Saturday, April 13, 2013

NOV AIIMS 2012 -GENERAL MEDICINE


GENERAL MEDICINE
1.                      A patient on amphotericin B develops hypokalemia of 2.3meq/l. K+ supplementation requires is?
a.       40meq over 24 hrs
b.      60meq over 24 he's
c.       80 meq over 24 hrs
d.      120-160meq over 24 hrs
Answer (A) 40meq over 24 hrs

2                      A patient with 12cm abscess in liver which was drained under sonographic monitoring 3 times and On follow up a residual cavity of 4cm was found to be present .An oral lumicidal drug was given for 14 days. Next plan of action shall be:           
a.       Stool examination serially
b.      USG weekly for 1 month followed by monthly USG till 1 year.
c.       USG weekly for 1 month followed by CT scan at 3 months.
d.      Monthly CT scan
Answer (b) USG weekly for 1 month followed by monthly USG till 1 year.


3.                      Which of the following is Not true aboutpolymyositis ?
a.       Limb girdle weakness
b.      Ophthalmoplegia
c.       Para-neoplastic syndrome
d.      Spontaneous discharge in EMG.
Answer (B) Ophthalmoplegia

4.                      35 year old female with recurrent renal stone. not advised is:
a.       Increase water 
b.      Restrict protein
c.       Restrict salt
d.      increased salt intake
Answer (D) 

5                     A 28 yr old man has lenticonus and ESRD now. His maternal uncle also died of similar illness. Diagnosis is
a.       ARPKD          
b.      ADPKD
c.       Oxalosis
d.      Alport's syndrome
Answer: (D) Alport’s syndrome

5.                      Pinna calcification Except
a.       Gout
b.      Onchrnosis
c.       Frost bite
d.      Addisons disease
Answer (a) Gout
6.                      Which of the following doesnot need treatment?
a.       Neuroblastoma
b.      Burkitts
c.       t cell lymphoblastic leukemia
d.      Not Recalled
Answer is A

7.                      With ageing, a slight decrease in cognitive impairment is seen due to increase in level of
a.       Homocysteine
b.      Taurine
c.       Methionine
d.      Cysteine
Answer (a) Homocysteine

8.                      A Patient presents with pain in Meta-Tarso-Phalangeal jointsM.T.P.andis a known case of Chronic Renal Failure. This is due to accumulation of-
a.       Rh factor
b.      Uric acid
c.       Serum urea
d.      HLA B27 typing
Answer (b) Uric Acid

9.                      SARS causative agent
a.       Corona-virus
b.      Picorna-virus
c.       Myxovirus
d.      Recalled
Answer: (a) Corona-virus

10.                      Blink reflex is used for?
a.       Mid pontine lesions
b.      Neuromuscular transmission
c.       Axonal neuropathy
d.      Motor neuron disease
Answer (a) Mid pontine lesions
11.                      Grisel syndrome all are true except:
a.       Post-adeniodectomy
b.      Conservation treatment
c.       Inflammation of cervical spine ligaments
d.      No need for neurosurgeon
Answer (d) No need for neurosurgeon

12                      Cervical syringomyelia all are seen except
a.       Burning sensation in hands
b.      Hypertrophy of abductor pollicis brevis
c.       Plantar extensor
d.      Absent biceps reflex.
Answer: (b) Hypertrophy of abductor pollicis brevis
13.                      70year female is on treatment with Alendronate for severe osteoporosis.Now she complains of pain in right thigh. What is the next investigation to be performed?
a.       DEXA scan
b.      x ray
c.       Serum vitamin D levels
d.      Serum alkaline phosphate levels
Answer (b) X-ray

14.                      A 70 year old retired Military person with good previous medical record complains of bi-temporal headache which is decreased in lying down position. He states that he gets relief by giving pressure over bilateral temples. The patient also complains of loss of appetite with feeling feverish.
a.       Chronic tension headache
b.      Temporal arteritis
c.       Migraine
d.      Fibromyalgia
Answer (b) Temporal arteritis

15.                      A patient of rheumatoid arthritis develops sudden onset Quadriparesis, , increased muscle tone of limbs with exaggerated tendon jerks and worseningof  gait. The investigation to be done:
a.       Flexion and extension Cervical area X ray of neck
b.      MRI brain
c.       EMG and NCV
d.      Carotid angiography
Answer( a) Flexion and extension Cervical area X ray of neck

16.                      Patient with ICD collapses, ICD imaging modality
a.       Chest x ray
b.      MRI
c.       CT
d.      USG
Answer (a) Chest X ray

17.                      Type 1 renal tubular acidosis all are true,Except?
a.       Renal stones
b.      Hypokalemia
c.       > 4mg/ day Sodium bicarbonate         
d.      Urine pH > 5.
Answer (c) > 4mg/ day Sodium bicarbonate

18.                      A diabetes mellitus patient with fungal infection of sinuses and peri-orbital region with significant visual impairment:
a.       Amphotericin B
b.      Itraconazole
c.       Ketoconazole
d.      Broad spectrum antibiotics
Answer: Amphotericin B

19.                      Gait apraxia?
a.       ACA
b.      MCA
c.       PCA
d.      Posterior choroidal artery
Answer a ACA

20.                      Prions, which of following is correct
a.       Long incubation period
b.      Destroyed by autoclaving at 121C
c.       Nucleic acid present
d.      Immunogenic
Answer (a) Long incubation period

21.                      A patient with Tubercular meningitis was taking ATT regularly. At end of 1 month of regular intake of drugs deterioration in sensorium is noted in condition of the patient. Which of the following investigations is not required on emergency evaluation?
a.       MRI
b.      NCCT 
c.       CSF examination
d.      Liver function tests
Answer (c) CSF examination

22.                      What is feature of temporal arteritis
a.       Giant cell arteritis
b.      Granulomatous vasculitis
c.       Necrotizing vasculitis
d.      Leucocytoclasticvasculitis
Answer (a) Giant cell arteritis
23.                      A patient withHepatits C, exhibits hypo-complimentemia, 2g/day proteinuria andhematuria is present. The most probable diagnosis is: 
a.       M.P.G.N.        
b.      Cryo-globulinemia
c.       Membranous Glomerulopathy
d.      Post-infectious Glomerulonephritis
Answer (a) M.P.G.N.

24                      All are indicated in a patient increased s. cysteine and multiple renal stones except:
a.       Cysteamine or
b.      Increase fluid intake
c.       Alkalinisation of urine
d.      Pencillamine
Answer: (a) Cysteamine 

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