(Study Material) ALL INDIA 2005 (AIPGE 2005 January, Answers, Explanation and Notes) (Pg-10)
PAPER : ALL INDIA 2005 (AIPGE 2005 January, Answers, Explanation and Notes)
Page -10
Q.226. Misoprostol has been found to be effective in all of the following
except:
1. Missed abortion.
2. Induction of labour.
3. Menorrhagia.
4. Prevention of post-partum hemorrhage (PPH).
Q.227. All of the following appear to decrease hot flushes in menopausal women
except:
1. Androgens.
2. Raloxifene.
3. Isoflavones.
4. Tibotone.
Answer is 2
CMDT2004/1140
• Androgen deficiency contributes to hot flushes; loss of libido and sexual
hair, muscle atrophy, and osteoporosis, selected women may be treated with low
dose methyl testosterone. Androgen should not be given to women with liver
disease; during pregnancy or breast-feeding.
• Raloxifene alternative to estrogen in postmenopausal women to prevent
osteoporosis. But it does not reduce hot flushes, vaginal dryness, skin
wrinkling, or breast atrophy. While it can lead to hot flushes as a side effect.
• Raloxifene increases risk of venous thromboembolism.
• Tibolone have mixed estrogenic, progestogenic and weak androgenic activity,
it reduces the climacteric-related complication.
• Isoflavons - are phytoestrogen (soy phytoestrogen occurs nasturally)
- Bind weakly to E.R.? but strongly to E.R.B.
- Daily intake of Soy proteins reduces hot flushes by about 45% with in 12
weeks.
Q.228. In a case of Dysgerminoma of ovary one of the following tumor markers is
likely to be raised:
1. Serum HCG.
2. Serum alphafetoprotein.
3. Serum lactic dehydrogenase.
4. Serum inhibin.
Malcolm Coppleson,
Gynecologic Answer is 3 Oncology
2nd ed/918-921.
Lipincott - Roven publication, S - Jean Emans, Marc
R - Pediatric and adolescent gynecology 4th ed./575.
Dysgerminoma is most common malignant germ cell tumor of the ovary, representing
2% of all ovarian malignancies.
LDH, PLAP, and CA 125 may be elevated and in some instances can serve as tumor
marker. LDH in particular has been successful in predicting recurrence in
testicular seminoma and dysgerminoma.
LDH is elevated in some patient with dysgerminoma, and the levels and the
isoenzyme pattern (LDH-1 and LDH-2) may be useful in suggesting the diagnosis
preoperatively.
Q.229. Use of one of the following vaccination is absolutely contraindicated in
pregnancy:
1. Hepatitis-B.
2. Cholera.
3. Rabies.
4. Yellow fever.
Q.230. The most common cause of secondary amenorrhoea in India is:
1. Endometrial tuberculosis.
2. Premature ovarian failure.
3. Potycystic ovarian syndrome.
4. Sheehan’s syndrome.
Q.231. In Klippel-Feil syndrome, the patient has all of the following clinical
features except:
1. Low hair line.
2. Bilatereal Neck webbing.
3. Bilateral shortness of sternomastoid muscles.
4. Gross limitations of neck movements.
Q.232. The most common sequelae of tuberculous spondylitis in an adolescent is:
1. Fibrous Ankylosis.
2. Bony-Ankylosis.
3. Pathological dislocation.
4. Chronic osteomyelitis.
Q.233. In Radionuclide imaging the most useful radio pharmaceutical for skeletal
imaging is:
1. Gallium 67 (67Ga).
2. Technetium-sulphur-colloid (99mTc-Sc).
3. Technetium-99m (99mTc).
4. Technetium-99m linked to Methylene disphosphonate (99mTc-MDP).
Q.234. Heberden’s arthropathy affects:
1. Lumbar spine.
2. Symmetrically large joints.
3. Sacroiliac joints.
4. Distal interphalangeal joints.
Q.235. Subtrochanteric fractures of femur can be treated by all of the following
methods except:
1. Skeletal traction on Thomas’ splint.
2. Smith Petersen Nail.
3. Condylar blade plate.
4. Ender’s nail.
Q235. Ref- Chapman”s orthopaedic surgery 3rd Ed ,Pg 655-660
-Locked medullary nails were used for closed nailing of proximal femoral
fractures. All closed
adult subtrochantic fractures below the level of lesser trochanter can be safely
nailed with first generation nail, regardless of the fracture pattern or degree
of communition
-Ender”s nail has particular advantage in unusual situations where the soft
tissues around the hip preclude the use of any device that enters for hip, and
ender”s nail can be inserted through the knee
-Condylar blade plate is used for anatomic reduction and stable fixation of all
fragments
Q.235. Apley’s Orthopedics 8th ed/694
Chapman’s orthopedic surgery 3rd ed/653.
Treatment of subtrochanteric fracture
• Open reduction and internal fixation is treatment of choice.
• Compression (Dynamic) Hip screw and plate is satisfactory.
• Intramedullary nail are equally good for stablization
• Devices used in subtrachenteric fracture are -
1)Locked nail (interlocking nail) - Altanail technique is reamed locked
intramedullary nailing.
2)Zickel’s nail
3)Ender nail
4)95o blade plate.
5)95o dynamic condylar screw.
• There has been nearly a complete elimination of nonoperative treatment in
adult and increase in
operative treatment of sub-trochanteric fracture.
Answer is (1).
Q.236. All of the following are true about fracture of the atlas vertebra,
except:
1. Jefferson fracture is the most common type.
2. Quadriplegia is seen in 80% cases.
3. Atlantooccipital fusion may sometimes be needed.
4. CT scans should be done for diagnosis.
236. Apley’s Orthopedics 8th ed/650.
Fracture atlas -
• Jefferson fracture.
• Usually no neurological deficit.
• Fracture seen on open mouth view.
• CT scan is particularly helpful.
• Undisplaced fracture - Treated with semi-rigid collar or halo vast until
fracture unite.
• If sideway spreading of latest mass (> 7 mm on open mouth view) or
ruptured transverse ligament
or unstable injury - treated with holo cast for several weeks.
• If persisting instability on X-ray - a Posterior C1-2 (atlanto axial)
arthrodesis is
considered.
• Fracture of atlas are associated with injury elsewhere in cervical spine in
upto 50% of cases.
Odontoid fracture and hangman’s fracture should be excluded.
CAMPBELL’S operative Orthopedics 9th ed/2722
Chapman’s Orthopaedic Surgery 3rd ed/3674-77.
- The initial description of C1 arch was given by Jefferson (so fracture C1 arch
in whole can be said Jefferson fracture). But typical Jefferson fracture is type
III fracture, which having
fracture of both anterior and posterior arch of atlas. It is called the burst
fracture (Jefferson fracture), which is characterized by 4 fracture - 2 in
posterior arch and 2 in anterior arch.
- However most common injury is type I fracture which is isolated posterior arch
fracture.
- It is result from the hyperextension - axial loading injury.
- Second M/c fracture is lateral mass fracture.
- Typical Jeferrson fracture is 3rd m/c fracture.
Hence only correct choice is (4).
But best answer of this question is (2), because neurological deficit is seen in
atlantoaxial dislocation (even if it is also severe.
Q.237. A 30 year old man had road traffic accident and sustained fracture of
femur. Two days later he developed sudden breathlessness. The most probable
cause can be:
1. Pneumonia.
2. Congestive heart failure.
3. Bronchial asthma.
4. Fat Embolism.
Q.238. A 45 year old was given steroids after renal transplant. After 2 years he
had difficulty in walking and pain in both hips. Which one of the following is
most likely cause?
1. Primary Osteoarthritis.
2. Avascular necrosis.
3. Tuberculosis.
4. Aluminum toxicity.
Q.239. All of the following are branches of the external carotid artery except:
1. Superior thyroid artery.
2. Anterior Ethmoidal artery.
3. Occipital artery.
4. Posterior auricular artery.
239. B.D. Chaurusiya Head and Neck ed. /p 103 and 87
Branches of external carotid A
(A) Anterior - Sup. thyroid, lingual and facial
(B) Posterior - occipital, post. auricular
© Medial - ascending pharyngeal
(d) Terminal - Maxillary and superficial temporal A
- Anterior ethmoidal A is branch of ophthalmic A, this is branch of interior
carotid A.
Q.240. All are true for Gradenigo’s syndrome except:
1.It is associated with conductive hearing loss.
2.It is caused by an abscess in the petrous apex.
3.It leads to involvement of the Cranial nerves V and VI.
4.It is characterized by retro-orbital pain.
Q240. Ref-Diseases of Ear, Nose & Throat,3rd Ed,P L Dhingra,Pg-103
Gradenigo Syndrome is the classical presentation of petrositis & consists of
triad of
a.External rectus palsy (vi nerve palsy)
b.Deep seated ear or retro-orbital pain(vth nerve involvement)
c.Persistent ear discharge-ie petrositis
Hence the Answer is 1
Q240. Ref-Diseases of Ear, Nose & Throat. 3rd edition, P.L.Dhingra
Gradenigo’s syndrome is the
classical presentation of petrositis & consists of triad of:
1.External rectus palsy (VIth nerve palsy)
2.Deep-seated ear or retro-orbital pain (Vth nerve involvement).
3.Persistent ear discharge-which points to petrosistis.
Q.241. The most common and earliest manifestation of carcinoma of the glottis
is:
1. Hoarseness.
2. Haemoptysis.
3. Cervical lymph nodes.
4. Stridor.
241. Dahnert’s radiological review manual 5th edition/382.
- Glottic C.A is most common type of C.A. larynx.
- Earliest symptom is hoarseness.
- M/C symptom is hoarseness in C.A. Glottis.
- Supraglottic carcinoma is detected late due to minimal symptomatology.
Answer - (1).
Q.242. Abbey-Estlander flap is used in the reconstruction of:
1. Buccal mucosa.
2. Lip.
3. Tongue.
4. Palate.
Q.243. Androphonia can be corrected by doing:
1. Type 1 Thyroplasty.
2. Type 2 Thyroplasty.
3. Type 3 Thyroplasty.
4. Type 4 Thyroplasty.
Q243 . Ref –ENT,Head & Neck Sur 22nd Ed- Vol-3,Pgs 2072,2089-90.
Isshiki categorized laryngeal phonosurgery in to four types based on
Functional alteration of vocal folds
-medial displacement (type-1 thyroplasty)
-lateral displacement (type-2)
-shortening or relaxation (type-3)
-elongation or tensioning procedures (type-4)
-lenthening procedure (type-4) have been advocated for vocal fold bowing
resulting from aging or trauma , post-surgical defects, androphonia & gender
transformation
-type –3 for adductor spasmodic dysphonia, mutational falcetto & gender
transformation.
Ans-D
Q.244. In which one of the following perineural invasion in head and neck cancer
is most commonly seen?
1. Adenocarcinoma.
2. Adenoid cystic carcinoma.
3. Basal Cell Adenoma.
4. Squamous cell carcinoma.
244. Robbin/s Pathology
Dahnert radiological review manual 5th eds/369
- Adenoid cystic C.A. (Cylindroma)
40-70 yr age group, M=F
- Most common malignant neoplasms of minor salivary gland
(Hard Palate is commonest site)
- This tumor have propensity for perineural spread along facial nerve.
Q.245. Use of Seigel’s speculum during examination of the ear provides all
except:
1. Magnification.
2. Assessment of movement of ithe tympanic membrane.
3. Removal of foreign body from the ear.
4. As applicator for the powdered antibiotic of ear.
Textbook of ENT by Mohd. Maqbool 10th ed/26
- Speculum consists of a 10 diopter lens and a side to be connected with a
rubber bulb.
- An air tight system is produced in canal and pressure is increased by bulb.
- Speculum is useful for the following reason -
1) It gives a magnified view of the membrane
2) It is helpful to assess the mobility of the membrane.
3) The speculum is used to elicit the fistula sign.
4) By varying the pressure, discharge through the perforation can be sucked out
as well as medication can be put into the middle ear.
Hence Answer is (3).
Q.246. Blood specimen for neonatal thyroid screening is obtained on:
1. Cord blood.
2. 24 hours after birth.
3. 48 hours after birth.
4. 72 hours after birth.
Q.247. A child with recurrent urinary tract infections is most likely to show:
1. Posterior urethral valves.
2. Vesicoureteric reflux.
3. Neurogenic bladder.
4. Renal and ureteric calculi.
Q.248. The appropriate approach to a neonate presenting with vaginal bleeding on
day 4 of life is:
1. Administration of vitamin K.
2. Investigation for bleeding disorder.
3. No specific therapy.
4. Administration of 10ml/kg of fresh frozen plasma over 4 hours.
O.P. Ghai Pediatrics 5th ed./125
Answer is (3)
Menstrual like bleeding may occur from 3rd to 7th day of life this is attributed
to
transplacental passage of hormones and estrogen withdrawal after birth, no
therapy is required.
Q.249. Which one of the following drugs is used for fetal therapy of congenital
adrenal
hyperplasia?
1. Hydrocortisone.
2. Prednisolone.
3. Fludrocortisone.
4. Dexamethasone.
249.- Fetal medicine, Charles H. Rodeck Ist ed./831.
- To prevent the birth of virilized females, Evans et al. First administered
dexamethasone at a
dose of .25 mg q.i.d. to a mother known to be a risk of CAH.
- It is currently recommended to start the therapy at 7th weeks of gestation.
Fima Lifschiz - Pediatric endocrinology 3rd ed/315.
- Px with dexamethasone was recently employed in pregnancies at risk for 21-
hydroxilase deficiency.
- The current recommendation is to treat the mother with a pregnancy at risk for
21-OH deficiency with dexamethasone in a dose of .5 mg TDS as soon as
pregnancy is recognized.
Q.250. The coagulation profile in a 13-year old girl with Menorrhagia having von
Willebrands disease is:
1. Isolated prolonged PTT with a normal PT.
2. Isolated prolonged PT with a normal PTT.
3. Prolongation of both PT and PTT.
4. Prolongation of thrombin time.
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