AIPGMEE 2016 MCQs Physiology

A 38-year-old male patient with a duodenal ulcer is treated successfully with the drug cimetidine. The basis for cimetidine's inhibition of gastric H+ secretion is that it
(A) blocks muscarinic receptors on parietal cells
(B) blocks H2 receptors on parietal cells
(C) increases intracellular cyclic adenosine monophosphate (CAMP) levels
(D) blocks H+,K+-adenosine triphosphatase (ATPase)
(E) enhances the action of acetylcholine (ACh) on parietal cells

The answer is B
Cimetidine is a reversible inhibitor of H2 receptors on parietal cells and blocks H+ secretion. Cyclic adenosine monophosphate (cAMP) (the second messenger for histamine) levels would be expected to decrease, not increase. Cimetidine also blocks the action of acetylcholine (ACh) to stimulate H+ secretion. Omeprazole blocks H+, K+-adenosine triphosphatase (ATPase) directly.

AIPGMEE 2016 Medicine MCQ

A 22-year-old female presents to the ED with an overdose.
She has a history of depression, and there were
empty bottles found at her bedside. The bottles had contained
clonazepam (a benzodiazepine) and nortriptyline
(a tricyclic). The patient is unconscious with diminished
breathing and is unable to protect her own airway.
The BEST next step is to:
A) Intubate the patient.
B) Begin gastric lavage and administer charcoal.
C) Administer flumazenil, a benzodiazepine antagonist,
to awaken her and improve her respirations.
D) Administer bicarbonate.
E) None of the above.
Discussion
The correct answer is A. This patient should be intubated.
Remember that in any emergency situation that
the ABCs (airway, breathing, and circulation) are the
priority. Answer B is incorrect because, as noted above,
patients who are lavaged have a higher incidence of
pulmonary aspiration—an even greater concern in the
obtunded patient. In fact, airway protection is mandatory
before undertaking lavage. Answer C is incorrect.
Flumazenil will reverse the benzodiazepine. However,
we know from experience that seizures in patients who
have had flumazenil are particularly difficult to control.
This would be particularly problematic in a patient
with a mixed overdose, such as with a tricyclic, where
seizures are common. Thus, it is recommended that
flumazenil be used only as a reversal agent after procedural
sedation in patients who are not on chronic
benzodiazepines.
* *
You notice that the patient begins to have an abnormal
ECG tracing.
Which of the following findings would you expect
to find in a tricyclic overdose?
A) Normal QRS complex.
B) 2nd- and 3rd-degree heart block.
C) Widened QRS complex.
D) Sinus tachycardia.
E) All of the above.
Discussion
The correct answer is E. All of the above findings can be
seen with a tricyclic overdose. In fact, the most common
presenting rhythm is a narrow-complex sinus tachycardia.
As toxicity progresses, you can get a prolonged PR
interval, a widened QRS complex and a prolonged QT
interval. Heart blocks (2nd- and 3rd-degree) herald a
poor outcome and may be seen late in the course. Asystole
is not a primary rhythm in tricyclic overdose and
tends to reflect the end-stage of another arrhythmia.

AIPGMEE 2016 MCQ Pharmacology

The neurotransmitter system in the brain most affected in Alzheimer’s disease is:
A. Glutaminergic
B. Gabaergic
C. Dopaminergic
D. Cholinergic

AIPGMEE 2016 Obstetrics MCQ

1. All are true cardiovascular ,changes in pregnancy EXCEPT

A.Apex beat shifted to 4th intercostal space

B.A systolic murmur in apical and pulmonary area

C.Split 1st sound

D.ECG shows right axis duration

E.drop in diastolic BP

ANS.D

EXPLANTION:-

Cardiovascular changes in pregnancy Apex beat shifted to 4th ICS Pulse rate -increased Split 1st  sound Systolic murmur Mammary murmur X-ray-enlarged cardiac shadow ECG-Lt axis deviation Cardiac output -->> increased by 40%

Mid preg. -drop in diastolic BP

Venous pressure ,is -increased

Peripheral resistance is decreased

Clinical indicators of heart disease during pregnancy

Cyanosis

Clubbing

Persistent neck vein distension

Systolic .murmur greater than grade 1111

Diastolic murmur

Cardiomegaly

Susstained arrhythmia

Second sound split

Loud P2

Left parasternal lift

Ref:-

Subject- Obstetrics, Topic- Pregnancy

AIPGMEE 2016 Pathology MCQ

A 33-year-old man has experienced nausea and vomiting and has become mildly icteric over the past week. On physical examination, his temperature is 37.4° C. Laboratory studies show serum AST of 208 U/L and ALT of 274 U/L. Serologic findings for HBsAg and HBcAb are positive.
A liver biopsy specimen examined microscopically shows focal death of hepatocytes with a portal inflammatory cell infiltrate. Which of the following is the most likely mechanism by which his liver cell injury occurs under these conditions?
A Activated macrophage cytokine release
B Antibody-mediated destruction of HBsAg-expressing liver cells
C CD4+ lymphocyte recognition of circulating HBsAg
D CD8+ lymphocyte recognition of viral peptide presented by MHC class I molecules
E NK cell recognition of viral peptide presented by MHC class II molecules
Answer - D

Virus-infected cells are recognized and killed by
cytotoxic
CD8+ T cells. The T cell receptor on the CD8+ T cells
binds to the complex of viral peptide and MHC class I molecules
displayed on the surface of the infected cell. Natural
killer (NK) cells also recognize MHC class I molecules with
self-peptides, but this self-recognition inhibits NK cell killing.
Viruses that inhibit MHC I expression of peptides may
hide from cytotoxic cells, but not from NK cells. The other
listed options are not the major immune response to hepatitis
viral infection

NEET 2016 PG AIPGMEE Pharmacology MCQ

The following second generation anti-histaminic is
not likely to produce ventricular arrhythmias when
administered along with ketoconazole:
A. Mizolastine
B. Ebastine
C. Terfenadine
D. Astemizole
Mizolastine This nonsedating antihistaminic
is effective in allergic rhinitis and urticaria by
single daily dosing despite a t½ of 8–10 hr and no
active metabolite.

AIPGMEE 2016 SPM MCQ

A person has received complete immunization against tetanus 10 years ago, now he presents with a clean wound without any lacerations from an injury sustained 3 hours ago. He should now be given

(a) Full course of tetanus toxoid 

(b) Single dose of tetanus toxoid

(c) Human tetanus globulin

(d) Human tetanus globulin and single dose of toxoid

Ans. (b)

[Ref. Park 21/e p287, Park 22/c p286]

• In the given question, a person has received complete immunization against tetanus 10 years ago,

• Thus he is in immunity category B

• Now, he presents with a clean wound without any lacerations from an injury sustained 3 hours ago,

• Thus he should now be given single dose of tetanus toxoid

AIPGMEE 2016 Pediatrics MCQs

1. The best description of the Apgar score is that it:

A.Accurately predicts who will develop cerebral palsy

B.Assesses newborn infants in need of resuscitation

C.Accurately predicts a low umbilical cord pH

D.Is unaffected by maternal opiate pain relief

E.Accurately predicts newborn infants who will die in the neonatal period

ANS.B

EXPLANTION:-

The Apgar score is a practical method of systematically assessing newborn infants immediately after birth. A low score may be due to fetal distress but may also be due to a number of factors, including prematurity and drugs given to the mother during labor. The Apgar score was not designed to predict neurologic outcome. Indeed, the score is normal in most patients in whom cerebral palsy subsequently develops, and the incidence of cerebral palsy is low in infants with Apgar scores of 0-3 at 5 min (but higher than in infants with Apgar scores of 7-10). Low Apgar scores and umbilical artery blood pH predict neonatal death. An Apgar score of 0-3 at 5 min is uncommon but is a better predictor of neonatal death (in both term and preterm infants) than an umbilical artery pH ≤ 7.0; the presence of both variables increases the relative risk of neonatal mortality in term and preterm infants. Infants who fail to initiate respiration should receive prompt resuscitation and close observation. (See Chapter 88, page 536.)

Ref:- Nelson Textbook of Pediatrics  19th edn

AIPGMEE 2016 SPM MCQs

All of the following are blood-borne infections except:
(a) Hepatitis B
(b) Hepatitis C
(c) Hepatitis E
(d) Hepatitis G
Ans. (c) Hepatitis E [Ref. Park 21/e p!97, Park 22/e pi98]
HEPATITIS E:
• Enterically transmitted hepatitis non-A, non-B [HNANB]
• HEVis essentially a waterborne disease, transmitted through water or food supplies, contaminated by faeces
• Incubation Period: 2-9 weeks
HEV in pregnancy: Fulminant form is common in Hepatitis E infection during Pregnancy (up to 20% cases) with a
high case fatality rate (up to 80%)