(Paper) AIIMS EXAMINATION PAPER WITH ANSWERS EXPLANATIONS YEAR 2003 (Pg-2)

AIIMS EXAMINATION PAPER WITH ANSWERS EXPLANATIONS YEAR 2003

Page -2

26 With reference to bacteroides fragilis all of the following statements are true except. 

1 It is the most frequent anaerobe isolated from clinical samples. 
2. It is not uniformly sensitive to metronidazole.
3. The lipopolysaccharide formed by B. fragills is structurally and functionally different from the conventional endotoxin. 
4. Shock and disseminated intravascular coagulation are common in bacteremia due to B. fragilis
Ans 4 DIC and purpura are less common as LPS lacks biological potency as seen in other gram -ve bacteria.

27. All of following statements are true regarding Q fever except. 

1. It is a zoonotic infection. 
2. Human disease is characterized by an interstitial pneumonia 
3. No rash is seen 
4. Weil Felix reaction is very useful for diagnosis. 
Ans 4

28. The following statements are true regarding botulism except.

1. Infant botulism is caused by ingestion of preformed toxin. 
2. Clostridium botulinum A, B, C and F cause human disease. 
3. The gene for botulinum toxin is encoded by a bacteriophage. 
4. Clostridium boriatti may cause botulism. 
Ans 1

29. Streptococcal Toxic shock syndrome is due to the following virulence factor. 

1. M protein 
2. Pyrogenic exotoxin 
3. Streptolysin O. 
4. Carbohydrate cell wall. 
Ans 2 M protein resists phagocytosis. Pyrogenic toxin causes TSS.

30. A 24 year old male presents to a STD clinic with a single painless ulcer on external genitalia. The choice of laboratory test to look for the etiological agent would be: 

1. Scrappings from ulcer for culture on chocolate agar with antibiotic supplement.
2. Serology for detection of specific IgM antibodies. 
3. Scrappings from ulcer for dark field microscopy. 
4. Scrappings from ulcer for tissue culture. 
Ans 3 (presumably to look for Treponema pallidium.)

31. There has been an outbreak of food borne salmonella gastroenteritis in the community and the stool samples have been received in the laboratory. Which is the enrichment medium of choice:

1. Cary Blair medium 
2. V R medium 
3. Selenite "F" medium 
4. Thioglycollate medium. 
Ans 3

32. A 20 year old male had pain abdomen and mild fever followed by gastroenteritis. The stool examination showed presence of pus cells and RBCs on microscopy. The etiological agent responsible is most likely to be: 

1. Enteroinvasive E. coli. 
2. Enterotoxigenic E. coli. 
3. Enteropathiogenic E. coli. 
4. Enetroaggregative E. coli. 
Ans 1

33. A man presents with fever and chills 2 weeks after a louse bite. There was a maculo-popular rash on the trunk which spread peripherally. The casue of this infection can be: 
1. Scurb typhus. 
2. Endemic typhus. 
3. Rickettsial pox. 
4. Epidemic typhus. 
Ans 2

34. The virulence factor of Nesseria gonorrhoeae includes all of the following except.
1. Outer membrane proteins 
2. IgA Protease 
3. M- Proteins 
4. Pilli 
Ans 3

35 A patient in an ICU is on a CVP line. His blood culture shows growth of grain positive cocci which are catalase positive and coagulase negative. The most likely etiological agent is: 

1. Staplylococcus aureus 
2. Staplylococcus epidermidis 
3. Streptococcus pyogenes 
4. Enterococcus faecalis. 
Ans

36. According to WHO criteria, the minimum normal sperm count is: 

1 10 million/ml
2 20 million/ml
3 40 million/ml
4 60 million/ml
Ans 2 (Below 20 is oligospermia, Normal is 60-120 Million/ ml)

37 In triple screening test for Down's syndrome during pregnancy all of the following are included except.
1. Serum beta hCG 
2. Serum oestriol 
3. Maternal serum Alfa fetoprotein 
4. Acetyl cholinesterase
Ans 4

38 An optic nerve injury may result in all of the following except.
1. Loss of vision in that eye. 
2. Dilatation of pupil.
3. Ptosis 
4. Loss of light reflex. 
Ans 3

39. The commonest cause of occipito- posterior position of fetal head during labour is: 

1.Maternal obesity 
2.Deflexion of fetal head 
3.Multiparity 
4.Android pelvis.
Ans 2

40. The commonest cause of breech presentation is 
1. Prematurity 
2. Hydrocephalus 
3. Placenta previa 
4. Polyhydramnios 
Ans

41. The commonest congenital anomaly seen in pregnancy with diabetes mellitus is 
1. Multicystic kidneys 
2. Oesophageal atresia 
3. Neural tube defect 
4. Enalapril 
Ans

42. Use of which of the following drug is contra-indicated in pregnancy. 
1. Digoxin 
2. Nigedipine 
3. Amoxycillin 
4. Ealapril 
Ans 4

43. Following renal disorder is associated with worst pregnancy outcome. 
1. Systemic lupus erythematosus 
2 IgA nephropathy 
3. Autosomal dominant polycystic kidney disease 
4. Scleroderma 

Ans 1 COGDT 2003 says that "Scleroderma remains the same or improves slightly during pregnancy." ADPKD presents like scleroderma after 40.IgA nephropathy improves in pregnancy. SLE is associated with a bad outcome about 30% stillbirths. SO SLE is the answer here. ALSO as COGDT says that in quiescent SLE pregnancy may be normal or result in preterm baby without other serious complications.

44. A perimanopausal lady with well differentiated adenocarcinoma of uterus has more than half myometrial invasion, vaginal metastasis and inguinal lymph node metastasis. She is staged as:

1. Stage III B 
2 Stage III C
3. Stage IV a 
4. Stage IV b 
Ans 4 Page 1109 CSDT 11 ed. (Table). Only vaginal metastiais would be stage IIIB, only more than half invasion of myometrium would have been stage IC.

45. The following combination of agents are the most preferred for short day care surgeries 

1. Propofol, fentanyl, isoflurane 
2 Thiopentone sodium, morphine, halothane 
3. Ketamine, pethidine halothane 
4. Propofol, morphine, halothane 
Ans 1 Ref Lee.

46. All of the following drugs have been used for medical abortion, except. 
1. Mifepristone. 
2. Misoprostol
3. Methotrexate 
4. Atosiban 
Ans 4 [Page 547 Dutta "Atosiban is an oxytocin analogue, It counteracts the effect of endogenous oxytocin.So, It can inhibit oxytocin induced preterm labour.]
[Medical abortion: Done when women come within 49 days from LMP.
Protocol is IM Methotrexate (50 mg/metre square) given on day 1 and then Misoprostol (prostaglandlin E1) inserted Vaginally on day 5,6,7. Suction curretage may be needed after 2 weeks if pregnancy appears viable, IF gestational sac persists for more than 4 weeks after methotraxate or IF excessive bleeding occurs during anytime. (only 10-15 % require Suction curretage)]
[About Mifepristone: = RU-486, It is a synthetic steroid. It occupies progesterone binding sites but does not release heat shock protein[Progesterone does].
So this drug blocks stimulatory effect of progesterone on endometrial growth, also it blocks inhibitory effect of progesterone on uterine contractility--causing abortion.
It has been used with prostaglandlins to cause abortions]
[Team AIPPG; & Murali, Bangalore (MMC)]

47. A 21 year old primigravida is admitted at 39 weeks gestation with painless antepartum haemorrhage. On examination uterus is soft, non tender and head engaged. The management for her would be: 

1. Blood transfusion and sedatives. 
2. A speculum examination 
3. Pelvic examination in OT 
4. Tocolysis and sedatives. 
Ans 3

48. Which statement is true regarding VENTOUSE (Vacuum Extractor) 
1. Minor scalp abrasions and subgaleal haematomas to new born are moe frequent than forceps.
2. Can be applied when foetal head is above the level of ischial spine. 
3. Maternal trauma is more frequent than forceps. 
4. Can not be used when fetal head is not fully rotated. 
Ans 2

49. A drop in fetal heart rate that typically lasts less than 2 minutes and is usually associated with umbilical cord compression is called. 
1. Early declaration 
2. Late declaration 
3. Variable declaration 
4. Prolonged declaration 
Ans 3 [Visit AIPPG forum / Message Board at www.aippg.net/forum]

50. All the following are known side effects with the use of tocolytic therapy except.
1. Tachycardia 
2. Hypotension 
3. Hyperglycemia 
4. Fever 
Ans 2

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