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Stop codons are:
A, B, C i.e. UAA, UAG, UGA
4
UAA
UAG
UGA
All
Biochemistry
null
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multi
Addition of large amounts of platinum to a casting gold alloy will:
Platinum It increases strength and corrosion resistance. It also increases melting point and has a whitening effect on the alloy. It helps to reduce the grain size. The transformation between vapor, liquid, and solid is called the change of state. A change from the solid to the liquid state will require additional energy—kinetic energy—to break loose from the force of attraction. This additional energy is called the latent heat of fusion. The temperature at which this change occurs is known as the melting temperature or fusion temperature. Mannapalli 3 ed page 274; Phillips 12th ed page 18
3
Decrease its strength and ability to be hardened
Decrease its tarnish resistance
Increase its fusion temperature
Redden the alloy
Dental
null
a1cc97b5-9749-4270-9722-733d934df9b4
multi
Corneal sensation is tested by which device?
ANSWER: (C) AesthesiometerREF: Khurana 4th Ed Pg 472See PLATE O -21 KEY PLATE O-21 KEYTESTING CORNEAL SENSATIONS:(B) To test the corneal sensations, patient is asked to look ahead; the examiner touches the corneal surface with a fine twisted cotton (which is brought from the side to avoid menace reflex) and observes the blinking response. Normally, there is a brisk reflex closure of lids. Always compare the effect with that on the opposite side. The exact quantitative measurement of corneal sensations is made with the help of an aesthesiometer.(A) The most common quantitative method is the handheld esthesiometer (Cochet-Bonnet). It tests only A delta fibres and not C and temperature fibres. Noncontact corneal aesthesiometer {uses air puff technique) is another method. Tne advantage of NCCA over the Cochet-Bonnet aesthesiometer is that a large, continuous range of stimulus intensities can be produced. Furthermore, the stimulus is more precise and sensory-specific, testing is less variable than with use of a filament, there is no corneal microtrauma is prevented. Patient apprehension is also lesser, & lower stimulus thresholds can be detected. However it is not commercially available & is less portable.
3
Pachymeter
Keratometer
Aesthesiometer
Vernier calliper
Ophthalmology
Cornea
c4887cdd-3926-4d1c-b297-648e694c5092
multi
The autonomic nervous system of the gut, Auerbach and Meissner plexus, are embryologically derived from the following structure:
Neurons in the enteric system are derived from neural crest cells originally associated with occipitocervical and sacral regions. It regulates gastrointestinal motility, secretory activity, vascular activity, and inflammation. The first group is the myenteric plexus (also called Auerbach's plexus), which is located between the muscular layers that make up the gastrointestinal system, from the esophagus at the rostral end to the rectum at the caudal end. Additional projections to smaller ganglia are also associated with the pancreas and gallbladder. The submucosa plexus, also called Meissner's plexus, is largely confined to the submucosa of the gut and is most prominent within the small intestine, where it regulates secretory activity and innervates blood vessels. Ref: Waxman S.G. (2010). Chapter 20. The Autonomic Nervous System. In S.G. Waxman (Ed), Clinical Neuroanatomy, 26e.
1
Neural crest
Yolk sac
Primordial germ cell
Epithelial lining of gut
Anatomy
null
a4705b96-38e6-4fa9-b074-b57bb9df7484
multi
Anterior fontanelle closes at:
c. 12-20 months(Ref: Nelson's 20/e p 2792)Anterior fontanelle is a diamond-shaped structure at the junction of the frontal and parietal bones, that is open at birth and usually measures 22cm. The average time of closure is 18 mo, but the fontanelle can dose normally as early as 9 months.
3
2-3 months
4-7 months
12-20 months
24-30 months
Pediatrics
Growth, Development, and Behavior
4110c490-1515-4d32-a172-45de29f644e9
single
A 4-yr old male child presents with muscle weakness. His mother tells that her child has difficulty in climbing stairs and getting up from the floor. On muscle biopsy, small muscle fibrils and absent of dystrophin was found. what is the diagnosis out of given options?
Duchenne Muscular Dystrophy Progressive weakness Calf muscle involvement Pseudo hyperophy Difficulty in climbing stairs Gower sign present (+) Wheel chair bound Patient Death - CHF/ Pneumonia CPK MM: Increased IOC: - PCR for dystrophin gene (Dystrophin gene absent) Rx: - Chest Physiotherapy NOTE:Immunohistochemical studies for dystrophin show Absence of the normal sarcolemma staining pattern in Duchenne muscular dystrophin Reduced staining in Becker muscular dystrophy.
2
Becker's muscle dystrophy
Duchenne muscular dystrophy
Myotonic dystrophy
Limb-girdle muscular dystrophy
Pediatrics
NEET Jan 2020
169b3aad-2700-488f-8061-1a83eee03e3d
multi
Alternative for SMR:
(b) Septoplasty(Ref. Cummings, 6th ed., 481)Septoplasty is more conservative procedure than SMR and is the preferred surgery for DNS.
2
Tympanoplasty
Septoplasty
Caldwell-Luc operation
Turboplasty
ENT
Disease of External Nose & Nasal Septum
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single
The following structures do NOT have lymphatics, except
Lymph capillaries - Lymph capillaries (or lymphatic capillaries) begin blindly in tissues where they form a network. The structure of lymph capillaries is basically similar to that of blood capillaries, but is adapted for much greater permeability. There is an inner lining of endothelium. The basal lamina is absent or poorly developed. Pericytes or connective tissue are not present around the capillary. As compared to blood capillaries, much larger molecules can pass through the walls of lymph capillaries. These include colloidal material, fat droplets, and paiculate matter such as bacteria. It is believed that these substances pass into lymph capillaries through gaps between endothelial cells lining the capillary; or by pinocytosis. Lymph capillaries are present in most tissues of the body. They are absent in avascular tissues (e.g., the cornea, hair, nails); in the splenic pulp; and in the bone marrow. It has been held that lymphatics are not present in nervous tissue, but we now know that some vessels are present. REF : Inderbir Singh's Textbook of Human Histology, seventh edition, pg.no., 130.
1
Bone marrow
cornea
nail
hair
Anatomy
General anatomy
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Investigation of choice for SPINAL METASTASIS?
MRI is the Investigation Of Choice for Most spinal imaging including: Spinal metastasis Spinal tumors Potts' spine Intramedullary spinal cord metastasis
1
MRI
BONE SCAN
XRAY SPINE
CT scan
Radiology
Magnetic Resonance Imaging
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A 2 year old female child was brough to a PHC with a history of cough and fever for 4 days with inability to dink for last 12 hours. On examination, the child was having weight of 5 kg and respiratory rate of 45/minute with fever. The child will be classified as suffering from -
As per history, the child has fever, cough and was unable to drink. The history points to very severe disease. classification of pneumonia. Fast breathing is present when the respiratory rate is : 1. 60 breaths/min or more in child < 2 months of age. 2. 50 breaths/min or more in child aged 2-12 months. 3. 40 breaths/min or mote in child 12 months - 5 yrs. VERY SEVERE DISEASE:- 1. Not able to drink 2. Convulsions, abnormally sleepy/ difficult to wake. 3. Stridor in calm child 4. Severe malnutrition Treatment- Refer urgently to hospital. Give first fose of antibiotics. Treat fever and wheeze , if present. If cerebral malaria possible, give antimalarial. SEVERE PNEUMONIA Most impoant sign to consider when deciding if the child has pneumonia are the RR and chest indrawing. A child with chest indrawing may not have fast breathing if the child becomes exhausted. Then the breathing slows down. Un such cases chest indrawing may be the only sign in a child with severe pneumonia. Other signs: 1. Nasal flare 2. Grunting 3. Cyanosis 4. Wheezing Treatment:- Refer urgently to hospital. Give first dose antibiotics. Treat fever and wheeze if present. PMEUMONIA:- 1. Fast breathing 2. No chest indrawing Treatment:- Advice mother to give home care. Give an antibiotic. Treat fever and wheeze if present. Advice mother to return eith child in 2 days for reassessment, or earlier if child gets worse. No pneumonia:- 1. Simple cough or cold. Treatment:- Assess and treat ear problems or sore throat. Assess and treat other problems. Advice mother to give home care. Treat fever and wheeze if present. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.170}
1
Very severe disease
Sever pneumonia
Pneumonia
No pneumonia
Social & Preventive Medicine
Communicable diseases
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single
Imaging studies of a patient with a genetic disorder shows 'central dot sign' which is characteristic of:
Caroli disease (Todani type V choledochal cyst) is an autosomal-recessive disorder resulting cystic dilation of the intrahepatic bile ducts. Imaging methods show intrahepatic saccular or fusiform dilated cystic structures of varying sizes that communicate with the biliary tree. The presence of tiny dots with contrast enhancement within the dilated intrahepatic bile duct ("central dot sign") is considered very suggestive of Caroli disease. The "central dot sign" represents the enhancing poal branches surrounded by cystic alterations of the intrahepatic biliary ducts. Also know: Caroli syndrome: If all levels of the intrahepatic biliary tree are involved, features of both congenital hepatic fibrosis and Caroli disease are present; this condition has been termed Caroli syndrome. Ref: Moele K.J. (2012). Chapter 9. State-of-the-A Imaging of the Gastrointestinal System. In N.J. Greenberger, R.S. Blumberg, R. Burakoff (Eds), CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 2e.
3
Primary sclerosing cholangitis
Liver Hamaoma
Caroli's disease
Polycystic liver disease
Surgery
null
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single
A 65 year old man has stools positive for occult blood which of the following is most likely location of bowel cancer
Distal colon cancers are M/C.
1
Sigmoid
Transverse colon
Appendix
Ascending colon
Medicine
null
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single
Appropriate size of oropharyngeal airways is measured from ?
Oropharyngeal airway Guedel oropharyngeal airway (used to lift the tongue above oropharynx) Take either from the midpoint of the incisor or corner of the lip to angle of the mandible Used in unconscious person; as laryngospasm can occur in conscious person by its use
2
Incisor teeth to tragus of the ear
Corner of mouth to angle of mandible
Tip of nose to angle of mandible
Ala of nose to angle of mandible
Anaesthesia
Airway
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Boundaries of upper triangular space include all except -
-        Boundaries of upper triangular space    Medial- Teres minor    Lateral- Long head of triceps    Inferior- Teres major    Content- circumflex scapular artery
3
Teres minor
Teres major
Subscapularis
Triceps
Anatomy
null
129de833-31c5-4756-bc2a-4c65619134f2
multi
A patient with cirrhosis of liver has the following coagulation parameters, Platelet count 2,00,000, Prothrombin time 25s/12s, Activated partial thromboplastin time 60s/35s, thrombin time 15s/ 15s. In this patient -
null
1
D-dimer will be normal
Fibrinogen will be <100 mg
ATIII will be high
Protein C will be elevated
Medicine
null
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single
Quetlet index, used to assess obesity, is represented as ?
Ans. is 'c' i.e., Weight divided by square of Height
3
Weight divided by Height
Height divided by weight
Weight divided by square of Height
Height divided by square of weight
Social & Preventive Medicine
null
372d8053-8de8-4e47-bb7b-e02c2af55e4d
single
What is the emergent management of tension pneumothorax?
Tension pneumothorax is a medical emergency.In case of tension pneumothorax,immediate release of the positive pressure by inseion of a large-bore needle into the pleural space through the second anterior intercostal space is beneficial.If the tension is not relieved,the patient is likely to die from inadequate cardiac output, or marked hypoxaemia. Harrison's medicine-18th edition,page no:2181.
3
Chest X-ray
Emergency room thoracotomy if unstable
Immediate needle thoracostomy in 2nd intercostal space
Tube thoracostomy in 5th ICS
Medicine
Respiratory system
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single
Oxygen dissociation cure is shifted to left by all except -
Ans. is 'd' i.e., Decreased pH
4
Increased pH
Decrease PCO2
Decreased 2,3 DPG
Decreased pH
Physiology
null
e616d110-a1bb-44db-9047-c35ec2d419fe
multi
Treatment for 32 years old multipara with dysfunctional uterine bleeding (DUB) is :
Ans. is a i.e. Progesterones Guys, It is very impoant to clear your facts on Management of DUB and Polymenorrhea in different age groups. You must read the question very carefully as management of Polymenorrhea and DUB is different. First lets understand the basics regarding Polymenorrhea and DUB. Polymenorrhea : It is cyclical bleeding which is normal in amount but occurs at frequent intervals (< 21 days). Polymenorrhea occurs in ovulatory bleeding where the ovary goes through its normal cycle but does it more quickly. The acceleration mainly affects the follicular phase of menstrual cycle. Physiological Following menarche Preceeding menopause Pathological Chronic congestion of ovaries as in : chronic salpingo-oophiritis DUB : DUB is defined as a state of abnormal uterine bleeding without any clinically detectable organic pelvic pathology. It is mostly anovulatory (80%) i.e., there is deficeincy of progesteron,.so it can be treated successfully with progesterone, Also know : In anovulatory cycles : If progesterone is commenced during an episode of heavy bleeding -- Progesterone of choice is Norethisterone acetatedeg as it has better hemostatic action whereas for cyclical maintenance therapy dydrogesterone or medroxy progesterone acetate is preferred.
1
Progesterone
Danazol
Prostaglandins
Endometrial ablation
Gynaecology & Obstetrics
null
12ed4638-f4e3-4115-8c11-305229d04615
single
The crude death rate of a population is 8/1000. So the beds for this population must be-
.
1
4\/1000
8\/1000
10\/1000
2\/1000
Social & Preventive Medicine
Epidemiology
bee48002-efe5-416c-8772-61b1a29545af
single
A 39-year-old woman claims that she injured her hand at work. She asses that the pain caused by her injury prevents her from working. She has no fuher hand problems after she receives a Rs1 Lakh workers' compensation settlement. This clinical presentation is an example of
This presentation is an example of malingering, feigning illness for obvious gain (the Rs 1 lakh workers' compensation settlement). Evidence for this is that the woman has no fuher hand problems after she receives the money. In conversion disorder, somatization disorder, factitious disorder, and factitious disorder by proxy there is no obvious or material gain related to the symptoms
4
factitious disorder
conversion disorder
factitious disorder by proxy
malingering
Psychiatry
Neurotic, Stress Related and Somatoform Disorders
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single
All of the following are signs of good attachment during breast feeding EXCEPT:
Ans. (c) Lower areola is more visible than upperRef : OP Ghai 8th ed./154* I would suggest you to cram this question as it has been repeated multiple times and I think will be eternally as its a basic skill for managing patients.Please refer to above explanation.
3
Baby's mouth is wide open
Baby's lower lip is everted
Lower areola is more visible than upper
Baby's chin touching the breast
Pediatrics
Newborn Infant - Parent-Infant Bonding
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Which of the following is not an adverse effect of amiodarone?
Adverse effects of Amiodarone: The Thyroid (both hypo and hypehyroidism) Periphery of Peripheral neuropathy My Myocardial depression Lung Lung fibrosis Liver and Liver Toxicity Cornea is Corneal microdeposits Photosensitive Photosensitivity
4
Hypehyroidism
Corneal microdeposits
Pulmonary fibrosis
Nephrotoxicity
Pharmacology
Hematology and CVS
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single
Rotigotine is ?
Ans. is 'a' i.e., Dopamine agonist Rotigotine Rotigotine is a dopamine agonist drug and is indicated in the treatment of parkinosonism. Rotigotine is intended to be delivered through transdermal patches, so as to ensure a slow and constant dosage in a 24-hour period. Side effects are--skin reaction at the patch site, nausea, vomiting, diziness, drowsiness, insomnia.
1
Dopamine agonist
Dopamine antagonist
GABA agonist
GABA antagonist
Pharmacology
null
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Flexion extension in neck occurs at -
Ans. is 'b' i.e., Atlanto-occipital joint o Atlantoaxial joint - Rotatory movement around vertical axis (Right to left and left to right movements).o Atlanto-occipitai joint - (i) Flexion-extension around transverse axis, (ii) Slight lateral flexion around antero-posterior axis.Also knowo Atlanto-occipital joint:- Median........................ Pivot joint.- Lateral .........................Plane synovial joint.o Atlantoaxial joint ............Ellipsoid joint.
2
Atlanto-axial joint
Atlanto-occipital joint
C6-C7 joint
C7-T1 joint
Anatomy
Osteology of Head and Neck
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single
Among the following muscles, the one that is found in the first layer of the sole is:
Flexor digitorum brevis
2
Adductor hallucis
Flexor digitorum brevis
Flexor digiti minimi brevis
Flexor hallucis longus
Anatomy
null
7161ae2b-32cb-4737-b3f7-5fc974b4afd6
multi
Turner's syndrome is characterized by following except:
Ans. D. Tall stature. (Ref. Harrison's 18th/pg. 3049; Chapter 349.)Turner's Syndrome (Gonadal Dxsgenesis: 45.X)# PATHOPHYSIOLOGY- Approximately one-half of individuals with Turner's syndrome have a 45,X karyotype, about 20% have 45,X/46,XX mosaicism, and the remainder have structural abnormalities of the X chromosome such as X fragments, isochromosomes, or rings. The clinical features of TS result from haploinsufficiency of multiple X chromosomal genes (e.g., short stature homeobox, SHOX). However, imprinted genes also may be affected when the inherited X has different parental origins.# CLINICAL FEATURES- TS is characterized by bilateral streak gonads, primary amenorrhea, short stature, and multiple congenital anomalies in phenotypic females. It affects 1 in 2500 women and is diagnosed at different ages depending on the dominant clinical features. Prenatally, a diagnosis of TS usually is made incidentally after chorionic villus sampling or amniocentesis for unrelated reasons such as advanced maternal age. Prenatal ultrasound findings include increased nuchal translucency. The postnatal diagnosis of TS should be considered in female neonates or infants with lymphedema, nuchal folds, low hairline, or left-sided cardiac defects and in girls with unexplained growth failure or pubertal delay. The vast majority of women with TS develop complete ovarian failure.# Treatment:- Individuals with congenital heart defects (CHDs) (30%) (bicuspid aortic valve, 30-50%; coarctation of the aorta, 30%; aortic root dilation, 5%) require long-term follow, antibiotic prophylaxis for dental or surgical procedures, and serial imaging of aortic root dimensions, as progressive aortic root dilation is associated with increased risk of aortic dissection.- Individuals found to have congenital renal and urinary tract malformations (30%) are at risk for urinary tract infections, hypertension, and nephrocalcinosis. Hypertension can occur independently.- Clitoral enlargement or other evidence of virilization suggests the presence of covert, translocated Y chromosomal material and is associated with increased risk of gonadoblastoma, apparently as a consequence of Y chromosomal genes distinct from SRY.Autoimmune hypothyroidism (15-30%) can occur in childhood.- The treatment of short stature in children with TS remains a challenge, as untreated final height rarely exceeds 150 cm in nonmosaic 45,X TS. High-dose recombinant growth hormone stimulates growth rate in children with TS and may be used alone or in combination with low doses of the nonaromatizable anabolic steroid oxandrolone (up to 0.05 mg/kg per d) in an older child (>9 years).- Most physicians now choose to initiate low-dose estrogen therapy.
4
Renal malformations
Primary amenorrhea
Lymphedema
Tall stature
Medicine
Genetics
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multi
XDR means extensive drug resistance to
Ans. (d) All of the aboveRef.: K. Park 23rd ed. /199-200Definition of Extensive Drug Resistance* Resistance to both isoniazid (H) and rifampicin, and* Resistance to 1 fluoroquinolones and* Resistance to one 2nd line injectables out of 3 (kanamycin, amikacin, capreomycin).Older Definition of XDR* Resistance of isoniazid (H) and rifampicin both +* Resistance to any 3rd line drugs.Also Know*Multiple drug resistance (MDR) means resistance to resistance to isoniazid (H) and rifampicin (R).
4
H+R
1 Fluoroquinolone
Minimum of 1 injectable drug
All of the above
Social & Preventive Medicine
Tuberculosis
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multi
Which of the following statements about Insulinoma is true:
Answer is A (Present in Pancreas): The most common site of Insulinomas is the Pancreas.
1
Present in Pancreas
Mostly malignant
Surgery is usually not required
Usually multiple
Medicine
null
11bd6052-f6f2-4e4a-a49a-bae21b44f816
multi
Bitemporal hemianopic field defect is charactersitic of:
C i.e. Pituitary tumour
3
Glaucoma
Optic neuritis
Pituitary tumour
Retinal detachment
Ophthalmology
null
aa248a4e-b413-4c9a-9597-ed026c982967
single
A 62-year-old man develops scaling and non-scaling patches, and plaques over his chest and back. They are itchy, but not painful. The rest of the examination is normal, except for lymphadenopathy. Examinations of the blood film and skin biopsy histology, both, reveal unusually large monocytoid cells. Which of the following is the most likely diagnosis?
These large cells are typical of Sezary syndrome, a leukemic form of cutaneus T-cell lymphoma (CTCL). This is frequently an early presentation of mycosis fungoides or CTCL. There may be a relationship to human T-cell lymphotropic virus (HTLV) I and II, but it is not universal. CTCL is a malignancy of helper T cells (CD4+).
3
leukemia
visceral B-cell lymphoma
primary cutaneous T-cell lymphoma
viral infection (usually Epstein-Barr)
Medicine
Skin
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multi
In Endometrial carcinoma, which of the following tumor suppressor gene occurs?
o PTEN is a tumor suppressor gene which is implicated in the causation of endometrial and prostate carcinoma.
3
P53
Rb
PTEN
APC
Biochemistry
null
b4c5b684-0fd0-403b-8f4f-c8b305e21192
single
Which amino acid is regarded as collector of amino groups?
First step in catabolism of amino acids is the transfer of NH3 group from amino acid to Alpha Keto- Glutarate forming Glutamate- known as Transamination. So Glutamate is regarded as collector of amino groups. Note:-The safe non-toxic form of ammonia transpo in blood from most body tissues is Glutamine. Collector is Glutamate, transpoer is Glutamine
4
Aspaate
Arginine
Cysteine
Glutamate
Biochemistry
Urea cycle
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Breast conservation surgery is contraindicated in-
Ans. is 'a' i.e., Pregnancy Conservative breast cancer managementAbsolute ContraindicationsPregnancy is an absolute contraindication to the use of breast irradiation. However, in many cases, it may be possible to perform breast-conserving surgery in the third trimester and treat the patient with irradiation after delivery.Women with tw o or more primary tumors in separate quadrants of the breast or with diffuse malignant- appearing microcalcifications are not considered candidate for breast conservation treatment.A history of prior therapeutic irradiation to the breast region that would require retreatment to an excessively high total-radiation dose to a significant volume is another absolute contraindication.Persistent positive margins after reasonable surgical attempts.Relative ContraindicationsA history of collagen vascular disease is a relative contraindication to breast conservation treatment because published reports indicate that such patients tolerate irradiation poorly. Most radiation oncologists will not treat patients with scleroderma or active lupus erythematosus, considering it an absolute contraindication. In contrast, rheumatoid arthritis is not a relative or an absolute contraindication.The presence of multiple gross tumors in the same quadrant and indeterminate calcifications must be carefully assessed for suitability because studies in this area are not definitive.Tumor size is not an absolute contraindication to breast conservation treatment, although there is little published experience in treating patients with tumor sizes greater than four to five cm. However, a relative contraindication is the presence of a large tumor in a small breast in which an adequate resection would result in significant cosmetic alteration. In this circumstance, preoperative chemotherapy should be considered.Breast size can be a relative contraindication. Large pendulous breast is a relative contraindication, as it presents difficulty in delivering a uniform radiation dose.Centrally located tumor for which removal of the nipple areola complex is required to obtain a tumor free margin is a relative contraindication. It depends on patient acceptability. The nipple and areola can now be reconstructed.
1
Pregnancy
Axillary node involvement
Subareolar lump tnt
Large pendulous breast
Surgery
Breast Cancer - Treatments
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single
A child had pustular lesion on leg. On gram staining gram positive cocci are seen. To establish the diagnosis of Group A streptococcal erythroderma, the test used is?
Streptococcal erythroderma is caused by streptococcus pyogenes. Sensitivity to bacitracin is employed as a convenient method for differentiating str.pyogenes from other hemolytic streptococci. Pustule: A vesicle filled with leukocyte. Most common cause is virus. Most common bacterial cause is str.pyogenes. Str.pyogenes is the etiological agent in most of streptococcal skin infection. Vancomycin is the drug of choice. Ref: Ananthanarayan 7th Ed Page 205
4
Bile solubility test
Novobiocin sensitivity
Optochin sensitivity
Bacitracin sensitivity
Microbiology
null
1a345aef-3211-4f23-ae64-41a6bf7939c8
single
The term 'recrudescence' in malaria refers to:
Ans. c. Recurrence of sexual parasitemia after completion of treatment
3
Same as relapse in P.vivax and P ovale malaria
Resistance to antimalarial drugs
Recurrence of sexual parasitemia after completion of treatment
Reinfection with the same species
Microbiology
null
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single
A male with azoospermia. On examination size of testis normal FSH normal testosterone normal. Most probable cause is
A normal level of FSH in azoospermia suggests an obstructive lesion in the vas or epididymis. High FSH may indicate primary gonadal failure.
4
MAL descended testis
Klinefelter's syndrome
Kallmann's syndrome
VAS obstruction
Gynaecology & Obstetrics
null
05a49e26-6693-4e3f-a5fc-06ed9d5b65c4
multi
Reticulocytosis is not a feature of
Ref Harrison 19 th ed pg 630 Progressive CKD is usually associated with a moderate to severe hypoproliferative anemia; the level of the anemia corre- lates with the stage of CKD. Red cells are typically normocytic and normochromic, and reticulocytes are decreased.
4
Paroxysmal nocturnal hemoglobinuria
Following acute bleeding
Hereditary spherocytosis
Anemia in CRF
Anatomy
Haematology
92da265b-50b6-43db-82b0-7990d582fac9
single
Which of the following antimicrobial agents act solely on the gram positive bacterial cell wall ?
Ans. is 'd' i.e., Vancomycin o Among the given options only vancomycin acts on cell wall.
4
Ciprofloxacin
Gentamicin
Tetracycline
Vancomycin
Pharmacology
null
91320884-9a60-402b-8601-14e0b0db4739
multi
A patient presents to the emergency department with self-harm and indicates suicidal intent. Which of the following conditions does not warrant an immediate specialist assessment -
Serious physical illness, Formal thought disorders (Schizophrenia), social isolation (depression) and acute alcohol intoxication are all established risk factors for suicidal ideation / completed suicide and should be assessed by a mental health specialist. An accurate specialist assessment cannot, however, be performed on an intoxicated individual and hence immediate referral to mental health specialist is not warranted for such patients until the patient is sober.
2
Formal thought disorder
Acute alcohol intoxication
Chronic severe physical illness
Social isolation
Psychiatry
null
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Erb's paralysis involves -
Ans. is 'a' i.e., C5 C6ERB'S PARALYSISo One region of upper trunk (C? CJ of the brachial plexus is called Erb 'is point where six nerv es meet.Erb's pointo Injury at this point results in Erb's paralysis.o The injury is due to undue separation of the head from the shoulder, which may be seen in : -i) Birth injuryii) Fall on the shoulderiii) During AnesthesiaClinical features of Erb's palsyMuscles paralysed : Mainly biceps brachii, deltoid, branchialis and brachioradialis. Partly supraspinatus, infraspinatus and supinator. Deformity (position of the limb)Arm . Hanges by the side: it is adducted and medially rotatedForearm : Extended and pronatedThe deformity is known as 'policeman's tip hand' or "porter's tip hand'.C) Disability: The following movements are lost.o Abduction and lateral rotation of the arm (shoulder).o Flexion and supination of the forearm.o Biceps and supinator jerks are lost.o Sensations are lost over a small area over the lower part of the deltoid.
1
C5C6
C8T1
T1T2
None
Orthopaedics
Erb's Palsy
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Retropharyngeal space extends from base of skull to:
Retropharyngeal space: It lies behind the pharynxbetween the buccopharyngeal fascia covering pharyngeal constrictor muscles and the pre vertebral fascia. It extendsfrom the base of skull to the bifurcation of trachea. Thespace is divided into two lateral compartments (spaces ofGillette) by a fibrous raphe. Each lateral spacecontains retropharyngeal nodes which usually disappear at3-4 years of age. Parapharyngeal space communicates withthe retropharyngeal space. Infection of retropharyngealspace can pass down behind the oesophagus into themediastinum .
2
Hyoid bone
Bifurcation of trachea
Angle of mandible
Cricoid cartilage
Unknown
null
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Dennie Morgan folds are seen in
Ans. b (Atopic dermatitis) (Ref. H - 18th/pg. 52, 52)Half of patients with Atopic dermatitis (AD) present within the first year of life, and 80% present by 5 years of age. About 80% ultimately coexpress allergic rhinitis or asthma. The infantile pattern is characterized by weeping inflammatory patches and crusted plaques on the face, neck, and extensor surfaces. The childhood and adolescent pattern is marked by dermatitis of flexural skin, particularly in the antecubital and popliteal fossae. AD may resolve spontaneously, but approximately 40% of all individuals affected as children will have dermatitis in adult life. The distribution of lesions may be similar to those seen in childhood; however, adults frequently have localized disease, manifesting as lichen simplex chronicus or hand eczema (see below). In patients with localized disease, AD may be suspected because of a typical personal history, family history, or the presence of cutaneous stigmata of AD such as perioral pallor, an extra fold of skin beneath the lower eyelid (Dennie-Morgan folds), increased palmar skin markings, and an increased incidence of cutaneous infections, particularly with Staphylococcus aureus. Regardless of other manifestations, pruritus is a prominent characteristic of AD in all age groups and is exacerbated by dry skin. Many of the cutaneous findings in affected patients, such as lichenification, are secondary to rubbing and scratching.SKIN FEATURES OF ATOPIC DERMATITIS# Atopic Pleat (Dennie-Morgan fold): An extra fold of skin that develops under the eye.# Cheilitis: Inflammation of the skin on and around the lips.# Hyperlinear Palms: Increased number of skin creases on the palms.# Hyperpigmented Eyelids: Eyelids that have become darker in color from inflammation or hay fever.# Ichthyosis: Dry, rectangular scales on the skin.# Keratosis Pilaris: Small, rough bumps, generally on the face, upper arms, and thighs.# Lichenification: Thick, leathery skin resulting from constant scratching and rubbing.# Papules: Small raised bumps that may open when scratched and become crusty and infected.# Urticaria: Hives (red, raised bumps) that may occur after exposure to an allergen, at the beginning of flares, or after exercise or a hot bath.# White dermographism: excessive redness along line of stroke with thin objecteTYPES OF ECZEMA (DERMATITIS)# Allergic contact eczema (dermatitis): A red, itchy, weepy reaction where the skin has come into contact with a substance that the immune system recognizes as foreign, such as poison ivy or certain preservatives in creams and lotions.# Atopic dermatitis: A chronic skin disease characterized by itchy, inflamed skin.# Contact eczema: A localized reaction that includes redness, itching, and burning where the skin has come into contact with an allergen (an allergy-causing substance) or with an irritant such as an acid, a cleaning agent, or other chemical.# Dyshidrotic eczema: Irritation of the skin on the palms of hands and soles of the feet characterized by clear, deep blisters that itch and bum.# Neurodermatitis: Scaly patches of the skin on the head, lower legs, wrists, or forearms caused by a localized itch (such as an insect bite) that become intensely irritated when scratched.# Nummular eczema: Coin-shaped patches of irritated skin--most common on the arms, back, buttocks, and lower legs--that may be crusted, scaling, and extremely itchy.# Seborrheic eczema: Yellowish, oily, scaly patches of skin on the scalp, face, and occasionally other parts of the body.# Stasis dermatitis: A skin irritation on the lower legs, generally related to circulatory problems.
2
Lichen planus
Atopic dermatitis
Keratosis pilaris
Nummular eczema
Skin
Dermatitis Erythema
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The maximum ozone concentration in polluted atmosphere is dependent on the concentration and ratio of nitrogen oxides and which one of the following-
Ans. is 'c' i.e., Valate organic compounds Ground level ozone is formed from Nitrogen Oxides (NO) and valati le organic compounds (VOC), e.g., Methane
3
Carbon monoxide
Lead
Volate organic compounds
Sulphur dioxide
Social & Preventive Medicine
null
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All of the following causes decrease in BP except
Vasomotor discharges affect autoregulation.With sympathetic stimulation, the constant-flow, or plateau, pa of the pressure-flow curve is extended to the rightThat is, greater increases in pressure can occurSo, inhibition of vasomotor centre decreases sympathetic drive which results in decreased blood pressure. Vagal stimulation (parasympathetic) or sympathetic inhibition too have similar resultsRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No: 575
2
Inhibition of vasomotor centre
Disinhibition of vasomotor center
Vagal center Stimulation
Sympathetic inhibition
Physiology
Cardiovascular system
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In a case of acute exacerbation of asthma, salbutamol was given and no improvement noticed, intravenous corticosteroids and aminophylline was given and condition improved. What is the mechanism of corticosteroid in acute asthma?
ANS. ACorticosteroids has a dual effect in acute asthma with an early facilitatory effect on airway beta 2 adrenoreceptor sensitivity and a later effect on airway inflammation, which further emphasizes the need for corticosteroids to be administered as early as possible during an acute asthma attack.# Newer monoclonal antibodies in respiratory condition1. Pitakinra: IL-3 and 4 antagonist (used in bronchial asthma)2. Resilizumab: IL-5 antagonist (used in bronchial asthma)3. Mepolizumab: IL-5 blocker (useful in hypereisnophilic vasculitis)4. Omalizumab: Against IG E (in bronchial asthma)5. Pavilizumab: Used against respiratory syncitial virus (AIIMS November 2016).
1
Corticosteroid increase bronchial responsiveness to salbutamol
Corticosteroids cause direct bronchodilation when used with xanthines
Corticosteroids indirectly increase the effect of xanthines on adenosine receptor
Corticosteroids increase mucociliary clearance.
Pharmacology
Asthma
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Which of the following is a negative stain:
Ans. (a) Negrosin(Ref: Bancroft's histological techniques, 7th edition)Examples of negative stain are:*Negrosin: Stains bacteria, Cryptococcus, test for viability (sperms)*India Ink: Stains Cryptococcus
1
Negrosin
Fonatana
ZN stain
Albert stain
Pathology
Histo Pathology
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single
Primigravida with full term, complains of faintness on lying down and se feels well when turns to side or sitting position. This is due to:
SUPINE HYPOTENSION SYNDROME (POSTURAL HYPOTENSION): During late pregnancy, the gravid uterus produces a compression effect on the inferior vena cava when the patient is in supine position. In 90% cases this, however, results in opening up of the collateral circulation by means of paravertebral and azygos veins. In some cases (10%), when the collateral circulation fails to open up, the venous return of the heart may be seriously curtailed. This results in production of hypotension, tachycardia and syncope called as supine hypotensive syndrome. The normal blood pressure is quickly restored by turning the patient to lateral position. That is why pregnant females are advised to lie in lateral positions best being left lateral.
2
Increased abdominal pressure
IVC compression
Increased intracranial pressure
After heavy lunch
Gynaecology & Obstetrics
null
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Myotonic dystrophy is inherited in chromosomes -
Myotonic dystrophy is associated with a trinucleotide CTG repeat expansion on chromosome 9. This expansion affects the mRNA for the dystrophila myotonia protein kinase (DMPK). Myotonic dystrophy The characteristic feature of myotonic dystrophy is myotonia, i.e., the sustained involuntary contraction of a group of muscles. Of all the dystrophies, only myotonic dystrophy shows pathological changes in the intrafusal fibres of the muscle spindles. Extra-muscular abnormalities are : - Cataract       Frontal baldness Gonadal atrophy         DM Dementia             Decreased IgG
3
21
20
19
24
Pathology
null
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Kehr's sign seen in splenic rupture is -
null
1
Pain over left shoulder
Pain over right scapula
Periumbilical pain
Pain over renal angle
Surgery
null
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single
Deficiency of hypocretin leads to
Hypocretin is a neurotransmitter that promotes wakefulness and it's deficiency leads to Narcolepsy.
3
Somnambulism
Bruxism
Narcolepsy
Restless leg symdrome
Psychiatry
null
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single
Which of the element is found in the active site of glutathione peroxidase for its function?
In red blood cells, the pentose phosphate pathway is the sole source of NADPH for the reduction of oxidized glutathione catalyzed by glutathione reductase, a flavoprotein containing FAD. Reduced glutathione removes H2O2 in a reaction catalyzed by glutathione peroxidase, an enzyme that contains the selenium analog of cysteine (selenocysteine) at the active site. Ref: Bender D.A., Mayes P.A. (2011). Chapter 21. The Pentose Phosphate Pathway & Other Pathways of Hexose Metabolism. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.
4
Chromium
Manganese
Zinc
Selenium
Biochemistry
null
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single
Pulmonary vascular resistance is reduced by:
Acutely increasing pulmonary venous pressure will raise capillary pressure and result in recruitment and distension of the capillaries. The other choices are incorrect because removing one lung greatly reduces the vascular bed, 10% oxygen breathing results in hypoxic pulmonary vasoconstriction, reducing lung volume to residual volume increases the resistance of the extra-alveolar vessels, and mechanically ventilating the lung with positive pressure increases the alveolar pressure and therefore tends to compress the capillaries.
4
Removal of one lung
Breathing a 10% oxygen mixture
Exhaling from functional residual capacity to residual volume
Acutely increasing pulmonary venous pressure
Physiology
Respiratory System Pa 1
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All can cause pulmonary eosinophilia except-
Trichnella does not pass through the lungs during its life cycle. The other three pass through the lungs as a pa of their life cycle. They cause Loffler's syndrome - in which eosinophils accumilate in the lungs in response to parasitic infection. Strongyloides can also cause Loffler's syndrome. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition
2
Necator americanus
Trichinella spiralis
Ankylostoma duodenale
Ascaris lumbricoides
Microbiology
parasitology
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True about Standard Deviation Curve
(A) Mean = Median# STANDARD DEVIATION:> The standard deviation is the most frequently used measure of deviation. In simple terms, it is defined as 'Root -Means - Square- Deviation'.> SD is the "average" degree to which scores deviate from the mean.> More precisely, you measure how far all your measurements are from the mean, square each one, and add them all up. The result is called the variance.> Take the square root of the variance, and you have the standard deviation.
1
Mean = Median
Mean = 2 X Median
Median = variance
Standard deviation = 2 variance
Social & Preventive Medicine
Miscellaneous
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multi
Paris green is a -
Paris green or copper acetoarsenite is emerald green, microcrystalline powder practically insoluble in water. Paris green is a stomach poison and to be effective it must be ingested by larvae. Paris green kills anopheles larvae as they are surface feeders. Bottom feeding larvae are also killed when applied as special granular formulation. The recommended dose is 1 kg of actual Paris green per hectare of water surface. Paris green is a stomach poison used as an anti-larval measure to control mosquito. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 832
1
Stomach poison
Contact poison
Repellent
Rodenticide
Social & Preventive Medicine
Environment and health
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single
A patient in shock comes to you in trauma ward. You examine him and decide not to give him vasoconstrictors. Which is the type of shock your patient is having ?
Sympathomimetic drugs are indicated in all types of shock except secondary shock. In this condition, there is reflex vasoconstriction. Alpha blockers are useful in this type of shock.
3
Neurogenic shock
Haemorrhagic shock
Secondary shock
Hypotension due to spinal anaesthesia
Pharmacology
Sympathetic System
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single
Superior thyoid artery is a branch of -
Ans. is 'a' i.e., External carotid artery Branches of external carotid arteryFrom medial sideAscending pharyngealFrom frontSuperior thyroid arteryLingual arteryFacial arteryFrom behindOccipital arteryPosterior auricular arteryTerminal branchesSuperficial temporal arteryMaxillary artery
1
External carotid artery
Internal carotid artery
Common carotid artery
Arch of aorta
Anatomy
Head & Neck
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single
Hodgkin's lymphoma with lacunar cells is?
Ans. is 'b' i.e., Nodular sclerotic type Distinctive features of different types of HD1) Nodular sclerosis* It is the most common variant of HD. It is the only variant which is equally common in females and males (all other variants are more common in males). It occurs in adolescent and young adults. It frequently involves mediastinum.* Lacunar cells are seen on histology. It has excellent prognosis (2nd best after lymphyocytic predominance type). Reed-Sternberg cells are positive for CD 15 and CD 30. Fibrous bands are present which divide cellular areas into nodules : nodular sclerosis. Cellular components are lacunar cells, occasional RS cells, T-cells, eosinophils, plasma cells and macrophages.* It has no association with EBV (EBV negative).2) Mixed cellularity* It is the 2nd most common type overall, but the most common type of HD in India. It is more common in males and has biphasic age incidence (Bimodal age distribution), i.e. seen in young adults and in older age > 55 years.* Mononuclear variant along with clasical Reed-Sternberg cells are seen. RS cells are positive for CD 15 and CD 30.* It is associated with EBV (EBV positive).3) Lymphocyte rich* It is more common in males and is seen in older adults. It has frequent classical RS cells. RS cells are positive for CD 15 and CD 30. It is associated with EBV (EBVpositive). Prognosis is good to excellent.4) Lymphocyte depletion* It is more common in older males and HIV-infected individuals. Pleomorphic variants RS cells are seen, along with Hodgkin cells (atypical histiocytes). There is paucity of lymphocytes. It has maximum area of necrosis. Cells are positive for CD 15 and CD 30.* It has the worst prognosis. It is the least common type of HD.5) Lymphocytic predominance* It is more common in young males. Popcorn cells (Lympho-histocytic cells: L & H cells) are seen. Follicular dendritic cells are also seen. RS cells are positive for CD 20, but negative for CD 15 and CD 30.* It is not associated with EBV (EBV negative). It has the best prognosis. Mediastinal involvement may occur.
2
Mixed cellularity type
Nodular sclerotic type
Lymphocyte predominant type
Lymphocytic depletion type
Pathology
Neoplasia
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single
Crystallization and storage of insulin requires ?
Ans. is `b' i.e., Zn++ Zinc ions are essential for the formation of hexameric insulin and hormone crystallization. Following the synthesis of proinsulin, zinc promotes the formation of proinsulin hexamers and increases its solubility before conversion to insulin. Proinsulin binds 30 zinc ions, of which 2 to 4 are coordinated within the molecule. These zinc ions appear to be impoant for the solubility of proinsulin hexamers. With the removal of C-peptide from each proinsulin monomers, the resulting insulin increases its coordination of zinc to up to six ions per hexamer, which decreases its solubility and increases its crystallization within the secretory vesicle. The insulin, stored as crystalline hexamer, is resistant from proteolytic attack within the vesicle. Upon release of insulin into the bloodsteam, zinc is also released and the insulin becomes soluble in the blood.
2
Mn++
Zn++
Cu++
Ca++
Pharmacology
null
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multi
Genital elephantiasis is caused by-
Ans. is 'b' i.e., LGV o LGV is caused by chlamydia trachomatis, serotypes L1, L2, L3. Serotype L2 is the most common cause. The clinical course of LGV consist of following three stages:-1) First stage (Primary LGV):- Self limited, Single, asymptomatic, painless, nonbleeding genital ulcer.2) Secondary stage:- Painful inguinal lymphadenopathy (Remember - Ulcer is pain less but lymphodenopathy is tender & painful). Swollen lymph nodes coalesce to form bubos, i.e., matted lymph nodes. Buboes may rupture to form discharging sinus. Groove's sign - Enlarge lymph nodes both above and below inguinal ligament.3) Tertiary LGV (genitorectal syndrome):- Characterized by proctocolitis.o Complications of LGV1) Esthiomene -Enlargement, thickening and fibrosis of labia.2) Elephantiasis of the genitals3) Rectal stricture4) Systemic - Arthritis, pneumonitis, Perihepatitiso Frei's test was used for diagnosis (not used now)o Treatment - Doxycycline/tetracycline is DOC. Erythromycin is an alternative.
2
Herpes genitalis
LGV
Gonorrhea
Syphilis
Skin
S.T.D.
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In MRI the field used is
MR scans are obtained by placing the patient in a static magnetic field of 0.02 to 4 tesla (T) strength.
3
0.05 tesla
100 tesla
1.1 tesla
11 tesla
Radiology
null
111ddce1-dfec-4a94-be09-cf732a4277fe
single
Ribnotching of 4-9th ribs with double bulging is seen in :
Answer is C (Coarctation of Aoa) Rib notching and double bulge sign are characteristic radiological signs of coarcation of aoru Signs in coarctation of aoa Abnormal Aoic arch Commonest finding Site of narrowing may be seen as an identation. e Classic '3 signQ or double bulge sign' Q on left border of aoic shadow is formed by (above downwards) - prestenotic dilatation - coarctation itself (indentation) - poststenotic dilatation Inferior Rib notching Is a frequent sign in adults. It is not seen until late childhood. It is seen on the inferior margin of posterior halves of ribs from 3rd or 4th ribs downwards. Rib notching is due to enlargement of intercostal aeries which act as collateral vessels. These collateral vessels produce indentation, on the ribs at the above sites.
3
Aoic aneurysm
Aoic dessection
Co-arctation of aoa
Diaphragmatic hernia
Medicine
null
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single
ICDS does not include
null
3
Immunisation
Health education
Family planning
Nutrition
Social & Preventive Medicine
null
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single
The following are related to uterine souffle except :
Uterine souffle is due to increase in blood flow through the dilated uterine vessels.Reference:DC Dutta&;s Textbook of obstetrics,8th edition,page no:79
3
It is a soft blowing systolic murmur heard on the sides of pregnant uterus
The sound is synchronous with the maternal pulse
It is due to increased blood flow through the placental site
It can be heard even in a big fibroid
Gynaecology & Obstetrics
General obstetrics
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multi
The side effect of phenytoin when its plasma concentration is above therapeutic level is :
null
1
Ataxia
Gum hypertrophy
Osteomalacia
Hirsutism
Pharmacology
null
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multi
Apoptotic genes regulating programmed cell death type 2, autophagy is:
C i.e.BCL-2Ref: Genetic Home ReferenceExplanation:Autophagy:Autophagy is a process in which a cell eats its own contents (Greek: auto, self; phagy, eating).It involves the delivery of cytoplasmic materials to the lysosome for degradation.Autophagy is an adaptive response that is enhanced during nutrient deprivation, allowing the cell to cannibalize itself to survive.Autophagy can be categorized into three types:Chaperone-mediated autophagy (direct translocation across the lysosomal membrane by chaperone proteins).Microautophagy(inward invagination of lysosomal membrane for delivery).Macroautophagy (hereafter referred to as autophagy), the major form of autophagy involving the sequestration and transportation of portions of cytosol in a double-membrane bound autophagic vacuole (autophagosome).There are many genes and proteins involved in autophagy; BCL2 is one among the notable ones.
3
p53
BAX
BCL-2
None of the above
Pathology
Cellular Pathology
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multi
A 6-year-old boy is taken to a paediatrician because he has developed pain in his right hip. On physical examination, the doctor feels a large mass near the iliac crest. Plain X-ray films demonstrate a large lytic lesion of the ilium. MRI studies show that the tumor appears to arise in the bone, but extends into the adjacent soft tissues. A large incisional biopsy demonstrates a tumor composed of sheets of small, round, blue cells. Which of the following is the most likely diagnosis?
Ewing sarcoma is the second most common type of bone tumor (after osteosarcoma) in children and adolescents. The tumor is usually a lytic bone lesion, and often both invades the medullary cavity of the bone and extends into extraosseous tissues. Grossly, the tumor is often tan-white in color and shows focal areas of hemorrhage and necrosis. Microscopically, it is composed of sheets of small, round cells with scanty cytoplasm that may appear clear because of their glycogen content. Chondrosarcoma is composed of malignant hyaline and myxoid cailage. Giant cell tumor of bone contains multinucleated giant cells in a background of mononuclear stromal cells. Malignant fibrous histiocytoma has a background of spindled fibroblasts in a storiform pattern admixed with bizarre, multinucleated tumor giant cells.
2
Chondrosarcoma
Ewing sarcoma
Giant cell tumor of bone
Malignant fibrous histiocytoma
Surgery
null
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multi
Best mode to control leprosy eradication programme is -
<p> Early diagnosis and treatment. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:321. <\p>
2
Mass chemotherapy
Early diagnosis and treatment
High risk chemotherapy
Health education
Social & Preventive Medicine
Communicable diseases
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single
Polyribosyl ribitol phosphate PRP antigen is present in the capsule of H. influenzae
Capsular polysaccharide of serotype b has PRP antigen that is also used in vaccine preparation because of it's immunogenic propey.
2
Serotype a
Serotype b
Serotype c
Serotype d
Anatomy
Bacteriology
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single
Lower lip blood supply:
Ans. B Labial nasal arteryRef: Gray's Anatomy 41st ed. P 498* External carotid artery gives rise to facial artery branch, which has several branches over face.* Superior labial-supplies to upper lip and antero-inferior part of nasal septum.* Inferior labial-supplies to lower lip.* Lateral nasal-to the ala and dorsum of nose.* Angular-supplies the lacrimal sac and orbicularis oculi.
2
Angular artery
Lateral nasal artery
Labial artery
Greater palatine artery
Anatomy
Neuroanatomy
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single
The most common accessory pathways leading to WPW syndrome is:
Answer is A (Left free wall) Left free wall accessory pathways are most common. 'Left free wall accessary pathways are most common followed by posteroseptal, right free wall and anteroseptal locations ' -'Braunwald Hea Diseases: Review & Assessment' by Lilly (2012)/Q249 The most common accessary pathway connects the left atrium to the left ventricle followed by posterior septal, right free wall and anterior septal accessary pathways'
1
Left free wall
Posteroseptal
Right free wall
Anteroseptal
Medicine
null
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multi
Site for 1st order bone grafting -
Option a, b, c, d & e all can be used as a source of bone graft. However, most common and primary source of bone graft is iliac crest of pelvis.
1
Pelvis
Tibial metaphysis
Medial malleolus
Femoral condyle
Orthopaedics
null
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multi
Crocodile tears is due to
Crocodile tears or gustatory lacrimation is due to faulty regeneration of parasympathetic nerve fibres. Ref: Dhingra 6th edition pg. 98
4
Cross innervation of facial nerve fibers
Cross innervation of trigeminal nerve fibers
Improper regeneration of trigeminal nerve
Improper regeneration of facial nerve
ENT
Ear
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single
The hormone associated with cold adaption is
Thyroxine increases the metabolism.
2
Growth hormone
Thyroxine
Insulin
Melanocyte stimulating hormone
Physiology
null
a5d9f949-0cc1-4f57-aaaf-bb727e39ed3b
single
All of the following may occur in Down's syndrome except-
Ans. is 'b i.e., Undescended testis Undescended testis has not been described as an association with Down's syndrome.
2
Hypothyroidism
Undescended testis
Ventricular septa! defect
Brushfield's spots
Pediatrics
null
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multi
All are seen in malignant hyperthermia except –
There is tachycardia (not bradycardia).
1
Bradycardia
Hyperkalemia
Metabolic acidosis
Hypertension
Anaesthesia
null
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multi
Best diagnostic method for breast lump is ?
Ans is 'c' ie. Biopsy First investigation is -------> FNAC Best & the definitive investigation is -------> Open biopsy Preferred method -------> Core needle biopsy "Core-needle biopsy is the preferred method for diagnosis of palpable or nonpalpable breast abnormalities." - Schwaz 9/e p425 The diagnosis of breast cancer depends ultimately upon examination of tissue or cells removed by biopsy or FNAC (also known as FNA biopsy). The treatment should never be undeaken without a confirmed diagnosis of cancer. Thus a biopsy (biopsy includes all kinds of biopsy including FNA biopsy, also known as FNAC) should be done of all suspicious masses found on physical examination and in the absence of a mass of suspicious lesions demonstrated by mammography. A breast mass should not be followed without a biopsy. Exception to this is perhaps in the premenopausal woman with a nonsuspicious mass presumed to be fibrocystic disease. A lesion such as this could be observed through one or two menstrual cycles. However if the mass does not completely resolve during this time, it must be biopsied. For biopsy, FNAC (or FNAB) is the simplest method Schwaz writes - "The combination of diagnostic mammography, ultrasound or sterotactic localization and fine needle aspiration biopsy is almost 100% accurate in the diagnosis of breast cancer. However while FNA biopsy permits cytological evaluation, core-needle or open biopsy also permits the analysis of breast tissue architecture and allows the pathologist to determine whether invasive cancer is present. Core-needle biopsy is preferred over open biopsy for nonpalpable breast lesions because a single surgical procedure can be planned based on the results of the core biopsy. The advantages of core-needle biopsy include a low complication rate, avoidance of scarring, and a lower cost." CSDT writes? "Open biopsy under local anaesthesia as a separate procedure prior to deciding upon definitive treatment is the most reliable means of diagnosis."
3
USG
Mammogram
Biopsy
FNAC
Surgery
null
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Lignocaine can be used in all except-
Lignocaine Injection belongs to two groups of medicines known as local anaesthetics and antiarrhythmic drugs. Local anaesthetics stop pain and feeling in the area around where it is injected; antiarrhythmic drugs work by restoring irregular and/or rapid hea beats to normal.
4
Ventricular fibrillation
Spinal Anaesthesia
Epidural Anaesthesia
Convulsion
Anaesthesia
Regional Anesthesia
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Recommended contact period in chlorination -
Ans. is 'b' i.e., 1 hour Principles of chlorinationo Water should be clear and free of turbidity.o Chlorine demand of the water should be estimated, which is the amount of chlorine needed to destroy bacteria, oxidize all organic matter and neutrilize all ammonical substances present in water. The point at which the chlorine demand of water is met is called break point chlorination. If further chlorine is added beyond break point, free chlorine begins to appear in water
2
30 minutes
1 hour
2 hours
3 hours
Social & Preventive Medicine
Water
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single
Hyl's law is used to determine:-
Hyl's law: To detemine the sex of the sternum In males, the body is longer than twice the length of manubrium. In females, the body is shoer than twice the length of manubrium.
2
Ageing of skull
Sexing of sternum
Ageing of sternum
Sexing of skull
Forensic Medicine
Human identification
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single
The receptor through which M-tropic HIV strains bind
.
1
CCR5
CXCR4
CXCR5
Any of the above
Pathology
All India exam
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multi
All of the following are antioxidant except:September 2005
Ans. B: Vitamin BAntioxidants are a group of compounds that help to protect the body from the formation and elimination of free radicals. Free-radicals are formed from exposure to sunlight and pollution and also as a byproduct of cell metabolism. Alcohol, cigarette smoke, stress and even diet also affect the level of free-radical development in the body. Excellent antioxidants include Vitamin A, Vitamin E, Vitamin C, zinc, selenium, ginkgo biloba, grape seed extract, and green tea extract.
2
Vitamin A
Vitamin B
Vitamin C
Vitamin E
Social & Preventive Medicine
null
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multi
A six year old male baby presents to a hospital with recurrent gross hematuria for 2 years. There is no h/o burning mictuition or pyuria. Urine routine examination domonstrated no pus cells and urine culture was sterile. Serum c3 levels were normal. What is the most Probable diagnosis -
Wilms' tumor, also known as nephroblastoma, is a cancer of the kidneys that typically occurs in children, rarely in adults.It is named after Max Wilms, the German surgeon (1867-1918) who first described it Wilms' tumor has many causes, which can broadly be categorized as syndromic and non-syndromic. Syndromic causes of Wilms' tumor occur as a result of alterations to genes such as the Wilms Tumor 1 (WT1) or Wilms Tumor 2 (WT2) genes, and the tumor presents with a group of other signs and symptoms. Non-syndromic Wilms' tumor is not associated with other symptoms or pathologies. Many, but not all, cases of Wilms' tumor develop from nephrogenic rests, which are fragments of tissue in or around the kidney that develop before bih and become cancerous after bih. In paicular, cases of bilateral Wilms' tumor, as well as cases of Wilms' tumor derived from ceain genetic syndromes such as Denys-Drash syndrome, are strongly associated with nephrogenic rests. Most nephroblastomas are on one side of the body only and are found on both sides in less than 5% of cases, although people with Denys-Drash syndrome mostly have bilateral or multiple tumors. They tend to be encapsulated and vascularized tumors that do not cross the midline of the abdomen. In cases of metastasis it is usually to the lung. A rupture of Wilms' tumor puts the patient at risk of bleeding and peritoneal dissemination of the tumor. In such cases, surgical intervention by a surgeon who is experienced in the removal of such a fragile tumor is imperative. Pathologically, a triphasic nephroblastoma comprises three elements: blastema mesenchyme (stroma) epithelium Wilms' tumor is a malignant tumor containing metanephric blastema, stromal and epithelial derivatives. Characteristic is the presence of aboive tubules and glomeruli surrounded by a spindled cell stroma. The stroma may include striated muscle, cailage, bone, fat tissue, and fibrous tissue. Dysfunction is caused when the tumor compresses the normal kidney parenchyma. The mesenchymal component may include cells showing rhabdomyoid differentiation or malignancy (rhabdomyosarcomatous Wilms). Wilms' tumors may be separated into 2 prognostic groups based on pathologic characteristics: Favorable - Contains well developed components mentioned above Anaplastic - Contains diffuse anaplasia (poorly developed cells) Mutations of the WT1 gene on chromosome 11p13 are observed in approximately 20% of Wilms' tumors.At least half of the Wilms' tumors with mutations in WT1 also carry mutations in CTNNB1, the gene encoding the proto-oncogene beta-catenin Typical signs and symptoms of Wilms' tumor include the following: a painless, palpable abdominal mass loss of appetite abdominal pain fever nausea and vomiting blood in the urine (in about 20% of cases) high blood pressure in some cases (especially if synchronous or metachronous bilateral kidney involvement) Rarely as varicocele Ref Harrison20th edition pg 277
1
Wilm's tumour
IgA nephropathy
Post-strepcoccal glomerulonephritis
Urinary tract Infection
Medicine
Kidney
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Which of the following hazardous chemical is used as anti-knocking agent in gasoline:
Another prominent lead product was tetraethyl lead, a gasoline additive invented in 1921 to solve "knocking" problems that had become commonplace with the development of high compression engines operating at high temperatures. Soon after reaching its peak 50 years later, the use of this lead compound declined as the installation of catalytic conveers became mandatory on the exhaust systems of passenger cars and also by environment protection laws. Ref :
3
Arsenic
Asbestos
Lead
Mercury
Social & Preventive Medicine
null
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single
Maximum rise in Prolactin levels is seen with:
Risperidone is the single most likely Atypical Antipsychotic associated with a high likelihood of inducing Hyperprolactinemia. Amongst the options provided. Maximum rise in Prolactin levels is seen with Risperidone. With the exception of risperidone and paliperidone, atypical antipsychotic agents show limited (olanzapine, ziprasidone) to almost no effects (clozapine) on prolactin secretion. How does Risperidone Lead to Hyperprolactinaemia? Dopamine acts on the pituitary as an inhibitor of prolactin secretion. Blockade of dopamine D2 receptors by atypical antipyschotics most likely to induce hyperprolactinemia. Atypical Antipsychotics: Moderate to High Propensity to induce hyperprolactinemia: Risperidone Paliperidone Paliperidone is a 9-hydroxy active metabolite of risperidone. Little or Limited Propensity to induce hyperprolactinemia: Olanzapine Ziprasidone Quentiapine Asenapine Iloperidone Almost None or No Propensity to induce hyperprolactinemia: Clozapine Aripiprazole Ref: Goodman and Gilman 13th edition Pgno: 284
4
Clozapine
Olanzapine
Ziprasidone
Risperidone
Pharmacology
Central Nervous system
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single
Which of the following are the features of pernicious anemia?
Features of pernicious anemia: Hyper-segmented neutrophils Howell-Jolly bodies Megaloblasts Macro-ovalocytosis Ataxia, Subacute combined degeneration of spinal cord Increase levels of methyl malonyl CoA, homocysteine
4
Hyper-segmented neutrophils
Subacute combined degeneration of spinal cord
Gastric mucosal atrophy
All of the above
Pathology
Megaloblastic Anemia
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multi
Acute Papilloedema present with A/E:
C i.e. Severe loss of vision In papilloedema there is painless gradually progressive loss of vision (negligible ie usually not severeQ) which is usually bilateralQ which occurs after a long time only when optic atrophy sets in. So, Papilloedema ultimately leads to postneuritic optic atrophyQ and visual loss is not a feature of Acute Papilloedema
3
Post neuritic atrophy
Increase blind spot
Severe loss of vision
Hypermic field
Ophthalmology
null
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single
Soft contact lenses are made of
Soft contact lenses: Soft contact lenses are made up of HEMA (hydroxyethylmethacrylate) which is hydrophilic. Advantages : Being soft and oxygen permeable, they are most comfoable and so well tolerated. Disadvantages : Problems of proteinaceous deposits, getting cracked, limited life, inferior optical quality, more chances of corneal infections, and inability to correct astigmatism of more than one dioptre. Reference :- A K KHURANA; page:-564
2
Polymethyl methacrylate
Hydroxymethyl methacrylate
Silicone
Glass
Ophthalmology
Optics and refraction
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single
A 56-year-old woman diagnosed with cancer in her left breast underwent a mastectomy with axillary lymph node dissection. Postoperatively, she develops marked swelling of the left arm that has persisted for 6 months. Now on physical examination, her temperature is 36.9deg C. Her left arm is not tender or erythematous, and it is not painful with movement or to touch, but it is enlarged with a doughy consistency. Which of the following is the most likely mechanism for these findings?
The surgery disrupted lymphatic return, resulting in functional lymphatic obstruction and lymphedema of the arm. The lymphatic channels are important in scavenging fluid and protein that have leaked into the extravascular tissues from the intravascular compartment. Although the amount of fluid that is drained through the lymphatics is not great, it can build up gradually. Cellulitis is caused by an infection of the skin and subcutaneous tissue, and displays erythema, warmth, and tenderness. Congestive heart failure can lead to peripheral edema, which is most marked in dependent areas such as the lower extremities and over the sacrum (in bedridden patients). Decreased plasma oncotic pressure from hypoalbuminemia, or sodium and water retention with heart or renal failure, leads to more generalized edema. Phlebothrombosis leads to swelling with pain and tenderness, but it is uncommon in the upper extremities.
4
Cellulitis
Congestive heart failure
Decreased plasma oncotic pressure
Lymphedema
Pathology
Hemodynamics
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single
SCID which is true -
Ans. is 'a' i.e., .4denosine deaminase deficiency SODX-Linked recessiveAutosomal recessiveo Most common type of SC ID (50-60%)o Adenosine deaminase deficiencyo Mutation in the common y-chain(.Most common autosomal recessivesubunit of cytokine (IL-2) receptorsform of SCID) o Mutation in JAK - 3 o Mutation in recombinase - activating genes (RAG-1 or RAG-2) o Mutation in Class II MHC moleculeSevere combined immunodeficiencyo Severe combined immunodeficiency (SCID) syndrome is characterized by gross functional impairment of both humoral and cell mediated immunity.o Deficiency of ADA results in overproduction and accumulation of deoxyadenosine which is converted to dAMP, dADP & dATP. dATP is a powerful inhibitor of ribonucleotide reductase,o Thus, it deprives the cell of precursor deoxyribmolecules for DNA synthesis., resulting in apoptosis of lymphocytes.Clinical manifestationso Infants present with prominent thrush (oral candidiasis), extensive diaper rash, and failure to thrive,o Recurrent infection with Candida albicans, P.carinii, Pseudomonas, CMV, varicella and bacteria,o All patients with SCID have very small thymuses( < lgm) that usually fail to descend from the neck, contain no thymocytes and lack corticomeduilary distinction or Hassall corpuscles.o Both the follicular and paracortical areas of the spleen are depleted of lymphocytes,o Lymph nodes, tonsils, adenoids andpeyerspatches are absent or extremely underdeveloped,o Children with SCID rarely survive beyond 1 year and do not tolerate live vaccines.o The only available treatment is bone marrow transplantation. Gene therapy has been successful in X-linked SCID.o In autosomal recessive ( ADA deficiency ) there is rib cage abnormalities simitar to a rachitic rosary and chondroosseous dysplasia, which occur predominantly in the vertebral bodies where a 'bone-in- bone' effect is observed.
1
Adenosine deaminase deficiency
Decreased circulating lymphocytes
NADPH oxidase deficiency
Cl esterase dificiency
Pathology
Disease of Infancy & Childhood
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Which fungicide is used as a spray for the control of bagassosis-
- bagassosis is the occupational disease of lung caused by inhalation of sugarcane dust. - it is caused due to a thermophilic actinomycete, Thermoactinomyces sacchari. - preventive measures include bagasse control done by keeping the moisture content above 20 percent and spraying the bagasse with 2 percent propionic acid, a widely fungicide. Reference: Park's textbook of preventive and social medicine, 23rd edition, pg no:807 <\p>
3
2% acetic acid
2% formic acid
2% propionic acid
25% pmhenyl mercury
Social & Preventive Medicine
Hospital waste and disaster management, Occupational health
62ea3325-fc62-4e29-884d-da5135d4dfde
single
Pellegra deficiency of -
Ans. is 'a' i.e., Niacin Beri-berio Deficiency of thiamine (Vit Bl)o Can be dry (neural involvement)o Wet (cardiac involvent)o AcutePellagrao Niacin (Vit B3) defo Dermatitiso Diarrheao Dementia
1
Niacin
Thiamine
Riboflavin
Folate
Pediatrics
Micronutrient Mineral Deficiencies
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single
A 33-year-old woman has had fever and increasing fatigue for the past 2 months. Over the past year, she has noticed the soreness of her muscles and joints and has had a 4-kg weight loss. On physical examination, her temperature is 37.5degC, pulse is 80/min, respirations are 15/min, and blood pressure is 145/95 mm Hg. She has pain on deep inspiration, and a friction rub is heard on auscultation of the chest. Laboratory findings show glucose, 73 mg/dL; total protein, 5.2 g/dL; albumin, 2.9 g/dL; and creatinine, 2.4 mg/dL. Serum complement levels are decreased. CBC shows hemoglobin of 9.7 g /dL, platelet count of 85,000/mm3, and WBC count of 3560/mm3. A renal biopsy specimen shows diffuse proliferative glomerulonephritis with extensive granular immune deposits of IgG and C1q in capillary loops and mesangium. After being treated with immunosuppressive therapy consisting of prednisone and cyclophosphamide, her condition improves. Which of the following serologic studies is most likely to be positive in this patient?
Lupus nephritis is one manifestation of systemic problems related to immune complex deposition, including fever, arthralgias, myalgias, pancytopenia, and serositis with pericarditis and pleuritis, which are characteristic of systemic lupus erythematosus (SLE). Renal disease is common in SLE, and a renal biopsy helps to determine the severity of involvement and the appropriate therapy. Anti-centromere antibody is most specific for limited scleroderma (formerly CREST syndrome), which is unlikely to have renal involvement. Anti-DNA topoisomerase I antibody is more specific for diffuse scleroderma, which does have renal involvement, although usually, this manifests as vascular disease and not as glomerulonephritis. The anti-glomerular basement membrane antibody is characteristic of Goodpasture syndrome, in which the IgG antibody is deposited in a linear fashion along glomerular capillary basement membranes. Anti-histone antibody may be present in drug-induced lupus. ANCAs can be seen in some forms of vasculitis, such as ANCA-associated granulomatous vasculitis or microscopic polyangiitis. Antiribonucleoprotein is present in mixed connective tissue disease, which has some features of SLE but usually does not include severe renal involvement.
3
Anti centromere antibody
Anti-DNA topoisomerase I antibody
Anti-double-stranded DNA antibody
Anti-glomerular basement membrane antibody
Pathology
Kidney
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single
Sudden onset of cough followed by increasing dyspnea is characteristic of
PatientsMC presents with chest pain, often sharp and pleuritic and may lead to severe respiratory embarrassment or becomes dull and persistent.Dyspnea is the 2nd MC symptom.Less common symptoms include a nonproductive cough and ohopnea.Physical findings may be normal if the Pneumothorax is less than 25%.Characteristic physical finding includes diminished chest excursion and (Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2181, 2221, 3212)
4
Pleural effusion
Lobar pneumonia
Myocardial infarct
Pneumothorax
Pathology
All India exam
a2526611-906c-4455-ac54-adffd8e24a35
single
Spider leg appearence is seen in:
Ans: A (Adult polycystic kidney disease) Ref: Harrison's online. 18th ed.Explanation:Some important features in Contrast RadiographsSpider leg appearance -- Polycystic kidneyCobra head appearance -- UreteroceleFlower vase appearance of ureters -- Horse shoe kidnexSandy patches -- Schistosomiasis of bladderSoap bubble appearance -- HydronephrosisApple core lesion on barium -- Ca colonClaw appearance on barium enema -- IntussusceptionSaw tooth appearance -- Diverticula of colonBirds beak appearance of esophagus on barium meal -- AchalasiaCork screw appearance of esophagus on barium meal -- Diffuse esophageal spasmString sign of kantor-- Crohn's disseaseThumb printing sign -- Ischemic colitisEGG SHELL CALCIFICATION -- Silicosis. Sarcoidosis. Scleroderma. Histoplasmosis, Amyloidosis, lymphoma following radiotherapy
1
Adult polycystic kidney disease
Wilm's Tumor
Horse shoe kidney
Vesicoureteral reflux
Radiology
CT and MRI of the Kidney
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single
Pseudo bubo is seen in ?
Ans. is 'a' i.e., Donovanosis
1
Donovanosis
LGV
Chancroid
Leprosy
Skin
null
ac868315-3d89-403b-8e38-31bdcd44c6fb
single
Erysipeloid is transmitted by
ERYSIPELOID Caused by Erysipelothrix rhusiopathiae present on dead animal matter (swine) Transmitted by contact with animal Presents as pain, swelling and purplish erythema at the site of inoculation Causes Whale finger Penicillin - DOC
4
Droplet
Feco-oral Mosquito bite
Mosquito bite
Contact with animal
Dental
Bacterial infections
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single
Indirect hyperbilirubinemia are seen in ?
Ans is 'c' i.e., Gilbe syndrome
3
Dubin-Johnson syndrome
Rotor syndrome
Gilbe syndrome
Gallstone
Pediatrics
null
4801e2ae-44db-492f-b02b-db74e841a52b
multi
The following are true for Bordetella pertussis except:
Ans. is 'd' i.e., Infection can be prevented by a acellular vaccineRef: (Harrison, 19th/e, p. 1021 and Ananthanarayan, 9th/e, p. 333)Vaccine prevents disease not infection.
4
It is a strict human Pathogen
It can be cultured from the patient during catarrahal stage
It leads to invasion of the respiratory mucosa
Infection can be prevented by a acellular vaccine
Microbiology
Bacteria
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