic duct c.Common bile duct d.Extrahepatic bile duct

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