INICET 2024 PYQ

INICET 2024 questions past paper recall by subject

Anatomy

1. In posterior interosseous nerve (PIN) palsy, which function is primarily affected?

A. Wrist flexion
B. Extension of fingers
C. Extension of the wrist
D. Wrist drop

2. Which electrolyte disturbance is commonly seen in tumor lysis syndrome?

A. Hypocalcemia
B. Hyperkalemia
C. Hyperphosphatemia
D. All of the above

3. At birth, the oocyte is arrested in which stage of meiosis?

A. Diplotene
B. Zygotene
C. Pachytene
D. Leptotene

4. Which muscle helps stabilize the pelvis during the lifting of the opposite leg?

A. Gluteus maximus
B. Vastus medialis
C. Gluteus medius
D. Tensor fasciae latae

5. The first migration of epiblast cells leads to the formation of which germ layer?

A. Endoderm
B. Ectoderm
C. Notochord
D. Mesoderm

6. In human sperm cells, the mitochondrial sheath is present in:

A. Connecting segment
B. Tail
C. Middle piece
D. Head

7. Which cranial nerve does NOT pass through the superior orbital fissure?

A. Optic nerve (II)
B. Abducent nerve (VI)
C. Trochlear nerve (IV)
D. Oculomotor nerve (III)

Biochemistry

8. Ideal anticoagulant for HbA1c estimation is:

A. EDTA
B. Fluoride
C. Heparin
D. Citrate

9. Which amino acid donates nitrogen to sodium benzoate in urea cycle disorders?

A. Glutamine
B. Arginine
C. Glycine
D. Glutamate

10. Copper deficiency affecting lysyl oxidase is seen in:

A. Menkes disease
B. Scoliosis
C. Ehlers-Danlos syndrome
D. Scurvy

11. A diabetic patient presents with high VLDL. Which of the following explains the condition?

A. High LPL, Low HSL
B. Low LPL, Low HSL
C. High HSL, Low LPL
D. High HSL, High LPL

12. Tube used for serum electrolyte estimation is:

A. Grey top
B. Lavender top
C. Green top
D. Yellow top

13. Which of the following is an essential fatty acid?

A. Linoleic acid
B. Glutamic acid
C. Linolenic acid
D. DHEA

14. Which of the following does NOT inhibit cytochrome oxidase?

A. Cyanide
B. Nitric oxide
C. Hydrogen sulfide
D. Carbon monoxide

15. Match the amino acid with its derivative:

Histidine, Tyrosine, Tryptophan, Cysteine

a. Catecholamines, b. Histamine, c. Glutathione, d. Melatonin

A. 1-b, 2-a, 3-d, 4-c
B. 1-a, 2-c, 3-b, 4-d
C. 1-d, 2-c, 3-b, 4-a
D. 1-b, 2-c, 3-d, 4-a

16. Enzymes used in recombinant DNA technology include all except:

A. Terminal transferase
B. Isomerase
C. Phosphatase
D. CRISPR-Cas9

17. Which is true regarding pancreatitis?

A. Amylase remains high for 30 days
B. Lipase is more specific than amylase
C. Lipase indicates severity
D. Amylase is more specific than lipase

18. Which amino acid is the main source for phenylbutyrate (urea cycle disorder therapy)?

A. Glycine
B. Glutamate
C. Arginine
D. Aspartate

19. Which of the following is true regarding serum calcium estimation?

A. Prolonged immobilization increases free and total calcium
B. Apply a tight tourniquet
C. Use citrate or oxalate tubes
D. Fist clenching is advised

Physiology

20. Which of the following is responsible for enteric nervous regulation?

A. Myenteric plexus
B. Enterochromaffin cells
C. Interstitial cells of Cajal
D. Vagal afferents

21. Increased pulse pressure in old age is due to:

A. Increased cross-sectional area
B. Decreased arterial compliance
C. Increased cardiac output
D. Decreased viscosity

22. Which of the following types of transport does NOT require ATP? A. Paracellular Transport B. Simple Diffusion C. Facilated diffusion D. Na/K ATPase

A. A, B, C
B. A, B, C, D
C. A, C, D
D. B, D

23. Peripheral chemoreceptors are most sensitive to:

A. Hypoxia
B. Acidosis
C. Hypercapnia
D. Alkalosis

24. What is the primary mechanism of heat loss in hot and dry climates?

A. Radiation
B. Conduction
C. Evaporation
D. Convection

25. Which receptor is responsible for static 2-point discrimination?

A. Pacinian corpuscle
B. Merkel's
C. Meissner's
D. All of the above

26. Which of the following decreases GFR?

A. Decreased filtration coefficient
B. Increased Bowman's capsule hydrostatic pressure
C. Increased glomerular hydrostatic pressure
D. Decreased glomerular oncotic pressure

27. Adrenal medulla secretes catecholamines in response to all except:

A. Hyperglycemia
B. Smoking
C. Standing up
D. Exercise

28. In packed RBC transfusion, what type of oxygen dissociation curve is seen?

A. No Change
B. Right Shift
C. Left Shift
D. Negative Shift

29. All of the following are seen in decompression sickness except:

A. Hearing loss
B. Hemodilution
C. Coagulopathy
D. Vision loss

30. What factors contribute to the latent period in a single muscle twitch?

1. NMJ transmission

2. Excitation-contraction coupling

3. Time from stimulus to onset of contraction

4. Calcium reuptake via SERCA

A. 1, 3, 4
B. 1, 2, 3
C. 1, 2, 4
D. 1, 3, 2

31. Match the hormones with their receptors:

A. Acetylcholine

B. Levothyroxine

C. Insulin

D. Growth hormone

Receptors:

A. JAK-STAT

B. Tyrosine kinase

C. Intracellular

D. Ligand-gated ion channel

A. A-D, B-C, C-B, D-A
B. A-C, B-A, C-D, D-B
C. A-C, B-D, C-A, D-B
D. A-A, B-D, C-C, D-B

32. Which of the following is correct about physiological dead space?

A. Inadequately ventilated alveoli
B. Inadequately perfused alveoli
C. Measured by spirometry
D. Less than anatomical dead space

33. Which of the following is seen in heat exhaustion?

A. Loss of thermoregulation
B. Intense physical exertion
C. Both A and B
D. None of the above

Pharmacology

34. Which antiepileptic drug modulates voltage-gated sodium channels and enhances slow inactivation?

A. Ethosuximide
B. Lamotrigine
C. Lacosamide
D. Phenytoin

35. Which of the following is true about Pretomanid?

A. Acts by inhibiting free radicals
B. Approved for treatment of XDR-TB with bedaquiline and linezolid
C. Approved for drug-resistant malaria
D. Contraindicated with CYP2D6 inducers

36. Drug of choice for Fasciola hepatica infection:

A. Triclabendazole
B. Albendazole
C. Mebendazole
D. Praziquantel

37. Which general anesthetic drug causes adrenal suppression?

A. Etomidate
B. Ketamine
C. Propofol
D. Thiopentone

38. Which drug binds to the GABA-A receptor and inhibits it?

A. Phenytoin
B. Valproate
C. Tiagabine
D. Ganaxolone

39. Which of the following antidotes is correctly matched with the toxin?

A. Arsenic – Desferrioxamine
B. Benzodiazepines – Flumazenil
C. Barbiturates – Fomepizole
D. Atropine – L-carnitine

40. A rheumatoid arthritis patient is intolerant to TNF-α inhibitors. Which JAK inhibitor can be used?

A. Erenumab
B. Leflunomide
C. Sulfasalazine
D. Tofacitinib

41. Which of the following drugs used for breast cancer is a PARP inhibitor?

A. Palbociclib
B. Vemurafenib
C. Gemcitabine
D. Rucaparib

42. Which of the following is true about iron isomaltose 1000?

A. Preferred as oral single dose
B. More immunogenic than iron dextran
C. Single dose replenishes iron stores
D. Not given with erythropoietin

43. A post-MI patient on atorvastatin, aspirin, and metoprolol has cholesterol 238, triglycerides 125, and HDL 50. Which drug should be added?

A. Bempedoic acid
B. Evolocumab
C. Ezetimibe
D. All

44. Half-life of digoxin in a 46 kg female (Clearance = 4.6, Vd = 6 L/kg):

A. 40 hours
B. 42 hours
C. 44 hours
D. 46 hours

45. All of the following drugs are used in uncomplicated malaria EXCEPT:

A. Artemether
B. Primaquine
C. Sulfadoxine-pyrimethamine
D. Chloroquine

46. Which antiretroviral drugs bind to the CD4 receptor and affect CXCR4 and CCR5?

A. Dolutegravir
B. Maraviroc
C. Tenofovir
D. Ibalizumab

47. Which conditions lead to a fall in diastolic BP?

1. Loss of sympathetic outflow in lumbar region

2. Beta-1 agonist

3. Alpha blockade

4. Beta-2 agonist

A. 1 and 4 only
B. 1, 2, 3 only
C. 1, 3, 4 only
D. 2, 3, 4 only

48. Which statement is correct about fosphenytoin?

A. Safe dose of phenytoin is 250 mg/mL
B. Max oral dose causes cerebellar/vestibular symptoms and brain atrophy
C. Given to all seizure patients regardless of CNS side effects
D. High doses can cause cardiotoxicity in elderly and nephrotoxicity in young

Pathology

49. Which of the following is NOT a live vaccine?

A. Hepatitis B
B. Measles
C. Varicella
D. Rotavirus

50. Umbilical bleeding with normal BT, PT, aPTT, and positive urea clot test suggests deficiency of:

A. Factor XII
B. Factor IX
C. Factor XIII
D. Factor VIII

51. Which protein is involved in epithelial-to-mesenchymal transition (EMT)?

A. SNAIL & TWIST
B. MMP-9
C. TFI & TFII
D. Cathepsin

52. A 5-year-old child presents with gum bleeding and peripheral smear showing CD19, CD22, TdT positivity. Likely diagnosis:

A. AML
B. CML
C. ALL – B-cell type
D. ALL – T-cell type

53. Most common inherited cause of hypercoagulability:

A. Factor V Leiden mutation
B. Protein C or S mutation
C. Antithrombin III deficiency
D. Prothrombin mutation

54. Match the tumor markers with associated conditions:

1. AFP – A. Hepatoblastoma, HCC

2. β-HCG – B. Choriocarcinoma

3. Calcitonin – C. Medullary thyroid carcinoma

4. Catecholamines – D. Pheochromocytoma

A. 1-C, 2-A, 3-B, 4-D
B. 1-B, 2-D, 3-C, 4-A
C. 1-C, 2-B, 3-D, 4-A
D. 1-A, 2-A, 3-C, 4-D

55. Which is NOT part of Carney's complex?

A. Ebstein anomaly
B. Lentigines
C. Schwannoma
D. Atrial myxoma

56. Which blood product is NOT produced by centrifugation?

A. RBC
B. Cryoprecipitate
C. Platelet concentrate
D. Albumin

57. Technique used to detect aneuploidy:

A. Sanger sequencing
B. Karyotyping
C. FISH
D. PCR

58. A 45-year-old woman has Raynaud's phenomenon, dysphagia, heartburn, telangiectasia, and positive ANA . Diagnosis:

A. Limited Sclerosis
B. Sjögren syndrome
C. Scleroderma
D. SLE

59. Match the following syndromes with gene mutations:

A. Juvenile polyposis – 1. SMAD4

B. FAP – 2. APC

C. Peutz-Jeghers – 3. STK11

D. Tuberous sclerosis – 4. TSC1/2

A. 1-C, 2-B, 3-A, 4-D
B. 1-B, 2-D, 3-C, 4-A
C. 1-C, 2-A, 3-B, 4-D
D. 1-A, 2-B, 3-C, 4-D

60. Which is incorrect regarding celiac disease?

A. Anti-gliadin antibodies are present
B. IgA tTG antibodies are diagnostic
C. Marsh criteria is used for diagnosis
D. Associated with HLA DQ6

61. Which cancers are vaccine preventable? (Multiple options)

A. Merkel cell carcinoma
B. Cervical cancer
C. Hepatocellular carcinoma
D. Burkitt’s lymphoma

62. Match the following inclusion bodies to diseases:

A. Negri bodies – Rabies

B. Lewy bodies – Parkinson’s disease

C. Dutcher bodies – Multiple myeloma

D. MG bodies – Malakoplakia

A. 1-C, 2-D, 3-A, 4-B
B. 1-B, 2-A, 3-C, 4-D
C. 1-A, 2-B, 3-C, 4-D
D. 1-C, 2-D, 3-A, 4-B

63. Not required for T-cell activation:

A. MHC-APC interaction
B. PD1
C. CD28
D. CD80/86

Microbiology

64. Which test is used for antibiotic sensitivity?

A. E-test
B. Elek test
C. Latex agglutination
D. CAMP test

65. COVID-19 prevention does NOT include:

A. Wearing a mask
B. Ivermectin
C. Cough etiquette
D. Vaccination

66. Which of the following is NOT a cold sterilization method?

A. UV rays
B. Plasma sterilization
C. Gamma rays
D. Autoclaving

67. Which media is used to grow Mycobacterium tuberculosis?

A. Sabouraud’s dextrose agar
B. LJ medium
C. Mueller-Hinton agar
D. Blood agar

68. A farmer presents with blunt chest trauma. Acid-fast, branching bacteria are seen. Likely organism?

A. Listeria monocytogenes
B. Mycobacterium tuberculosis
C. Nocardia
D. Actinomyces

69. A patient with right-sided abdominal pain and hydatid cyst on USG. Likely organism:

A. Taenia saginata
B. Entamoeba histolytica
C. Echinococcus granulosus
D. Taenia solium

70. Which of the following is NOT true about Cryptococcus?

A. Seen in AIDS
B. Found in bird droppings
C. All pathogenic species are urease positive
D. Infection occurs when CD4 >500

71. Which of the following is a gram-positive cocci in chains?

A. Nocardia
B. Enterococcus
C. Micrococcus
D. Streptococcus

72. Which of the following is NOT true about Ascaris lumbricoides?

A. Mostly asymptomatic
B. Heavy infection causes rectal prolapse
C. Unembryonated egg matures in soil
D. Can cause asthma-like symptoms

73. Sterilization of a wire loop is best done by:

A. Autoclave
B. Flame until red hot
C. Plasma sterilization
D. Pass over flame three times

74. Match the following infections with their organisms:

A. Rat bite fever – a. Streptobacillus

B. Oroya fever – b. Bartonella

C. Pinta – c. Treponema

D. Donovanosis – d. Klebsiella

A. A-a, B-b, C-c, D-d
B. A-B, B-D, C-A, D-C
C. A-B, B-A, C-D, D-C
D. A-A, B-D, C-C, D-B

75. All of the following cause urethritis in males EXCEPT:

A. Gardnerella
B. Trichomonas
C. Gonococcus
D. Chlamydia

Ophthalmology

76. Which of the following is true about Ophthalmic Viscosurgical Devices (OVDs) used in cataract surgery?

A. Can be left in the eye permanently
B. Maintain anterior chamber during capsulorhexis
C. SF6 and perfluoropropane are common viscoelastic substances
D. Corneal epithelium is damaged

77. Investigation of choice for Best disease:

A. Multifocal ERG
B. Electro-oculogram (EOG)
C. Visual evoked potential
D. Electroretinogram (ERG)

78. First step in chemical injury to the eye:

A. Antibiotic eye drops
B. IOP measurement
C. Copious irrigation
D. Visual acuity assessment

79. Which of the following causes sudden painless vision loss?

A. Glaucoma
B. Iridocyclitis
C. Diabetic retinopathy
D. Keratoconus

80. Optic disc: Retinal venous lumen ratio is:

A. 1:3
B. 1:5
C. 2:3
D. 3:5

81. Findings seen in diabetic retinopathy include:

A. Tractional retinal detachment
B. Retinoschisis
C. Myopia
D. Posterior staphyloma

82. Pterygium can lead to:

A. Astigmatism
B. Epiphora
C. Macular edema
D. Purulent discharge

83. Which of the following is NOT derived from neural crest?

A. Ciliary muscle
B. Choroidal melanocytes
C. Ciliary ganglion
D. Retinal pigment epithelium

84. Fluorescein angiography of microaneurysms shows:

A. Hypofluorescent dots
B. Hyperfluorescent dots
C. Hyperfluorescent lines
D. Branching patterns

85. Child presents with leukocoria and intraocular calcified mass. Likely diagnosis:

A. Retinopathy of prematurity
B. Congenital cataract
C. Coats disease
D. Retinoblastoma

86. Findings in macular corneal opacity include:

A. Iris details visible
B. Both iris and pupil visible
C. Both iris and pupil not visible
D. Only pupil margin visible

87. Which is NOT found in the inner segment of photoreceptors?

A. Mitochondria
B. Ribosomes
C. Golgi apparatus
D. Membrane discs

88. Correct order of retinal layers (outer to inner):

A. Retinal pigment epithelium → Layer of rods and cones → Outer nuclear layer → Ganglion cell layer → Nerve fiber layer
B. Ganglion cell layer → Inner plexiform layer → Inner nuclear layer → Outer plexiform layer → Outer nuclear layer
C. Internal limiting membrane → Nerve fiber layer → Ganglion cell layer → Inner plexiform layer → Outer nuclear layer
D. Internal limiting membrane → Ganglion cell layer → Inner nuclear layer → Outer nuclear layer → RPE

89. Which part of the eye has the highest refractive power?

A. Cornea
B. Lens
C. Vitreous humor
D. Retina

90. Which of the following is true about keratoconus?

A. Presents with sudden pain and redness
B. Associated with irregular astigmatism
C. Leads to hypermetropia
D. Common in elderly population

91. Which test is used to detect visual field defects?

A. Schirmer’s test
B. Amsler grid test
C. Optical coherence tomography
D. Ishihara test

92. Which type of cataract is commonly associated with diabetes?

A. Nuclear cataract
B. Posterior subcapsular cataract
C. Cortical cataract
D. Snowflake cataract

93. Which of the following is the hallmark of angle-closure glaucoma?

A. Gradual loss of peripheral vision
B. Optic disc cupping
C. Sudden eye pain and halos around lights
D. Progressive increase in intraocular pressure

ENT

94. Which fracture is shown in the given facial bone diagram(longitudinal nasal septal)?

A. Chevallet
B. Le Fort
C. Jaffray
D. Nasal bone

95. Audiogram shows a flat curve with poor air conduction, normal bone conduction. Diagnosis?

A. Conductive hearing loss
B. Sensorineural hearing loss
C. Auditory neuropathy spectrum disorder
D. Mixed hearing loss

96. Carhart’s notch is seen in:

A. Ménière’s disease
B. Semicircular canal dehiscence
C. Otosclerosis
D. CHL

97. Most common test used in neonatal hearing screening:

A. BERA
B. PTA
C. OAE
D. None of the above

Anesthesia

98. True about pediatric resuscitation:

A. Adrenaline dose is 0.01 mg/kg of 1:1000 concentration
B. Chest compression depth is 1/3 of anteroposterior diameter
C. Adenosine is given IV
D. Compression:Ventilation ratio is 3:2 with 2 rescuers

99. Short-acting effect of thiopentone is due to:

A. Rapid redistribution to adipose and muscle
B. Renal elimination
C. High lipid solubility
D. Redistribution to brain

100. Management for multiple thoracic rib fractures not relieved by analgesics:

A. Thoracic epidural analgesia
B. Lumbar epidural
C. Supraclavicular block
D. Cervical epidural

101. Jackson-Rees circuit is used in:

A. Pediatric anesthesia
B. General anesthesia
C. Obstetric anesthesia
D. Epidural anesthesia

102. Ambu Aura-40 is a:

A. 1st-generation supraglottic airway
B. 2nd-generation supraglottic airway
C. 3rd-generation supraglottic airway
D. 4th-generation supraglottic airway

Dermatology

103. Feature that does NOT help differentiate psoriasis from other arthropathies:

A. Nail pitting
B. Enthesitis
C. Dactylitis
D. Diarrhea

104. Gardener in the Himalayas with painless nodules and axillary lymphadenopathy. Likely organism:

A. Histoplasma
B. Blastomycosis
C. Sporothrix schenckii
D. Coccidioidomycosis

105. Approved topical agent for onychomycosis:

A. Tavaborole
B. Griseofulvin
C. Itraconazole
D. Caspofungin

106. Most likely organism in infection after walking barefoot:

A. Madurella mycetomatis
B. Curvularia
C. Nocardia
D. Sporothrix schenckii

Radiology

107. Investigation of choice for ureteric stones:

A. CECT
B. Non-contrast CT (NCCT)
C. USG
D. Ureteroscopy

108. Elderly man with progressive dysphagia and bad breath. Image shows pouch. Diagnosis:

A. Achalasia
B. Esophageal cancer
C. Zenker’s diverticulum
D. Diffuse esophageal spasm

109. Elderly woman with weight loss, trivial trauma, and pelvic lesion. Diagnosis?

A. Eosinophilic granuloma
B. Disseminated TB
C. Brown tumor
D. Metastasis

110. Which of the following is incorrect regarding pneumonia imaging?

A. Pyogenic – Patchy infiltrates
B. Mycoplasma – Interstitial infiltrates
C. Malignancy – Hilar lymphadenopathy with infiltrates
D. Aspiration – Affects upper lobe and anterior lower lobe

111. Pleural effusion with lymphocyte predominance, low ADA, bilateral hilar enlargement in Xray, Tree in bud in HRCT. Likely pathology finding?

A. Necrotizing granuloma with giant cells
B. Fungal hyphae with lymphocytes
C. Reactive lymphoid hyperplasia
D. Anthracotic pigment

Psychiatry

112. Match the drugs with their uses:

A. Delirium tremens – 1. Oxazepam

B. Alcohol dependence – 2. Acamprosate

C. Smoking cessation – 3. Varenicline

D. Opioid overdose – 4. Naloxone

A. A-2, B-4, C-3, D-1
B. A-4, B-2, C-3, D-1
C. A-2, B-3, C-4, D-1
D. A-1, B-2, C-3, D-4

Medicine

113. 25-year-old female with palpitations and dizziness while playing. Most likely diagnosis?

D. Uhl anomaly
A. Hypertrophic obstructive cardiomyopathy
C. Brugada syndrome
B. Arrhythmogenic right ventricular dysplasia

114. Post-CPR management after return of spontaneous circulation includes all EXCEPT:

C. SpO₂ 92–98%
A. Target temperature of 32–36°C if patient is awake
D. Emergent cardiac intervention if STEMI present
B. MAP >65 mmHg

115. eGFR Grade 3B is defined as:

B. 15–29 mL/min
C. 45–59 mL/min
A. 30–44 mL/min
D. 60–89 mL/min

116. First investigation for pheochromocytoma diagnosis:

D. USG whole abdomen
C. Urinary metanephrines
B. Plasma catecholamines
A. Urinary VMA

117. Which is NOT a cause of high anion gap metabolic acidosis?

B. Acute kidney injury
C. Diarrhea
A. Ketoacidosis
D. Inborn error of metabolism

118. Which is NOT a component of TTP (Thrombotic Thrombocytopenic Purpura)?

C. Microangiopathic hemolytic anemia
D. Thrombosis
A. Renal failure
B. Thrombocytopenia

119. Which is NOT a feature of Autoimmune Polyendocrine Syndrome type I?

B. Type 1 DM
A. Onset in infancy
D. Mucocutaneous candidiasis
C. Hyperparathyroidism

120. Which is NOT true about Behçet’s disease?

D. Associated with thrombosis
B. Pathergy test is under ISG criteria
C. GI involvement resembles Crohn’s
A. Ulcers on dorsal aspect of penis

121. Patient with multiple duodenal ulcers, gastrin >2000 pg/mL. Most likely diagnosis?

C. Glucagonoma
A. Gastrinoma
B. Insulinoma
D. VIPoma

122. In stroke, which of the following should NOT be done?

B. Reduce SBP <140 mmHg in hemorrhagic stroke
D. Rapid drop in BP with antihypertensives
C. Reduce SBP <160 mmHg before thrombolysis
A. Measure BP multiple times

123. Which vaccine is NOT routinely recommended after 65 years of age?

B. HPV
D. Influenza
A. Hepatitis B
C. Varicella zoster

124. Which of the following should be avoided during blood collection for serum calcium estimation?

C. Prolonged immobilization
A. Sodium citrate vial
B. Fist clenching
D. All of the above

125. JAK inhibitor used in severe ulcerative colitis:

D. Ustekinumab
A. Tofacitinib
C. Ozanimod
B. Vedolizumab

126. Which statement is FALSE about GBS (Guillain-Barré Syndrome)?

B. CSF shows albuminocytologic dissociation
C. Plasmapheresis is ineffective
D. Areflexia is part of diagnostic criteria
A. IVIG is first-line

127. Which of the following is the correct criterion for acute allograft rejection?

C. 10% increase in BUN and creatinine
B. 10% increase in creatinine
D. No rise in creatinine
A. 5% increase in creatinine

128. Which of the following is an acquired thrombophilia?

D. Factor V Leiden
C. Antithrombin III deficiency
B. PNH (Paroxysmal nocturnal hemoglobinuria)
A. Protein S deficiency

129. Which is NOT a feature of cystic fibrosis?

C. Nasal polyps
B. Meconium ileus
A. Bleeding tendency
D. Biliary atresia

130. Which is TRUE about hemolytic anemia?

D. ↓ Reticulocyte count
B. ↓ LDH
A. ↑ Urine urobilinogen and indirect bilirubin
C. Hypoplastic marrow

131. Which is NOT part of NADAS criteria?

C. Diastolic murmur
B. ↑ Troponins
D. Abnormal chest X-ray
A. CHF

132. Which is TRUE about intermittent claudication?

A. Occurs at fixed distance and relieved by rest
B. Rest pain at night
C. Worsens on bending down
D. Pentoxifylline is ineffective

133. Which statement is FALSE about Guillain-Barré Syndrome (GBS)?

A. IVIG is first-line
D. Areflexia is part of diagnostic criteria
B. CSF shows albuminocytologic dissociation
C. Plasmapheresis is ineffective

134. First-line JAK inhibitor used in severe ulcerative colitis:

B. Vedolizumab
C. Ozanimod
A. Tofacitinib
D. Ustekinumab

135. Which of the following should not be avoided during blood collection for serum calcium estimation?

C. Prolonged immobilization
D. Rapid removal of tourniquet
B. Fist clenching
A. Sodium citrate vial

136. Which vaccine is NOT routinely recommended after 65 years of age?

D. Influenza
C. Varicella zoster
A. Hepatitis B
B. HPV

137. In stroke, which of the following should NOT be done?

D. Rapid drop in BP with antihypertensives
B. Reduce SBP <140 mmHg in hemorrhagic stroke
A. Measure BP multiple times
C. Reduce SBP <160 mmHg before thrombolysis

Options are in irregular pattern. Always note options orders in real exam too.

Orthopaedics

138. Elderly patient with trivial fall and fracture. Likely cause?

B. Brown tumor
A. Osteoporosis
D. Eosinophilic granuloma
C. Metastasis

139. Young male with back pain, stiffness, recurrent eye pain. Likely HLA type?

C. HLA-DR3
B. HLA-DQB1
A. HLA-B27
D. HLA-DR4

140. 47-year-old female with intracapsular fracture neck of femur. Best management?

B. Closed reduction
A. ORIF
D. Closed reduction with traction
C. Hemiarthroplasty

Paediatrics

141. Which is NOT true about extrahepatic biliary atresia?

C. Kasai procedure should be after 90 days
A. HIDA scan used for diagnosis
D. Most common cause of neonatal cholestasis
B. Biopsy differentiates from other causes

142. Primary stimulus for closure of ductus arteriosus:

D. Low CO₂ levels
B. High oxygen tension
C. Increased pulmonary resistance
A. Epinephrine

143. Child with anemia, thrombocytopenia, hematuria after diarrhea. Likely organism?

D. Yersinia
B. Salmonella
A. E. coli O157:H7
C. Shigella

144. Treatment failure in severe acute malnutrition (SAM) includes all EXCEPT:

C. Weight gain <5 g/kg/day by day 10
B. Weight for height reaches –2 Z-score
D. No edema reduction by day 10
A. Appetite not improved by day 5

145. Neonatal cholestasis is most commonly caused by:

B. Biopsy differentiates from other causes
C. Kasai procedure should be after 90 days
A. HIDA scan used for diagnosis
D. Most common cause of neonatal cholestasis

146. Primary stimulus for closure of ductus arteriosus:

A. Epinephrine
C. Increased pulmonary resistance
D. Low CO₂ levels
B. High oxygen tension

147. Child with anemia, thrombocytopenia, hematuria after diarrhea. Likely organism?

D. Yersinia
C. Shigella
A. E. coli O157:H7
B. Salmonella

Surgery

148. Best next step in a trauma patient with chest trauma, SBP 85 mmHg, GCS <8, absent breath sounds:

D. CT chest
A. USG
C. Secure airway + ICD placement
B. Chest X-ray

149. Which is NOT part of the primary survey in trauma?

C. CECT
B. Pelvic X-ray
D. eFAST
A. Chest X-ray

150. Which is NOT part of MEN 2B syndrome?

A. PTH hyperplasia
D. Marfanoid habitus
C. Mucosal neuroma
B. Pheochromocytoma

151. Female with papillary thyroid cancer post-radiation. Treatment of choice:

D. Total thyroidectomy
A. Hemithyroidectomy with MRND
B. Total thyroidectomy with MRND
C. Hemithyroidectomy

152. CA breast case 6×7 cm invading muscle and nodes. TNM stage?

C. T3N2
B. T4b
A. T4a
D. T2N3

153. Most common symptom in esophageal carcinoma:

D. Dysphagia to solids
A. Regurgitation
C. Dysphagia to liquids
B. Cough

154. Post-gastrectomy patient with lower limb weakness. Cause?

C. Vitamin B12 deficiency
D. Folate deficiency
B. Niacin deficiency
A. Vitamin B6 deficiency

155. Truelove and Witts classification is used for:

D. Crohn’s disease
B. Hepatic encephalopathy
A. Severe ulcerative colitis
C. Gastric ulcer

156. Best investigation for intermittent left iliac pain with hematuria:

B. X-ray KUB
D. USG KUB
A. Non-contrast CT KUB
C. Ureteroscopy

157. Angle between telescope and instrument during laparoscopy is called:

B. Elevation angle
A. Azimuth angle
C. Working angle
D. Manipulation angle

158. Which is FALSE regarding ERAS (Enhanced Recovery After Surgery)?

D. Opioid-sparing analgesia
C. Early mobilization
B. Prolonged fasting not needed
A. Increases hospital stay

159. CA oral cavity with spread to maxillary sinus and tongue muscles. Stage?

A. T4a
B. T4b
C. T3
D. T2

160. During splenectomy, bleeding most likely occurs from:

C. Right gastroepiploic artery
B. Left gastroepiploic artery
D. Splenic artery
A. Short gastric artery

161. Wound left open after contaminated surgery and closed on day 5. Type of healing:

C. Tertiary intention
A. Primary intention
D. None
B. Secondary intention

OBGYN

162. Which is TRUE regarding breast milk jaundice?

B. It is conjugated hyperbilirubinemia
C. Phototherapy is always required
D. Unconjugated hyperbilirubinemia
A. Breastfeeding should be stopped

163. At what age does a child copy a cross, tell stories, and go to the toilet alone?

D. 5 years
C. 4 years
B. 3 years
A. 2 years

164. Causative agent of croup in children:

C. C. diphtheriae
B. Streptococcus pneumoniae
A. H. influenzae
D. Parainfluenza virus

165. Unexplained infertility is diagnosed when everything is normal. Percentage of such cases?

B. 15%
D. 30%
A. 5%
C. 25%

166. Female with imperforate hymen and acute urinary retention. Diagnosis?

C. Vaginal atresia
D. Müllerian agenesis
A. Transverse vaginal septum
B. Imperforate hymen

167. What is restitution in labor?

A. Active head rotation
C. Untwisting of head
D. All of the above
B. Passive rotation with shoulder

168. NOT part of active management of third stage of labor:

B. Controlled cord traction
C. Bimanual compression
D. Uterotonics
A. Uterine massage

169. Smallest diameter of female pelvis:

A. Obstetric conjugate
C. True conjugate
D. Anatomical conjugate
B. Diagonal conjugate

170. Instrumental delivery is NOT indicated in:

D. Prolonged second stage
C. Cephalopelvic disproportion
B. Maternal exhaustion
A. Fetal distress

171. Early onset eclampsia is defined as before:

C. 28 weeks
A. 30 weeks
D. 34 weeks
B. 32 weeks

172. Whiff test positive with foul-smelling vaginal discharge suggests:

D. Physiological discharge
B. Trichomonas vaginalis
C. Candida
A. Gardnerella vaginalis

173. Athletic woman with amenorrhea, FSH low, LH low, prolactin normal. Diagnosis?

D. Hypogonadotropic hypogonadism
A. Primary ovarian insufficiency
B. Normogonadotropic normogonadism
C. Hypergonadotropic hypogonadism

174. Physiological changes in pregnancy EXCEPT:

D. Insulin resistance
B. Mild fasting hypoglycemia
C. Increased SBP and DBP by 6 weeks
A. Hemodilution

175. NOT a marker in quadruple test:

A. Estriol
C. Inhibin B
B. AFP
D. None of the above

176. 21-year-old female with 6×5 cm ovarian mass and warfarin use. Best step?

A. Surgical exploration
B. CA-125
D. Repeat USG after 6 weeks
C. MRI

177. Cervical cancer screening for 21-year-old in low-resource setting:

B. Pap + HPV every 5 years
C. Pap smear every 3 years
D. Pap smear only in high-risk
A. Pap smear every 5 years

Community Medicine

178. Which of the following hepatitis viruses is waterborne?

A. HBV
B. HAV
C. HCV
D. HDV

179. Which is NOT a component of the Anemia Mukt Bharat initiative?

A. 6 institutional mechanisms
B. 6 beneficiaries
C. 6 health functionaries
D. 6 interventions

180. In field setting, malaria diagnosis is done by:

A. Buffy coat
B. HRP2/Rapid diagnostic test
C. Thin smear
D. Thick smear

181. Correct sequence in a randomized controlled trial (RCT):

A. Randomization → Inclusion/Exclusion → Blinding → Analysis
B. Analysis → Blinding → Inclusion/Exclusion → Randomization
C. Inclusion/Exclusion → Randomization → Blinding → Analysis
D. Blinding → Randomization → Analysis → Inclusion/Exclusion

182. Which is true regarding Universal Health Coverage (UHC)?

A. Fragmented health system helps achieve UHC
B. UHC ensures access to quality services without financial hardship
C. UHC provides free services to all at point of care regardless of national resources
D. UHC primarily targets tertiary care

183. Screening of family members for hypertension and diabetes in a village is classified as:

A. Anonymous screening
B. Mass screening
C. Multiphasic screening
D. Selective screening

184. ICER is used in which analysis model?

A. Cost-benefit analysis
B. Cost-effective analysis
C. Input-output analysis
D. Cost evaluation

185. Methods to prevent and manage Zika virus infection include all EXCEPT:

A. NSAIDs for symptoms
B. Delay pregnancy attempt
C. FDA-approved vaccine
D. Source reduction, treat fever with paracetamol

186. Which among the following is NOT a high-risk group for HIV?

A. Long-distance truck drivers
B. MSM
C. IV drug abusers
D. Commercial sex workers

187. Pus swab should be disposed of in which biomedical waste bag?

A. Black
B. Yellow
C. Red
D. White

188. A student presents with unknown poisoning and silver nitrate breath test is positive (black color). Treatment of choice:

A. BAL
B. Prussian blue
C. Atropine
D. Magnesium sulfate

Forensics

189. Marshall's triad (punctate bruises, abrasions, punctate lacerations) is seen in which type of explosion injury?

A. Tertiary
B. Quaternary
C. Secondary
D. Primary

190. Which poisoning is treated using BAL (British Anti-Lewisite)?

A. Lead carbonate
B. Mercury
C. Arsenic trioxide
D. Phosphorus