ERRATA LIST- I ( 1 – 10 SUBJECTS ) – TARGET JIPMER 2ND EDITION

1. ANATOMY - 1 2. PHYSIOLOGY - 6 3. BIOCHEM - NIL 4. MICROBIOLOGY – EXPLANATORY NOTES CORRECTED Q.No 189 5. PATHOLOGY - 2 6. FM – NIL 7. PHARM - NIL 8. OPHTHAL - NIL 9. ENT - NIL 10. SPM - 8

1. ANATOMY

159. 5th cranial nerve-true are all except A. Arises from hindbrain B. Provides sensory innervations to whole face C. Innervates muscles to mastication D. Supplies parasympathetic fibres to salivary glands

Answer D ) Parasympathetic to salivary glands are by facial and glossopharyngeal Grays anatomy 40

th edition )

2. PHYSIOLOGY

4. Production of all of the following are increased at night, except A. ACTH B. Cortisol C. Melatonin D. Insulin

Answer D ) INSULIN

12. Normal levels of Hb A1 C are A. 2-4% B. 4-6% C. 6-8% D. 8-10%

ANSWER B ) 4- 6 %

For people without diabetes, the range is 20-41 mmol/mol (4-5.9%)

For people with diabetes, an HbA1c level of 48 mmol/mol (6.5%) is considered good control, although some

people may prefer their numbers to be closer to that of non-diabetics

35. The structure helping in maintaining muscle tone is A. Annular spiral bundle B. Fascicular bundle C. Muscle spindle D. Golgi tendon organ

ANSWER C ) MUSCLE SPINDLE

Muscle spindle Stretch receptors present in skeletal muscle Functions – maintains muscle tone , posture & control of voluntary

movement Golgi tendon organ High threshold stretch receptors present in tendon

Supplied by group Ib afferent fibres and detect muscle tension Pacinian corpuscle Pressure receptors in fascia throughout the muscles , tendons , joints &

periosteum Supplied by II afferent fibres and detect vibration

Free nerve endings Pain receptors in muscle , tendons , fasciae , joints Supplied by group III & IV afferent fibres and detect noxious stimuli

48. Least amount of CO2 is present in A. Anatomical dead space - end inspiration phase B. Anatomical dead space - end expiration phase C. Alveoli - end inspiration phase D. Alveoli - end expiration phase

ANSWER A ) Anatomical dead space - end inspiration phase

Normal capnogram Phase Feature I Represents beginning of expiration

First part of gas passing out of patient’s mouth comes from mechanical & anatomical dead spaces and contain no CO2 . So capnograph register zero

II Sharply rising expiratory upstroke front , which represents mixing of dead space gas with alveolar gas

III End expiratory slowly rising plateau – alveolar gas exhalation IV Sharp rise in PCO2 at the terminal end of phase III plateau

Sudden closure of small airways abruptly releasing CO2 rich gases O Inspiratory phase – sharp downward return of traces towards zero at the onset of

inspiration

147. All the following reactions are facilitated by thyroid peroxidase except ( CONTROVERSIAL Q ) A. Trapping of iodide. B. Conversion of iodide to iodine C. Secretion of thyroglobulin into colloid D. Binding of iodine to thyroglobulin ANSWER – A and C

Uptake of iodide by thyroid gland against chemical & electrical

Iodine trapping gradients , linked to Na+-K+ pump Synthesis & secretion of thyroglobulin

Thyroglobulin synthesized on rough endoplasmic reticulum of thyroid epithelial cells

These units move to apical plasma membrane & release into the lumen of the follicle

Oxidation of iodide Iodide transported into lumen of follicles by pendrin Iodide oxidised to iodine by peroxidase

Organification of thyroglobulin

Iodination of tyrosine residues in thyroglobulin molecule by thyroid peroxidase

Coupling reaction 2 molecules of DIT form thyroxine ( T4 ) 1 molecule DIT + 1 molecule of MIT to form TIT ( T3 ) Reactions are mediated by peroxidase

Storage Stored in lumen of follicle as colloid for several months 163. Glomerular filtration rate is decreased by all except A. Decrease in capillary hydrostatic pressure B. Increased tubular hydrostatic pressure C. Decreased effective filtration surface area D. Decreased plasma protein levels

Answer D ) Decreased plasma protein levels

Factoring affecting GFR Filtration coefficient ( Kf ) – Directly proportional to GFR Hydrostatic pressure in Bowman’s space fluid – Inversely proportional to GFR Glomerular capillary hydrostatic pressure ( PGC ) – Directly proportional to GFR Glomerular capillary oncotic pressure - Inversely proportional to GFR Sympathetic stimulation – Increased GFR →constriction of afferent arteriole

MICROBIOLOGY

Q. NO 189 EXPLANATORY NOTES IS WRONG

SWIMMING POOL GRANULOMA IS CAUSED BY M. Marinum

PLEASE REVISE THIS TABLE ( VERY IMPORTANT FOR JIPMER )

PATHOLOGY

18. All are causes of Hyperprolactinemia except A. Chronic renal failure B. Diabetes mellitus C. Thyrotoxicosis D. Metoclopramide ( CONTROVERSIAL ANSWER BROMOCRIPTANE REMOVED )

Answer B. Diabetes Mellitus Causes of Hyperprolactinemia a) Physiologic hyperprolactinemia – pregnancy b) Pathological hyperprolactinemia – lactotroph hyperplasia c) Drugs – phenothiazines , haloperidol , reserpine , estrogens , Metoclopramide d) Renal failure , hypothyroidism 105. Suggested criteria for the clinical diagnosis of Polycythemia vera (PV) include all, except A. Low arterial oxygen saturation B. Elevated red cell mass C. Increased counts of cells of all lineages D. Splenomegaly

Answer A ) A. Low arterial oxygen saturation Please Revise the criteria for POLY CYTHEMIA VERA

Major Criteria

1. Hemoglobin of more than 18.5 g/dL in men, 16.5 g/dL in women, or elevated red cell mass

greater than 25% above mean normal predicted value.

2. Presence of JAK2 617V greater than F or other functionally similar mutations, such as the

exon 12 mutation of JAK2.

Minor Criteria

1. Bone marrow biopsy showing hypercellularity with prominent erythroid, granulocytic,

and megakaryocytic proliferation.

2. Serum erythropoietin level below normal range.

3. Endogenous erythroid colony formation in vitro.

Other confirmatory findings no longer required for diagnosis include:

Oxygen saturation with arterial blood gas greater than 92%.

Splenomegaly.

Thrombocytosis (>400,000 platelets/mm3).

Leukocytosis (>12,000/mm3).

Leukocyte alkaline phosphatase (>100 units in the absence of fever or infection).

PSM

5. Human development index (HDI) A. Education, social status & life expectancy B. Education, life expectancy & purchasing power C. Life expectancy, gross national product and per capita income D. Per capita income, education & life expectancy ANSWER D. Per capita income, education & life expectancy

Published on 4 November 2010 (and updated on 10 June 2011), starting with the 2010 Human Development

Report the HDI combines three dimensions:

A long and healthy life: Life expectancy at birth

Education index: Mean years of schooling and Expected years of schooling

A decent standard of living: GNI per capita

17. Target of population reduction in India (National Poiicy-2000) is to be achieved by A. 2005 B. 2010 C. 2015 D. 2020

Answer B ) 2010 ( ANSWER CORRECTED by Professor Community Medicine)

18. In Parlance, size of family in demography is defined as ( OLD Q – 2001 ) . A. Number of children a couple has at a point of time B. Total number of persons in a family C. Total number of children born by women between 15 to 45 years age D. Total fertility rate

Answer D ) Total Fertility Rate ( ANSWER CORRECTED by Professor Community Medicine )

21. Which of the following is false about Japanese Encephalitis? A. Pigs are amplifiers B. Transmitted from man to man by mosquito C. Orchid birds acts as reservoirs D. Cross reacts with Dengue virus Answer B ) Transmitted from man to man by mosquito ( TYPO – ERROR ) EXPLANATION ( JE Cross reacts with DENGUE VIRUS )

Human is an incidental dead end 24. 24. Which of the following is not a content of rehydration solution for malnutrition? A. Amino acids B. Magnesium C. Sodium D. Potassium Answer A. Amino acids ( TYPO ERROR – EXPLANATION IS RIGHT ) Dehydration may be overestimated in a marasmic/wasted child and underestimated in a kwashiorkor/edematous child. The diagnosis is based instead on whether the person has been having diarrhea. Rehydration Solution for

Malnutrition (ReSoMal) contains less salt and more sugar and potassium than regular ORS. In addition, the World Health Organization recommends that all malnourished individuals with diarrhea

be treated with a course of broad-spectrum antibiotics. Supplemental zinc is still recommended, and a dehydrated person should still continue to be given food.

ReSoMal recipe

Ingredient Amount

Water 2 litres

WHO-ORS One 1-litre packet*

Sucrose 50 g

Electrolyte/mineral solution 40 ml

* 3.5 g sodium chloride, 2.9 g trisodium citrate dihydrate, 1.5 g potassium chloride, 20 g glucose.

37. The antimalarial of choice in a pregnant woman in the 1st trimester who is chloroquine resistant is A. Proguanil B. Mefloquine C. Quinine D. Dapsone&pyrimethamine C. Quinine ( Answer Corrected )

Non complicated malaria

alternatives for pregnant

women

Chloroquine-sensitive (see uncomplicated malaria sections above for chloroquine-sensitive species by region)

Chloroquine phosphate: Treatment as above

Chloroquine resistant P. falciparum (see sections above for regions with chloroquine resistantP. falciparum)

Quinine sulfate plus Clindamycin Quinine sulfate: Treatment as above Clindamycin: Treatment as above

Chloroquine-resistant P. vivax (see uncomplicated malaria sections above for regions with chloroquine-resistant P. vivax)

Quinine sulfate Quinine sulfate: 648 mg po tid x 7 days; supplied as 324 mg tablets

70. A lady presenting with menorrhagia, IUCD of choice A. Nova T B. Copper T C. Progestasert D. Lippes loop Answer C. Progestasert GENERATION EXAMPLES MECHANISM OF ACTION First generation

Lippes loop Foreign –body reactions in uterus causing cellular and biochemical changes in the endometrium and uterine fluids , impair the viability of the gamete and thus reduce its chances of fertilization

Second generation

Copper -7 Copper –T-200 Cu –T-220-C Cu –T-380 A or Ag ML-Cu -250 ML-Cu-375

Produces local effects. Copper seems to enhance cellular response in endometrium .By altering biochemical composition of cervical mucus , copper ions may affect sperm motility , capacitation and survival

Third generation

Progestasert Levonorgestrel

Increase the viscosity of cervical mucus .Prevent sperm from entering the cervix . Also maintain high levels of progesterone on endometrium and low levels of estrogen , thereby sustaining an endometrium unfavourable to implantation.

72. . The study type in which 5 cases/year arestudied about a rare disease A. Case control B. Cross sectional C. Cohort study D. Randomized control trail Answer A ) For rare diseases CASE CONTROL study is the best study . There is some recall error in the question

111. Best test for studying incidence of malaria: A. Spleen rate B. Infant parasite rate C. Annual Parasite incidence D. Parasite density index Answer C. Annual Parasite incidence is the best test for studying incidence Parasite Density Index – average degree of Parasitemia Infant parasite rate – Percentage of infants below the age of one year showing malaria parasites in their

blood films . It is regarded as most sensitive index of recent transmission of malaria in a locality. Proportional case rate – Number of cases diagnosed as clinical malaria for every 100 patients attending

the hospitals and dispensaries. Annual parasite index = Confirmed cases during one year / population under surveillance * 100 Annual blood examination rate = No of slides examined /population * 100 Parasite rate - Percentage of children between 2 and 10 years showing malaria parasites in their blood

films Spleen rate- Percentage of children between 2 and 10 years showing enlargement of spleen Average enlarged spleen – average size of enlarges spleen 141. Physical quality of life index is measured by all, except: A. Infant mortality B. Life expectancy at age one C. Literacy D. Per capita income ANSWER D. PER CAPITA INCOME 149. Diagnostic accuracy of a test is determined by: A. Sensitivity B. Specificity C. Predictive value D. Odds ratio Answer C. Predictive value Predictive value reflects the diagnostic power of the test. The 'predictive value of a positive test' indicates the

probability that a patient with a positive test result has in fact; the disease in question. The more prevalent a

disease, in a given population, the more accurate will be the predictive value of a positive screening test. the

predictive value of a positive test falls as disease prevalence declines.

1. In positive predictive test the denominator is: True positive + False positive.

2. In negative predictive test, the denominator is: False negative + True negative

151. If a mother has had measles, her newborn baby is immune to this disease for: A. 4 to 6 months B. 6 to 12 months C. 1 to 3 years D. 3 to 6 years Answer A. 4 to 6 months 153. Dengue hemorrhagic fever is diagnosed by: A. Acute onset of high fever, presence of petechiae, epistaxis and platelet count > 2 lakh

B. Acute onset of high fever, positive tourniquet test, epistaxis or malena and malena and platelet count > 1.5 lakh C. Acute onset of high fever 2 to 7 days, associated with hemorrhagic manifestation e.g. hemoptysis and platelet count less than 1.5 lakh D. Acute onset of high fever, positive tourniquet test, bleeding gum and platelet count less than 1.0 lakh Answer D. Acute onset of high fever, positive tourniquet test, bleeding gum and platelet count less than 1.0 lakh 181. The most widespread disease transmissible from animal to man A. Rabies B. Brucellosis C. Anthrax D. Leptospirosis ANSWER D ) LEPTOSPIROSIS According to Current Edition of PARK , It is D ) LEPTOSPIROSIS