20. Meiosis occurs at which of the following transformation: [AIIMS-NOV-2007]
a. Primary spermatocyte to intermediate spermatocyte
b. Primary spermatocyte to secondary spermatocyte
c. Secondary spermatocyte to round spermatid
d. Round spermatid to elongated spermatid
POSITIVE MODEL-12-05-07-QUESTION & DISCUSSION-7
7. During spermatogenesis,which of the following undergo a second meiotic division
a) Spermatogonia b) Primary spermatocytes
c) Secondary spermatocytes d) Spermatide
7. Ans (c)
| Name | Event |
| Spermatogenesis | Spermatogonia à Sperm |
| Spermato cytogenesis | Spermatogonia à Spermatocytes |
| Sermiogenesis | Inert spermatids à Actively motile sperms |
Spermatogenesis
Spermatogonia
Mitosis
Primary spermatocyte 1st meiosis*
Secondary spermatocyte
2nd meiosis
Spermatids
| Capacitation of sperms | Fallopian tube (Cervix) |
| Sertoli cells | Supporting cells |
| Interstitial cells of leydig | Testosterone |
| Chromosome number of spermatid | Haploid 22 Autosome + X or Y |
| Penetration of Zona pellucida | Acrosome |
18. The ureter develops from: [AIIMS-NOV-2007]
a. Metanephros
b. Mesonephros
c. Mesonephric duct
d. Paramesonephric duct
POSITIVE MODEL-12-05-2007-QUESTION &DISCUSSION-21
21. All are derivatives of mesonephric duct in males except
a) Epididymis b) Vasdeferens
c) Appendix of epididymis
d) Appendix of Testis
21. Ans (d) (Singh – 297)
Mesonephric duct
- males
| * Ureteric bud - Ureters(AIIMS-NOV-2007***), collecting tubules |
| * Trigone of bladder |
| * Postr. Wall of part of prostatic urethra |
| * Epididymis* |
| * Ductus Deferens* |
| * Seminal vesicle |
| * Ejaculatory Ducts |
| * Mesodermal part of prostrate |
| * Appendix of epididymis * |
Appendix of Testis
- Remanant of
9. Gall bladder epithelium is: [AIIMS-NOV-2007]
a. Simple squamous
b. Simple cuboidal with stereocilia
c. Simple columnar
d. Simple columnar with brush border
POSITIVE MODEL-12-05-2007-QUESTION &DISCUSSION- 33,40
33. Pick out the odd one out
a) Ductus deferens – pseudostratified columnar
b) Fallopian tube – ciliated simple columnar
c) Vagina – stratified squamous keratinised
d) Oesophagus – stratified squamous non keratinized
33. Ans ( c )
Epithelium
¯ ¯
* Simple stratified * Squamous
pseudo stratified * Cuboidal
* Columnar
A) Simple
| Type | Site |
| Squamous | * Mesothelium (cavities eg. Pleura) * Blood vessel, lymphatic Lumen – endothelium |
| Cuboidal | * Small excretory ducts * PCT |
| Columnar | * Digestive organs - Stomach - Small Intestine - Large Intestine - Gall Bladder (Microvilli --> striated border) |
B) Pseudostratified columnar
- A single layer
- Not all cells reach the surface
| Site * Respiratory passage - Trachea - Bronchi - Bronchioles (Large) * Genital - Epididymis - Vasdeferens (stereo cilia) |
C) Stratified epithelium
i) Stratified squamous
| Keratinised | Non keratinised |
| Epidermis (palms and soles) | * Mouth * Pharynx * Oesophagus * Vagina * Analcanal |
ii) Stratified Cuboidal and Stratified Columnar
- Limited distribution
- Excretory ducts of pancreas
Salivary gland
Sweat gland
Transitional Epithelium
- Exclusively in excretory passage of urinary
system
- Calyx
Pelvis
Ureters
Bladder
Cartilage
| * Hyaline | Trachea |
| * Fibrous | Intervertebral Disc |
| * Elastic | Epiglottis |
| Structure | Epithelium |
| * Tonsil | - Stratified squamous |
| * Tongue papilla | - Stratified squamous – partial keratinisation |
| * Lip | - Stratified squamous keratinised |
| * Anal canal - upper - lower | - Simple columnar - Stratified squamous |
| Nose a) Olfactory epithelium | - Psuedo stratified columnar epithelium |
| b) Respiratory epithelium | - Pseudo stratified ciliated columnar |
| Respiratory * Terminal bronchiole | - Ciliated columnar (elura cells) Nonciliated cuboidal |
| * Respiratory Bronchiole | - Simple cuboidal (cilia absent) |
| * Alveoli | - Simple squamous |
40. A simple cuboidal or columnar epithelium with extensive basal infoldings of plasma membrane is characteristically found in
a) collecting tubules of kidney
b) lining epithelium of small intestine
c) striated ducts of the parotid Gland
d) Lining epithelium of the oral cavity
40. Ans.: (c) (Ref. Histology – singh-43-50)
Epithelium
| K Simple – cell surface has no particular specialization K ‘Striated’ - ‘Microvilli’ is regular ‘Brush Border’ – Microvilli’ is irregular |
| Site | Epithelium |
| · Collecting tubules of Kidney | Cuboidal epithelium with prominent brush border. |
| · Small intestine | · Columnar epithelium with striated border |
| · Ducts of Glands | · Simple cuboidal* |
| · Oral cavity | · Non kertinized stratified squamous |
Parotid ducts
| K Intercalated ducts K Striated ducts K Excretory Ducts | o Cuboidal o columnar o Columnar |
* Striated Ducts
- The cells lining show an
interesting ultrastructure
- Extensive deep infoldings of basal part of cell membranes* à basal striations
- Numerous mitochondria in between the infoldings.
Squamous – Simple
| · Alveoli of lungs · ‘Cavities’ – pleura (eg) · Lining of heart (endocardium) · Blood vessels, lymphatics (endothelium) · Internal Ear · Renal Tubules |
A) 1. Simple columnar
| · Mucous membrane of stomach · Large intestine |
2. Columnar – Striated
| · small intestine – brush border of GB(AIIMS-NOV-2007***) |
3. Columnar - ciliated
| · Respiratory Tract · Uterus · Uterine Tubes · Efferent ductules of testes · Middle Ear, auditory tube · Ependymal lining · Ventricles |
4. Columnar - Pseudo Stratified
| · Ductus Deferens · Male urethra · Auditory tube (some part) |
5. Columnar
- ciliated Pseudostratified
| · Trachea · Large bronchi |
B) Cuboidal
| · Follicles of Thyroid · Ducts of many Glands · Surface of ovary · Inner surface of lens · Pigment layer of Retina · Choroid plexus · PCT (Brush border) |
C) 1- Stratified Squamous – Non keratinised
| · Mouth · Tongue · Pharynx · Esophagus · Vagina · Cornea |
2- Stratified Squamous
- Keratinized à Epidermis
Transistional epithelium
| · Renal Pelvis · Calyx · Ureter · Urinary bladder · Urethra (Part) |
12. Urothelium does not line: [AIIMS-NOV-2007]
a. Collecting ducts
b. Minor calyx
c. Ureter
d. Urinary bladder
POSITIVE MODEL-12-05-2007-QUESTION &DISCUSSION- 33,40
33. Pick out the odd one out
a) Ductus deferens – pseudostratified columnar
b) Fallopian tube – ciliated simple columnar
c) Vagina – stratified squamous keratinised
d) Oesophagus – stratified squamous non keratinized
33. Ans ( c )
Epithelium
¯ ¯
* Simple stratified * Squamous
pseudo stratified * Cuboidal
* Columnar
A) Simple
| Type | Site |
| Squamous | * Mesothelium (cavities eg. Pleura) * Blood vessel, lymphatic Lumen – endothelium |
| Cuboidal | * Small excretory ducts * PCT |
| Columnar | * Digestive organs - Stomach - Small Intestine - Large Intestine - Gall Bladder (Microvilli --> striated border) |
B) Pseudostratified columnar
- A single layer
- Not all cells reach the surface
| Site * Respiratory passage - Trachea - Bronchi - Bronchioles (Large) * Genital - Epididymis - Vasdeferens (stereo cilia) |
C) Stratified epithelium
i) Stratified squamous
| Keratinised | Non keratinised |
| Epidermis (palms and soles) | * Mouth * Pharynx * Oesophagus * Vagina * Analcanal |
ii) Stratified Cuboidal and Stratified Columnar
- Limited distribution
- Excretory ducts of pancreas
Salivary gland
Sweat gland
Transitional Epithelium(AIIMS-NOV-2007***)
- Exclusively in excretory passage of urinary
system
- Calyx
Pelvis
Ureters
Bladder
Cartilage
| * Hyaline | Trachea |
| * Fibrous | Intervertebral Disc |
| * Elastic | Epiglottis |
| Structure | Epithelium |
| * Tonsil | - Stratified squamous |
| * Tongue papilla | - Stratified squamous – partial keratinisation |
| * Lip | - Stratified squamous keratinised |
| * Anal canal - upper - lower | - Simple columnar - Stratified squamous |
| Nose a) Olfactory epithelium | - Psuedo stratified columnar epithelium |
| b) Respiratory epithelium | - Pseudo stratified ciliated columnar |
| Respiratory * Terminal bronchiole | - Ciliated columnar (elura cells) Nonciliated cuboidal |
| * Respiratory Bronchiole | - Simple cuboidal (cilia absent) |
| * Alveoli | - Simple squamous |
40. A simple cuboidal or columnar epithelium with extensive basal infoldings of plasma membrane is characteristically found in
a) collecting tubules of kidney
b) lining epithelium of small intestine
c) striated ducts of the parotid Gland
d) Lining epithelium of the oral cavity
40. Ans.: (c) (Ref. Histology – singh-43-50)
Epithelium
| K Simple – cell surface has no particular specialization K ‘Striated’ - ‘Microvilli’ is regular ‘Brush Border’ – Microvilli’ is irregular |
| Site | Epithelium |
| · Collecting tubules of Kidney | Cuboidal epithelium with prominent brush border. |
| · Small intestine | · Columnar epithelium with striated border |
| · Ducts of Glands | · Simple cuboidal* |
| · Oral cavity | · Non kertinized stratified squamous |
Parotid ducts
| K Intercalated ducts K Striated ducts K Excretory Ducts | o Cuboidal o columnar o Columnar |
* Striated Ducts
- The cells lining show an
interesting ultrastructure
- Extensive deep infoldings of basal part of cell membranes* à basal striations
- Numerous mitochondria in between the infoldings.
Squamous – Simple
| · Alveoli of lungs · ‘Cavities’ – pleura (eg) · Lining of heart (endocardium) · Blood vessels, lymphatics (endothelium) · Internal Ear · Renal Tubules |
B) 1. Simple columnar
| · Mucous membrane of stomach · Large intestine |
2. Columnar – Striated
| · small intestine – brush border of GB |
3. Columnar - ciliated
| · Respiratory Tract · Uterus · Uterine Tubes · Efferent ductules of testes · Middle Ear, auditory tube · Ependymal lining · Ventricles |
4. Columnar - Pseudo Stratified
| · Ductus Deferens · Male urethra · Auditory tube (some part) |
5. Columnar
- ciliated Pseudostratified
| · Trachea · Large bronchi |
B) Cuboidal
| · Follicles of Thyroid · Ducts of many Glands · Surface of ovary · Inner surface of lens · Pigment layer of Retina · Choroid plexus · PCT (Brush border) |
C) 1- Stratified Squamous – Non keratinised
| · Mouth · Tongue · Pharynx · Esophagus · Vagina · Cornea |
2- Stratified Squamous
- Keratinized à Epidermis
Transistional epithelium
| · Renal Pelvis · Calyx · Ureter · Urinary bladder · Urethra (Part) |
117. In Hyaline cartilage, type of collagen present is: [AIIMS-NOV-2007]
a. Type 1
b. Type 2
c. Type 3
d. Type 4
Ans[b]
POSITIVE MODEL-12-05-2007-QUESTION &DISCUSSION- 135
(Also in MKT,OPERATION HARRI)
135. Embryonic Dermis contains ______ Type collagen
a) I b) II c) III d) IV
135. Ans (c)
Collagen
| Type | Distribution |
| I | · Skin · Tendon · Bone · Dentin · Fascia |
| II | · Cartilage **(only)-AIIMS-NOV-2007) |
| III (Reticulin) | · Skin · Bolld vessels · Uterus · Embryonic Dermis |
| IV | · Basement membrane |
115. Not used to stain fats: [AIIMS-NOV-2007]
a. Oil red O
b. Congo red
c. Sudan III
d. Sudan black
POSITIVE MODEL-12-05-2007-QUESTION &DISCUSSION- 112
112. All of the following are stains used to detect lipids except
a) Oil red O b) Sudan Black B
c) Osmium Tetroxide d) Mucicarmine
112. Ans (d)
| Stain | Tissue |
| A. Carbohydrate - PAS - Mucicarmine - Alcian blue (AB) - Combined AB - PAS | - Acid mucin - Acid mucin - Neutral mucin |
| B. Connective Tissue - Vangieson’s - Masson’s Trichrome - Phospho tungstic acid Hematoxylin - Verhoeff’s elastic - Gordon & sweet | - Collagen - Collagen - Muscle and glial filaments - Elastic fibre - Reticular fibre |
| C. Lipids - Oil Red O - - Osmium Tetroxide | - Fats -Fats - Fats |
| D. Neural Tissue - Luxol fast blue - Bielschowsky’s | - Myelin - Axons |
| E. Pigment and Minerals - Prussian blue - Masson – Fontana - Alizarin Red - Von kossa - Rubeanic acid - Grimelius | - Iron - Melanin - Calcium - Mineralized bone - Copper - Argyrophilic |
Immunoflorescence
Source of light – Mercury vapour and xenon
Gas Lamp
34. . Metabolic alkalosis is seen in: [AIIMS-NOV-2007]
a. Mineralocortoid excess
b. Increased excretion of base
c. Decreased secretion of H+ ion
d. Deficiency of mineralocorticoids
135. Metabolic alkalosis is seen in all except (POSITIVE MODEL 2 2007)
a) Thilazide diuretic therapy
b) Prolonged vomiting
c) Uretero-sigmoidostomy d) Cushing’s disease
(Also in OPERATION HARRI)
125. Micronodular cirrhosis is seen in all except: [AIIMS-NOV-2007]
a. Chronic hepatitis B with…
b. Alcoholic hepatitis
c. Chronic cirrhosis secondary to biliary stasis
d. Hemochromatosis
POSITIVE MODEL 2 2007-QUESTION-32
32. All of the following can produce macro nodular cirrhosis except (POSITIVE MODEL -2- 2007-QUESTION-32)
a) Viral Hepatitis b) Hemo chromatosis
c) α1 antitrypsin deficiency d)
32. Ans (b) (P-644,647, HM)
Cirrhosis
| Macro (> 3 mm) | Micro(AIIMS-NOV-2007***) |
| · Alchoholic* · Post necrotic - Viral Hepatitis - Drugs, Toxins ®CCL4,Phosphorus - - Clonorchiasis * α1 antitrypsin (micro or macro) | · Primary biliary · Hemochro matosis** · Alchoholic · Nutritional |
198.
a. Pulmonary embolism
b. Tuberculosis
c. Bronchogenic Ca
d. ..
POSITIVE MODEL-4-QUESTION-33
33. A 57 year old man develops acute shortness of breath shortly after a 12-h automobile ride. The patient consults his internist, and findings on physical examination are normal except for tachypnea and tachycardia. An electrocardiogram reveals sinus tachycardia but is otherwise normal. All the following statements regarding this patient’s disease process are true EXCEPT (POSITIVE MODEL-4)
a) An arterial blood gas measurement (ABG) is likely to reveal a partial pressure of oxygen (Paco2) of less than 80 torr
b) An ABG is likely to reveal a respiratory alkalosis (an elevated pH and reduced partial pressure of carbon dioxide (Paco2)
c) The patient should be admitted to the hospital, and if there is no cotraindication to anticoagulation, intravenous heparin should be started pending further testing
d) Normal findings upon examination of the lower extremities are extremely unusual in this clinical setting
e) The mortality for this condition, when untreated, is very high
33.Ans (d)
Pulmonary Thrombo embolism
* The most common source of paradoxical embolism – Calf vein thrombosis
* 50% DVT of pelvic veins, proximal leg veins
® Pulmonary embolism (asymptomatic)
Physiological effects
| - Pulmonary vascular resistance - Impaired gas exchange ( dead space) - Alveolar hyperventilation - Increased airway resistance - ¯ Pulmonary compliance |
Usual cause of death – Progressive RVF
* Wells Diagnostic score
- Maximum – 12.5 points
- If £ 4 points, PE is only 8%
| Character | Points |
| * Clinical signs and symptoms of DVT | 3.0 |
| * Alternative diagnosis is less likely than PE | 3.0 |
| * HR > 100 | 1.5 |
| * Immobilisation or surgery in the previous 4 wks | 1.5 |
| * Previous DVT / PE | 1.5 |
| * Hemoptysis | 1.0 |
| * Malignancy | 1.0 |
Clinical
| * Massive | - Hypotension |
| * Moderate or large | RV Hypokinesis - Normal pressure |
| * Small | -RV Function – -Pressure - |
Pulmonary infarction indicates small PE
Symptoms & Sign
* Dyspnoea – Most frequent symptom
* Tachypnoea – Most frequent sign
* Signs of DVT – only in 50%
Investigations
| * Blood Tests - D-dimer > 500 ng/mL - PaO2, PaCo2 ¯ * ECG - Most frequent - ‘T’ wave inversion in V1 – V4 (RVstrain) - Tachycardia - ‘S’ in lead I - ‘Q’ in lead III Chest Xray A normal Xray in a Dyspnoeic pt ® PE |
| * Westermark’s sign | - Focal oligemia |
| * | * Peripheral wedge shaped opacity above the diaphragm |
| * Palla’s sign | * Enlarged Right descending pulmonary Artery |
* Ultrasound – Loss of compressibility of vein
* CT chest – supersedes lung scan
* Lung scan – Two or more segmental perfusion defects in the presence of normal ventilation
ECHO
- 50% normal
- Mc Conell’s sign*
- RV free wall Hypokinesis with normal RV apical motion ® specific for PE
Pulmonary angio:
- Most specific*
- As small as 1-2 mm
Intraluminal filling defect
Treatment
- Heparin – INR 2.0 – 3.0
- LMWH
- IVC filter
- Thrombolysis
- Embolectomy (Trt of idiopathic DVT – Anticoaggulants indefinitely)
99. Hyperglycemia is caused by all except: [AIIMS-NOV-2007]
a. Beta blockers
b. Glucocorticoids
c. ..
d. ..
POSITIVE-PRETEST-SESSION-30-QUEST-22
22. All the following drugs cause hyperglycaemia EXCEPT
a) Quinine
b) Cyclosporine
c) L asparaginase
d) Tacrolimus
(Also in OPERATION HARRI)
174. In osteomalacia, all are true except: [AIIMS-NOV-2007]
a. Increased serum alkaline phosphatase
b. Increased serum calcium
c. Looser’s zones
d. Proximal myopathy
POSITIVE-MODEL-4-QUEST-126
(Also in OPERATION HARRI)
154. True about Ogilive’s syndrome are all except: [AIIMS-NOV-2007]
a. It is caused by mechanical obstruction of the colon
b. It involves entire / part of the large colon
c. It occurs after previous surgery
d. It occurs commonly after narcotic use
POSITIVE-MODEL-4-QUEST-180,2O2
180. Find the Wrong statement about paralytic ileus
a) After a laparotomy paralytic ileus upto 48 hrs is normal
b)
c) Small intestine starts action in 16 hrs after laparotomy
d) Spinal anaesthesia causes paralytic ileus
e) Colonic pseudo-obstruction is called Ogilvie’s syndrome
180. Ans ( d )
Paralytic Ileus
| * Absence of Peristalic waves secondary to neuromuscular failure * Post operative - 24 – 72 hrs - prolonged in hypo proteinemia or metabolic abnormality * Colonic Pseudo obstruction - acute – Ogilivie syndrome - marked cecal distention - absence of mechanical cause or acute intra abdominal disease(AIIMS-NOV-2007**) - Trt - colonic decompression - 25% - Recurrence |
202. Colonic pseudo-obstruction may be associated with all the following, EXCEPT
(a) Diabetes (b) Porphyria
(c) Hypokalemia
(d) Uremia. (e) Hyperthyroidism
202. Ans : E
| Occurs in hypothyroidism. Septicemia, spinal and pelvic trauma, Phenothiazine therapy, stroke etc. can also cause. Also called Ogilvie’s syndrome. X-ray shows dilated caecum. Usually responds to conservative management. Colonoscopic decompression, resection etc. rarely needed. |
2. Uppermost structure seen at the hilus of the left lung is: [AIIMS-NOV-2007]
a. Pulmonary artery
b. Pulmonary vein
c. Bronchus
d. Bronchial artery
POSITIVE-MODEL-4-QUEST-229
229. The root of left lung:
a) has eparterial and hyperterial
bronchi
b) lies opposite to 2-4th costal cartilages
c) the pulmonary ligament stretches downward from it to the level of the diaphragm
d) is crossed below by the arch of aorta
229. Ans (c)
Root of Left Lung
| * Contents - Bronchus - Bronchial Artery - Pulmonary Artery - Pulmonary Vein – Upper - Lower - Pulmonary Plexus of Nerves * Arch of Aorta – Crosses above * Eparterial & hyparterial bronchi – Right Lung |
(Also in consultant’s discussion)
3. Ulnar injury in the arm leads to all except: [AIIMS-NOV-2007]
a. Sensory loss of the medial 1/3rd of the hand
b. Weakness of the hypothenar muscles
c. Claw hand
d. adduction of thumb
Ans[d]
POSITIVE-MODEL-4 QUEST-266
266. Mr.X. Fell from a tree and sustained injury in his elbow. In the process his ulnar nerve was cut. One of the following is true
a) part of the flexor digitorum superficialis (sublimis) is paralysed
b) there is a loss of sensation in the back of the index finger
c) flexion at the metacarpophalangeal joints of the ring and little fingers is lost if their interphalangeal joints are kept extended
d) the distal phalanges of all the fingers are extended at the distal interphalangeal joints
266. Ans (c)
· Flex digitorum Superficialis
· Median N
· Sensation at back of index finger – Posterior cutaneous nerve of fore arm
