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1) A 10 yr old girl presents with swelling of one knee joint. All of the following conditions can be considered in the differential diagnosis, except:

a) Tuberculosis
b) Juvenile Rheumatoid Arthritis
c) Haemophilia
d) Villonodular synovitis

2) Avascular necrosis can be a possible sequel of fracture of all the following bones, except:
a) Femur neck
b) Scaphoid
c) Talus
d) Calcaneum

3) Sciatic nerve palsy may occur in the following injury:
a) Posterior dislocation of hip joint
b) Fracture of neck femur
c) Trochanteric fracture
d) Anterior dislocation of hip

4) A 30 yr old male was brought to the casualty following a road traffic accident. His physical examination revealed that his right lower limb was short , internally rotated, and flexed and adducted at the hip. The most likely diagnosis is:
a) Fracture of neck femur
b) Trochanteric fracture
c) Central fracture dislocation of hip
d) Posterior dislocation of hip

5) Kinebock's disease is due to avascular necrosis of:
a) Femoral neck
b) Medial cuneiform
c) Lunate bone
d) Scaphoid bone

6) Thiamine deficiency is known to occur in all of the following except?
a) Food faddist
b) Homocystinemia
c) Chronic alcoholic
d) Chronic heart failure patient on diuretics

7) The 'P' value of a randomized controlled trial comparing operation A (new procedure) & operation B (gold standard) is 0.04. From this, we conclude that ?
a) Type II error is small and we can accept the findings of the study
The probability of false negative conclusion that operation A is better than operation B, when in the truth it is not, is 4%
The power of study to detect a difference between the operation A & B is 96%
d)  The probability of a false positive conclusion that the operation A is better than operation B, when in truth it is not is 4%

8) As a part of space-research program, a physiologist was asked to investigate the effect of flight-induced stress on blood pressure. Accordingly, the blood pressure of the cosmonauts were to be measured twice: once before the take off, and once after the space craft entered the designated orbit around the earth. For a proper comparison, the pre-flight blood pressure should be recorded in ?
a) The lying position
The sitting position
The standing position
Any position, as long as the post flight recording is made in the same position

9)The "SAFE" strategy has been developed for the control of ?
a) Onchocerciasis
Refractive error
Ocular trauma

10) The commonest cause of low vision in India is ?
a) Uncorrected refractive errors

11) Most important epidemiological tool used for assessing disability in children is ?
a) Activities of Daily living (ADL) scale
Wing's Handicaps, Behavior and Skills (HBS) Schedule
c) Binet and Simon IQ tests
d) Physical Quality of life index (PQLI)

12) Elemental iron and folic acid contents of iron and folic acid adult tablets supplied uner the "National Programme for Anaemia Prophylaxis" are" ?
a) 60 mg elemental iron & 250 micro gms of folic acid
100 mg elemental iron and 500 micro gms of folic acid
c) 120 mg of elemental iron and 750 micro gms of folic acid
d) 200 mg of elemental iron and 1000 micro gms of folic acid

13) Scope of family planning services include all of the following except ?
a) Screening for cervical cancer
Providing services for unmarried mothers
c) Screening for HIV infection
d) Providing adoption services

14) Class II exposure in animal bites includes the following ?
a) Scratches without oozing of blood
Licks on fresh wound
c) Scratch with oozing of blood on palm
d) Bites from wild animals

15) Denominator while calculating the secondary attack rate includes ?
a) All the people living in next fifty houses
All the close contacts
c) All the susceptible's amongst the close contact
d) All the susceptibles in the whole village

16) The response which is graded by an observer on an agree or disagree continuum is based on ?
a) Visual analog scale
Guttman scale
c) Likert scale
d) Adjectival scale

17) For calculation of sample size for a prevalence study all of the following are necessary except ?
a) prevalence of the disease in population
Power of study
c) Significance level
d) Desired precision

18) In one single visit, a 9 month old, un-immunized child can be given the following vaccination ?
a) Only BCG
b) BCG, DPT-1, OPV-1
c) DPT-1, OPV-1, Measles
d) BCG, DPT-1, OPV-1, Measles

19) For controlling an outbreak of cholera, all of the following measures are recommended except ?
a) Mass chemoprophylaxis
Proper disposal of excreta
c) Chlorination of water
d) Early detection and management of cases

20) Leprosy is considered a public health problem if the prevalence of leprosy is more than ?
a) 1 per 10,000
2 per 10,000
c) 5 per 10,000
d) 10 per 10,000

21) The organism most commonly causing genital filariasis in most parts of Bihar and Eastern U.P. is ?
a) Wuchereria bancrofti
Brugia malayi
c) Onchocerca volvulus
d) Dirofilaria

22) The Vitamin A supplement administered in "Prevention of nutritional blindness in children programme" contains ?
a) 25,000 i.u./ml
1 lakh i.u./ml
c) 3 lakh i.u./ml
d) 5 lakh i.u./ml

23) The Protein Efficiency ratio (PER) is defined as ?
a) The gain in weight of young animals per unit weight of protein consumed.
The product of digestibility coefficient and biological value
c) The percentage of protein absorbed, into the blood
d) The percentage of nitrogen absorbed from the protein absorbed from the diet

24) A measure of location which divides the distribution in the ratio of 3:1 is ?
a) Median
First quartile
c) Third quartile
d) Mode

25) In the management of leprosy, Lepromin test is most useful for ?
a) Herd immunity.
c) Treatment
d) Epidemiological  investigations

26) Elemental iron and folic acid contents of pediatric iron - folic acid tablets supplied under RCH program are ?
a) 20 mg iron & 100 micro gms of folic acid
40 mg iron & 100 micro gms of folic acid
c) 40 mg iron & 50 micro gms of folic acid
d) 60 mg iron & 100 micro gms of folic acid.

27) For the calculation of positive predictive value of a screening test, the denominator is comprised of ?
a) True positives + False negatives
False positives + True negatives
c) True positives + False positives
d) True positives + True negatives

28) Elements of primary health care include all of the following except ?
a) Adequate supply of safe water and basic sanitation
Providing essential drugs
c) Sound referral system
d) Health Education

29) The Chi-square test is used to measure the degree of ?
a) Causal relationship between exposure and effect
Association between two variables
c) Correlation between two variables
d) Agreement between two observations

30) The parameters of sensitivity and specificity are used for assessing ?
a) Criterion validity.
Construct validity
c) Discriminant validity
d) Content validity

31) A nineteen year old female with short stature, wide spread nipples and primary amenorrhoea most likely has a karyotype of:
a) 47,XX+18
b) 46,XXY
c) 47,XXY
d) 45X

32) Which of the following procedures are used as routine technique for karyotyping using light microscopy?
a) C-banding
b) G-banding
c) Q-banding
d) BrdV-staining

33) Leucoerythroblastic picture may be seen in all of the following, except:
a) Myelofibrosis
b) Metastatic carcinoma
c) Gaucher's disease
d) Thalessemia

34) All of the following are poor prognostic factors for acute myeloid leukemia's, except:
a) Age more than 60 yrs
b) Leukocyte count more than 1,00,000/microL
c) Secondary Leukemia's
d) Presence of t(8:21)

35) Which of the following increases the susceptibility to coronary artery disease?
a) Type V hyperlipoproteinemia
b) Von willebrandt's disease
c) Nephrotic syndrome
d) Systemic lupus erythematosus

36) Extensive pleural thickening and calcification especially involving the diaphragmatic pleura are classical features of:
a) Coal worker's pneumoconiosis
b) Asbestosis
c) Silicosis
d) Siderosis

37) A 30 yr old HIV positive patient presents with fever, dyspnoea and non-productive cough. Patient is cyanosed. His chest X Ray reveals bilateral, symmetrical interstitial infiltrates. The most likely diagnosis is:
a) Tuberculosis
b) Cryptococcosis
c) Pneumocystis carinii pneumonia
d) Toxoplasmosis

38) The pathologic changes are proliferative and usually confined to mesangial cells; usually focal and segmental
a) Hematuria may be gross or microscopic
b) On immunofluorscence deposits contain both IgA and IgG
c) Absence of associated proteinuria is pathognomonic
d) The pathologic changes are proliferative and usually confined to mesangial cells; usually focal and segmental

39) An eight yr old boy presents with back pain and mild fever. His plain X ray of the dorso-lumbar spine reveals a solitary collapsed dorsal vertebra with preserved disc spaces. There was no associated soft tissue shadow. The most likely diagnosis is:
a) Ewing's sarcoma
b) Tuberculosis
c) Histiocytosis
d) Metastasis

40) An albino girl gets married to a normal boy. What are the chances of their having an affected child and what are the chances of their children being carriers?
a) None affected, all carriers
b) All normal
c) 50% carriers
d) 50% affected, 50% carriers

41) A 1 month old baby presents with frequent vomiting and failure to thrive. There are features of moderate dehydration. Blood sodium is 122 mEq/L and potassium is 6.1 mEq/L. The most likely diagnosis is:
a) Gitelman syndrome
b) Barter Syndrome
c) 21-hydroxylase deficiency
d) 11-beta-hydroxylase deficiency

42) Transient myeloproliferative disorder of the newborn is seen in association with:
a) Turner syndrome
b) Down's syndrome
c) Neurofibromatosis
d) Ataxia telangiectasia

43) A 2 month baby presents with history of jaundice, turmeric colored urine, and pale stools since birth. Examination reveals liver span of 10 cms, firm in consistency and spleen of 3 cms. The most specific investigation for establishing the diagnosis would be:
a) Liver function tests
b) Ultrasound abdomen
c) Peoperative cholangiogram
d) Liver biopsy

44) The most appropriate drug used for chelation therapy in beta thalessemia major is:
a) Oral desferrioxamine
b) Oral deferiprone
c) Intramuscular EDTA
d) Oral succimer

45) Which endocrine disorder is associated with epiphyseal dysgenesis?
a) Hypothyroidism
b) Cushing's syndrome
c) Addison's disease
d) Hypoparathyroidism

46) A couple with a family history of beta thalessemia major in a distant relative, has come for counseling. The husband has HbA2 of 4.8% and the wife has HbA2 of 2.3%.The risk of having a child with beta thalessemia major is:
a) 50%
b) 25%
c)  5%
d) 0%

47) A 5 yr old boy passed 18 loose stools in last 24hrs and vomited twice in last 4 hours. He is irritable but drinking fluids. The optimal therapy for this child is:
a) Intravenous fluids
b) Oral rehydration therapy
c) Intravenous fluid initially for 4 hrs followed by oral fluids
d) Plain water ad libitum

48) A child aged 24 months was brought to the Primary health centre with complaints of cough and fever for the past 2 days. On examination, the child weighed 11 kg, respiratory rate was 38 / min, chest indrawing was present. The most appropriate management for this patient is:
a) Classify as pneumonia and refer urgently to secondary level hospital
b) Classify as pneumonia, start antibiotics and advise to report after 2 days
c) Classify as severe pneumonia, start antibiotics and refer urgently
d) Classify as severe pneumonia and refer urgently

49) Which one of the following statements is false with regard to Xanthogranulomatous pyelonephritis in children:
a) Often affects those younger than 8 yrs of age
b) It affects the kidney focally more frequently than diffusely
c) Boys are affected more frequently
d) Clinical presentation in children is same as in adults

50) Which one of the following statements is false with regard to pyuria in children?
a) Presence of more than 5 WBC/hpf for girls and more than 3 WBC/hpf for boys
b) Infection can occur without pyuria
c) Pyuria may be present without Urinary tract infection
d) Isolated pyuria is neither confirmatory nor diagnostic for UTI


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