TargetPG Tamil Nadu PG Entrance - Self Assessment & Review – Question Papers of TNPG 2002 to 2006 with Answers References, Explanations, Discussion, Mnemonics, Tables and Diagrams
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Question Stem
148) The rate of increase in head circumference in 0 - 3 months is
Choices given
A) 2 cm per month
B) 1 cm per month
C) ½ cm per month
D) 0.25 cm per 3 months
Answer
A) 2 cm per month
Reference
Nelson 15th Edition Table 11.5
Question Analysis
| Based on | Question Category | Question Grade | Question Type | Books | Target PG Opinion |
| Fact | Subtle Point | PG Entrance | Straight forward | Given in All books | Needs Memory |
Facts about Growth and Caloric Requirements
| Age | Approximate Daily Weight Gain (g) | Approximate Monthly Weight Gain | Growth in Length (cm/mo) | Growth in Head Circumference (cm/mo) | Recommended Daily Allowance (kcal/kg/day) |
| 0–3 mo | 30 | 2 lb | 3.5 | 2.00 | 115 |
| 3–6 mo | 20 | 1 1/4 lb | 2.0 | 1.00 | 110 |
| 6–9 mo | 15 | 1 lb | 1.5 | 0.50 | 100 |
| 9–12 mo | 12 | 13 oz | 1.2 | 0.50 | 100 |
| 1–3 yr | 8 | 8 oz | 1.0 | 0.25 | 100 |
| 4–6 yr | 6 | 6 oz | 3 cm/yr | 1 cm/yr | 90–100 |
Interpretation
Self Explanatory
Remarks
Another way of remembering
| Time | Head Circumference |
| Birth | 35 cm |
| 3 months | 40 cm |
| 6 months | 44 cm |
| 12 months | 47 cm |
| 2 years | 49 cm |
| 12 years | 52 cm |
Tit Bits
| Period | Rate of Growth |
| 0 to 3 months | 2 cm per month |
| 3 to 6 months | 1 cm per month |
| 6 to 12 months | ½ cm per month |
| 1 to 2 years | ½ cm per 3 months |
| 2 to 7 years | ½ cm per year |
| 7 to 12 years | 1/3 cm per year |
Question Stem
201) Acute Cholecystitis is associated with
Choices given
A) Hyperaesthesia in Sherren’s Triangle
B) Boas’ Sign
C) Bed shaking Test of Bapat
D) Sign-de-dance
Answer
B) Murphy’s Sign
Reference
A manual on Clinical Surgery, 5th Edition Das Page 362, 340
Question Analysis
| Based on | Question Category | Question Grade | Question Type | Books | Target PG Opinion |
| Concept | Clinically Applied point | MBBS | Straight forward | Given in All books | Needs Memory |
Facts
Ä An area of hyperaesthesia between the 9th and 11th rib on the posteriorly on the right side is known as the Boas’ sign and is suggestive of Acute Cholecystitis
Ä To elicit tenderness in cholecystitis one may place the right hand just below the right costal margin on the lateral border of the right rectus (the gall bladder point). Moderate pressure is exerted with the fingers to palpate the fundus of the gall bladder. The patient is now asked to take a deep breath in, the gall bladder descends and is hurt by the examining finger. The patient will immediately wince with a ‘catch’ in the breath if the organ is inflamed. This is called Murphy’s sign (Moynihan’s method)
Interpretation
A) Presence of hyperaesthesia in the Sherren’s Triangle (this is formed by lines joining the umbilicus, right anterior superior iliac spine and symphysis pubis) is regarded as a good guide in the diagnosis of gangrenous appendicitis
B) Murphy’s Sign and Boas’ sign are seen in Cholecystitis
C) Bed shaking Test of Bapat can be applied when early peritonitis is still on doubt. The foot end of the bed is moved slightly and this will evoke pain at the position of the inflamed organ
D) In Intussusception, a sausage shaped lump may be felt in the epigastrium or left lumbar region. It is usually associated with empty right iliac fossa(Sign-de-dance) .
Remarks
Ä Other signs in Acute Appendicitis include
o Rovsing’s Sign
o Blumberg’s sign
o Cope Psoas Test
o Obturator Test
o Baldwing’s Test
Tit Bits
Ä Murphy's sign (inspiratory arrest during subcostal palpation) is widely regarded as pathognomonic of cholecystitis. It is certainly present in patients with established acute cholecystitis, but it only reflects peritoneal inflammation in the right upper quadrant, other causes of which include chronic cholecystitis, acute hepatitis, and a localized abscess around a perforated duodenal ulcer.
Question Stem
113) ICDS components all except
Choices given
A) Immunization
B) Iron and Folic Acid Preparation
C) Vitamin A Prophylaxis
D) Iodine deficiency precautions
Answer
D) Iodine deficiency precautions
Reference
Park 17th Edition Pages 407, 455
Question Analysis
| Based on | Question Category | Question Grade | Question Type | Books | Target PG Opinion |
| Fact | Basic point | PG Entrance | Straight forward | Given in Park | Needs Memory |
Facts
The components of the ICDS scheme are
- Supplementary Nutrition
- Nutrition and Health Education
- Immunization
- Health Check Up
- Record of Height and Weight at periodical intervals
- Watch over milestones
- Immunization
- General Check up every 3 to 6 months to detect disease, malnutrition
- Treatment for diseases like Diarrhoea, Dysentrery, Respiratory tract infection etc
- Deworming
- Prophylaxis against vitamin A deficiency and Anaemia
- Referral of serious cases
- Non – formal School Education
Interpretation
Where as ICDS scheme has Iron and Folic Acid Supplementation and Vitamin A administration, iodine Deficiency precaution is not one of the components
Remarks
Ä Supplementary Nutrition is given for 300 days a year
Ä Non formal School education is imparted to children of the ages 3 - 6
Ä Administrative Unit is
o Community development Block every 1,00,000 population in Rural / Urban Areas and
o Tribal Development Block every 35,000 population
Tit Bits
The Supplementary Nutrition in ICDS Scheme is
Ä Children below 1 year
o 200 Cal and 8 to 10 grams of protein
Ä Children 1 - 6 years
o 300 Cal and 15 grams of protein
Ä Pregnant and Nursing mother
o 500 Cal and 25 grams of protein
Question Stem
237) Eustachian Tube
Choices given
A) Connects Inner Ear with Nasopharynx
B) Consists of a Bony Part of 25mm and Cartilaginous Part of 15 mm
C) Posterolateral Part is Cartilagenous
D) It maintains the Pressure between Middle Ear and nasopharynx
Answer
D) It maintains the Pressure between Middle Ear and nasopharynx
Reference
Diseases of Ear, Nose and Throat. - P.L.Dhingra - 3rd Edition Page 75
Question Analysis
| Based on | Question Category | Question Grade | Question Type | Books | Target PG Opinion |
| Fact | Basic point
| MBBS
| Straight forward
| Given in Robbins | Needs Memory
|
Facts
Eustachian Tube is also called as Pharyngotympanic Tube or Auditory Tube. The functions of the tube are
- Ventilation
- Regulation of Middle Ear Pressure
- Middle Ear Clearance of secretions
Interpretation
A) Eustachian Tube Connects Middle Ear with Nasopharynx
B) Eustachian Tube Consists of a Bony Part of 15mm and Cartilaginous Part of 25 mm
C) Anteromedial Part of the Eustachian Tube is Cartilagenous
D) It maintains the Pressure between Middle Ear and nasopharynx
Remarks
Ä The lining of the tube is respiratory pseudostratified ciliated columnar epithelium
Ä Behind the tubal elevation the lateral wall of nasopharynx has a variable depression, the pharyngeal recess or fossa of Rosenmüller
Tit Bits
Ä In the Right Atrium, valve of the inferior vena cava is called as Eustachian valve.
Question Stem
200) Sebaceous cyst is
Choices given
A) A horny induration of the cuticle with a hard centre caused by undue pressure, chiefly affecting the toes and feet
B) A localized thickened or hardened part of skin
C) A dry, rough excrescence on the skin
D) A Retention Cyst
Answer
A)
Reference
A manual on Clinical Surgery, 5th Edition Das page 42
A textbook of Surgical Short Cases, 2nd Edition Das, page 4
Question Analysis
| Based on | Question Category | Question Grade | Question Type | Books | Target PG Opinion |
| Concept | Basic point | MBBS | Straight forward | Given in Short Cases Das | Needs Memory |
Facts
Ä Epidermal inclusion cysts, are often incorrectly referred to as sebaceous cysts and are the most commonly encountered cysts of the skin.
Ä They may occur in childhood, but are more common in early adulthood; the most common sites are the scalp, face, and back. Lesions may be solitary or multiple, and present as 0.5 to 5.0 cm spherical, slightly compressible, intradermal or subcutaneous masses.
Ä A dilated follicular orifice may connect the cyst to the cutaneous surface, usually near the dome of the cyst. The wall of the cyst is composed of fully differentiated epithelium which reproduces the epidermis.
Ä Desquamated keratinocytes are shed into the centre of the cyst, forming a white cheesy material. Infection of epidermal inclusion cysts leads to fibrosis of the surrounding dermis. This event is of importance to the surgeon; previously infected cysts may be difficult to dissect and en-bloc excision is the treatment of choice. Cysts that have not previously been infected or manipulated surgically may be bluntly dissected free of the surrounding tissue following a simple equatorial incision of the overlying skin. Cysts on the face, however, should have their lining teased from within via a small incision to minimize cosmetic deformity.
Interpretation
A) A corn is a horny induration of the cuticle with a hard centre caused by undue pressure, chiefly affecting the toes and feet
B) A callosity is a localized thickened or hardened part of skin
C) A wart is a dry, rough excrescence on the skin
D) A sebaceous cyst is a retention cyst of sebaceous glands .
Remarks
Ä Muir-Torre Syndrome. was described by Muir and co-workers in 1967 and Torre in 1968 to include sebaceous adenomas, epidermoid cysts, fibromas, desmoids, lipomas, fibrosarcomas, and leiomyomas with visceral cancers. 9
Tit Bits
Ä Gardner's syndrome is a familial disease consisting of gastrointestinal adenomatous polyposis; osteomas of the mandible, skull, and long bones; and a variety of soft tissue lesions, including sebaceous cysts, fibromas, lipomas, and desmoid tumors
Question Stem
236) Central or Centro Caecal loss of vision occurs in
Choices given
A) Optic Neuritis
B) Lesion of Optic Tract
C) Lesions of Optic Chiasma
D) Lesions of Occipital Lobe
Answer
A) Optic Neuritis
Reference
Nema 4th Edition page 273
Question Analysis
| Based on | Question Category | Question Grade | Question Type | Books | Target PG Opinion |
| Fact | Clinically Applied point | PG Entrance | Straight forward | Given in most books | Needs Memory |
Facts
Let us see the differences between Papillitis and Papilledema
| Papillitis | Papilloedema |
| Unilateral | Bilateral |
| Sudden Diminision of Vision | Central Vision is unimpaired for a long time |
| Ill Sustained Pupillary Reaction (Marcus Gunn Pupil) | Pupil Round and reacts to light briskly |
| Media might be hazy due to exudation into vitreous | Media Clear |
| Disc Swelling Rarely more than 2 to 3 D | May be as high as 6 D |
| Central or Centro Caecal Scotoma (between fixation and Blind Spot) especially for Red and Green | Enlarged Blind Spot(due to separation of retina around the disc by the edema) and concentric constriction of field due to optic nerve atrophy |
| Normal X Ray Skull | Sliver beaten appearance and erosion of posterior clinoid |
| Condition temporary | Condition progresses until treated |
|
|
|
Interpretation
Self Explanatory
Remarks
Ä Pseudoneuritis or Pseudopapillitis is a condition occurring in Hypermetropic Eyes and there is no venous engorgement, edema or exudates and blind spot is not enlarged. A flourescein angiogram reveals no leakage
Tit Bits
Ä Refer to Question 231, TNPG 2004
Question Stem
231) Wernicke's Hemianopia occurs in lesions of
Choices given
A) Optic nerve
B) Optic Chiasma
C) Optic Tract
D) Occipital Lobe
Answer
C) Optic Tract
Reference
Parson 19th Edition Page 528, 120
Question Analysis
| Based on | Question Category | Question Grade | Question Type | Books | Target PG Opinion |
| Fact | Clinically Applied point | PG Entrance | Straight forward | Given in most books | Needs Memory |
Facts
| Site of Lesion | Clinical Presentation |
| Optic Nerve | Ipsilateral Blindness Marcus Gunn Pupil |
| Optic Chiasma | Bitemoporal Hemianopia |
| Distension of 3rd Ventricle Atheroma Carotid Aneurysm Post Communicating Arteries | Binasal hemianopia |
| Optic Tract | Homonymous Hemianopia Wernicke’s Hemianopic Pupil |
| Temporal Lobe | Inferior Quadrantic homonymous defect |
| Parietal Lobe | Superior Quadrantic homonymous defect |
| Optic Radiations | Homonymous Hemianopia with Macular Sparing |
| Occipital Lobe | Homonymous Hemianopia with Macular Sparing |
Interpretation
Self Explanatory
Remarks
Ä Earliest lesion in Pituitary
Ä Unilateral Central Scotoma + Contralateral Sup Quadrantanopia due to invlovement of von Willebrands knee
Ä Early loss in Intra Sellar and Extra Sellar Tumours
Ä Upper half of the field is defective
Ä Early Loss in Supra Sellar Tumours
Ä Lower Half of the field is defective
Tit Bits
Ä Riddoch's Phenonemon is Appreciation of a dim kinetic image is retained with loss of appreciation of static bright image and is seen in Occipital Lobe lesions
Ä Refer to Question Number 236, TNPG 2003 Section
Question Stem
101) Dichotomy refers to
Choices given
A) Marrying two wives
B) Marrying two husbands
C) Fee Splitting
D) A type of plant
Answer
C) Fee Splitting
Reference
The Essentials of Forensic Medicine and Toxicology 17th Edition Narayana Reddy Page 22
Question Analysis
| Based on | Question Category | Question Grade | Question Type | Books | Target PG Opinion |
| Concept | Basic point | MBBS | Straight forward | Given in Reddy | Needs memory |
Facts
Dichotomy of fee splitting is receiving or giving commission or other benefits to a professional colleague or manufacturer or trader in drugs, appliances or a chemist, dentist etc.
Interpretation
A) A male marrying two females is bigamy
B) A female marrying two males is biandry!! - a common practice in gypsies
C) Dichotomy is “fee Splitting”
D) There are a group of plants called as Dichotomous plants so named because of the branching pattern. In Human Body, Branching of Trachea, Retinal and to a certain extent pulmonary vasculature is dichotomous
Remarks
Ä Look at the references given for a complete list
Ä Question 101 TNPG 2003 Paper has a similar questions
Tit Bits
Ä The Geneva Convention Act prohibits the use of Red Cross and other allied emblems for any purpose without the approval of Government of India, and imposes the penalty on any one who uses such emblems. It is the right only of the members of Medical Services of Any Army
