Sure

Success MAGIC, Ramgopal's Facebook MCQs

ABOUT THESE MCQS
!
!

!
!

I have been posting MCQs regularly since 2013, on my Facebook page and these MCQs have been
well received by the PG aspirants
These were compiled and printed in the 7th edition of "Sure Success MAGIC"; however these have
been omitted from the new 9th edn since I convinced the publisher to make it available online for
free download.....so here they are.
SOME of these MCQs have been asked in recent exams like - Dawson fingers and Splendore
Hoeppli phenomenon in DNBCT, Ocriplasmin and burnt rope odour in AIIMS, French paradox in
Karnataka CET etc....
For
more
such
MCQs
keep
in
touch
with
my
Facebook
page
at
www.facebook.com/suresuccessramgopal.
Website: www.suresuccessmagic.blogspot.com

All the Best,

Dr B Ramgopal.


Read on......
Acute anterior uveitis associated with
hypopyon is seen with this therapy:
a. Zidovudine
b. Maraviroc
c. Reltegravir
d. Rifabutin
D (Rifabutin). Rifabutin is used for
prophylaxis of disseminated MAc infection in
AIDS patients; also used in TB and Crohns. It is
well known to be a/w hypopyon uveitis as a
side effect. ALSO NOTE: Cidofovir can also
cause this effect.
All are features of Bourneville's disease except
a. Cardiac rhabdomyoma
b. Konen's fibromas
c. Pancreatic Ca
d. Retinal angiomas
Answer to this morning's qn is "c" (pancreatic
Ca). Renal cell ca is a/w Tuberous sclerosis
(Bourneville's) and not pancreatic ca. Konen's
subungual firbomas are also seen. ALSO
NOTE: Retinal astrocytoma (mulberry tumor)
is also seen.
The Pulvinar sign refers to T2 hyperintensity in
the posterior thalamic nuclei (the pulvinar). It
is classically described in
a. Arnold Chiari malformation
b. Parkinson disease
c. Creutzfelt Jakob disease
d. Alzheimer's disease
Answer to this evening's question (pulvinar
sign) is "C" (CJD) as all of you said......actually
its in 'variant CJD' Also NOTE: "Hockey stick
sign" in variant CJD : hyperintense signal
involving the pulvinar and dorsomedial
thalamic nuclei bilaterally on FLAIR, which has
the shape of a hockey stick.
A 12-year-old girl with sickle cell disease has
pain in her right arm. An x-ray of the right
upper extremity shows bony lesions consistent
with osteomyelitis. Which of the following is
the most likely causal organism?
(A) Clostridium septicum
(B) Enterococcus faecalis
(C) Pseudomonas aeruginosa
(D) Salmonella enteritidis
Answer to yesterday nights (osteomyelitis)
question is "d" - salmonella Abut 80% cases of
osteomyelitis in sickel cell patients are caused

by salmonella. ALSO NOTE: H-shaped

vertebra is also seen in Sickle cell disease
Info about antisnythetase syndrome
Antisynthetase syndrome" is seen in subset
of patients with polymyositis and
dermatomyositis consisting of inflammatory
arthritis, fever, Raynaud phenomenon,
mechanics hands (hyperkeratosis along the
radial and palmar aspects of the fingers)
interstitial lung disease, and often severe
muscle disease a/w anti-Jo1, anti-PL7/PL12
antibodies. ALSO Note: Anti 155/140 is seen
in dermatomyositis a/w malignancy
Holman Miller sign / Antral sign indicates
anterior bowing of the posterior wall of
maxillary antrum and is seen in
a. Orbital complication of FESS surgery
b. Post optic nerve decompression surgery
c. Juvenile nasopharyngeal angiofibroma
d. Grossly Deviated nasal septum
Answer to yesterday nights question: is "c" as
all of u said Holman Miller sign / Antral sign
indicates anterior bowing of the posterior wall
of maxillary antrum is seen in Juvenile
Nasopharyngeal angiofirboma Also Note:
JNA occurs only in males
Quilty effect is seen in
A. Kidney transplantation
B. Lung transplantation
C. Cardiac transplantation
D. Bone marrow transplantation
ANSWER to this mornings question (quilty) is
"c" (cardiac transplanatation) Quilty effect
refers to lymphocytic infiltrates in the
endocardium of cardiac allografts. Quilty effect
is generally not regarded as a manifestation of
rejection and should be distinguished from
focal interstitial lymphoid infiltrates of cellular
rejection. Also Note: Azzopardi effect in small
cell Ca lung
Open ring sign is relatively specific for
a. Space occupying lesion
b. Intracranial hypertension
c. Demyelination
d. Intracranial abscess
Answer to this evenings question (open ring) is
"c" demyelination... The open ring sign (white
matter crescent sign) is a relatively specific sign
for demyelination, helpful in distinguishing
between ring enhancing lesions. The enhancing
component is thought to represent advancing
front of demyelination and thus favours the
white matter side of the lesion. The open part
of the ring will therefore usually point towards
the grey matter. Also NOTE: McDonald's MRI

criteria are used for Multiple sclerosis

All are features of acromegaly except
a. Sweaty handshake
b. Hypotension
c. Visual field loss
d. Headaches
ANSWER to acromegaly question....is "b"
(hypotension).... HYPERtesnion is seen in
acromegaly and the other choices are also
correct.....be aware of clinical features of all
endocrine disorders.....easily askable question
in exams... ALSo nOTE: Acromegaly a/w
insulin resistance and diabetes.
NAPQI is a toxic metabolite formed during
metabolism of
a. Acetylsalicylic acid
b. Paracetamol
c. Ibuprofen
d. Diclofenac
Answer to this morning's NAPQI question
NAPQI (N-acetyl-p-benzoquinone imine) is a
toxic byproduct produced during the
metabolism of the analgesic
paracetamol/crocin (acetaminophen). NAPQI
is rendered harmless because it combines with
glutathione. But if theres too much NAPQI,
which can happen with an acetaminophen
overdose, or not enough glutathione to sop up
NAPQI, which happens if you havent eaten
well or are malnourished, then liver damage
can occur.
Which of the following vitamin deficiencies has
been correlated with occurrence of
hypertension
a. Vitamin B6
b. Vitamin D
c. Vitamin C
d. Vitamin B12
Answer to this evening's question (HTN) is B
(vitamin D12) Vitamin D deficiency is said to
cause hypertension, the leading factor in heart
attacks and stroke. A new study presented at
the annual conference of the European Society
of Human Genetics in Paris recently
announced these findings, stating that there is
a causal association between vitamin D status
and blood pression.
Reverse halo sign is seen in all except
a. Blastomycosis
b. Sarcoidosis
c. Cryptogenic organising pneumonia
d. Bronchial asthma
Answer to yestday nights (reverse halo)
question is "D".... The reversed halo sign (also

known as the atoll sign, reverse halo sign, and

the fairy ring sign) is defined by central
ground-glass opacity with a surrounding halo
or crescent of consolidation. The reversed halo
sign was first described and is most commonly
associated with COP (cryptogenic organising
Pneumonia) but is not specific to this disease.1
It has been reported in the setting of bacterial
pneumonia, mucormycosis,
paracoccidioidomycosis, tuberculosis,
sarcoidosis, radiofrequency ablation,
lymphomatoid granulomatosis, Wegener
granulomatosis, tumor, and pulmonary
infarcts. The reversed halo sign is seen in
approximately 20% of patients with COP and
10% of cases of South American blastomycosis.
The MC cause of Parinauds oculoglandular
syndrome is
a. pasteurella multicoda
b. . toxocara canis
c. Leptospira canicola
d. bartonella henslae
ANSWER to this mornings (parinaud's)
question..... Parinaud's oculoglandular
syndrome (POS) consists of the characteristic
granulomatous conjunctival inflammation,
usually unilateral, with extension to or
involvement of local, ipsilateral lymph
nodes. Cat-scratch disease (Bartonella henselae)
is by far the most common etiology.
"Blue diaper syndrome" is due to defect in
intestinal absorption of
a. Vitamin B12
b. Iron
c. Tryptophan
d. Thiamine
Answer to yestday's (blue diaper) question: is
C (tryptophan) Blue Diaper syndrome is a
hereditary metabolic disorder characterised by
hypercalcaemia with nephrocalcinosis and
indicanuria. Affected infants present with
digestive problems, fever and periodic
irritability. Visual disturbances have also been
reported. The disease is associated with a
defect in intestinal TRYPTOPHAN absorption
that leads to a bluish discoloration of the urine
when it comes into contact with the air.
autosomal recessive or X-linked. mutations in
the LAT2 and TAT1 genes, encoding two
amino acid transporters.
ALSO
RED diaper syn-serrratia marcesans, BLACK
diaper-alkaptonuria
The NEW layer of the human cornea (Dua's

layer - after Harminder Dua) is proposed to lie

between
A. Epithelium and Bowman's membrane
B. Bowman's membrane and stroma
C. Stroma and Descemet's membrane
D. Descemet's membrane and endothelium
ANSWER to this evening's (Dua's layer)
question: Professor Harminder Dua has
published a study in the journal,
Ophthalmology that found a new layer in the
human cornea. The research involved
examining donated eyes and disecting the
corneas. Prof Dua has named the new layer
Dua's layer. A strong, acellular corneal layer
exists BETWEEN the stroma and Descemets
membrane (pre-Descemet's). The discovery
may significantly alter posterior corneal
surgery and affect treatment of conditions such
as acute hydrops, descemetocele and preDescemets dystrophies
A lil Baddtameezee here.......but couldn't resist
asking this question.........just for kicks...... In
the movies YJHD, which textbook is Deepika
Padukone reading in Manali A. Human
Physiology B. Neuro immunology C. Medical
Biochemistry D. ECG made easy
Have u watched the movie ? :)
Circle of Hebra seen in ?
a. Atopic dermatitis
b. Bullous pemhigoid
c. Porphyira cutanea tarda
d. Scabies
Hebra: The main sites affacted in scabies like
axillae, elbows, wrists, hands, and crotch form
an imaginary circle called the circle of Hebra named after Ferdinand von Hebra who
discovered the cause of scabies
"Dot-in-circle" sign on MRI seen in
A. Cycticercosis
B. Amputated foot
C. Mycetoma
D. Cellulitis
Dot in circle sign: has recently been proposed
as a highly specific magnetic resonance
imaging (MRI) and ultrasonography (USG)
sign of mycetoma, which may allow a
noninvasive as well as early diagnosis; tiny
hypointense foci within the hyperintense
spherical lesion - high-signal areas seen on MRI
represented inflammatory granulomata, the
low-intensity tissue seen surrounding these
lesions represented the fibrous matrix, and the
small central hypointense foci within the
granulomata represented the fungal balls or
grains

A 50-year-old man being treated for increased

serum LDL concentration has muscle pain that
has recently become more severe, especially
with exercise. He is most likely to be taking a
drug with which of the following mechanisms
of action?
(A) Binding bile acids
(B) Decreasing binding of bile acids
(C) Decreasing production of LDL
(D) Inhibiting the activity of 3-hydroxy-3methylglutaryl (HMG) CoA reductase
Answer to this morning's question is (D) as all
of u said Statins act by inhibiting HMG-CoA
reductase, the rate-limiting step in cholesterol
biosynthesis. Myopathy and rhabdomyolysis
are rare but serious side effects.
Recent AIIMS journal related
question: "Hockey stick" sign is seen in
hemiagenesis of which organ?
a. Adrenal
b. Thyroid
c. Pancreas
d. Liver
Answer to this mornings "hockey"
question: Thyroid hemiagenesis - hockey stick
sign; MC left lobe is absent. Also NOTE:
Hockey stick sign in CJD: refers to the
hyperintense signal involving the pulvinar and
dorsomedial thalamic nuclei bilaterally on
FLAIR, in cases of variant Creutzfeldt-Jakob
disease (vCJD), which has the shape of a
hockey stick.
Intraoperative Floppy Iris Syndrome which
causes problems during cataract surgery is a/w
use of
a. Sildenafil
b. Tamsulosin
c. Aliskiren
d. Atropine
Answer to this evening's (IFIS) question is B as
all of u said The reason why tamsulosin can
cause Intraoperative Floppy Iris Syndrome
(IFIS) is the same as the reason for its
mechanism of action for treating BPH: it
relaxes the smooth muscle of the bladder
neckand, inadvertently, the iris dilator as
wellby specifically targeting the alpha1A
receptors. Its specificity significantly reduces
the postural hypotension that is common to
nonselective alpha blockers used to treat BPH.
The blockade of this receptor subtype,
however, renders ineffective the conventional
dilator drops used in cataract surgery. Other
drugs implicated to cause IFIS are alpha1
blockers, such as terazosin and alfuzosin and

Doxazosin.
Romidepsin is a histone deacetylase inhibitor
approved for treatment of
a. Psoriatic arthritis
b. Cutaneous T cell lymphoma
c. Rheumatoid arthritis
d. Steven Johnson's syndrome
Answer to this morning's romidepsin
question: Romidepsin and vorinostat are
second line therapy for CTCL (in patients with
failed prior systemic therapy) - both are histone
deacetylase inhibitors.
Which vitamin is used in treating ketatoconus?
B1
B2
B6
B12
Answer to this mornings keratoconus
question Vitamin B2 riboflavin eyedrops is
used in performing collagen cross linking - A
procedure to strengthen the cornea - the B2
moistened cornea is exposed to UV light
Which medical student observed glass pieces in
world war fighter pilot's eyes and invented the
intraocular lenses ?
a. .Helmholtz
b. elschnig
c. harold ridley
d. . von graefe
People who r crazy enough to think they can
change the world are usually the ones who
DO!!! - Steve Jobs ......true to this Harold Ridley
was one who did this by introducing IOLs
....thats the answer for this mrnings
qn.....GOOGLE his name to read his story
Splinter hemorrhages at optic disc margin are
more common in
a . primary open angle glaucoma
b. primary angle closure glaucoma
c. normal tension glaucoma
d. drug induced glaucoma
Answer to this morning AIIMS type qn is
normal tension glaucoma. splinter
hemorrhages at disc margin r a sign of ongoing
damage to the optic nerve and maybe found in
any type of glaucoma but MC in normal
tensiom glauvoma
Russell's sign is seen in
A. anorexia nervosa
B. bulimia nervosa
C. morbid obsesity
D. AIDS cachexia
answer is bulimia nervosa - russell sign-

abrasions and callus over knuckles can occur

in bulimia nervosa due to inserting hand in
mouth for inducing vomiting
Magical thinking is seen in this pers disorder
a . schizoid
b . schizotypal
c . narcissistic
d . antisocial
Answer to this evenings question is
schizoTypal disorder - characterized by:
magical Thinking, Other features:
Inappropriate/constricted affect, ideas (not
delusions) of reference, unusual perceptions
(e.g. bodily illusions), odd ideas (about
telepathy), suspiciousness,
circumstantial/tangential thinking, eccentricity
and excess social anxiety. More common in
relatives of people with SZ.
Which of the following drugs has been
"popped" as an 'orgasm enhancer'
a. Cocaine
b. Marijuana
c. Amyl Nitrite
d. Amphetamines
amyl nitrite as the answer since it has been
used as "poppers" for enhancing
orgasms.....{'popping' is the sound which
occurs when the amyl nitrite ampule is
broken/popped}..BUT if u look at other
references cocaine, MDMA (ecstacy), LSD have
also been used for the same purpose............
Patient on which of the following drugs should
be screened for cataract formation ?
a. tamsulosin
b. quetapine
c. Clozapine
d. Olanzapine
Answer to this morn qn is B quetiapine - As per
drug package insert 6 monthly eye checkup
needed to rule out cataract. Dr AU and Dr PBH
- topper who wrote their tips few days earlier
mentioned that - dont rush into qm and reason
it out. Tamsulosin causes floppy iris mo doubt
BUT NOT cataracts....u ll come across lotsa
elder men using tamsulosin...for BPH....if it
was causing catracts imagine ....It would have
been banned. as for clozapine , remember
agranulocytosis and weight gain fr olanzapine
Pavithran's nose sign is seen in
a. Acne rosacea
b. Acne vulgaris
c. Exfoliative dermatitis
d. Pustular psoriasis
answer to nose sign qn is c . exfol derm. it is the

sparing of nose, discovered by dr pavithran,

probably due to sun exposure which reduces
the scaling or frequent nose blowing which
removes scales from the nose area. More such
MCQs daily.....share with ur frnds
Holoprosencephaly is seen in
a. patau synd
b. edward synd
c. down synd
d. turner synd
Answer to this evenings "holo.." qb is Triaosmy
13, patau syndrome as all of u
said Holoprosencephaly results from
incomplete separation of the two hemispheres.
Results from incomplete or absent division of
the embryonic forebrain (prosencephalon).
Comb sign is seen in
a. Ulcerative colitis
b. Pseudomembranous colitis
c. Crohns disease
d. TB ileitis
Answer to yestday nights (comb qn) is Crohn's
disease as all of u said... The comb sign refers
to the appearance of the mesentary when
increased flow, fibrofatty proliferation and
perivascular inflammatory infiltration outlines
the intestinal arcades. This forms linear
densities on the mesenteric side of the affected
segments of small bowel. It is a sign of active
CROHN'S disease and is seen on both CT and
MRI.
A 25 yr old man presented with blurred vision
2 days after being started on treatment for
migraine. His IOP was 34 mmHg in both eyes
and he had - 2 D myopia (earlier emmetropic).
The causative drug is
a. Sumatriptan
b. Flunarizine
c. Topiramate
d. Propranolol
Answer to this morn qn... Topiramate is a sulfa
derivative that is commonly prescribed in india
by neurologists - it is a/w idiosyncratic
reaction of induced myopia, shallow antr
chamber and angle closure glaucoma. - due to supraciliary fluid collection and antr rotation of
ciliary body; YAG PI will not help; stop
offending drug and cycloplegic to pull back the
lens-iris diaphragm. Important coz commonly encountered and likely to be asked
in AIIMS/any other exams
Which drug used to treat psoriasis has been
withdrawn since it caused PML (progressive
multifocal leukencephalopathy) ?
A. Adalimumab

B. Infliximab.
C. Ustekinumab
D. Efalizumab
efaliz has been linked with PML n also the
fumaric acid esters r implicated.
CURB score is used for
a. Cannabis addiction
b. Pneumonia
c. Intestinal obstruction
d. Acute pancreatitis
Answer to yestday's qn...... CURB-65 Severity
Score for Community-Acquired Pneumonia:
Calculates the CURB-65 Score to estimate
pneumonia mortality to help determine
inpatient vs. outpatient
treatment. Confusion BUN > 19 mg/dL (7
mmol/L) / Respiratory Rate 30 / Systolic
BP < 90 mmHg or Diastolic BP 60 mmHg /
Age 65
In which type of lung ca is gynecomastia
common
a. small cell
b. large cell
c. epidermoid
d. adeno ca
Answer for this morn gynecomastia qn is large
cell type of lung Ca. Also remember SIADH Small cell ca hypercalcemia - Squamous cell
ca DIC - Adeno Ca
The most frequently altered gene in estrogendependent endometrioid endometrial
carcinoma tumors is
A. p53
B. PTEN
C. kRAS
D. Her2/neu
Answer to yestday night's qn........ Bokhman
have generally categorized endometrial cancer
into two broad groups of tumors using both
clinical and histopathological variables:
estrogen-dependent endometrioid endometrial
carcinomas (EECs), or type I, and nonendometrioid endometrial carcinomas
(NEECs), or type II tumors . The most
frequently altered gene in estrogen-dependent
endometrioid endometrial carcinoma tumors is
PTEN. In contrast, p53 mutations or Her2/neu
overexpression are more frequent in nonendometrioid tumors
Egg shell calcification of lymph nodes is seen in
all except
a. Silicosis
b. Coal pneumoconiosis
c. Sarcoidosis

d. Leukemia
Answer to this morn qn.........pretty
straightforward qn being asked in various
entrances from time immemorial...... Egg shell
calcification of LNs : Silicosis, sarcoidosis,
lymphoma (following radiotherapy) and coal
workers pneumoconiosis - the mnemonic I
use in my book is "SILly SARah LYMPed to the
COAL mine"....
Maddreys Discriminant Function is used for
A. Alcoholic hepatitis
B. Subarachnoid hemorrhage
C. end stage liver disease
D. Acute MI
Answer to yest night's qn..... Maddrey's
discriminant function (DF) was described to
predict prognosis in alcohol-related hepatitis
and identify patients suitable for treatment
with steroids ALSO KNOW: abt the other
options: SAH - Hunt and Hess scale end stage
liver disease: MELD Acute MI - TIMI and
GRACE scores
Velaglucerase alfa is used in treatment of
a. Tay Sach's disease
b. Niemann Pick's disease
c. Fabry's disease
d. Gaucher's diseas
ANSWER to this aftn qn. is D.
Gaucher's.... Enzyme replacement therapy for
type 1 Gaucher disease is now available and
includes imiglucerase, velaglucerase alfa, and
taliglucerase alfa. Most patients receive the
recombinant enzyme imiglucerase
Lorenzo's oil is used in
A. Metahcormatic leukodystrophy
B. Adrenoleukodystrophy
C. Krabbe's disease
D. Gaucher's disease
Answer to this evening's qn......As Aruna and
many others said ......is B
(adrenoleukodystrophy) Lorenzos oil is a
combination of two chemicals called erucic acid
and oleic acid.Lorenzos oil is used as a
treatment for two related inherited conditions adrenoleukodystrophy (ALD), which occurs in
children; and adrenomyeloneuropathy, which
occurs in adults. The oil is named after a child,
Lorenzo Odone, who developed ALD. His
parents discovered a mixture of fatty acids that
seemed to slow progression of the disease. The
mixture became known as Lorenzos oil. ALSO a movie of the same name based on this
true story was made in 1992 and that's the
picture I had posted. These disorders cause
accumulation of very long-chain fatty

acids(VLCFA) in the blood and many other

tissues.The white matter of the brain, the
Leydig cells of the testes and the adrenal cortex
are the most severely affected systems.The
levels of VLCFA can be normalized by
treatment with Lorenzo's oil, but this does not
alter the progression of the disease.
All are pervasive developmental disorders
except
a. Autism
b. Asperger
c. ADHD
d. Rett
Answer to this aftn question: Pervasive dev
disorders are: Infantile autism Aspergers
syndrome (MC boys) Retts syndrome
(affects only girls) Childhood disintegrative
disorder Pervasive dev disorder not
otherwise specified
Honeycomb exudates within alveolar spaces
maybe seen in this infection
a. Klebsiella
b. Pneumocystis
c. Seratia
d. Histoplasma
ANSWER for this evenings qn is B
(pneumocystis)..... The finding in the alveoli of
a hyaline foamy granular eosinophilic exudate
with a "honeycomb" aspect on examination of
lung sections stained with haematoxylin and
eosin is a common criterion employed by
pathologists for the recognition of PCP
Endemic cardiomyopathy is a/w deficiency of
a. Iron
b. Selenium
c. Fluorine
d. Calcium
Endemic cardiomyopathy - strt. forward Q Keshan's disease - selenium deficiency - was
also asked in UPSC last sunday as Tkss naidu
said....
which anti depressant is used topically as anti
pruritic ?
a. mirtazapine
b. fluoxetine
c. doxepine
d. fluvoxamine
Doxepin cream is antipruritic
DUSN - diffuse unilatetal subacute
neuroretinitis is caused by a. cestodes b.
protozoa c. nematodes d. trematodes
DUSN - nematodes in subretina classically
(AIIMS type qn) ......such "newer" questions, pls
note somewhere, so that'll serve for 'revision'

sometime - of course I have given this in my

"Quick review of Opthalmology" book released
recently.....BUT for other subjects qns make
notes within ur notes
Pseudohemoptysis may be seen in this
infection
a. M . tuberculosis
b. Klebsiella
c. pseudomonas
d. serratia
Pseudohemoptysis = serratia - red pigment also causes "red diaper" syndrome (hope u
remember blue diaper syndrome I had posted
few weeks back)
Pseudoproptosis is seen in
a. pseudotumor orbit
b. frontal sinus mucocele
c. high myopia
d. pleomorphic lacrimal adenoma
Pseudoproptosis = high myopia - here the
eyeball is larger (more axial length) - giving a
false appearance of myopia (see if any of yr
frnds have this !!)
Amitabh said "mere paas MAA hain"..... NBE
took this seriously n asked many BAAPs in
NEET ..... so Who is the baap of psychosomatic
medicine ?
a. franz josef gall
b. carl jung
c. franz alexander
d. sigmund freud
Baap of psychosomatic medicine - Franz
Alexander ; Sigmund Freud is MORE famous
...YES...but he is Baap of "psychoanalysis"
Grid iron abdomen is seen in
a. briquet syndrome
b. hypochondriasis
c. munchausen syndrome
d. body dysmorphic disorder
GRID iron abdomen is the appearance of a
scarred abdomen in Munchausen's syndrome;
due to multiple surgeries done for feigned
symptoms.
Pseudosulcus vocalis is a/w
a. vocal abuse
b. tuberculosis
c. laryngoesophageal reflux
d. chronic strroid use
n laryngo-esohageal reflux, Specific findings
include laryngeal hyperemia, posterior
commissure hypertrophy, Pseudosulcus
vocalis, and thick endolaryngeal mucus
Component of corpora quadrigemina is

A. Fourth ventricle
B. Medulla
C. Superior colliculus
D. Sigmoid sinus
n the brain, the CORPORA quadrigemina
(Latin for "quadruplet bodies") are the four
colliculitwo inferior, two superiorlocated
on the tectum of the dorsal aspect of the
midbrain.
AIIMS type qn ..... Which is considered best
prophylaxis for acute postop endophthalmitis ?
a. topical gatifloxacin
b. povidone eyedrops
c. intracameral moxifloxacin
d. oral low dose prednisone for a week
Only proven accepted prophylaxis for postop
endophthalmitis is the instillation of povidone
iodine eyedrops in the conjunctival cul de sac
before. Intracameral moxifolxacin has been
used but not accepted/practciced worldwide.
Labyirynthine A. is MC a branch of
a. basilar A
b . vertebral A
c. antr inf cerebellar A
d. middle cerebral A
Labyrynthine A is a branch of AICA in
majority of cases and only occassionally from
basilar A.
Dehisence of anterior wall ox external auditory
canal causes infection in parotid gland via
a. fissure of santorini
b . notch of rivinus
c. petrous fissure
d. retropharyngeal fissure
Anterior wall of extl auditory canal has two
fissures / deficiencies- called as Fissures of
santorini through which parotid or superficial
mastoid infection can appear in the canal and
vice versa
Wide habenula perforata can cause problems
during which surgery ?
a. mastoidectomy
b. FESS surgery
c. stapedectomy
d. transphenoidal pituitary surgery
Habenula perforata: the openings thro which
branches of cochlear nerve enter the cochlea; if
wide it can leas to perilymph gusher is stapes
surgery;
Verocay bodies maybe found in
a. glomus jugulare
b. acoustic neuroma

c. juvenile nasopharyngeal angiofibroma

d. neuroblastoma
In schwannoma (acoustic neuroma/vestibular
schwannoma), which is benign the more
cellular "Antoni A" pattern with palisading
nuclei surrounding pink are Verocay bodies.

20 nail dystrophy maybe a/w
a. TB
b. leprosy
c. alopecia aerata
d. SLE
20 nail dystrophy a/w alopecia
aerata...strt.forward....
which of the follwing is not used in treating
otosclerosis
a . sodium fluoride
b . gentamicin
c . stapedectomy
d . mastoidectomy
Otosclerosis - gentamicin is used for "chemical
labyrinthectomy"; fluoride for cochlear
otosclerosis; stapedectomy of course...........as
for mastoidectomy- NOT for otosclerosis..
Lymphadenopathy in triangle of Ho falls into
which stage in TNM classification of
Nasopharyngeal ca?
N0
N1
N2
N3
ome of my questions may seem "lil
vague"....only with the aim of giving u that one
xtra point or extra info.......NOT to test ur
knowledge in any way....... Triangle of Ho is
the supraclavicular fossa..........In Ca
nasopharynx TNM classification, the node (N)
classification is different; less weightage is
given to level 1 and 2 nodes (even 6 cm nodes
are N1 category); node enlargement of
supraclavicular fossa or Ho's triangle (triangle
between medial and lateral ends of clavicle and
point where neck meets the shoulder) is
considered N3
Fukalas operation is done for
a. congenital ptosis
b. high myopia
c. bladeless lasik
d. limbal dermoid
Fukala's operation refers to clear lens extraction
in high myopia - not routinely done now since
a/w retinal detachment;

Piano key sign is seen in

a. shoulder dislocation
b. radioulnar joint instability
c. tibiofibular instability
d. rib fracture
Piano key sign: Distal radioulnar joint
instability ALSO in Floating Ulnar Head
(Piano-Key Sign) in Rheumatoid arthritis
ALSO in Piano Key Sign Test (Spring Test) in
Instability of the acromioclavicular joint
This fracture has been dubbed the "unsolved
fracture" for more than a century...
A. Fracture neck of femur
B. Fracture shaft of femur
C. Vertebral fracture
D. Fracture scaphoid
UNSOLVED fracture is an eponym for
intracapsular fracture neck f femur
Which of the following IOP lowering drug
causes dry mouth
a. brimonidine
b. brinzolamide
c. tafluprost
d. timolol
Brimonidine is alfa agonist - causes DRy mouth
n DRowsiness
Regarding choanal atresia all are true except
a. mc in females
b. bony atresia mc
c. left sided mc
d. a/w CHARGE syndrome
Choanal atresia: Unilateral and MC in females
on Right side; Bony atresia is MC; CHARGE =
Coloboma, Heart defect, Atresia choanae (also
known as choanal atresia), Retarded growth
and development, Genital abnormality, and
Ear abnormality.
Cattle trucking appearance is seen in
CRAO
CRVO
BRAO
BRVO
C(R)Attle trucking is seen in CRAo :
segmentation of blood column in the
attenuated retinal vessels; also called "boxcarring"
MC tooth involved in oro antral fistula is
a. upper canine
b. upper central incisor
c. upper first molar
d. lower first molar
Oro-antral fistula MC due to extraction of
Upper first molar as all of u said; This is a

fistulous communication between the floor of

the maxillary sinus to the oral cavity
Very commonly asked......was asked in jipmer
2013 also Melanocytes are derived from
a. surface ectoderm
b. neural ectoderm
c. neural crest
d. mesoderm
elanocytes are of neural crest origin......very
commonly asked as I said earlier....
Most common premalignant oral lesion is
A. Leukoplakia
B. Submucus fibrosis
C. Oral Lichen planus
D. Oral hairy leukoplakia
Leukoplakia is MC premalignant oral lesion.
ALSO NOTE erythroplakia has 17 tmes
malignant potential as compared to
leukoplakia
MC location for thyroglossal cyst is
A. beneath foramen cecum
B. subhyoid
C. suprahyoid
D. in floor of the mouth
Thyroglossal cyst MC site is subhyoid
Girls like long eyelashes. Which of the follwing
is FDA approved for eyelash lengthening ?
a. latanoprost
b. bimatoprost
c. travoprost
d. tafluprost
Long lashes - all PG analog eyedrops used for
glaucoma cause this along with lid skin and iris
pigmentation; FDA approved is (Latisse) Bimatoprost;
Burnt Rope odour is a/w which poisoning
a. Hydrogen sulphide
b. Cyanide
c. Nitrobenzene
d. Cannabis
urnt rope - cannabis; H2S - rotten eggs; cyanide
- bitter almonds ; nitrobenzene - shoe polish
Cracked mud retina seen in
a. CMV retinitis
b. Acute retinal necrosis
c. Progressive outer retinal necrosis
d. Retinitis pigmentosa
Answer to this morn qn.........."cracked mud"-PORN Progressive outer retinal necrosis
(PORN), is seen in patients who are
immunocompromised (e.g., AIDS) who present
with rapid outer retinal necrosis. Multifocal
lesions with deep retinal opacification are

characteristic of PORN. The lesions can be

located in the peripheral retina with or without
macular involvement. They classically have a
cracked mud appearance where there is
perivenular clearing of the retinal opacification

at all."
a. Sir Robert Huthcinson
b. Sir Joseph Lister
c. Sir William Osler
d. Sir Garfield Sobers

Myer-Cotton's grading is for:

A. subglottic stenosis
B. laryngeal carcinoma
C. superior nerve palsy
D. vocal cord misuse

William Osler

nswer to this mornings qn..... Myers and

Cotton devised a classification scheme for
grading circumferential subglottic stenosis
from I-IV, which is established endoscopically
and by using noncuffed pediatric endotracheal
tubes of various sizes and sizing the airway.
The scale describes stenosis as a percent of area
that is obstructed. The system contains 4
grades, as follows: Grade I - Obstruction of 050% of the lumen obstruction Grade II Obstruction of 51-70% of the lumen Grade III Obstruction of 71-99% of the lumen Grade IV Obstruction of 100% of the lumen (ie, no
detectable lumen)
Splendore Hoeppli phenomenon is seen in
a. kaposi sarcoma
b. actinomycosis
c. sarcoidosis
d. SLE
Splendore-Hoeppli phenomenon (asteroid
bodies) is the in vivo formation of intensely
eosinophilic material (radiate, star-like,
asteroid or club-shaped configurations) around
microorganisms (fungi, bacteria and parasites)
or biologically inert substances. The
characteristic formation of the peribacterial or
perifungal Splendore-Hoeppli reaction
probably prevents phagocytosis and
intracellular killing of the insulting agent
leading to chronicity of infection. Infections
that can generate Splendore-Hoeppli
reaction: 1. The fungal infections include
sporotrichosis, pityrosporum folliculitis,
zygomycosis, candidiasis, aspergillosis and
blastomycosis. 2. The bacterial infections
include botryomycosis, nocardiosis and
ACTINOMYCOSIS. 3. The parasitic conditions
include orbital pythiosis, strongyloidiasis,
schistosomiasis and cutaneous larva migrans.
In addition, 4. Splendore-Hoeppli reaction
may be seen with non-infective pathology such
as hypereosinophilic syndrome and allergic
conjunctival granulomas.
"To study the phenomenon of disease without
books is to sail an uncharted sea, while to
study books without patients is not to go to sea

The risk of acquiring HIV infection from a

needlestick with infected blood is
approximately
a. 1:100
b. 1:150
c. 1:300
d. 1: 500
Answer to yest nights question Risk of
acquiring HIV from needprick injury from HIV
positive person is -- As per CMDT 2013: 1:300 - As per 18th harrison = 0.3% = 1: 300
(approx) For mucocutaneous exposure it is
0.09% !
Tropical spastic paraparesis is caused by
a. HIV 1
b. HIV 2
c. HTLV 1
d. HTLV 2
HTLV-I is the cause of two important diseases:
-- Adult T cell leukemia/lymphoma (ATL).
and -- tropical spastic paraparesis, also called
HTLV-I-associated myelopathy (HAM)
Shield cataract is seen in
a. vernal catarrh
b . atopic eczema
c. myotonic dystrophy
d. trauma
hield cataract is in atopic dermatitis Shield
ulcer is in vernal catarrh Trauma rosette Myotonic dystrophy - christmas tree
cataract
MC intracranial space occupying lesion in HIV
infected patients is
a. Toxoplasmosis
b. Primary CNS lymphoma
c. Metastases
d. Cryptococcal meningitis
Ans to yest night qn as per CMDT 2013..... MC
intracranial SOL in AIDS is Toxoplasmosis.
Second MC is CNS lymphoma
Bulkeleys membrane is a/w
a. lichen planus
b. psoriasis
c. scabies
d. pemphigus
Bulkeley's membrane: When the scales are
completely scraped off, the stratum mucosum

(basement membrane) is exposed and is seen as

a moist red surface (membrane of Bulkeley)
MC ocular manif of HIV is
a. PORN
b. CMV. retinitis
c. Acute retinal necrosis
d. Cotton wool spots
Cotton wool spots are MC ocular manif of
AIDS
MC opportunistic infection in AIDS IS
a. toxoplasmosis
b. pnemocystis
c. cryptococcosis
d. CMV
Lastly MC opportunistic infection in AIDS is
pneumocystis pneumonia.....
Pneumocystis prophylaxis should be initiated
when the CD4 percentage falls below
10%
15%
20%
25%
Answer to yest nights qn..........is
15% Pneumocystis prophylaxis is compulsory
when CD4 count < 200/microL - we know that
- its is equalt to 15% CD4 percentage (as per
Harrison's 18th; CMDT also says 14%)
MC. hematologic abnormality in HIV is
a. thrombocytopenia
b. anemia
c. eoinophilia
d. neutrophil leucocytosis
Ans to this morning's qn.................MC
hematologic abnormality in HIV infection is
ANEMIA. Among the specific reversible
causes of anemia in the setting of HIV infection
are drug toxicity, systemic fungal and
mycobacterial infections, nutritional
deficiencies, and parvovirus B19
infections. ALSO KNOW: Zidovudine causes
macrocytosis
MC type of shock is
a. cardiogenic
b. neurogenic
c. hypovolemic
d. septic
MC type of shock is hypovolemic
shock..... Also Know: MC cause of septic shock
is gram negative bacteremia
Banana fractures is seen in
a. Osteoporosis
b. Osteomalacia
c. Paget's disease

d. Rickets
"Banana fractures" occur in long bones affected
by Paget's disease. These cortical insufficiency
fractures are so named because they occur
along the tensile (convex) surface of the
weakened and often bowed pagetoid bone,
analogous to the site where the skin of a
banana would break upon "snapping" it open.
The lateral cortex of the proximal femur is a
common site for banana fractures; conventional
stress fractures (osteomalacia) of the proximal
femur, in contrast, usually occur along the
compressive (concave) surface.
Erdheim's disease is a risk factor for
a. Acute appendicitis
b. Acute aortic dissection
c. Acute subarachnoid hemorrhage
d. Acute pancreatitis
ANS to this morn qn.......Erdheim's disease
refers to cystic medial necrosis found in
Marfan's and Ehler's Danlos syndrome - It is a
risk factor for Aortic dissection........
So one more dissecting MCQ..
Inv. of choice for acute aortic dissection is
a. MRI
b. CT scan
c. ECHO
d. TEE
ANS to this evening's question:......A combo of
Harrison's, 18th, CMDT 2013 and Washington
manual of critical care.... For acute aortic
dissection: A multiplanar CT scan is the
immediate diagnostic imaging modality of
choice; Transesophageal echocardiography
(TEE) is an excellent diagnostic imaging
method BUT it is generally not readily
available in the acute setting. MRI is
excellent for chronic dissection; also can detect
blood flow, which may be useful in
characterizing antegrade versus retrograde
dissection, BUT in the acute situation, the
longer imaging time and the difficulty of
monitoring patients in the MRI scanner make
the CT scan preferable.
Pseudopapillitis is seen in
a. high myopia
b. high hypermetropia
c. high astigmatism
d. status post LASIK
ANS to yest qn is high hypermetropia....... here
the optic nerve is crowded and heaped up and
gives appearance of a blurred disc margin as
would appear in true papillitis - hence called
pseudopapillitis

MC Heart diease in HIV is

a. coronary heart disease
b. dilated cardiomyopathy
c. hypertrophic cardiomyopathy
d. kaposi sarcoma of heart

B. Serum Albumin
C. Serum Creatinine
D. INR

NS to this morning's questions:..... MC Heart

diease in HIV is coronary heart disease as per
Harrison's 18th........cardiovascular disease may
be a/w classic risk factors such as smoking, a
direct consequence of HIV infection, or a
complication of HAART. Patients with HIV
infection have higher levels of triglycerides,
lower levels of HDL cholesterol, and a higher
prevalence of smoking than cohorts of
individuals without HIV infection.....As per
Sande's HIV/AIDS Medicine: Medical
Management of AIDS 2013: incidence of dilated
cardiomyopathy has decreased...

Which drug causes nephrolithiasis

a. zidovudine
b. indinavir
c. maraviroc
d. raltegravir
Indinavir
Sunset glow fundus appearance is seen in
a. PORN
b. Pars planitis
c. vitreous hemorrhage
d. VKH syndrome
VKH
Hang glider sign is seen in
a. scabies
b. lichen planus
c. urticaria
d. psoriasis
Hang glider sign: Scabies ---- The biting
apparatus of Sarcoptes scabiei mites and the
two front pairs of legs consist of thick darkbrown chitin layers. In low magnification they
take the shape of a dark triangle (hang glider
sign).
The risk of maternal fetal transmission in ptnt
receving anti HIV prophylaxis is
a. 2%
b. 4%
c. 6%
d. 8%
Maternal-fetal HIV transmission has been
reduced to about 1% to 2% in developed
countries with Antiretroviral treatment of the
pregnant mother.
MELD score includes all except
A. Serum bilirubin

MELD score includes serum creatinine, Serum

bilirubin and INR...

Which antiglaucoma drug would u avoid in a

ptnt who has undergone penetrating
keratoplasty
a. timolol
b. brimonidine
c. betaxolol
d. brinzolamide
Carbonic anhydrase inhibitors (brinzolamide,
dorzolamide) can worsen corneal condition in
post keratoplasty patients and any cases where
corneal endothelium is suspect...
Nasolacrimal duct opens into
a. superior meatus
b. middle meatus
c. inferior meatus
d. vestibular
Nasolacrimal duct opens into Inferior
meatus....why such a simple question ......Like i
always say - u HAVE to get the simple ones
ALSO right
COCA-COLA Bottle sign is seen in
a. Pseudotumor cerebri
b. Thyroid ophthalmopathy
c. Orbital myocysticercosis
d. Dacryoadenitis
ANS.............Coca cola bottle sign is seen in
Thyroid eye disease. This refers to the
appearance of the orbital rectus muscles in
thyroid eye disease. The belly of the muscle
enlarges with sparing of the tendinous
insertion simulating the appearance of a
traditional coke bottle. BUT in orbital
pseudotumour the tendinous insertions are
NOT spared (they are enlarged) which helps in
distinguishing between the two conditions.
Roos provocative test is use for
a. Glenoidal labrum tear
b. Thoracic outlet syndrome
c. Rotator cuff pathology
d. radioulnar instability
A diagnostic tool used in the identification of
Thoracic Outlet Syndrome (TOS) It is also
known as the elevated arm stress test or
"EAST". The patient has both arms in the 90
abduction-external rotation postion Shoulders
and elbows are in the frontal plane of the
chest The patient is to open and close the hands

slowly over a 3-minute period Only forearm

muscle fatigue and minimal distress Possible
symptoms if TOS is present: gradual increase
in pain at neck and shoulder, progressing
down the arm Paraesthesia in forearm and
fingers In case of arterial compression: arm
pallor with arm elevated, reactive hyperemia
when limb is lowered In case of vernous
compression: Cyanosis and swelling Inability
to complete test, and patient drops arms in lap
in marked distress, recognized as reproduction
of usual symptoms
Aprepitant is an
a. antiulcer drug
b. anti craving drug
c. antifungal
d. antiemetic
prepitant is an anti-emetic drug - NK1 receptor
anatgonist used for chemotherapy induced
vomiting and postop vomiting
All are brain tumor associated syndromes
except
a. gorlin syndrome
b. NF 2
c. MEN 2
d. Cowden syndrome
MEN 1 has pituitary adenoma and NoT MEN
2; as for Gorlin's syndrome (has been asked in
KCET before) - Basal cell nevus syndrome- has
Medulloblastomas and Basal cell
carcinoma Cowdens - Dysplastic cerebellar
gangliocytoma (Lhermitte-Duclos disease),
meningioma, astrocytoma Breast, endometrial,
thyroid cancer And NF-2 of course has
vestibular schwannomas
Dapsone is used in treating
a. dermatomyositis
b. dermatitis herpetiformis
c. atopic dermatitis
d. acrodermatitis enteropathica
ANS...... Dapsone is the mainstay of treatment
for dermatitis herpetiformis along with a
gluten free diet.
Tigered effect of myocardium is seen in
a. acute severe hypoxia
b. prolonged moderate hypoxia
c. amyloidosis
d. sarcoidosis
TIGERED effect: grossly apparent bands of
yellowed myocardium Iintracellular fat
deposits) alternating with bands of darker, redbrown, uninvolved heart - seen in prolonged
moderate hypoxia (as in profound anemia).
Epidemic dropsy maybe a/w all except

a. dyspnea
b. diarrhea
c. convulsions
d. pedal edema
Epidemic dropsy: Heart failure (generalised
edema, lower limb pitting edema); Dyspnea;
Diarrhea; Glaucoma (hypersecretion glaucoma)
V sign of naclerio is seen in
a. Duodenal ulcers
b. Boorhave's syndrome
c. Aortic dissection
d. Suprapleural bleb rupture
Naclerio's V Sign : a sign described on the plain
X-ray in patients with a pneumomediastinum
occurring often secondary to an oesophageal
rupture (Boerhaave's) . It is seen as a V-shaped
air collection. One limb of the V is produced by
mediastinal air outlining the left lower lateral
mediastinal border. The other limb is produced
by air between the parietal pleura and medial
left hemidiaphragm.
Zieve's syndrome includes all except
a. hyperlipidemia
b. hemolysis
c. jaundice
d. hypertension
ANS... Zieve, in 1958, described a syndrome
a/ w alcohol abuse consisting of: - jaundice, -hyperlipidemia, and --- transient hemolytic
anemia,
Zidovudine is a/w which kind of anemia ?
a. Microcytic
b. Macrocytic
c. Hemolytic
d. Normocytic
Zidovudine macrocytic anemia.
The "sag sign" is used for which injury
a. med collateral ligament
b. latetal collateral ligament
c. postr cruciate ligament
d. antr cruciate ligament
Posterior Sag Sign used To assess for integrity
of the PCL. The posterior cruciate ligament is
responsible for resisting against excessive
posterior translation of the tibia on the femur,
due to its attachments on posteriorly on the
tibial plateau and anteriorly on the lateral side
of the medial femoral condyle. In the position
of 45 degrees of hip flexion and 90 degrees of
knee flexion, gravity places a force on the tibia
that pulls the tibia posteriorly, but is blocked
by an intact PCL. In the absence of a PCL, the
tibia appears to "sag."

Bexarotene gel is used in treatment of

a. Psoriasis
b. Lichen planus
c. Mycosis fungoides
d. Urticaria
ANS.....bexarotene gel (retinoid) - Cutaneous T
cell lymphoma (mycoses fungoides) ALSO
KNOW: for CTCL - electron beam therapy;
romidepsin and vorinostat (second line for
CTCL)
The MC indication for heart transplantation in
children greater than 1 year of age is
a. congenital heart disease
b. cardiomyopathy
c. rheumatic heart disease
d. premature coronary heart disease
ANS..... -- MC cause of heart transplant in
infants (< 1 year) = cong heart disease -- MC
cause of heart transplant in children > 1 year =
cardiomyopathy (dilated especially). -- The
first pediatric heart transplant was performed
in1967 byDr. Adrian Kantrowitz three days
after the first adult heart transplant was
performed by Dr Christian Barnard
Inv of choice for primary sclerosing cholangitis
is
a. MRCP
b sgot/sgpt
C. u/s
d. ct scan
ANS...... The definitive diagnosis of Pri
Sclerosing Chlanigitis requires
cholangiographic imaging. Over the last
several years, MRI with magnetic resonance
cholangiopancreatography (MRCP) has been
used as the imaging technique of choice for
initial evaluation. ----- Harrison 18th. (ERCP
was considered gold standard but is
complicated by pancreatitis and sepsis)
As per 'Jenkins Rule', Suture Length : Wound
Length should be
2:1
4:1
6:1
8:1
Ans....for Jenkin's rule...4:1 Jenkin's Rule is a
principle of surgery relating to closure of
surgical wounds. It states that the required
length of the surgical suture material for
closure of a wound with interrupted stitches is
FOUR times the length of the wound, as each
bite should be 1cm from the edge, and placed
1cm from the previous suture.
Loefflers serum slope is an example of

a. enriched media
b enrichment media
c. selective media
d. indicator media
Enriched media: Addition of extra nutrients in
the form of blood, serum, egg yolk etc, to basal
medium makes them enriched media. Enriched
media are used to grow nutritionally exacting
(fastidious) bacteria. Blood agar
(streptococcus), chocolate agar (hemophilus),
Loefflers serum slope (C.diphtheriae) etc are
few of the enriched media.
POLO MINT sign is seen in
a. Cysticercosis
b. Portal vein thrombosis
c. Toxoplamsosis
d. retinoblastoma
The polo mint sign is a description given to a
venous thrombosis on contrast enhanced CT
imaging. When viewed in the axial plane, a
thin rim of contrast persists around a central
filling defect due to thrombus. - like POLO
mint -the 'mint with a hole'. It is orginally
described to refer to the appearances of a
pulmonary embolus on CTPA, but the
appearances are the same for any venous
thrombosis, such as in the portal vein
Esophageal inlet patch consists of
a. squamous metaplasia
b. ectopic gastric mucosa
c. congenital AV malformation
d. smoking related ulceration
ANS.........Harrison's 18th......esoph inlet
patch..... -- Heterotopic gastric mucosa, also
known as an esophageal inlet patch, is a focus
of gastric type epithelium in the proximal
cervical esophagus -- The inlet patch is thought
to result from incomplete replacement of
embryonic columnar epithelium with
squamous epithelium. -- The majority of
patches are asymptomatic, but acid production
can occur as most contain fundic type gastric
epithelium with parietal cells.
Masson Fontana Stain is used for
a. Melanin
b. Amyloid
c. Fat
d. Iron
ANS.... Fontana-Masson stain uses silver. It
stains argentaffin granules and melanin black
"Hot cross bun" sign on MRI is seen in variety
of neurodegenerative diseases (variant CJD,
parkinsonism sec to vasculitis, spinocerebellar
atrophy)....in which structure?

A. Corpus callosum
B. Lateral ventricles
C. Pons.
D. Circle of Willis
ANS...... The hot cross bun sign refers to the
MRI appearance of the pons in a variety of
neurodegenerative diseases. T2 hyperintensity
forms a cross on axial images through the pons,
representing degeneration of pontocerebellar
tracts.
Andre Thomas sign is seen in
a. Radial N lesion
b. Ulnar Nerve lesion
c. Median N lesion
d. Sciatic N lesion
ANS.......Andre Thomas...............In Ulnar N
palsy, as clawing becomes more severe, finger
extension becomes more difficult. Patients
sometimes flex their wrist to extend their
digits, taking advantage of extrinsic tenodesis =
Andr Thomas sign and is a poor prognostic
indicator for successful tendon transfers
"Coudability sign" is seen in
a. Psoriasis
b. Alopecia aerata
c. Lichen planus
d. Seborrheic dermatitis
ANS....."coudaibility sign" Proximally tapered
hairs which can be kinked easily/ bent easily
resembling a bent foley's catheter (coude
catheter) - seen as a sign of alopecia aerata....
A capsular tension ring is useful in the
following situation (during cataract surgery)
A. Posterior capsular rupture
B. Subluxated lens
C. Posterior polar cataract
D. Grade IV nuclear cataract
ANS.....capsular tension ring....B
(subluxation) Used in cases where there is
zonular dialysis - especially in trauamatic lens
subluxation or any other cause of zonular
dialysis such as may occur in cataract surgery
in pseudoexfoliation syndrome
Which is a non penetrating glaucoma surgery
?
a. trabeculectomy
b. trabeculotomy
c. deep sclerectomy
d. goniotomy
Non - penetrating glaucoma surgeries (NPGS)
refer to surgeries which DO NOT
penetrate/enter the anterior chamber. The 2
newer NPGS are Deep sclerectomy and
Viscocanalostomy. These have been devised to

minimise side effects (hypotony, shallow

anterior chamber) of traditional penetrating
glaucoma surgeries....
ANP32D and SENP1, have significantly
increased expression in
a. Addison's disease
b. Monge's disease
c. Caisson's disease
d. AIDS
Monge's disease (chronic mountain sickness) increased expression of these 2 genes have
been found as per today's news......ANP32D
and SENP1,......thought maybe worth sharing
(also Monge's disease by itself is a DNB one
liner)...
Inv of choice for pericardial effusion is
a. echo
b. CT
c. MRI
d.. Transesophageal echo
Ans......Pericardial effusion.....Inv of choice Echocardiography (transthoracic 2D
ECHO). Trans esophageal echo is useful in
detecting loculated posterior effusions or in
postop settings where retrosternal hematoma
can impair transthoracic image quality
Emperipolesis is a distinct feature of
a. Refsum disease
b. Rosai dorfman dis
c. Mikulicz syndrome
d. Systemic sclerosis
ANS......Emperipolesis.............Rosai Dorfman
Disease was originally called sinus histiocytosis
with massive lymphadenopathy. This disease
typically presents as massive but painless
bilateral cervical lymph node enlargement
accompanied sometimes by fever, in the first
two decades of life. Leucocytosis, raised ESR
and polyclonal hypergammaglobulinemia can
be seen on investigation. Microscopic
examination of an affected lymph node shows
dilated sinusoids packed with foamy
histiocytes, which contain intact lymphocytes
and/or plasma cells within their cytoplasm,
termed emperipolesis. Histiocytes with
emperipolesis are considered a constant feature
of great diagnostic importance.
Dieulafoy disease due to aberrant submucosal
artery in
a. esophagus
b. stomach
c. duodenum
d. large intestine
ANS.......Dieulafoy's

Lesion.........Stomach...........One of you Dr
Ashish has commented that this was asked in
todays DNB aftn session......that's enuff to
inspire me to keep posting qns for the next 6
months.... Also called persistent caliber
artery, Dieulafoy's Lesionis a large-caliber
arteriole that runs immediately beneath the GI
mucosa and bleeds through a pinpoint mucosal
erosion. It is seen MC on the lesser curvature
of the proximal stomach, causes impressive
arterial hemorrhage, and may be difficult to
diagnose; it is often recognized only after
repeated endoscopy for recurrent bleeding.
Trofile assay n Phenoscript assay r used to find
if ptnt is susceptible to..
a. raltegravir
b. fosamprenavir
c. maraviroc
d. efavirenz
ANS.....maraviroc The two major coreceptors for HIV-1 are CCR5 and CXCR4.
Maraviroc is effective only against CCR5
positive viruses and two assays - Trofile assay
and Phenoscript assay are used to find if the
patients' virus is susceptible to maraviroc.
Beck's triad consists of all except
a. hypotension,
b. distended neck veins
c. muffled heart sounds
d. decreased JVP
ANS.........Beck's triad............3D's -- Decreased
BP (hypotension) -- Distended neck veins
(increased JVP) -- Distant heart sounds
Ibritumomab tiuxetan been used in
a. Breast cancer
b. Lung cancer
c. Prostate cancer
d. Lymphoma
ANS........NH lymphoma Radiolabelled
antibodies are currently under investigation as
a means of delivering high levels of radiation
locally to the tumor bed, thereby avoiding
systemic toxicity. Ibritumomab tiuxetan is
radiolabeled antibody, FDA approved for the
treatment of relapsed low-grade non-Hodgkin
lymphoma
Interface dermatitis is a characteristic feature
of
a. psoriasis
b lichen planus
c. pemphigus vulgaris
d. impetigo
Ans.....(B).....Lichen Planus.... Interface or
lichenoid dermatitis refers to a pattern of

reaction of the skin characterized by an

inflammatory infiltrate that appears to obscure
the dermo-epidermal junction when observed
at low power examination. Lichen planus is
the prototype of interface dermatitis. Here the
inflammatory infiltrate hugs and obscures the
DE unction and forms a band-like pattern in
the superficial dermis.
Iris hyperchromia is due to
a. pilocarpine
b. brimonidine
c. brinzolamide
d. bimatoprost
ANS.....Iris hyperchromia....(D)
..Bimatoprost PG analogs (bimatoprost,
latanoprost, travoprost) cause - increase in
length of lashes - Periocular
hyperpigmentation - iris hyperpigmentation conjunctival congestion
Roflumilast is used in treatment of
a. Bronchial asthma
b. COPD
c. Cystic fibrosis
d. Erectile impotence
ANS...B....COPD Roflumilast is a selective
phosphodiesterase 4 inhibitor indicated as a
treatment to reduce the risk of COPD
exacerbations in patients with severe COPD
associated with chronic bronchitis and a
history of exacerbations It is not a
bronchodilator and is not indicated for the
relief of acute bronchospasm.
Rice grain calcification in brain is seen in
a. multiple sclerosis
b. atherosclerosis
c. cysticercosis
d. benign intracranial htn
ANS.....(C) ....cysticercosis The rice grain
calcification is characteristic of infection with
Taenia solium (cysticercosis); when the
inflammatory response of the host kills the
larval cysts (cysticerci), they undergo
granulomatous change and become calcified.
Zebra stripe sign is seen in
a. Achondroplasia
b. Osteogenesis imperfecta
c. Osteoporosis
d. Scurvy
Zebra stripe sign...(B)...osteogenesis imp......:
Zebra stripe sign occurs where children with
osteogenesis imperfecta have been treated with
cyclical bisphosphonate therapy, e.g.
pamidronate. When the drug is delivered in
cycles, dense bone is formed while treatment is

being given. This results in dense stripes across

the metaphyses of bones which can be
visualised radiographically.
Cases on the rise in Bangalore schools.... Hand,
Foot and Mouth disease is caused by
A. Poliovirus
B. Coxsackie virus
C. Influenza virus
D. HIV
HFM disease (B) - Coxsackie A16 virus
MC.....self limiting illness in children.....being
reported in Bangalore schools recently/...
Cawthrone's exercise is used for
a. Ataxia
b. Vertigo
c. During Pregnancy
d. strengthening squinted ocular muscles
Ans....... Cawthorne's exercise:
Vertigo Frenkel's exercise: Ataxia Kegel's
exercise: Pelvic floor strengthening in
pregnancy
Ideal body weight is used in dosage calculation
for
a. suxamethonium
b. vecuronium
c bupivacaine
d. adrenaline
Drugs dosed on ideal body weight (IBW) =
vecuronium; rocuronium, remifentanil recovery maybe prolonged when dosed
according to total body weight. Suxameth
should be dosed on Total body weight since
dosing on IBW provides inadequate paralysis.
Acne agminata is a/w
a. acne vulgaris
b. acne rosaceae
c. TB
d. steroid use
Acne agminata (lupus miliaris disseminatus
faceiei) has NO relation to TB; Oxford
handbook of dermat says it is probably a
variant of granulomatous rosacea. Newer name
is FIGURE (Facial Idiopathic Granulomas with
Regressive Evolution),
STOP Bang questionnaire is for
a. chronic alcoholism
b obstructive sleep apnea
c. erectile impotence
d. bipolar disorder
STOP BANG - to screen for Obs sleep apnea ; S
noring T ired O bserved blood P ressure B
MI A ge N eck circumference G ender
Mizuo phenomenon is seen in

a . leber amaurosis
b . oguchi disease
c . best disease
d . VKH syndrome
MIZUO-Nakamura phenomenon: involves a
change of color of the fundus from red in the
dark-adapted state to golden immediately or
shortly after the onset of light. Seen in 1.
Oguchi disease (congenital stationary night
blindnes)
Corona mortis is a/w which artery
a. right hepatic artery
b sup mesenteric artery
c. left gastric artery
d. accessory obturator artery
CORONA mortis: means crown of death. It
indicates the presence of both the normal and
variant obturator artery with extensive
anastomoses. The variant vessels are at risk of
injury not only in groin surgery but also in
orthopedic surgery and pelvic fractures, and
are to be dealt with care during surgical
procedures
Largest branch of celiac artery is
A. Left gastric artery
B. Common hepatic artery
C. Splenic artery
D. Sup. mesenteric artery
Branches of celiac trunk are Common hepatic
A Splenic A (largest) Left gastric A (smallest)
DC-SIGN is encoded by
CD 29
CD 209
CD 20
CD 92
ANS.....DC SIGN....CD209......Obviously I
didn't ask this qn to test ur knowledge of
ABCD.... or 1234.... .....I came across this while
updating the AIDS chapter of new Sure Success
MAGIC from H-18th and thought of sharing
with you.. DC SIGN = Dendritic Cell-Specific
Intercellular adhesion molecule-3-Grabbing
Non-integrin) also known as CD209 ; it's is a Ctype lectin receptor present on the surface of
both macrophages and dendritic cells. It binds
various microorganisms by recognizing highmannose-containing glycoproteins on the
ICAM3 (intercellular adhesion molecule3) of
their envelopes and especially functions as
receptor for several viruses such as HIV and
Hepatitis C. Binding to DC-SIGN can promote
HIV and Hepatitis C virus to infect T-cell from
dendritic cells. Thus binding to DC-SIGN is an
essential process for HIV infection

Krukenburg spindle seen in

a. pseudoexfoliation syn
b pigment dispersion syn
c. plateau iris syn
d. ICE syndrome

d. fibrillin

Ans....(B)....Pigment disp
syndrome Krukenburg spindle refers to
pigment deposition on the corneal
endothelium in the formof a spindle - seen in
pigment dispersion syndrome; also a/w iris
concavity

As per BIRADS known biopsy proven

malignancy is grouped under grade
a. 3
b. 4
c. 5
d. 6

Endothelial plaque is characteristic of

a. disciform keratitis
b. aspergillus keratitis
c. fuchs endothelial dystrophy
d. acanthameba keratitis

BI-RADS = 'breast imaging reporting and data

system', 0- incomplete, 1- negative, 2-benign
findings, 3-probably benign, 4-suspicious
abnormality, 5-highly suspicious of
malignancy, 6- with known biopsy proven
malignancy.

Ans.....(B).....Aspergillus (fungal) In contrast to

bacteria fungi can not only infiltrate through
the corneal stroma, but even penetrate
Descemet membrane to reach the anterior
chamber. When this happens iritis, hypopyon
and an endothelial PLAQUE can become
evident and corneal perforation may occur
Pellagra like skin lesion is seen in
a. cystinuria
b. hartnup disease
c. phenylketonuria
d. essential fructosuria
ANS.....(B)......Hartnup Hartnup disease is an
autosomal recessive metabolic disorder
affecting the absorption of neutral amino acids
(particularly tryptophan that can be, in turn,
converted into serotonin, melatonin and
niacin). Patients present with -- pellagralike
skin eruptions, -- cerebellar ataxia, and -gross aminoaciduria
Sugammadex provides rapid reversal from
neuromuscular blockade induced by
A. Atracurium
B. Mivacurium
C. Pancuronium
D. Rocuronium
ANS......(D)...rocuronium Sugammadex is a
synthetic, modified gamma-cyclodextrin and is
the first and only selective relaxant binding
agent (SRBA). Sugammadex is a unique
reversal agent because it encapsulates and then
inactivates Rocuronium and Vecuronium
rather than counteracting their effects.
Gene mutation a/w steroid resistant nephrotic
syndrome
a. myocilin
b. nephrin
c. podocin

ANS...... -- Podocin: steroid resistant nephrotic

syndrome -- Nephrin: congenital NS (Finnish)
type -- Fibrillin: Marfan's syndrome -Optineurin: Pri open angle glaucoma

PGMI classification is used for

a. Brain
b. Breast
c. Liver
d. Retinoblastoma
Two classification systems used to evaluate the
quality of mammograms: PGMI ('perfect',
'good', 'moderate' and 'inadequate') and EAR
('excellent', 'acceptable' and 'repeat').
Strawberry shaped head is seen in
A. Trisomy 13
B. Trisomy 18
C. Trisomy 21
D. Turners syndrome
A strawberry head is a head that has a
deformity with narrowing of the frontal region
and flattening of the occipital region.
Strawberry heads are markers for TRISOMY 18
The French paradox is quoted with reference
to
A. Benign prostatic hypertrophy
B. Anorexia nervosa
C. Coronary heart disease
D. Early onset senile cataracts
The French paradox is the observation of low
coronary heart disease (CHD) death rates
despite high intake of dietary cholesterol and
saturated fat