NIMSET PG Medical Speciality Questions (MD/MS)

 

Each question is followed by 4 alternatives. Answer represents the one that is most appropriate among the alternatives

Anesthesiology

 

Ques   Shown below are normal and an abnormal endtidal-CO2 traces during general anesthesia

  

The depicted abnormal trace is typically seen in which one of the following conditions

            (A)   bronchospasm

            (B)   endotracheal tube disconnection

            (C)   acute hypoxemia

            (D)   venous air embolism

 

 

Ques   Thiopentone sodium (350 mg) was injected through a cannula placed in the cubital fossa for induction of anesthesia to a man weighing 60 Kg.  Patient was still awake even after three minutes and the fingers of the ipsilateral hand started turning blue in colour. Patient complained of severe pain in the hand.  Which one of the following interventions is most appropriate at this stage.

            (A)   injection of more thiopentone suspecting inadequate dose of thiopentone

            (B)   immediate removal of the cannula

            (C)   injection of xylocaine (lidocaine) through the same cannula

            (D)   injection of sodium bicarbonate through the cannula to treat acidosis caused by tissue hypoxia

General Medicine

 

Ques   In a patient suspected to be having pheochromocytoma, the investigations revealed normal chest radiograph, normal ultrasonogram study of the abdomen, normal plain computed tomography (CT) scan of the abdomen and elevated 24-hour urine vanillyl mandelic acid (VMA) levels.  Ideal test to localize the suspected tumor is

            (A)   color Doppler sonography of the abdomen

            (B)   contrast CT scan of the abdomen

            (C)   magnetic resonance imaging (MRI) scan of the abdomen

            (D)   meta-iodo bezyl guanidine (MIBG) scan

 

Ques   A 40-year old female woman who underwent total gastrectomy five years earlier presented with anemia (hemoglobin of 7 gm%).  Essential laboratory findings included total leukocyte count (TLC) of 3,600/cumm, and platelet count of 70,000/cumm.  There were hypersegmented polymorphs on peripheral smear. The investigation of choice to establish the diagnosis is

            (A)   isotope scan of bone marrow

            (B)   red cell survival studies

            (C)   morphologic study of bone marrow aspirate

            (D)   chromosomal analysis

Hospital Administration

 

Ques  Of the four layouts depicted below, which one is better suited for a 6-bedded intensive care unit (ICU)

           

            (A)   layout 1

            (B)   layout 2

            (C)   layout 3

            (D)   layout 4

 

Ques  In cost-effectiveness analysis, which one of the following items is a suitable measure of health benefits i.e. the denominator in cost-effectiveness ratio

            (A)   quality adjusted life years

            (B)   costs saved in preventing a disease

            (C)   opportunity cost

            (D)   direct medical care costs

Orthopedics

               

Ques   A deformity in the right hip is masked by exaggerated lordosis as shown     

in Figure 1.  The deformity is unmasked by flexion of normal opposite i.e. left hip as shown in Figure 2.

               

                The deformity in the right hip is

                (A)   fixed flexion

                (B)   fixed abduction

                (C)   fixed internal rotation

                (D)   fixed adduction

 

Ques   A 65-year old male patient is investigated for carcinoma prostate with severe back               pain.  His serum prostate specific antigen (PSA)  is 35 ng/ml (normal is < 4 ng/ml).  The best investigation for staging will be

                (A)   serial (weekly) PSA levels

                (B)   bone scan with technetium-99m

                (C)   conventional skeletal survey

                (D)   magnetic resonance imaging (MRI)

 

Pathology

 

Ques   A 30-year old man presented with fever, epistaxis, cough, and oliguria. Relevant investigations showed nodular infiltrates in the lung, active urine sediment, and advanced renal failure.  Biopsy from lung lesions showed necrotizing granulomatous inflammation.  The serological marker most specific for the suspected disease is

            (A)   p-ANCA

            (B)   anti Sm

            (C)   c-ANCA

            (D)   anti  U1 RNP

 

Ques   Which one of the following is the classic morphologic manifestation of membranous nephropathy.

            (A)   nodular sclerosis of glomerular tuft

            (B)   crescent formation

            (C)   adhesion formation between glomerular tuft and Bowman's capsule

            (D)   subepithelial deposits of electron-dense material and spikes

Radiation Oncology

 

Ques   A 40-year old female woman who underwent total gastrectomy five years earlier presented with anemia (hemoglobin of 7 gm%).  Essential laboratory findings included total leukocyte count (TLC) of 3,600/cumm, and platelet count of 70,000/cumm.  There were hypersegmented polymorphs on peripheral smear. The investigation of choice to establish the diagnosis is

            (A)   isotope scan of bone marrow

            (B)   red cell survival studies

            (C)   morphologic study of bone marrow aspirate

            (D)   chromosomal analysis

 

Ques   A 58-year old woman presented with long standing history of erythematous skin rashes with recent appearance of plaques over the skin of extremities.  The biopsy of one of the lesions revealed an infiltrative lesion with characteristic cells showing epidermotropism.  The most probable diagnosis is

            (A)   cutaneous T cell lymphoma

            (B)   blast cell crisis in chronic myeloid leukemia (CML)

            (C)   systemic mastocytosis

            (D)   psoriasis