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A 53-year-old woman who is being treated for metastatic breast cancer is noted to have some lethargy, fatigue, and an elevated serum calcium level. She is brought into the ER for near comatose state, thought to be caused by the hypercalcemia. After addressing the ABCs (airway, breathing, circulation), wof is the best therapy for this patient
|
Hypercalcaemia of malignancy:- Severe hypercalcaemia, a common complication of malignancy, is a medical emergency with altered consciousness. Treatment:- Pamidronate or zoledronate are the most effective drugs, but take 24-48 hours to act. They may be supplemented by i.m. calcitonin 6-12 hourly for 2 days to achieve rapid action. Vigorous i.v. hydration is instituted first. After volume repletion, furosemide is added to enhance Ca2+ excretion and to prevent volume overload. This is followed by BPN infusion. This therapy reduces serum calcium within few hours and corrects the attending dehydration. Oral BPNs are not useful. Coicosteroids also lower plasma Ca2+, but are slow to act, take 1-2 weeks. Ref:- kd tripathi; pg num:-344
| 3 |
Bisphosphonates
|
IV estrogen therapy
|
Saline infusion and furosemide
|
Vitamin D
|
Pharmacology
|
Endocrinology
|
d293b701-c3b4-41c6-aaa1-df01ed50c010
|
single
|
True statement among the following
|
Other high yielding pointsI127 is stable iodine isotopeI-131 Has half-life of 8 daysThe gamma-emitting isotopes iodine-123 (half-life 13 hours) used as nuclear imaging tracers to evaluate the anatomic and physiologic function of the thyroid. Iodine-125 is commonly used by radiation oncologists in low dose rate brachytherapy in the treatment of cancer at sites other than the thyroid, especially in prostate cancer. When I-125 is used therapeutically, it is encapsulated in titanium seeds and implanted in the area of a tumour, where it remains. The low energy of the gamma spectrum, in this case, limits radiation damage to tissues far from the implanted capsule. Iodine-125, due to its suitable longer half-life and less penetrating gamma spectrum, is also often preferred for laboratory tests that rely on iodine as a tracer that is counted by a gamma counter, such as in radioimmunoassaying
| 1 |
Half life of I125 is 60 days
|
Half life of I131 is 12 days
|
I131 is used in RIA for thyroid hormones
|
I125 is preferred over 123 for thyroid scan
|
Microbiology
|
All India exam
|
30fa6dd8-3d15-4273-afb4-a2558813d23c
|
multi
|
About Head's paradoxical reflex, which of the following fact is TRUE?
|
Head's paradoxical reflex: Inflation of lungs, under ceain conditions, enhances inspiratory activity. Since inflation induces fuher inflation of lungs, the reflex is considered paradoxical. The vagal fibers mediating Head's paradoxical reflex carry information originating in receptors present in lungs. This reflex has a role in initiation of respiration at bih. Ref: Understanding Medical Physiology By R.L. Bijlani, M.D., RL Bijlani MD SM DSc (Hon Causa) FAMS, S. Manjunatha, M.D., 2010, Page 245.
| 1 |
It plays an impoant role in normal respiration
|
It is mediated by tracheobronchial-stretch receptors
|
It is stimulated by hyperinflation of lungs
|
It inhibits respiration
|
Physiology
| null |
7aff6d14-e114-43b0-8599-5ae1210d56c3
|
multi
|
Nevirapine is -
|
Ans is 'b' i.e., NNRTI o Nevirapine is NNRTIThese drugs inhibit reverse transcriptase by acting at a site (allosteric site) different from NRTIs.These are selective for HIV-1 and have no activity against HIV-2.Resistance to these drugs develops very rapidly.o NNRI drug groupEfavirenz, nevirapine, etravirtue and delavirdine,o Mechanism of action :These are nucleotide unrelated compounds which directly inhibit HIV reverse transcriptase without the need for intracellular phosphory-lation.Adverse effectsRashes (Steven Johnson Syndrome & Toxic epidermal necrolysis)NauseaHeadach, FeverRise in live enzyme (hepatotoxic)o Nevirapine is used in pregnancy to prevent vertical transmission.o It decrease transmission to 13% as compared to 21.5% by zidovudine.o NNRTI donot cause lipodystrophy like NRTIs and RTIs# Nevirapine and efavirenz are enzyme inducers and delaviridine is enzyme inhibitor.
| 2 |
NRTI
|
NNRTI
|
E-TI
|
FI
|
Pharmacology
|
Anti-Viral
|
af9649bd-3d9f-45fa-b457-9c532ef17aaf
|
single
|
Not true about viral envelop?
|
Ans. is 'd' i.e., Propagates in next generation Envelope is lipoprotein in nature, lipid is derived from host cell, while protein is virus coded. Enveloped viruses are susceptible to the action of lipid solvents like ether, chloroform and bile salts. Envelop is not propagated in next generation. Rather progeny virions synthesize new envelop (by self protein and host lipid).
| 4 |
Lipid is derived from host cells
|
Protein is derived from virus itself
|
Dissolves in solvent
|
Propagates in next generation
|
Microbiology
| null |
629e4caf-feb3-4dbe-b525-480caf1fe130
|
multi
|
Incompletly descended testis is commonest on?
|
Ans. is 'a' i.e., Right side
| 1 |
Right side
|
Left side
|
Both side
|
Right sided only
|
Surgery
| null |
85f46bca-9c46-4208-935a-833a92638951
|
multi
|
Vein of Galen drains into
|
The vein of Galen,also known as the great cerebral vein or great vein of Galen is a single median vein.It is formed by union of the two internal cerebral veins.It terminates in the straight sinus.Its tributaries include the basal veins,and veins from the pineal body,the colliculi,the cerebellum,and the adjoining pa of the occipital lobes of the cerebrum. REF.B D Chaurasia's Human Anatomy,Vol 3,Fifth edition,Pg 448
| 3 |
Internal jugular vein
|
External jugular vein
|
Straight sinus
|
Superior sagittal sinus
|
Anatomy
|
Brain
|
4de0b7ea-e294-4b8d-9707-d7dd530df7b0
|
single
|
As per immunisation schdule, Hepatitis A vaccine is recommended at:
|
2 years
| 2 |
1 year
|
2 years
|
5 years
|
10 years
|
Social & Preventive Medicine
| null |
ba2d3a4d-b94d-4cae-857e-aa61dc702b1c
|
single
|
Which of the following agents do not act via GABAA-cl – channel complex receptors
| null | 4 |
Zopiclone.
|
Benzodiazepines.
|
Thiopentone.
|
Promethazine.
|
Pharmacology
| null |
074ec9cc-0b69-4e7e-8a61-861bac073b5d
|
single
|
Which drug is contraindicated in pregnancy ?
|
Captopril
| 3 |
Methyldopa
|
Hydralazine
|
Captopril
|
All of the above
|
Gynaecology & Obstetrics
| null |
7ac471df-52bd-4e71-a9e3-e8ca486edef3
|
multi
|
All of the following statements about penicillin-binding proteins are true EXCEPT :
|
Beta-lactam antibiotics act by inhibiting the cross-linking of peptidoglycan chains in the bacterial cell wall. This action is carried out by transpeptidase enzyme. Transpeptidases and similar enzymes involved in cross-linking are called penicillin-binding proteins (PBPs). All beta-lactam antibiotics bind to PBPs and inhibit cell wall synthesis.
The drugs in p-lactam category are:
Penicillin
Cephalosporins
Carbapenems e.g imipenem
Monobactam e.g. aztreonam
Mutation in PBPs is an important cause of methicillin resistance in Staphylococcus aureus.
Vancomycin does not bind to PBPs but acts by inhibiting transglycosylase.
| 3 |
Present on cell surface
|
Mutation in PBPs gives rise to resistance
|
These are target site of vancomycin
|
These are targeted by imipenem
|
Pharmacology
| null |
a1b623ce-9859-4254-b22f-c65c8f70e0cb
|
multi
|
Antiepileptic drug not associated with enzyme induction or inhibition propey is ?
|
Ans. is 'd' i.e., Ethosuximide
| 4 |
Phenytoin
|
Valproate
|
Carbamazepine
|
Ethosuximide
|
Pharmacology
| null |
d0131852-8d01-44a1-bf4a-046d76ce319c
|
single
|
Mobile eye care services are not done at which level
| null | 2 |
Primary care level
|
Tertiary care
|
Secondary care
|
District hospitals
|
Social & Preventive Medicine
| null |
7a59dd15-c44a-40d0-a322-f273ac6ef426
|
single
|
All are true about anthropometric measurements except:-
|
Standing height is about 0.7 cm less than recumbent length. If a child < 2 years old, measure recumbent length- Infantometer If >= 2-year age and able to stand, measure standing height- Stadiometer
| 4 |
Bih weight triples by 1 year
|
Skinfold thickness is measured in sub scapular region
|
Weight is measured to the nearest 100 gram
|
Standing height is about 2.5 cm more than recumbent length
|
Pediatrics
|
Growth
|
5720b369-815c-4deb-83ba-e5a2e79ff192
|
multi
|
With which of the following of viral hepatitis infection in pegnancy, the maternal moality is highest ?
|
Ans. is 'd' i.e., Hepatitis E A unique feature of Hepatitis E is the clinical severity and high case fatality rate (20-40%) when it affects pregnant women, especially in last trimester.
| 4 |
Hepatitis A
|
Hepatitis B
|
Hepatitis C
|
Hepatitis E
|
Microbiology
| null |
6e813485-a6bc-4339-a1cf-900fcb4d0aca
|
single
|
DOC for primary open angle glaucoma is
|
Latanoprost-pgf2 alpha is the DOC for primary open angle glaucoma while acetazolamide is the DOC for acute congestive glaucoma Ref: KDT 6th ed pg 139-140
| 4 |
Beta-blockers
|
CA inhibitors
|
Miotics
|
PG analogues
|
Pharmacology
|
Autonomic nervous system
|
775c3149-327d-4fd3-91c1-d7a0dbd95482
|
single
|
The post-operative quality of life (QOL) scores of 200 prostate cancer patients has a mean of 60 and a standard deviation of 10. How many patients are expected to have a QOL score between 40 and 80?
|
The values enclosed in a normal distribution curve are:
| 1 |
190
|
136
|
120
|
140
|
Unknown
| null |
aa47507a-ca29-44bb-b111-d6ac5a88232b
|
single
|
All of the following structures are normally palpable upon vaginal examination Except the:
|
Normally, the sacral promontory is too distant to be palpable on vaginal examination. If the sacral promontory is palpable, this indicates that the conjugate diameter of the pelvis is smaller than normal, and a normal vaginal delivery may not be possible. The ischial spines are palpable. This landmark is used for administering a pudendal nerve block. The pudendal nerve wraps around the ischial spine and sacrospinous ligament. The rectouterine pouch is palpable through the wall of the posterior fornix of the vagina. The ovary and uterine tubes are palpable in the broad ligament.
| 4 |
Uterine tubes
|
Ovary
|
Rectouterine pouch
|
Sacral promontory
|
Gynaecology & Obstetrics
|
General obstetrics
|
389b8866-8626-43e2-bd1e-e74afbc52a19
|
multi
|
A 65 years old man presenting with complaints of chest pain, fever, cough with sputum. O/E of sputum, pus cells with gram positive cocci present. Blood agar showed positive result. How will you differentiate this from other gram positive cocci?a) Bacitracinb) Optochin sensitivityc) Bile solubilityd) Coagulase positivity
| null | 2 |
a
|
bc
|
ac
|
ad
|
Microbiology
| null |
96a9a968-a34c-4592-891b-8b419bc3bd6e
|
single
|
A 32-year-old woman with poorly controlled diabetes mellitus delivers a healthy boy at 38 weeks of gestation. As a result of maternal hyperglycemia during pregnancy, pancreatic islets in the neonate would be expected to show which of the following morphologic responses to injury?
|
Hyperplasia Infants of diabetic mothers show a 5% to 10% incidence of major developmental abnormalities, including anomalies of the hea and great vessels and neural tube defects. During fetal development, the islet cells of the pancreas have the proliferative capacity and respond to increased demand for insulin by undergoing physiologic hyperplasia. Fetus may develop hyperplasia of the pancreatic b cells, which may secrete insulin autonomously and cause hypoglycemia at bih. -Metaplasia (choice D) is defined as the conversion of one differentiated cell pathway to another. Diagnosis: Diabetes mellitus
| 3 |
Atrophy
|
Dysplasia
|
Hyperplasia
|
Metaplasia
|
Pathology
|
Basic Concepts
|
04874b42-892f-4efe-ad82-e4fb40818c4b
|
single
|
Which of the following is not given in acute severe digitalis toxicity?
|
Ref-KDT 6/e p499 Hypokalemia precipitates digtals toxicity but in acute severe digtalis toxicity, there Is already hyperkalenia.
| 1 |
Potassium
|
Digibind
|
Lignocaine
|
None of these
|
Anatomy
|
Other topics and Adverse effects
|
01e10cc5-daa9-4613-8cc7-867d0fca4d6b
|
multi
|
Which of the following is transfused in a patient who has severe burn injuries?
| null | 2 |
Blood
|
Plasma
|
Platelets
|
Erythrocytes
|
Surgery
| null |
bc250e6a-6e80-433b-bb03-cc2cf4a28ebe
|
single
|
Black gun powder composition -
|
The synopsis of forensic medicine & toxicology ; Dr k.s narayan reddy ; 28th edition ; Pg.no. 125 Fine grains travel 60cm or more ,one gram of powder produces 3,000-4,500c.c of gas
| 3 |
Carcoal 60% + Potassium nitrate 20% + sulphur 20%
|
Charcoal 25% + Potassium nitrate 70% + sulphur 05%
|
Charcoal 15% + Potassium nitrate 75% + sulphur 10%
|
Charcoal 65% + Potassium nitrate 20% + sulphur 15%
|
Forensic Medicine
|
Mechanical injuries
|
37926254-2d03-4b64-98b3-e165f94e2a49
|
single
|
The best example of a proto-oncogene activated by point mutation is -
| null | 1 |
Ras
|
N-myc
|
L-myc
|
Abl
|
Pathology
| null |
f4a629a1-acb2-4efc-a2db-6f9a267f9c8d
|
single
|
Metalloproteins help in jaundice by the following mechanism :
|
B i.e. Inhibit heme oxygenaseTin & Zn porphyrins and mesoporphyrins inhibits the activity of heme oxygenase Q and decrease formation of bilirubin Best method for Estimation of .Hb come in blood is - Cyanmethhemoglobin methodQ
| 2 |
Increased glucoronyl transferase activity
|
Inhibit heme oxygenase
|
Decrease RBC lysis
|
Increase Y and Z receptors
|
Physiology
| null |
f1d5675e-9067-4a21-a5b1-17e22be99a02
|
multi
|
Features of trigeminal neuralgia do not include
|
Trigeminal neuralgia is an archetype of orofacial neuralgias that follows the anatomic distribution of fifth nerve that exhibits a trigger zone, stimulation of which initiates a paroxysm of pain. It is characterised by paroxysmal, excruciating pain in trigeminal dermatornes. Latency (refers to the short time period between stimulation of a trigger area and pain onset) and refractory period (occurs following an attack and during this time pain may not be initiated) are other 2 attack related phenomena related to TN.
| 1 |
Paresthesia
|
Paroxysmal pain
|
Refractory period
|
Presence of trigger zone
|
Pathology
| null |
6a2a08ac-58cf-4094-ad80-bfa82551317d
|
single
|
Middle cerebellar peduncle transmits fibres of
|
A. i.e. Pontocerebellar pathway
| 1 |
Ponto cerebellar pathway
|
Tectospinal pathway
|
Spinocerebellar pathway
|
Olivo cerebellar pathway
|
Anatomy
| null |
e31d24f7-a3dd-4dc2-a296-db8ecd38256c
|
single
|
BPF (Brazilian purpuric fever) is caused by:
|
H. aegyptius:
→ Identical to non-capsulated H.influenza, now named as H.influenza biotype aegyptius.
→ Causes highly contagious form of conjunctivitis (PINK EYE) and Brazilian purpuric fever.
→ BPF (Brazilian purpuric fever): Conjunctivitis proceeding to fulminant septicemia in infants and children with high fatality.
| 1 |
H.influenzae biotype aegyptius
|
V. cholerae
|
Salmonella
|
None of the above
|
Microbiology
| null |
4e34c637-7ad0-40c3-baed-d16d28c5a2da
|
multi
|
Structures preserved in functional radical dissection of the neck, except
| null | 3 |
Internal jugular vein
|
Sternomastoid
|
Lymph nodes
|
Accessory nerve
|
Surgery
| null |
51417339-3dfd-4b92-b317-b4b5719003b0
|
multi
|
The proximal pa of the aoa is derived from which of the following?
|
Proximal pa / arch of aoa is fromed by: 1. Left horn of aoic sac 2. Left 4th phyrangeal arch aery 3. Left dorsal aoa - Neural crest cells migrate to truncus aeriousus and forms AP septum (spiral septum) which divides Truncus into anterior Aoa and posterior Pulmonary trunk. Thus the proximal pa of the aoa is derived from the truncus aeriosus. - From truncus aeriosus develops aoic sac with left and right horns . - Truncus aeriosus forms the outflow tract and blood is pumped by hea into phrangeal arch aeries and dorsal aoa
| 1 |
Truncus aeriosus
|
Bulbus cordis
|
Primitive ventricle
|
Primitive atrium
|
Anatomy
|
Bronchopulmonary Segments, Embryonic veins
|
63eaec8c-654a-4838-8b8b-5edc60997a9c
|
single
|
Elements of primary heath care are the following except-
|
Ans. is 'c' i.e., Cost effictiveness
| 3 |
Health education
|
Intersectoral coordination
|
Cost effectiveness
|
Provision of essential drugs
|
Social & Preventive Medicine
| null |
bb66faee-977a-4cc4-b204-702019f83896
|
multi
|
Primary sinusoidal dilatation of liver is also known as
|
Peliosis hepatis is an uncommon vascular condition characterised by multiple, randomly distributed, blood-filled cavities throughout the liver. The size of the cavities usually ranges between a few millimetres and 3 cm in diameter. In the past, it was a mere histological curiosity occasionally found at autopsies, but has been increasingly recognised with wide-ranging conditions from AIDS to the use of anabolic steroids. It also occasionally affects spleen, lymph nodes, lungs, kidneys, adrenal glands, bone marrow, and other pas of gastrointestinal tract.
| 2 |
Hepar lobatum
|
Peliosis hepatic
|
Von-Meyerburg complex
|
Caroli's disease
|
Anatomy
|
G.I.T
|
6abbe3eb-6d7b-40d8-ad84-42162c42f857
|
single
|
True about helicobacter pylori are all except ?
|
Ans. is 'd' i.e., It provides life long immunity . There is no effective immunity against H. pylori infection. The immune response to H. pylon includes both the production of antibody (local and systemic) and a cell-mediated response but is ineffective in clearing the bacterium. . H. Pylori has a protective role against gastroesophageal reflux disease (GERD) and adenocarcinoma of the esophagus and gastric cardia. . Antral predominant gastritis is most closely linked with duodenal ulceration, whereas pangastritis is linked with gastric ulceration and adenocarcinoma. Antral gastritis --> duodenal ulcer Pangastritis --> Gastric ulcer Gastric adenocarcinoma . IL - 1 fi is the major proinflammatory cytokine in peptic ulcer disease. About other options . Urea breath test is the most consistently accurate test. . H. pylori is a gram negative, flagellate bacillus which is motile by lophotrichous flagella.
| 4 |
Urea breath test is diagnostic
|
Gram negative, flagellate bacilli
|
Risk factor for development of adenocarcinoma of stomach
|
It provides life long immunity
|
Microbiology
| null |
214e6d48-2c2a-41f5-8516-bbd0d8ef53fd
|
multi
|
Necrosis of PCT is caused by
|
Action of phenol phenol has both local and systemic action. Locally city acts as a corrosive and after absorption it possesses necrotic effects. Phenol is protoplasmic poison. It combines with proteins and denatures it. It deeply penetrates the tissues and produces necrosis. After absorption it causes capillary damage and clotting in superficial vessels. It also acts on the CNS, hea and kidney. It affects the proximal convoluted tubules and causes renal failure. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 413
| 2 |
Arsenic
|
Phenol
|
Alcohol
|
Amantia
|
Forensic Medicine
|
Poisoning
|
332756c6-998c-4b75-87b9-96f0aee0d649
|
single
|
In spinal anaesthesia, the needle is piereced upto –
|
In spinal anesthesia LA is injected into subarachnoid space (space between pia matter and arachnoid matter).
| 4 |
Subdural space
|
Extradural space
|
Epidural space
|
Subarachnoid space
|
Anaesthesia
| null |
ace1f0f1-ba7e-464d-bbc7-d4f71cb6d07d
|
single
|
A third gravida is admitted with complaint of sudden onset right sided lower abdominal pain after a period of 5-week amenorrhea. Her PR is 130 and BP is 80/50 mmHg. TVS reveals large amount of free fluid in the pelvis and empty uterine cavity. What is the next step?
|
Ans. C. Perform urgent laparotomyAmenorrhea and lower abdominal pain with empty uterine cavity on USG raise the suspicion of ectopic pregnancy. The clinical presentation of shock and large amounts of free fluid in the pelvis point to hemodynamic instability associated with ruptured ectopic pregnancy. Therefore, this patient is managed with an urgent laparotomy.
| 3 |
Perform laparoscopy
|
Treat with IM methotrexate
|
Perform urgent laparotomy
|
Do serum Beta HCG to confirm diagnosis
|
Gynaecology & Obstetrics
|
Ecotopic Pregnancy
|
dfc1805f-48d5-401a-b957-10170927b942
|
multi
|
True about lecithin - sphingomyelin ratio is
|
Concentration of lecithin relative to sphingomyelin begins to rise at 32 - 34 weeks. L / S ratio < 2 suggests high risk of RDS.
| 1 |
Concentration of Lecithin and sphingomyelin before 34 weeks in amniotic fluid is equal
|
Concentration of Lecithin is more than sphingomyelin in amniotic fluid before 34 weeks.
|
After 32 to 34 weeks, concentration of sphingomyelin relative to Lecithin begins to rise
|
There is increased risk of Respiratory distress syndrome if L/S ratio is > 2
|
Gynaecology & Obstetrics
| null |
5c18b98c-9e0d-491c-ad3b-3d8f21778dab
|
multi
|
Lipoprotein A shows homology with:
|
(Refer: Harper’s Illustrated Biochemistry, 27th edition)
Lipoprotein A, Lp (a)
Lp (a) is a lipoprotein similar to LDL in lipid and protein composition, but it contains an additional protein called apolipoprotein(a)
Apo (a) is synthesized in the liver and attached to apoB-100 by a disulfide linkage.
The major site of clearance of Lp(a) is the liver, but the uptake pathway is not known.
Lp (a) causes fibrin complex deposition.
Lp (a) has structural similarity with Plasminogen.
Inhibits the tissue plasminogen action.
Inhibits the solubilization of fibrin by the action of plasmin.
Oxidized Lp (a) taken up by macrophages.
Lp (a) as a risk factor for atherosclerotic diseases such as coronary heart disease and stroke.
| 1 |
Plasminogen
|
Albumin
|
Prothrombin
|
Plasmin
|
Unknown
| null |
58d8211f-91b2-4187-bdd1-814fbcbe7cf2
|
single
|
Most common site of brain Hemorrhage is?
|
Ans. (a) PutamenRef: Harrison 19th ed. / 2582* Most common site of brain hemorrhage is Putamen.* Intra-parenychmal hemorrhage is most lethal and has mortality rate of 40%.* The IOC is NCCT. For management BP must be controlled which is to maintain a target BP of 160/90.
| 1 |
Putamen
|
Internal capsule
|
Ventral pons
|
Cerebellum
|
Medicine
|
Cerebrovascular
|
1c05299f-74f4-4174-b1b4-0b0fac795310
|
single
|
All of the following are intravenous anesthetic induction agents except -
|
Ans. is 'd' i.e., Bupivacaine
| 4 |
Thiopentone sodium
|
Ketamine
|
Etomidate
|
Bupivacaine
|
Anaesthesia
|
Miscellaneous General Anesthesia
|
fca54da6-9936-411b-aebf-2669b42e3a80
|
multi
|
A premature infant is born with a patent ductus aeriosus. Its closure can be stimulated by administration of
|
Before 2 weeks of gestation indomethacin 0.2mg/kg dose orally every 12-24 hr for 3 doses. Ref : Ghai essential pediatrics,eighth edition P.no: 419
| 4 |
Prostaglandin analogue
|
Estrogen
|
Anti-estrogen compounds
|
Prostaglandin inhibitors
|
Pediatrics
|
C.V.S
|
c67832fc-0811-49d2-b49c-984e87ff6759
|
single
|
Not true about Intracapsular neck fracture
| null | 4 |
< 1 inch shortening
|
< 45 degree of external rotation
|
Trivial trauma can cause fracture
|
Severe pain around hip
|
Orthopaedics
| null |
21c72ae9-b897-44e4-932f-77e52915c7a1
|
multi
|
Which of the following is acid fast:
|
Ans: a (Oocyst of Cryptosporidium) Ref: Harrison, 16th ed, p. 1250Oocyst of Cryptosporidium is acid fastAcid fast organisms include1. Nocardia2. Legionella micoadie3. Bacterial spores4. Rhodococcus5. Isospora6. Mycobacterium7. Spermatic head8. Cryptococcus cyst
| 1 |
Oocyst of Cryptosporidium
|
Cyst of entamoeba
|
Hydatid disease cyst
|
Cysticercus cyst
|
Microbiology
|
Parasitology
|
6d611665-6b53-414c-b579-77bc413a7184
|
single
|
Zenker diveiculum occurs at:
|
Diveicula of the esophagus are mainly located above the LES (epiphrenic diveiculum) or the UES (pharyngoesophageal--or Zenker--diveiculum). They are both caused by abnormalities involving the LES or the UES, which result in protrusion of the mucosa and submucosa through the muscular layers
| 1 |
Upper esophageal spinchter
|
Lower esophageal sphincter
|
Both of the above
|
None of the above
|
Unknown
| null |
2b2fe3b8-154c-4c57-9f78-64f29518f07b
|
multi
|
All the following are exceptions to Koch's postulates except?
|
M leprae & T pallidum – Cannot be grown invitro however can be maintained in animals.
N gonorrhoea – There is no animal model, however bacteria can be grown in vitro.
| 4 |
Mycobacterium Leprae
|
Treponema pallidum
|
Neisseria gonorrhoea
|
Vibrio cholerae
|
Microbiology
| null |
833c72a4-0713-4949-81b3-d1c85c5012a2
|
multi
|
Study of disease in a traveller from one part to another
| null | 3 |
Eugenics
|
Ergonomics
|
Emporiatrics
|
None
|
Social & Preventive Medicine
| null |
3a9d2e7d-99c2-42f6-a824-836cf9c4898d
|
multi
|
In pediatric advanced life suppo, intraosseous access for drug/fluid administration is recommended for
|
** Intraosseous (IO) access was initially thought to be less applicable in patients older than 6 years, now there is growing suppo for consideration of IO techniques in patients of any age as rapid and equally effective alternatives to intravenous (IV) peripheral lines. Intraosseous infusion (IO) is the process of injecting directly into the marrow of a bone to provide a non-collapsible entry point into the systemic venous system.This technique is used in emergency situations to provide fluids and medication when intravenous access is not available or not feasible. A comparison of intravenous (IV), intramuscular (IM), and intraosseous (IO) routes of administration concluded that the intraosseous route is demonstrably superior to intramuscularand comparable to intravenous administration (in delivering paediatric anaesthetic drugs).Due to the rapid advance and adoption of superior intraosseous access technology, IO access has now become the preferred method of establishing vascular access for patients in whom traditional access is difficult or impossible.
| 2 |
<1yr
|
<6 yrs
|
<12yrs
|
Any age
|
Pediatrics
|
Fluid and electrolytes
|
f6b3113f-11dc-42a7-8752-0359a722e9fc
|
single
|
Not true about vaccines ?
|
Ans. is 'c' i.e., In vaccine l monitor if the color of inner square is same as outer background, vaccine is good for use Vaccine Vial monitor An impoant improvement in PPI during 1998 has been the use of vaccine l monitor. Colour monitors or labels are put on vaccine bottles. Each label has a circle of deep blue colour. Inside it is a white square which changes colour and gradually becomes blue, if vaccine bottle is exposed to higher temprature. When the colour of the white square becomes blue like that of surrounding circle, the vaccine should be considered ineffective. Thereby, the health worker can easily asceain that the vaccine being given is effective or not.
| 3 |
Two live vaccines can be given at same time at different sites
|
Two live vaccines at same site should be given at least 3 weeks apa
|
In vaccine l monitor if the color of inner square is same as outer background, vaccine is good for use
|
Live and killed vaccines can be given together
|
Social & Preventive Medicine
| null |
4f6babcf-83b1-4af9-ba6f-1788822702a4
|
multi
|
Which finding on electron microscopy indicates irreversible cell injury ?
|
. Flocculent densities in the mitochondria
| 3 |
Dilatation of endoplasmic reticulum
|
Dissociation of ribosomes from rough endoplasmic reticulum.
|
Flocculent densities in the mitochondria
|
Myelin figures.
|
Pathology
| null |
fa555b6d-cb51-41d9-9c22-68c3e59dbccc
|
single
|
Tests for detection of heavy metal:
|
A i.e. Harrison Gilroy test; B i.e. Atomic absorption Spectroscopy; C i.e. Neutron activation analysis
| 4 |
Harrison's Gilroy test.
|
Atomic absorption spectroscopy
|
Neutron activation analysis
|
All
|
Forensic Medicine
| null |
ddf0d559-9f75-4c46-af70-9eb9e80211b5
|
multi
|
Antitschkow cells in acute rheumatic fever are derived from -
|
Ans, is 'c' i.e., Macrophages Antitschkow cellso Antitschkow cells are modified macrophages with abundant cytoplasm and central round to ovoid nuclei in which the chromatin is disposed in the central, slender wavy ribbon like pattern-caterpillar cells.
| 3 |
Lymphocytes
|
Histiocytes
|
Macrophages
|
Neutrophils
|
Pathology
|
Rheumatic Fever
|
323f2f85-ef0d-47bf-af74-7188bad088d8
|
single
|
All are motile, EXCEPT:
|
C perfringens is a large, Gram-positive, nonmotile rod with square ends. Hemolysis and gas production are characteristic. In broth containing fermentable carbohydrate, growth of C perfringens is accompanied by the production of large amounts of hydrogen and carbon dioxide gas, which can also be produced in necrotic tissues; hence the term gas gangrene. Ref: Ray C.G., Ryan K.J. (2010). Chapter 29. Clostridium, Peptostreptococcus, Bacteroides, and Other Anaerobes. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e.
| 3 |
Cl.histolyticum
|
Cl.tetanosporum
|
Cl.perfringens
|
Cl.septicum
|
Microbiology
| null |
07ab47dd-685d-48c7-944d-4e481cdb28cc
|
multi
|
Which of the following drugs can be used for the treatment of chloroquine resistant malaria in children?
|
CHLOROQUINE It is a rapidly acting erythrocytic schizontocide against all species of plasmodia; controls most clinical attacks in 1-2 days with disappearance of parasites from peripheral blood in 1-3 days. Therapeutic plasma concentrations are in the range of 15-30 ng/ml. However, it has no effect on pre- and exo-erythrocytic phases of the parasite-does not prevent relapses in vivax and ovale malaria. Resistance in P. falciparum is associated with a decreased ability of the parasite to accumulate chloroquine. Veraparnil, a Ca2+ channel blocker, has been found to restore both the chloroquine concentrating ability as well as sensitivity to this drug. For pediatric patients, the treatment options are the same as for adults except the drug dose is adjusted by patient weight. The pediatric dose should never exceed the recommended adult dose. Pediatric dosing may be difficult due to unavailability of non-capsule forms of quinine. If unable to provide pediatric doses of quinine, consider one of the other three options. If using a quinine-based regimen for children less than eight years old, doxycycline and tetracycline are generally not indicated; therefore, quinine can be given alone for a full 7 days regardless of where the infection was acquired or given in combination with clindamycin as recommended above. In rare instances, doxycycline or tetracycline can be used in combination with quinine in children less than 8 years old if other treatment options are not available or are not tolerated, and the benefit of adding doxycycline or tetracycline is judged to outweigh the risk. If infections initially attributed to "species not identified" are subsequently diagnosed as being due to P. vivax or P. ovale, additional treatment with primaquine should be administered. ESSENTIALS OF MEDICAL PHARMACOLOGY, www.cdc.gov/malaria/diagnosis_treatment K.D.TRIPATHI SIXTH EDITION PAGE NO:785
| 4 |
Chloroquine
|
Doxycycline
|
Tetracycline
|
Clindamycin
|
Pharmacology
|
Chemotherapy
|
ac408e0e-2d8e-4d74-adb3-d1b04594bb4c
|
single
|
Schiller duval bodies are seen in:
|
Ref: Dutta Textbook of Gynecology 5th edition pg.368 Explanation: Schiller duval bodies are characteristic histological feature of endodermal sinus tumour. They are tuft of vascular tissue inside cystic spaces lined by flattened epithelium. ENDODERMAL SINUS TUMOUR aka Yolk Sac Tumour Originate from multipotential embryonal tissue as a result of selective differentiation of yolk sac structures Peak - 15 to 20 years of age Second most common malignant germ cell tumour of ovary Unilateral, solid, >10 cms diameter Micro-schiller duval bodies, eosinophilic hyaline bodies containing alphaprotein Associated with dysgerminoma Treatment- surgical staging and unilateral salpingo oopherectomy Combination chemotherapy - POMB-ACE regimen (cyclophosphamide, vincristine, methotrexate, bleomycin, actinomycin D, cisplatin, etoposide) VAC regimen, VBP regimen Tumor marker- alphafetoprotein >20 microgm/ml. Elevated alpha 1 antitrypsin Respond well to chemotherapy and good survival rate
| 1 |
Endodermal sinus tumour
|
Embryonal carcinoma
|
Dermoid cyst
|
Brenner tumour
|
Gynaecology & Obstetrics
|
Pathology (Carcinoma Ovary)
|
a2b69420-96b6-4fea-a38e-3f85c6c76ee2
|
single
|
All of the following are findings of patients with schizophrenia except
|
Studies using CT have consistently shown that the brains of patients with schizophrenia have lateral and third ventricular enlargement and some degree of reduction in coical volume. Disorders of smooth visual pursuit and the disinhibition of saccadic eye movements are commonly seen in patients with schizophrenia. Electroencephalographic studies of patients with schizophrenia indicate that a high number have abnormal records, increased sensitivity to activation procedures, decreased a-activity, and increased 7- and 8-activity. No studies have shown impaired cerebellar functioning.
| 4 |
Lateral and third ventricle enlargement
|
Deficits in smooth-pursuit eye movements
|
Increased incidence of abnormally slow electroencephalogram tracings
|
Cerebellar dysfunction
|
Psychiatry
| null |
a633df50-afc8-4b88-bccd-4bf737898448
|
multi
|
A dead body with suspected poisoning is having hypostasis of red-brown or deep blue in color. It is suggestive of poisoning due to -
|
Reddish brown or chocolate colored or deep blue hypostasis is suggestive of poisoning due to nitrates, nitrites, nitrobenzene, due to the formation of methemoglobin.
| 1 |
Nitrates
|
Carbon monoxide
|
Cyanides
|
Barbiturates
|
Forensic Medicine
| null |
965601b1-8159-4de8-919a-b4a2908a54b8
|
single
|
A Doctor is taking history from a Diabetes patient and decides to make a cha to assess joint involvement/ which cha should
|
A tree diagram is simply a way of representing a sequence of events along with their probabilities In the given question, Branches can indicate different joints involvement in the case of Diabetes: Fuher branches can indicate if test conducted was positive or not It can fuher help in Decision making for treatment joint wise and overall
| 4 |
Pie cha
|
Venn diagram
|
Histogram
|
Tree diagram
|
Social & Preventive Medicine
|
Biostats
|
22cf5ea5-23dc-41cd-bc4f-6ee389daa653
|
single
|
A 2-day-old newborn male is admitted to the pediatric intensive care unit with cyanosis and tachypnea. Cardiac ultrasound and MRI examinations reveal totally anomalous pulmonary connections. Which of the following embryologic events is responsible for this malformation?
|
The right horn of the sinus venosus has two divisions: One develops into the sinus venarum, the smooth interior aspect of the right atrial wall; the other half develops into the pulmonary veins. Abnormal septation of the sinus venosus can lead to inappropriate pulmonary connections. Abnormal development of the left sinus horn would present with abnormalities in the coronary sinus, whereas incorrect development of the septum secundum can result in an atrial septal defect but would not be involved with anomalous pulmonary veins. The left sinual horn develops into the coronary sinus, and the right sinual horn is incorporated into the right atrial wall.
| 1 |
Abnormal septation of the sinus venosus
|
Abnormal development of the septum secundum
|
Abnormal development of the left sinus horn
|
Abnormal development of the coronary sinus
|
Anatomy
|
Thorax
|
cffc135b-251f-4e8f-96f4-ff519222feb4
|
multi
|
Energy expenditure in resting state depends on
|
Both basal metabolic rate and resting metabolic rate are usually expressed in terms of daily rates of energy expenditure. The early work of the scientists J. Ahur Harris and Francis G. Benedict showed that approximate values could be derived using body surface area (computed from height and weight), age, and sex, along with the oxygen and carbon dioxide measures taken from calorimetry. Studies also showed that by eliminating the sex differences that occur with the accumulation of adipose tissue by expressing metabolic rate per unit of "fat-free" or lean body mass, the values between sexes for basal metabolism are essentially the same. The Katch-McArdle Formula (BMR) , where LBM is the lean body mass in kg. The Cunningham Formula (RMR): , where LBM is the lean body mass in kgRef: Ganong&;s review of medical physiology;24th edition; page no-489
| 1 |
Lean body mass
|
Adipose tissue
|
Resting hea rate
|
Exercise
|
Physiology
|
Endocrinology
|
d1511608-5b9c-47fd-aa2d-af307d162436
|
single
|
Which of the following generated heat by disconnecting electron transport from phosphorylation?
|
Dinitrophenol is an uncoupling agent, that disconnects electron transport from phosphorylation and generates lot of heat at the cost of ATP. Other options are inhibitors of electron transport chain.
| 3 |
Pericidin A
|
Rotenone
|
Dinitrophenol
|
Dimercaprol
|
Biochemistry
| null |
ec78bda3-6a66-49ca-b53b-cea3770c98a0
|
multi
|
Normal pressure Hydrocephalus is characterized by all except:
|
Answer is A (Aphasia): Ataxia, Urinary incontinence & Dementia constitute the characteristic triad of Normal Pressure Hydrocephalus.
| 1 |
Aphasia
|
Dementia
|
Ataxia
|
Urinary incontinence
|
Medicine
| null |
7c1ec317-0910-4906-8e39-1c61a4a99fbd
|
multi
|
Earliest fetal anomaly that can be diagnosed with USG: September 2009
|
Ans. D: Anencephaly Many structural abnormalities in the fetus can be reliably diagnosed by an ultrasound scan, and these can usually be made before 20 weeks. Common examples include hydrocephalus, anencephaly, myelomeningocoele, achondroplasia and other dwarfism, spina bifida, exomphalos, Gastroschisis, duodenal atresia and fetal hydrops. First trimester ultrasonic 'soft' markers for chromosomal abnormalities such as the absence of fetal nasal bone, an increased fetal nuchal translucency (the area at the back of the neck) are now in common use to enable detection of Down syndrome fetuses. Ultrasound can also assist in other diagnostic procedures in prenatal diagnosis such as amniocentesis, chorionic villus sampling, cordocentesis (percutaneous umbilical blood sampling) and in fetal therapy.
| 4 |
Duodenal atresia
|
Fetal hydrops
|
Down's syndrome
|
Anencephaly
|
Gynaecology & Obstetrics
| null |
5f956301-789c-4c15-b5bb-f4c365353e40
|
single
|
Resistance to acyclovir is most commonly due to mutation in a viral gene that encodes a protein that :
| null | 2 |
Converts viral RNA into DNA
|
Phosphorylates acyclovir
|
Transports acyclovir into the cell
|
Transports acyclovir out of the cell
|
Pharmacology
| null |
c86eef6a-f048-485b-bf62-96ea9d5fe9b5
|
single
|
Blow out fracture of orbit commonly involves:-
|
Blow out fracture of orbit Floor is involved first M.C fracture of orbit Force of blow cause a rise in intraorbital pressure with resultant fracture at the weakest point of orbital wall which is floor. THOUGH medial wall is thinnest but it is suppoed by ethmoid air cells which absorb pressure , thus it is not the most commonly fractured wall. Entrapment of inferior rectus in inferior wall fracture = not able to look up Features 1. Enophthalmous 2. Diplopia 3. Infra orbital nerve anesthesia
| 1 |
Floor is involved first
|
Medial wall is involved first as it is the thinnest
|
The patient is not able to look up due to superior rectus palsy
|
Roof is involved first as it bears the maximum impact
|
Ophthalmology
|
Trauma
|
4410abbb-bde5-4809-84f7-b377cd623572
|
multi
|
What is caused by Candida albicans
|
Candidiasis:- * C. albicans common inhabitant of skin, GU and GI tract * Oppounistic organism, can become pathogen in skin, nails and mucous membranes Ref:- Sima Jain; pg num:- 233 * Frequently infects interiginous areas.
| 4 |
Moniliasis
|
Perleche
|
Paronychia
|
All of the above
|
Dental
|
Fungal infections, Scabies, Pediculosis
|
c0d61d59-82cd-41b8-a5e5-34d1c36969bd
|
multi
|
Gottron papules' seen in dermatomyositis all are true except
|
Gottrons papules are violaceous papules on bony prominences of hands , elbows, knees and feet. present in 1/3of patients. gottrons sign presence of symmetric violaceous or erythematous macules in same distribution as that of gottrons papules. IADVL textbook of dermatology page 1248
| 3 |
seen on knuckles
|
Violaceous papules
|
Bullous lesions
|
Seen in 1/3 of patients
|
Dental
|
Autoimmune skin disorders
|
78615509-2833-4d67-940a-b2414a4075dd
|
multi
|
Site of absorption of Vitamin B12:
|
Ans. A. Ileum(Ref: Harper 31/e page 533-540)Site of absorption of Iron--Proximal DuodenumSite of absorption of Folic acid--Proximal jejunumSite of absorption of Cobalamin--Ileum
| 1 |
Ileum
|
Jejunum
|
Duodenum
|
Stomach
|
Biochemistry
|
Nutrition & Digestion
|
c921fbc8-a9f9-42d0-82d6-a46b7cf58973
|
single
|
Persistant vomiting most likely causes-
|
Metabolic alkalosis occurs as a result of loss of nonvolatile acid HCl while vomiting( from the extracellular fluid.
| 2 |
Hyperkalemia
|
Acidic urine excretion
|
Hypochloraemia
|
Hyperventilation.
|
Medicine
|
Fluid and electrolytes
|
91d4bc94-b0b1-4908-81da-3e6575e884a1
|
single
|
Hangover following alcohol consumption can be treated with -
|
Ans. is 4b' i.e., Thiamine o Thiamine helps prevent the buildup of glutarate in the brain, which may be associated with part of the headache associated with hangover.
| 2 |
Pyridoxine
|
Thiamine
|
Riboflavin
|
Niacin
|
Psychiatry
|
Alcohol-Related Disorders
|
81af1eab-3586-4ece-869f-9a0e2ddd5019
|
single
|
Graft from sister to brother is -
|
Ans. is 'b' i.e., Allograft
| 2 |
Isograft
|
Allograft
|
Autograft
|
Heterograft
|
Surgery
| null |
8c4d39e5-0998-4874-b409-b8ab0de9bf83
|
multi
|
The maximum number of death in children occur in following age group -
|
Ans. is 'c' i.e., First 7 days
| 3 |
2-5 years
|
1-2 years
|
first 7 days
|
6 months - 12 months
|
Social & Preventive Medicine
| null |
dc57adaf-656f-4940-85ac-291db92bf34b
|
single
|
The following statements regarding halothane are true except:
|
Halothane is a volatile, non-irritant and non-inflammable liquid. It has relatively low blood-gas partition coefficient hence induction is rapid and pleasant. It has myocardial depressant action that reduces the cardiac output. It also blunts the baroreceptor reflexes. Hence it produces hypotension. It does not cause laryngospasm, bronchospasm, coughing, but may produce bronchodilation due to a direct action on the bronchial smooth muscles hence is preferred in patients with bronchial asthma. It can increase cerebral blood flow and CSF pressure hence is contraindicated in patients with intracranial lesions.
| 4 |
It is contraindicated in patients with intracranial lesions.
|
It can cause hyportension.
|
It allows smooth and rapid loss of unconsciousness.
|
It is contraindicated in patients with bronchial asthma.
|
Pharmacology
| null |
e7e2e3ae-24ab-41a3-8deb-385050365925
|
multi
|
All of the following statements regarding systemic sclerosis are TRUE, EXCEPT:
|
Patients with systemic sclerosis: Have increased serum antibodies to human cytomegalovirus (hCMV) Evidence of human parvovirus B19 infection is seen It is more in miners exposed to silica. It is more in polyvinyl chloride, epoxy resins, and aromatic hydrocarbons including toluene and trichloroethylene exposures. Bleomycin, pentazocine and cocaine are implicated with systemic sclerosis Women with silicone breast implants-more risk Eosinophilia-myalgia syndrome (EMS) have marked eosinophilia, severe myalgia and scleroderma-like chronic skin lesions. It is linked to the consumption of L-tryptophan used as dietary supplements. It is not a subtype of systemic sclerosis. Similar features also seen with toxic oil syndrome. Ref: Harrison,E-18,P- 2758.
| 2 |
Increased serum antibodies to human cytomegalovirus are seen
|
Eosinophilia myalgia syndrome is a subtype of systemic sclerosis
|
The incidence of SSc is increased among miners exposed to silica
|
Bleomycin, pentazocine and cocaine may produce systemic sclerosis like illness
|
Medicine
| null |
df454658-7836-4af9-a72c-41ef4b71a0bd
|
multi
|
Number of oocytes at bih ?
|
Ans. is 'a' i.e., 2 million In humans, no new ova are formed after bih. During fetal development, the ovaries contain over 7 million primordial follicles. However,-many undergo atresia (involution) before bih and others are lost after bih. At the time of bih, there are 2 million ova, but 50% of these are atretic. The million that are normal undergo the first pa of the first meiotic division at about this time and enter a stage of arrest in prophase in which those that survive persist until adulthood. Atresia continues during development, and the number of ova in both of the ovaries at the time of pubey is less than 300,000.
| 1 |
2 million
|
6 million
|
5 million
|
10 million
|
Physiology
| null |
a3215d53-566c-41b2-a2db-22eb609985cf
|
single
|
Joint erosions are typically absent in:`
|
Ahritis seen in SLE is Non-erosive ahritis (without deformity).
| 2 |
Rheumatoid ahritis
|
Systemic lupus erythematosus
|
Psoriatic ahritis
|
Osteoahritis
|
Pediatrics
|
Primary Immunodeficiency
|
36125a8d-e8da-40b2-8eaf-eef877e878fc
|
multi
|
True about thermal burn injury:
|
Ans is D (Zone of stasis is associated with vascular damage) Pathophysiology of Burns Burn causes coagulative necrosis of the epidermis and underlying tissues, with the depth depending on the temperature to which the skin is exposed and the duration of exposure. The area of cutaneous injury has been divided into three zones: zone of coagulation, zone of stasis, and zone of hyperemia Zone of coagulation: The volume injured most severely, in the center of the wound, is the zone of coagulation. This is the area of necrosis where the cells have been disrupted. The tissue is irreversibly damaged at the time of injury. Zone of stasis: Outside the zone of coagulation is the zone of stasis. The zone of stasis is ischemic but potentially salvageable. Depending on the wound environment, can either survive or progress to coagulative necrosis. The zone of stasis is associated with vascular damage and vessel leakage.. Zone of hyperaemia: Beyond the zone of stasis lies the zone of hyperaemia This area is characterized by minimal cell injury but with vasodilatation due to neighboring inflammation-induced mediators. This region contains clearly ble tissue from which the healing process begins and is generally not at risk for fuher necrosis. In practice, attentive wound care and careful fluid resuscitation may salvage the zone of stasis and prevent a superficial injury from becoming full thickness
| 4 |
Zone of stasis is the innermost layer
|
Zone of hyperaemia is the middle layer
|
Zone of coagulation is the outermost layer
|
Zone of stasis is associated with vascular damage
|
Surgery
| null |
ff45abe5-609e-4792-82e2-1cb77d8edfb4
|
multi
|
35 yr old female with ptosis & proximal muscle weakness. Test to be done for diagnosis - (REPEATED)
|
Harrison's principles of internal medicine 17t edition. *Single fibre electromyography ,blocking and jitter ,with normal fiber density,confirmatory.
| 4 |
none
|
Muscle biopsy
|
CPK level
|
EMG
|
Medicine
|
C.N.S
|
a4bfb9fa-18b9-4e39-a6bf-6fceb6654c6f
|
multi
|
Which among the following is false regarding the need of chest radiograph in a patient of the acute abdomen –
|
For the acute abdomen, chest X-ray is essential because:-
For small pneumoperitoneum, chest x-ray in an upright position (erect) is best.
A number of chest conditions may present as an acute abdominal pain (e.g. lower lobe pneumonia, MI).
The acute abdominal condition may be complicated by chest pathology, e.g. pleural effusion frequently complicates acute pancreatitis.
Even when chest radiograph is normal it acts as a valuable baseline.
| 1 |
Supine chest radiograph is the best radiograph for showing presence of a small pnetunoperitoneum
|
A number of chest conditions can present as acute abdominal condition
|
Acute abdominal condition may be complicated by the chest pathology
|
Even when the chest radiograph is normal it acts as a most valuable baseline
|
Radiology
| null |
eaf0919c-a3c1-4203-a9f4-399797f1d1d4
|
multi
|
Hepatitis E is mostly transmitted through:
|
Feco oral route
| 2 |
Skin
|
Feco oral route
|
Blood
|
Sexual route
|
Microbiology
| null |
fe7900d9-c811-49d1-b06b-c52de3a658db
|
single
|
Which of the following is false about dumping syndrome
|
Dumping syndrome patients come with cardiovascular and gastrointestinal symptoms like palpitation, sweating, weakness, abdominal bloating, cramps and vomiting
Patient should be advised low carbohydrates and sugar and high fats and protein diet.
Somatostatin analogues are used as treatment
| 4 |
Patients may have cardiovascular symptoms
|
Low carbohydrate and high protein diet must be taken
|
Fluids should be taken in between meals
|
Supplementation of pectin will increase symptoms
|
Surgery
| null |
fd61f990-e394-4c4c-8f32-c44afc83b070
|
multi
|
Which of the following drug is used for mass prophylaxis for prevention of meningococcal meningitis
|
Rifampicin was used formerly but now Ciprofloxacin is the preferred drug for mass prophylaxis for prevention of meningococcal meningitis.
| 1 |
Ciprofloxacin
|
Rifampicin
|
Ceftriaxone
|
Minocycline
|
Pharmacology
| null |
e6bab962-ac3d-4c1a-bbd1-fbab1646e8dc
|
single
|
Overall optimum degree of taper of tooth preparation for maxillary anterior tooth is:
|
For anterior preparations, 10 degree taper is recommended.
For cast preparations, 6 degree taper is optimum.
Ref: Stephen Rosenstiel, Martin Land, and Junhei Fujimoto, Contemporary Fixed Prosthodontics 5th Edition
| 2 |
6 degrees
|
10 degrees
|
14 degrees
|
19 degrees
|
Dental
| null |
54cf4fc2-9b78-4d03-bc01-8d89027e4af1
|
multi
|
Most accurate and safest method to diagnose viable pregnancy at 6 weeks:(AIIMS May 2015, Nov 2014, May 2013)
|
Ans. b. USG for fetal cardiac activity (Ref: Dutta 6/e p68)Most accurate and safest method to diagnose viable pregnancy at 6 weeks is USG for fetal cardiac activity.Doppler is most sensitive but not safe in early pregnancy.Earliest diagnosis of pregnancy can he established safely by ultrasound for the fetal cardiac activity."An intrauterine gestational sac is reliably visualized with transvaginal sonography by 5 weeks, and an embryo with cardiac activity by 6 weeks. The embryo should be visible transvaginally once the mean sac diameter has reached 20 mm-- otherwise the gestation is anembryonic. Cardiac motion is usually visible with transvaginal imaging when the embryo length has reached 5 mm. If an embryo less than 7 mm is not identified to have cardiac activity, a subsequent examination is recommended in 1 week (American Institute of Ultrasound in Medicine, 2013a). "--Williams Obstetrics 24/e p196Most accurate and safest method to diagnose viable pregnancy at 6 weeks is USG for fetal cardiac activity.USG for fetal cardiac activity: At 6 weeks it is routine to detect fetal cardiac activity by ultrasound (and Doppler is not indicated).Doppler is most sensitive but not safe in early pregnancyDoppler examination of fetal vessels in early pregnancy should not be performed without a clinical indication- Ultrasound Obstet Gynecol 2011; 37:625-628Week 6 - Gestational Age (Fetal age 4 weeks)5 1/2 to 6 1/2 weeks is usually a very good time to detect either a fetal pole or even a fetal heart-beat by vaginal ultrasound.The fetal pole is the first visible sign of a developing embryo.The fetal pole now allows for crown to rump measurements (CRL) to be taken, so that pregnancy dating can be a bit more accurate.The fetal pole may be seen at a crown-rump length (CRL) of 2-4 mm, and the heartbeat may be seen as a regular flutter when the CRL has reached 5 mm.If a vaginal ultrasound is done and no fetal pole or cardiac activity is seen, another ultrasound scan should be done in 3-7 days.Human Chorionic GonadotrophinhCG is a glycoproteinIt consists of a hormone non-specific a and a hormone specific P subunitQ.It is chemically and functionally similar to pituitary luteinizing hormoneThe a subunit is biochemically similar to LH, FSH and TSH whereas B subunit is relatively unique to hCGHave highest carbohydrate content (30%) of any human hormoneFunctions of Human Chorionic Gonadotrophin* Rescue and maintenance of corpus luteum till 6 weeks of pregnancyQ* Stimulates both adrenal and placental steroidogenesisQ* Stimulates maternal thyroidQ because of its thyrotrophic activity* Immunosuppressive activityQ which may inhibit the matemal process of immunorejection of the fetus as the homograft* Stimulates Leydig cells of the male fetusQ to* produce testosterone in conjunction with fetal pituitary gonadotrophinsLevels of hCG:Production by syncytiotrophoblastQHalf life=24 hours. Doubling time=48 hours (2 days)QBy radio immunoassay detected in maternal serum or urine as early as 8-9 days following ovulationQ.Maximum blood and urine level 100-200 lU/ml between 60-70 days of pregnancyQDisappears from circulation within 2 weeks following deliveryQHigh levels of hCG is detected in* Multiple pregnancyQ* Hydatidiform mole or ChoriocarcinomaQ* Down's syndromeQ* Erythroblastosis fetalisQ resulting from maternal D-Ag isoimmunizationhCG is decreased in ectopic pregnancy and impending spontaneous abortion.
| 2 |
Doppler for fetal cardiac activity
|
USG for fetal cardiac activity
|
Urinary Beta-hCG determination
|
PV examination to check uterus size of 6 weeks
|
Gynaecology & Obstetrics
|
Diagnosis of Pregnancy
|
348910ec-9cf5-429b-85a0-2cbcc9d73d29
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single
|
Ratio of Sodium : Glucose in WHO Reduced Osmolarity ORS is
| null | 2 |
1:04
|
1:01
|
1:03
|
1:02
|
Social & Preventive Medicine
| null |
3f9899f9-9355-4255-b78f-bdc79d7d98a2
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single
|
A 20 years old male patient presents to the STD clinic with a genital ulcer. The gram stain of the smear from ulcer shows gram negative coccobacilli. The most appropriate media for culture would be:
|
The clinical picture is suggestive of soft sore (chancroid) caused by Haemophilus ducreyi. Chocolate agar with IsoVitaleX is used for its culture. Other culture media: Thayer Main Medium - Gonococci Blood agar with X & V factors - Haemophilus influenzae Tellurite blood agar - Corynbacterium diphtheriae Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition
| 3 |
Thayer Main Medium
|
Blood agar with X & V factors
|
Chocolate agar with IsoVitaleX
|
Teilurite blood agar
|
Microbiology
|
Bacteriology
|
1d64d349-9d5a-497f-b6d5-64691b529e77
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single
|
Anakinra is a ?
|
Ans. is 'a' i.e., IL-1 antagonist Anakinra is an IL-1 antagonist. It is used for some rare syndromes dependent on IL-1 production : Neonatal - onset inflammatory disease Muckle - Wells syndrome Familial cold uicaria Systemic juvenile - onset inflammatory ahritis RA
| 1 |
IL - 1 antagonist
|
IL - 2 antagonist
|
IL - 6 antagonist
|
IL - 10 antagonist
|
Pharmacology
| null |
c6768a86-a55f-449f-948f-2fd6090235bb
|
single
|
Which of the following is produced sexually?
|
Ans. is 'a' i.e., Ascospore(Ref: Ananthanarayan, 8th/e, p. 601)* Sexual spores: Oospore, Zygospore, Ascospore, Basidiospore (Memory Aid - BOZA).* Asexual spores (Conidia): Sporangiospore, Arthrospore, Blastospore, Chlamydospore (CABS).
| 1 |
Ascospore
|
Conidium
|
Blastoconidia
|
Yeast buds
|
Microbiology
|
Mycology
|
f25cea7a-3eb9-4089-b2d7-9d1776377e59
|
multi
|
From ART drugs which acts through inhibition of integrase activity of virus -
|
Ans. is 'a' i.e., Raltegravir New drugs in HIV infectiono Etravirine is recently approved NNRTI. This is second generation NNRTI and is effective against HIV resistant to first generation NNRTI (Efavirenz, Delaviridine. Nevirapine).Fusion inhibitors (Entry inhibitors)o Enfluvtritide binds to Gp41 subunit of HIV envelop protein and inhibits the fusion of viral and host cell membrane.o Maraviroc is a CCR5 Co-receptor antagonist and is only active against "CCR - 5 - tropic virus" which tends to predominate early in infection.Integrase inhibitorso Raltegravir and Elvitegravir act by inhibiting enzyme integrase.
| 1 |
Raltegravir
|
Tiprinavir
|
Enfuvirtide
|
Etravirine
|
Pharmacology
|
Anti-Viral
|
db58437b-393a-4435-959b-0946c7a9e597
|
single
|
What type of fracture of petrous temporal bone has got the highest chance of facial nerve paralysis?
|
B i.e. Transverse
| 2 |
Longitudinal
|
Transverse
|
Oblique
|
All have equal incidence
|
Surgery
| null |
9f544362-1f19-4f5e-a526-627335083339
|
multi
|
A 4 year old child with one tooth less than the normal dentition shows a large tooth with two crowns and two root canals, the anomaly is :
| null | 2 |
Dilaceration
|
Fusion
|
Gemination
|
Concrescence
|
Pathology
| null |
247b1fd7-81c3-46ba-aa3c-a603e54a2e63
|
single
|
A 71-year-old man is evaluated in the ER for a recent finding of high ESR in a routine blood test. He has history of hypertension, well controlled with metoprolol. His physical examination is completely normal. His laboratory workup reveals hemoglobin 12.6 gm/dL, leukocyte count 8500/mL, and platelet 265,000/mL. Total protein 6.2 g/dL, albumin 3.4 g/dL, BUN 16 mg/dL, creatinine 0.75 mg/dL, and calcium 9.2 mg/dL. Serum protein electrophoresis reveals a sharp, narrow spike, serum immunofixation reveals M-protein 1.2 gm/dL, bone marrow examination reveals less than 10% of monoclonal plasma cells. A skeletal survey is negative for any lytic lesions.
|
Multiple myeloma would best explain this patient's presentation. The onset of myeloma is often insidious. Pain caused by bone involvement, anemia, renal insufficiency, and bacterial pneumonia often follow. This patient presented with fatigue and bone pain, then developed bacterial pneumonia probably secondary to Streptococcus pneumoniae, an encapsulated organism for which antibody to the polysaccharide capsule is not adequately produced by the myeloma patient. There is also evidence for renal insufficiency. Hypercalcemia is frequently seen in patients with multiple myeloma and may be life-threatening. Definitive diagnosis of multiple myeloma is made by demonstrating greater than 30% plasma cells in the bone marrow. Seventy-five percent of patients with myeloma will have a monoclonal M spike on serum protein electrophoresis, but 25% will produce primarily Bence-Jones proteins, which, because of their small size, do not accumulate in the serum but are excreted in the urine. Urine protein electrophoresis will identify these patients. Approximately 1% of patients with myeloma will present with a non-secretory myeloma. Patients with non-secretory myeloma have no M-protein on serum/urine electrophoresis and immunofixation; the diagnosis can be made only with bone marrow biopsy. The bone scan in myeloma is usually negative. The radionuclide is taken up by osteoblasts, and myeloma is usually a purely osteolytic process. Renal biopsy might show monoclonal protein deposition in the kidney or intratubular casts but would not be the first diagnostic procedure. Rouleaux formation in peripheral smear is a characteristic finding of myeloma, although it is neither sensitive nor specific.Waldenstrom macroglobulinemia may cause hyper-viscosity syndrome with CNS manifestations including headache, blurring of vision, dizziness, nystagmus, ataxic gait, drowsiness, or even coma. Peripheral neuropathy, coagulopathy, lymphadenopathy, hepatosplenomegaly, and nonspecific constitutional symptoms are often present. An unusual gap between serum total protein and albumin indicates hyperglobulinemia, and a monoclonal IgM spike on serum protein electrophoresis helps establish an initial diagnosis. Bone marrow biopsy revealing more than 10% of lymphoid and plasmacytoid cells confirms the diagnosis. Unlike multiple myeloma, bony lesions are uncommon in Waldenstrom macroglobulinemia, whereas lymphadenopathy and organomegaly are uncommon in myeloma.Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant plasma cell disorder which is often suspected and detected incidentally from routine blood workup. The patients are asymptomatic with no end-organ damage such as renal failure, hypercalcemia, anemia, or lytic bone lesion. The serum electrophoresis reveals an M spike but the amount of M-protein on immunofixation is usually less than 3 gm/dL and bone marrow contains less than 10% of monoclonal plasma cells. Monitoring of patients is important since MGUS can progress to multiple myeloma over a period of time. It is recommended to get the first evaluation 6 months after initial diagnosis followed by annual or biannual checkup.
| 3 |
Multiple myeloma
|
Smoldering multiple myeloma
|
Monoclonal gammopathy of undetermined significance
|
Waldenstrom macroglobulinemia
|
Medicine
|
Oncology
|
f30c229e-2f1b-4e7a-abfc-bcbc6c888144
|
single
|
The measures to prevent veical transmission of HIV are all, EXCEPT:
|
For prevention of mother-to-child transmission of HIV infection, the following is advocated: 1) Antenatal antiretroviral therapy (HAA), to be staed once positive status is confirmed irrespective CD4 counts or clinical stage of disease 2) Nevirapine during labor (if the patient is not on HAA) 3) Minimal interventions, avoid ARM, instrumental delivery, repeated PV examinations 4) Avoiding breast feeding reduces incidence of veical transmission. Although in developed countries exclusive breast feeding is preferred. Second best option is Exclusive replacement feeding. But mixed feeding is absolutely contraindicated 5) Vitamin A supplementation to mother has been found to decrease the veical transmission in few studies 6) LSCS is to be done ONLY for obstetric indications. Although it is reasonable to perform an elective LSCS if viral copies is >1000/mL 7) Nevirapine prophylaxis to newborn irrespective of type of feeding
| 1 |
Vaginal delivery
|
Administration of vitamin A
|
Stop breast feeding
|
Treatment with zidovudine
|
Gynaecology & Obstetrics
|
Medical Illness Complicating Pregnancy
|
310f94c1-46b3-4f8e-b74a-6a7c08d016d2
|
multi
|
A person 'X' hits another person 'y' with a wooden stick on provocation. This leads to formation of a bruise 3cm x 3 on the forearm. No other injuries are noted. Which of the following is true, regarding his punishment -
|
The synopsis of forensic medicine & toxicology;Dr k.s narayan reddy; 28th edition; pg.no. 155 ; It is voluntary cause of hu ,so under S.323,I.P.C.imprisonment up to one year or with fine or both .
| 1 |
Imprisonment for one year and\/or fine of Rs. 1000
|
Imprisonment for two year and\/or fine of Rs. 5000
|
Imprisonment for 1 month and \/or fine of Rs. 500
|
Rigrous imprisonment for six months
|
Forensic Medicine
|
Mechanical injuries
|
cd854745-54cb-4816-91f1-d06a93df2d7e
|
multi
|
The Prevalence of the following with its degree may correlate with Disease activity in SLE
|
(B) Lymphopenia # Autoimmune Hemolytic Anemia (AIHA) It is characterized by elevated reticulocyte counts, low haptoglobin levels, increased indirect bilirubin concentration and a positive direct Coombs' test. It has been noted in up to 10% of patients with SLE. Presence of hemolytic anemia may associate with manifestations of severe disease such as renal disease, seizures and serositis. Presence of both immunoglobulin and complements on red blood cells is usually associated with some degree of hemolysis, while presence of complements alone (C3 and /or C4) is often not associated with hemolysis AIHA responds to steroids (1 mg/kg per day prednisone or its equivalent in divided doses) in 75 to 96% of patients. Once the hematocrit begins to rise and the reticulocyte count falls, steroids can be rapidly tapered.SLICC CLASSIFICATION CRITERIA FOR SYSTEMIC LUPUS ERYTHEMATOSUSRequirements: > criteria (at least 1 clinical and 1 laboratory criteria. Or Biopsy-proven lupus nephritis with positive ANA or Anti-DNAClinical CriteriaImmunologic Criteria* Acute Cutaneous Lupus* ANA* Chronic cutaneous Lupus* Anti-DNA* Oral or nasal ulcers* Ant-Sm* Non-Scarring alopecia* Antiphospholipid Ab* Arthritis* Low complement (C3, C4, CH50)* Serositis* Direct Coomb's test* Renal * Neurologic* Hemolytic anemia* Leukopenia* Thrombocytopenia (<100,000/mm3)> Leucopenia It is a typical feature of SLE which may occur as a result of lymphopenia, neutropenia or a combination of both. Prevalence of lymphopenia in SLE ranges from 20 to 81% and its degree may correlate with disease activity. Both T and B lymphocytes are reduced, while natural killer cells are typically increased. Reduced surface expression of complement regulatory proteins CD55 and CD59 has been found in leucopenic patients with SLE. Deficiency of these proteins may make these cells susceptible to complement-mediated lysis. There is increasing evidence that endogenous production of type 1 interferons (IFNs) is implicated in the pathogenesis of neutropenia and lymphopenia in SLE. Elevated serum levels of IFN-a in SLE correlate inversely with leucocyte numbers# Neutropenia It is a common feature of SLE, with a prevalence rate of 47%, it may be mediated by anti-neutrophil antibodies. Increased levels of TNF-related apoptosis-inducing ligand (TRAIL) in SLE and may contribute to Neutropenia (through excessive neutrophil apoptosis mediated neutropenia).# Thrombocytopenia It has a reported prevalence ranging from 7 to 30% in large series of patients with SLE. Increased peripheral destruction of platelets and presence of anti-platelet antibodies, is the most likely pathogenic mechanism. Thrombocytopenia is an independent risk factor for increased mortality in SLE.
| 2 |
Autoimmune Hemolytic anemia
|
Lymphopenia
|
Neutropenia
|
Thrombocytopenia
|
Medicine
|
Miscellaneous
|
b0aacc0c-74e0-457d-bbf8-ef03821845d9
|
single
|
Which one of the following is primary prevention:
|
Suppo
| 2 |
Active treatment
|
Suppo
|
Both of the above
|
None of the above
|
Social & Preventive Medicine
| null |
f394557e-d443-4911-a3d2-d3aac893e980
|
multi
|
30 year male with chronic diarrhoea, anemia, raised liver enzymes. Most likely associated with:
|
Answer is B (Anti-endomysial antibody): Presence of chronic diarrhea, anemia and elevated liver enzymes is consistent with a diagnosis of Coeliac disease. Antiendomysial antibodies are highly sensitive and specific for diagnosis of celiac disease and the single best answer of choice amongst the options provided.
| 2 |
Antimitochondrial antibody
|
Anti-endomysial antibody
|
Anti-smooth muscle antibody
|
Antinuclear antibody
|
Medicine
| null |
f82492fc-0ae8-464b-996c-8865af31cd75
|
single
|
All of the following lesions may be classified as
odontogenic tumours EXCEPT
| null | 2 |
Acanthomatous ameloblastoma
|
Branchial cleft cyst
|
Myxoma
|
Simple ameloblastoma
|
Pathology
| null |
0fbcbef0-32de-4cc6-9ca0-0067956ef8a3
|
multi
|
On voluntary admission, the maximum number of days a person can be admitted as per mental health care act is:
| null | 2 |
48 hours
|
30 days
|
60 days
|
90 days
|
Forensic Medicine
|
NEET Jan 2020
|
69e26b65-302a-43d5-a764-fe72bd7d8bc7
|
single
|
True about Ca vulva associated/predisposed by 7 True about Ca vulva associate
|
Ans. is a, b and c i.e. Paget's disease; Vulvar intraepithelial neoplasia; and Bowen's disease Premalignant lesion of vulva : Vulvar intraepithelial neoplasia VIN (most common. Paget's disease - Chronic vulvar dystrophies Condyloma accuminata. Bowen's disease is a type of VIN when among the ordinary atypical cells. large bloated cells called Bowen cells are also present.
| 4 |
Paget's disease
|
Vulval intraepithelial neoplasia
|
Bowen's disease
|
All
|
Gynaecology & Obstetrics
| null |
6f9c3027-6a25-433a-896e-a9b5333aaadc
|
multi
|
Bajaj committee in 1986 proposed
|
Bajaj Committee, 1986An "Expe Committee for Health Manpower Planning, Production and Management" was constituted in 1985 under Dr J.S. Bajaj, the then professor at AIIMS. Major recommendations are :Formulation of National Medical & Health Education Policy.Formulation of National Health Manpower Policy.Establishment of an Educational Commission for Health Sciences (ECHS) on the lines of UGC.Establishment of Health Science Universities in various states and union territories.Establishment of health manpower cells at centre and in the states.Vocationalisation of education at 10+2 levels as regards health-related fields with appropriate incentives, so that good quality paramedical personnel may be available in adequate numbers.Carrying out a realistic health manpower survey.
| 2 |
Multipurpose health worker
|
Manpower and planning
|
Rural health service
|
Integrated health services
|
Social & Preventive Medicine
|
Health education & planning
|
fb7788f1-39e5-4a7f-a76d-6acbba8efc5d
|
single
|
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