LAST MINUTE REVISION POINTS (LMRP) for JIPMER NOVEMBER 2017 Bhatiya

Indian PG JIPMER
#1

  1. Liver is held in its position by Intra-abdominal pressure and tone of muscles, Peritoneal fold and Attachment of hepatic veins to IVC. 2. Injury to facial nerve below geniculate ganglion and above stylomastoid foramen level causes injury to chordatympanic branch of facial nerve which leads to loss of taste sensation in anterior 2/3 of tongue, loss of submandibular and sublingual gland secretions. 3. Root of the mesentery crosses the following 5 structures: 3rd part of the duodenum, Aorta, Inferior vena cava, Right ureter, Right psoas major. 4. Azygos lobe is a congenital variation of the upper lobe of the right lung. 5. Ligament maintaining Atlantoaxial stability is: Transverse ligament. 6. Myelination in intrauterine period starts at: 20 weeks. 7. Wrist can be adducted more than abduction because: Ulnar styloid process placed more proximally . 8. Cervical pleura is a continuation of Costal pleura. 9. Deep inguinal ring is derived from: Fascia transversalis. 10. In-turned ischial spines are features of male hip bone. 11. Gray ramus communicates is grey in colour due to: Post- ganglionic non-myelinated sympathetic fibres. 12. Fast pain –Aδ-type fibers, Slow pain- C-type fibers, Heat and Cold sensation- by A delta and C fibers . 13. Enterohepatic circulation in GIT occurs at the level of: Terminal ileum . 14. According to Starling law, force of contraction is directly proportional to: End diastolic length of muscle fibres . 15. Contractility is a variable independent from loading conditions, whereas the ejection fraction can be affected by changes in preload and afterload. 16. Lipoprotein A Lp(a) consists of 1 mol of LDL attached to a 1 mol of apo(a). Apo(a) shows structural homologies to plasminogen. 17. Glucose uptake in skeletal muscles, heart and adipose tissues is mediated by GLUT 4 which requires insulin. 18. Acetyl Co-A carboxylase is the rate- limiting step of fatty acid synthesis. Fatty acid synthesis. occurs during well fed state. Insulin is the predominant hormone during well-fed state.

  2. Function of pseudouridine arm of t RNA: For t-RNA and attaches to it. 20. Enzyme required for synthesis of both ketone bodies and cholesterol is: HMG CoA synthase. 21. Pyridoxine is a co- factor for : Decarboxylation reactions. 22. Oxygen dependent reactions in liver take place in : Zone 1. 23. Catabolism of long chain fatty acids occur in: Mitochondria. 24. Rate limiting step in de novo purine synthesis is PRPP glutamine amidotransferase . 25. Insulin: Acts on intrinsic tyrosine kinase receptors . 26. Carbohydrate moiety of Antigen recognizing site in RBC used for blood grouping is: Fucose . 27.Function of Golgi apparatus: Storing and packing of proteins. 28. Fusion inhibitor approved for used in HIV is : Enfuvirtide 29. Heparin “clears” lipemic plasma in vivo by causing the release of lipoprotein lipase into the circulation. 30. Lenalidomide may increase the risk of deep venous thrombosis and pulmonary embolus . Concurrent use of corticosteroids may further increase this risk. 31. Diuretics (Thiazide, Furosemide) by causing Na+ loss promote proximal tubular reabsorption of Na+ as well as Li+ causing plasma levels of lithium rise. 32. Lab monitoring of a patient on low molecular weight heparin (LMWH) is done by estimating: Anti-Xa. 33. N acetyl cysteine replenishes the glutathione stores of liver and prevents binding of the toxic metabolites to the other cellular constituents. 34. Adverse Effects of Ethambutol are:  Low visual acuity, defects in colour vision and field defects due to optic neuritis  Nausea  Rashes  Fever  Neurological manifestations  Hyperuricemia 35. Mechanism of action of alendronate is: Inhibits osteoclasts. 36. Alteration of Penicllin binding proteins is responsible for both low level and high level resistance seen in Strepococcus pneumoniae to penicillin G and Staphylococcus to nafcillin. 37. Negri bodies, found in pyramidal neurons of the hippocampus and Purkinje cells of the cerebellum. 38. Most severe form of hereditary spherocytosis is caused by the mutation of: Alpha spectrin . 39. A specific feature of apoptosis is the activation of several members of a family of cysteine proteases named caspases. 40. Antigen used in the interferon gamma release assay (IGRA) for the diagnosis of latent TB is: ESAT6. 41.Characteristics of Staphylococcus Aureus:  Gram positive cocci
    Arranged in clusters  Non-motile  Catalase positive  OXIDASE negative 42. Northern blot technique is used in the detection of: RNA. 43. Internal putrefaction earliest seen in: Undersurface of liver. 44. Drooling of saliva is pathognomonic of: Antemortem hanging . 45. According to MTP act, abortion can be done till: 20 weeks. 46. Correlation co-efficient of 0.5 indicate:Weak association. 47. The colour of bag used to dispose sharp wastes Is: Blue white translucent . 48.Preventing obesity becomes primordial prevention for most of the Non –communicable diseases. 49. Cold Spots on bone scan causes are: Multiple myeloma, Bone infarction . 50. Timely primary percutaneous coronary intervention (PCI) is the preferred therapy for ST-segment elevation myocardial infarction (STEMI). 51. Most sensitive test for diagnosis of H. Pylori: Rapid urease test . 52. Number connection test is done to detect: Hepatic encephalopathy . 53. Reversible myocardial ischemia is best diagnosed by: PET scan. 54. Conglomerate bodies found in: Sarcoidosis. 55. Appropriate antibiotic therapy instituted before the 9th day of symptoms of acute GAS pharyngitis is highly effective in preventing 1st attacks of acute rheumatic fever from that episode. 56. Hepatitis B Vaccination can decrease the incidence of Hepatitis B and thus Hepatocellular carcinoma. 57. The SMA is the most commonly involved vessel in acute mesenteric ischemia. 58. Source of bleeding ulcer on lesser curvature of stomach is: Right gastric artery & left gastric artery . 59. The ideal time when invertogram should be done in a newborn : After 6 hours 60. Causes of SVCS are : Squamous cell and Small cell lung Ca,Lymphoma,Thrombosis following intra venous catheter use, Metastasis from Testicular and Breast Ca. 61. Second only to the spleen, injury to the liver is extremely common after blunt abdominal trauma. 62. Intussuception is frequently associated with: Sub mucosal lipoma. 63.The Alkali Denaturation Test  Used to differentiate fetal or neonatal blood from maternal blood (Qualitative).  Positive test indicates that blood is of fetal origin.  Negative test indicates that the blood is of maternal origin. 64. Absolute indications for therapeutic termination in maternal heart disease during pregnancy :  Primary pulmonary hypertension.  Eisenmenger’s syndrome.
     Pulmonary veno-occlusive disease. 65. Varicella immunoglobulin to be given in: Non immunised mother exposed to varicella infection . 66. Drug of choice in a pregnant woman with Chamydia trachomatis infection is: Amoxicillin . 67. HAIR-AN syndrome. Patient with PCOS characterized by hyperandrogenism, insulin resistance and acanthosis nigricans. 68. Possible Late Sequelae of PCOS:  Diabetes mellitus  Endometrial hyperplasia and carcinoma  Hypertension and cardiovascular disease  Obstructive sleep apnea. 69. Light bulb sign in X-ray shoulder is seen in: Post dislocation of shoulder . 70. Pointing index in supracondylar fracture is due to : Anterior interosseous nerve injury . 71. Best management of open fracture is: Debridement . 72.Increase in bone girth occurs by appositional bone formation by generative cells in the deepest layer of periosteum. 73. Hook of hamate in a hyperextended hand causes compression of: Ulnar nerve. 74. The Classic O’Donoghue Triad:  Characterized by an injury to: - - - The anterior cruciate ligament The medial collateral ligament (or tibial collateral ligament) The medial meniscus. 75. Achondroplasia typically manifests at birth with short limbs, a long narrow trunk, and a large head with midfacial hypoplasia and prominent forehead and skeletal radiographs confirm the diagnosis. 76. Treatment of choice in newborn with club foot: Both manipulation and splint. 77. Function of cruciate ligaments: Prevents anteroposterior instability. 78. In children, cavitation is most commonly caused by Streptococcus pneumoniae and less frequently by Aspergillus spp., Legionella spp. And Staphylococcus aureus… 79. Weight for height/ WHO grade for acute severe malnutrition : Z score less than -3 80. Bedwetting is considered normal in girls and boys till the age of: 4 and 5 years respectively . 81. Chromium→ Potentiates the action of insulin : And its DEFICIENCY causes:  Impaired glucose tolerance  Peripheral neuropathy  Encephalopathy. 82.COACH syndrome (cerebellar vermis hypoplasia, oligophrenia, congenital ataxia, coloboma, and hepatic fibrosis).

  3. WHO grade of a HIV child with parotid enlargement: Stage 2. 84. CHF develops in infants with large VSDs, but usually not until 6 to 8 weeks of age. 85. Sevoflurane is favoured in paediatric practice for gaseous induction, but desflurane or isoflurane are marginally the preferred agents for maintenance of anesthesia in children with Liver disease undergoing major abdominal surgery. 86. Stereotactic Radiosurgery: It is a type of external beam radiation therapy. 87. A patient with a perceptional disorder is able to see an object without any external stimulus. This phenomenon is known as: Hallucination . 88. The middle ear communicates with the mastoid area posteriorly and the nasopharynx (via the pharyngotympanic tube) anteriorly . 89. Inferior tympanic artery is a branch of : Ascending pharyngeal artery . 90. The collecting duct develops from the ureteric bud and is thus technically not part of the nephron. 91. Mesorectal Fascia : Contains  Superior rectal artery and its branches.  Superior rectal vein and tributaries.  Lymphatic vessels and nodes along the superior rectal artery.  Branches from the inferior mesenteric plexus which descend to innervate the rectum.  Loose adipose connective tissue. 92. Posterior Cricoarytenoid: The only muscle produce abduction of vocal cord (open the rima glottides). 93. Retropharyngeal space situated behind the pharynx. It extends from the base of skull to the infrahyoid region, where it continuous with retrovisceral space (retrovisceral space extends upto superior mediastinum/bifurcation of trachea). 94. Claudius Cells are considered as supporting cells within the Organ of Corti in the Cochlea. 95. Secretory phase of endometrium is due to which hormone : Progesterone. 96. Most common progesterone metabolite in urine : Pregnanediol . 97. Together with endothelial cells of blood vessels within the fascicle, perineurial cells constitute part of the blood-nerve barrier. 98. One molecule of DPG is bound per hemoglobin tetramer, in its central cavity, in the T-form, when the space between the H-helices of the beta chains is just wide enough to accommodate it. 99. Utilization of ketone bodies by :  Heart  Brain (especially when starving).  Skeletal muscle.  Renal cortex. Ketones are NOT utilized by:

RBC- Since it does NOT contain mitochondria.  Liver- Since it does NOT contain thiophorase enzyme. 100. Only thiazide used in renal failure when GFR is less than 30-40 ml/min: Metolazon

LMRPs for JIMPER Nov. 2017 (PART -2)
101. Azoles inhibit the fungal cytochrome P450 enzyme lansoterol l4- demethylase’ and thus impair ergosterol synthesis leading to a cascade of membrane abnormalities in the fungus.
102. The capillary leak syndrome is a dose dependent phenomenon that is well described for GM-CSF when the daily dosage is 32 micrograms/kg or greater.
103. Antiplatelet agents are used in primary and secondary prevention of thrombotic cerebrovascular or cardiovascular disease. It is not used in heart failure .
104. Melanocyte differentiation markers :
• S100
• Gp 100/HMB-45
• Typrosinase.
• MART- 1/Melan-A.
• HMW_ MAA
• Ki67
• MiTF
• S100
105. Goodpasture syndrome is caused by circulating autoantibodies against the noncollagenous domain of the α3 chain of collagen IV.
106. Most common benign tumor of oesophagus is: Leiomyoma.
107. Atypical lymphocytes in infectious mononucleosis are made up of: CD8 + T cells.
108. Best disinfectant for endoscopes is: Glutaraldehyde.
109. Activators of Alternate Complement Pathway:
• Bacterial endotoxins (Most potent)
• Zymogen
• IgA
• IgG4
• Cobra venom
110. Exotoxin are made up of patients, heat labile and highly antigenic .
111.Red velvety appearance of stomach mucosa is seen in the poisoning of: Arsenic.
112. The seeds of Abrus precatorius contains an active principle Abrin, a toxalbumen, which is similar to viperine snake venom.
113. Live vaccines: BCG, Measles, Yellow fever, Measles, Rubella, Tyhoid (Oral), Influenza, Mumps
114. Case Control Studies=From effects to cause=Best to study rare studies.
115. The ICMR recommended daily allowance (RDA) for Iron is 38 mg/day during pregnancy and 30 mg/day during lactation.
116. Gas used in retinal tamponade: SF6 ( sulphur hexafluoride).
117. Ng Yag Laser used in : Iridotomy (Glaucoma), Capsulotomy (Posterior Capsular opacification).
118. Soft contact lenses are made up of: HEMA.
119. The most common clinical course of contrast nephropathy is characterized by a rise in serum creatinine beginning 24-48 hours following exposure, peaking within 3-5 days, and resolving within I week.
120. Unless and otherwise proved, a diastolic murmur is always organic.
121. Amiodarone is the DOC in resistant VT.
122. Catheter associated asymptomatic bacteriuria (CA- ABU):
• Urine culture positivity in catheterized patients.
• No symptoms.
• No treatment required
• Remove / Replace catheters if not required.
123. In anemia due to lead poisoning, bone marrow will characteristically show:Basophilic stippling.
124. ECG features seen in hyperkalemia:
• Sine wave pattern
• Tall T waves
• Widening of QRS complex.
125. Palpable purpura is seen in: HSP, Giant cell arteritis, Drug induced vasculitis .
126. First marker to rise in myocardial infarction is: Myoglobin.
126. OSAHS is defined as the coexistence of unexplained excessive daytime sleepiness with at least five obstructed breathing events (apnea or hypopnea) per hour of sleep.
127. Best treatment to prolong life in COPD patients is: Oxygen .
128. Prolonged tourniquet application cause spurious or Factitious Hyperkalemia.
129. HUS can be differentiated from TTP by: Absence of neurological symptoms .
130. Cisplatin/5-FU-based chemotherapy is now a standard therapy in the preoperative treatment of esophageal squamous cell Ca and gastroesophageal junction adenocarcinoma.
131. The only neoplasms of salivary glands known to consistently concentrate Tc-99m pertechnetate (Hot spot) are Warthin’s tumor and oncocytoma.
132. Complications of sentinel lymph node biopsy and axillary node sampling include hematoma formation, wound infection, seroma, lymphedema and damage to intercostobrachial nerve.
133. Desmoid tumours are commonly associated with familial adenomatous polyposis (FAP), in which colonic polyps are the most common feature.
134. A 40 year old multiparous woman was detected to have CIN-2 by PAP smear,the next line of management is Colposcopy .
135. Whiff test is useful in the diagnosis of : Bacterial vaginosis .
136. Most accurate method to detect pregnancy at 6 weeks gestation is: USG fetal cardiac activity .
137. Wandering acetabulum is seen in: Tuberculosis .
138. Mallet finger is: Avulsion of extensor tendon of DIP joint.
139. Monteggia fracture: Fracture of shaft of the proximal third of ulna associated with dislocation of the proximal radio-ulnar joint.
140. Hinge fracture is seen in: Basilar skull fracture .
141. Hill-Sachs lesion: Cortical depression fracture in the posterolateral aspect of the head of the humerus.
142. Meralgia parasthetica is due to the involvement of: Lateral cutaneous nerve of thigh.
143. Object permanence in a child is seen after: 6 months.
144. Normal Anion Gap is seen in :
• Diarrhoea
• Renal tubular acidosis (Distal, Proximal and Hyperkalemic types).
• Urinary tract diversions.
• Post-hypocapnia.
• Ammonium chloride intake.
145. Breastfeeding should be avoided by a mother on ATT for : 2 weeks.
146. Factors affecting efficacy of phototherapy are :
• Irradiance (Intensity of lights).
• Surface area exposed.
• Distance from phototherapy unit.
• Initial serum total bilirubin at the start of phototherapy.
• Skin pigmentation
• Duration of exposure
• Adequacy of breastfeeding.
147. Lepra type 2 reaction is : Type 3 hypersensitivity reaction.
148. Most common organism causing Tinea capitis is: Trichosporum tonsurans.
149. Acute contact dermatitis is best treated : by moist compresses.
150. Frie’s skin test used to diagnose: LGV.
151. Best spontaneous breathing circuit is: Mapleson A.
152. Post lumbar puncture headache is minimized by Use of small bore needle, adequate hydration, to avoid pillow for next 24 hours,lie in prone position,avoid spinal if history of headache, avoid sitting in postoperative period.
153. Muscle most resistant to the action of non depolarizing muscle relaxants is: Diaphragm.
154. Lithium should be stopped how many days before surgery: 2 days.
155. Non rebreathing masks: Can deliver upto 80% of oxygen.
Rebreathing masks: When tightly fit, they can provide 100% oxygen.
156. Symptomatic spinal injury without any radiological evidence most commonly found in: Children.
157. The dose of radiation for point A for early and locally advancing cervical cancer during brachytherapy according to ABS guideline is: 80- 85Gy and 85-95Gy.
158. According to ICD-10, F letter is used to denote mental illness.
159. A patient has chronic low grade depression for 2 years in : Dysthymia.
160. Mini mental state examination is used in the diagnosis of: Dementia .
161. A patient who is alert but not giving response is best categorized as: Hysteria .
162. Lateral wall of the Orbit : This is the strongest wall.Formed by two bones, Zygomatic bone and Orbital surface of greater wing of sphenoid .
163. Perineal body: It is fibromuscular node formed by 9 muscles :

  1. Pair of superficial and deep transverse perinii.
  2. Two sphincters- External anal sphincter & sphincter uretherae .
  3. Levator anii muscle- Pubococcygeus & Illicoccygeus but not ischiococcygeus.
  4. Bulbospongiosus .
  5. Depressors of mandible are : Lateral pterygoids, Digastric, Geniohyoids, Mylohyoids .
  6. Hardest substance in teeth: Enamel .
  7. 3rd pouch derivatives :- Thymus, Inferior parathyroid gland.
  8. Mesonephric duct(Wolffian duct)derivatives : In males
    • Duct of epididymis
    • Vas deferens
    • Ejaculatory duct
    • Part of bladder and prostatic urethra
    • Appendix of testis
    • In female( Duct of epoophoron-Gartner’s duct).
  9. Better predictor of vagal tone? Basal heart rate
  10. Testis is the source for: Testosterone, Dehydroepiandrosterone, Androstenodione
  11. Foramen Spinosum transmits:Middle meningeal artery,Emissary veins,Nervous spinosum (MEN).
  12. Neutrophils increase in number after exercise due to: Demargination.
  13. The enzyme deficient in Phenyl Ketonuria is: Phenylalanine hydroxylase .
  14. Most common enzyme deficient in urea cycle: Carbamoyl phosphate synthase I .
  15. Peptidyl tranferase is: Ribozyme.
  16. The most important function of 2,3 DPG is: O2 release .
  17. Glucagon hydrochloride is used in poisoning of: Beta blocker .
  18. Drug used in Narcoanalysis is: Scopalamine .
  19. Concomitant administration of proton pump inhibitors of CYP2C19, with Clopidogrel, produces a small reduction in the inhibitory effects of clopidogrel on ADP-induced platelet aggregation.
  20. Drug used in both type of diabetes is: Pramlintide .
  21. Ethanol is used in Ethylene glycol poisoning. Mechanism of action is Competitive inhibition of Alchohol dehydrogenase .
  22. Primaries which produce predominantly sclerotic/osteoblastic lesions: Prostate adenocarcinoma, Ca Colon, Ca Breast .
    182.C- Myc on chromosome 8 is seen in: Burkitt’s lymphoma .
  23. Single donor pheresis platelets are stored between 20 deg C and 24 deg C with gentle agitation on a platelet agitator for 5 days.
    185.HPV – tumorogenesis is mediated by: p21 inactivation.
  24. Macllums patch is usually seen in: Left atrium .
  25. The macrophage to epitheliod conversion in Mycobacterium tuberculosis infection is mediated by: IFN –Y.
  26. Fibrinoid necrosis is a characteristic feature of Malignant hypertension.
  27. It is important to document the presence of nephrogenic rests in the resected specimen, since these patients are at an increased risk of developing Wilms tumors in the contralateral kidney and require frequent and regular surveillance for many years.
  28. Florence test detects ‘Choline’ in Semen .
  29. Recommended concentration of iodine in iodised salt at consumer level is: 15 ppm.
  30. Recommended residual chlorine level after 1 hr contact period is: 0.5ppm.
  31. Ultra low volume fogging is done for: Malathion .
  32. Target in RNTCP case detection for tuberculosis: 70%.
    195.Mouse nibbled appearance of vocal cords is seen in: Tb larynx .
  33. The frequency used in tympanometry is: 220 Hz.
  34. Mild tracheostomy is done : at the level of 2-3 tracheal rings .
  35. Dalen fuch nodules are seen in: Sympathetic opthalmitis .
  36. Gold standard test for diagnosing GERD: Ambulatory pH monitoring .
  37. Delayed clotting in abetalipoproteinemia is due to: Reduced clotting factor synthesis .