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Normal capacity of the renal pelvis is
|
• The average capacity of the renal pelvis is 4–8 ml.
| 1 |
7 ml
|
10 ml
|
15 ml
|
20 ml
|
Surgery
| null |
5d6a33ef-b45b-4134-941c-125242ed0d97
|
single
|
Nitric oxide acts by:
|
Ans: A (cGMP) Ref: Harper's Illustrated biochemistry, 28th edition.Explanation:Classification of Hormones by Mechanism of ActionI. Hormones that hind to intracellular receptors* Androgens* Calcitriol (1.252-D3) Estrogens* Glucocorticoids* Mineralocorticoids* Progestins* Retinoic acid* Thyroid hormones (T3 and T4)II. Hormones that bifid to cell surface receptorsA. The second messenger is cAMP* Alpha2 -Adrenergic catecholamines* Alpha-Adrenergic catecholamines* Adrenocorticotropic hormone* Antidiuretic hormone* Calcitonin* Chorionic gonadotropin, human* Corticotropin-releasing hormone* Follicle-stimulating hormone* Glucagon* Lipotropin* Luteinizing hormone* Melanocyte-stimulating hormone* Parathyroid hormone* Somatostatin* Thyroid-stimulating hormoneB. The second messenger is cGMP* Atrial natriuretic factor* Nitric oxide (EDRF)C. The second messenger is calcium or phosphatidvlinositols (or both)* Acetylcholine (muscarinic)* Alpha1 -Adrenergic catecholamines* Angiotensin II* Antidiuretic hormone (vasopressin)* Cholecystokinin* Gastrin* Gonadotropin-releasing hormone* Oxytocin* Platelet-derived growth factor* Substance P* Thyrotropin-releasing hormoneD. The second messenger is a kinase or phosphatase cascade* Adiponectin* Chorionic somatomammotropin* Epidermal growth factor* Erythropoietin* Fibroblast growth factor* Growth hormone* Insulin* Insulin-like growth factors I and II* Leptin* Nerve growth factor* Platelet-derived growth factor* Prolactin
| 1 |
cGMP
|
cAMP
|
Calcium
|
Kinase
|
Biochemistry
|
Proteins and Amino Acids
|
8aeadeb9-403f-4958-a71b-bb6e338552be
|
single
|
The law relating distending pressure and tension in a blood vessel wall is called:
|
Law of Laplace states that transluminal pressure varies inversely with vessel radius and is directly propoional to tension that develops in the vessel walls. It means the pressure pushes against the wall causing them to stretch(tension), as the size of the vessels decreases the tension in the wall decreases too. Law of Laplace states that tension in the wall of a cylinder (T) is equal to the product of the transmural pressure (P) and the radius (r) divided by the wall thickness (w). T =Pr/w Einthoven's law The relationships of the bipolar limb leads are such that the sum of the electrical currents recorded in leads I and III equal the sum of the electric current recorded in lead II. This relationship is called Einthoven's law, and is expressed mathematically as: Lead I + Lead III = Lead II It follows that if the values for any two of the leads are known, the value for the third. Frank-Starling law of the hea: which states that the ventricular output is propoional to the ventricular end-diastolic volume. Ref: Principles of medical physiology, By Sabyasachi Sicar,Page 212.
| 3 |
Frank Starling's law
|
Einthoven's law
|
Law of Laplace
|
Many's law
|
Physiology
| null |
492c499e-8fdb-4811-b668-bef281b7877f
|
multi
|
Which of the following are goals of orthognathic surgery?
|
The goals of ortho esthetics are:
To improve facial esthetic and self-image of patient.
To shorten orthodontic treatment time and improve orthodontic treatment results.
To improve PDL stability and prognosis.
To correct jaw relationships prior to major restorative procedure.
| 4 |
To improve facial esthetics
|
To shorten orthodontic treatment time
|
To improve orthodontic treatment results
|
All of the above
|
Dental
| null |
4e1ce8a4-c144-446a-9f12-f6eb1ce71bb6
|
multi
|
'Rule of Nine' to estimate surface area of burns was given by:
|
Ans. B i.e. Alexander Wallace
| 2 |
Moiz Kaposi
|
Alexander Wallace
|
Joseph Lister
|
Thomas Barclay
|
Surgery
| null |
d003cb01-dff2-41f6-af9b-19f16fa34e74
|
multi
|
The most predominantly occurring amino acid in collagen is
|
Tropocollagen, the repeating unit of a mature collagen fiber, consists of three collagen polypeptides, each containing about 1000 amino acids, bundled together in a unique conformation, the collagen triple helix. Every third amino acid residue in collagen is a glycine residue. Collagen is also rich in proline and hydroxyproline, yielding a repetitive Gly-X-Y pattern in which Y generally is proline or hydroxyproline.Reference: Explanation: Harper's Biochemistry; 30th edition; Chapter 5; proteins: higher Orders of Structure
| 4 |
Valine
|
Cysteine
|
Arginine
|
Glycine
|
Biochemistry
|
Structure and function of protein
|
0fdc18b3-2d73-4f3c-b975-37e5e9f25569
|
single
|
Fluid of choice in child with bu rn < 24 hour is -
|
Ans. is 'c' i.e., Ringer lactate Fluid resuscitation in burn injuryo Parkland formula Initial 24 hours: Ringer's lactated (RL) solution 4 mL'kg/% bum for adults and 3 ml/kg/% bum for children. RL solution is added for maintenance for children:4 ml'kg/hour for chiIdren weighing 0-10 kg40 ml/hour+2 ml.'hour for children weighing 10-20 kg60 ml.'hour + 1 ml'kg/hour for children weighing 20 kg or higher This formula recommends no colloid in the initial 24 hours.Next 24 hours: Colloids given as 20-60% of calculated plasma volume. No crystalloids. Glucose in water is added in amounts required to maintain a urinary output of 0.5-1 ml/hour in adults and 1 ml/hour in children.
| 3 |
Fresh frozen plasma
|
Isolye-P
|
Ringer lactate
|
Plailet tranfusion
|
Pediatrics
|
Fluid and Electrolyte Treatment of Specific Disorders
|
fc26c1fc-2dd8-4341-a5be-e3ca0d176f09
|
single
|
All are causes of infantile tremor syndrome EXCEPT:
|
Vitamin B1 deficency REF: OP Ghai ed p. 558 Vitamin B 12 deficiency not B1 deficiency causes infantile tremor syndrome Causes of infantile tremor syndrome: Malnutrition Vitamin B12 deficiency Infections Magnesium deficiency Toxins Tyrosinase defects
| 4 |
Malnutrition
|
Magnesium deficiency
|
Infections
|
Vitamin B1 deficency
|
Pediatrics
| null |
f9f479c0-1029-461c-9c93-3e7211816f93
|
multi
|
True statement regarding SLE in children-
|
Ans. is None
| 4 |
Skin pigmentation more common than adults
|
No sex difference
|
Renal involvement more common
|
None
|
Pediatrics
| null |
2f6420d5-ec3a-4a9d-8327-4f254444eb70
|
multi
|
An anxiolytic benzodiazepine which is also antidepressant : September 2007
|
Ans. C: Alprazolam Alprazolam is approved for the sho-term treatment of panic disorder, with or without agoraphobia. Alprazolam is very effective in the sho-term symptomatic relief of moderate to severe anxiety, essential tremor, and panic attacks. Alprazolam is indicated for the management of anxiety disorders or the sho-term relief of symptoms of anxiety. Alprazolam is recommended for the sho-term treatment of severe acute anxiety. Alprazolam is sometimes prescribed for anxiety with associated depression. The antidepressant effects of alprazolam may be due to its effects on beta-adrenergic receptors. Other benzodiazepines are not known to have antidepressant activity.
| 3 |
Lorazepam
|
Oxazepam
|
Alprazolam
|
Chlordiazepoxid
|
Pharmacology
| null |
5d32cfd4-424e-47e7-abbd-2cf0ca4857c3
|
single
|
Synthesis of secretory proteins takes place in
|
Secretory proteins are synthesized in EPR Reference: Harper; 30th edition
| 2 |
Golgi complex
|
Endoplasmic reticulum
|
First in cytoplasm then in nucleus
|
First in endoplasmic reticulum then in cytoplasm
|
Biochemistry
|
Structure and function of protein
|
fd10d1e9-ab22-4693-ab5e-47f01a9fe2c0
|
single
|
All muscles of the palate are supplied by pharyngeal plexus, EXCEPT:
|
With the exception of tensor veli palatini, which is supplied by the motor branch of the mandibular division of the trigeminal through the nerve to medial pterygoid, the muscles are supplied by the cranial pa of the accessory nerve the pharyngeal plexus.Ref: Gray's anatomy 40th edition, Chapter 35
| 1 |
Tensor veli palatine
|
Palatoglossus
|
Palatopharyngeus
|
None of the above
|
Anatomy
| null |
7fe3cc0e-cb7a-48a3-8e65-a03450551e33
|
multi
|
in whic of the following cardiac condition PULSATILE LIVER AND ASCITES is seen ?
|
Most commonly, TR is secondary to marked dilation of the tricuspid annulus from RV enlargement due to PA hypeension. Functional TR may complicate RV enlargement of any cause, including an inferior MI that involves the RV. It is commonly seen in the late stages of hea failure due to rheumatic or congenital hea disease with severe PA hypeension (pulmonary aery systolic pressure >55 mmHg), as well as in ischemic and idiopathic dilated cardiomyopathies. It is reversible in pa if PA hypeension can be relieved. Rheumatic fever may produce organic (primary) TR, often associated with TS. Infarction of RV papillary muscles, tricuspid valve prolapse, carcinoid hea disease, endomyocardial fibrosis, radiation, infective endocarditis, and trauma all may produce TR. With the onset of TR in patients with PA hypeension, symptoms of pulmonary congestion diminish, but the clinical manifestations of right-sided hea failure become intensified. The neck veins are distended with prominent v waves and rapid y descents, marked hepatomegaly, ascites, pleural effusions, edema, systolic pulsations of the liver, and a positive hepatojugular reflex. ref : Harrison&;s principle of internal medicine,20th edition,pg no.1948
| 1 |
TR
|
Critical pulmonary stenosis
|
MR
|
MS
|
Medicine
|
C.V.S
|
29a7c47a-69ef-4552-b026-73e84c2d22be
|
single
|
Which is not seen in tuberous sclerosis?
|
Tuberous sclerosis characterized by angiofibroma,astrocytoma,subependymal lesion and white matter lesion. Ref : Ghai essential of pediatrics, eighth edition, p.no:586
| 2 |
Astrocytoma
|
Ependymoma
|
White matter lesions
|
Subpendymal nodules
|
Pediatrics
|
C.V.S
|
132df81e-37b8-4ce8-8f96-57908cc231bd
|
single
|
Amyloid is stained with: September 2009, March 2013
|
Ans. C: Congo red
| 3 |
Lugol's iodine
|
Methyl violet
|
Congo red
|
Sudan black
|
Pathology
| null |
40c34aed-a15f-425c-aa17-92165547d8ff
|
single
|
A 55 year old female comes to the eye casualty with history of severe eye pain, redness and diminished vision. On examination, the visual acuity is 6/60, there is circumcorneal congestion, corneal oedema and a shallow anterior chamber. Which of the following is the best drug of choice –
|
Approach in acute congestive glaucoma
Start i.v. mannitol or i.v. acetazolamide
When IOT starts falling, start topical pilocarpine or β-blocker (timolol).
Apraclonidine/latanoprost may be added.
Once i.o.t. is reduced, surgery is done.
| 2 |
Atropine ointment
|
IV mannitol
|
Ciprofloxacin eye drops
|
Betamethasone eye drops
|
Ophthalmology
| null |
60f5a98d-c460-4900-972f-b81b8e087eca
|
multi
|
Phase 4 clinical trial is carried out -
|
Ans. is 'b' i.e., After a drug is marketed Phase 4 clinical trial is post marketing survellance.
| 2 |
Before the marketing approval of a drug
|
After a drug is marketed
|
For drugs used in rare diseases
|
For drugs used in pediatric patients
|
Pharmacology
| null |
dea92445-1202-4995-8c29-8b37f077f99e
|
single
|
Charlie chaplin gait is seen in?
|
Ans. is 'a' i.e., External rotation deformity of tibia Charlie Chaplin Gait Gait that occurs in bilateral external torsion of the tibia caused by faulty sitting or sleeping habits as in maintenance of the spread eagle or frog leg posture. It is seen in alkaptonuria, bilateral external tibial torsion, and flat feet with valgus at ankle.
| 1 |
Congenial coxa vara
|
Tibial torsion
|
DDH
|
Genu valgus
|
Surgery
| null |
e9364aeb-e188-4b45-bde6-589831cf66b3
|
single
|
Which of the following is not a component of Gradenigo's syndrome?
|
Discharge from ear is not present in gradeinigo syndrome. Gradenigo Syndrome (GS) is classically described as a clinicaltriad of otitis media, facial pain, and abducens palsy that in the past most commonly developed from infection in the petrous temporal bone (i.e., petrous apicitis). Ref ganong's review of medical physiology 25e p438
| 2 |
Deep seated orbital pain
|
Greisinger sign positive
|
Abducent nerve palsy
|
Discharge from ear
|
Physiology
|
All India exam
|
d8ee3fce-d3c7-4c4a-b5b8-10b89f9b44cf
|
single
|
Which cells are absent in the cerebellar coex
|
There are five types of cells in the cerebellum Purkinje cells, Stellate cells, Golgi cells, Basket cells, Granule cells Ref : Ganong 25th ed/page 248
| 2 |
Purkinje cells
|
Bipolar cells
|
Granule cells
|
Golgi cells
|
Physiology
|
Nervous system
|
67a691f6-7088-4b0c-81c1-dcc4c1a10429
|
single
|
RDA of vitamin A in an adolescent female ?
|
Ans. is 'c' i.e., 600 mcg
| 3 |
400 mcg
|
350 mcg
|
600 mcg
|
800 mcg
|
Social & Preventive Medicine
| null |
bb6dab88-73a5-445b-9ccc-ed534ace1d81
|
single
|
Bronchiectasis means .....................of bronchi -
|
Ref:Textbook of pathology (Harsh mohan)6th edition, page no.484 BRONCHIECTASIS Bronchiectasis is defined as abnormal and irreversible dilatation of the bronchi and bronchioles (greater than 2 mm in diameter) developing secondary to inflammatory weakening of the bronchial walls. The most characteristic clinical manifestation of bronchiectasis is persistent cough with expectoration of copious amounts of foul-smelling, purulent sputum. Post-infectious cases commonly develop in childhood and in early adult life.
| 2 |
Inflammation
|
Dilatation
|
Cavitation
|
All
|
Pathology
|
Respiratory system
|
eee66082-9520-47bc-9999-4a288e6e5ed2
|
multi
|
Degloving injury is: March 2013 (h)
|
Ans. D i.e. Avulsion injury Degloving injury It is a type of avulsion in which an extensive section of skin is completely torn off the underlying tissue, severing its blood supply. It is named by analogy to the process of removing a glove. Typically, degloving injuries affect the extremities and limbs.
| 4 |
Surgeon made wound
|
Lacerated wound
|
Blunt injury
|
Avulsion injury
|
Surgery
| null |
4a20c6ed-cc94-43e8-8a75-13d4fdcde87d
|
single
|
True statement about the paralysis of the recurrent laryngeal nerve is
|
Paralysis of recurrent laryngeal nerve common on the left side.
The common causes are
Bronchogenic cancer
Accidental trauma
Thyroid surgery
Thyroid disease (benign or malignant)
Cervical lymphadenopathy
Carcinoma cervical oesophagus
Carcinoma thoracic oesophagus
Aortic aneurysm
Mediastinal lymphadenopathy
| 1 |
Common on left side
|
50% idiopathic
|
Cord will lie laterally
|
Speech therapy given
|
ENT
| null |
a79abaa3-fc25-4ca7-8de3-8cfb426ff4d6
|
multi
|
A 10 yr old boy, unconscious with 2 days h/o fever, comes to pediatric ICU with R.R 46/min, B.P.110/80 and E1 V1 M3 on Glasgow coma scale, next step of Mx includes
|
There is increased respiratory rate.the child must be intubated and venilated to provide suppo . Reference: GHAI Essential pediatrics, 8th edition
| 1 |
Intubate and ventilate
|
Give 0.9% NaCl
|
Sta dopamine at the rate of 1-2 g/min/kg
|
Dopamine at the rate of 1-2 g/min/kg & furosemide
|
Pediatrics
|
Central Nervous system
|
c759f002-d46b-414f-ba92-1b8ad31ee46c
|
multi
|
Which of the following colonic polyps is not premalignant
|
.Juvenile Polyps * Commonest polyp of colorectum in infants and children. * Can cause intussusception, prolapse through rectum, bleeding. * Colonoscopic polypectomy is done. * Not a pre-malignant condition. ref:SRB&;s manual of surgery ,ed 3,pg no 831
| 1 |
Juvenile polyps
|
Hamaomatous polyps associated with peutz jegher's syndrome
|
Villous adenoma
|
Tubular adenomas
|
Surgery
|
G.I.T
|
b5e90eeb-0969-4829-a165-4dc3e824d314
|
single
|
Putrefaction is delayed in poisoning due to :
|
A i.e. Carbolic acid
| 1 |
Carbolic acid
|
Organophosphorus
|
Lead
|
All
|
Forensic Medicine
| null |
044e0f26-43e8-47f0-be46-af1feba96a44
|
multi
|
The pump responsible for gastric acid secretion is
|
Gastric parietal cells are highly specialized for their unusual task of secreting concentrated acid. The cells are packed with mitochondria that supply energy to drive the apical H+,K+-ATPase, or proton pump, that moves H+ ions out of the parietal cell against a concentration gradient. The apical membrane also contains potassium channels, which supply the K+ ions to be exchanged for H+, and Cl- channels that supply the counterion for HCl secretion.
| 3 |
H+ ATPase
|
Na+ - H+ ATPase
|
H+ - K+ ATPase
|
Ca2+ - H+ ATPase
|
Physiology
|
Gastrointestinal System
|
172c8e1c-73fb-472e-b0df-6f3f73812e0b
|
single
|
A 32 year old woamn with two live children was brought to emergency with the history of missed period for 15 dyas, spotting since 7 days and pain abdomen since 6hrs. Her pulse was 120/min, pallor ++, systolic BP BOmmHg. There was fullness and ternderness on per abdomen examination. Cu-T thread was seen through external os on P/S examination On PN examination, cervical movements were tender, uterus was bulky and soft. There was fullness in pouch of Douglas. She is most likely suffering from :
|
Rupture ectopic pregnancy
| 3 |
Pelvic inflammatory disease
|
Missed aboriton with infectkion
|
Rupture ectopic pregnancy
|
Threatened aboriton
|
Gynaecology & Obstetrics
| null |
24a3b80f-bc6a-415d-9c68-9ec9bc5f16d0
|
multi
|
A cardiologist asks for measurement of electromechanical systole (QS2) and left ventricular ejection time (LVET), and pre-ejection period (PEP). The cardiologist is informed by the technician that the carotid transducer is not functioning. Which of the following readings could not be obtained
|
Electromechanical systole (QS2)- Time interval between the beginning of Q wave and beginning of the second heart sound. It requires ECG and phonocardiogram.
Left ventricular ejection time (LVET)- Interval between the beginning of carotid pressure to the dicrotic notch. Requires carotid pulse tracing.
Pre-ejection systole (PEP)- Difference between QS2 and LVET.
| 4 |
QS2
|
QS2 and LVET
|
QS2 and PEP
|
LVET and PEP
|
Physiology
| null |
883c9a0b-8999-4a24-9d62-4dd82de7dced
|
single
|
Treatment of chronic phase of CML is :
| null | 1 |
Imatinib
|
Hydroxyurea
|
Interferon
|
Cytarabine
|
Pharmacology
| null |
16a0395d-6ea9-4dac-a0a4-7f77a8420e13
|
single
|
Treatment of cord prolapse is based on all of the following factors, except:
| null | 3 |
Fetal viability
|
Fetal maturity
|
Fetal weight
|
Cervical dilatation
|
Gynaecology & Obstetrics
| null |
5d062b83-d730-4f33-af80-478d28e8399d
|
multi
|
Pap smear is an example of -
|
Ans. is 'b' i.e., Secondary level of prevention o In secondary prevention, action halts the progress of a disease at its incipient stage and prevents complication. o Screening tests (e.g. - Pap smear), helps in diagnosis at early stage so that adequate treatment can halt disease progression and prevent complication.
| 2 |
Primary level of prevention
|
Secondary level of prevention
|
Teritary level of prevention
|
None of the above
|
Social & Preventive Medicine
| null |
a1041e37-ff61-4353-85e5-fb472b6394f1
|
multi
|
All are true about sulphonyl ureas except?
|
Sulphonyl ureas are mainly used in Type 2 DM because Type 1 DM is characterized by autoimmune destruction of β - cells of pancreas and atleast 30% of β - cells should be present for sulphonyl ureas to be effective.
| 3 |
It blocks ATP sensitive K+ channels and increase insulin release
|
They have higher risk of causing hypoglycemia than meglitinides
|
They are used mainly in type 1 DM
|
Chlorpropamide can cause dilutional hyponatremia
|
Pharmacology
| null |
e14969c5-2737-4e85-b64f-810baf670a94
|
multi
|
The usefulness of a ‘screening test’ in a community depends on its?
|
Predictive value of a test signifies diagnostic power of the test.
attribute of an idea screening test is its repeatability or reliability or reproducibility.
Sensitivity has been defined as the ability of the test to identify correctly all those who have the disease, that is true positive (Hence determines the usefulness of the screening test.
| 1 |
Sensitivity
|
Specificity
|
Reliability
|
Predicitive value
|
Unknown
| null |
59ffaf86-997e-42e1-bfce-0e1397fd77d7
|
single
|
Differential white blood cell counts in the laboratory are useful in the diagnosis of:
| null | 2 |
Anemia
|
Eosinophilia
|
Vitamin deficiency
|
Spherocytosis
|
Physiology
| null |
cd5138c8-ed26-44bc-88cc-57875333639e
|
single
|
Which of the functions are TRUE regarding C-terminal domain of androgen receptor protein?
|
The androgen receptor proteins contain 3 common domains: 1- Highly conserved central domain that is responsible for DNA binding 2- N-terminal region that is involved in trascriptional activation, and 3- C-terminal domain that binds ligand Ref: Harper's Illustrated Biochemistry 27th Edition, Page 477; Molecular cell biology, December 19 (12); 8383 - 8392; Urotext Basics By R. A. S. Hemat, Edition 2003, Page 68.
| 1 |
Ligand binding
|
Increasing biological half life
|
Increasing the affinity of receptor to DNA
|
Increasing the level of transcription
|
Biochemistry
| null |
0d0d06fe-93fd-4600-94a1-0f3ccaf260bb
|
multi
|
Riboflavin deficiency is assessed by
|
Riboflavin deficiency is assessed by Glutathione reductase. The two biologically active forms are flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD), formed by the transfer of an adenosine monophosphate moiety from ATP to FMN (Figure 28.15). FMN and FAD are each capable of reversibly accepting two hydrogen atoms, forming FMNH2or FADH2. FMN and FAD are bound tightly--sometimes covalently--to flavoenzymes that catalyze the oxidation or reduction of a substrate. Riboflavin deficiency is not associated with a major human disease, although it frequently accompanies other vitamin deficiencies. Deficiency symptoms include dermatitis, cheilosis (fissuring at the corners of the mouth), and glossitis (the tongue appearing smooth and purplish). Reference: Lippincott Textbook of Biochemistry pg no. 380,381
| 2 |
Transketolase
|
Glutathione reductase
|
PDH
|
None
|
Biochemistry
|
vitamins
|
81c61bcf-ef9b-4ef3-807f-1833fef8bed7
|
multi
|
Investigation of choice to Determine Local Invasion in Esophageal Carcinoma(T staging) is?
|
Endoscopic Ultrasound - Determines Local Invasion In Esophageal Carcinoma(T staging).
| 3 |
Transabdominal Usg
|
CECT
|
Endpscopic USG
|
MRI
|
Radiology
|
ULTRASOUND
|
ecd48525-260d-4e2d-9250-e5bd15ca7826
|
single
|
CCK-PZ causes all of the following except :
|
C i.e. Increased gastrin secretion
| 3 |
Gall bladder contraction
|
Pancreatic enzyme secretion
|
Increased gastrin secretion
|
Decreased lower esophageal sphinictor
|
Physiology
| null |
b24a6686-d2a4-4d4b-8a3b-cbaad55e48d0
|
multi
|
The recommended size of endotracheal tube for 1 year old child is
|
Tube diameter in mm
= Age in years/4 + 4
= 1/4 + 4
= 17/4
= 4.2
| 3 |
2.5
|
3
|
4
|
5
|
Anaesthesia
| null |
92736f6a-a3e7-41cb-b4dc-2e6edfb3f8da
|
single
|
Parinaud's Syndrome is associated with all EXCEPT
|
(D) Nuclear gaze palsy # Parinaud's Syndrome or Dorsal Midbrain Syndrome and vertical gaze palsy, is an inability to move the eyes up or down. It is caused a tumor of the pineal gland which compresses the vertical gaze center at the rostral interstitial nucleus of medial longitudinal fasciculus (riMLF). The eyes lose the ability to move upward.# Parinaud's Syndrome is a cluster of abnormalities of eye movement and pupil dysfunction, characterized by:> Paralysis of upgaze: Downward gaze is usually preserved. This vertical palsy is supranuclear, so Doll's head maneuver should elevate the eyes, but eventually all upward gaze mechanisms fail.> Pseudo-Argyll Robertson pupils: Accommodative paresis ensues, and pupils become mid-dilated and show light-near dissociation.> Convergence-Retraction nystagmus: Attempts at upward gaze often produce this phenomenon. On fast up-gaze, the eyes pull in and the globes retract. The easiest way to bring out this reaction is to ask the patient to follow down-going stripes on an optokinetic drum.> Eyelid retraction (Collier's sign) Conjugate down gaze in the primary position: "setting-sun sign". Neurosurgeons will often see this sign most commonly in patients with failed ventriculoperitoneal shunts. It is also commonly associated with bilateral papilledema. It has less commonly been associated with spasm of accommodation on attempted upward gaze, pseudoabducens palsy (also known as thalamic esotropia) or slower movements of the abducting eye than the adducting eye during horizontal saccades, see-saw nystagmus and associated ocular motility deficits including skew deviation, oculomotor nerve palsy, trochlear nerve palsy and internuclear ophthalmoplegia.> Classically, it has been associated with three major groups: Young patients with brain tumors in the pineal gland or midbrain: pinealoma (intracranial germinomas) are the most common lesion producing this syndrome. Women in their 20s-30s with multiple sclerosis Older patients following stroke of the upper brainstem
| 4 |
Collier's sign may be present
|
Can be caused by hydrocephalus with acquiductal stenosis
|
Light near dissociation of pupil
|
Nuclear gaze palsy
|
Medicine
|
Miscellaneous
|
b5994841-4c71-4a5c-8aa4-c7afa2b6fa2d
|
multi
|
Which of the following teeth have more than one occlusal form:
| null | 3 |
Maxillary 1st premolar
|
Maxillary 2nd premolar
|
Maxillary 1st molar
|
Mandibular 1st molar
|
Dental
| null |
55daa13d-b09c-4b71-a6b3-fbd608e7d861
|
single
|
While handling a febrile neutropenic patient all are essential except -
| null | 2 |
Repeated hand washing of hospital person
|
White cell infusion
|
Prophylactic antibiotic
|
Colony stimulating factor for macrophages
|
Medicine
| null |
0c3b4814-6a05-45fd-a448-ebd3a2ed3dd8
|
multi
|
Ring scotoma is seen in: September 2012
|
Ans. B i.e. Retinitis pigmentosa
| 2 |
Glaucoma
|
Retinitis pigmentosa
|
Sympathetic ophthalmia
|
Vitreous hemorrhage
|
Ophthalmology
| null |
abd07eca-4a1d-4741-bd1f-d97819cc4959
|
single
|
Rigor mois occurs first in which voluntary muscle: Delhi 06, 07; COMEDK 08; SGPGI 11
|
Ans. Muscles of eyelids
| 1 |
Muscles of eyelids
|
Small muscles of hands
|
Neck muscles
|
Face muscles
|
Forensic Medicine
| null |
a209cab2-17fa-4ce5-81f7-8374016623d6
|
multi
|
A patient suddenly experienced pain radiating along the medial border of the dorsum of foot. Which of the following nerve is most likely to be involved?
|
Since the patient is having pain along the medial border of dorsum of foot, he is most likely suffering from an injury to saphenous nerve. Saphenous nerve is the terminal sensory branch of femoral nerve. It provides sensory innervations to the medial region of the heel, medial malleolus, medial border of foot as far as great toe. Ref: Grays Anatomy for Students, 2nd Edition, Page 625; Clinical Anatomy By Regions By Richard S. Snell, 8th Edition, Page 627
| 2 |
Sural nerve
|
Saphenous nerve
|
Deep peroneal nerve
|
Superficial peroneal nerve
|
Surgery
| null |
f6331671-e816-44a1-9437-4cf01e33783f
|
single
|
The factor which promotes virulence of M. tuberculosis ?
|
Ans. is 'b' i.e., Cord factor Virulence factors . Virulent strains of tubercle bacilli form microscopic "serpentine cord" in which acid fast bacilli are arranged in parallel chains, cord formation is correlated with virulence. A "cord factor" has been extracted from virulent bacilli with pateroleum ether. It inhibits migration of leukocytes, causes chronic granulomas, and can serve as an immunologic "adjuvant". . Other virulence factors for M. tuberculosis. i) Lipoarabinomannan Facilitates the survival of M. tuberculosis within macrophages. ii) Kat G --> Encodes for catalase, an enzyme protective against oxidative stress. rpoV --> The main sigma factor initiating transcription of several genes. iv) erp gene --> Encoding a protein required for multiplication. v) Virulence has been linked paially to the bacterium's lipid rich cell wall and to its glycolipid capsule, both of which confer resistance to complement and free radicals to the phagocytes. Following gene which contribute to virulence have been added in 18"Ve of Harrison . Region of difference- 1 (RD-l) :- Encodes for early secretory antigen- 6 (ESAT-6) and culture filterate protein- 10 (CPF-10) . LeuD, Pan CD and isocitrate lyase gene (icl 1) . Sigma factor C(sig C) and Sigma factor H (sig H) genes . Car D gene Remember . The major factor in virulence of M. tuberculosis is its ability to survive within macrophages.
| 2 |
Wax D
|
Cord factor
|
Muramyl dipeptide
|
Muramyl dipeptide
|
Microbiology
| null |
a02059d8-4bc0-4901-a623-afbae21fd98f
|
single
|
Which of the following is consistent with diagnosis of De-Quervain thyroiditis?
|
De Quervain thyroiditis is characterised by fever, constitutional symptoms and painful enlarged thyroid due to viral etiology. Initially T4 and T3 are elevated due to damage to follicles. RAIU uptake is reduced. Subsequently hypothyroid phase sets in and RAIU becomes normal. Option A is wrong due to increased RAIU uptake which is never possible in viral thyroiditis. Option B is consistent with Grave's disease with increased RAIU. Option C indicates Central hypothyroidism. Option D indicates late phase of De Quervain thyroiditis.
| 4 |
45 year female with 2 week history of painful thyroid gland with elevated T4, T3 and low TSH. RAIU shows increased uptake
|
25 year female with painless enlarged thyroid with elevated T4,T3 and undetectable TSH. RAIU shows increased uptake
|
45 year female with fatigue and low T4, T3 and Low TSH
|
45 year male with painful thyroid 8 weeks ago with low free T4, T3 and elevated TSH
|
Medicine
|
Diseases of Thyroid
|
895ed723-4ea7-4f40-812f-d69b4ca8e0ca
|
single
|
Peripheral blood smear examination of a post splenectomy patient would show the presence of:
|
In the absence of a functional spleen, nuclear remnants are not culled from the red cells and remain as small homogeneously staining blue inclusions, known as Howell-Jolly bodies. Dohle bodies are light blue-gray, oval, inclusions located in the peripheral cytoplasm of neutrophils seen in infections, burns physical truma etc. Sphere-shaped red blood cells are known as spherocytes. Spherocytes are found in hereditary spherocytosis and autoimmune hemolytic anemia. Hypersegmented neutrophils are seen in vitamin B12 deficiency. Ref: Harrisons principles of internal medicine, 18th edition, chapter: 57
| 4 |
Dohle bodies
|
Hypersegmented neutrophils
|
Spherocytes
|
Howell-Jolly bodies
|
Pathology
| null |
3d096d5f-f236-4638-b89c-16c59ccfde7e
|
single
|
Toxicity of local anaesthesia is reversed by :
| null | 3 |
IV epinephrine
|
IV nalorphine
|
IV Barbiturates
|
IV sodium bicarbonate
|
Surgery
| null |
b3d9f7c0-1f61-44d2-ab2c-4ecb8925ad05
|
single
|
Which is the most common micro-organism known to cause tropical pyomisitis?
|
Tropical pyomyositis, a disease often seen in tropical countries, is characterised by suppuration within skeletal muscles, manifesting as single or multiple abscesses. The most common organism implicated is Staphylococcus aureus. In 20%-50% of cases there is a history of trauma to the affected muscles. Commonly involved muscles are quadriceps, glutei, pectoralis major, serratus anterior, biceps, iliopsoas, gastrocnemius, abdominal and spinal muscles. Early diagnosis is often missed because of lack of specific signs, unfamiliarity with the disease, atypical manifestations, and a wide range of differential diagnosis. Diagnostic techniques like ultrasound and computed tomography/magnetic resonance imaging are very useful in diagnosis. The diagnosis is confirmed either by biopsy or aspiration of pus from the affected muscles. The initial antibiotic of choice is cloxacillin. Incision and drainage are important components of management. Treatment for Gram negative or anaerobic organisms should be instituted, whenever indicated. Physicians should become more familiar with this potentially life threatening but curable infective disease entity.
| 4 |
Streptococcus viridans
|
Staphylococcus albus
|
Klebsiella pneumoniae
|
Staphylococcus aureus
|
Microbiology
|
Misc.
|
478f8fe7-b710-4f04-8a6d-b8bb746a0eb0
|
single
|
A temporary, provisional view held by the people on a point of view is -
|
- opinions are views held by people on a point of dispute. - they are based on the evidence available at a time Reference : Park's textbook of preventive and social medicine, 25th edition, pg no:732 <\p>
| 1 |
Opinion
|
Practice
|
Attitude
|
Belief
|
Social & Preventive Medicine
|
Social science, Mental health & Genetics
|
aac92220-8896-4a63-976b-458e2b5bcf12
|
single
|
Drug of choice for treatment of neurocysticercosis is:-
|
Both praziquantal and albendazole are effective against neurocysticercosis. Albendazole is preferred because of its more efficacy and lesser duration of treatment
| 3 |
Pyrantel palmoate
|
Praziquantel
|
Albendazole
|
Ivermectin
|
Pharmacology
|
Anti-Parasitic Drugs
|
b481645e-1103-4e29-b328-7c0af584247f
|
single
|
Adrenal insufficiency causes: March 2011
|
Ans. B: Low blood pressure Features of an acute adrenal crisis include circulatory shock with severe hypotension, hyponatremia, hyperkalemia and, in some instances hypoglycemia and hypercalcemia.
| 2 |
A rise in plasma sodium/potassium ratio
|
Low blood pressure
|
Increase breakdown of protein
|
All
|
Medicine
| null |
901a76cc-d9ef-4fcb-961a-3978ede1e74d
|
multi
|
The commonest cause of Intracerebral Bleed is:
|
Answer is C (Hypeension): An intracerebral bleed (parenchymal) invariably results from rupture of small perforating aeries or aerioles as a result of Hypeension.
| 3 |
Thrombocytopenia
|
Diabetes
|
Hypeension
|
Berry aneurysm
|
Medicine
| null |
d6e56f6f-f526-4484-93b1-168c5e9ec2b6
|
single
|
Following is the most important factor in the management of shock:
| null | 4 |
Blood pressure
|
Cardiac output
|
CVP to 8 cm of water
|
Deficiency of effective circulating blood volume
|
Pathology
| null |
c76d4d4a-2bd4-4369-ba27-74ccb961fc31
|
single
|
For the prevention of human rabies, immediate flushing and washing the wound(s) in animal bite cases, with plenty of soap and water, under running tap should be carried out for how much time
|
Local wound Treatment in Rabies Purpose of local treatment is to remove as much virus as possible, from site of inoculation, before it is absorbed on local nerve endings Local wound treatment can reduce chances of rabies upto 80% Immediate flushing and washing wound area with plenty of soap and running water for minimum 15 minutes is of paramount impoance Suturing : Not recommended ; if necessary, do 24-48 hours later under cover of Anti-rabies serum (Local application with prior sensitivity testing) Chemical treatment with virucidal agents (Alcohol, tincture, 0.01% aqueous iodine) Ref: Park 25th edition Pgno : 296
| 3 |
2 minutes
|
1 minute
|
15 minutes
|
5 minutes
|
Social & Preventive Medicine
|
Communicable diseases
|
070129f2-755f-4b28-a046-dbb7367a13c2
|
single
|
During the ear examination, cough occurs due to stimulation of?
|
Arnold nerve. It is an auricular branch of the jugular ganglion of the vagus. It supplies the skin of posterior pa of pinna on the medial surface of the concha, and posterior wall of the external auditory canal and tympanic membrane. The auricular nerve is the afferent limb of the Ear-Cough or Arnold Reflex. Ref: Dhingra 6th edition pg no 446
| 1 |
Vagus
|
Trigeminal
|
Hypoglossal
|
Trochlear
|
ENT
|
Ear
|
1b71a00e-2c7b-47af-9e2e-dabab0ddd943
|
single
|
Which of the following is not a radiological feature of meningioma?
|
Ans. Decalcification inner table
| 4 |
Lamellar calcification
|
Enlarged foramen spinosum
|
Increased meningeal vascular markings
|
Decalcification inner table
|
Radiology
| null |
f9c47044-8956-4a24-98cc-27e334c2acf3
|
single
|
Gall bladder stone formation in influenced by all except:
|
Answer is D (Hypercholesterolemia): It is increased concentration of cholesterol relative to bile salts in bile that promotes gall stone formation. Serum cholesterol may well be normal. All ether options are known local factors that promote gall stone formation and hence Hypercholesterolemia is the single best answer of exclusion. Formation of Gall stones is promoted by following factors : Increased concentration of cholesterol relative to bile salts in bile. (With or without hypercholesterolemia) Stasis Infection Clofibrate therapy : This drug is used to excrete cholesterol in hyperlipoprotenemia It therefore increases the concentration of cholesterol in bile. Hyperalimentation : Parental supplementation leads to hypofunction of Gall bladder, thus contibuting to gall stone formation by 'Stasis'. Primary biliary cirrhosis : Leads to a decrease in bile acid secretions. Decreased salts are unable to keep cholesterol in solution and therefore lead to precipitation of cholesterol stones
| 4 |
Clofibrate therapy
|
Hyperalimentation
|
Primary biliary cirrhosis
|
Hypercholesterolemia
|
Medicine
| null |
6e3007c9-afa1-420c-8625-86c74ea55a25
|
multi
|
The failure of a calcium hydroxide pulpotomy done on a
primary 1st molar is due to:
| null | 1 |
Internal resorption
|
External resorption
|
Pulp calcification
|
Pulp fibrosis
|
Dental
| null |
21b7dd5c-97e4-41d1-9208-f9a2da5d18fe
|
single
|
First antiboy to appear in hepatitis:
|
Ans. b. IgM anti HBc
| 2 |
IgM anti HBe
|
IgM anti HBc
|
IgG anti HBe
|
IgM anti HBs
|
Microbiology
| null |
e274527b-3b94-41c0-8bf4-1ca94cc26054
|
single
|
All of the following affect resting ventilation except
|
B i.e. J receptorTidal volume excessive load is prevented by (or lung maintains the tidal volume by) activation of slowly adapting pulmonary (or bronchial) stretch receptorsQ."Inflation of lungs induces fuher inflation" due to elastic recoil of alveoli. With inflation of the lungs, there is augmentation of respiratory effo= Head's paradoxical reflex.Excessive inflation of lungs cause reflex inhibition of inflation- this is Hering Breuer inflation reflex mediated by vagus. Conversely, excessive deflation of lungs cause reflex inhibition of expiration - this is Hering- Breuer deflation reflex.- Physiological role of J (juxta-capilary/alveolar) reflex is unceain but it occurs in pathological states such as pulmonary congestion, pulmonary edemaQ and embolism when the J recptors are stimulated by large lung hyper inflation, or intravascular chemicals like capsaicin, bradykinin & serotonin etc.- Slowly adapting pulmonary stretch receptors are stimulated by lung inflation (not hyper inflation) - Ganong p 632 table 37.2. Hyper inflation (over stretching) of lungs stimulate stretch receptors and lead to Hering - Breuer inflation reflex. However, more recent work indicates HB reflex may be impoant in new born babies but are largely inactive in adult human unless the tidal volume exceeds 1 liter (John west) /1.5 liter (Guyton), as in exercise. So we can extract inference that, although stretch receptors get stimulated by (normal-quiet) inflation, the HBI reflex occurs only after lung hyper inflation.Nonchemical Responses Mediated by Pulmonary Receptors and ReflexesReceptor TypeLocationImpulse travel in(i.e. Vagalinnervation)StimulusResponse/ ReflexSlowly adaptingAirwayMyelinated vagalLung inflationQ- Inspiratory timeStretch Receptorsmoothfibers shoening(pulmonary orbronchial stretchreceptors)muscle (?) - Hering-Breuerinflation & deflationreflexesQ - Bronchodilation - Hyperpnea - TachycardiaRapidly adaptingAirwayMyelinated vagal- Lung- Increased airwayIrritant Receptorsepithelial cellsfibersHyperinflationQresistance i.e. broncho(type of - Exogenous &constriction (egstretch/mechano- endogenousasthama)receptor) substances eghistamine andprostaglandins- Mucus secretion- Cough_ Hering-Breuerdeflation reflexJ (Juxta-In pulmonaryUnmyelinated- Lung Hyper- Apnea (d/t intensecapillary/alveolar)interstitial(pulmonaryinflationQ (large)stimulation) f/b rapid,Receptorsspace close tovagal)- Exogenous &shallow breathing(Juxta pulmonarybloodC fibersendogenous(tachypnea) andcapillary receptorcapillaries of agents egdyspneaor pulmonary Cfiber receptor)- Pulmonarycirculation- Bronchialcirculation capsaicin,bradykinin,serotonin,histamine,prostaglandins,phenyl diguanide-Pulmonary edema, embolism- Broncho constriction- Mucus secretion- Brady cardia-Hypotension(-pulmonarychemoreflex) & congestionQ * Bronchial C fiber receptors located in the airways and innervated by nonmyelinated fibers are activated bychemicals (notably bradykinin)injected into bronchial aery. Their stimulation gives rise to tachypnea, bronchoconstriction, and airway secretion. Along with type J (juxta pulmonary capillary) receptors, they contribute to air way defence reflexes.* Receptors in nose & upper airway (nasopharynx, larynx & trachea) responding to mechanical & chemical stimulation 1/t sneezing, coughing, broncho constriction and aryngospasm.* Impulses from joint & muscle receptors of moving limb stimulates ventilation during early exercise.* Gamma system or muscle spindle of thoracic intercostal muscles and diaphragm sense elongation of these muscles and reflexly control strength of contraction. For example dyspnoea is sensed by unusually large respiratory effos required to move the lung.* Pain cause apnea followed by hyperventilation. Heating of skin (or fever) result in hyperventilation (paly d/t stimulation of hypothalamic thermoreceptor).* Aerial (aoic & carotid sinus) baroreceptor stimulation by increased BP causes reflex hypoventilation or apnea; whereas decreased BP 1/t hyperventilation (thereby enhancing venous return following severe hemorrhage).
| 2 |
Stretch receptors
|
J receptor
|
Oxygen
|
PCO2
|
Physiology
| null |
f4c96f85-cd54-4a09-b11e-2405d4cee275
|
multi
|
A 22-year-old woman consults you for treatment of hirsutism. She is obese and has facial acne and hirsutism on her face and periareolar regions and a male escutcheon. Serum LH level is 35 mIU/mL and FSH is 9 mIU/mL. Androstenedione and testosterone levels are mildly elevated, but serum DHAS is normal. The patient does not wish to conceive at this time. Which of the following single agents is the most appropriate treatment of her condition?
|
This patient has polycystic ovarian syndrome (PCOS), diagnosed by the clinical picture, abnormally high LH-to-FSH ratio (which should normally be approximately 1:1), and elevated androgen but normal DHAS. DHAS is a marker of adrenal androgen production; when normal, it essentially excludes adrenal sources of hyperandrogenism. Several medications have been used to treat hirsutism associated with PCOS. For many years contraceptives were the most frequently used agents; they can suppress hair growth in up to two-thirds of treated patients. They act by directly suppressing ovarian steroid production and increasing hepatic binding globulin production, which binds circulating hormone and lowers the concentration of metabolically active (free unbound) androgen. However, clinical improvement can take as long as 6 months to manifest. Other medications that have shown promise include medroxyprogesterone acetate, spironolactone, cimetidine, and GnRH agonists, which suppress ovarian steroid production. However, GnRH analogues are expensive and have been associated with significant bone demineralization after only 6 months of therapy in some patients. Surgical wedge resection is no longer considered an appropriate therapy for PCOS given the success of pharmacologic agents and the ovarian adhesions that were frequently associated with this surgery.
| 1 |
Oral contraceptives
|
Corticosteroids
|
GnRH
|
Parlodel
|
Gynaecology & Obstetrics
|
Physiology & Histology
|
a0a49f3a-6744-48ff-9661-0ecd2dcd6305
|
single
|
When undertaking bleaching of vital teeth of the
following are done except:
| null | 3 |
Prophylaxis
|
Use of protective eye glasses
|
Use of local anaesthesia
|
Polishing after treatment
|
Dental
| null |
9822ee4f-fad4-4533-b971-793a1a7ce4dc
|
multi
|
The composition of ORS recommended by WHO is
| null | 3 |
3.5 g NaCl
|
4.5 g NaCl
|
2.9 g sodium-potassium citrate
|
2.8 g sodium bicarbonate
|
Social & Preventive Medicine
| null |
15e4a3b8-d8b8-4683-b31c-89ac1585e9dc
|
single
|
Inversion of nipple occurs due to the involvement of
|
Breast carcinoma arising from lactiferous ducts is called as ductal carcinoma.
Breast carcinoma arising from lobules is called as lobular carcinoma. It is 10% common.
Cutaneous Manifestations of Carcinoma Breast
Peau d’orange: Due to obstruction of dermal lymphatics, openings of the sebaceous glands and hair follicles get buried in oedema giving rise to orange peel appearance.
Dimpling of skin due to infiltration of ligament of Cooper.
Retraction of nipple due to infiltration of lactiferous duct.
Ulceration, discharge from the nipple and areola.
Skin ulceration and function.
Cancer-en-cuirasse: Skin over the chest wall and breast is studded with cancer nodules appearing like an armour coat.
| 4 |
Breast lobules
|
Montogomory tubercles
|
Cooper ligament
|
Lactiferous ducts
|
Surgery
| null |
07266217-abc8-4533-9cf7-4c855242f945
|
single
|
The principle that in spinal cord, the dorsal roots are sensory and the ventral roots are motor, is known as:
|
Bell Megendie Law: States that in spinal cord, the dorsal roots are sensory and the ventral roots are motor. Dale's principle: Same neurotransmitter is released at all branches of a neuron. Monro Kellie hypothesis: The blood volume in the cranial cavity is approximately constant. As the cranium is rigid (except in a young child) and as the brain is viually incompressible the combined volume of brain tissue, cerebrospinal fluid (CSF), and intracranial blood is nearly constant. Muller's doctrine of specific nerve energies: When a paicular nerve pathway from a paicular sense organ is stimulated, the sensation produced is that for which the receptor is specialized, no matter how the pathway was stimulated.
| 1 |
Bell-Magendie law
|
Dale's principle
|
Monro-Kellie hypothesis
|
Muller's doctrine
|
Physiology
|
Sensory System
|
0d2a2bc9-ec3d-4e06-b579-406415e2d635
|
single
|
A 60 year old man who is a known case of coronary artery disease with drug eluting stent placed 1year ago, presents with lump in abdomen and is posted for laparoscopic diagnostic evaluation. He is also hypertensive patient. Which of the following medications should he discontinue prior to procedure
|
Clopidogrel has to be stopped 7 days prior to surgery.
| 2 |
Atenolol
|
Clopidogrel
|
Simvastatin
|
Aspirin
|
Anaesthesia
| null |
0084aa06-8b00-4ccb-93ef-6df696b750b8
|
single
|
Impoant step in activation of naive CD 4+ T cells and initiation of cell mediated immune response is played by Interleukin?
|
Ans. is 'b' i.e., 2 Activation of CD4+ T Cells: Naive CD4+ T cells recognize peptides displayed by dendritic cells and secrete IL-2, which functions as an autocrine growth factor to stimulate proliferation of the antigen- responsive T cells. The subsequent differentiation of antigen-stimulated T cells to TH1 or TH17 cells is driven by the cytokines produced by APCs at the time of T-cell acti- vation. In some situations the APCs (dendritic cells and macrophages) produce IL-12, which induces differentiation of CD4+ T cells to the TH1 subset. IFN-y produced by these effector cells promotes fuher TH1 development, thus amplifying the reaction. If the APCs produce inflammatory cytokines such as IL-1, IL-6, and a close relative of IL-12 called IL-23, these stimulate differentiation of T cells to the TH17 subset.
| 2 |
1
|
2
|
3
|
4
|
Pathology
| null |
b77be92c-10d8-47e2-907c-a633e1ec616f
|
multi
|
A 60-years-old man with diabetes mellitus presents with painless, swollen right ankle joint. Radiographs of the ankle shows destroyed joint with large no. Of loose bodies. The most probable diagnosis is:
|
Patient of diabetes with painless swollen joint is enough for the diagnosis of charcot's joint. X-Ray Features Marked destructive changes with periaicular erosions Joint space narrowing Osteophyte formation Subchondral sclerosis Loose bodies. The changes simulate osteoahritis, but the absence of pain is diagnostic. Similarly, it may be difficult to differentiate it from osteomyelitis but joint margins in charcot's ahropathy are distinct , while in osteomyelitis its blurred. MRI/Bone scan can fuher help in D/D but CT scan is not useful.
| 1 |
Charcot's joint
|
Clutton's joint
|
Osteoahritis
|
Rheumatoid ahritis
|
Orthopaedics
|
Joint disorders
|
c5103336-0668-44b5-911c-ef4b35e8feaf
|
single
|
Death of the mother from an automobile accident comes under
|
Nonmaternal death: Death of the mother that results from accidental or incidental causes not related to pregnancy. An example is death from an automobile accident or concurrent malignancy(Ref: William's Obstetrics; 25th edition)
| 3 |
Direct maternal death
|
Indirect maternal death
|
Nonmaternal death
|
None of the above
|
Gynaecology & Obstetrics
|
All India exam
|
4561777c-bd6b-46bf-961f-d4ac5ba3f141
|
multi
|
Anti–TNF alpha drugs are used for the treatment of all of following diseases EXCEPT :
|
There is already under-expression of TNF-α in SLE, therefore we cannot use anti-TNF drugs for this condition. It is further strengthened by the fact that anti-TNF alpha drugs like infliximab cause SLE as the adverse effect.
Indications for TNF-α inhibitors
Rheumatoid arthritis
Juvenile arthritis
Psoriatic arthritis
Psoriasis
Ankylosing spondylitis
Crohn's disease
| 1 |
Systemic lupus erythematosis
|
Seronegative arthritis
|
Psoriatic arthritis
|
Crohn's disease
|
Pharmacology
| null |
cecfa7c5-8084-4091-816d-ed9b62203e4e
|
multi
|
The rate of cooling down of dead bodies in tropical climate is: Delhi 06; Kerala 06; UP 07
|
Ans. 0.5degC/h
| 2 |
0.2degC/h
|
0.5degC/h
|
1.5degC/h
|
2degC/h
|
Forensic Medicine
| null |
b198555f-572c-4426-a967-a48fc417e5a0
|
single
|
A 73-year-old man has ischemic rest pain of the left calf. Workup reveals occlusion of the left superficial femoral artery. He is scheduled for an elective femoral-popliteal bypass. A good way to reduce the risk of infection would be to:
|
Shaving is associated with an increased incidence of wound infection compared to the use of electric clippers or depilatories, as well as compared to no hair removal at all. Prophylactic antibiotics should be started within 60 minutes of the incision time. Plastic adherent drapes and antibiotic wound irrigation have not been proven to reduce wound infection rates. Wound infection rates increase as duration of surgery increases beyond 2 hours due to the reemergence of skin flora.
| 4 |
Irrigate the wound with bacitracin during the operation
|
Start cefazolin 1 gIV 4 hours before the surgery
|
Use a plastic adherent drape
|
Not shave the leg
|
Surgery
|
Miscellaneous
|
8f88ef31-b8a5-45c7-94c2-6822c26d8b39
|
single
|
A pregnant woman with fibroid uterus develops acute pain in abdomen with low grade fever and mild leucocytosis at 28 weeks. The most likely diagnosis is:
|
Red degeneration This complication occurs during pregnancy (2nd trimester) Myoma becomes tense and tender Symptoms: Abdominal pain, constitutional upset and fever Rx :bed rest and analgesics. Never operate In case of torsion of fibroid, severe abdominal pain is there but fever and raised leucocyte count is not seen. Fibroids in pregnancy can cause Aboions Fetal malpresentations Obstructed labour Abruption Postpaum hemorrhage Red Degneration Myomas in the uterine incision area may make it impossible to make a lower segment incision and hence an upper (Classical) incision is often required. Fibroids may also impair the uterine retraction after delivery/LSCS and may hence predispose to more cesarean Hysterectomies.
| 3 |
Preterm labour
|
Torsion of fibroid
|
Red degeneration of fibroid
|
Infection in Fibroid
|
Gynaecology & Obstetrics
|
Fibroids
|
9ebea45d-3d4c-43d6-8712-3165037dd534
|
single
|
Classification of aoic dissection depends upon?
|
Ans. is 'b' i.e., Level of aoa affectedClassification of Aoic dissectiono The risk and nature of serious complications of dissection depend strongly on the level of aoa affected, with the most serious complications occuring from the aoic valve to the arch.o Thus aoic dissections are generally classified into two types -1. Proximal lesion (Type A)o More common and more dangerous.o Involve either the ascending poion only or both ascending and the descending poion of aoa.2. Distal lesion (Type B)o Involve only discending pa distal to subclan aery.
| 2 |
Cause of dissection
|
Level of aoa affected
|
Percentage of aoa affected
|
None
|
Pathology
| null |
fbd853be-310f-4e62-96b5-dddcb8cee4b2
|
multi
|
A child having IQ of 25 falls in which category?
|
ANSWER: (C) DependentREF: Shorter Oxford Textbook of Psychiatry 5th edition p. 708-712, Current Diagnosis & Treatment in Psychiatry p. 543CLASSIFICATION OF MENTAL RETARDATION: Mild MRModerate MRSevere MRProfound MRIQ50-7035-5020-35<20Quality of lifeEducableTrainableDependentNeeds life supportProgressClass 6Class 2--
| 3 |
Educable
|
Trainable
|
Dependent
|
Needs life support
|
Pediatrics
|
Neurologic Evaluation
|
c92fe108-a70a-40ba-a0b1-705115a411d0
|
multi
|
The symptoms of dietary deficiency of niacin (which results in pellagra) will be less severe if the diet has a high content of:
|
a. Tryptophan(Ref: Nelson's 20/e p 325, Ghai 8/e p 118)Tryptophan can be converted to nicotinamide adenine dinucleotide (NAD) 60mg tryptophan gives rise to 1mg niacin.
| 1 |
Tryptophan
|
Tyrosine
|
Thymine
|
Thiamine
|
Pediatrics
|
Nutrition
|
1974768c-77ac-41b4-8897-eec835d8c3ff
|
single
|
Blood supply of posterior limb of internal capsule includes all except-
|
Posterior limb of internal capsule is supplied by three sets of arteries :
striate branch of middle cerebral artery,
anterior choroid artery; and
posterolateral branches of posterior cerebral artery.
| 2 |
Middle cerebral artery
|
Anterior cerebral artery
|
Anterior choroidal artery
|
Posterior cerebral artery
|
Anatomy
| null |
485305c9-fc36-42a2-ab04-94e696601d86
|
multi
|
Blood vessels can be harvested from a body for the purpose of transplantation latest by what period after death?
|
The periods within which some organs should be removed are as follows Cornea - 6 hours Skin - 24 hours Bone - 48 hours Blood vessels - 72 hours Ref: Essentials of forensic medicine and toxicology by Narayan reddy, edition 21, page 112
| 4 |
8 hours
|
12 hours
|
48 hours
|
72 hours
|
Forensic Medicine
| null |
3b9e48ec-21a1-4b0c-91f9-9ee375381ffe
|
single
|
According to 357 (c) CrPC, all hospitals (Govt or private) shell provide the first aid medical care free of cost to victims of offences covered by the following section except:
|
C. 302 Treatment of victims : * All hospitals, public or private, whether run by the Central Government, the State Government, local bodies or any other person, shall immediately, provide the first-aid or medical treatment, free of cost, to the victims of any offence covered under section 326A, 376, 376A, 376B, 376C, 376D or section 376E of the Indian Penal Code, and shall immediately inform the police of such incident.
| 3 |
326 A IPC
|
376 IPC
|
302 IPC
|
376 A IPC
|
Forensic Medicine
|
Sexual offences
|
76f9d27a-bfbc-4491-911f-bdf406db3e53
|
multi
|
In a chronic smoker, a highly malignant aggressive and metastatic lung carcinoma is :
|
Cigarette smoking is most strongly associated with squamous Cell Ca and small cell Ca and less commonly associated with Adenocarcinoma.
But small cell Ca is highly malignant & Blood stream metastasis occurs early in the course of this Ca.So the answer is small cell carcinoma.
Also Remember
M.C Variety of lung Ca in India → Squamous Cell Ca*
M.C Variety in world → Adenocarcinoma*
M.C Variety in young Patients → Adenocarcinoma*
Histological Variety that cavitates → Squamous cell Ca*
M.C Histological variety to metastasi → Small cell Ca*
Lung to lung metastasis is seen in → Bronchoalveolar Ca (a type of adeno Ca)
Clubbing least common in which Ca → Small cell Ca*
Gynaecomastia is seen in which type of Ca → large Cell Ca*
Thrombophlebitis is seen with which Ca → Adenocarcinoma*
Most common site for metastasis from ca lung → Adrenals* (Ref Robbins Basis 7/e, p 760)
Lung Ca with worst prognosis → Small cell Ca*
Variety most responsive to chemotherapy → Small cell Ca*
Variety most responsive to radiotherapy → Small cell Ca*
M.C Endocrine Gland to be involved by metastasis → Adrenal*
Variety with best prognosis → Squamous cell CA*
Variety that is central in location → Squamous cell & small cell Ca*
Variety that is peripheral in location → Adenocarcinoma*
Most common variety with Cushing's syndrome → Small cell Ca*
Most common variety with Hypercalcemia → d/t PTH like substance Secretion → Squamous cell Ca*
| 4 |
Squamous cell Carcinoma
|
Adenocarcinoma
|
Large cell carcinoma
|
Small cell Carcinoma
|
Medicine
| null |
a8b586ea-206b-4212-8995-9c243da81597
|
multi
|
Hypersensitivity vasculitis affects -
| null | 1 |
Post-capillary venules
|
Arterioles
|
Veins
|
Medium-sized arteries
|
Medicine
| null |
15602abf-3f96-4c57-9307-12667465300d
|
single
|
Which of the following is a prodrug is -
|
(C) (Primidone) (38 - H 18th) (23, 413 - KDT 7th)PRIMIDONE - A deoxybarbiturate converted by liver to phenobarbitone and phenylethyl malonamide (PEMA). Its antiepileptic activity is mainly due to those active metabolites because t 1/2 of primidone (6-14 hr.) is less than that of its active metabolites, About 1/3 primidone is excreted unchanged by Kidney.Prodrugs are inactive compounds that require metabolism to generate active metabolites that mediate the drug effects. Examples include many angiotensin-converting enzyme (ACE) inhibitors, the angiotensin receptor blocker losartan, the antineoplastic irinotecan, the anti-estrogen tamoxifen, the analgesic codeine (whose active metabolite morphine probably underlies the opioid effect during codeine administration), and the antiplatelet drug clopidogrel. Drug metabolism has also been implicated in bioactivation of procarcinogens and in generation of reactive metabolites that mediate certain adverse drug effects (e.g., acetaminophen hepatotoxicity).ProdrugActive formLevodopa- DopamineEnalapril- Enalaprilata-Methyldopa- a-methylnorepinephrineDipivefrine- EpinephrineSulindac- Sulfide metaboliteProguanil- CycloguanilPrednisone- PrednisoloneBacampicillin- AmpicillinSulfasalazine- 5-Aminosalicylic acidCyclophosphamideAidophosphamide, phosphoramide mustard, acroleinFluorouracil- Fluorouridine monophosphateMercaptopurine- Methylmercaptopurine ribonucleotideAcyclovir- Acyclovir triphosphate
| 3 |
Phenytoin
|
Carbamazepine
|
Primidone
|
Valproic acid
|
Pharmacology
|
General Pharmacology
|
5b94e95b-5d3c-4f56-97d7-efbf27c7f37a
|
single
|
The following are examples of apoptosis, except
|
NecrosisApoptosisAlways pathological Maybe physiological or pathological Associated with disruption of cellular homeostasis Impoant for development, homeostasis & elimination of pathogens & tumour cellsAffects contiguous group of cellsAffects single cellCell size increased Cell size shrunken Passive Active Cause inflammatory reaction No inflammatory reaction Plasma membrane disrupted Plasma membrane intact Smear pattern on electrophoresis Step ladder pattern on electrophoresis
| 2 |
Menstrual cycle
|
Tumour necrosis
|
Graft versus host disease
|
Pathological atrophy following duct obstruction
|
Anatomy
|
All India exam
|
62bbda75-f770-4740-8d7f-5bc8a164acc3
|
multi
|
Which of the following antifungal agents binds to ergosterol
|
POLYENE ANTIBIOTICS Amphotericin B (AMB) Mech of action:- The polyenes have high affinity for ergosterol present in fungal cell membrane. They combine with it, get inseed into the membrane and several polyene molecules together orient themselves in such a way as to form a 'micropore'. The hydrophilic side forms the interior of the pore through which ions, amino acids and other water-soluble substances move out. The micropore is stabilized by membrane sterols which fill up the spaces between the AMB molecules on the lipophilic side--constituting the outer surface of the pore. Thus, cell permeability is markedly increased. Ref:- kd tripathi; pg num:-787
| 3 |
Flucytosine
|
Terbinafine
|
Amphotericin B
|
Fluconazole
|
Pharmacology
|
Antibiotics
|
f49a8772-f8de-41ae-bd9a-101ef8f9e716
|
single
|
After digestion by restriction endonucleases DNA bands can re-joined by which of the following substance?
|
DNA ligase is used to join the DNA bands formed after digestion by restriction endonuclease. DNA gyrase: Its a special type of topoisomerase, has the unusual propey of being able to introduce negative supercoils into resting DNA. This facilitates the future replication of DNA because the negative supercoils neutralise the positive supercoils introduced during opening of the double helix.
| 2 |
DNA polymerase
|
DNA ligase
|
DNA topoisomerase
|
DNA gyrase
|
Biochemistry
| null |
945aef4d-9873-461e-80f8-866581bd6a66
|
single
|
Abnormalities of copper metabolism are implicated in the pathogenesis of all the following ExceptEXPL
|
(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 344)
| 4 |
Wilson's disease
|
Menkes Kinky-hair syndrome
|
Indian childhood cirrhosis
|
Keshan disease
|
Pediatrics
|
All India exam
|
b0b74d21-ea72-4b47-a0c4-c691fe45567f
|
multi
|
Carcinoma in situ of skin is called as:
| null | 2 |
Cowden syndrome.
|
Bowen disease.
|
Both
|
None
|
Pathology
| null |
28a4b7ba-cccf-4d2d-8a96-d0dd09cba045
|
multi
|
All the following pathogenic bacteria fulfill Kochs postulates except
|
Koch's postulates: A microorganism was accepted as the causative agent of infectious disease, only when it satisfied all the following criteria: 1. The microorganism must be present in every case of the disease but absent from healthy host. 2. The suspected microorganism must be isolated and grown in a pure culture from lesions of the disease. 3. The isolated organism, in pure culture, when inoculated in suitable laboratory animals should produce a similar disease. 4. The same microorganism must be isolated again in pure culture from the lesions produced in experimental animals. Most of the human bacterial pathogens satisfy Koch's postulates except for Mycobacterium leprae (leprosy) Treponema pallidum (syphilis) Both these bacteria are yet to be grown in cell-free culture media.
| 1 |
Treponema pallidum
|
Yersinia pestis
|
Bacillus anthracis
|
Helicobacter pylori
|
Microbiology
|
General Microbiology Pa 1 (History, Microscopy, Stains and Structure and Physiology of Bacteria)
|
c532d362-8ba4-4ad3-918d-2d924b10c55d
|
multi
|
Levinthal Coles Lillie bodies are seen in -
|
Ans. is 'b' i.e., Psittacosis * In psittacosis infected cells, including alveolar macrophages from patients, and mouse brain, yolk sac and cell cultures shows inclusion bodies - Levinthal - Cole - Lillie (LCL) bodies.
| 2 |
LGV
|
Psittacosis
|
KalaAzar
|
Chicken pox
|
Microbiology
|
Virology
|
9ce6e8cc-ca13-4ef2-bfbd-ac063cf227bf
|
single
|
Low grade squamous Intraepithelial leison of cervix in Bethseda system includes :
|
Dysplasias are graded as: 1. Mild dysplasia (CIN-I). The undifferentiated cells are confined to the lower one-third of the epithelium. The cells are more differentiated towards the surface. Mild dysplasia due to infection is often seen in young women indulging in sexual activity. CIN-I is lately described as low grade squamous intraepithelial lesions (LSIL) according to the Bethesda classification. 'Ascus' is a term described in the Bethesda system as atypical cells of undetermined significance. The intermediate cells mostly display mild dysplasia with enlarged nuclei and irregular outline. One per cent progress to cancer over the years. 2. Moderate dysplasia (CIN-II). Undifferentiated cells occupy the lower 50-75% of the epithelial thickness. The cells are mostly intermediate with moderate nuclear enlargement, hyperchromasia, irregular chromatin and multiple nucleation. Thiy per cent of CIN II regress, 40% persist and the rest progress to invasive cancer. 3. Severe dysplasia and carcinoma in situ (CIN-III). In this grade of dysplasia, the entire thickness of the epithelium is replaced by abnormal cells. There is no cornification and stratification is lost. The basement membrane, however, is intact and there is no stromal infiltration. Often, an abrupt change in histological appearance from normal to abnormal is apparent. The cytology cells are mostly parabasal with increased nuclear-cytoplasmic ratio. The nuclei are irregular, with coarse chromatin material; mitosis and multinucleation are common. Almost all progress to invasive cancer over 10-15 years. 4. Tadpole cells are seen in invasive cancer. CIN-II and CIN-III are described as high-grade squamous intraepithelial lesions (HSIL) according to the latest Bethesda classification. HSIL have a propensity to progress and become invasive, and therefore need investigations and treatment.In cervix , low grade squamous Intraepithelial leison ( LSIL ) in 2001 Bethseda system includes cervical intraepithelial neoplasia I Reference: Textbook of Gynaecology; 16th edition; Pg no:486
| 1 |
CIN 1
|
CIN 2
|
CIN 3
|
Squamous metaplasia
|
Gynaecology & Obstetrics
|
Gynaecological oncology
|
da06f0a5-5292-496f-80b4-78f16955d295
|
single
|
Which of the following fracture is known as "fracture a-la signature"?
|
Depressed fractures are produced by local deformation of the skull. In this, fractured bone is driven inwards into the skull cavity. The outer table is driven into the diploe, the inner table is fractured irregularly and to a greater extent and may be comminuted. They are also called 'fractures a la signature' (signature fractures), as their pattern often resembles the weapon or agent which caused it. Ref: The Essentials of Forensic Medicine and Toxicology by K S Narayan Reddy, 27th edition, Page 216.
| 1 |
A depressed fracture
|
A fissured fracture
|
Separation of the suture
|
A ring fracture
|
Forensic Medicine
| null |
9ddd350b-7074-40ab-bab7-f0003984ad1e
|
single
|
Which of the following is a terminal axillary lymph node?
|
Apical group of lymph nodes are the terminal axillary lymph nodes. Lymphatic drainage of axillary lymph nodes Anterior, posterior, lateral - central - apical - infra clavicular - supraclavicular - right jugular trunk - right lymphatic duct - right jugulo subclan venous angle
| 4 |
central
|
lateral
|
anterior
|
apical
|
Anatomy
|
Upper limb : Miscellaneous
|
26060999-5f56-4a34-84be-0f8e1ae7f56e
|
single
|
All of the following are ture regarding cephalosporins except -
|
Ans. is 'b' i.e., Active against olny gram negative bacteria Cephalosporins are active against gram positive as well as gram negative bacteria, and are bactericidal. o Ceftriaxone is a parentral cephalosporin. o Third generation cephalosporins are highly resistant to beta-lactamases from gram negative bacteria.
| 2 |
Bactericidal agents
|
Active against only gram negative bacteria
|
IIIrd generation are resistant to beta-lactamases from gram negative bacteria
|
Ceftriaxone is administered parenterally
|
Pharmacology
| null |
5395f0d5-df5f-4d5d-bfa7-94bbab8621bd
|
multi
|
A 30-year-old female presents with a 3-month history of 10kg weight loss despite an increased appetite. She also complains of anxiety, diarrhea and amenorrhea. Examination reveals a fine tremor, brisk reflexes and a systolic murmur heard throughout the precordium. A urine pregnancy screen was negative. What is the most likely finding on examining the pulse?
|
Female, weight loss in spite of appetite, amenorrhea, tremors, brisk reflexes are features of Thyrotoxicosis Option A- Pulses Paradoxus is feature of C. Tamponade it is ruled out Option B- Collapsing pulse- Rapidly rising pulse, which collapses suddenly as aerial pressure falls rapidly, during late systole and diastole (Corrigan's pulse). -Feature of aoic regurgitation & AR have Diastolic murmur. Option C- Thyrotoxicosis can be Associated with A. fibrillation. So, irregularly irregular pulse can be presentation of Thyrotoxicosis. Option D- Pulsus Alternans is feature of LVF.
| 3 |
Pulsus paradoxus
|
Collapsing pulse
|
Irregularly irregular pulse
|
Pulsus alternans
|
Medicine
|
Murmurs
|
ce207c6c-d13c-40df-8e90-ed857aebb3a4
|
single
|
Advantage of cisatracurium over atracurium is?
|
Ans. (D) Releases less histamine(Ref: Goodman and Gilman 13th/e p182)Both atracurium and cis-atracurium are non-depolarizing neuromuscular blockers.Both of these are intermediate acting agents (both have same duration of action).Both of these agents are cardiostableAtracurium has faster onset of action as compared to cis-atracurium.Both are eliminated by Hoffman's elimination. Atracurium is also metabolized by liver to some extent and result in production of a metabolite laudanosine that can cause CNS toxicity including seizures. On the other hand cis-atracurium is almost completely eliminated by Hoffman's elimination and produce negligible laudanosine.Major advantage of cis-atracurium over atracurium is that the former do not release histamine.
| 4 |
Short duration of action
|
Rapid onset
|
Less allergic
|
Releases less histamine
|
Pharmacology
|
Anaesthesia
|
db35fe68-a1ca-4186-8913-9b4efb4da43c
|
multi
|
The initiation of hemoglobin synthesis requires:
|
Ans. (b) GlycineRef: Harper's Biochemistry, 30th ed. pg. 326-28* Heme is synthesized in a complex series of steps involving enzymes in the mitochondrion and in the cytosol of the cell* The first step in heme synthesis takes place in the mitochondrion. Steps in heme synthesis are:# Condensation of succinyl CoA and glycine by ALA synthase to form 5-aminolevulic acid (ALA).# 5 ALA is transported to the cytosol where a series of reactions produce a ring structure called coproporphyrinogen III. This molecule returns to the mitochondrion where an addition reaction produces protoporphyrin IX.# The enzyme ferro chelatase inserts iron into the ring structure of protoporphyrin IX to produce heme.
| 2 |
Histidine
|
Glycine
|
Folate
|
Iron
|
Biochemistry
|
Proteins and Amino Acids
|
e91962cc-3d50-407d-8209-efae81c174c5
|
single
|
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