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Exam Title :
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QUESTION 1. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRVU
VTVElPTiAw
PART A : Questions 1 - 50
In the central part of palm on a line drawn At line drawn across palm at
Surface
across palm at distal border of fully proximal border of fully
marking
extended thumb extended thumb
3 palmar metacarpal
branches: these join the
digital branches of
4 digital branches supplying medial 3 & ½
Branches superficial palmar arch 3
fingers and lateral 3 digital branches
perforating arteries: these
anastomose with dorsal
metacarpal arteries.
QUESTION 2. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRVU
VTVElPTiAx
All are Uncoupler of oxidative Phosphorylation, except:
a) Thyroxine
b) Thermogenin
c) 2,4 DNP
d) Cyanide
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Correct Answer: D
Your Answer: D
Explanation
Ans. D. Cyanide
Uncouplers: Allow ETC to work normally but dissipate the proton gradient created by the ETC,
bypassing the ATP synthase complex, the Fo-F1 particle, also known as Complex V.
➢ Exogenous
● 2,4-Dinitrophenol
● Dicumarol
➢ Endogenous:
● via UCP-1
▪ Thermogenin
● Via UCP-3
▪ Thyroxine
▪ Norepinephrine
▪ Epinephrine
▪ Leptin
● Via UCP-4
▪ Purine nucleotides
QUESTION 3. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRVU
VTVElPTiAy
True statements about the kidney include:
a) The blood flow accounts for 75% of the total cardiac output.
b) The blood flow is greater in the renal medulla than in the cortex.
c) Over 99% of filtered water is reabsorbed by the kidney.
d) Antidiuretic hormone decreases the water permeability of the collecting duct.
Correct Answer: C
Your Answer: C
Explanation
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· The kidneys receive about 1.2 litres of blood per minute which is about 25% of the cardiac
output
· The blood flow is 20 times greater in the renal cortex than the renal medulla. Over 99% of the
filtered water is reabsorbed by the kidney.
· Antidiuretic hormone increases the water permeability of the collecting duct and hence
increases water retention.
· Kidney secrets erythropoietin which is essential for red blood cell production .
QUESTION 4. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRVU
VTVElPTiAz
Choose the correct statement for the given histological section?
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QUESTION 5. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRVU
VTVElPTiA0
Triangle of Koch is the landmark for :
a) SA node
b) Bundle of His
c) AV node
d) Purkinje fibres
Correct Answer: C
Your Answer: C
Explanation
Ans. C. AV node
Triangle of Koch
Boundaries
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QUESTION 6. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRVU
VTVElPTiA1
During moderate exercise, blood flow is maintained in which of the following organs?
a) Kidney
b) Skeletal muscle
c) Skin
d) Heart
Correct Answer: C
Your Answer: D
Explanation
Ans. C. Skin
QUESTION 7. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRVU
VTVElPTiA2
All of the following can be used as substrate for gluconeogenesis, except:
a) Pyruvate
b) Alanine
c) Acetyl Co A
d) lactate
Correct Answer: C
Your Answer: C
Explanation
Ans. C. Acetyl Co A
❖ Pyruvate
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❖ Lactate
❖ Glycerol
QUESTION 8. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRVU
VTVElPTiA3
Sciatic bed includes all the following Except:
a) Piriformis
b) Obturator internus
c) Adductor magnus
d) Superior gemellus
Correct Answer: A
Your Answer: C
Explanation
Ans. A. Piriformis
· The bed is contributed by- superior gemellus, obturator internus, inferior gemellus, Quadratus
femoris & adductor magnus.
QUESTION 9. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRVU
VTVElPTiA4
CO 2 is primarily transported in the arterial blood as:
a) Dissolved CO 2
b) Carbonic Acid
c) Carbamino-hemoglobin
d) Bicarbonate
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Bicarbonate
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QUESTION 10. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRV
VTVElPTiA5
Which of the following apoprotein is found exclusively associated with chylomicrons?
a) Apo A
b) Apo B48
c) Apo CII
d) Apo D
Correct Answer: B
Your Answer: B
Explanation
· Apo B48 is found exclusively associated with chylomicrons and no other lipoprotein particle.
Apo B48 is synthesized from an mRNA that is transcribed from the Apo B100 gene.
· Following transcription, the mRNA is edited within the intestinal epithelium yielding the Apo
B48 transcript. Apo(a) is an apoprotein found disulfide bonded to Apo B100.
· This then forms a complex with LDL, generating a novel lipoprotein particle identified as
lipoprotein(a), Lp(a). Lp(a) has a strong resemblance to plasminogen and its presence in the
circulation is highly correlated with premature coronary artery disease.
· Apo CII is present in chylomicrons, VLDLs, LDLs, IDLs, and HDLs and is necessary for the
activation of endothelial cell LPL. Apo D is found exclusively with HDLs and is also associated
with cholesterol ester transfer protein (CETP) activity.
· Apo E is found in chylomicrons,VLDLs, LDLs, IDLs, and HDLs. It is necessary for interaction of
lipoprotein with the LDL-receptor (which is also referred to as the Apo B100/Apo E receptor).
a) Maxillary artery
b) Ophthalamic artery
c) Optic nerve
d) Central vein of retina
Correct Answer: A
Your Answer: A
Explanation
· The optic nerve which contains the central artery & vein of retina & the ophthalmic artery
pass through optic canal.
· The maxillary artery is a branch of external carotid & is divided into three parts by lateral
pterygoid muscle. It lies in the infratemporal fossa.
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a) Centromere
b) Telomere
c) Both A & B
d) VNTRs
Correct Answer: C
Your Answer: B
Explanation
Organization of DNA:
a) Pituitary adenoma
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b) Hypothyroidism
c) Sick euthyroid syndrome
d) Pregnancy
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Hypothyroidism
· The patient has both symptoms and a biochemical profile consistent with hypothyroidism.
· A raised prolactin is a well-recognised association. The mechanism of this is not entirely clear
but probably involves an increased prolactin response to the rise in thyrotrophin-releasing
hormone (TRH).
· Apart from a pituitary prolactinoma, other pathological causes of a raised prolactin include:
hypothalamic/pituitary disease, renal impairment (reduced prolactin excretion) and drugs such
as dopamine antagonists (bromocriptine).
· Physiological causes are sleep, pregnancy, exercise, stress and puberty in girls.
a) Adrenaline
b) Nor adrenaline
c) Vitamin D
d) Dopamine
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Correct Answer: C
Your Answer: C
Explanation
Ans. C. Vitamin D
· Aldosterone
· Cortisol
· Calcitriol
· Estrogen
· Progesterone
· Testosterone
· Thyroid hormones
Other than the thyroid hormones, all factors that use the nuclear receptor are steroid hormones
a) Western Blot
b) Electrophoresis
c) Tandem MS
d) ELISA
Correct Answer: C
Your Answer: C
Explanation
Ans. C. Tandem MS
· Tandem MS involves use of two Mass spectrometers one after the other, i.e. in series. The first
MS will separate the various analytes as per q/m, while the second one will identify each
separated analyte. As many as 40 IEMs can be identified from a single sample, and it is the
preferred technique for neonatal screening for metabolic diseases.
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a) Azygos vein
b) Hemiazygos vein
c) Accessory hemiazygos vein
d) Left brachiocephalic vein
Correct Answer: B
Your Answer: B
Explanation
HEMIAZYGOS VEIN :
a) Stellate cells
b) Basket cells
c) Granule cells
d) Golgi cells
Correct Answer: C
Your Answer: C
Explanation
· Purkinje cells are inhibited by all other cortical interneurons (A, B, D).
· Purkinje neurons project to deep nuclei; they are only output from cerebellar cortex to deep
nuclei.
a) Vit. B1
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b) Vit. B2
c) Vit. B3
d) Vit. B12
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Vit. B2
Riboflavin: Vitamin B2
· Ariboflavinosis results in normochromic normocytic anemia and stomatitis, which presents as:
· Deficiency is sometimes called "pellagra sine pellagra", since the stomatitis of pellagra is
similar.
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Explanation
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a) Aorta
b) Inferior vena cava
c) Portal vein
d) Liver
Correct Answer: B
Your Answer: B
Explanation
· It is situated behind the free margin of the lesser omentum at the level of
· t12 vertebra.
Relationship:
· Anteriorly: Right free margin of the lesser omentum containing portal vein, hepatic artery and
bile duct.
· Posteriorly: The inferior vena cava, right suprarenal gland and t12 vertebra.
a) Cellular polarity
b) Transmission of action potentials from one fibre to another in skeletal muscle
c) Rapid transmission of action potentials by purkinje fibres
d) None
Correct Answer: C
Your Answer: C
Explanation
· The gap junction is a specialised channel of transport and communication for small molecules
and ions between the cytoplasm of two closely apposed cells.
· Electron microscopy reveals the two cell membranes to be separated by only 1–2nm at the
point where the gap junctions are sited.
· Each membrane has a large number of small protein channels termed connexons. Individual
connexons of both cells are joined to each other to create a communicating tunnel, which spans
the membrane gap.
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· Each connexon on each membrane is made up of six polypeptide chain subunits, which span
the membrane.
· Electrophysiological studies have shown low electrical resistance for the cell when there are
abundant gap junctions. Injection of low molecular-weight dyes results in rapid spread between
cells.
· Therefore, gap junctions provide a pathway by which small molecules and ions can rapidly
move down concentration gradients between cells.
· Gap junctions are evident in epithelia and smooth muscle. They permit all of the cells to act as
a syncytium.
a) Glycolysis
b) Krebs’ cycle
c) Oxidative Phosphorylation
d) Salvage Pathway
Correct Answer: C
Your Answer: B
Explanation
· Thus, hypocalcemia causes downregulation of these important pathways, besides causing the
regular physiological alterations related to muscle contraction, like tetany, etc.
· Fluoroacetate combines with oxaloacetate to form the reactive compound fluoro citrate which
binds tightly to the enzyme aconitase. This is the primary mode of toxicity of the molecule, but
secondary effects due to the free fluoride from both the precursor (fluoroacetate) and product
(fluoro citrate) by inducing hypocalcemia are significant; both physiological effects and
biochemical effects are seen.
· In addition, the action of fluoride in cytoplasm is well known. It Chelates the Mg++ ion, and
interferes with the action of enzyme Enolase, thereby inhibiting glycolysis.
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Ans. A. Vessels that run upwards from gastroduodenal and retroduodenal arteries
· The bile duct is sub classified into three segments hilar, supraduodenal & retropancreatic.
· It arises from the superior Pancreaticoduodenal artery, right branch of hepatic artery, cystic
artery, gastroduodenal artery and retroduodenal artery.
· The most important of these vessels run along the lateral border of ducts and are called 3 ‘o’
clock & 9 ‘o’ clock arteries.
· The hilar duct receives blood from surrounding vessel forming a rich network on surface of the
ducts in continuity with the plexus around supraduodenal duct.
· The retropancreatic common bile duct gets its blood supply from retroduodenal artery.
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A. Synovial lining extends deep to annular ligament and continue with superior RU joint
C. B is the anterior band of ulnar collateral ligament and is the strongest of all three bands
Ans. C. Galactosemia
1. Galactokinase
3. Epimerase
Deficiency of any of these three enzymes can present with Galactosemia, however,
most commonly, the deficiency of GALT is encountered. The important presentations of
galactosemia include:
· Jaundice
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· Lethargy
· Hypotonia
· Sepsis ( E coli)
· Seizures
· Brain edema
o In patients of neonatal DM, both the tests would give positive result.
a) 8-12 Hz
b) 18-30 Hz
c) 4-7 Hz
d) <4 Hz
Correct Answer: D
Your Answer: D
Explanation
Ans. D. <4 Hz
· Awake state - Beta wave dominates. EEG is said to be desynchronised, it displays low voltage,
high frequency activity (18-20 Hz)
· Relaxed individual with eyes closed - Alpha wave predominates, frequency 8-12 Hz & 50-100 V
amplitude. Most marked in parietooccipital area.
o Stage I NREM sleep - Alpha waves interspersed with low frequency (4-7 Hz) theta waves.
o Stage II NREM sleep - EEG slows further, but slow wave activity interrupted by sleep spindles
(12-14 Hz) & by large K complexes (large, low potentials)
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o REM sleep - EEG again become desynchronized. Low voltage, fast activity of REM sleep
resembles that seen in aroused subject.
o Muscle tone is completely lost; but phasic contractions occur in number of muscles, most
notably eye muscles.
a) Median nerve
b) Radial nerve
c) Musculocutaneus nerve
d) Posterior interosseous nerve
Correct Answer: B
Your Answer: B
Explanation
The following are branches of the radial nerve (including the superficial branch of the radial
nerve and the deep branch of the radial nerve/posterior interosseous nerve).
Cutaneous
Cutaneous innervation by the radial nerve is provided by the following nerve branches:
The superficial branch of the radial nerve provides sensory innervation to much of the back of
the hand, including the web of skin between the thumb and index finger.
Motor
Muscles of the posterior forearm. All the labelled muscles (that is, all the visible muscles except
the ones on the dorsal hand and one at top left) are innervated by the radial nerve, and
represent all muscles innervated by the radial nerve except for the Supinator.
· Anconeus
· Brachioradialis
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· Supinator
Posterior interosseous nerve (a continuation of the deep branch after the Supinator):
· Extensor digitorum
· Extensor indicis
The radial nerve (and its deep branch) provides motor innervation to the muscles in the
posterior compartment of the arm and forearm, which are mostly extensors.
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Correct Answer: B
Your Answer: B
Explanation
❖ Normal fasting blood glucose value < 100 mg% (ADA criteria)/ 110 mg% (WHO criteria)
❖ Normal two hour post glucose loading with 75gm < 140 mg%. Physiologically, the level
returns to fasting glucose level or less.
a) Gas embolism
b) Fat embolism
c) Amniotic fluid
d) Tumor embolism
Correct Answer: A
Your Answer: A
Explanation
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· If a diver has been beneath the sea long enough that large amounts of nitrogen have dissolved
in his or her body and the diver then suddenly comes back to the surface of the sea, significant
quantities of nitrogen bubbles can develop in the body fluids either intracellularly or
extracellularly and can cause minor or serious damage in almost any area of the body,
depending on the number and sizes of bubbles formed; this is called decompression sickness
· In 5 to 10% of the patient nervous system symptoms occur ranging from dizziness to paralysis
or collapse and unconsciousness. 2% of patients develop “the chokes” caused by gas embolism
in the capillaries of the lungs; patient complains of dyspnoea followed by severe pulmonary
edema and occasionally, death.
a) Type I
b) Type III
c) Type IV
d) Type II
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Type II
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a) Erythrocyte transketolase
b) Fatty acid synthase
c) Phosphofructokinase-1
d) Pyruvate dehydrogenase
Correct Answer: D
Your Answer: D
Explanation
❖ Fatty acid synthase is the enzyme complex involved in fatty acid synthesis, and also not
related to energy production.
❖ PFK-1 is an enzyme of glycolysis, but it does not use TPP, but Mg ++ ion.
❖ Pyruvate dehydrogenase catalyses the bridging reaction between glycolysis and TCA cycle,
and it requires TPP. Other enzymes requiring TPP include α-ketoglutarate dehydrogenase and
branched-chain keto-acid dehydrogenase.
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2 nd Arch – Facial
Pre trematric nerve persist for 1 st arch only and that is chorda tympani branch of facial nerve
a) Hypothalamus
b) Midbrain
c) Pons
d) Medulla
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Medulla
· Vomiting is believed to be controlled by two distinct brain centres-the vomiting centre and the
chemoreceptor trigger zone-both located in the medulla oblongata.
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· The vomiting centre initiates and controls the act of emesis, which involves a series of
contractions of the smooth muscles lining the digestive tract.
a) Corpus callosum
b) Fornix
c) cerebellum
d) hypothalamus
Correct Answer: D
Your Answer: D
Explanation
Ans. D. D- hypothalamus
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QUESTION 35. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRV
PTiAzNA==
The following is an example for unusual base :
a) Di hydro uracil
b) Adenine
c) Cytosine
d) Uracil
Correct Answer: A
Your Answer: A
Explanation
Two types of nitrogenous bases are present in all nucleic acids namely : Purines :
o Adenine
o Guanine
Pyrimidines :
· Cytosine
· Thymine
· Uracil
A few other modified pyrimidine bases like dihydrouracil and 5-methyl cytosine are rarely found
in some types of RNA.
a) Na+
b) HCO3
c) PO4
d) H+
Correct Answer: D
Your Answer: D
Explanation
Ans. D. H+
Transport proteins involved in the movement of Na+ and Cl- Across the apical
membranes of Renal Tubular Cells
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Site
Na + amino acid Con
Na + uptake, amino acid uptake
Proximal tubule transporter
Na/H exchanger
Na + uptake, H* extrusion
Cl/base exchanger
Cl- uptake
a) Hip
b) Shoulder
c) Knee
d) Elbow
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Hip
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a) Bile salt
b) CCK
c) Secretin
d) Gastrin
Correct Answer: A
Your Answer: A
Explanation
· Cholagogue is the one which causes gall bladder contraction, thereby increasing flow (eg CCK
– PZ)
a) Glycogen synthesis
b) Galactose metabolism
c) Heparin synthesis
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d) Sphingolipid synthesis
Correct Answer: D
Your Answer: C
Explanation
❖ UDP galactose is converted to UDP glucose in the final step of its metabolism.
❖ UDP glucose gets converted to UDP-glucuronic acid, which can then be isomerised to
iduronic acid, both of which are essential precursors to glycosaminoglycan (GAG) synthesis.
UDP-glucuronic acid is also used for conjugation of bilirubin.
a) A
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b) B
c) C
d) D
Correct Answer: D
Your Answer: C
Explanation
Ans. D. (D)
The iliopsoas muscle is the chief flexor of the thigh and inserts on the lesser trochanter.
a) Sedation
b) Diuresis
c) Miosis
d) Constipation
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Constipation
Because of the stimulation of µ receptor constipation will occur. They can be found in the
intestinal tract.
This will be the cause of constipation i.e. a major side effect of μ agonists, due to inhibition of
peristaltic action.
• Sedation
• Analgesia
• Miosis
• Dysphoria
• Diuresis
Among the five related receptors the κ-opioid receptor will bind opium-like compounds in the
brain which are responsible for mediating the effects of these compounds.
• Mood
• Perception of pain
• Consciousness
• Motor control
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QUESTION 42. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRV
PTiA0MQ==
Increased afferent input discharge by the baroreceptor:
· Baroreceptor are found in the carotid sinus, as well as the atria, aorta and pulmonary
circulation.
· They are stretch receptors that detect low pressures. With stretch due to an increase in blood
pressure the afferent discharge increases, leading to reduced sympathetic discharge, reduced
vasoconstriction and bradycardia; cardiac output falls, as does peripheral vascular resistance.
· At normal blood pressure the baroreceptor fire slowly, A fall in discharge would increase renin
production.
a) Riboflavin
b) Pyridoxine
c) Niacin
d) Thiamine
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Thiamine
Beriberi:
– It involves CNS in the form of parasthesia, general weakness, atrophy, foot and wrist drop.
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– It involves CVS in the form of palpitation, tachycardia, AR, edema, high cardiac output failure
Wernicke’s encephalopathy:
a) Curve ‘A’ indicates RPF which increase initially due to decrease plasma oncotic pressure
b) Curve ‘A’ indicates GFR which increase initially due to increase hydrostatic pressure of
glomerulus
c) Curve ‘B’ indicates RPF which decreases due to increase afferent arteriole resistance
d) Curve ‘B’ indicates GFR which decreases due to decrease hydrostatic pressure of
glomerulus
Correct Answer: B
Your Answer: B
Explanation
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Ans. B. Curve ‘A’ indicates GFR which increase initially due to increase hydrostatic
pressure of glomerulus
Curve A: GFR, which increases initially due to increased hydrostatic pressure in glomerulus,
later decreases due to increase oncotic pressure of glomerular capillary as well as severe
decrease in hydrostatic pressure of glomerular capillary.
Curve B: RPF, which decreases proportionately with increased efferent arterioles resistance.
· Mutations in the HPRT1 gene cause a severe deficiency of the enzyme hypoxanthine
phosphoribosyltransferase 1.
· This enzyme is responsible for recycling purines, a type of building block of DNA and its
chemical cousin RNA.
· When this enzyme is lacking, the breakdown of purines results in abnormally high levels of
uric acid in the body.
· It is unclear how a shortage of this enzyme causes the neurological and behavioral problems
characteristic of Lesch-Nyhan syndrome.
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Your Answer: A
Explanation
· Hypoxia is the chief stimulus to erythropoiesis. Around 85% of erythropoietin (166 amino
acids) is produced by the kidneys and 15% is produced by the liver.
· The rate-controlling enzyme for porphyrin and haem synthesis is ALA-S. Its synthesis is
inhibited by haemoglobin in polycythemia rubra vera.
· Genetically engineered erythropoietin is now available for the treatment of anaemia caused by
renal failure.
· Consequently, noncompetitive inhibitors bind to enzymes in locations remote from the active
site.
· For this reason, the degree of inhibition is based solely upon the concentration of inhibitor and
increasing the substrate concentrations do not compete with or change the inhibition.
a) Hydrogen ions
b) Potassium ions
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c) Sodium ions
d) Calcium ions
Correct Answer: B
Your Answer: B
Explanation
· The Na+ channels rapidly enter the inactivated state and remain in this state for a few
milliseconds before returning to the resting state.
· In addition, the direction of the electrical gradient for Na+ is reversed during the overshoot
because the membrane potential is reversed, and this limits Na+ influx.
· The net movement of positive charge out of the cell due to K+ efflux at this time helps
complete the process of repolarization.
· The slow return of the K+ channels to the closed state also explains the after-
hyperpolarization.
a) Progesterone
b) Glucagon
c) Aldosterone
d) Epinephrine
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Glucagon
· The balance and integration of the metabolism of fats and carbohydrates are mediated by the
hormones insulin, glucagon, epinephrine, and norepinephrine.
· All of these hormones exercise acute effects upon metabolism. Glucagon stimulates
gluconeogenesis and blocks glycolysis.
· When blood sugar levels get low, the α cells of the pancreas release glucagon. The main
targets of glucagon are the liver and adipose tissue.
· In the liver, glucagon stimulates the cyclic AMP–mediated cascade that causes
Phosphorylation of phosphorylase and glycogen synthesis.
· This effectively turns off glycogen synthase and turns on glycogen phosphorylase, thereby
causing a breakdown of glycogen and a production of glucose in liver, which ultimately raises
blood glucose levels.
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· Insulin and glucagon are two antagonistic hormones that maintain the balance of sugar and
fatty acids in blood. Insulin is produced by the cells of the pancreas and its release is stimulated
by high levels of glucose in the blood. It has a number of effects, but its major effect is to allow
the entry of glucose into cells.
· Insulin also allows the dephosphorylation of key regulatory enzymes. The consequence of
these actions is to allow glycogen synthesis and storage in both muscle and liver, suppression of
gluconeogenesis, acceleration of glycolysis, promotion of the synthesis of fatty acids, and
promotion of the uptake and synthesis of amino acids into protein.
A double superior vena cava is characterized by the persistence of the left anterior cardinal
vein and failure of the left brachiocephalic vein to form. The persistent left anterior cardinal
vein, the left superior vena cava, drains into the right atrium by way of the coronary sinus.
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The Image shows the transmission cycle of which of the following arboviruses?
a) JEV
b) WNV
c) YF
d) KFD
Correct Answer: B
Your Answer: A
Explanation
Ans. B. WNV
· Widely distributed in Europe, Africa, Middle East, Asia, Russia and South West Africa.
· Reservoir - birds (crows, sparrows, jays); crow and blue jays highly susceptible and die; some
birds remain asymptomatic and become amplifying reservoirs
· Humans/horses are dead end hosts as they have insufficient viremia to infect feeding
mosquitoes.
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QUESTION 52. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRV
PTiA1MQ==
The extrinsic incubation period for dengue is-
a) 8-12 days
b) 20-30 days
c) 30-40 days
d) 1-5 days
Correct Answer: A
Your Answer: D
Explanation
· The EIP is commonly defined as “the interval between the acquisition of an infectious agent by
a vector and the vector's ability to transmit the agent to other susceptible vertebrate hosts”
a) Zidovudine
b) Lamivudine
c) Stavudine
d) Didanosine
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Lamivudine
NRTIs:
These compounds inhibit both HIV- 1 and HIV-2, and several have broad- spectrum activity
against other human and animal retroviruses
Drug having activity against for both HIV and HBV are “LET”
· Lamivudine
· Emtricitabine
· Tenofovir
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1967 Junganwala- integrate services- equal pay for equal work, special pay for special work,
good service condition, no private practice
a) Edrophonium
b) Neostigmine
c) Dyflos
d) Tacrine
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Neostigmine
· Edrophonium and tacrine attach only to the anionic site of AChE via weak electrostatic bonds.
Reactivation of enzyme occurs in < 10 min, and does not involve hydrolysis of the inhibitor, but
only its diffusion
· Carbamates like neostigmine attach to both Anionic & esteritic site while OGPs (dyflos) attach
only to esteratic site of the AChE enzyme.
· The carbamylated enzyme undergoes slow hydrolysis (30 minutes to 6 hours) - Considered
Reversible inhibitors
· The phosphorylated enzyme has covalent bonds. It is extremely stable and reacts with water
very slowly (hundreds of hours) – considered Irreversible inhibitors.
a) Adenovirus type 18
b) Adenovirus type 8
c) Entero virus 72
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d) Adenovirus type 7
Correct Answer: A
Your Answer: Unanswered
Explanation
· Types 12, 18 and 31 are able to induce tumors when inoculated into new born hamsters.
· However, adenoviruses have not yet directly been implicated in tumors in humans.
a) Ependymoma
b) Oligodendroglioma
c) Glioblastoma multiforme
d) Medulloblastoma
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Ependymoma
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a) Arsenic poisoning
b) Lead poisoning
c) Mercury poisoning
d) Cadmium poisoning
Correct Answer: A
Your Answer: A
Explanation
Acute Arsenic poisoning is a metallic taste in the mouth and some odor of garlic in the breath.
• Abdominal pain
• Watery diarrhea
• Nausea
• Vomiting
After monthly post an Acute Intoxication, which transverse white striae in the nails (Aldrich-
Mees lines) and it may become apparent.
a) Meropenem
b) Cotrimoxazole
c) Amikacin
d) Doxycycline
Correct Answer: C
Your Answer: A
Explanation
Ans. C. Amikacin
Cepacia syndrome
· Rapidly fatal syndrome of respiratory distress and septicaemia caused by B. cepacia in Cystic
fibrosis patients
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· Cotrimoxazole, meropenem, and doxycycline are the most effective agents in vitro and may be
started as first line agents
· The vaccines use virus-like particles (VLPs) that consist of the HPV L1 major capsid protein.
· The L1 protein self-assembles into VLPs when expressed in eukaryotic cells (i.e., yeast for
Gardasil vaccine or insect cells for the Cervarix vaccine). These VLPs contain the same epitopes
as the HPV virion. However, they do not contain genetic material and cannot transmit infection.
a) Sandfly
b) TseTse fly
c) Mansonia mosquito
d) Simulum fly
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Sandfly
· Phlebotomus
· Habitat- Holes and crevices in walls, tress, dark rooms, sand bed
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· Sandfly hops DDT sprayed till 4-6 feet height. only female bites
· P. Argentipes- Kala Azar( Visceral Leishmaniasis) P. Papatasi and P.sargeinti- Oriental sore (
cutaneous L.)
a) Strongyloides
b) Trichuris
c) Wuchereria
d) Ascaris
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Strongyloides.
· Since the females are ovo-viviparous, eggs are not seen. In immunocompromised,
disseminated infection can occur
· Strongyloides is the smallest nematode and rhabditiform larvae is the most common form seen
in the stool specimen.
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a) Congo-red
b) Crystal violet
c) Methenamine silver
d) Thioflavin T
Correct Answer: C
Your Answer: B
Explanation
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Alcian blue
a) <3/60-1/60
b) <1/60-perception
c) No perception of light
d) All of the above
Correct Answer: D
Your Answer: D
Explanation
a) Heart
b) Spleen
c) Kidney
d) Lung
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Lung
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Red infarcts 3. In tissues with dual circulation (e.g. Lung & S. Intestine)
(Haemorrhagic): Occur
with 4. In tissues that were previously congested because of
sluggish venous out flow.
1. Arterial occlusions, or
White infarcts: occur 2. In solid organs e.g. Heart, spleen, kidney and brain
with where the solidity of tissue limits the amount of
hemorrhage that can seep into the area of ischemic
necrosis.
a) Shock
b) Liver failure
c) Concomitant beta blocker use
d) MI
Correct Answer: D
Your Answer: D
Explanation
Ans. D. MI
· Liver failure
· Prolonged infusion
· MI: As lidocaine binds to beta-1 acidic glycoprotein, which is increased in MI. The free drug
decreases and hence for the same clinical effect dose needs to be increased.
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QUESTION 67. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdRV
PTiA2Ng==
Overlapping of bones in intrauterine death is known as:
a) Spalding Sign
b) Robert’s Sign
c) Wood's Sign.
d) Ewald’s sign
Correct Answer: A
Your Answer: A
Explanation
a) 4 per 1000 LB
b) 6 per 1000 LB
c) 40 per 1000 LB
d) 60 per 1000 LB
Correct Answer: A
Your Answer: A
Explanation
Live births 2500, No of deaths as per definition= 5 due to infections + 2 due to obstructed
labour+ 3 due to PPH, due to electrocution cannot be included.
So 5+2+3/2500*1000= 4
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a) Bernadino Ramazzini
b) John Snow
c) Ignaz Semmelweis
d) Robert Koch
Correct Answer: A
Your Answer: C
Explanation
a) Pimavanserin
b) Valbenazine
c) Lofexidine
d) Botox
Correct Answer: B
Your Answer: A
Explanation
Ans. B. Valbenazine
· De tetrabenazine
· Valbenazine
a) Melanin
b) Hemosiderin
c) Bilirubin
d) Lipofuscin
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Correct Answer: B
Your Answer: B
Explanation
Ans. B. Hemosiderin
Perl’s stain (Prussian blue stain) is used for demonstration of hemosiderin in tissues 1471
· Males commonly are symptomatic (dysuria, urethral discharge) in comparison to females who
are often asymptomatic.
· Prostatitis and epididymitis may occur following ascent of the infection. Proctitis is seen
following anal sex
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a) Smothering + throttling
b) Smothering + Mugging
c) Smothering + Traumatic asphyxia
d) Smothering + Ligature strangulation
Correct Answer: C
Your Answer: C
Explanation
· Asphyxia by smothering is caused by blocking air entry into the lungs by simultaneous closure
of the nose and mouth.
· They are usually homicidal, rarely suicidal and very rarely accidental. Bruises or abrasions on
the cheeks, around the mouth, lips or lesions within the lips or mouth are the features of
smothering.
· ESIC 2.0- 2015 launch- Abhiyan Indradhanush- daily new bed sheet VIBGYOR pattern- Sunday
violet, Saturday red.
· Special OPD for geriatric and disabled, online health records- Project panchdeep
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a) Sotalol
b) Pindolol
c) Nadolol
d) Betaxolol
Correct Answer: B
Your Answer: D
Explanation
Ans. B. Pindolol
Pindolol being a lipid soluble drug can across blood brain barrier and cause central side-effects
like nightmares and seizures.
a) Hepatitis
b) Cirrhosis
c) Jaundice
d) Cholangitis
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Cirrhosis
a) Aphthous ulcer
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b) Cheilosis
c) Hairy leukoplakia
d) Oral thrush
Correct Answer: D
Your Answer: D
Explanation
· The patient has oral thrush, a lesion resulting from oral candidiasis in persons who are
immunocompromised.
· During the inter-epidemic periods, the vibrios are maintained in saline waters of coastal seas
and brackish estuaries.
· Pathogenicity of V. cholerae is not d/t O antigen but specific virulence factors like CT, Tc
a) Serum sickness
b) Arthus reaction
c) Anaphylaxis
d) Lupus nephritis
Correct Answer: C
Your Answer: C
Explanation
Ans. C. Anaphylaxis
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· These reactions are often called allergy, and the antigens that elicit them are allergens
immediate hypersensitivity may occur as a systemic disorder as a local reaction.
a) 6 hours
b) 12 hours
c) 24 hours
d) 48 hours
Correct Answer: C
Your Answer: B
Explanation
Ans. C. 24 hours
Research had proved that following sexual intercourse motile spermatozoa should be found in
vagina for 24 hrs,that they are likely to be found up to 3 days later, and occasionally they are
found 7 days later.
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a) C. tetani
b) V. cholerae
c) S. aureus
d) Hemophilus
Correct Answer: A
Your Answer: A
Explanation
Ans. A. C. tetani .
Since, there is no further human to human transmission, tetanus is a dead end infection.
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· The T. vaginalis trophozoite is oval or pear shaped. It is slightly larger than a white blood cell,
measuring 9 X 7 μm.
· It has four flagellae and a fifth flagellum is folded into an undulating membrane.
· T. vaginalis inhabits the lower genital tract of females and the urethra and prostate of males.
Hence can be seen in the urine sediment.
a) ACE
b) NPHS 2
c) HOX 11
d) PAX
Correct Answer: B
Your Answer: B
Explanation
Ans. B. NPHS 2
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· Recently certain gene mutations have been recognized which are associated with certain
glomerulonephritis, producing nephrotic syndrome.
· The gene mutations codes certain proteins and the common feature of these proteins is their
localization to the structures of the glomerular filtration barrier; such as slit diaphragm and
Podocyte cytoskeletal structures such as actin.
· Their specific functions and interaction are incompletely understood, but it is clear that the
integrity of each is necessary to maintain the normal glomerular filtration barrier
a) Beta 1 receptor
b) M2 receptor
c) Tyrosine kinase receptor
d) Mineralocorticoid receptor
Correct Answer: D
Your Answer: D
Explanation
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a)
b)
c)
d)
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Cobra
Option A is cobra snake; option B is Mamba snake; Option C is Black widow spider; Option D is
Krait snake.
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a) 15 ppm
b) 20 ppm
c) 25 ppm
d) 30 ppm
Correct Answer: D
Your Answer: D
Explanation
Ans. D. 30 ppm
· Double fortified salt (DFS)- iron +iodine- 40 microgram of iodine + 1 mg iron per gram of salt
· Iodized oil ( for administration)- oral 2 ml single dose for 2 years and IM 1 ml single dose for 4
years
a) An anaerobic environment
b) pH of >4.6
c) High salt and sugar concentrations
d) Temperatures of >4°c
Correct Answer: C
Your Answer: Unanswered
Explanation
Toxin production in canned food with spores of C. botulinum requires a rare confluence of
product storage conditions: An anaerobic environment, a pH of >4.6, low salt and sugar
concentrations, and temperatures of >4°C.
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DALY is:
Ans. A. No. of years lost due to ill health, disability or early death
a) Physical antagonist
b) Chemical antagonist
c) Pharmacokinetic antagonist
d) Competitive antagonist
Correct Answer: C
Your Answer: C
Explanation
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a) Plasma cell
b) Eosinophil
c) Lymphocyte
d) Macrophage
Correct Answer: A
Your Answer: D
Explanation
Plasma cells Ovoid cells with abundant deep blue cytoplasm and perinuclear hof, eccentric
nucleus with coarse chromatin and clock face (art wheel) pattern
a) 40 min
b) 10 min
c) 60 min
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d) 90 min
Correct Answer: A
Your Answer: A
Explanation
Ans. A. 40 min
Feature Time
· ABC- Always better control A- outstandingly important ( very tight control as costly), B
average important ( less tight control as medium cost), C relatively unimportant ( least control)
for maintaining drug inventory and rationalizing the budget.
· VED, V- Vital- very important 10%, E- essential drugs- ok can come in some time ( 40% of total
item), D- Desirable – can wait for long time ( 50% of drugs), so explain with name of drugs
· FIFO- first in first out, HML- high cost, medium cost, low cost, FSN- fast, slow, non moving,
SDR- scarce, difficult, easy to acquire
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· Act, a surface protein, induces host cell actin polymerization, which propels them to the cell
membrane. Pushing against the host cell membrane, they cause formation of elongated
protrusions called filopods.
· These filopods are ingested by adjacent epithelial cells, macrophages, and hepatocytes, the
listeriae are released, and the cycle begins again.
· L monocytogenes can move from cell to cell without being exposed to antibodies, complement,
or PMN’s. Shigella flexneri and Rickettsiae also usurp the host cells’ actin and contractile
system to spread their infections.
a) Medullary type
b) Follicular type
c) Papillary type
d) Anaplastic type
Correct Answer: C
Your Answer: C
Explanation
Papillary carcinoma of thyroid is the most common thyroid carcinoma, comprising 60-70% of
cases.
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a) 2
b) 20
c) 24
d) 30
Correct Answer: C
Your Answer: C
Explanation
Ans. C. 24
Number of teeth are 24 at the age of 11 out of which, 20 are permanent comprising of-
• 8 incisors
• 4 molars
• 8 premolars and 4 deciduous teeth.
· PMSMA is the scheme launched for pregnant women under which free checkups will be done
on 9th of every month.
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· Breast feeding promotion is not a part of PMSMA rather it’s in another initiative known as
MAA (mothers absolute affection)
Toxin is produced locally and is absorbed from the local site of multiplication causing toxemia.
However, toxin may not always be detectable in the serum.
Dependency ratio = (No of people aged 0-14 and those aged 65 and over/number of people
aged 15 to 64 years) X 100
a) Sarcoma
b) Lymphoma
c) Carcinoma
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d) None
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Sarcoma
· Two cell types can be seen microscopically in synovial sarcoma. One fibrous type, known as a
spindle or sarcomatous cell, is relatively small and uniform, and found in sheets. The other is
epithelial in appearance.
· Classical synovial sarcoma has a biphasic appearance with both types present. Synovial
sarcoma can also appear to be poorly differentiated or to be monophasic fibrous, consisting only
of sheets of spindle cells. Some authorities state that, extremely rarely, there can be a
monophasic epithelial form which causes difficulty in differential diagnosis.
· Like other soft tissue sarcomas, there is no universal grading system for reporting
histopathology results.
· In Europe, the Trojani or French system is gaining in popularity while the NCI grading system
is more common in the United States.
The Trojani system scores the sample, depending on tumour differentiation, mitotic index, and
tumour necrosis, between 0 and 6 and then converts this into a grade of between 1 and 3, with
1 representing a less aggressive tumour. The NCI system is also a three-grade one, but takes a
number of other factors into account.
a) 3 hours
b) 6 hours
c) 9 hours
d) 18 hours
Correct Answer: A
Your Answer: A
Explanation
Ans. A. 3 hours
· Hence even after increasing the dose in this case half- life continues to be 3 hours.
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A 35-year-old female patient presented with a history of vulval pruritus and vaginal
discharge that started 10 days ago. Pap smear showed numerous acute inflammatory
cells along with planoconvex eggs 50-60 micron in size (Image). What is the likely
diagnosis ?
a) Candida
b) Trichuris
c) Trichomonas
d) Enterobius
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Enterobius
· Migrating female worms may enter vagina/urethra and cause vaginitis or urethritis.
· The female may lay eggs there, as in the case in the question above.
a) 50 mcg/dl
b) 70 mcg/dl
c) 90 mcg/dl
d) 110 mcg/dl
Correct Answer: B
Your Answer: D
Explanation
Ans. B. 70 mcg/dl
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· Diagnosis- Coproporphyrin in urine (CPU) >150 mcg/L- useful screening test as well indicates
exposure
· Quantitative Indicators- Lead in blood- > 70 mcg/dl- appearance of clinical symptoms, lead in
urine- >0.8 mg/l
a) Lymphoid
b) Neural
c) Vascular
d) Muscular
Correct Answer: C
Your Answer: C
Explanation
Ans. C. Vascular
Kaposi sarcoma (KS) is vascular neoplasm caused by human herpesvirus 8 (HHV8) that is highly
associated with acquired immunodeficiency syndrome (AIDS).
a) Bacillus stearothermophilus
b) Bacillus atropheus
c) Bacillus subtilis
d) Bacillus cereus
Correct Answer: C
Your Answer: C
Explanation
· Spores of Bacillus subtilis are used as biological control in hot air oven sterilization.
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· Spores and crystalline insecticidal proteins produced by B. thuringiensis have been used to
control insect pests like mosquitoes.
a) Phase V
b) Phase III
c) Phase II
d) Phase IV
Correct Answer: B
Your Answer: D
Explanation
Phase 0- Healthy human volunteer- 10-12- micro dosing and effect on body
Phase I- Healthy human volunteer- 20-100 – sub therapeutic dose- for dose ranging- safety and
non toxicity- max tolerable dose of the drug
Phase II- patients- 100-300- therapeutic dose- effectiveness of drug in the disease- efficacy and
safety in therapeutic doses- max drugs fail in phase II as efficacy not up to the expectation
Phase III- patients- 1000-2000- therapeutic doses- compare with known existing drug in
therapeutic doses- BABE study- after this u get FDA approval- new drug can be launched in
market
Phase IV- patients- any person taking drug in the general population- post marketing
surveillance- it is the longest phase- long term side effects
Phase V- translational research- data from all reported use- research on ongoing data collected-
no patients or volunteers
a) 5 ASA agents
b) Steroids
c) Azathioprine
d) Infliximab
Correct Answer: B
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Your Answer: A
Explanation
Ans. B. Steroids
Steroids
· Steroids are used only for treatment of an acute attack of UC (DOC in moderate/severe cases)
and CD (DOC in mild case) but not for maintenance of remission as long-term therapy is
associated with deleterious side-effects.
· Oral budesonide is the initial steroid of choice as it is associated with lesser side-effects.
a) KCNJ2
b) RYR1
c) CLC1
d) CACN1S
Correct Answer: B
Your Answer: B
Explanation
Ans. B. RYR1
· RYR1—Mutations in the RYR1 gene disrupt the function of the ryanodine receptor, which
regulates calcium release from the sarcoplasmic reticulum.
· RYR1 mutations are linked to a congenital myopathy (central core disease) and to malignant
hyperthermia.
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· The group of voluntary muscles which were at strenuous work just before death goes into a
sudden state of stiffening, instead of passing to primary flaccidity after death.
· Involves only a group of voluntary muscles (which were in contraction before death)
· Cadaveric spasm passes into rigor mortis without interruption and disappears when rigor
disappear.
· The attitude/last act of the person at the time of death is preserved. The cause and manner of
death can be determined.
Conditions: Firearm in the hands of victims in suicidal gunshot injuries, plants and weeds in the
hands of victims in drowning, the weapon in the hands of victims in cut throat injuries
suggesting the manner of death.
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QUESTION 110. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdR
PTiAxMDk=
MYPA agar is used for?
a) B. anthrax
b) B. cereus
c) Campylobacter
d) S. aureus
Correct Answer: B
Your Answer: B
Explanation
Ans. B. B. cereus
· Mannitol egg yolk phenol red polymyxin agar is the selective medium for Bacillus cereus .
· Polymyxin lysozyme EDTA thallium acetate is the selective medium for Bacillus anthracis .
· Skirrow’s medium and Butzler medium are selective media for Campylobacter .
· Ludlam’s medium and salt agar are selective media for S. aureus .
a) Coccidioides immitis
b) Cryptococcus neoformans
c) Geotrichum candidum
d) Candida albicans
Correct Answer: B
Your Answer: B
Explanation
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Halo around the yeast cell in negative staining. From this itself you can get the diagnosis - the
only capsulated fungus is Cryptococcus.
a) Nikshay
b) Nishkay
c) e-DOTS
d) Nischay
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Nikshay
a) Phenytoin
b) Carbamazepine
c) Primidone
d) Valproic acid
Correct Answer: C
Your Answer: C
Explanation
Ans. C. Primidone
· Its antiepileptic activity is mainly due to those active metabolites because t1/2 of primidone
(6-14 hr.) is less than that of its active metabolites.
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Myocardial infarction
Failure of myocardial pump
Ventricular rupture
resulting from intrinsic
Arrhythmia
Cardiogenic myocardial damage,
Cardiac tamponade extrinsic pressure, or
pulmonary obstruction to outflow
a) Levonorgestrel
b) Ormeloxifene
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c) Ethinyl estradiol
d) Progesterone
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Ormeloxifene
a) t (8 : 14)
b) t (14 : 18)
c) t (2 : 13)
d) t (1 : 13)
Correct Answer: A
Your Answer: A
Explanation
Ans. A. t (8 : 14)
All types of Burkitt's lymphoma are characterized by dysregulation of the c-myc gene by one of
three chromosomal translocations. This gene is found at 8q24.
· The most common variant is t(8;14)(q24;q32), which accounts for approximately 85% of cases.
This involves c-myc and IGH. A variant of this, a three-way translocation, t(8;14;18), has also
been identified.
a) 50 L
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b) 5 L
c) 18 L
d) 180 L
Correct Answer: B
Your Answer: A
Explanation
Ans. B. 5 L
= 30 mg/0.6 mg/dL
= 50 dL = 5L
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a) 50 % of wages
b) 75% of wages
c) 90 % of wages
d) 100 % of wages
Correct Answer: D
Your Answer: D
Explanation
· Sickness benefit- 70% of avg daily wage. Extended sickness benefit- 70% of avg daily wage for
2 yrs (34 diseases)
· Enhanced sickness benefit- family welfare- vasectomy 7 days, tubectomy 14 days at 100%
wage.
· Maternity benefit ( leave with pay)- now till 26 weeks, abortion- 6 weeks, adoption- 12 weeks (
first time), work from home after 26 weeks allowed in special condition.
a) Pneumocystis
b) Paragonimus
c) Fasciola
d) Clonorchis
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Paragonimus.
· Adults of Paragonimus reside in the cystic cavities in the lungs of the definitive host.
· Eggs are expelled out in sputum and if sputum is swallowed, also in feces.
· The eggs are oval, 90 x 50 μ long unembryonated and have a shouldered operculum.
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a) Aminoglycosides
b) Cephalosporins
c) Bacitracin
d) Meropenem
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Aminoglycosides
Aminoglycosides (Streptomycin, Gentamicin etc) causes misreading of mRNA code and affect
permeability.
a) AL
b) AA
c) Transthyretin
d) Procalcitonin
Correct Answer: A
Your Answer: Unanswered
Explanation
Ans. A. AL
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QUESTION 123. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdR
ElPTiAxMjI=
A patient is admitted with multiple bacterial infections and is found to have a
complete absence of C3. Which complement-mediated function would remain intact in
such a patient?
a) Lysis of bacteria
b) Opsonization of bacteria
c) Generation of anaphylatoxins
d) None of the above.
Correct Answer: D
Your Answer: A
Explanation
All these functions are mediated by complement components that come after C3 and in its
absence cannot be activated.
a) P 53
b) Her 2 neu
c) RET protooncogene
d) Rb gene
Correct Answer: C
Your Answer: C
Explanation
· The RET protein is a receptor for the glial cell lined derived neurotrophic factor and
structurally releated proteins that promote cell survival during neural development.
· Adrenal medulla
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a) Nitro-glycerine
b) Clevidipine
c) Enalaprilat
d) Nitroprusside
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Clevidipine
a) NVBDCP
b) NLEP
c) NHM
d) IDSP
Correct Answer: B
Your Answer: B
Explanation
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The lotus here represents beauty and purity. Affected thumb tip and normal fingers, along with
the shape of the house it makes symbolizes that affected person can become a useful member of
the society. The rising sun is for hope and optimism.
A low BOD is an indicator of good quality of water and a high BOD indicates polluted water
because the dissolved oxygen is consumed by bacteria when large amount of organic matter is
present in sewage.
a) Substantia nigra
b) Nucleus basalis of Meynert
c) Dorsal raphe
d) All of the above
Correct Answer: D
Your Answer: A
Explanation
· The clinical presentation of Lewy body disease varies according to the site of Lewy body
formation and associated neuronal loss. In Parkinson disease, the Lewy bodies are found in the
substantia nigra of the midbrain, coupled with the loss of pigmented neurons. In persons with
the dementia of diffuse Lewy body disease, there are Lewy bodies in the neocortex. Some
persons have the Lewy bodies in both locations.
· The basal ganglia and diencephalon may also be involved in some cases.
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· With idiopathic Parkinson disease, Lewy bodies are typically found in the substantia nigra,
nucleus basalis of Meynert, dorsal raphe, locus ceruleus, dorsal motor nucleus of the vagus
nerve, and hypothalamus. In cases Lewy body dementia, cortical Lewy bodies are prominent,
but there are typically findings of Alzheimer disease as well.
a) Adalimumab
b) Etanercept
c) Infliximab
d) Anakinra
Correct Answer: C
Your Answer: C
Explanation
Ans. C. Infliximab
Drug Dose
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a) 30 – 50 m
b) 50 – 80 m
c) 80 – 110 m
d) 110 – 130 m
Correct Answer: A
Your Answer: Unanswered
Explanation
Ans. A. 30 – 50 m
SHOTGUNS
· The smooth-bore weapon consists of a metal barrel which has parallel sides “double barreled”.
- They usually fire a large number of small spherical lead shot.
· Ammunition consists of cartridge (metal base containing a central firing cap supporting plastic
or cardboard tube).
· Inside the cartridge there is a wad of paper & cardboard, with a mass of lead pellets.
a) Deficiency of nutrient
b) Vehicle food must be consumed by the target group
c) Affordable
d) Taste should be good so that target group consumes
Correct Answer: D
Your Answer: A
Explanation
Taste is not a criteria, but the nutrient should not alter the taste of the vehicle food
a) Zileuton
b) Zafirlukast
c) Montelukast
d) Omalizumab
Correct Answer: A
Your Answer: A
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Explanation
Ans. A. Zileuton
· The duration of action is short with hepatotoxic potentials. These limitations have restricted to
use.
a) Aspergillus
b) Mucor
c) Rhizomucor
d) Penicillium
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Mucor
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In the given image you are not seeing any rhizoids that rules out rhizo mucor; Aseptate hyphae
rules out Penicillium and Aspergillus. So the answer is MUCOR.
a) Ataxia telangiectasia
b) Downs syndrome
c) Kliffel feil syndrome
d) None of above
Correct Answer: A
Your Answer: A
Explanation
· The mutant ATM gene has sequence similarity to the phosphatidyl-inositol-3 kinases that are
involved in signal transduction.
· The ATM gene belongs to a conserved family of genes that monitor DNA repair and coordinate
DNA synthesis with cell division.
· The deleterious effects of the ATM gene are widespread. Truncal ataxia may become evident
when walking begins and is progressive.
· Persistence of very high serum levels of oncofetal proteins, including fetoprotein and
carcinoembryonic antigen, may be of diagnostic value.
· The peripheral T cell pool is reduced in size, especially in lymphoid tissue compartments.
Cutaneous anergy and delayed rejection of skin allografts are common.
· B lymphocyte development is normal, most patients are deficient in serum IgE and IgA, and a
smaller number have reduced serum levels of IgG, particularly of the IgG2, IgG4 subclasses.
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· The defect in DNA repair mechanisms in AT patients renders their cells highly susceptible to
radiation-induced chromosomal damage and resultant tumor development.
a) Welcome’s classification
b) Gomez classification
c) IAP classification
d) Quetelet’s index
Correct Answer: D
Your Answer: D
Explanation
a) Before 6 weeks
b) Before 16 weeks
c) Before 26 weeks
d) Before full term
Correct Answer: D
Your Answer: Unanswered
Explanation
Legally, abortion (miscarriage) is the premature expulsion of the fetus from the mother’s womb
at any time of pregnancy before the term of pregnancy is completed.
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· Directorate of National Vector Borne Disease Control Programme (NVBDCP) is the central
nodal agency for the prevention and control of vector borne diseases.
· Rifampin inhibits DNA dependent RNA polymerase of mycobacteria & other microorganisms
by forming a stable drug-enzyme complex leading to suppression of initiation of chain formation
(but not chain elongation) in RNA synthesis.
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a) Goodpasture’s syndrome
b) Churg-Strauss Syndrome
c) Alport syndrome
d) Wegner’s granulomatosis
Correct Answer: C
Your Answer: C
Explanation
· Such changes may present in other diseases, but are most pronounced and widespread in
Alport’s syndrome.
· Alport’s patients early in their disease typically have diffuse thinning of the basement
membrane which thickens over time into multilamellous surrounding lucent areas that often
contain granules of varying density.
· The characteristic electron electron microscopic finding of fully developed disease is that
glomerular basement membrane shows irregular foci of thickening alternating with attenuation
(thinning) with pronounced splitting and lamination of lamina densa often with distinctive
basket weave appearance.
a) 1.5 mg/Lit
b) 1 mg/Lit
c) 0.5 mg/Lit
d) 2 mg/Lit
Correct Answer: A
Your Answer: B
Explanation
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QUESTION 141. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdR
PTiAxNDA=
Which of the following anti-microbials is associated with prolongation of the QT
interval?
a) Co-amoxiclav
b) Gentamicin
c) Cefuroxime
d) Erythromycin
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Erythromycin
· Permanent sterilization method- micro inserts are placed in Fallopian tubes- once activated
tissue growth and scarring- in 3 months occlusion- no anesthesia, no incision, no admission
required. 99.8 % effective, 36 min procedure time
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a) MEN type I
b) MEN type II
c) MEN type III
d) MEN type IV
Correct Answer: A
Your Answer: A
Explanation
· Multiple endocrine neoplasia type 1 (MEN-1 syndrome) or Wermer syndrome is part of a group
of disorders that affect the endocrine system.
· These disorders greatly increase the risk of developing multiple cancerous and noncancerous
tumors in glands such as the parathyroid, pituitary, and pancreas. Multiple endocrine neoplasia
occurs when tumors are found in at least two endocrine glands.
· Tumors can also develop in organs and tissues other than endocrine glands. If the tumors
become cancerous, some cases can be life threatening. The disorder affects 1 in 30,000 people.
a) Lactulose
b) Calcium polycarbophil
c) Bisacodyl
d) Milk of Magnesia
Correct Answer: C
Your Answer: D
Explanation
Ans. C. Bisacodyl
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· Bran
· Psyllium
· Calcium polycarbophil
· Isopghol
· Docusate
· Lactulose
· Phenolphthalein
· Bisacodyl
3 Stimulant laxatives
· Sodium picosulfate
· Oxyphenisatin
· Magnesium sulfate
· Magnesium citrate
· Magnesium hydroxide
· Milk of magnesia
4 Osmotic laxatives
· Sodium sulfate
· Sodium phosphate
· Castor oil
· Senna
5 Anthraquinone laxatives
· Cascara sagrada
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biopsy showed numerous small yeast cells and the culture shown below was isolated.
What is the causative organism?
a) Cryptococcus neoformans
b) Penicillium marneffi
c) Histoplasma capsulatum
d) Trichophyton rubrum
Correct Answer: B
Your Answer: C
Explanation
· The clinical feature includes umbilicated papular, molluscum contagiosum-like skin lesions, in
face, upper trunk, pinnae and arms and non specific febrile illness in patient at risk. (M/c in
HIV)
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a) G1/S
b) G2/M
c) G1/ G2
d) S/ G2
Correct Answer: A
Your Answer: A
Explanation
Ans. A. G1/S
Defects in the G1/S checkpoint are more important in cancer, in that these lead to dysregulated
growth as well as a mutator phenotype.
a) 2–3 mins
b) 2–3 hours
c) 2–3 days
d) 12–18 hours
Correct Answer: B
Your Answer: Unanswered
Explanation
· Zolpidem is a prescription medication used for the short-term treatment of insomnia, as well
as some brain disorders.
· It works quickly (usually within 15 minutes) and has a short half-life (2–3 hours).
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a) Cobalt
b) Cadmium
c) Barium
d) Antimony
Correct Answer: A
Your Answer: B
Explanation
Ans. A. Cobalt
a) Appropriate technology
b) Social Marketing
c) Community participation
d) Intersectoral involvement
Correct Answer: B
Your Answer: B
Explanation
· Social marketing is the use of commercial marketing principles and techniques to improve the
welfare of people and the physical, social and economic environment in which they live.
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· It involves planning, and long term approach to change the human behavior.
a) Follicular carcinoma
b) Papillary carcinoma
c) Anaplastic carcinoma
d) Medullary carcinoma
Correct Answer: C
Your Answer: A
Explanation
Microscopically the parent tissue is not visible but it shows marked nuclear polymorphism
suggestive of anaplastic carcinoma.
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a) Gissane’s angle
b) Neutral angle
c) Bohler’s angle
d) Kite’s angle
Correct Answer: C
Your Answer: C
Explanation
· It is formed by lines joining top of posterior facet to top of calcaneal tuberosity and another
line joining top of anterior facet to top of superior facet in the lateral view of calcaneum.
a) Papilloma
b) Nodule
c) Ulcer
d) Neurological disorder
Correct Answer: A
Your Answer: Unanswered
Explanation
Ans. A. Papilloma
Stroboscopy is a special method used to visualize vocal fold vibration. It uses a synchronized ,
flashing light passed through a flexible or rigid telescope.
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The flashes of light from the stroboscope are synchronized to the vocal fold vibration at a
slightly slower speed, allowing the examiner to observe vocal fold vibration during sound
production in what appears to be slow motion. This slow motion picture is an illusion, as the
speed of actual vocal fold vibration is not changed by stroboscopy. Because vocal fold vibration
is so fast, the slow motion view is actually derived from many successive vibration cycles. This
special viewing helps to evaluate each vocal fold’s vibration properties during the different
phases of the vocal fold’s vibration cycle.
Video laryngoscopy with stroboscopy is the essential diagnostic procedure for the evaluation of
laryngeal mucosa, vocal fold motion biomechanics, and mucosal vibration. Nodule and ulcer
both will affect the vibration of vocal fold and can be diagnosed by videostroboscopy. It is also
used in certain neurological disorders that affect vocal fold vibration.
However it can also be used in papilloma disease but mainly in between the surgeries to look
for post operative scarring (remember papilloma requires multiple surgeries). However
papilloma doesn’t usually require videostroboscopy for its diagnosis
a) T Cells
b) B Cells
c) Dendritic cells
d) Giant cells
Correct Answer: A
Your Answer: A
Explanation
Ans. A. T Cells
Rheumatoid arthritis ( RA ) is one of the most common auto immune chronic inflammatory
syndromes. Evidence supports a role for T-helper (Th) cells , Th17 cells , and impaired CD4
+CD25(hi) regulatory T cell (Regulatory) function in the pathogenesis of RA.
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Your Answer: D
Explanation
a) Bacterial vaginosis
b) Candidal vaginitis
c) Primary syphilis
d) Secondary syphilis
Correct Answer: A
Your Answer: A
Explanation
• The positive predictive value is of around 95% of this test for the presence of BV.
• These vaginal epithelial cells contain many attached bacteria and hence create a poorly
defined border of stippled cells.
a) Hypotonia
b) Tall stature
c) Hypotelorism
d) Encephalocele
Correct Answer: A
Your Answer: Unanswered
Explanation
Ans. A. Hypotonia
• Hypotonia
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• Short stature
• Moon-like face
• Hypertelorism
• High-arched palate
• Mental retardation.
a) S3
b) S4
c) Opening snap
d) Reversed split S2
Correct Answer: D
Your Answer: D
Explanation
Second heart sound (S2) is composed of aortic closure followed by pulmonic closure. Because,
inspiration increases blood return to the right side of heart, pulmonic closure is delayed which
results in normal splitting of S2 during inspiration. Paradoxical or reverse splitting of S2 refers
to narrowed splitting of S2 during inspiration as compared with expiration because pulmonic
closure precedes aortic closure. It can occur in the following - LBBB, Aortic stenosis, HOCM,
severe hypertension, and RV pacemaker.
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a) Goldenhar syndrome
b) Crouzon syndrome
c) Russell Silver syndrome
d) Treacher Collins syndrome
Correct Answer: D
Your Answer: D
Explanation
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Flame-shaped haemorrhages are superficial; while the dot and blot haemorrhages are present
in the deeper layers of retina.
a) Diabetic retinopathy
b) Demyelinating optic neuritis
c) Craniopharyngioma
d) Diabetes insipidus
Correct Answer: B
Your Answer: B
Explanation
Evaluating cognition in NPH. The CSF tap test, sometimes lumbar tap test or Miller Fisher Test,
is a medical test that is used to decide whether shunting of cerebrospinal fluid (CSF) would be
helpful in a patient with suspected normal pressure hydrocephalus (NPH).
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The test involves removing 30 mL of cerebrospinal fluid (CSF) through a lumbar puncture, after
which cognitive function is clinically reassessed. Clinical improvement showed a high predictive
value for subsequent success with shunting.
a) USG
b) DOPA -PET
c) MRI
d) MIBG scan
Correct Answer: B
Your Answer: B
Explanation
Pheochromocytoma
· MRI has been the primary method of diagnosis for adrenal pheochromocytoma which shows
light bulb appearance on a T2 weighted MRI. MIBG scanning can play a complementary role in
evaluating intra adrenal pheochromocytoma.
· It is 80-90% sensitive for adrenal one. MIBG scintigraphy is extremely valuable in imaging of
extra adrenal and recurrent pheochromocytoma. MIBG is a precursor of catecholamines and
therefore, is actively taken up in catecholamines producing tissues. recently introduction of F-
DOPA PET has markedly increased the diagnostic accuracy of imaging investigation for
localization of both intra as well as extra adrenal pheochromocytoma.
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a) Syncope
b) Seizures
c) Mental retardation
d) Ataxia
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Seizures
This is a non contrast axial CT scan of the head taken at high parietal level. Here we can
identify multiple subcentimetric calcified lesions scattered in the neuro parenchyma typically at
the gray white matter interface. Some of the lesions on left side in posterior aspect have
surrounding hypodensity/edema. These findings suggest multiple infective granulomas, mostly
Neurocysticercosis.
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In ALS, early involvement of musculature supplied by the cranial nerves has a much graver
prognosis than early limb involvement. This may be a consequence of disturbed swallowing,
with recurrent aspiration as a result, or disturbed ventilatory activity. Fasciculations of the
tongue develop with deterioration of hypoglossal nuclei.
a) Catecholamine
b) Propofol
c) Ketamine
d) Thiopentone
Correct Answer: C
Your Answer: B
Explanation
Ans. C. Ketamine
· Ketamine produces profound analgesia. It produces a state where one feels “dissociated” from
his own body.
· It does not produce unconsciousness. Propofol and thiopentone are the induction agents
causing unconsciousness quickly.
· They are poor analgesics. Catecholamines e.g. Adrenaline, Noradrenaline do not produce
analgesia.
a) Methoxyflurane
b) Isoflurane
c) Enflurane
d) None of the above
Correct Answer: B
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Your Answer: D
Explanation
Ans. B. Isoflurane
· Methoxyflurane and enflurane are metabolized in the body producing inorganic fluoride which
is quite toxic to the renal tubules and can cause high-output renal failure; hence contra-
indicated in renal failure.
Since isoflurane is sufficiently lipid insoluble; it is exhaled back through respiration before any
significant metabolism occurs.
a) Pityriasis rosea
b) Pityriasis versicolor
c) Indeterminate leprosy
d) Pityriasis alba
Correct Answer: D
Your Answer: D
Explanation
· Occurs predominantly in children between the ages of 3 and 16 years. the sexes are equally
susceptible.
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· The individual lesion is a rounded, oval or irregular plaque, which is red, pink or skin-coloured
and has fine lamellar or branny scaling. Initially, the erythema may be conspicuous and there
may even be minimal serous crusting. Later, the erythema subsides completely, and at the stage
at which the lesions are commonly seen by a physician they show only persistent fine scaling
and hypopigmentation.
· There are usually several patches ranging from 0.5 to 2 cm in diameter, but they may be
larger, especially on the trunk. In children, the lesions are often confined to the face, and are
most common around the mouth, chin and cheeks. In 20% of affected children the neck, arms
and there are scattered lesions on the trunk and limbs.
· The course is extremely variable. The average duration of the common facial form in childhood
is a year or more.
P. Versicolor.
· Scaly macule.
· Perifollicular
Indeterminated leprosy:
· Non scaly
· Epidermal atrophy
· Anesthesia
P. Rosea.
· Herald patch
· Collarette scaling
· Firtree appearance
· Common in females
a) Carcinoma esophagus
b) Lower esophageal mucosal ring
c) Achalasia cardia
d) Reflux esophagitis with esophageal stricture.
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Correct Answer: C
Your Answer: B
Explanation
Dysphagia of achalasia is progressive initially then reaches a plateau phase in most cases
a) Bilious vomiting
b) Refusal of feeds
c) Generalized abdominal distension
d) Failure to pass meconium in the first 24 hours
Correct Answer: A
Your Answer: A
Explanation
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a) Ankylosing spondylitis
b) Diffuse idiopathic skeletal hyperostosis (DISH)
c) OA spine
d) Osteopetrosis
Correct Answer: A
Your Answer: A
Explanation
· Involvement of the lumbar spine and the classical Bamboo spine appearance points towards
the diagnosis of Ankylosing spondylitis.
· A close differential diagnosis remains to be DISH. See the table below to differentiate the
two conditions.
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a) Abscess
b) Glioblastoma
c) Metastasis
d) Meningioma
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Meningioma
· Thick ring enhancing lesion with perilesional edema is seen in left temporal lobe. D/d of such
thick ring enhancing lesion include — abscess, high grade astrocytoma (glioblastoma), solitary
metastasis.
· Meningioma is NOT likely, for simple reason that meningioma is not a parenchymal (intra-
axial) lesion. It arises from arachnoid cap cells and is a extra-axial benign tumor
(extraparenchymal).
· Moreover meningiomas are highly vascular, and typically show homogenous vivid
enhancement. Dural tail sign may be seen.
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a) Endometrial polyp
b) Adenomyotic nodule
c) Calcified fibroid
d) AVM
Correct Answer: C
Your Answer: C
Explanation
· The arrow points to a echogenic lesion with acoustic shadowing, suggesting calcification. This
calcification is in the myometrium- a calcified fibroid
· Adenomyosis is usually diffuse causing thinking of posterior wall with ‘globular ‘uterus and of
focal, the nodule is hypoechoic (black).
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Ans. D. AIN
The most common nerve involved in Supracondylar humerus fractures is Anterior interosseous
nerve (AIN), a branch of median nerve. FPL is supplied by same.
a) Bullous myringitis
b) Vestibular schwannoma
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a) Cochlear aqueduct
b) Endolymphatic sac
c) Vestibular aqueduct
d) Hyrtle fissure
Correct Answer: A
Your Answer: A
Explanation
Cochlear aqueduct connects scala tympani with subarachnoid space. so infection can be
transmitted
a) Face
b) Vertex
c) After coming head in breech
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d) Brow
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Brow
a. Simpson forceps are the most commonly used among the types of forceps and has an
elongated cephalic curve. These are used when there is substantial molding , that is, temporary
elongation of the fetal head as it moves through the birth canal
b. There is the ample pelvic curve in the single blade above and the cephalic curve evident in
the articulated blades below. The fenestrated blade and the wide shank in front of the English-
style lock characterize the Simpson forceps.
Pavlik harness is an abduction orthosis used to treat cases of CDH in age group less than 6
months. By maintaining the joint in abduction it ensures containment of the head within the
acetabulum so that development remains normal and the joint remodels.
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QUESTION 178. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdR
ElPTiAxNzc=
The Vipoma syndrome also is called the WDHA syndrome because of the presence of ;
Vipoma
· The Vipoma syndrome also is called the WDHA syndrome because of the presence of watery
diarrhea, hypokalemia, and achlorhydria.
· Serum VIP levels must be measured on multiple occasions because the excess secretion of VIP
is episodic, and single measurements might be normal and misleading.
· A CT scan localizes most Vipoma, although as with all islet cell tumors, EUS is the most
sensitive imaging method.
· Vipoma are more commonly located in the distal pancreas and most have spread outside the
pancreas.
· Palliative debulking operations can sometimes improve symptoms for a period along with
Somatostatin analogy.
· Hepatic artery embolization also has been reported as a potentially beneficial treatment
a) Retinal detachment
b) Opacification of posterior capsule
c) Vitreous haemorrhage
d) None
Correct Answer: B
Your Answer: B
Explanation
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"Opacification of the posterior capsule caused by proliferation of cells in capsular bag remains
the most frequent complication of ECCE and IOL surgery".
a) Supratrochlear nerve
b) Nasociliary nerve
c) Infraorbital nerve
d) Supraorbital nerve
Correct Answer: B
Your Answer: A
Explanation
· The lacrimal sac is the upper dilated end of the nasolacrimal duct, and is lodged in a deep
groove formed by the lacrimal bone and frontal process of the maxilla. It connects the lacrimal
canaliculi, which drain tears from the eye's surface, and the nasolacrimal duct, which conveys
this fluid into the nasal cavity.
a) Fasciotomy
b) Cock up splint
c) Bone shortening
d) Turn buckle splint
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Fasciotomy
Volkmann’s ischemia is synonymous with Compartment syndrome. If the same is missed, there
occurs necrosis followed by fibrosis of fore arm flexors leading to a flexion contracture in hand
also called as Volkmann’s ischemic contracture.
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QUESTION 182. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdR
PTiAxODE=
Identify the projective personality test?
a) CAT
b) TAT
c) MMPI
d) Rorschach Test
Correct Answer: A
Your Answer: Unanswered
Explanation
Ans. A. CAT
· It is Children Apperception Test [CAT]- modified for Indian children by Uma Chaudhry i.e.
Indian Modification of Children's Apperception Test (CAT).
· It is projective personality test used in children, to assess their cause of psychological stress.
a) Cocaine
b) Bath Salt
c) Cannabis
d) LSD
Correct Answer: B
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Your Answer: D
Explanation
· Bath Salt - is synthetic cathinones also known as- mephedrone/ meaw-meaw it is discovered as
new psychoactive substance/ substance of abuse.
a) Active mobilization
b) Passive mobilization
c) Infra Red Therapy
d) Immobilization
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Immobilization
· When silent and ALP/ESR levels are normal, it can safely be removed (generally after 1.5
years) if causing block in movements.
· Indomethacin / low dose radiation / bisphosphonates can be given prophylactically in high risk
patients to prevent MO formation.
a) Cornua
b) Ampulla
c) Isthmus
d) Infundibulum
Correct Answer: C
Your Answer: C
Explanation
Ans. C. Isthmus
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· For female tubal sterilization, Isthmus is said to be the most common site. It is the part of the
fallopian tube which is sealed or cut in a sterilization procedure or tubal ligation.
· The mid isthmic portion of the tube is grasped in the bipolar electrocoagulation technique.
Additionally, radiofrequency electric current is applied to three adjacent areas and coagulating
3 cm of tube. Hulka clips are also placed across the mid isthmus.
a) Pseudobulbar palsy
b) MND
c) Multiple sclerosis
d) Syringomyelia
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Syringomyelia
· Jaw jerk-Afferent impulse of this reflex are carried through sensory portion of the trigeminal
nerve the efferent impulse through trigeminal nerve with its reflex centre in PONS.
· So this jerk like any other jerk will become brisk in a UMN lesion/supranuclear lesion OR a
lesion above pons, never in a lesion with the spinal cord. All are lesions supranuclear/UMN
except Syringomyelia
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QUESTION 187. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdR
lPTiAxODY=
Which of the following is true about obstructive azoospermia ?
Azoospermia
Hypogonadotrophic Hypergonadotropic
Obstructive Azoospermia
Azoospermia Azoospermia
a) Graves' disease
b) Hashimoto's thyroiditis
c) Multinodular toxic goiter
d) Papillary carcinoma
Correct Answer: A
Your Answer: A
Explanation
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· Multinodular toxic goiter also results in hyperthyroidism, but does not lead to exophthalmos.
Papillary carcinoma will only very rarely present as a hypersecreting nodule.
· This is considered to be one of the most common thyroid cancer. Out of all the thyroid cancers
this type has the best prognosis.
a) HPV 16
b) HPV 18
c) HPV 33
d) HPV 35
Correct Answer: A
Your Answer: A
Explanation
Ans. A. HPV 16
Overall the most common agent associated with carcinoma cervix is HPV 16 (followed
by HPV 18)
HPV 16 is the dominant cancer related HPV accounting for 40-70 percent of invasive s
quamous cell cervical worldwide. This serotype is also the most common HPV found among low
grade lesion and in women without neoplasia. The prevalence of HPV 18 is much lower than
that of HPV 16 in an even higher proportion or cervical adenocarcinomas and adenosquamous
carcinomas.
· More than 100 HPV types have now been identified and have been classified as High Risk(HR)
or low risk (LR) subtypes based on their cervical cancer oncogenicity
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a) Atopic dermatitis
b) Syringoma
c) Sarcoidosis
d) Lichen nitidus
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Syringoma
Syringoma: being tumour of sweat glands , in which there are small cords and strands of
epithelial cells, some in a “tadpole” configuration. There are scattered lumens, often lined with
clear cells, with a bluish substance within them.
a) 28 days
b) 21 days
c) 14 days
d) 7 days
Correct Answer: B
Your Answer: Unanswered
Explanation
Ans. B. 21 days
· With CPDA1 (citrate phosphate dextrose adenine) blood can be stored for 35 days.
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a) Lidocaine
b) Bupivacaine
c) Tetracaine
d) Prilocaine
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Prilocaine
· The systemic toxicity of prilocaine is comparatively low, however its metabolite, o-toluidine, is
known to cause methemoglobinemia.
· Therefore dose limits for prilocaine should be strictly observed. Prilocaine is not recommended
for use in labor pains or infants.
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a) Applanation tonometer
b) Indentation Tonometer
c) Pascal Dynamic Contour Tonometer
d) Rebound Tonometer
Correct Answer: A
Your Answer: Unanswered
Explanation
TONOMETRY
§ It is the procedure eye care professionals perform to determine the intraocular pressure
(IOP), the fluid pressure inside the eye.
Methods:
APPLANATION TONOMETRY
§ Applanation tonometry is based on the Imbert-Fick principle, which states that the pressure
inside an ideal dry, thin-walled sphere equals the force necessary to flatten its surface divided
by the area of flattening (P = F/A, where P = pressure, F = force and A = area). In applanation
tonometry, the cornea is flattened and the IOP is determined by varying the applanating force
or the area flattened.
1. The Goldmann applanation tonometer measures the force necessary to flatten an area of the
cornea of 3.06mm diameter.
2. The Perkins tonometer is a type of portable applanation tonometer, which may be useful in
children, anesthetised patients who need to lie flat, or patients unable to co-operate with a
sitting slit lamp examination.
3. Non-Contact Tonometry
§ In air puff tonometry, the applanating force is a column of air which is emitted with gradually
increasing intensity.
INDENTATION TONOMETRY
§ The principle of indentation tonometry is that a force or a weight will indent or sink into a soft
eye further than into a hard eye.
1. Schiotz Tonometer
2. It consists of a curved footplate which is placed on the cornea of a supine subject. A weighted
plunger attached to the footplate sinks into the cornea in an amount that is indirectly
proportional to the pressure in the eye.
3. Pneumo tonometer
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1. Tono-Pen
REBOUND TONOMETRY
· It determines intraocular pressure by bouncing a small plastic tipped metal probe against the
cornea. The device uses an induction coil to magnetise the probe and fire it against the cornea.
As the probe bounces against the cornea and back into the device, it creates an induction
current from which the intraocular pressure is calculated.
· The Pascal Dynamic Tonometer utilizes a piezoelectric sensor embedded in the tip of the
tonometer to measure the dynamic pulsatile fluctuations in IOP.
a) Iron
b) Vitamin C
c) Vitamin D
d) Calcium
Correct Answer: C
Your Answer: C
Explanation
Ans. C. Vitamin D
· Vitamin D is found in smaller amounts in breast milk when compared with infant formulas.
· Iron is also found in smaller amounts in breast milk; however, it has increased bioavailability,
and supplementation is not required.
· Vitamin C, calcium, and folic acid are found in the appropriate quantities in breast milk.
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a) Hyperreflexia
b) Myotonia
c) Babinski.
d) Myerson sign.
Correct Answer: D
Your Answer: D
Explanation
· Myerson’s sign or glabellar tap sign is a medical condition where a patient is unable to resist
blinking when tapped on the glabella, the area above the nose and between the eyebrows.
a) ERCP
b) MRCP
c) PET
d) Liver Biopsy
Correct Answer: B
Your Answer: D
Explanation
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Ans. B. MRCP
· MRCP is an excellent imaging technique for gall bladder and biliary system.
a) 10 gm
b) 11 gm
c) 12 gm
d) 13 gm
Correct Answer: B
Your Answer: C
Explanation
Ans. B. 11 gm
a) Aspirin only
b) Low dose Aspirin + LMW heparin
c) Start Low dose Aspirin + LMW heparin + Prednisolone
d) No treatment
Correct Answer: B
Your Answer: C
Explanation
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· Combined unfractionated heparin and low-dose aspirin regimens are thought to reduce the
risk of spontaneous pregnancy loss by 54%, resulting in a live-birth rate of 70-80%.
· Evidence from small, controlled trials (25-50 patients) has suggested that patients with
recurrent pregnancy loss associated with antiphospholipid antibodies and without prior
thromboembolism benefit from treatment with low-dose unfractionated heparin at prophylactic
doses of 5,000-10,000 IU twice daily, in addition to low-dose aspirin at 70-81 mg daily.
a) Complete breech
b) Incomplete breech
c) Frank breech
d) Vertex
Correct Answer: B
Your Answer: B
Explanation
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a) ALT
b) AST
c) HBsAg
d) Prothrombin time
Correct Answer: D
Your Answer: D
Explanation
The prothrombin test gives an indication of the degree of hepatic injury. The other tests listed
do not. A prolonged prothrombin time can be an ominous sign.
a) Akathisia
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b) Tardive dyskinesia
c) Rabbit syndrome
d) Acute dystonia
Correct Answer: B
Your Answer: B
Explanation
· As the patient in question is taking anti psychotic since long more than 6 months so she will
definitely experiencing some delayed side effect i.e. Tardive [late onset] dyskinesia [ she has
developed involuntary, abnormal irregular movements]
a) Schizophrenia
b) OCD
c) Depression
d) None of the above
Correct Answer: C
Your Answer: C
Explanation
Ans. C. Depression
· This is rTMS - its evidence based use is only in depression when used for mental disorders
a) I/V rtPA
b) Intraarterial Calcium channel blockers.
c) VP Shunt.
d) I/V Fosphenytoin.
Correct Answer: B
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Your Answer: B
Explanation
· The patient is suffering from post subarachnoid hemorrhage vasospasm. This is a common
complication that can occur in the first 14 days after SAH, and can lead to further neurological
deficits or even death if not quickly recognized and treated. The main emergent therapy
remains intraarterial administration of calcium channel blockers like nimodipine and
angioplasty.
· IV tPA would not be indicated, even if this patient had an ischemic stroke, because of her
recent hemorrhage and cranial surgery.
· Although seizures are a possible cause of reduced level of alertness, new focal findings in the
setting of an SAH should prompt an evaluation for vasospasm.
a) Zenker’s diverticulum
b) Ca hypopharynx
c) Ca oesophagus
d) All of the above
Correct Answer: A
Your Answer: A
Explanation
It shows a smooth-surfaced filling defect in the barium column which arises from the posterior
pharyngeal wall at approximately the level of the 5th cervical vertebra. This is the typical
appearance of a prominent cricopharyngeus muscle. In this case, there is no associated
Zenker’s diverticulum.
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Your Answer: D
Explanation
a) Restrictive cardiomyopathy
b) Constrictive pericarditis
c) Cardiac tamponade
d) All
Correct Answer: C
Your Answer: C
Explanation
a) Neutrophils
b) Lymphocytes
c) Macrophages
d) Monocytes
Correct Answer: C
Your Answer: C
Explanation
Ans. C. Macrophages
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· Macrophages become the predominant cell type and become involved in removal of necrotic
debris.
a) Right hydronephrosis
b) Left hydronephrosis and proximal hydroureter
c) UB rupture
d) Right ureterocele
Correct Answer: B
Your Answer: B
Explanation
This is a delayed phase image. The contrast material in the renal pelvicalyceal system is
appearing white as it is Iodinated contrast material – a positive contrast material. Most of the
contrast on right side has washed off. Hence the right ureter is not well seen.
It is apparent that the left pelvicalyceal system is dilated along with dilatation of the proximal
left ureter as well. This could be due to a left ureteric calculus, but it is not possible to see the
calculus here as the contrast will overlap the opacity of the calculus.
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QUESTION 209. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdR
PTiAyMDg=
The drug of choice to treat Chlamydia infection in pregnancy is :
a) Tetracycline
b) Doxycycline
c) Erythromycin
d) Azithromycin
Correct Answer: D
Your Answer: C
Explanation
Ans. D. Azithromycin
· Azithromycin has now replaced erythromycin as the drug of first choice for the treatment of
Chlamydia infection in pregnancy.
· Azithromycin has the distinct advantage of single dose treatment (Ig as a single dose ) and
hence a 100% compliance
Regimen Drug
Erythromycin base
Alternative Erythromycin
Ethylsuccinate
a) Vasa previa
b) Decidua basalis
c) Battle dore placenta
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d) Succenturiate placenta
Correct Answer: A
Your Answer: A
Explanation
· Vasa previa is an uncommon condition in which fetal blood vessels traverse the lower uterine
segment in advance of the presenting part.
· Neither the umbilical cord nor the placenta supports the vessels.
· Vasa previa presents with painless vaginal bleeding at the time of spontaneous rupture of
membranes or amniotomy (AROM).
· Fetal mortality for cases not recognized before the onset of labor is reported to range between
22.5% and 100
a) Monosomy
b) Trisomy
c) Triploidy
d) Aneuploidy
Correct Answer: D
Your Answer: B
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Explanation
Ans. D. Aneuploidy
· The most common cause of first trimester abortion is aneuploidy and among it the most
common cause is trisomy as a group. The most common individual cause is monosomy X
· The most common cause of recurrent abortions is idiopathic followed by APLA followed by
uterine structural anomalies
· A quick non-invasive test to look for the presence of H. pylori is a urea breath test. This test
can be done as an outpatient and gives a rapid, accurate response. Patients should not have
received any proton pump inhibitors or antimicrobials in the meantime. Stool antigen test is
another good option if urea breath testing is not available.
· If the urea breath test is positive >1 month after completion of first-line therapy, second-line
therapy with a proton pump inhibitor, bismuth subsalicylate, tetracycline, and metronidazole
may be indicated.
· If the urea breath test is negative, the remaining symptoms are unlikely due to persistent H.
pylori infection. Serology is useful only for diagnosing infection initially, but it can remain
positive and therefore misleading in those who have cleared H. pylori.
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· Patients who are at risk of developing this, it is indicative to obtain screening colonoscopy
commencing at either age 20 to 25 years or 10 years younger than the youngest age at
diagnosis in the family, whichever comes first.
· Thus, the patients mentioned in the question above may also have Colon, Endometrium and
Ovary tumors.
a) Enterogenous
b) Chylolymphatic
c) Dermoid
d) Urogenital remnant
Correct Answer: B
Your Answer: A
Explanation
Ans. B. Chylolymphatic
· Chylolymphatic,
· Simple (mesothelial)
· Enterogenous
· Urogenital remnant
· Chylolymphatc cyst, the most common mesenteric cyst, arises in congenitally misplaced
lymphatic tissue that has no efferent communication with he lymphatic system; it arises most
frequently in the mesentery of the ileum usually solitary has a blood supply that is independent
from the adjacent intestine so that enucleation is possible without resection of intestine.
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a) Weight gain
b) Morning sickness
c) Enlargement of uterus
d) Amenorrhea
Correct Answer: C
Your Answer: A
Explanation
a) 22-24 wks
b) 28-32 wks
c) 24-26 wks
d) 32-34 wks
Correct Answer: B
Your Answer: A
Explanation
This screening test for PIH is done between 28-32 wks. BP is measured with the patient on her
side first and then the patient is asked to roll on her back to check the BP one again. An
increase of 20mHg in diastolic pressure from side to back position indicates a positive “roll over
test”. A negative test is of value.
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a) ORS
b) Vit. A
c) Calories 175Kcal/kg/d
d) Potassium supplementation for 4 weeks
Correct Answer: C
Your Answer: C
Explanation
This is a child with SAM and so much high calories should not be given in initial phase of
treatment
a) Dubin-Johnson syndrome.
b) Hereditary spherocytosis.
c) Rotor's syndrome.
d) biliary atresia
Correct Answer: B
Your Answer: B
Explanation
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· Rotor's syndrome is a rare autosomal recessive condition associated with the inability to
excrete organic anions into bile and is associated with a conjugated hyper bilirubinaemia.
Rotor's syndrome
a) Digoxin
b) Adenosine
c) Procainamide
d) Amiodarone
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Digoxin
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· Characteristic are hydrocephalus, seizures with focal defects, spinal or bulbar palsies,
microcephaly, and decreased IQ. Investigations such as skull x-ray or CT scan show calcification
of the periventricular area, tachyzoite in the CSF and positive blood titres.
· Pyrimethamine and Sulphadiazine have a synergistic effect in treating it, and folinic acid may
be necessary to prevent seizures.
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a) Leflunomide
b) Chloroquine
c) Ibuprofen
d) Methotrexate
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Chloroquine
When high doses of Chloroquine are used for prolonged duration, it can result in Bull’s eye
maculopathy .
EXTRA EDGE
a) 1
b) 0.3
c) 0.5
d) 0.8
Correct Answer: B
Your Answer: B
Explanation
Ans. B. 0.3
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· As the patient mentioned in the question above has developed gangrene of the toe ankle to
brachial pressure ratio must be less than 0.3.
· In order to ascertain the presence and magnitude of occlusive disease, ratio of ankle to
brachial systolic pressure (ankle brachial index) is obtained.
· The ankle brachial index of 0.9 - 1.0 indicates minimal arterial occlusive disease or normalcy.
· Presence of ischemic rest pain or severe occlusive arterial disease is indicative in case the ABI
is less than 0.5.
· ABI less than 0.3 is compatible with trophic changes over the lower extremity.
· Over half the cases of endocarditis in intravenous drug abusers are caused by Staphylococcus
aureus.
· The tricuspid valve is preferentially involved (50% of cases), followed by the aortic (25%) and
mitral (20%) valves.
· Cardiac murmurs and peripheral stigmata are rare with endocarditis in intravenous drug
abusers, especially when the tricuspid valve is involved. Septic and aseptic pulmonary emboli
are common.
· If positive blood cultures persist on antibiotic therapy for the treatment of endocarditis,
surgical valve replacement is necessary in all cases.
a) Thiamine
b) Riboflavin
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c) Cyanocobalamine
d) Ascorobic acid
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Riboflavin
Magenta tongue,
Riboflavin angular stomatitis, <0.6 mg -
seborrhoea, cheilosis
a) Sodium channel
b) Potassium channel
c) Chrolide channel
d) Calcium channel
Correct Answer: D
Your Answer: B
Explanation
· Mutations in the voltage-sensitive, skeletal muscle calcium channel cause the disease.
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a) It is related to Seborrhea
b) May be seen in patients with Parkinson’s disease, history of Cerebrovascular accidents
c) Also known as Dandruff if it occurs in the scalp.
d) It may be associated with a yeast-like fungus, Pityrosporum orbiculare.
Correct Answer: A
Your Answer: D
Explanation
SEBORRHEIC DERMATITIS
The term covers at least three common patterns of eczema, mainly affecting hairy areas, and
often showing characteristic greasy yellowish scales. These patterns may merge together:
· A red scaly or exudative eruption of the scalp, ears ,face and eyebrows. May be associated
with chronic blepharitis and otitis externa.
· Dry scaly ‘petaloid’ lesions of the presternal and interscapular areas. There may also be
extensive follicular papules or pustules on the trunk (seborrheic folliculitis or Pityrosporum
folliculitis).
In the first week of life, it typically occurs in the scalp (“cradle cap”), face, or groin.
In adults, it is seen in patients with Parkinson’s disease, CVA and HIV infection.
Cause:
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· The success of treatments directed against yeasts has suggested that overgrowth of the
Pityrosporum yeast skin commensal plays an important part in the development of seborrheic
eczema.
Treatment
· Topical antifungal, topical steroids, Two per cent sulphur and 2% salicylic acid .
· Medicated shampoo, which may contain ketoconazole, tar, salicylic acid, sulphur, zinc or
selenium sulphide.
· For severe and unresponsive cases a short course of oral itraconazole may be helpful.
a) Rapid induction
b) Minimal change in cardiac function
c) Minimal change in respiratory rate
d) Analgesic
Correct Answer: D
Your Answer: A
Explanation
Ans. D. Analgesic
Etomidate
· Rapid induction
· Not analgesic
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a) Boyles
b) O2 cylinder
c) Quinkes needle
d) LMA
Correct Answer: C
Your Answer: C
Explanation
The Quincke spinal needles have a Luer lock connection on the hub, a medium length cutting
bevel, and a sharp tip. The fitted arrangement of stylet and cannula hub provides proper needle
bevel orientation.
a) Xeroderma pigmentosa
b) Urticaria pigmentosa
c) Herpes zoster
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d) Glucagonoma
Correct Answer: B
Your Answer: B
Explanation
Urticaria pigmentosa
· Generalized and symmetrical eruptions (usually maculopapular) with predilection for trunk.
· Palms and soles tend to be spared and mucous membranes rarely affected.
· Gentle rubbing or stroking of a lesion causes local itching, erythema, and wheal formation
after 2-5 minutes, which may persist for 30 min to several hrs. This is called Darier’s sign
· Darier’s sign is due to local release of histamine from mast cell granules.
· Rx.
o Antihistaminic
o Aspirin
o Photochemotherapy
o Disodium cromoglycate
o Ketalifen
o Interferons
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Your Answer: A
Explanation
· High urinary specific gravity, nocturia, and daytime oliguria occur in addition to low urinary
sodium content in untreated CHF.
· These changes are the result of the activation of the renin-angiotensin-aldosterone system.
a) Normal saline
b) Dextrose 5%
c) Ringer lactate
d) Whole blood
Correct Answer: C
Your Answer: C
Explanation
· The most commonly used Fluid for Resuscitation in burns is represented by Ringer lactate.
· Some centres use Human Albumin Solution or Fresh-Frozen Plasma while some centres use
Hypertonic saline.
· Intravenous Resuscitation is indicated for children with a burn more than 10% TBSA and
adults with 15% TBSA.
· The most extensively used formula for computing Fluid Replacement in the first 24 hours is
Parkland formula.
Parkland Formula:
· In the initial 8 hours, Half of this volume is given while the second half is given in the
subsequent 16 hours
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a) Hypercalcemia
b) Mental retardation
c) Subvalvular aortic stenosis
d) Elfin facies
Correct Answer: C
Your Answer: C
Explanation
a) Epidermal
b) Dermoepidermal junction
c) Superficial dermis
d) Deep dermis
Correct Answer: D
Your Answer: B
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Explanation
Deep dermis. Notice the bluish color which is s/o deep dermal melanin. The lesion is actually a
Mongolian spot.
a) Adenoma
b) Lipoma
c) Hamartoma
d) Leiomyoma
Correct Answer: A
Your Answer: D
Explanation
Ans. A. Adenoma
· Epithelial polyps are most common benign tumor of stomach. They are of five types.
· Hamartomatous.
· Inflammatory.
· Heterotopic.
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a) administration of a uterotonic soon after the birth of the baby preferably oxytocin
b) clamping of the cord following observation of a uterine contraction ( at around 3 minutes ie.
Delayed
a) Mc Donald operation
b) Purandare’s operation
c) Khanna’s sling operation
d) Abdominal sling operation
Correct Answer: A
Your Answer: A
Explanation
Mc Donald cerclage procedure and Shirodkar cerclage procedure are done for managing
incompetent os.
· The principle supports of the uterus are the transverse cervical ligaments (cardinal ligaments),
uterosacral ligaments and the round ligament.
· The infundibular ligaments attach the ovaries to the posteo-lateral wall of the uterus.
· The pyriformis muscle lines the lateral wall of the pelvis overlying the iliosacral ligament.
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QUESTION 238. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdR
lPTiAyMzc=
A Patient presented with Fever and cough. Most likely diagnosis is ?
If you watch carefully you will see a ill defined haziness in the immediate right paracardiac
region.
This haziness is obscuring the right heart border and hence is suggestive of right middle lobe
consolidation. This question is a direct application of the Silhouette sign – Most important sign
in chest radiology.
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Ans. D. CT Enterography
· Enteroclysis is not more widely used because of perceived patient discomfort potentially high
radiation dose and extraluminal pathology is not assessable.
· USG has a limited role in the diagnosis and management of disorders of the small intestine.
· CT (IV + Oral contrast) show the extent of spread of the mass and evaluate sites of neoplastic
involvement like abdominal lymph nodes and solid organs, allowing accurate staging at a single
examination. Bowel distension with oral mannitol (CT enterography) has further enhanced the
evaluation of small bowel pathology.
I. Congenital
II Acquired : Bradycardia
Hypokalemia
Disopyramide, phenothiazine, CA
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Treatment-
SALMON PATCH:
· Present at birth
· Seen over forehead in the midline and over the occiput. Disappear by the age of 1 year
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a) Inverted papilloma
b) Tumour of maxillary sinus
c) Allergic fungal sinusitis
d) Nasal spur
Correct Answer: C
Your Answer: C
Explanation
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· Increased interaural latency of wave 5 of >0.2 msec,: difference of latency of wave 5 in the
two ears is >0.2 msec suggests retrocochlear pathology. this is most diagnostic finding in
acoustic neuroma
a) Amenorrhoea
b) Quickening
c) Foetal heart sounds
d) Distention of abdomen
Correct Answer: C
Your Answer: C
Explanation
Presence of fetal heart sounds is considered to be one of the most diagnostic sign of pregnancy.
· Ultrasonographic evidence of gestational sac and embryo in early pregnancy and even later.
Probable signs:
· Osiander’s sign (increased pulsation felt through lateral fornix by 8 weeks), Chadwick’s sign
(Blue hue of vagina), and Goodell sign (softening of cervix)
· Softening of cervix
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Women with prior gestational trophoblastic disease or successfully treated neoplasia usually do
not have impaired fertility and their pregnancy outcomes are usually normal. The primary
concern in these women is their 2-percent risk for developing trophoblastic disease in a
subsequent pregnancy. Sonographic evaluation is recommended in early pregnancy, and
subsequently if indicated. At delivery, the placenta or products of conception are sent for
pathological evaluation, and a serum hCG level is measured 6 weeks post- partum.
a) Prayer sign
b) Sclerodactyly
c) Boutonniere deformity
d) Arachnodactyly
Correct Answer: C
Your Answer: C
Explanation
The Image shows flexion at PIP and extension at DIP, which is suggestive of process of
boutonniere deformity. It is seen in RA.
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QUESTION 247. MTQ3MStTQVNJUkVLSEEgUCtzYXNpcmVraGEzMTRAZ21haWwuY29tKzc3MDgwMDE4NzdR
lPTiAyNDY=
In a case of ovarian tumor revealed unilateral ovarian tumor with ascites positive for
malignant cells. Laparotomy is performed. All other structures were free of disease.
Stage of her disease is:
a) Stage I c
b) Stage III a
c) Stage III b
d) Stage III c
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Stage I c
The patient falls under FIGO staging, stage Ic because it has ovarian tumor with ascites positive
for malignant cells.
a) Mitral Stenosis
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b) Mitral regurgitation
c) Aortic stenosis
d) Aortic regurgitation
Correct Answer: A
Your Answer: A
Explanation
· Symptoms usually appear when stenosis narrows this to less than 2.5 cm2.
· Women with mitral valve area < 1cm2 have the high rate of pulmonary edema (55%) and
arrhythmia (33%).
Ans. A. Lunate dislocates anteriorly, while other carpal bones remains in place.
Wrist dislocations
Types
· Lunate dislocation – lunate dislocates anteriorly, while other carpal bones remains in place.
· Perilunate dislocation – lunate stays in place while other carpal bones dislocate posteriorly.
Perilunate dislocation is the more common type, & when it is associated with fracture scaphoid,
it is known as trans scaphoid perilunate fracture dislocation. Median nerve is the M/C nerve
injury in lunate/ perilunate dislocation.
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a) Renal vessels
b) Knee joints
c) Skin
d) Cornea
Correct Answer: A
Your Answer: A
Explanation
· Amyloid is abnormal pathological protein resulting from improper folding of proteins and
deposited extracellularly as fibrils and disrupt their normal function.
· The most common site of deposition is kidney, followed by, liver, spleen, lymph nodes,
adrenals, thyroid, GIT, heart etc.
· In systemic amyloidosis, any organ can show deposition of Amyloid. Among all organs, kidneys
are most commonly and most seriously get affected by Amyloidosis.
· A thryoglossal duct cyst is the most common of the clinically important anomalies of thyroid
development
· Both cysts and sinus tracts can develop along the course of the thyroglossal duct.
· Normally the thyroglossal duct becomes obliterated early in embryonic life but occasionally it
may persist as a cyst or a draining sinus tract.
· Removal of the cyst or sinus usually requires excision of the central part of the hyoid bone and
dissection of the tract to the base of the tongue (the sistrunk operation), if recurrence is to be
minimized.
Thyroglossal fistula
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· It is never congenital
Treatment:
· As thyroglossal tract is closely related to the body of hyoid bone, the central part must be
excised together with the cyst or fistula (Sistrunk operation)
Hutchinson syndrome is seen in Neuroblastoma. In this , there is irritability and tenderness due
to involvement of skeletal system .
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a) Glaucoma
b) Hemiparesis
c) MR
d) CT head shows candle wax dripping appearance
Correct Answer: D
Your Answer: D
Explanation
The Image represents Sturge Weber syndrome. CT head shows tram track appearance in this
syndrome .Candle wax dripping appearance is seen in Tuberous sclerosis.
a) Epithelial tumours
b) Sex cord stromal tumours
c) Germ cell tumours
d) Metastatic tumours
Correct Answer: A
Your Answer: A
Explanation
Cancer or ovary
Serous, mucinous
endometrioid clear Peri/postmenopausal
Epithelial Coelomic epithelium
cell Brenner (45+year)
undifferentiated
Dysgerminoma,
Prepuberal pubertal
Germs cell tumours Primitive germ cells endodermal teratoma
(15-20 years)
chorio carcinoma
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a) Hypothyroidism
b) Cushing’s syndrome
c) Addison’s disease
d) Hypoparathyroidism
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Hypothyroidism
· Delayed dentition
· Demineralization
· Hypertelorism
a) Black
b) Brown
c) Dark yellow
d) Pale yellow
Correct Answer: D
Your Answer: D
Explanation
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Cholesterol stones:
· Cholesterol stones arise exclusively in the gallbladder and are composed of cholesterol,
ranging from 100% pure (which is rare) down to around 50% Pure cholesterol stones are pale
yellow, round to ovoid, and have a finely granular, hard external surface which on transaction
reveals a glistening radiating crystalline palisade.
· Stones composed largely of cholesterol are radiolucent; sufficient calcium carbonate is found
in 10% to 20% of cholesterol stones of render them radiopaque
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Vagina is developed mainly from the Mullerian ducts and party from the urogenital sinus.
Upper 1/3 of vagina develops from the fused uterovaginal canal of the Mullerian ducts.
· Mucous membrane is developed from the endoderm of the canalized (vaginal plate)
sinovaginal bulb(urogenital sinus).
· The musculature is developed from the mesoderm of the fused caudal vertical part of
the Mullerian ducts.
· The hymen is developed from the junction of the Mullerian tubercle (mesodermal) and the
urogenital sinus (endodermal).
· Lower 2/3 is developed entirely from the endoderm of the urogenital sinus.
· Vaginal introitus is developed from the ectoderm of the genital folds after rupture of the
bilaminar urogenital membrane
a) Mediastinum
b) Urogenital diaphragm
c) Diaphragm
d) Dura
Correct Answer: C
Your Answer: C
Explanation
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Ans. C. Diaphragm
· In infants with Bochdalek type congenital diaphragmatic hernia the severity of pulmonary
hypoplasia and the resultant pulmonary hypertension are key determinants of survival.
a) Hyperchloremia
b) Hypochloremia
c) Hyperkalemia
d) Hypokalemia
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Hyperchloremia.
In an normal anion gap metabolic acidosis there is by definition a rise in the serum chloride
equivalent to the fall in the serum bicarbonate such that the anion gap (Na - Cl - HCO3) remains
unchanged.
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b) Surgery is rhinoplasty
c) Columella of nose is formed by medial crus of both lower lateral cartilage and septa
cartilage
d) Surgery is extensive septoplasty
Correct Answer: D
Your Answer: C
Explanation
Image is of rhinoplasty
· Olfactory Reference Disorder is characterized by persistent preoccupation with the belief that
one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or
only slightly noticeable to others.
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· Individuals experience excessive self-consciousness about the perceived odour, often with
ideas of reference (i.e., the conviction that people are taking notice, judging, or talking about
the odour).
a) Methylprednisolone
b) Dipyridamole
c) Vincristine
d) Plasmapheresis
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Plasmapheresis
· Today, the treatment of Thrombotic Thrombocytopenic Purpura involves a daily single plasma
volume exchange (plasmapheresis), which is continued until the platelet count normalizes and
there is minimal hemolysis.
· Seriously ill patients may receive fresh frozen plasma infusions (without exchange) for several
hours until plasmapheresis can be arranged.
· The plasma exchange must sometimes be continued for 10 days or longer to obtain a complete
remission in seriously ill patients - Thrombotic Thrombocytopenic Purpura Treatment is first
tapered and later discontinued if normal laboratory parameters are maintained.
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· The Bender Visual Motor Gestalt Test, devised by the American neuropsychiatrist Lauretta
Bender in 1938, is a technique that consists of nine figures that are copied by the subject.
· The subject is then asked to copy the designs from memory, thus, the Bender designs can be
used as a test of both visual and motor coordination and immediate visual memory.
· Porphyrias are basically classified into Hepatic and Erythropoietic depending on whether
enzyme deficiency occurs in liver or Bone marrow.
· In Porphyria Cutanea Tarda (the commonest type of porphyria), there is hepatic and bone
marrow involvement, though it is classified as a hepatic porphyria.
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a) Ray amputation
b) Forefoot amputation
c) Syme’s amputation
d) Below knee amputation
Correct Answer: C
Your Answer: C
Explanation
· For any amputation to heal the local residual stump needs good vascularity, in Syme’s
amputation it is essential to preserve the blood supply to the heel flap by meticulous clean
dissection of the calcaneus.
· The tibia and fibula are sectioned as low as possible to the top of the joint.
· This type of procedure is rarely suitable for severely ischemic athermanous limbs because of
the poor healing of the heel flap.
a) 15%
b) 20%
c) 30%
d) 40%
Correct Answer: D
Your Answer: Unanswered
Explanation
Ans. D. 40%
Second Birth
Birth outcome
≤34 weeks (%)
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a) Carcinoma endometrium
b) Carcinoma cervix
c) Carcinoma vulva
d) Carcinoma vagina
Correct Answer: C
Your Answer: C
Explanation
Vulvar carcinoma is the most promising site for sentinel lymph node biopsy strategy. Studies
suggest that a sentinel node can be identified in most patients. Sentinel node is always located
in the groin making vulva an ideal site for sentinel node biopsy'. 'The detection of SLN is
currently a standard component of the surgical treatment of malignant melanoma, breast
cancer and is a promising staging technique for patients with vulvar cancer. In cervical cancer
SLN mapping is more recent and preliminary studies indicate that it may be a feasible
technique' - 'Trends in Cervical Cancer' by Varaj Sentinel Lymph Node (SLN) Biopsy for
Gynaecological Malignancies
a. The sentinel lymph node is defined as the first draining lymph node to receive lymphatic
drainage from the tumor site. A negative sentinel lymph node would thus predict the absence of
lymph node metastasis in the entire draining basin.
b. Sentinel lymph node evaluation in female genital tract cancers is relatively new and a
number of promising studies are under evaluation.
c. The concept has shown most promising results in vulvar cancer followed by cervical cancer.
d. (SLN is however not yet accepted as a standard procedure for either of these). For
endometrial cancer the concept of sentinel lymph node biopsy has been studied by small studies
and requires further larger studies. Results from current studies are favorable but not to the
same extent as vulvar and cervical cancers.
e. For vaginal cancer the concept of sentient lymph node biopsy is very new and studies are
limited mainly to case reports.
a) Shivering
b) Breakdown of brown fat
c) Universal flexion
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d) Cutaneous vasoconstrictions
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Shivering
· Mechanisms for Thermogenesis in new born are mainly due to rapid increase in circulating
catecholamines due to cold stress
· Peripheral vasoconstriction
a) Anencephaly
b) Iniencephaly
c) Aneniniencephaly
d) Complete craniospinal rachischisis
Correct Answer: B
Your Answer: A
Explanation
Ans. B. Iniencephaly
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A rare neural tube defect characterized by extreme retroflexion of the head with the absence of
neck due to spinal deformities.
a) Dexrazoxane
b) Amifostine
c) Leucovorin
d) Bisphosphonates
Correct Answer: A
Your Answer: A
Explanation
Ans. A. Dexrazoxane
· Cardiotoxicity induced by Doxorubicin is an important side effect which can be modified by the
use of Dexrazoxane.
· Dexrazoxane : Iron chelator that decreases free radical formation ~ Protects myocardium from
anthracycline induced injury.
· Amifostine Radio protective agent (Reduces renal toxicity caused by cisplatin) Leucovorin:
Reduces bone marrow & mucosal toxicity caused by methotrexate other measures [(Vigorous
hydration, bicarbonate loading) Asparaginase, Carboxypeptidase G2] Mesna: Reduces bladder
toxicity caused by Cyclophosphamide.
· Bisphosphonate: Reduces bone pain & frequency of new skeletal events in metastatic breast
cancer & Multiple myeloma.
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a) Battledore Placenta
b) Velamentous Insertion
c) Normal
d) Circumvallate
Correct Answer: A
Your Answer: A
Explanation
· The battledore placenta can be defined as an abnormal insertion of the umbilical cord. The
condition is also known as the marginal cord insertion.
· Battledore placenta can be found in association with other conditions, such as: monochorionic
twin pregnancy, intrauterine growth retardation, pre-term birth and low-weight at birth.
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a) Ear
b) Face
c) Eyelid
d) Neck
Correct Answer: C
Your Answer: C
Explanation
Ans. C. Eyelid
· Keloids are defined as scars that grow beyond the borders of the original wounds, and these
scars rarely regress with time. Keloids are more prevalent in patients with more darkly
pigmented skin; they develop in 15% to 20% of African Americans, Asians, and Hispanics.
· Keloids appear to have a genetic predisposition. Keloid scars tend to occur above the clavicles,
on the trunk, on the upper extremities, and on the face. They cannot be prevented at this time
and are often refractory to medical and surgical intervention.
· Hypertrophic scars, in contrast, are raised scars that remain within the confines of the original
wound and frequently regress spontaneously.
· Keloids most frequently develop on the upper back and chest, neck shoulders, jaw, ear lobes
and legs. These areas all share the quality of high tension on healing wounds.
a) LASIK
b) Concave lens
c) Convex lens
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d) Radial keratotomy
Correct Answer: C
Your Answer: B
Explanation
· Chorea is an abnormal involuntary movement derived from the Greek word “dance”. It is
characterized by brief, abrupt, irregular, unpredictable, non-stereotyped movements.
· In milder cases, they may appear purposeful; the patient often appears fidgety and clumsy.
· There is a wide range of seemingly unrelated causes, from pregnancy (chorea gravidarum) to
inherited forms such as Huntington’s disease and benign hereditary chorea, infection/immune-
related such as Sydenham’s chorea and systemic lupus erythematosus, focal vascular lesions in
the basal ganglia, drugs such as levodopa, neuroleptics and oral contraception, various
metabolic and endocrinological disorders such as hyperthyroidism, hypo/hyperparathyroidism
and hypo/hyperglycemia.
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a) Epithelium
b) Bowman’s layer
c) Posterior stroma
d) Descemet’s membrane
Correct Answer: D
Your Answer: D
Explanation
Image shows a Kayser- Fletcher ring in the cornea, which represents deposition of copper in the
posterior lamella of Descemet’s membrane.
a) Toxoplasma
b) Toxocara
c) Rubella
d) Scurvy
Correct Answer: C
Your Answer: C
Explanation
Ans. C. Rubella
1. Retinopathy - visually insignificant, subtle 'salt and pepper' pigmentary disturbance. Most
marked at the macula, later develop
choroidal neovascularization.
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3. Microphthalmos
5. Miscellaneous - stromal keratopathy, iritis, iris atrophy, and extreme refractive errors,
pendular nystagmus and strabismus
Toxoplasma retinitis
i) "Satellite lesion"
a) Polydioxanone
b) Polyester
c) Polyglactin
d) Monocryl
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Polyester
Non absorbable
Absorbable sutures Raw material Raw material
suture
Copolymer of lactide
Coated Vicryl
and glycolide coated Mersilene polyester Plyethylene
suture (polyglactin
with 370 and calcium fiber suture terephthalate
910)
stearate
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Isotactic crystalline
PDS II Suture Prolene
Polyester polymer stereoisomer of
(Polydioxanone) polypropylene suture
polypropylene
a) Mallampati I
b) Mallampati II
c) Mallampati III
d) Mallampati IV
Correct Answer: B
Your Answer: B
Explanation
· Mallampati II - faucial pillars, soft palate can be visualized, but the uvula is masked by the
base of the tongue
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a) I-Gel
b) BASKA
c) LMA Supreme
d) Classic LMA
Correct Answer: B
Your Answer: A
Explanation
Ans. B. BASKA
a) Teratoma
b) Yolk sac tumor
c) Choriocarcinoma
d) Dysgerminoma
Correct Answer: B
Your Answer: B
Explanation
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Alpha Feto protein (AFP) level are elevated in non- seminomatous germ cell tumors
(NSGCT) including embryora. a carcinoma, yolk sac tumor and mixed germ cell
tumors.
AFP
Tumor AFP hCG Tumor
hCG
Embryonal carcinoma
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a) Emollients
b) Topical glucocorticoids
c) Dosulepin
d) Doxepin
Correct Answer: C
Your Answer: Unanswered
Explanation
Ans. C. Dosulepin
· Hyperpigmentation, lichenification, and scaling in the antecubital fossae are seen in this
patient suggesting the diagnosis of atopic dermatitis. Therapy for AD should include avoidance
of cutaneous irritants, adequate moisturizing through the application of emollients, judicious
use of topical anti-inflammatory agents, and prompt treatment of secondary infection.
· Low to mid-potency topical glucocorticoids are employed in most treatment regimens for AD.
· Control of pruritus is essential for treatment because AD often represents “an itch that
rashes”. Antihistamines are most often used to control pruritus. Diphenhydramine (25 mg every
4-6 h), hydroxyzine (10-25mg every 6 h), or doxepin (10-25 mg at bedtime) are useful primarily
due to their sedating action.
a) Cancer stomach
b) Pyloric stenosis
c) Small-bowel obstruction
d) Diuretics
Correct Answer: B
Your Answer: Unanswered
Explanation
Metabolic Alkalosis is the most common acid base disturbance in the surgical patients usually
result from excessive vomiting (as in pyloric stenosis) and excessive administration of sodium
bicarbonate during resuscitation.
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· Excoriated secondary syphilitic papules in women can be confused with multiple small
chancres. Chancre Redux is a recurrence of the primary sore at its original site.
· Pseudochancre Redux describes gummatous (tertiary stage) recurrence at the site of the
primary chancre.
a) Progestasert
b) Mirena
c) Lippes loop
d) Vaginal ring
Correct Answer: C
Your Answer: C
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Explanation
a) Phenytoin
b) Carbamazepine
c) Topiramate
d) Lamotrigine
Correct Answer: D
Your Answer: B
Explanation
Ans. D. Lamotrigine
Use of other contraceptives should be encouraged for women who are long-term users of any of
these drugs. When a COC is chosen, a preparation containing a minimum of 30 µg of ethinyl
estradiol (EE) should be used.
a) Biliary Sepsis
b) Biliary Colic
c) Appendicitis
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d) Sigmoid Diverticulitis
Correct Answer: A
Your Answer: A
Explanation
“ The majority of hepatic abscesses were used to result from portal spread of Intra-abdominal
infections (e.g. appendicitis, diverticulitis, colitis) but with approved management of these
conditions spread now occur primarily through the biliary tree or arterial supply as in patients
suffering from cholangitis or after biliary tract manipulation.”
a) 35 mL per period
b) 55 mL per period
c) 80 mL per period
d) 120 mL per period
Correct Answer: C
Your Answer: C
Explanation
· Menorrhagia ('heavy periods') is defined as a blood loss of greater than 80 mL per period.
· This definition is rather arbitrary, but represents the level of blood loss at which a fall in
haemoglobin and hematocrit concentration commonly occurs.
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· The Rose Bengal stains the inferior cornea showing inferior superficial punctate keratitis. This
is seen in dry eyes and exposure keratitis.
· Superior limbic keratoconjunctivitis typically shows staining in the superior cornea. Whereas
Thygeson and adenoviral keratitis tends to have staining which involve the whole cornea and
are less dense.
a) Baclofen
b) Diazepam
c) Cyclobenzaprine
d) Dantrolene
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Dantrolene
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· It is caused by a sudden increase in the availability of calcium (Ca) ions in the mycoplasma of
muscle.
· Dantrolene, which interferes with release of Ca ions from the sarcoplasmic reticulum, is
indicated in treatment of the disorder.
· The first three agents are centrally acting skeletal muscle relaxants that are not useful in the
treatment of malignant hyperthermia.
a) Isoflurane
b) Enflurane
c) Methoxyflurane
d) Halothane
Correct Answer: D
Your Answer: D
Explanation
Ans. D. Halothane
· It undergoes significant metabolism in humans with about 20% of the absorbed dose
recovered as metabolites.
· Halothane can cause postoperative jaundice and hepatic necrosis with repeated administration
in rare instances.
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a) Stratum basale
b) Stratum granulosum
c) Stratum corneum
d) The dermis
Correct Answer: C
Your Answer: C
Explanation
Scabies, also known as the seven-year itch, is a contagious skin infestation by the mite
Sarcoptes scabiei. Scabies mite burrows into stratum corneum to live and deposit eggs. These
burrows are visible clinically as irregular grey- brown lines.
a) Hypercalcemia
b) Hyperphosphatemia
c) Hyperchloremia
d) Increased Alkaline phosphatase.
Correct Answer: B
Your Answer: B
Explanation
Ans. B. Hyperphosphatemia.
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· It causes hypophosphatemia.
a) Biliary atresia
b) Sclerosing cholangitis
c) Hepatitis A
d) Cirrhosis
Correct Answer: A
Your Answer: C
Explanation
Children Adult
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Biliary atresia
· It is urticaria pigmentosa.
· This produces the wheal and flare of the lesion. It is known as Darier’s sign.
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a) TORP
b) PORP
c) Stapes prosthesis
d) All of the above
Correct Answer: B
Your Answer: C
Explanation
Ans. B. PORP
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a. Early folliculo genesis is gonadotropin independent. FSH rescues the antral follicles and
selects a cohort of follicles for further development.
b. Early folliculo genesis is dependent on FSH. LH acts on the theca interna cells to secrete
androgens which act as substrate for the synthesis of increased amount of estrogens by the
granulose cells of the developing dominant follicle. Thus LH also contributed to folliculo
genesis. For a healthy dominant follicle, it is important to change the androgenic environment
of the follicle to estrogenic.
c. Granulosa cells in the follicular phase also secrete inhibin B, which along with estradiol
causes negative feedback on the pituitary to decrease FSH levels.
d. Inhibin A is the form of inhibin synthesized by the luteinized granulosa cells of the ovary in
the luteal phase, under the control of LH
e. FSH in the early follicular phase, induces LH receptors on the granulose cells. Thus, in the
late follicular phase, the luteinized granulose cells synthesize low amounts of progesterone, that
cause positive feedback on the pituitary to increase LH secretion, thus, long with estradiol
contributing to LH surge.
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a) Chvostek sign
b) Troisier sign
c) Trousseau’s sign
d) Lhermitte’s sign
Correct Answer: C
Your Answer: C
Explanation
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Review in
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