SVIMS 2014

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1290

Biochemistry

11) Which of the following descriptions of DNA replication is not common to the

synthesis of both leading and lagging strands?

A) RNA primer is synthesized

B) Helicase continuously unwinds duplex DNA at the replication fork during

synthesis

C) DNA polymerase III synthesizes DNA

D) DNA ligase repeatedly joins the ends of DNA along growing strand

Correct answer: C     2014 svims

Multiple DNA polymerases take on different roles in the DNA replication process.

In E. coli, DNA Pol III is the polymerase enzyme primarily responsible for DNA

replication. It assembles into a replication complex at the replication fork that exhibits

extremely high processivity, remaining intact for the entire replication cycle.

  • In contrast, DNA Pol I is the enzyme responsible for replacing RNA primers with DNA. DNA Pol I has a 5′ to 3′ exonuclease activity in addition to its polymerase activity, and uses its exonuclease activity to degrade the RNA primers ahead of it as it extends the DNA strand behind it, in a process called nick translation.
    • Pol I is much less processive than Pol III because its primary function in DNA replication is to create many short DNA regions rather than a few very long regions.

Leading strand

  • The leading strand is the strand of nascent DNA which is being synthesized in the same direction as the growing replication fork.
  • A polymerase "reads" the leading strand template and adds complementary nucleotides to the nascent leading strand on a continuous basis.
  • The polymerase involved in leading strand synthesis is DNA polymerase III (DNA Pol III) in prokaryotes and presumably Pol ε in yeasts. In human cells the leading and lagging strands are synthesized by Pol ε and Pol δ, respectively, within the nucleus and Pol γ in the mitochondria.
  • Pol ε can substitute for Pol δ in special circumstances

@ 12) Niacin is synthesized from

A) Tyrosine

B) Phenylalanine

C) Threonine

D) Tryptophan

Correct Answer D

Answer given by examiner : C         2014 svims

 

13) Which of the following steps in the biosynthesis of cholesterol is thought to be

rate controlling and the locus of metabolic regulation?

A) Squalene Lanosterol

B) 3-hydroxy-3-methyl glutaryl CoA Mevalonic acid

C) Lanosterol Cholesterol

D) Mevalonic acid Geranyl pyrophosphate

Correct answer: B     2014 svims

the HMG-CoA Reductase reaction is ratelimiting for cholesterol synthesis.

 

14) Fish oils are rich in

A) ω 6 fatty acid

B) ω 3 fatty acid

C) ω 9 fatty acid

D) Hydroxy fatty acid

Correct answer: B     2014 svims

Fish is a good source of protein and, unlike fatty meat products, it’s not

high in saturated fat. Fish is also a good source of omega3 fatty acids

 

15) The rate limiting step in fatty acid synthesis is catalyzed by

A) Malonyl transacylase

B) Thioesterase

C) Acetyl transacylase

D) Acetyl CoA carboxylase

Correct answer: D     2014 svims

ACC is a biotin-containing enzyme which catalyzes the carboxylation of acetylCoA to malonyl-CoA, the ratelimiting step in fatty acid synthesis

 

PATHOLOGY

 

33. Reinke crystalloids are seen in

A) Gonadoblastoma

B) Leydig cell tumours

C) Sertoli cell tumours

D) Fibrothecoma

Correct answer: B  2014 svims

 

SPM    

 

48) Loss of abnormality of psychological, physiological or anatomical structure or

function refers to

A) Inability

B) Disability

C) Impairment

D) Handicap

Correct answer: C 2014 svims

 

49) In ‘Integrated Management of Childhood Illness’ (IMCI) the following diseases are covered except

A) Pneumonia

B) Diarrhea

C) Malnutrition

D) Urinary tract infection

Correct answer: D     2014 svims

 

50.) Pulmonary hypertension is defined as an increase in mean pulmonary

artery pressure

A) > 25 mmHg at rest

B) < 25 mmHg at rest

C) > 15 mmHg at rest

D) < 15 mmHg at rest

Correct answer: A     2014 svims

 

Medicine

 

68) Which is pathognomonic of motor neuron disease

A) Fasciculation

B) Bladder bowel involvement

C) Pseudohypertrophy

D) Sensory loss in patchy manner

Correct answer: A     2014 svims

 

69) Medial medullary syndrome is characterized by

A) Diplopia

B) Dysarthria

C) Dysphagia

D) Contralateral hemiparesis

Correct answer: D    2014 svims

 

70) The following are the features of thalassemia except

A) Bone marrow hyperplasia

B) Hair on end appearance

C) Splenomegaly is seen

D) Increased osmotic fragility

Correct answer: D    2014 svims

 

Some diseases linked to increased OF include hereditary spherocytosis and

hypernatremia, while some linked to decreased OF include chronic liver disease, iron

deficiency anemia, thalassemia, hyponatremia, polycythemia vera, and sickle cell

anemia after splenectomy.

71) In Steven Johnson syndrome total body surface area blistering is

A) < 10%

B) 10-30%

C) > 30%

D) 30-50%

Correct answer: A    2014 svims

SJS and TEN are clinically similar except for their distribution. By one

commonly accepted definition, changes affect < 10% of body surface area in

SJS and > 30% of body surface area in TEN; involvement of 15 to 30% of

body surface area is considered SJS/TEN overlap.

 

 

72) All the following conditions cause hypertension except

A) Lead poisoning

B) Acute porphyria

C) Cushing’s syndrome

D) Bartter’s syndrome

Correct answer: D    2014 svims

  • Bartter syndrome and Gitelman syndrome (also called tubular hypomagnesemia-hypokalemia with hypocalciuria) are autosomal recessive disorders with a characteristic set of metabolic abnormalities
  • These include hypokalemia, metabolic alkalosis, hyperreninemia, hyperplasia of the juxtaglomerular apparatus (the source of renin in the kidney), hyperaldosteronism, and, in some patients, hypomagnesemia.
  • The hyperaldosteronism associated with Bartter and Gitelman syndromes is a secondary form of hyperaldosteronism that results from a volume contraction-induced increase in renin. These patients are not hypertensive
  • The tubular defects in sodium chloride transport are almost identical to that seen with chronic ingestion of a loop diuretic (mimicking Bartter syndrome) or a thiazide diuretic (mimicking Gitelman syndrome).
  • The salt wasting that occurs results in the following features common to patients with both disorders

 

73) Organism responsible for recurrent Mollaret meningitis is

A) Herpes virus type 2

B) Epstein Barr virus

C) Coccidia

D) Herpes virus type 1

Correct answer: A    2014 svims

Mollaret’s meningitis is a recurrent or chronic inflammation of meninges. Since Mollaret meningitis is a recurrent, benign (non-cancerous), aseptic meningitis, it is now referred to as benign recurrent lymphocytic meningitis.

  • Although for a long time, the cause of Mollaret’s meningitis was not known, recent work has associated this problem with herpes simplex viruses, which cause cold sores and genital herpes.
  • Cases of Mollaret’s resulting from Varicella zoster virus infection, diagnosed by PCR, have been documented. In these cases, PCR for herpes simplex was negative. Some patients also report frequent shingles outbreaks.
  • The chickenpox virus is part of the herpes family.
  • CNS epidermoid cysts can give rise to Mollaret’s meningitis especially with surgical manipulation of cyst contents.

74) Indication for cardiac resynchronization in chronic heart failure

A) NYHA class II

B) QRS duration > 120ms

C) Ejection faction > 40%

D) Atrial fibrillation

Correct answer: B    2014 svims

Cardiac resynchronization therapy (CRT) is a relatively new therapy for

patients with symptomatic heart failure resulting from systolic

dysfunction. CRT is achieved by simultaneously pacing both the left

and right ventricles. Biventricular pacing resynchronizes the timing of

global left ventricular depolarization and improves mechanical

contractility and mitral regurgitation.

 

75) Mechanism of action of sitagliptin

A) DPP IV inhibitor

B) GLP I agonist

C) Inhibit hepatic gluconeogenesis

D) PPAR-gamma receptor agonist

Correct answer: A    2014 svims

Sitagliptin  is an oral antihyperglycemic (antidiabetic drug) of the dipeptidyl

peptidase-4 (DPP-4) inhibitor class. This enzyme-inhibiting drug is used either alone

or in combination with other oral antihyperglycemic agents (such as metformin or a

thiazolidinedione) for treatment of diabetes mellitus type 2 The benefit of this medicine

is its fewer side effects (e.g., less hypoglycemia, less weight gain) in the control of blood

glucose values. While safety is its advantage, efficacy is often challenged as it is often

recommended to be combined with other agents such as metformin.

 

76) Egg shell pattern of calcification on X-ray is seen in

A) Silicosis

B) Asbestosis

C) Bagassosis

D) Berylliosis

Correct answer: A    2014 svims

 

77) Bilateral facial paralysis is seen in

A) Ramsay Hunt syndrome

B) Acoustic neuroma

C) GB syndrome

D) Cholesteatoma

Correct answer: C 2014 svims

 

78) Most common cause of arterial occlusion in 25 year male is

A) Atherosclerosis

B) Buerger’s disease

C) Syphilis

D) Trauma

Correct answer: B     2014 svims

 

79) By 2020 COPD is expected to be

A) Sixth leading cause of death

B) Third leading cause of death

C) Tenth leading cause of death

D) Eleventh leading cause of death

Correct answer: C     2014 svims

 

80) Light’s criteria is used to

A) Assess the severity of COPD

B) Analysis of BAL

C) Assess the severity of pneumonia

D) Analysis of pleural fluid

Correct answer: D 2014 svims

 

PEDIATRICS

 

87) In neonatal ventilation the ratio of compression to ventilation is

A) 2 : 1

B) 3 : 1

C) 4 : 1

D) 5 : 1

Correct answer: B     2014 svims

 

Dermatology

 

95) Anagen phase of hair indicates

A) The phase of activity and growth

B) The phase of transition

C) The phase of resting

D) The phase of degeneration

Correct answer: A     2014 svims

 

ANESTHESIA

 

100) Hallucinations are seen after ___ anaesthesia

A) Ketomine

B) Thiopentone

C) Fentanyl

D) Nitrous oxide

Correct answer: A     2014 svims

 

Radiology

 

110) Best radiographic view for fracture of C1, C2 vertebrae is

A) AP view

B) Odontoid view

C) Lateral view

D) Oblique view

Correct answer: B     2014 svims

 

SURGERY

 

130) The treatment of choice for an adenocarcinoma of rectum 8 cm from the

anal verge is

A) Chemoradiation

B) Anterior resection

C) Abdominoperineal resection

D) 5-FU with leucovorin

Correct answer: B     2014 svims

 

131) Which of the following organs have the maximum cold storage time

A) Kidney

B) Liver

C) Pancreas

D) Heart

Correct answer: C     2014 svims

 

132) The most preferred dosage schedule of tamoxifen in ER positive breast cancer is

A) 10mg OD for 2 years

B) 10mg OD for 5 years

C) 20mg OD for 2 years

D) 20mg OD for 5 years

Correct answer: B     2014 svims

 

133) Hypernephroma arises from

A) Glomerular cells

B) Renal tubular cells

C) Vasa recta

D) Juxtaglomerular apparatus

Correct answer: B     2014 svims

 

 

134) Which of the following is a “muscle splitting” incision

A) Kocher’s

B) Rutherford-Morrison’s

C) Gridiron

D) Pfennensteils

Correct answer: C     2014 svims

 

135) The scope of FNAC is limited in the following thyroid neoplasm

A) Follicular

B) Papillary

B) Anaplastic

D) Medullary

Correct answer: A     2014 svims

 

136) In Crile’s procedure one of the following is done

A) Selective neck dissection

B) Classical radical neck dissection

C) Modified radical neck dissection

D) Supra omohydiod neck dissection

Correct answer: C     2014 svims

 

137) A patient with spontaneous eye opening, who is confused and localizes pain has a Glascow Coma Score of

A) 9

B) 11

C) 13

D) 15

Correct answer: C     2014 svims

 

138) One of the following is high grade tumour of parotid

A) Warthin’s tumour

B) Non hodgkins lymphoma of parotid

C) Acinik cell Ca

D) Poorly differentiated mucoepidermoid CA

Correct answer: D     2014 svims

 

ORTHOPEDICS

 

156) Grid laser photocoagulation is indicated in

A) Ischemic maculopathy

B) Clinically significant macular edema

C) Macular hole

D) Proliferative diabetic retinopathy

Correct answer: B     2014 svims

 

157) Patients with the specific HLA antigen are susceptible to be affected with uveitis

A) HLA B20

B) HLA B27

C) HLA C13

D) HLA B22

Correct answer: B     2014 svims

 

158) Ice pack test is an outpatient diagnostic test to confirm this disease

A) Horner’s syndrome

B) Alzheimer’s disease

C) Myasthenia gravis

D) Oculomotor nerve palsy

Correct answer: C     2014 svims

 

ENT

 

166) Otoacoustic emissions are produced by

A) Inner hair cells

B) Outer hair cells

C) Basilar membrane

D) Auditory nerve

Correct answer: B     2014 svims

 

167) One of the following syndromes involves sensorineural hearing loss associated with abnormality of thyroxin synthesis

A) Alport

B) Pendred

C) Klippel feil

D) Usher

Correct answer: B     2014 svims

 

168) Type I thyroplasty is for vocal cord

A) Mediallisation

B) Lateralization

C) Shortening

D) Lengthening

Correct answer: A     2014 svims

 

GOB

 

193) The only indication for internal podalic version is

A) Singleton pregnancy with transverse lie

B) Second of twin in transverse lie

C) Vertex presentation with cord prolapsed

D) Compound presentation

Correct answer: B     2014 svims

 

194) The type of pelvis that is associated with “Deep Transverse Arrest” in labour is

A) Gynecoid

B) Android

C) Anthropoid

D) Flat

Correct answer: B     2014 svims

 

195) Commonest cause of early abortion is

A) Chromosomal abnormalities

B) Maternal infections

C) Endocrine abnormalities

D) Immunological

Correct answer: A     2014 svims

 

196) Commonest site of metastases in choriocarcinoma is

A) Lungs

B) Vagina

C) Brain

D) Liver

Correct answer: A     2014 svims

 

197) The following is true with respect to fibroids except

A) Fibroids are known to increase in size during pregnancy

B) Can cause symptoms such as menorrhagia, dysmenorrhoea, infertility

C) Often undergo sacromatous change if left untreated

D) Red degeneration in fibroid develops most frequently during pregnancy

Correc t answer: C     2014 svims

 

198) Which one of the following steps is not included in Fothergill’s repair?

A) Amputation of Cx

B) Anterior Colporraphy

C) Opening of POD

D) Posterior Colpoperineorraphy

Correct answer: C     2014 svims

 

199) The most common site of endometriosis

A) Ovary

B) Broad ligament

C) Round ligament

D) Lungs

Correct answer: A     2014 svims

 

200) Following are benign ovarian tumours except

A) Serous cystadenoma

B) Mucinous cystadenoma

C) Dysgerminoma

D) Dermoid cyst

Correct answer: C     2014 svims