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Ram Devi presented with generalized edema sweating and flushing tachycardia and fever after bee sting. This is -
|
Ans. is 'b' i.e., IgE mediated reaction o The symptoms of the patient are d/t hypersensitivity type I reaction Type I is mediated by IgE and it flairs up within minutes. o There are typical features of anaphylaxis (systemic Type I hypersensitivity). Clinical manifestations of anaphylaxis o Flushing and tachycardia are usually the first and are invariant symptoms of anaphylaxis. o Uicaria (pruritis) o Angiodema o Respiratory distress and wheezing due to bronchoconstriction. o Confusion and alteration of mental status can occur.
| 2 |
T cell mediated cytotoxicity
|
IgE mediated reaction
|
IgG mediated reaction
|
IgA mediated hypersensitivity reaction
|
Pathology
| null |
e8990fe2-1a63-402b-bad4-37c9ff55dc32
|
single
|
DOC for herpes zoster is –
|
For typical cases of herpes zoster, oral acyclovir is used. Oral famciclovir or valaciclovir have advantage of a more convenient dosing.
| 2 |
Vidarabine
|
Acyclovir
|
Idoxuridine
|
Aclidine
|
Dental
| null |
05745e2b-e1d2-4421-a562-6b599ee6f767
|
single
|
Culture media used for diagnosis of EHEC 0157 : H7 is:
|
Non- DNA- dependent methods are used for routine diaggnosis of EHEC 0157: H7. This serotype is suggested by isolation of an E-coli that fails to fermant sorbitol on MacConkey sorbitol; latex aggulination confirms. Ref: Kliegman, Behrman, Jenson, Stanton (2008), "Nelson textbook of Pediatrics", Chapter 197, "Escherichia coli", Volume 1, Page 1196; Textbook of Microbiology By Ananihnarayanan, 7th Edition, Page 279; Medical Microbiology By Jawetz, 24th Edition, Page 254; Current Diagnosis and Treatment in Infectious Diseases, 11th Edition, Page 550
| 2 |
O7 culture
|
Sorbitol MacConkey media
|
XLD Agar
|
Deoxycholate Media
|
Microbiology
| null |
26d9f133-126a-4092-a03f-decc928f1671
|
single
|
Position of limb in posterior dislocation of hip ?
|
Ans. is 'b' i.e., Flexion, adduction & internal rotation
| 2 |
Flexion, abduction & external rotation
|
Flexion, adduction & internal rotation
|
Flexion, adduction & external rotation
|
Flexion, abduction & internal rotation
|
Surgery
| null |
b6e5c783-8b3e-4957-b3bc-77cec94a79e0
|
single
|
A diabetic patient 2 days after post cataract surgery develops develops hypopyon. What will be the management?
|
REF : AK KHURANA 7TH ED
| 1 |
Intravitreal antibiotics
|
Eye drops
|
Surgery
|
No treatment required
|
Ophthalmology
|
All India exam
|
5f4f931e-f94b-4c92-860c-cd940f2e8d0e
|
single
|
Which of the following is the most predominant constituent of sulfur granules of Actinomycosis is -
| null | 1 |
Organisms
|
Neutrophils and monocytes
|
Monocytes and lymphocytes
|
Eosinophils
|
Microbiology
| null |
6ab2f9eb-e670-4b61-825e-31b6436a50fd
|
single
|
Glutathione contains all except-
|
Ans. is 'b' i.e., Glutamine* Glutathione is a tripeptide* It is g glutamyl cysteinyl glycine* It is made up of three aminoacids - glutamic acid, cysteine and glycine* Hence Glutamine is not a component of glutathione
| 2 |
Cysteine
|
Glutamine
|
Glutamic acid
|
Glycine
|
Biochemistry
|
Proteins and Amino Acids
|
09e7bd2c-3eda-474f-b33b-659b8b7c6200
|
multi
|
Which of the following nerve stimulation may be considered for treatment of ADHD?
|
Ans. C. Trigeminal nerveExternal Trigeminal Nerve Stimulation (eTNS) System is indicated for patients ages 7 to 12 years old who are not currently taking prescription ADHD medication and is the first non-drug treatment for ADHD granted marketing authorization by the FDA.
| 3 |
Vagal Nerve
|
Facial Nerve
|
Trigeminal Nerve
|
Trochlear Nerve
|
Psychiatry
|
Miscellaneous
|
e1a3a36d-852b-4e5a-93ca-3d25c5671a94
|
single
|
Denis gave how many columns theory to define stability of spine:
|
(c) 3ExplanationDenis' Three-Column Theory- Proposed by Francis Denis, three-column concept divides a spinal segment into three parts: Anterior, middle, and posterior colums.- The anterior column comprises the anterior longitudinal ligament and the anterior half of the vertebral body; the middle column comprises the posterior half of the vertebral body and the posterior longitudinal ligament; the posterior column comprises the pedicles, the facet joints and the supraspinous ligaments.- Significance: If 2 out of 3 columns are involved it is labelled as unstable spinal injury.Denis 3 columns
| 3 |
1
|
2
|
3
|
4
|
Orthopaedics
|
Spinal Injuries
|
070f21b9-927c-462d-9edc-37ba9323ded8
|
single
|
Microcytic hypochromic anemia found in infestation of -
|
hookworm disease-microcytic,hypochromic anemia Ingest blood Sucks 0.2 ml blood daily Small bleeding point (Refer pgno:146 baveja 3rd edition)
| 1 |
Ancylostoma
|
Ascaris
|
Necator
|
Diphyllobothrium
|
Microbiology
|
parasitology
|
95968480-9a6b-4adb-a226-3cd59878a6ff
|
multi
|
Cotard's syndrome has ?
|
Ans. is 'c' i.e., Nihilistic delusions Types of delsions Based on the contents of delusions, they are divided into :- Persecutory delusions (paranoid) : - The patient feels that he is being persecuted against. There is false belief that one is being harmed, threatened, cheated, poisoned, harassed or spied on or is a victim of conspiracy to damage his reputation. The supposed persecutor of the patient may be people in the environment (e.g., members of family, neighbours, former friend) or may be political or religious groups. These delusions occur in schizophrenia (especially paranoid), severe affective disorders (sever mania or severe depression), and organic brain syndrome. This is the most common type of delusion. Delusion of persecution may occur in the context of primary delusional experiences, auditory hallucinations, bodily hallucinations or experiences of passivity. Grandiose delusion (expansive delusions) : - False belief that one is exceptionally powerful, talented or impoant. These delusions seen most commonly in mania, However, can also occur in schizophrenia and organic states. Delusions of reference : - False belief that ceain objects, people or events have intense personal significance and refer specifically to one self, e.g., believing that a television news reader is talking directly about oneself, or people walking on the road are talking about him. These delusions are seen in schizophrenia, mania and organic states. Religious delusions : - False belief peaining to a religious theme, often grandiose in nature, e.g., believing that one is a special messenger from God. These delusions are seen in schizophrenia. Delusions of love (erotomania) : - False belief that another person is in love with one (commoner in woman). In one form, termed de clerambault sydrome, a woman (usually) believes that a man, frequently older and of higher status, is in love with her. Delusion of infidility (morbid jealousy, othello syndrome :- False belief that one's lover has been unfaithful. These are seen in schizophrenia, alcohol related psychosis, organic states. Delusion of misidentification : - a) Capgras syndrome (Delusion of double) : - Belief that a familiar person has been replaced by an exact double i.e. an impostor. b) Fregoli syndrome : - Belief that a complete stranger is actually a familiar person already known to one. Delusion of self accusation or guilt : - False feeling of remorse of guilt. It occur in Depression. Nihilistic delusions : - False belief that oneself, others or the world is non-existent or about to end. There are pessimistic ideas that the patient's career is finished, he is about to die, world is doomed. These occurs in severe depression. If nihilistic delusions are accompanied by ideas concerning bodily function failure, e.g., putrefaction of intestines, etc., the syndrome is called COTARD's SYNDROME. Hypochondriacal delusions : - False belief about one's health, patient wrongly believes that he has severe medical illness, contrary to the all medical evidences. It is seen in depression. Delusion of infestations : - False belief that one is infested with small but visible organisms. As a monosymptomatic delusional disorder this is called EKBOM SYNDROME. It is seen in acute confusional state (due to drugs or alcohol withdrawal), in schizophrenia, in dementing illness, and as delusional eloboration of tactile hallucinatory experiences (secondary to formication). Delusion of control : - Belief that his actions, impulses or thoughts are controlled by an outside agency and accordingly called as made action, made impulse or made affect. Also called somatic passivity experiences (passivity phenomenon). Commonly seen in schizophrenia. Delusions concerning possession of thoughts - Patients with delusions about possession of thoughts may lose the conviction that their thoughts are their own. Most commonly seen in schizophrenia. Delusions of thought inseion - thoughts have been implanted by an outside agency. Delusions of thought withdrawal - thoughts are being taken out of their mind. This is usually accompanied by "thought block". Delusions of thought broadcast - unspoken thoughts are known to other people through radio, telepathy or in some other way.
| 3 |
Persecutory delusions
|
Religious delusions
|
Nihilistic delusions
|
Hypochondrical delusions
|
Psychiatry
| null |
e24e70c1-28d3-429c-b2ed-1233a7061886
|
single
|
As compared to Cow's milk, Human milk has:
|
Human milk contains higher quantities of Lactose Iron water Vit- A, C Cysteine, Taurine Linoleic acid, lenolenic acid, PUFA Casein: whey ratio Cow milk contain high quantities of Energy Proteins Fats Vit-B, D Na+, K+ Methionine Casein: whey ratio Hence, Comparative contents of nutrients given: Protein : Cow > Human Lactose : Human > Cow Iron :Human > Cow Vitamin :Human > Cow
| 3 |
More proteins
|
Less carbohydrates
|
More iron
|
Less of Vitamins
|
Social & Preventive Medicine
|
Paediatric Care in RCH: BW, BL, PEM, Breast Feeding
|
bab3570f-1813-42d5-962f-854fa8ed925c
|
single
|
A 74-year-old man presents to the emergency department with new symptoms of blood tinged sputum. For the past week he has noticed streaks of blood in his chronic daily sputum production. He reports no fever or chills, but has lost 10 lb in the past 6 months involuntarily. His past medical history is significant for hypertension, dyslipidemia, and a 40-pack year history of smoking.On physical examination, he has bilateral expiratory wheezes, and there is clubbing of his fingers. No lymph nodes are detected and the remaining examination is normal. A CXR reveals a left hilar mass. Which of the following suggests that the tumor is a small cell lung cancer?
|
SIADH is more characteristic of small cell lung cancer. Paraneoplastic syndromes are classified as metabolic, neuromuscular, connective tissue, dermatologic, and vascular. Acanthosis nigricans and other cutaneous manifestations (eg, dermatomyositis) are rare (< 1%). Clubbing is common and occurs in up to 30% of non-small cell lung cancers. The various endocrine syndromes occur in 12% of cases. At times, paraneoplastic syndromes may be the presenting finding in lung cancer or be the first sign of recurrence, most occur with non-small cell lung cancer. Stevens-Johnson syndrome usually follows drug allergy and is not a paraneoplastic syndrome.
| 1 |
syndrome of inappropriate anti diuretic hormone (SIADH) secretion
|
acanthosis nigricans
|
Cushing syndrome
|
leukemoid reaction
|
Medicine
|
Respiratory
|
886a2305-69db-4fc3-8270-5143c3b6c465
|
multi
|
Bechet's syndrome is characterized by all of the following eye manifestations, EXCEPT:
|
The eye disease is present in 50% of patients with Bechet's syndrome. It is usually present at the onset but may also develop within the first few years. Iritis, posterior uveitis, retinal vessel occlusions and optic neuritis can be seen in some patients with the syndrome. Note: Scarring and bilateral panuveitis is the most dreaded complication of Bechet's, since it occasionally progresses rapidly to blindness. Ref: Moutsopoulos H.M. (2012). Chapter 327. Behcet's Syndrome. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
| 4 |
Posterior uveitis
|
Iritis
|
Optic Neuritis
|
Retinal pigmentation
|
Ophthalmology
| null |
95233785-336c-4517-9daf-89b1a4903b5e
|
multi
|
Newborn 7 days old with vomiting and dehydration clinical examination was normal except for by hyperpigmentation of nipple. Electrolytes Na: 120 meq.K: 9 meq. most likely diagnosis -
| null | 2 |
Primary hypothyroidism
|
Cong. adrenal hyperplasia
|
Panhypopituitarism
|
Pyloric stenosis
|
Medicine
| null |
f5e99584-2aa9-49c4-b22a-fd3c0163365f
|
multi
|
A patient presented with normal eyesight and absence of direct and consensual light reflexes in left eye. Which of the following cranial nerves is suspected to be lesioned?
|
Ans. (a) OculomotorRef: Kanski 7/e, p. 815In complete optic nerve lesion of one side (afferent pupillary defect)The ipsilateral direct reflex is absentThe contralateral consensual reflex is absentIn oculomotor nerve lesion of one side (efferent pupillary defect)The ipsilateral direct reflex is absentThe ipsilateral consensual reflex is absent
| 1 |
Occulomotor
|
Trochlear
|
Optic
|
Abducent
|
Ophthalmology
|
Neuro-Ophthalmology
|
8ba0b2db-b75c-4f08-a9d9-9924bc42f13e
|
single
|
Secretions of GIT are controlled by
|
Secretions of GIT are controlled by the Meissner plexus. Ref: Ganong&;s Review of Medical Physiology 26th edition Pgno: 460
| 4 |
Myenteric plexuses
|
Auerbach plexuses
|
Meissner plexuses
|
Extrinsic nerve
|
Physiology
|
G.I.T
|
dd33afdb-d58b-46ac-9994-9f3a3d367ba1
|
single
|
Proteins are soed by :
|
A i.e. Golgi bodies
| 1 |
Golgi Bodies
|
Mitochondria
|
Ribosomes
|
Nuclear Membrane
|
Biochemistry
| null |
d55f0f31-d2c5-4dfd-8337-902f2bdbf139
|
single
|
Not true about IPV is -
|
<p> IPV /salk polio vaccine. Strains - Mahoney( salk type 1) MEF1( salk type 2) saukett( salk type 3) Inactivated in formaldehyde. Final vaccine mixture contains 40 units of type1, 8 units of type 2, and 32 units of type3. Administration- intramuscular injection or subcutaneous. Should be refrigerated to ensure no loss of potency. Freezing avoided. Either administered alone or in combination with other vaccine antigens including diphtheria,tetanus,whole cell or acellular peussis,Hepatitis B, or Haemophilus influenza type b. Primary/initial course consists of 4 inoculation: first 3doses given at an interval of 1-2 months and 4 th dose 6-12 months after 3 rd dose. First dose given when the infant is 6 weeks old. Additional doses recommended prior to school entry and then every 5 yrs until the age of 18. Alternatively one/two doses of OPV can be safely given as boosters after an initial course of immunisation with inactivated vaccine. Immunity:- induces circulating humoral antibodies(IgM,IgG,IgA). Doesn&;t induce intestinal or local immunity. The circulating antibodies protect the individual against paralytic polio,but do not prevent reinfection of gut by wild viruses. In case of epidemic, IPV is unsustainable because immunity is not rapidly achieved as more than one dose required to induce immunity and injections are to be avoided during epidemic as they are likely to precipitate paralysis. Advantages:- it doesn&;t contain living virus ,so safe to administer : 1. To persons with immunodeficiency diseases. 2. To persons undergoing coicosteroid and radiation therapy. 3. To those over 50 years who are receiving vaccine for first time. 4. During pregnancy. 5. IPV is an alternative to OPV for immunisation of children with HIV infection. No serious adverse effects noticed {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.206 }</p>
| 2 |
Given in 4 doses
|
Can't be given in AIDS patient
|
Is a killed vaccine
|
Also known as salk vaccine
|
Social & Preventive Medicine
|
Communicable diseases
|
531c8f9a-c04a-4201-b5db-1734693e2d29
|
multi
|
Type of collagen found in cailage:
|
Collagen has great tensile strength, and is the main component of fascia, cailage, ligaments, tendons, bone and teeth.Along with soft keratin, it is responsible for skin strength and elasticity, and its degradation leads to wrinkles that accompany aging.It strengthens blood vessels and plays a role in tissue development.It is present in the cornea and lens of the eye in crystalline form.The best stain for use in differentiating collagen from other fibers is Masson's trichrome stain.
| 2 |
Type I
|
Type II
|
Type III
|
Type IV
|
Biochemistry
| null |
10040108-74f1-48d5-ae80-da89350895fa
|
single
|
Side effect of SSRI
|
SIDE EFFECTS Paradoxical SUICIDE, this is a type of suicide where an antidepressant used to treat depression and decrease suicide increase the chance of suicidal attempt ( IT'S A PARADOX). The explanation that is given is SSRI initially activates the patient and decreases fatigue, thus patients with low mood and suicidal ideas will have more energy to act on the ideas. GIT- loose stools and ulcer thus it should not be given in an empty stomach SD- delays ejaculation. This mechanism is used for its prescription in patients with premature ejaculation ANXIETY WEIGHT GAIN INSOMNIA Ref.Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 1013
| 3 |
Nausea
|
Diarrhoea
|
Weight gain
|
Rash
|
Psychiatry
|
Pharmacotherapy in psychiatry
|
f515f84a-aba9-408c-ae16-bff3b22f53a4
|
single
|
Lymphatic drainage of oropharynx is mainly through
|
Lymphatics from oropharynx drain into the upper jugular chain, paicularly the jugulodigastric ( tonsilar) node. Some pas drain to the posterior cervical group also. The base of the tongue may drain bilaterally. Lymphatic drainage of the nasopharynx - upper deep cervical nodes. (Ref: Diseases of Ear, Nose and Throat, PL Dhingra; 7th edition, pg no. 271)
| 3 |
Superficial cervical lymph nodes
|
Submandibular nodes
|
Jugulodigastric nodes
|
Jugulo-omohyoid nodes
|
ENT
|
Pharynx
|
56ac3a38-2a21-4481-9167-085469c91a8d
|
single
|
When treating urinary tract infection (UTI) in the third trimester, the antibiotic of choice should be
|
Although quite effective, sulfonamides should be avoided during the last few weeks of pregnancy because they competitively inhibit the binding of bilirubin to albumin, which increases the risk of neonatal hyperbilirubinemia. Nitrofurantoin may not be tolerated in pregnancy because of the effect of nausea. It should also be avoided in late pregnancy because of the risk of hemolysis due to deficiency of erythrocyte phosphate dehydrogenase in the newborn. Tetracyclines are contraindicated during pregnancy because of dental staining in the fetus. Thus, the drugs of choice for treatment of UTI in pregnancy are ampicillin and the cephalosporins.
| 1 |
Cephalosporin
|
Tetracycline
|
Sulfonamide
|
Nitrofurantoin
|
Gynaecology & Obstetrics
|
Medical & Surgical Illness Complication Pregnancy
|
19b03ca0-c8ef-47a8-b11d-9ea71efb71ea
|
single
|
Which of the following is the most common renal cystic disease in infants is ?
|
Unilateral renal dysplasia is a form of renal dysplasia (RD; see this term), a renal tract malformation in which the development of one kidney is abnormal and incomplete. Unilateral RD can be segmental, and of variable severity, with renal aplasia corresponding to extreme RD. Reference: GHAI Essential pediatrics, 8th edition
| 3 |
Polycystic kidney
|
Simple renal cyst
|
Unilateral renal dysplasia
|
Calyceal cyst
|
Pediatrics
|
Urinary tract
|
e88fe02f-b768-4eca-9d28-32dfb8d67ad7
|
single
|
Which is not a RBC membrane protein?
|
The protein skeleton consists of 2D mesh of spectrin tetramers and oligomers. It is attached to RBC membrane by attaching to ankyrin. Membrane proteins like glycophorin also present. Ref: Textbook of medical physiology by N Geetha, 3rd edition, page no. 77
| 2 |
Ankyrin
|
Nebulin
|
Spectrin
|
Gycophorin
|
Physiology
|
Cardiovascular system
|
82007556-87e1-409b-9197-48e968100234
|
single
|
Pneumococcal vaccine is prepared from
|
Pneumococcal vaccine: A polyvalent polysaccharide vaccine representing the capsular antigens of the 23 most prevalent serotypes have been stated to give 80-90% protection. Given in patients with enhanced risk of pneumococcal infection, absent or dysfunctional spleen, sickle cell disease, immunodeficiency etc. It is not recommended in children under the age of two years and those with lymphoreticular malignancies and immunosuppressive therapy A 7 valent conjugate vaccine (conjugated to the CRM197 protein of C.diptheriae) is now available which can be used in children from two months to two years. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 228
| 2 |
Cell surface antigen
|
Capsular polysaccharide
|
exotoxin
|
M protein
|
Microbiology
|
Bacteriology
|
2b1619eb-e77e-486f-8dd0-9c697326d0c6
|
single
|
Flabby white lesions occur bilaterally on buccal mucosa
of a five-year-old child. The Lesions are a symptomatic
the child's mother says this condition is seen in few
other members of the family. The lesions are most likely:
| null | 4 |
Leukoplakia
|
Lichen planus
|
Submucous fibrosis
|
White sponge nerves
|
Dental
| null |
a2ec0a95-2f9e-4a1e-a90a-29e5d7ceb4fc
|
multi
|
Kennedy bar is also known as:
| null | 1 |
Double lingual bar
|
Lingual plate
|
Lingual bar
|
Palatal plate
|
Dental
| null |
58a77424-47f6-47ce-9c16-43d22323887c
|
single
|
Full blown immunodeficiency syndrome is characterized by -
|
Any HIV-infected individual with a CD4+ T cell count of <200/mL has AIDS by definition, regardless of the presence of symptoms or oppounistic diseases . (Harrison's Principles of internal medicine, 20 th edition, page 1506)
| 1 |
High viral titres with low CD4 count
|
Low viral titres with low CD4 count
|
High viral titres with high CD4 count
|
High CD4 and high CD8
|
Medicine
|
Infection
|
a3588f4d-7266-473d-b360-ca88e85312e8
|
single
|
True about Zenker's diveiculum is all, EXCEPT:
|
Zenker diveiculum originates from the posterior wall of the esophagus in a triangular area of weakness, limited inferiorly by the cricopharyngeus muscle and superiorly by the inferior constrictor muscles (ie, the Killian triangle). As the diveiculum enlarges, it tends to dete from the midline, mostly to the left
| 1 |
Originates from the anterior wall of the esophagus
|
Occurs through triangular area of weakness
|
It tends to dete from the midline, mostly to the left
|
None of the above
|
ENT
| null |
5930c046-6bb9-4f9b-9a7f-6444c9c91f20
|
multi
|
In an aphakic eye the anterior focal point from the anterior surface of cornea is about:
|
Ans. 23 mm
| 3 |
15 mm
|
21 mm
|
23 mm
|
31 mm
|
Ophthalmology
| null |
5fc37b24-114d-4c09-bf99-743b06b5fcbc
|
single
|
Tolerance develops to all of the following effects of opioids except
|
Decreased effects are seen with continuous usage of opioids except for miosis, constipation, and convulsions.Ref: HL Sharma 3rd ed Pg: 508
| 4 |
Constipation
|
Miosis
|
Convulsions
|
All of the above
|
Pharmacology
|
Autacoids
|
2d391417-6615-4691-901a-70fa67d7b70e
|
multi
|
Which of the following describes the pelvic outlet
|
Pelvic outlet consists of 2 triangular areas with a common base, which is a line drawn between the two ischial tuberosities.
Angle of pubic arch is 90 → 100 degrees.
Lateral boundaries of posterior triangle is formed by sacrotuberous ligaments.
| 4 |
Angle of pubic arch is less than 90 degrees.
|
Base of posterior triangle is the coccyx.
|
Descending inferior pubic rami form lateral boundaries of posterior triangle.
|
Common base of the two triangles is formed by a line drawn between the two ischial tuberosities.
|
Gynaecology & Obstetrics
| null |
3aea56a2-8ebf-427c-b7e2-5042a189742e
|
single
|
All of the following statements about vincristine are true except
|
Vincristine is a vinca allkaloid. It acts in M-phase of cell cycle by inhibiting the formation of spindle. It is a marrow sparing drug and causes peripheral neuropathy as a prominent adverse effect. It is used for the treatment of hematological malignancies like Hodgkin's lymphoma and leukemias.It is ineffective against solid tumors. Ref-KDT 6/e p824,825
| 4 |
It acts by inhibiting mitosis
|
It prominent adverse effects is peripheral neuropathy
|
It does not suppression bone marrow
|
It is a drug of choice for solid tumors
|
Anatomy
|
Other topics and Adverse effects
|
5de20fc4-64f1-4589-b54f-261fcde24f86
|
multi
|
Lipofuscin is associated with
|
o Deposition of lipofuscin in the heart is referred as brown atrophy
| 1 |
Brownatrophy
|
White atrophy
|
Red atrophy
|
Black atrophy
|
Pathology
| null |
2eadcedb-6c80-403b-83af-c99bea047b6a
|
single
|
Beefy red, foul smelling genital granuloma with a bleeding ulcer on touch is seen in -
|
Donovanosis is caused by Klebsiella granulomatis. It&;s morphology is that it is a single(sometimes multiple) asymptomatic ulcer. Floor is made of beefy , exuberant, granulation tissues that bleeds on manipulation. From illustrated synopsis of dermatology and sexually transmitted diseases neena khanna 5th edition page no 329
| 4 |
LGV
|
Chancroid
|
Primary syphilis
|
Donovanosis
|
Dental
|
Sexually transmitted diseases
|
53c134e3-d9ae-46e6-b018-1918b580acd7
|
single
|
A patient who was initially smear positive, who began the treatment and who remained or became smear positive again at five months or later during the course of treatment is called as
|
Failure case: A patient who was initially smeared positive, who began Rx and who remained or became smear positive again at five months or later during the course of Rx. Relapse: A patient who returns sputum smear positive having previously been treated for tuberculosis and declared cured after the completion of his treatment. Return after default: A patient who returns sputum smear positive, after having left Rx for at least two months.
| 2 |
Defaulter
|
Failure case
|
Relapse
|
None of the above
|
Social & Preventive Medicine
|
Communicable diseases
|
a2f2b032-1701-4e3d-9c16-29312f5c07a0
|
multi
|
Which cholesterol is designated as "Good Cholesterol"
|
HDL
The level of HDL in serum is inversely related to the incidence of ML
As it is "antiatherogenic" or "protective" in nature, HDL is known as "good cholesterol".
| 3 |
VLDL
|
LDL
|
HDL
|
IDL
|
Biochemistry
| null |
f46970af-f42b-4f2f-ab34-e6ff5afa4f5a
|
single
|
In JVP, a wave is due to?
|
Atrial contraction REF: Harrison's Internal Medicine 17th edition Chapter 220 Physical Examination of the Cardiovascular System, http://en.wikipedia.org/wiki/Jugular_ venous_pressure JVP WAVEFORM: Classically three upward deflections and two downward deflections have been described. 1. The " a " wave corresponds to right Atrial contraction and ends synchronously with the carotid aery pulse. The peak of the 'a' wave demarcates the end of atrial systole. 2. The " c " wave corresponds to right ventricular Contraction causing the triCuspid valve to bulge towards the right atrium. 3. The " x " descent follows the 'a' wave and corresponds to atrial relaXation and rapid atrial filling due to low pressure. 4. The " x' " (x prime) descent follows the 'c' wave and occurs as a result of the right ventricle pulling the tricuspid valve downward during ventricular systole. The x' (x prime) descent can be used as a measure of right ventricle contractility. 5. The " v " wave corresponds to Venous filling when the tricuspid valve is closed and venous pressure increases from venous return - this occurs during and following the carotid pulse. 6. The " y " descent corresponds to the rapid emptYing of the atrium into the ventricle following the opening of the tricuspid valve. ABNORMAL JVP: 1. Raised JVP, normal waveform Bradycardia Fluid overload Hea Failure 2. Raised JVP, absent pulsation Superior vena cava syndrome 3. Large 'a' wave (increased atrial contraction pressure) Tricuspid stenosis Right hea failure Pulmonary hypeension 4. Cannon 'a' wave (atria contracting against closed tricuspid valve) Atrial flutter Premature atrial rhythm (or tachycardia) Third degree hea block Ventricular ectopics Ventricular tachycardia 5. Absent 'a' wave (no unifocal atrial depolarisation) Atrial fibrillation 6. Large wave (c-v wave) Tricuspid regurgitation 7. Slow 'y' descent Tricuspid stenosis 8. Parodoxical JVP (Kussmaul's sign: JVP rises with inspiration, drops with expiration) Pericardial effusion Constrictive pericarditis Pericardial tamponade
| 3 |
Atrial filling
|
Atrial relaxation
|
Atrial contraction
|
Ventricular relaxation
|
Physiology
| null |
9f37aa48-703b-4ef6-bc64-43eb037928cd
|
single
|
Common site of regional enteritis is ?
|
Ans. is 'c' i.e., Distal ileum and colon Crohn disease (Terminal ileitis or regional enteritis) Crohn disease (CD) is an inflammatory bowel disease (IBD) which is characterized by ? 1) Sharply delimited and typically transmural involvement of the bowel by an inflammatory process with mucosal damage. 2) The presence of non caseating granulomas. 3) Fissuring with formation of fistula. o Any poion of intestine can be involved but most commonly small intestine is involved. Small intestine --> 40% Small intestine + colon --> 30% Colon --> 30%
| 3 |
Colon
|
Rectum
|
Distal ileum and colon
|
Caecum
|
Pediatrics
| null |
dddf13db-aee8-4ec9-a1b9-d5957805b1f0
|
single
|
Corrosion product of high copper amalgam
| null | 1 |
SnO
|
SnHg
|
Sn-O Cl
|
Cu-sn
|
Dental
| null |
d30d272d-020b-4b50-8570-ae1dfd12b61f
|
single
|
Dorsal surface of pons is related with?
|
The pons can be broadly divided into two pas: the basilar pa of the pons(ventral) and the pontine tegmentum( dorsal)The pontine tegmentum contains nuclei of the cranial nerves -5,6,7,8 and their associated fibre tracts, the pontine reticular formation, the mesopontine cholinergic system, the laterodorsal tegmental nucleus, and the respiratory centres - the pneumotaxic centre and the apneustic centre.Trochlear nucleus is in the midbrain whereas hypoglossal and vagal nuclei in the medulla.(Reference: vishram Singh textbook of clinical neuroanatomy second edition pg 80)
| 4 |
Trochlear nucleus
|
Motor nucleus of vagus
|
Hypoglossal
|
Facial
|
Anatomy
|
Brain
|
96e5f838-43d3-48e7-855e-0a998ba3e3cd
|
single
|
The given cell is activated by
|
TH2 cells secrete IL-4, IL-5, and IL-13, which recruit and activate eosinophils and are responsible for the alternative pathway of macrophage activationReference: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 3; Inflammation and Repair
| 3 |
IL-1
|
IL-2
|
IL-5
|
IL-6
|
Pathology
|
General pathology
|
19fd3aed-565b-4c12-9099-db43d4ee3cb6
|
single
|
Commonly used shunt in hydrocephalus management:
|
b. Ventriculoperitoneal(Ref: Nelson's 20/e p 2814)Therapy for hydrocephalus:Medical management, including use of acetazolamide and furosemide, can provide temporary relief.Most cases of hydrocephalus require extracranial shunts, particularly a ventriculoperitoneal shunt.The major complications of shunting are occlusion (characterized by headache, papilledema, emesis, mental status changes) and bacterial infection (fever, headache, meningismus), usually due to Staph epidermidis.Endoscopic third ventriculostomy (ETV) has evolved as a viable approach and criteria have been developed for its use, but the procedure might need to be repeated to be effective.
| 2 |
Ventriculoatrial
|
Ventriculoperitoneal
|
Ventriculopericardial
|
Ventriculopleural
|
Pediatrics
|
Central Nervous System
|
48881834-1d86-4415-b78d-6df107fad8e8
|
single
|
Integrated Management of childhood illness includes except
|
IMNCI is Indian adapta on of Global Programme of WHO & UNICEF to reduce childhood morbidity & moality
| 4 |
ARI
|
Malaria
|
Diarrhea
|
TB
|
Pathology
|
All India exam
|
836c98b6-66f8-44b4-bfeb-9fb646fad8af
|
multi
|
Pyometra is a complication associated with all of the following conditions except :
|
Ans. is a i.e. Carcinoma vulva
| 1 |
Carcinoma vulva
|
Carcinoma cervix
|
Carcinoma endometrium
|
Pelvic radiotherapy
|
Gynaecology & Obstetrics
| null |
add554eb-7a50-4035-9a74-5664f7dce8f4
|
multi
|
Which of the following statement is TRUE about endemic typhus?
|
Endemic typhus: Caused by Rickettsia typhi (ubiquitous). Humans usually acquire the infection in an urban or suburban setting when bitten by an infected flea, which releases infected feces while sucking blood. Laboratory diagnosis of rickettsial diseases is based on serologic analysis rather than isolation of the organism. Although rickettsiae can be grown in cell culture or embryonated eggs, this is a hazardous procedure that is not available in the standard clinical laboratory. Clinical Findings: Gradual onset of malaise, cough, fever, and headache Maculopapular rash concentrated on trunk with rapid fading Severe disease with mental confusion and signs of hepatic, cardiac, renal, and pulmonary involvement may develop. Treatment: Antibiotic treatment is most effective with doxycycline, 100 mg twice daily orally Note: Rocky Mountain spotted fever is caused by Rickettsia rickettsii, and Q fever is caused by Coxiella burnetii. Ref: Levinson W. (2012). Chapter 26. Rickettsiae. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.
| 2 |
Is caused by R. rickettsii
|
Is transmitted by the bite of fleas
|
Has no mammalian reservoir
|
Is caused by Coxiella burnetii
|
Microbiology
| null |
bb832e49-5964-4dfa-8757-345d6a2a4096
|
multi
|
Clopidogrel is an
| null | 3 |
Anti hypertensive
|
Antidiabetic
|
Antiplatelet
|
Anticoagulant
|
Pharmacology
| null |
3b0a6985-f3ee-49b3-b055-7e7f7c25ecfb
|
single
|
Contraindication of spinal anaesthesia is –
| null | 3 |
Hypertension
|
Renal disease
|
Clotting disorders
|
Diabetes
|
Anaesthesia
| null |
cd693a01-fbf4-4846-8545-3fb27b9fad7e
|
single
|
Urea is formed from which substrate?
|
A. Steps of Urea Cycle: 1. Formation of Carbamoyl Phosphate: Condensation of ammonium ion with bicarbonate ion resulting in the formation of carbamoyl phosphate by the help of the enzyme carbamoyl phosphate synthase-I present in the liver mitochondria. It requires Mg2+ and a dicarboxylic acid i.e. N-acetyl glutamate. This step requires 2 ATPs. 2. Synthesis of Citrulline: Carbamoyl phosphate formed in the first step combines with ornithine resulting in the synthesis of citrulline aided by the enzyme citrulline synthase or ornithine transcarbamoylase. Citrulline is easily permeable to the mitochondrial membrane and hence it diffuses into the cytosol. 3. Synthesis of Argininosuccinate: In the cytosol, citrulline combines with the amino acid aspaate forming argininosuccinate catalysed by the enzyme argininosuccinate synthase. It requires ATP which is hydrolysed to AMP resulting in utilization of two high energy bonds. Mg2+ acts as cofactor. 4. Cleavage of Argininosuccinate: The enzyme argininosuccinase acts reversibly to cleave argininosuccinate into Arginine and fumarate. Fumarate enters the TCA cycle (the linkage between TCA and urea cycle is known as Krebs bi-cycle). 5. Cleavage of Arginine: Arginine is lysed into ornithine and urea under the influence of the enzyme arginase. Hence arginine is known as semi-essential amino acid i.e. though it is synthesized in the body it is not available for protein synthesis. Ornithine is regenerated in this step and the urea cycle completes by the formation of urea. Ornithine and lysine are potent inhibitors of the enzyme arginase. Arginase is also present in testis, renal tubules, mammary gland and skin in minute quantities. The intermediate amino acids formed in the urea cycle i.e. ornithine, citrulline and argininosuccinate are known as non-protein amino acids. Ref-Sathyanarayana 4/e p370
| 4 |
Arginine
|
Orginine
|
Citruline
|
Aspaate
|
Biochemistry
|
Metabolism of nucleic acids
|
6b87c9f5-391d-42c1-8437-72371d3d7753
|
single
|
Which of the following statement (s) is/are true about Hb–O2 dissociation curvea) Fetal Hb shifts curve to leftb) Hypothermia shifts curve to leftc) Hypercarbia shifts curve to leftd) Left shift cause more O2 release to tissue
|
Hb-O2 dissociation curve shift to left indicates more affinity of Hb to O2, and thus less delivery of O2 to tissues.
Shift to left seen in
- Increased pH
- Decreased 2,3 DPG, temperature, PCO2
- HbF (Fetal)
Shift to right seen in
- Decreased pH
- Increased 2,3DPG, temperature, PCO2
- HbS (Sickle cell)
| 1 |
ab
|
a
|
ad
|
bc
|
Physiology
| null |
cfc9a4fa-7eb0-40be-a8fe-bc05e6dcff93
|
multi
|
Dose of iron and folic acid in pregrnancy is -
|
During pregnancy, 100 mg iron and 500 mcg FA should be given. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 594
| 3 |
20 mg iron and 100 mcg FA
|
30 mg iron and 250 mcg FA
|
100 mg iron and 500 mcg FA
|
100 mg iron and 100 mcg FA
|
Social & Preventive Medicine
|
obstetrics,pediatrics and geriatrics
|
72822ce1-7bdd-4213-a4b7-c1a5695363f9
|
single
|
Black gun powder composition ?
|
Ans. is 'c' i.e., Charcoal 15% + Potassium nitrate 75% + sulphur 10% The classical gun powder is known as black powder, consists of charcol (15%), Sulphur (10%), and potassium nitrate (75%). Depending on fineness, the black gun powder is designated as FG, FFG, FFFG. etc. (F = fineness). Pyrodex is another gun powder with same components, but with different ratios. Black gun powder produces smoke, i.e. It is smoke producing powder. Smokeless powder, in addition to black powder, has nitrocellulose (single base), or nitrocellulose plus nitroglycerine (double base), or nitrocellulose plus nitroglycerine plus nitroguanidine (triple base). Semi smokeless powder has 80% black powder and 20% smokeless powder (nitrocellulose).
| 3 |
Charcoal 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
| null |
1be32fcc-0ab6-4a58-8c78-a637b9d28430
|
single
|
What does the arrow point to in the fundus examination of a myopic patient?
|
Fundus findings in degenerative myopia:1A pale tessellated ('tigroid') appearance is due to diffuse attenuation of the RPE with visibility of large choroidal vessels.2Focal chorioretinal atrophy is characterized by the visibility of the larger choroidal vessels and eventually the sclera.3Anomalous optic nerve head which may appear unusually small, large or anomalous with a 'tilted' conformation. Peripapillary chorioretinal atrophy is very common, and in milder cases taking the form of a temporal crescent of thinned or absent RPE exposing the choroid and/or sclera.4'Lacquer cracks' are ruptures in the RPE-Bruch membrane-choriocapillaris complex characterized clinically by fine, irregular, yellow lines, often branching and crisscrossing at the posterior pole. They are present in around 5% of highly myopic eyes and can precede the development of CNV, retinal hemorrhages without CNV, and geographic atrophy. It is thought that the flaw in the RPE barrier constituted by the cracks provides a route through which choriocapillaris tissue can grow.5Lattice degeneration.6Subretinal 'coin' hemorrhages, which may be intermittent, may develop from lacquer cracks in the absence of CNV.7A Fuchs spot is a raised, circular, pigmented lesion at the macula developing after a subretinal hemorrhage has absorbed.8A staphyloma is an ectasia or bulging of the posterior sclera due to focal expansion and thinning. It occurs in about a third of eyes with pathological myopia, and is viually always peripapillary or involves the macula. Staphyloma development can be associated with macular hole formation.Ref: Kanski; 7th edition; Pg. 637
| 1 |
FosterFuchs spot
|
Lacquer cracks
|
Arlt line
|
Myopic crescent
|
Ophthalmology
|
Vitreous and retina
|
c8772169-4d76-4820-91b2-18f43b81a457
|
single
|
Corpus leuteum stas regressing after how many days of ovulation ?
|
Ans. is 'b' i.e., 10 daysIf ovum is not feilized, the corpus luteum stas degenerating around day 24 of cycle (about 10 days after ovulation) and is eventually is replaced by fibrous tissue, forming corpus albicans.Degeneration of corpus luteum is due to decline in level of LH (which is required for maintenance of corpus luteum) and increase in secretion of inhibin by luteal cell itself.
| 2 |
5 days
|
10 days
|
24 days
|
None
|
Physiology
| null |
02243e1a-2cec-4556-b273-ec07208cda06
|
multi
|
Mildly elevated bilirubin, normal liver enzymes are seen in?
|
Ans. is 'd' i.e., All of above
| 4 |
Malaria
|
Thalassemia
|
G-6 PD deficie
|
All of above
|
Pediatrics
| null |
5d0fe05c-3bc1-4732-a472-8e592bedc78d
|
multi
|
Which of the following is the first immunoglobulin to appear following infection?
|
IgM is the first immunoglobulin to appear after exposure to an antigen. They are relatively sho lived hence their demonstration in the serum indicates recent infection. Normal level of IgM is 1.2mg/ml. It is also the earliest to be synthesized by fetus beginning by about 20 weeks of age. As it cannot cross the placental barrier its presence in fetus or newborn indicates intrauterine infection. Its detection is therefore useful for diagnosis of congenital infections such as syphilis, rubella, HIV and toxoplasma. IgG is the major immunoglobulin in human serum. It is the only class of immunoglobulins which can cross the placenta. It binds to organisms and enhances their phagocytosis. It paicipates in most immunologic reactions such as complement fixation, precipitation, and neutralisation of toxins and viruses. Ref: Textbook of Microbiology By Surinder Kumar page 138.
| 2 |
IgG
|
IgM
|
IgA
|
IgE
|
Microbiology
| null |
173febf1-ce0f-4bff-b74d-0c9f6f1173ff
|
single
|
Which embryonic structure forms philtrum of upper lip
| null | 3 |
Maxillary process
|
Mandibular process.
|
Medial nasal process.
|
Lateral nasal process.
|
Anatomy
| null |
674108b9-4267-44db-bccb-483f205c674a
|
single
|
Anti-craving agents for alcohol dependence are all except aEUR'
|
Lorazepam Management of alcohol intoxicationDrugs used areLorazepam (can worsen the vitals because of C.N.S. depression)Haloperidol (can lower the seizure threshold)Other drugs which may be usedZiprasidoneOlanzapineManagement of alcohol withdrawlAll patients should be given oral multiple vitamin B1including 50-100 mg of thiamine daily for a week.Replace alcohol (CNS depressant) with any other C.N.S. depressant. Benzodiazepenes are commonly used for this purpose and chlordiazepoxide is the drug of choice because of its long half life.Delirium Tremens :?Some recommend, high dose Benzodiazepene while others recommend antipsychotics.Anticonvulsants are not given to control seizures seen in delirium Tremens.Management of alcoholic rehabilitationMainstay of alcoholic rehabilitation involves counselling, education and cognitive approaches. Several medications have also proved beneficial :-Naltrexone (opioid antagonist) ?It blocks opioid receptors and thus decrease the activity in dopamine rich ventral tegrnental reward system or decrease the feeling of pleasure or reward if alcohol is imbibed.Acamprosate ?Widely used in United States and Europe. The drug inhibits the action of NMDA receptors and has been hypothesized to act by decreasing mild symptoms of protracted withdrawl.Disulfiram (ALDH inhibitor)Drinking alcohol, while taking disulfiram, produces a reaction involving an increased pulse, changes in blood pressure, vomiting and diarrhoea. This can be dangerous especially for patients with hea disease, stroke, diabetes mellitus or hypeension.Thus most clinicians reserve this medication for patients who have a clear history of longer term abstinence associated with prior use of disulfiram and for those who might take the drug under the supervision of another individual.Other drugs under investigation for possible use in Alcoholics- Ondansetron (serotonin antagonist)- Topiramate (anticonvulsant)- Ratnonthant (cannabinoid receptor antagonist)
| 1 |
Lorazepam
|
Acamprosate
|
Topiramate
|
Naltrexone
|
Psychiatry
| null |
78d51779-e06a-4b5a-8edc-d119dbde5eef
|
multi
|
A 5-year old male child has been brought with a complaint that there is only one testis in the scrotum. On examination, it is found that the testis on the opposite side is felt in the inguinal canal. The patient should be advised?
|
Ans. is 'a' i.e., Orchipexy
| 1 |
Orchiopexy
|
To wait till pubey
|
Orchidectomy
|
Administration of androgens
|
Surgery
| null |
5a7f96e7-8f9e-48b7-a499-0fa0a8b20c6d
|
single
|
Hemophilia is associated with which chromosome ?
|
Hemophilia A and B - X linked recessive disorders. Hemophilia C - Autosomal recessive disorder. X linked recessive disorders SYSTEM DISEASE Musculoskeleton Duchenne Muscular dystrophy Blood Hemophilia A,B Chronic Granulomatous disease G-6-PD deficiency Immune Agammaglobinemia Wiskott-Aldrich Syndrome Metabolic Diabetes Insipidus Lesch-Nyhan Syndrome Nervous Fragile X Syndrome
| 1 |
X
|
Y
|
13
|
8
|
Pathology
|
Clotting factor
|
3cbdfa54-372b-4007-a601-efbcc180adf4
|
single
|
Rate limiting enzyme in gluconeogenesis -
|
Ans. is 'c' i.e., Fructose 1-6 bisphosphatase Most imp step =Pyruvate carboxylase, Only step at ER= G 6 Phosphatase RLS - F 1-6 Bisphosphatase. o Gluconeogenesis involves glycolysis, the citric acid cycle plus some special reactions. Glycolysis and gluconeogenesis share the same pathway but in opposite direction. Seven reactions of glycolysis are reversible and therefore are used with same enzyme in the synthesis of glucose by gluconeogenesis. However, three of the reactions ofglycolysis are irreversible and must be circumvented by four special reactions which are unique to gluconeogenesis and catalyzed by: i) Pyruvate carboxylase ii) Phosphoenolpyruvate carboxykinase iii) Fructose-1,6-bisphosphatase iv) Glucose-6-phosphatase. o These four enzymes are the key enzymes of gluconeogenesis (or gluconeogenesis enzymes). Among these four, pyruvate carboxylase is a mitocondrial enzyme and other three are cytoplasmic enzymes.
| 3 |
Phosphofructokinase-1
|
Pyruvate kinase
|
Fructose 1-6 bisphosphatase
|
Glucokinase
|
Biochemistry
|
Gluconeogenesis
|
6d1a5ac7-2e55-447f-80be-b3a623ae6830
|
single
|
Most common organism causing neonatal meningitis is
|
The most common causes of neonatal meningitis is bacterial infection of the blood, known as bacteremia (specifically group B streptococci (Streptococcus agalactiae), Escherichia coli, and Listeria monocytogenes . Reference: GHAI Essential pediatrics, 8th edition
| 1 |
E. coli
|
Listeria
|
Pseudomonas
|
Staph aureus
|
Pediatrics
|
Central Nervous system
|
e0550b1a-21d3-452e-94ce-36b5910bfab2
|
single
|
Loosening of association is an example of which of the following thought pathology?
|
Loosening of associations is an example of formal thought disorder, which is a disturbance in the form of thought rather than content of thought. It is a characteristic feature of schizophrenia.Loosening of association refers to lack of connection between the ideas expressed by the patient. The links between ideas may be illogical or they wander from the original theme. In its extreme form, loosening of association leads to totally incoherent thought and speech (word salad).Ref: Psychiatry By John Geddes, 4th edition page 248; Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 9th edition page 924; Psychopathology: History, Diagnosis, and Empirical Foundations By W. Edward Craighead, 2nd edition page 406.
| 3 |
Perseveration
|
Concrete thinking
|
Formal thought disorder
|
Schneiderian first rank symptoms
|
Psychiatry
| null |
ee31b90b-5445-4b6a-af79-6792157900b8
|
single
|
Virus that has association with anal warts?
|
Ans. a (HPV) (Ref. Bailey and Love 24th ed., 61.6)WART# It is a HPV-induced tumor-like lesion known to spontaneous resolution.# Transmission is by direct or intimate contact, the virus material usually being inoculated through an abrasion.# It is well recognised that patients with immune deficiencies develop widespread resistant warts.# They tend to occur on sites of trauma, such as the beard area, hands, genital region and feet.# Warts are more common in children and young adults.# Plantar warts occur on the sole and are usually multiple.# Curettage and diathermy give excellent results, as does cryotherapy, but the latter is often accompanied by pain.# The irritant 50 per cent podophyllin in liquid paraffin gives good results.# Use of liquid nitrogen is easier and is more effective. Recalcitrant lesions may respond to 585-nm pulsed dye laser.# Venereal warts and moist warts (papillomata acuminata) occur in the genital region.# Orf is caused by the virus that produces pustular dermatitis in sheep.ANAL WARTS# These are usually sexually transmitted, although anoreceptive intercourse is probably not necessary.# Rx: local scissor excision or destruction by some other local method, for example, diathermy or laser.# Less extensive wart infection can be controlled by application of podophyllin.# The wart virus (human papilloma virus) is able to incorporate in the human genome and cancer may develop.# The risk of progression of this intraepithelial neoplasia to invasive anal malignancy is small.
| 1 |
HPV
|
HIV
|
LMV
|
EBV
|
Surgery
|
Disorders of the Anal Canal
|
b26aca0a-381f-487d-ad5c-ea256eae595d
|
single
|
A person comes into your ER room with a very weak pulse after a suffering a heart attack. You suspect:
|
D: A very weak pulse shows that the heart is slowly ceasing to function as a result of pumping too hard.
A: The patient should not be sent home; close observation is necessary.
B: This stage is a life-threatening stage as the heart could tire itself out and stop functioning.
C: An early stage of shock shows a rapid, bounding pulse.
| 4 |
The weak pulse has nothing to do with shock or the heart attack, so send him home.
|
A late stage (decompensated) shock, the least life-threatening stage of shock.
|
A very early stage (compensated) shock, the most life-threatening stage of shock.
|
A late stage (decompensated) shock, the most life-threatening stage of shock
|
Medicine
| null |
69b293d4-b2d5-41ee-bb87-f2b21b1bb194
|
single
|
Commonest cause of death in peptic ulcer patients is -
| null | 2 |
Perforation
|
Hemorrhage
|
Pyloric stenosis
|
Maliganancy
|
Surgery
| null |
e54f486a-4313-41a4-9d1d-1822d73c60c7
|
single
|
Obesity predisposes to all, except ?
|
Ans. is 'c' i.e., Lung cancerObesity increases the risk of following diseases :-Greatly increased risk : NIDDM, gall bladder disease, insulin resistance, dyslipidaemia, sleep apnea and breathlessness.Moderately increased risk : Type-2 DM, hypeension, CHD, osteoahritis (knee), hyperuricemia and gout.Slight increased risk : Cancers (breast, endometrium, colon), PCOD, impaired feility, low back pain, and fetal defects.
| 3 |
Diabetes
|
Colon cancer
|
Lung cancer
|
Breast cancer
|
Social & Preventive Medicine
| null |
3835f6d7-c8bc-474d-bfba-0a24b0b9e322
|
multi
|
Kleiheur Bethke test is done for?
|
Ans. (b) Fetomaternal haemorrhage(Ref: Oski's Pediatrics: Principles & Practice, chapter 66; Dacie 11th/pg 307)APT test for differentiation of fetal & adult (maternal) hemoglobin in stool or vomitusMix 1 volume of sample with 5 volumes of water.Centrifuge mixture and remove clear-pink supernatant solution containing hemoglobin.Mix 1 ml of 1% sodium hydroxide with 4 ml supernatant and observe color change after 2 minutes.#Remains pink: Hemoglobin F#Turns yellow-brown: Hemoglobin A (maternal blood)A common approach to evaluating FMH is the rosette test to screen for the presence of fetal cells followed by the Kleihauer-Betke acid elution method to quantify the magnitude of feto-maternal bleed.The Kleihauer-Betke acid elution method:Quantitative estimate of the volume of FMH based on different solubility properties of HbF&HbA.On a peripheral smear treated with an acidic solution & counterstained, red cells containing acid-soluble HbA appear as pale ghosts compared to deeply red stained red cells containing acid-resistant HbFCan also be used to detect HbF containing cells in p-thalassemia, hereditary persistence of hemoglobin F, sickle cell disease &myelodysplastic syndrome.Increased HbF is also found in congenital red cell aplasia (Blackfan-Diamond syndrome) & congenital aplastic anemia (Fanconianemia), JMML, presence of erythropoietic stress (haemolysis, bleeding, recovery from acute bone marrow failure) and in pregnancy.
| 2 |
Cephalopelvic disproportion
|
Fetomaternal haemorrhage
|
Determining karyotype of normal fetus
|
Diagnosing fetal infections
|
Pathology
|
Misc. (R.B.C)
|
5a4dc59a-3894-4b21-94d7-ae15cd65c29a
|
single
|
In the video you can see a testicular procedure being done. This is the testicular sperm aspiration for azoospermic men. Which of the following procedures can be performed to help this couple have a successful embryo formation in the A "Assisted Reproductive Technology" Lab.
|
ICSI can be performed to help this couple have a successful embryo formation in the A In this one sperm is directly injected into mature egg prior to intrauterine transfer of the feilized eggs ICSI should be offered if the semen analysis shows <5 million motile sperm, | or absent motility of sperms. Many abnormal sperms Previous failed IVF Unexplained infeility IVF as well as other A procedures require at least 1,00,000 sperms per oocyte to have good chances of feilisation and with TESA, the number of sperms obtained is much less, good enough for ICSI (Intracytoplasmic Sperm Injection) that requires a single morphologically normal sperm. Hence sperms obtained from TESA are used for ICSI is the single best answer here.
| 1 |
Intra cytoplasmic Sperm Injection
|
In Vitro Feilization
|
Intra Uterine Insemination
|
Intra Vaginal insemination of the aspirated sperms
|
Gynaecology & Obstetrics
|
Infeility (Eggs'plantation!)
|
9b493010-e148-4a6a-b26c-0214b693a923
|
single
|
Nitisinone is an example of
|
Nitisinone is prescribed for infantile tyrosinemia because it decreases production of the substrate (fumarylacetoacetate) for the hydrolase, thus decreasing the velocity of the reaction preventing substrate accumulation.
| 4 |
Enzyme activation therapy
|
Enzyme replacement therapy
|
Substrate addition therapy
|
Substrate reduction therapy
|
Biochemistry
|
Phenylalanine and Tyrosine metabolism Detail
|
0a6afecc-fd25-4666-9aa1-6604604a57f7
|
multi
|
In which one of the following infection dendritic ulcer is seen?
|
A dendritic corneal ulcer is the hallmark sign of HSV infection, accompanied by stromal keratitis in more severe infection. These ulcers may begin as nondescript punctate keratopathies but quickly coalesce to form the familiar branching patterns. Because the virus invades and compromises the epithelial cells surrounding the ulcer, the leading edges (the so-called "terminal end-bulbs") will stain with rose bengal or lissamine green. Acyclovir 3% ointment is used as treatment.
| 1 |
Herpes simplex
|
Measles
|
Pseudomonas
|
Gonococcal infection
|
Ophthalmology
| null |
b3db1611-8fcb-4ef9-99b3-82e5eac51d4d
|
single
|
Durkheim work wras related to -
|
Ans. is 'c' i.e., Division of labor o Four major works of Durkheim are1) Division of Labor in society.2) Rules of sociological methods.3) Suicide4) Elementary forms of religious life.
| 3 |
Recommendation of multipurpose worker
|
Management in Health manpower
|
Division of labor
|
Integration of medical and health services
|
Social & Preventive Medicine
|
Health Planning and Management
|
9996b317-f498-4c47-9890-ca9b2a5d8f99
|
single
|
The hea lesion not found in Congenital Rubella infection is:
|
Answer is A (ASD) ASD is the single best answer of exclusion. Cardiac anomalies in congenital rubella are mentioned differently in different books ! We have chosen ASD as the one to be excluded as both GHAI & CPDT mention VSD as a finding is cases of congenital rubella. Neveheless Harrison mentions ASD as well, and so you are on your own, if you wish to differ. The commonest congenital cardiac anomaly is Congenital Rubella is PDA. According to GHAI : PDA > PS> VSD According to CPDT : PDA > PS> VSD According to Harrison : PDA > PS> ASD According to Nelson : PDA > PS (ASD & VSD not mentioned)
| 1 |
ASD
|
VSD
|
PDA
|
PS
|
Medicine
| null |
e79ba591-027f-4f27-a282-79150c47c629
|
single
|
Acute physiology and Chronic Health Evaluation (APACHE) scoring system is used as a scoring system to -
| null | 3 |
To predict postoperative cardiac risk
|
To predict postoperative pulmonary complications
|
To evaluate prognosis in the critical care settings
|
To evaluate prognosis after acute myocardial infarction
|
Medicine
| null |
6731c08c-ef84-4c1e-a5bf-635c272ca9d7
|
single
|
Lesions in Face -- False statement is:
|
Ans. (d) Stitch removed at 2 weeksRef: Bailey and Love 27th edition, Page 93* Repair face wounds as early in <24hours* In case of grafting -- Full thickness graft taken from behind ear gives good cosmetic match* Incision is always done parallel to Langer's lines and sutures are made perpendicular to them for cosmetic approximation.* Face sutures are removed on 5th day.
| 4 |
Suture done as early as possible
|
Full thickness graft is used
|
Suture perpendicular to Langer's line
|
Stitch removed at 2 weeks
|
Surgery
|
Plastic & Reconstructive Surgery
|
19e09a43-55bd-4e41-a3c8-929ddf833462
|
multi
|
Sirolimus is more likely than cyclosporine to cause:
|
(Ref: KDT 6/e p840) Cyclosporine and tacrolimus cause nephrotoxicity as an adverse effect. Sirolimus (rapamycin) results in bone marrow suppression and thus may cause anemia, thrombocytopenia and leukopenia.
| 4 |
Hypeension
|
Osteoporosis
|
Renal insufficiency
|
Thrombocytopenia
|
Pharmacology
|
Other topics and Adverse effects
|
f2e31b0d-af81-48cb-ac6c-9345c5382db2
|
single
|
Intraepidermal blisters are seen in all of the following condition excepts
|
Level of cleavage & blistering disorders- IADVL textbook of dermatology, page 1088 Intraepidermal Subcorneal / granular/upper spinous 1. Pemphigus erythematosus 2. Pemphigus foliaceous 3. Subcorneal pustular dermatosis 4. IgA pemphigus subscorneal pustular dermatosus type 5. Bullous congenital icthyosiform erythroderma 6. Staphylococcal scalded skin syndrome 7. Bullous impetigo Spinous layer Hailey hailey disease Spongiosis Herpes simplex and herpes zoster Insect bites Friction blister Supra basal Pemphigus vulgaris and vegetans Paraneoplastic pemphigus Transient acantholytic disorder IgA pemphigus intraepidermal type Sub epidermal Basal keratinocyte vacuolation or lysis Epidermolysis bullosa simplex Erythema multiforme Steven Johnson syndrome/ toxic epidermal necrolysis Fixed drug eruption Bullous lichen planus Basement membrane zone damage Bullous pemphigoid Mucous membrane pemphigoid Pemphigoid gestationis Dermatitis herpitiformis Linear Ig A disease Epidermolysis bullosa junctional and acquisita Porphyria cutanea tarda Bullous lupus erythematosus Dystrophic epidermolysis bullosa
| 4 |
Pemphigus foliaceous
|
Pemphigus vulgaris
|
Paraneoplastic pemphigus
|
Pemphigoid
|
Dental
|
Vestibulobullous disorders
|
2889f907-c3c0-48e7-a104-f4f06bc46dbf
|
multi
|
Which of the following has least ability to regenerate?
| null | 4 |
Liver
|
Bone
|
Collagen
|
Striated muscle
|
Pathology
| null |
fb9f4ae7-5146-4823-830b-0bddc69543ff
|
single
|
Pityriasis rosea clears with in?
|
Ans. is 'd' i.e., 6-12 weeks * P. rosea is self limiting disease, subsides with 6-12 weeks.Pityriasis rosea* P. rosea is a common scaly disorder, occuring usually in children and young adults (10-35 years). Characterized by round/oval pink brown patches with a superficial, centrifugal scale, distributed over trunk in a Christmas tree pattern. The exact etiology is not known, but it is considered to be a viral disease; Human Herpes virus 6 (HHV 6) and Human Herpes virus 7 (HHV 7) may play a role.Clinical manifestations of P. rosea* The disease starts with an upper respiratory prodrome or a mild flu. After 1-2 weeks, annular erythematous plaque appears on trunk that is referred to as mother patch or herald patch. Over the next 1-2 weeks, fresh patch appear all over the trunk, in a Christmas tree configuration or Fir tree Configuration. The lesions are pinkish in white skin, hence the name rosea. However, on the dark Indian skin the lesions are skin coloured or brown. The most characteristic clue for the diagnosis is the presence of a fine scale at the edge of the lesion referrred to as centrifugal scale or collarette scales or cigarette paper scales. Lesions subside with hyperpigmentation. Trunk is involved predominantly, Sometimes (in 20% of patients) lesions occur predominantly on extremities and neck (inverse pattern).* Hanging curtain sign is seen in patients with pityriasis rosea. When the skin is stretched across long axis of herald patch, the scale is noted to be finer, lighter, and attached to one end, which tends to fold across the line of scratch
| 4 |
1-2 weeks
|
2-4 weeks
|
4-8 weeks
|
6-12 weeks
|
Skin
|
Miscellaneous
|
b4a5d449-9209-4fed-94c3-09a7c3ea169b
|
single
|
Phenol red test/ Methyl red thread test for dry eye, true is
|
Phenol Red Thread test is the test to detect dry eye severity. When in contact with tear film it changes its colour from white to yellow to red. Its main advantage over Schirmertest is: a)It is Less time consuming as compared to schirmer test(15 sec) b)Anaesthesia of cornea is not required c)On the contact of tear strip with the tear it turns red d)Can be done in children easily e)Reflex tearing is minimal f)Differentiates between aqueous deficient & non aqueous deficient eyes
| 4 |
Need instillation of anesthesia before doing the test
|
Need a ph meter to interpret
|
Color changes if there is mucin deficiency
|
Color changes from white to red on contact with tear film and is used to measure the dryness status of eye
|
Ophthalmology
|
Nasolacrimal Disorders
|
ccba9258-e5a3-4b2f-8dd8-50164911e229
|
multi
|
Which of the following radioisotopes is commonly used as a source for external beam radiotherapy in the treatment of cancer patients?
|
Ans. Cobalt-60
| 4 |
Strontium-89
|
Radium-226
|
Cobalt-59
|
Cobalt-60
|
Radiology
| null |
f66dc075-7940-4ab1-aefe-eaca788c77c3
|
single
|
The antero-posterior diameter of the lens is increased in all except
|
Ans. (d) Morgagnian cataractOption a - In cortical cataract, due to progressive hydration, swelling (increase in AP diameter) of the lens occurs making the anterior chamber shallow.Option b - Increase in the anterior lens capsule curvature with axial lens thickness due to the action of ciliary muscle on zonules.Option c - Weill-Marchesani syndrome is associated with Microspherophakia, (small, spherical lens) leading to increase in AP diameter (the equatorial diameter decreases).Option d - Morgagnian is a type of Hypermature cataract, wherein the cortical material leaks out and is further liquefied, leaving a wrinkled capsule and a Shrunken lens.
| 4 |
Intumescent cataract
|
Accommodation
|
Weill-Marchesani syndrome
|
Morgagnian cataract
|
Ophthalmology
|
Lens
|
720ad3f8-bd97-46ef-a3d2-956bfcc20fee
|
multi
|
Earliest sign in X-ray in TB spine-
|
Ans- B Narrowing of disc space First clinical sign of TB Spine = Paraspinal muscle spasm First clinical sign of Pott paraplegia = Ankle Clonus > Extensor Plantar > Spasticity First X-ray Sign of Pott spine = Reduction of disc space End result of Pott spine = bony ankylosis Loss of Spinal curvature is a non specific X-ray finding which can happen even after prolonged sitting.
| 2 |
Paravertebral shadow
|
Narrowing of disc space
|
Gibbus
|
None of the above
|
Unknown
| null |
e3afdb34-2f23-46b1-8c92-7f55457236bd
|
multi
|
Which of the following Anti neoplastic drugs SHOULD NOT be given by rapid IV infusion?
|
Ans. is `b ' i.e., Cisplatin o Cisplatin is the most common culprit causing chemotherapy induced nausea and vomiting, therefore cisplatin is given as slow i.v. infusion(never bolus) to prevent vomiting.
| 2 |
Cyclophosphamide
|
Cisplatin
|
Bleomycin
|
Cytosine arabinoside
|
Pharmacology
| null |
e21c572c-7641-4ba0-93f8-aca084487f50
|
single
|
Aspirin is contraindicated in a patient who is on treatment with:
|
Aspirin can displace warfarin from protein binding sites elevating the free drug level, leading to prolongation of both bleeding time and prothrombin time. So it should not be used in patients on anticoagulation therapy due to increased risk of bleeding. Other drugs which were found to increase the level of warfarin are: Azapropazone Phenylbutazone Naproxen Mefenamic acid Ibuprofen Ref: Enzyme- and Transpoer-Based Drug-Drug Interactions: Progress and Future Challenges edited by K. Sandy Pang, page 656.
| 2 |
Prednisolone
|
Warfarin
|
Theophylline
|
Oral contraceptives
|
Pharmacology
| null |
2d043eeb-a1c2-43c9-acb4-594b6e1c37df
|
single
|
Cause of sudden loss of vision in a diabetic is due to:
|
Commonest cause of sudden loss of vision in a diabetic is vitreous hemorrhage Slow loss of vision in a diabetic is due to Cystoid macular edema Neovascular glaucoma
| 3 |
Neovascular glaucoma
|
Central retinal aery occlusion
|
Vitreous hemorrhage
|
None of the above
|
Ophthalmology
|
FMGE 2018
|
0a568a27-c005-445f-ab2f-fee777a5790c
|
multi
|
Late hyperglycemia in pregnancy is associated with
|
Fetal macrosomia Definition: Those infants exceeding the 90th percentile for a given gestational week are usually used as the threshold for macrosomia or large-for-gestational age (LGA) bihweight The primary effect attributed to gestational diabetes is excessive fetal size or macrosomia Maternal hyperglycemia prompts fetal hyperinsulinemia, paicularly during the second half of gestation . This in turn stimulates excessive somatic growth or macrosomia. Except for the brain, most fetal organs are affected by the macrosomia that characterizes the fetus of a diabetic woman. Infants are anthropometrically different from other large-forgestational age (LGA) infants with excessive fat deposition on the shoulders and trunk, which predisposes to shoulder dystocia or cesarean delivery The incidence of macrosomia rises significantly when mean maternal blood glucose concentrations chronically exceed 130 mg/dL Reference: William&;s Obstetrics; 24th edition; Chapter 57
| 1 |
Macrosomia
|
lUGR
|
Postmaturity
|
Congenital malformation
|
Gynaecology & Obstetrics
|
Medical, surgical and gynaecological illness complicating pregnancy
|
0d519093-8331-441f-8118-45dcb2621092
|
single
|
PMA index is used to record the status of:
| null | 1 |
Gingival disease
|
Carious teeth
|
Root caries
|
Periodontal disease
|
Dental
| null |
5f48d90a-b7aa-43dd-8402-ca6ecee6ebc9
|
single
|
All are features of emergence delirium with ketamine anesthesia except:-
|
Despite its reputation as a hallucinogen, sub-anesthetic ketamine does not consistently produce frank hallucinations. 5 - 30 % patients receiving intravenous ketamine has incidence of postoperative delirium and hallucination associated with it. prevention and treatment - intravenous midazolam
| 3 |
Visual illusions
|
Coical blindness
|
No hallucination
|
Auditory, proprioceptive and confusional illusions
|
Anaesthesia
|
Intravenous Anesthetic Agents
|
9783eb08-29c3-4ae5-8587-366082dcd36a
|
multi
|
Phlegmon is a
| null | 2 |
Sexually transmitted disease
|
Type of celtulites
|
Type of osteomyelitis
|
Venereal disease
|
Pathology
| null |
8d7fa9d7-af76-416e-a8d9-d6640a839701
|
multi
|
Which of these fatty acids is found exclusively in breast milk:
|
D i.e. Docosahexanoic Acid Most of the naturally occurring unsaturated fatty acids are cis-isomers. Trans-FA do not occur naturally in plants and occurs only in small amounts in animals as ruminant fat (eg butter fat) arising from the action of micro organisms in rumen. Cis isomers are less stable than trans FA.- Trans fatty acids formed during paial hydrogenation or hardening (saturation /deep frying)Q of vegetable oils - a procedure to improve stability or shelf life. Trans - FA increase incidence of coronary hea disease by increasing LDL and decreasing HDLQ.- Linoelic acid is the most impoant essential fatty acid because it serves as the basis for production of other EFAs like arachidonic acid & docosahexanoic acid. Arachidonic acid, a w-6 PUFA is essential as it is a precursor of prostaglandins & leukotrienes.Linoleic acid is the most impoant essential fatty acid, maximally found in Safflower oilQ>Corn oilQ> Sunflower oilQ- Docosahexanoic Acid (DHA; tai, 22:6) which is synthesized from a-linolenic acid or obtained directly from fish oils, is present in high concentrations in retina, cerebral coex, testis & sperm. DHA is paicularly needed for development of brain & retina and is supplied the placenta and milk. Milk is the constant and continuous source of DHA as placenta is not present at all time. Patients with Retinitis pigmentosa are repoed to have low levels of DHA.Plasma membrane contains both saturated & mono or poly unsaturated FA.
| 4 |
Linolaete
|
Linolenic
|
Palmitic
|
Docosahexanoic acid
|
Biochemistry
| null |
38b22b85-984d-443c-81a8-98d537b2b8e0
|
single
|
Mixed parotid tumour arises from -
| null | 2 |
Epithelium
|
Epithelium + Mesenchymal
|
Mesenchymal
|
None of the above
|
Surgery
| null |
543f0aeb-eed5-4869-9ac1-884909e1a46c
|
multi
|
A pregnant lady presented with painless bleeding in the 3rd trimester. Most common cause will be
|
Ans a Ref: Sheila balakrishna obs, page 157Clinical features of placenta previaSymptomsClassical presentation of painless antepartum haemorrhage. Recurrent initial bleeding is unusually not severeSignsPallor proportionate to amount of bleedingSize of the uterus correspond to period of amenorrhoeaUterus soft, non tenderMalpresentations and floating headFHS heard.
| 1 |
Placenta previa
|
Abruptio placentae
|
Vesicular mole
|
none
|
Surgery
|
Miscellaneous
|
4f34d9df-b78c-41a2-b43b-9dda2c8affd9
|
multi
|
Drugs used in ADHD are –
| null | 4 |
Atomoxetine
|
Methylphenidate
|
Dextroamphetamine
|
All the above
|
Pediatrics
| null |
3453950d-ac35-4677-83ea-9b562e94d8e9
|
multi
|
Which of the following is a mitochondrial enzyme of Urea Cycle
|
CPS - I is a mitochondrial enzyme and catalyses rate limiting step of Urea Cycle.
All the Cytoplasmic enzymes of urea cycle start with letter "A".
| 2 |
Arginase
|
Carbamoyl Phosphate synthetase I
|
Arginosuccinate lyase
|
Arginosuccinate synthetase.
|
Biochemistry
| null |
9e384746-9205-4554-aff1-2c6df103b8ba
|
single
|
On electron microscopy amyloid characteristically exhibits:
|
Propeies of Amyloid Proteins: -Physical Nature of Amyloid: Electron microscopy-- Continuous, non-branching fibrils with a diameter of approximately 7.5 to 10 nm. X-ray crystallography and infrared spectroscopy-- Cross-b-pleated sheet conformation. This conformation is responsible for the distinctive Congo red staining and birefringence of amyloid. -Chemical Nature of Amyloid The AL (amyloid light chain)-excess of the light chains will deposit outside the cell in the form of Amyloid protein.It is seen in Multiple Myeloma patients. The AA (amyloid-associated) type of amyloid fibril protein is derived from unique non-Ig protein made by the liver. b-amyloid protein (Ab)-Seen in Alzheimer disease.(deposition of Ab plaque in the brain,causing damage to the coical neurons lowering the acetylcholine levels ,leading to |Memory.
| 3 |
B-plated sheets
|
Hyaline globules
|
7.5-10 nm fibrils
|
20-25 nm fibrils
|
Pathology
|
Amyloidosis
|
9e879d62-0a47-4443-aa5e-1cd2aad4fbdc
|
multi
|
New name of mental retardation according to American Association of Mental Retardation:
|
Ans. c. Intellectual disabilityRef: First Aid for the Psychiatry Clerkship 4th Ed; Page No-122-23Intellectual disability (ID, intellectual developmental disorder) replaces the term mental retardation (MR) as per US law (Rosas Law), with the intention of decreasing stigmatization.ID is characterized by severely impaired cognitive and adaptive/social functioning.Severity level is currently based on adaptive functioning, indicating degree of support required.A single IQ score does not adequately capture this and is no longer used solely to determine ID severity.CAUSES OF MENTAL RETARDATIONCauseExamplesGenetic*. Down syndrome: Trisomy 21 (1/700 live births)*. Fragile X syndrome: Involves mutation of X chromosome, second most common cause of intellectual disability, M > F*. Others: Phenylketonuria, familial mental retardation, Prader-Willi syndrome, Williams syndrome, Angelman syndrome, tuberous sclerosisPrenatalInfection and toxins (TORCH):*. Toxoplasmosis*. Other (syphilis, AIDS, alcohol/illicit drugs)*. Rubella (German measles)*. Cytomegalovirus (CMV)*. Herpes simplexPerinatalAnoxia, prematurity, birth trauma, meningitis, hyperbilirubinemiaPostnatalHypothyroidism, malnutrition, toxin exposure, trauma, psychosocial CausesEXTRA MILECHARACTERISTIC PHYSICAL FEATURES OF GENETIC SYNDROMESDown syndrome: Epicanthic folds, flat nasal bridge, and palmar creaseFragile X syndrome: Macrocephaly, joint hyperlaxity, and macroorchidism in post pubertal males.Prader-Willi syndrome: Obese, small stature, and almond-shaped eyes.Fragile X syndrome facts and statisticsMost common inherited form of ID2nd most common cause of IDDue to FMR-1 gene mutationMales>femalesDown syndrome facts and statistics1/700 live birthsMost common chromosomal disorderTrisomy 21=3 copies of chromosome 21
| 3 |
Feeble Mindedness
|
Madness
|
Intellectual disability
|
Mentally unstable
|
Psychiatry
|
Mental Retardation
|
d92be5bd-1d67-4ea0-9e60-01fb598ce63e
|
multi
|
A 35-year-old man has had increasing dyspnea for the past 24 hours. A chest radiograph shows large, bilateral pleural effusions. Thoracentesis yields 500 mL of slightly cloudy yellow fluid from the right pleural cavity. Cytologic examination of the fluid shows many neutrophils, but no lymphocytes or RBCs. Which of the following mechanisms contributes most to the pleural fluid accumulation?
|
Exudation of fluid from venules and capillaries is a key component of the acute inflammatory process. Several mechanisms of increased vascular permeability have been proposed, including formation of interendothelial gaps by contraction of endothelium. This contraction can be caused by mediators such as histamine and leukotrienes. The vessels then become more "leaky," and the fluid leaves the intravascular space to accumulate extravascularly, forming effusions in body cavities or edema within tissues. Arteriolar vasoconstriction is a transient response to injury that helps diminish blood loss. Platelets adhere to damaged endothelium and promote hemostasis. Lymphatic obstruction results in the accumulation of protein-rich lymph and lymphocytes, producing a chylous effusion within a body cavity. After neutrophils reach the site of tissue injury outside of the vascular space, they release lysosomal enzymes that promote liquefaction.
| 2 |
Arteriolar vasoconstriction
|
Endothelial contraction
|
Inhibition of platelet adherence
|
Lymphatic obstruction
|
Pathology
|
Inflammation & Repair
|
79e642b8-e423-4b53-a3d1-57977ea565e4
|
single
|
A 13-year old girl came to the casualty with acute lower abdominal pain. She had a cyclical pain for the last 6 months. She has not yet attained her menarche. On examination, a tense bulge was seen in the region of the hymen. The most probable diagnosis is?
|
Imperforate hymen: congenital disorder where a hymen without an opening completely obstructs the vaginal outflow. Prevents the drainage of menstrual blood. This results in the accumulation of blood in the vagina leading to hematocolpos. This is visualised as the tense bulge. In long standing cases it can even lead to hematometra. Treatment involves a cruciate incision on the hymen with drainage of hematocolpos/ hematometra
| 2 |
Mayer-Rokitansky-Kuster-Hauser syndrome
|
Imperforate hymen
|
Asherman's syndrome
|
Congenital adrenal hyperplasia
|
Gynaecology & Obstetrics
|
Normal Menstruation, Abnormal Menstruation, Menopausal Physiology and forsight of conception
|
39c76adb-bf3f-4924-b11a-b47337e88195
|
single
|
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