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Which of the following findings expected on microscopic examination of biopsy from hea bowing ventricular hyperophy With asymmetric septal thickening
|
Patients with chronic IHD typically exhibit left ventricular hyperophy. The endocardium generally show patchy , fibrous thickening and mural thromboi may present Robbins page no. 384
| 2 |
Aschoff bodies
|
Disorganisation of myofibrils
|
infiltration by inflammatory cells
|
Localised fibrous scarring
|
Pathology
|
Cardiovascular system
|
9dd63e24-c2af-4862-8d27-52ea4a8d0d19
|
single
|
Which of the following is the mechanism of action of warfarin?
|
Warfarin inhibits vitamin K-dependent coagulation factor synthesis. These include factors II, VII, IX, and X, as well as protein C and S. Warfarin acts to increase the prothrombin time. Factors XI and XII are not vitamin K-dependent factors. Therefore, warfarin does not inhibit their synthesis. Activation of antithrombin III is a mechanism of action used by heparin. It acts to prolong the paial thromboplastin time. Fibrinolysis is a mechanism of action used by thrombolytic agents such as streptokinase and urokinase. These agents conve plasminogen to plasmin, promoting fibrinolysis. Inhibition of antithrombin III would promote clot formation. The goal of anticoagulation is to prevent clot formation. Ref: Weitz J.I. (2011). Chapter 30. Blood Coagulation and Anticoagulant, Fibrinolytic, and Antiplatelet Drugs. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.
| 4 |
Activation of antithrombin lll
|
Fibrinolysis
|
Inhibition of antithrombin lll
|
Inhibition of synthesis of clotting factors II, VII, IX, and X
|
Pharmacology
| null |
39b85a9b-d2f7-4060-9285-ca96add7dfc3
|
single
|
All of the following are the indications of non invasive ventilation except
|
Noninvasive ventilation (NIV) refers to the administration of ventilatory suppo without using an invasive aificial airway (endotracheal tube or tracheostomy tube). The use of noninvasive ventilation (see the video below) has markedly increased over the past two decades, and noninvasive ventilation has now become an integral tool in the management of both acute and chronic respiratory failure, in both the home setting and in the critical care unit. Noninvasive ventilation has been used as a replacement for invasive ventilation, and its flexibility also allows it to be a valuable complement in patient management. Its use in acute respiratory failure is well accepted and widespread. It is the focus of this review. The role of noninvasive ventilation in those with chronic respiratory failure is not as clear and remains to be defined. The key to the successful application of noninvasive ventilation is in recognizing its capabilities and limitations. This also requires identification of the appropriate patient for the application of noninvasive ventilation (NIV). Patient selection is crucial for the successful application of noninvasive ventilation. Once patients who require immediate intubation are eliminated, a careful assessment of the patient and his or her condition determines if the patient is a candidate for noninvasive ventilation. This requires evaluation on several levels, and it may involve a trial of noninvasive ventilation. The following variables and factors help identify patients who may be candidates for noninvasive positive-pressure ventilation. Absolute contraindications are as follows: Coma Cardiac arrest Respiratory arrest Any condition requiring immediate intubation Other contraindications (rare exceptions) are as follows: Cardiac instability - Shock and need for pressor suppo, ventricular dysrhythmias, complicated acute myocardial infarction GI bleeding - Intractable emesis and/or uncontrollable bleeding Inability to protect airway - Impaired cough or swallowing, poor clearance of secretions, depressed sensorium and lethargy Status epilepticus Potential for upper airway obstruction - Extensive head and neck tumors, any other tumor with extrinsic airway compression, angioedema or anaphylaxis causing airway compromise Other considerations that may limit application are as follows: Implementation - Staff learning curve and time requirements (nursing and respiratory therapy), potential for delay in definitive therapy (limit trials of therapy) After eliminating unsuitable candidates for noninvasive ventilation, successful application of noninvasive ventilation mandates close assessment and selection of patients and identification of conditions best suited for treatment. Not all patients with diagnoses capable of management with noninvasive ventilation (eg, Patient inclusion criteria are as follows: Patient cooperation (an essential component that excludes agitated, belligerent, or comatose patients) Dyspnea (moderate to severe, but sho of respiratory failure) Tachypnea (>24 breaths/min) Increased work of breathing (accessory muscle use, pursed-lips breathing) Hypercapnic Hypoxemia (PaO2/FIO2< 200 mm Hg, best in rapidly reversible causes of hypoxemia) NIV is indicated in adults as follows: Obstructive sleep apnea syndrome. Chronic obstructive pulmonary disease with exacerbation. Bilateral pneumonia. Acute congestivehea failure with pulmonary edema. Neuromuscular disorders. Acute lung injury/ Acute respiratory distress syndrome.
| 1 |
GCS <8
|
Conscious and cooperative patient
|
COPD
|
ARDS
|
Anaesthesia
|
Modes of Ventilation
|
921ccc2f-4c7f-41f0-baa0-216419f87ccc
|
multi
|
Decreased plasma renin activity is seen in:
|
Primary hyperaldosteronism is due to bilateral adrenal hyperplasia or due to adrenal adenoma. Both these conditions are autonomous and lead to aldosterone production in excess. The R.A.A.S system negative feedback will result in decrease in renin production. Low renin Hypeension is a feature of primary hyperaldosteronism. Causes of low renin hypeension Liddle syndrome Conn's syndrome Mineralocoicoid receptor mutation Apparent mineralocoicoid excess (AME) Glucocoicoid resistance Gordon syndrome Congenital adrenal hyperplasia (CAH)
| 1 |
Primary hyperaldosteronism
|
Baer syndrome
|
Pregnancy induced Hypeension
|
Secondary aldosteronism
|
Medicine
|
Disorders of Adrenal Gland
|
cd23b8e9-11e7-47a9-a87c-07e309cfcd09
|
single
|
A patient with necrotizing pancreatitis undergoes CT guided aspiration, which results in growth of E-coli on culture. The most appropriate treatment is:
|
Exploratory laparotomy The presence of secondary pancreatic infection suspected in patients whose systemic inflammatory response (fever, WBC count or organ dysfunction) fails to resolve, CT-guided aspiration of fluid from pancreatic bed for performance of Gram's stain & culture analysis is of critical impoance. A positive is Gram's stain or culture or identification of gas within pancreas on CT-scan, mandate operative intervention.
| 4 |
Culture appropriate antibiotic therapy
|
ERCP with sphincterotomy
|
CT guided placement of drain(s)
|
Exploratory laparotomy
|
Surgery
| null |
3e7b3276-5531-4eee-b302-5771fd7e2c74
|
single
|
which of the following is a SSRI
|
SSRI * IMPOANCE Most widely prescribed antidepressant * MECHANISM Specifically acts on serotonin transpoers and increases serotonin in synapse. DRUGS FLUOXETINE FLUVOXAMINE DAPOXETINE CITALOPRAM ESCITALOPRAM ESCITALOPRAM SERALINE PAROXETINE USE FLUOXETINE=============CHILDHOOD DEPRESSION FLUVOXAMINE===========OCD DAPOXETINE==============PME ESCITALOPRAM===========HEA SAFE, PATHOLOGICAL EMOTIONS PAROXETINE=========SEDATING, PANIC DISORDER IMPULSE CONTROL DISORDERS PME PARAPHILIA Ref., kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 955
| 2 |
clomipramine
|
fluoxetine
|
milnacipran
|
trazadone
|
Anatomy
|
Pharmacotherapy in psychiatry
|
91153f37-dc41-457e-b338-8d6d51ff1114
|
single
|
Drug used in hepatitis B infection is
|
Ans. is 'a' i.e., Entecavir Treatment of acute hepatitis Hepatitis B - No treatment is required. Hepatitis C - Pegylated Interferon (PEG - IFN). Treatment of chronic hepatitis Hepatitis B - Lamivudin, entecavir (preferred) or interferon. Hepatitis C - Pegylated Interferon (PEG - IFN), entecavir plus ribavirin.
| 1 |
Entecavir
|
Astacavir
|
Zanamivir
|
Abacavir
|
Pharmacology
| null |
39da6194-e889-475e-8f60-7fd534db254a
|
single
|
Precancerous condition of Ca stomach is -
| null | 2 |
Peptic ulcer
|
Chronic gastric atrophy
|
Achalasia cardia
|
Curling' s ulcer
|
Surgery
| null |
a5eadc98-7c65-4ead-8a7b-4d1e56b4ec5b
|
single
|
Frey's syndrome is due to the involvement of-
| null | 1 |
Auriculotemporal nerve
|
Glossopharyngeal nerve
|
Vagus nerve
|
All
|
ENT
| null |
519d8060-0842-4510-a88f-948fdec8a553
|
multi
|
Commonest site of intestinal atresia is in the ?
|
Ans. is 'a' i.e., Duodenum
| 1 |
Duodenum
|
Jeiunum
|
Ileum
|
Colon
|
Surgery
| null |
d455daf4-cfd0-42dc-a50c-24e90208851a
|
single
|
Which of the following is a myofunctional appliance?
|
Catalans or lower anterior inclined plane appliance is used to treat cross bites. The inclined plane has a 450 angulation, which forces the maxillary teeth in cross bite to a more labial position. It is teeth supported functional appliance. Expansion screw and Derichsweiler are expansion appliances.
| 1 |
Catalan's appliance
|
Hawley's appliance
|
Expansion screw
|
Derichsweiler appliance.
|
Dental
| null |
cd460ea0-6a86-482b-b2af-553ecd3277b1
|
single
|
An Afroamerican boy of 6 years of age presented with abdominal pain, chronic hemolysis and abnormal RBC shape on peripheral smear. Most likely disorder responsible for this condition:(AIIMS November 2014. November 2013)
|
Ans. a. Point mutation (Ref: Ghai 7/e p310-312; Harper's 27/e p368-371; Robbins 9/e p635-638, 8/e p646)An afroamerican kid of 6 years of age presented with abdominal pain, chronic hemolysis and abnormal RBC shape on peripheral smear. This patient is suffering from sickle cell anemia. Most likely disorder responsible for this condition point mutation. (AIIMS November 2013 repeat)'Sickle cell anemia is an autosomal recessive disease that results from the substitution of valine from glutamic acid at position 6 of the beta-globin gene (Point mutation). - Ghai 7/e p310Point mutations within coding sequences:A point mutation may alter the code in a triplet of bases and lead to the replacement of one amino acid by another in the gene product.An excellent example of this type is the sickle mutation affecting the B-globin chain of hemoglobinQ. Here the nucleotide triplet CTC (or GAG in mRNA), which encodes glutamic acid, is changed to CAC (or GUG in mRNA), which encodes valine. This single amino acid substitution alters the physicochemical properties of hemoglobin, giving rise to sickle cell anemia.Sickle Cell DiseaseSickle cell disease is a common hereditary hemoglobinopathy that occurs primarily in individuals of African descend.Caused by a point mutation in the sixth codon of B-globin that leads to the replacement of a glutamate residue with a valine residueQ.In certain populations in Africa the prevalence of heterozygosity is as high as 30%. This high frequency probably stems from protection afforded by HbS against falciparum malariaQ.Pathogenesis:HbS molecules undergo polymerization when deoxygenated.Initially the red cell cytosol converts from a freely flowing liquid to a viscous gel as HbS aggregates form.With continued deoxygenation aggregated HbS molecules assemble into long needle-like fibers within red cells, producing a distorted sickle or holly-leaf shapeQ.Presence of HbS underlies the major pathologic manifestationsChronic hemolysisQMicrovascular occlusionsQTissue damageQMorphology:Peripheral blood demonstrates variable numbers of irreversibly sickled cells, retieulocytosis, and target cells, Howell-Jolly bodiesQ (small nuclear remnants).The bone marrow is hyperplastic as a result of a compensatory erythroid hyperplasiaQ.Expansion of the marrow leads to bone resorption and secondary new bone formation, resulting in prominent cheekbones and changes in the skull that resemble a crew-cut in x-raysQ.Increased breakdown of hemoglobin can cause pigment gallstones and hyperbilirubinemiaQ.Splenic infarction, fibrosis, and progressive shrinkage (autosplenectomy)Q
| 1 |
Point mutation
|
Trinucleotide repeat
|
Antibody against RBC membrane
|
Genomic imprinting
|
Pathology
|
Hemolytic anemia
|
26bb9c99-ae6b-4ca0-a843-59889b187ade
|
single
|
Cnrnnonent of Advanced cardiovascular life suppo (ACLS) in accordance to AHA 2015 guideline:
|
Ans. B. Chest compression at least 5 cm/2 inchBasic life suppo (BLS), advanced cardiovascular life suppo (ACLS), and post-cardiac arrest care all describe a set of skills and knowledge applied sequentially during the treatment of patients who have a cardiac arrest.ACLS comprises the level of care between BLS and post-cardiac arrest careUpdate recommendations for advanced cardiac life suppo 2015:The combined use vasopressin and epinephrine offers no advantage to using standard-dose epinephrine in cardiac arrest.Vasopressin has been removed from the Adult Cardiac Arrest Algorithm-2015 update.Advanced Cardiac Life Suppo:Continuous chest compressions at a rate of lil)/rnin to 120/min, vnthout pauses for ventilation. The provider delivering ventilation should provide 1 breath every 6 seconds (10 breaths per minute).It may be reasonable to avoid and immediate$r correct hypotension (SBp < 90 mm Hg, MAp < 65 mmHg) during post-cardiac arrest care.
| 2 |
Chest compression 100-150 per minute
|
Chest compression at least 5 cm/2 inch
|
Vasopressors is used to maintain MAP > 70 mmHg in non-responsive to fluids
|
1 Breath every 8 seconds
|
Anaesthesia
| null |
8e322a0e-441d-4dca-a790-98dea980a004
|
multi
|
Which of the following inhalational agent is contraindicated in a patient with history of epilepsy -
| null | 2 |
Isoflurance
|
Enflurane
|
Halothane
|
Sevoflurane
|
Anaesthesia
| null |
29c56c36-7918-475a-aedd-d952e2204899
|
single
|
For split skin graft the best source is
|
(A) Autograft # Autograft is skin graft taken from an uninjured part of body (e.g. thigh skin) and is used for skin grafting in same person.> It is the best skin graft for open wounds because of very high rate of successful grafting.
| 1 |
Autograft
|
Homograft
|
Isograft
|
Xenograft
|
Surgery
|
Miscellaneous
|
a06e8b92-642c-4ef7-b104-c7a9e28f0822
|
single
|
The best treatment for Kawasaki disease is:
|
Kawasaki disease causes inflammation in the walls of medium-sized aeries throughout the body. It primarily affects children. The inflammation tends to affect the coronary aeries, which supply blood to the hea muscle. Kawasaki disease is sometimes called mucocutaneous lymph node syndrome because it also affects lymph nodes, skin, and the mucous membranes inside the mouth, nose, and throat. Signs of Kawasaki disease, such as a high fever and peeling skin, can be frightening. Doctor may recommend: Gamma globulin. Infusion of an immune protein (gamma globulin) through a vein (intravenously) can lower the risk of coronary aery problems. Aspirin. High doses of aspirin may help treat inflammation. Aspirin can also decrease pain and joint inflammation, as well as reduce the fever. Kawasaki treatment is a rare exception to the rule against aspirin use in children but only when given under the supervision of your child's doctor. Because of the risk of serious complications, initial treatment for Kawasaki disease usually is given in a hospital. REF KD Tripathi 8th ed
| 2 |
Aspirin
|
I.V. immunoglobulins
|
Coicosteroids
|
Methotrexate
|
Pharmacology
|
Immunomodulators
|
47a7d550-1128-4133-a88d-c3e95e76aa85
|
single
|
Zafirlukast used in asthmatic patients acts by
|
Drugs for Bronchial AsthmaMechanism of actionDrugsBronchodilators b2 sympathomimetics Salbutamol, Terbutaline, Bambuterol, Salmeterol, Formoterol, Ephedrine Methylxanthine Theophylline, Aminophylline, Choline theophyllineAnticholinergics Ipratropium bromide, Tiotropium bromide Leukotriene antagonist Montelukast, Zafirlukast Mast cell stabilizers Sodium cromoglycate, Ketotifen Coicosteroids Systemic Hydrocoisone, Prednisolone Inhalational Beclomethasone, Budesonide, Fluticasone, Flunisolide, Ciclesonide Anti IgE antibody Omalizumab (Refer: Rang and Dale's Clinical Pharmacology, 7th edition, pg no: 345)
| 3 |
Phosphodiesterase inhibition
|
Endothelium receptor blockage
|
Leukotriene receptor blockage
|
Lipoxygenase inhibitor
|
Anatomy
|
All India exam
|
af78d7d3-cb7a-4c9e-ad22-cfe40be06df8
|
single
|
Perforated corneal ulcer gives rise to: September 2012
|
Ans. A i.e. Anterior capsular cataract
| 1 |
Anterior capsular cataract
|
Posterior subcapsular cataract
|
Vossius ring
|
Rosette shaped cataract
|
Ophthalmology
| null |
0750e7aa-5b9d-46cd-a003-8ebbfc327c5a
|
single
|
A patient develops an infection of methicillin-resistant Staphylococcus aureus. Which of the following drug cannot be used to treat the infection:
|
Cefaclor is a second generation cephalosporin and is not active against MRSA.
| 3 |
Vancomycin.
|
Cotrimoxazole.
|
Cefaclor.
|
Ciprofloxacin.
|
Pharmacology
| null |
0a24032e-27c0-41af-ba27-d517336be129
|
single
|
Generalised hypercementosis seen in:
| null | 1 |
Paget's disease
|
Hypothyroidism
|
Trauma
|
All of the above
|
Radiology
| null |
dd1dcff7-8669-438d-9fba-210f5297331c
|
multi
|
any behaviour that is assosiated with cessation of aversive response is called as
|
Behavioral therapy is learning given by BF Skinner , according to him all behaviors are learned phenomenon and thus can be unlearned Positive reinforcement a type of reinforcement when a behavior is rewarded there is more chance that the behavior is repeated Negative reinforcement is that when a behavior is done and an aversive response is removed, the behavior is repeated. When I go and meet my girlfriend, she checks my messages and picks up fight (aversive response) suddenly I delete all messages one day and that day there was no fight (no aversive response) then that behavior is repeated (delete all messages before meeting my girlfriend) Extinction is the type of reinforcement where a behavior is done and a rewarding response is removed the chance is that behavior will not be repeated A child likes to play with children( reward) but when the child fights with other children( undesirable behavior) the child will be removed from playing( removing a reward) , then the child stops fighting with other children( reduction of undesirable behaviour) Ref. kaplon and sadock synopsis, 11 th edition, pg no. 845
| 4 |
punishment
|
positive reinforcrmrnt
|
omission
|
negative reinforcement
|
Anatomy
|
Treatment in psychiatry
|
27846fc3-5330-4fb0-bb12-f4d56d179e45
|
multi
|
Pomphylox affects ?
|
Ans is 'a' i.e., Palms & soles POMPHOLYX An attack of pompholyx is characterized by the sudden onset of crops of clear vesicles, which appear 'sago-like'. Itching may be severe, preceding the eruption of vesicles. The attack subsides spontaneously in 2-3 weeks . In mild cases, only the sides of the fingers may be affected, but in a typical case the vesicles develop symmetrically on the palms and/or soles
| 1 |
Palms & soles
|
Groin
|
Scalp
|
Trunk
|
Skin
| null |
95d73851-2c6f-47d1-9470-558387c5f4a5
|
single
|
Kleine Levine syndrome is
|
Kleine Levin syndrome- is the best-recognized recurrent hypersomnia. It afflicts males in early adolescence. In its classic form, the recurrent episodes are associated with a) extreme sleepiness (18- to 20-hour sleep periods) b) voracious eating, c)hypersexuality, d) disinhibition (e.g., aggression). Episodes typically last for a few days up to several weeks and appear once to ten times per year. A monosymptomatic hypersomnolent form can occur. Reference: P 2161 chap. 20 Sleep Disorders(Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 9th Edition)
| 4 |
Insomnia
|
Depression
|
Anxiety
|
Hypersomnia
|
Psychiatry
|
All India exam
|
5a31613f-0530-446a-bcf1-8f09e997687c
|
single
|
The normal defensive mechanism for protection of gastric mucosa against acid-pepsin digestion include which of the following?
|
Prostaglandin is one of the impoant defensive mechanism against erosion of the gastric mucosa. Impaired production of PG will result in peptic ulcer formation. Defensive mechanisms may be divided into anatomic and physiologic types. Anatomic mechanisms are adequate blood supply, proper tight junctions between epithelial cells etc. Physiologic mechanisms include production of mucus, PG, bicarbonate into the mucus etc. Regenerating capacity of epithelial cells also play an impoant role against the formation of peptic ulcer. Ref: Dohey G.M., Way L.W. (2010). Chapter 23. Stomach & Duodenum. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.
| 4 |
Secretion of bicarbonate into gastric mucosa
|
Adequate blood supply
|
Overproduction of PG by gastric epithelium
|
All of the above
|
Physiology
| null |
51a610fe-0c90-488c-b944-6b27d1df1796
|
multi
|
A 30 yrs woman 2+0, hypeension have menorrhagia. Which is best treatment for her aEUR'
|
MIRENA [Ref- Dewhurst text book of Gynae & Obs 7/e p. 399-404; A Comprehensive textbook of Ohs & Gynae Saillma Gupta 140, 141, 1421 The question does not give any clue regarding the aetiology of menorrhagia, so most probably the women is having D.U.B. i.e., dysfunctional uterine bleeding. When a woman present with menorrhagia, consideration must first be given to diagnosis. This requires an appropriate history and clinical examination cotnplented by suitable investigation. Anemia should be detected by full blood count and iron studies. Ultrasonography, sonohysterography and hysteroscopy are additional investigations that may diagnose a structural problem and should be utilized depending on their availability and the experience of the surgeon. Common causes of menorrhagia include local pathology such as fibroids, polyps, adenomyosis or infection. Rarer, hut impoant causes include genital malignancy (cervical, endometrial or myometrial) and systemic disorders such as thyroid disease and bleeding disorders. In over 50% cases no cause is found and the diagnosis of dysfunctional uterine bleeding is made. Dysfunctional uterine bleeding requires the following criteria :- i) Complaint of excessive menstrual blood loss (menorrhgia). ii) Adequate exlusion of pathology that may otherwise cause menorrhagia. Dysfunctional uterine bleeding may be ovulatory or nonovulatory. - Anovulatory cycles results in menorrhagia with regular cycles where as - Ovulatory cycles results in menorrhagia with irregular cycles. Most of the cases of dysfunctional uterine bleeding are secondary to anovulation. - Without ovulation the corpus luteum,fails to .form resulting in no progesterone secretion. - In the absence of progesterone there is no lateral phase or the secretor), phase. - The anovulatory woman is always in the follicular phase of the ovarian cycle and in the proliferative phase of endometrial cycle. - The only ovarian steroidal signal the endometrium receives is through estrogen. - Continuous stimulation of endometrium by estrogen produces proliferation of the endometrium to abnormal levels where it becomes fragile without the growth limiting and organizing effect of progesterone. - The endometrium finally outgrows its blood supply and degenerates. The end result is asynchronous breakdown of the endometrial lining at different levels. We can conclude that bleeding in anovulatory cycle occurs due to unopposed action of estrogen in the absence of progesterone. Anovulatory menstrual cycle gives rise to irregular bleeding. On the other hand, ovulatory cycles give rise to regular menstrual bleeding. These patients ovulate regularly. These patients have both the phases of menstrual cycle i.e.,.follicular phase and the secretory phase. Research has shown that several abnormalities can occur in the endometrium of women with DUB's ovulary cycles for example increased fibrinolytic activity and increased production of prostaglandins. These observation provide the rational basis for treatment in these women i.e., - Antifibrinolytics Trenaximic acid - Prostaglandin inhibitor acid Management of dysfunctional uterine bleeding. In D.U.B's there is no specific abnormality present therefore the choice of t/t must be considered in relation to several factors : ? Factors influencing tit -Presence of ovulatory or anovulatory cycles. - Need ,for contraception - Patient preference - Contraindication to t/t Heavy periods Require contraception No Regular cycles Yes .L Dysmenorrhoea significant symptoms No.L Tranexanic acid Yes No Yes Combined oral contraceptive or levonorgestral releasing intrauterine system Combined oral contraceptives or cyclical progestins Non steroidal anti inflammatory drugs Medical treatment can be conveniently divided into hormonal and nonhormonal : ? -As there is no hormonal defect the use of hormonal therapy does not correct an underlying disorder but merely imposes and external control of the cycle. - The two main first line t/t for menorrhagias associated with ovulatory cycles are non hormonal as the ovulatory cycles usually have no defect in menstrual cycle. - They have normal menstruation and regular cycle the abnormality usually lies in increased fibrinolysis and increased production of prostaglandin. First line drugs in ovulatory cycles (menorrhagia with regular cycles) - Antifibrinolytice (Trenaxamic acid) - NSAIDSQ Trenaxamic acid reduces menstrual loss by half and NSAID reduces it by one third. Both have the advantages of only being taken during menstruation, and aid to compliance and are paicularly useful in those women who either do not require contraception or do not wish to use a hormonal therapy. They are also of value in treating excessive menstrual blood loss associated with the use of non hormonal intrauterine contraceptive device. Hormonal therapy Progesterone Traditionally hormonal therapy for menorrhagia has been progesterone given during luteal phase of the cycle. Normally progesterone therapy will control anovulatory bleeding once uterine pathology is excluded. In women who do not ovulate but are more frankly hypogonadal cyclic progesterone therapy restores the normal sequence of steroid hormone stimulation, estrogen followed by estrogen plus progesterone followed by withdrawal bleeding. Progestins are usually not effective. Despite this they remain the first choice of many general practioners and gynaecologists. Progesterones are effective when given for 21 days in each cycle but the side effects are such that patient may not choose to continue with the t/t. Although progestins have contraceptive effect but they are not the best choice when contraception required. Combined contraceptive pill They are popular first line drugs for women who desire contraception. OCP's suppress pituitary gonadotropin release preventing ovulation. Like cyclical progestins they are useful for anovulatory bleeding as they impose a cycle. Levonorgesteral intrauterine system (MIRENA) It is a T shaped intrauterine device which releases levornorgestral at the rate of 20 mcg daily. This low hormone minimizes the systemic progestinic side effects and more patients will continue this therapy than cyclic progesterones. It exes its clinical effect by preventing endometrial proliferation and consequently reduces both the duration of bleeding and the amount of menstrual loss. The levonorgestral releasing system is also advocated as an alternative to surgery. Levonorgestrel-IUD versus surgical treatments A cost-utility model study from Hong Kong repoed that over a period of five years, treatment with the LNG-IUD compared with oral medical treatment, endometrial ablation, or hysterectomy was less expensive and accrued more quality adjusted life years. It is impoant to note that cost-utility calculations may vary in different health care settings. Endometrial ablation Vs Levonorgestrol IVD For women who wish to stop using chronic medical therapy or have contraindications to medications, minimally invasive options include the LNG-IUD or endometrial ablation. A systematic review of six randomized trials and a subsequent randomized trial:found that women with menorrhagia who were treated with either the LNG-IUD or endometrial ablation had similar reductions in menstrual blood loss at 6, 12, and 24 months, as well as similar improvements in quality of life. A meta-analysis of four randomized trials found that rates of dissatisfaction were similar for women treated with the LNG-IUD (17 percent) compared with endometrial ablation (18 percent) (OR 0.9, 95% CI 0.5-1.8). The decision to use the LNG-IUD or endometrial ablation depends upon a patient's preferences regarding treatment factors such as plans:for:feility and contraception, convenience, and risks of anesthesia. - The LNG-IUD is a reversible contraceptive. Pregnancy is contraindicated after endometrial ablation, but the procedure does not prevent pregnancy; thus, women will need to continue to use contraception following ablation. The LNG-IUD can be placed in an office setting for all women and requires no or local anesthesia. Endometrial ablation can also be done in an office by surgeons who are appropriately equipped, but is often performed in an operating room under general anesthesia. If successful, endometrial ablation is performed once, while the LNG-IUD needs to be replaced every live.
| 2 |
Combined pills
|
MIRENA
|
Hysterectomy
|
Transcervical resection of endometrium
|
Gynaecology & Obstetrics
| null |
f4f01706-9bc3-4e82-bdeb-e85b3ebe83e3
|
single
|
A patient arrives in the emergency room in a coma and has a serum Ca 2+ of 4.5 mM. You sta a saline infusion of which of the following drugs
|
Loop diuretics such as ethacrynic acid , Furosemide increase the excretion of Ca 2+. Ref:- KD Tripathi
| 1 |
Ethacrynic acid
|
Calcitonin
|
Hydrochlorothiazide
|
Spironolactone
|
Pharmacology
|
Autacoids
|
3622335f-0eb5-4403-92ce-1e74d00ac196
|
single
|
Beta-blockers are used in all of the following conditions except:-
|
Beta blockers are contra-indicated in AV block Beta-blockers are not given in AV blocks because they may precipitate and cause complete hea block USES OF BETA-BLOCKERS Cardiac (due to Beta 1 blockade) Extra cardiac (due to Beta 2 blockade) Hypeension PLAY : Performance anxiety , Pheochromocytoma (after a blockade) Classical angina The: Thyroid (Hypehyroidism) Myocardial infarction G: Glaucoma A: Akathisia, Alcohol and Opioid withdrawal M: Migraine prophylaxis Supraventricular arrhythmias E: Essential tremors Chronic CHF Hyperophic obstructive cardiomyopathy (DOC)
| 2 |
Essential tremors
|
AV block
|
Angina pectoris
|
Migraine prophylaxis
|
Pharmacology
|
ANS
|
db71926d-1082-4ae5-8256-a8e639be5511
|
multi
|
Muscle which dilates the palpebral apeure:
|
The levator palpebrae superioris muscle elevates and retracts the upper eyelid.
| 3 |
Orbicularis oculi
|
Orbicularis oris
|
Levator palpebrae superioris
|
Levator labii superioris
|
Anatomy
| null |
1eb1362e-3c32-483c-98c3-cdd6e167221b
|
single
|
All are seen in acute HIV syndrome Except
|
Clinical findings in HIV syndromeGeneralNeurologicDermatologic1. Fever2. Pharyngitis3. Lymphadenopathy4. Headache/Retroorbital pain5. Ahralgias/myalgias6. Lethargy/Malaise7. Anorexia/Weight loss8. Nausea/Vomiting/Diarrhea1. Meningitis2. Encephalitis3. Peripheral neuropathy4. Myelopathy1. Erythematous maculopapular rash2. Mucocutaneous ulcerationReference: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 226; Human Immunodeficiency virus disease: AIds and Related Disorders
| 1 |
Pneumonia
|
Lymphadenopathy
|
Myelopathy
|
Encephalitis
|
Medicine
|
Infection
|
f143ebc6-6f07-4b37-bf68-482bffbd392d
|
multi
|
A 40 year male has Hb-10 gm%, MCV-65 fL, RDW- 16% is, Platelet count 4.5 lac/mL. Additional finding is
|
Serum Iron and Total Iron-Binding Capacity The serum iron level represents the amount of circulating iron bound to transferrin. The TIBC is an indirect measure of the circulating transferrin. The normal range for the serum iron is 50-150 mg/dL; the normal range for TIBC is 300-360 mg/dL. Transferrin saturation, which is normally 25-50%, isobtained by the following formula: serum iron x 100 / TIBC. Iron deficiency states are associated with saturation levels below 20%. There is a diurnal variation in the serum iron. A transferrin saturation % >50% indicates that a dispropoionate amount of the iron bound to transferrin is being delivered to nonerythroid tissues. If this persists for an extended time, tissue iron overload may occur.Ref: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 126 Iron Deficiency and Other Hypoproliferative Anemias; Page no: 627
| 2 |
Low serum transferrin
|
Increased iron binding capacity
|
Increased Hb A2
|
Increased Serum copper
|
Medicine
|
C.V.S
|
86c0377f-36a7-4993-a032-566e37a692d1
|
single
|
O2 dissociation curve shift to right in all except
| null | 2 |
Diabetic ketoacidosis
|
Blood transfusion
|
High altitude
|
Anaemia
|
Physiology
| null |
964d07d0-1a22-4163-a9d6-0493893c5dca
|
multi
|
Which of the following is false with regard to prevalence ?
|
Prevalence:
Prevalence is defined as "the total number of all individuals who have an attribute or disease at a particular time (or during a particular period) divided by the population at risk of having the attribute or disease at this point in time or midway through the period.
Although referred to as a rate, prevalence rate is really a ratio.
Prevalence is of two types :
(a) Point prevalence
(b) Period prevalence
When the term "prevalence rate" is used, without any further qualification, it is taken to mean "point prevalence".
| 3 |
It is a product of incidence and duration.
|
It can be determined by a cross-sectional studies.
|
It is a rate.
|
Prevalence is point prevalence unless otherwise specified.
|
Dental
| null |
bdfbbae4-2d3f-4fb6-8c51-1302c7b74741
|
multi
|
All of the following relay in sensory cortex except
|
(D) Olfaction > The axons of the olfactory receptor neurons penetrate the cribriform plate and enter the olfactory bulb.> The 3 olfactory pathways that lead to the CNS are The pathway to the medial olfactory area anterior to the hypothalamus. The pathway to the lateral olfactory area of the pyriform cortex, which is the area of aversion development (Eg., smells inducing nausea). The pathway to the posterior part of the orbitofrontal cortex, which is an important area for analysis of smells.
| 4 |
Pain
|
Temperature
|
Touch
|
Olfaction
|
Physiology
|
Special Senses: Smell and Taste
|
038bdc89-5982-4d5a-81a7-43b18c9053a8
|
multi
|
5HT2A antagonist drug is ?
|
Ans. is 'd' i.e., Ketanserin
| 4 |
Clozapine
|
Cisapride
|
Sumatriptan
|
Ketanserin
|
Pharmacology
| null |
c6a2905e-ad17-4ff6-b07b-a5658f099ad6
|
single
|
Topical immunomodulator used for the treatment of genital warts is :
|
Drugs used for viral warts (condyloma acuminata) are
Imiquimod: It is an immune response modifier, useful in the treatment of external genital and peri-anal warts topically. Mechanism of action against these HPV-induced lesions is unknown. 5% cream is applied 3 times weekly and washed off 6-10 hours after each application. Recurrences appear to be less common than with ablative therapies. Local skin reactions and pigmentary skin lesions are the important side effects.
Resiquimod is another immunomodulator, which is used topically for HSV.
Podophyllin acts by inhibiting the polymerization of tubulin monomers in the mitotic spindle.
Interferon α-2b may be used intralesional for condyloma acuminata.
Acyclovir is used for HSV-1, HSV-2 and varicella zoster virus. It is not useful for CMV infections.
| 1 |
Imiquimod
|
Podophyllin
|
Interferon
|
Acyclovir
|
Pharmacology
| null |
be57e3f9-b06f-4a9c-b248-f35f6eaae6fe
|
single
|
Following can cause endometrial cancer:
|
Endometrial cancer is mainly caused by excessive estrogen
Metropathia hemorrhagica is the same as cystic glandular hyperplasia and is a causative factor for endometrial cancer. Ref Dutta Gynae 5th /ed p 184
Gynandroblastoma is a virilising tumor which secretes androgens (not estrogens) and so does not lead to endometrial cancer Ref. Shaw 14th /ed p 34
Dysgerminoma is a neutral tumor which does not secrete either male or female sex hormones but secretes placental alkaline phosphates, LDH and BHCG and therefore does not lead to endometrial cancer. - Ref Shaw 14th /ed 3386
| 1 |
Metropathia hemorrhagica
|
Gynandroblastoma
|
Dysgerminoma
|
All of the above
|
Gynaecology & Obstetrics
| null |
a371af3f-b09b-4a0b-beae-201a3fcb4ac4
|
multi
|
Beryllium expsore is associated with
|
Beryllium can produce a chronic granulomatous inflammatory disease that is similar to sarcoidosis.It is distinguished from sarcoidosis by evidence of a specific cell-mediated immune response(delayed hypersensitivity) to beryllium.Chest imaging shows nodules along septal lines.Pulmonary function tests show restrictive and /or obstructive ventilatory defects and decreased diffusing capacity. Ref:Harrison's medicine-18th edition,page no:2125.
| 2 |
Pulmonary fibrosis
|
Granulomatous lung disease
|
Lung cancer
|
Mesothelioma
|
Medicine
|
Respiratory system
|
9532816c-35d1-485a-8411-1cffb05261e5
|
single
|
All the following are trace elements required by body except
|
Major elements. Trace elements 1. Calcium. 1. Iron 2. Magnesium. 2. Iodine 3. Phosphorus. 3. Copper 4. Sodium. 4. Manganese 5. Potassium. 5. Zinc 6. Chloride. 6. Molybdenum 7. Sulfur. 7. Selenium 8. Fluoride.Ref: DM Vasudevan, page no: 411
| 4 |
Zinc
|
Copper
|
Selenium
|
Boron
|
Biochemistry
|
nutrition and digestion
|
9c914e4b-49d2-4e82-a2a9-037239877689
|
multi
|
Which type of vaccine is MMR?
|
ANSWER: (A) Live attenuatedREF: APPENDIX-46 below for "TYPES OF VACCINE"Live vaccines can me memorized as "BOMBEY-VT"; BCG, OPV (sabin), MMR (mumps, measles & rubella), Bubonic plague, epidemic typhus, yellow'- fever (17D), vaccinia,Oral Typhoid vaccine (Ty21a) APPENDIX - 46Types of VaccineTypeContentExamplesKilled vaccineskilled, but previously virulent, microorganisms that have been destroyed with chemicals or heat.Avian Flu vaccine; developed by Reverse Genetics techniques. Reverse genetics' is an approach to discovering the function of a gene by analyzing the phenotypic effects of specific gene sequences obtained by DNA sequencing. This investigative process proceeds in the opposite direction of so- called forward genetic screens of classical genetics. Simply put, while forward genetics seeks to find the genetic basis of a phenotype or trait, reverse genetics seeks to find what phenotypes arise as a result of particular genes.
| 1 |
Live attenuated
|
Killed
|
Toxoid
|
Subunit
|
Social & Preventive Medicine
|
Principles of Immunization and Vaccination
|
2ef2cdc0-e638-4f84-87de-6a602b4918c9
|
single
|
The following host tissue responses can be seen in acute infection, except?
|
Ans. (d) Granuloma formationRef: Robbiris pathology 9th ed. 197* Granuloma formation is characteristic of chronic granulomatous inflammation and is not seen in acute inflammation.* Vasodilation, increase in permeability, exudation, margination, rolling etc. are seen in acute inflammation.
| 4 |
Exudation
|
Vasodilation
|
Margination
|
Granuloma formation
|
Pathology
|
Cellular Pathology
|
d6984e31-4130-43aa-8bdf-e9ec5359444f
|
multi
|
Patient having fibroma of size 1.5 cm over the floor of the mouth, recommended biopsy:
| null | 2 |
Excisional biopsy
|
Incisional biopsy
|
Punch biopsy
|
Brush biopsy
|
Surgery
| null |
3be0217f-9e36-475e-aa48-556b229c8bc3
|
single
|
What does not make diagnosis of solitary pulmonary nodule
|
D i.e. Neurofibroma Primary complex in TB, produce solitary pulmonary nodule. Bronchial adenoma & Pulmonary hamaoma mostly produce solitary nodules d/ t their benign nature. Neurofibroma is almost always present at multiple foci. It is impoant to note that Hamaoma produces non cavitatory lesions.
| 4 |
Tuberculoma
|
Bronchial adenoma
|
Hamaoma
|
Neurofibroma
|
Radiology
| null |
df75fbce-783e-4e62-a4d2-f7c887e969fc
|
single
|
Commonest complication of parenteral nutrition includes all except: March 2007
|
Ans. B: Hyperkalemia Parenteral nutrition is indicated to prevent the adverse effects of malnutrition in patients who are unable to obtain adequate nutrients by oral or enteral routes. Other indications are sho gut syndrome, high-output fistula, prolonged ileus, or bowel obstruction. Sho-term TPN may be used if a person's digestive system has shut down (for instance by Peritonitis. Chronic TPN is performed through a central intravenous catheter, usually in the subclan or jugular vein. In infants, sometimes the umbilical vein is used. Complications: Catheter complications include pneumothorax, accidental aerial puncture, and catheter-related sepsis. The most common complication of TPN use is bacterial infection, usually due to the increased infection risk from having an indwelling central venous catheter. Liver failure / reversible cholestatic jaundice, often related to Fatty liver, may occur. Two related complications of TPN are venous thrombosis and rarely priapism. Fat infusion during TPN is assumed to contribute to both. Total parenteral nutrition increases the risk of acute cholecystitis due to complete unusage of gastrointestinal tract, which may result in bile stasis in the gallbladder. Metabolic complications include the Refeeding Syndrome characterised by hypophosphataemia and other electrolyte abnormalities. Nutrients deficiency: hypoglycemia/ hypocalcemia/ hypomagnesemia are also seen. Hyperglycemia is common at the sta of therapy, and hypoglycaemia is likely to occur with abrupt cessation of TPN. Hyperosmolar dehydration is also associated with excesss of glucose. Excess fat leads to hyperchlosterolemia and formation of lipoprotein X and hyperiglyceridemia. Excess of amino acids leads to hyperchloraemic metabolic acidosis, hypercalcemia and uremia.
| 2 |
Hyperglycemia
|
Hyperkalemia
|
Hyperosmolar dehydration
|
Azotemia
|
Surgery
| null |
090fbe39-5d76-4e29-bbc1-ffca2f769125
|
multi
|
35-year-old c/o fever, severe abdominal pain in epigastrium radiating to the back with a h/o binge drinking. Pulse is 120 bpm, BP is 90/60 mm Hg. CT Abdomen (P+C) was done. Most likely diagnosis is(AIIMS 2016)
|
Ans. B Acute pancreatitisObserve a bulky pancreas with fuzzy margins and adjacent fat stranding - s/o Acute pancreatitis. CE-CT scan is IOC. Balthazar grading systemQ and CT Severity Index (CTSI)Q are used for prognosis.
| 2 |
Peptic ulcer
|
Acute pancreatitis
|
Chronic calcific pancreatitis
|
Acute cholecystitis
|
Radiology
|
G.I.T.
|
3cb2d51b-404f-403a-a07d-fb8716c88f9e
|
single
|
A new born child has not passed meconium for 48 hrs. What is the diagnostic procedure of choice ?
|
A plain radiograph commonly shows signs of small bowel obstruction and a soft-tissue opacity. Diagnosis can be confirmed by an abdominal ultrasound scan or contrast enema. Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-80
| 2 |
USG
|
Contrast enema
|
CT
|
MRI
|
Surgery
|
G.I.T
|
71af1f2a-e412-406d-a1ac-6c5d42adda6a
|
single
|
A 25 year old male is undergoing incision and drainage of abscess under general anaesthesia with spontaneous respiration. The most efficient anaesthetic circuit is –
| null | 1 |
Maplelson A
|
Mapleson B
|
Mapleson C
|
Mapleson D
|
Anaesthesia
| null |
58b906ff-cc69-48ca-ba77-b7688ba49893
|
single
|
Site of maximum absortion of Iron
|
Mnemonic
Iron - Roman number One
So maximum absorption in first part of small intestine. i.e: Duodenum.
| 1 |
Duodenum
|
Jejunum
|
Ileum
|
Colon
|
Biochemistry
| null |
45f2ebf3-c7fe-46f5-bb15-37e3cbd14ab8
|
single
|
Conn's syndrome is
|
Primary hyperaldosteronism (Conn's syndrome ) is defined by hypeension, as a result of hypersecretion of aldosterone. In PHA, plasma renin activity is suppressed.The most frequent cause of Primary hyperaldosteronism is a unilateral adrenocoical adenoma. Apa from hypeension, patients complain of non-specific symptoms: headache, muscle weakness, cramps, neurological events, polyuria, polydypsia, and nocturia.Ref: Bailey and Love 27e pg: 841
| 1 |
Primary hyperaldosteronism
|
Secondary hyperaldosteronism
|
Primary hypoaldosteronism
|
Secondary hypoaldosteronism
|
Surgery
|
Endocrinology and breast
|
7e111e3c-b85d-4344-b80f-1a024b5ec050
|
single
|
Which of the following drugs in NOT recommended for intracheal administration during cardiopulmonary resuscitation –
|
Intratracheal drugs during CPR :- Adrenaline, atropine, lignocaine, naloxone.
| 2 |
Atropine
|
Sodium bicarbonate
|
Adrenaline
|
Lignocaine
|
Anaesthesia
| null |
ecbbb0c8-f520-4f65-8339-954246d26cb3
|
single
|
Fibrous pericardium is attached to
|
Fibrous pericardium base is broad and inseparably blended with the central tendon of the diaphragm.Ref: BD Chaurasia; Volume I; 6th Edition; Page no: 249
| 1 |
Central tendon
|
Right crus
|
Left crus
|
Pleura
|
Anatomy
|
Thorax
|
a9443a3a-c1ca-40a5-a175-5075439ccc0b
|
single
|
There was a sudden increases in the size of thyroid swelling along with pain. Most likely cause is ?
|
Ans. is 'a' i.e., Hemorrhage within the cyst (thyroid)
| 1 |
Hemorrhage within the cyst (Thyroid)
|
Malignant change
|
Nodular goiter
|
Colloid goiter
|
Surgery
| null |
04cbcadc-7c5d-4690-8a15-a42d83d2259f
|
single
|
Which of the following is the second most common congenital defect in entire spectrum of congenital deformities?
|
Cleft lip and palate is the most common congenital defect of facial structures and the second most congenital defect in the entire spectrum of congenital deformities (first common is clubfoot).
| 2 |
Clubfoot
|
Cleft lip and palate
|
Osteogenesis imperfecta
|
Ectodermal dysplasia
|
Dental
| null |
b74e0e0a-bebe-46a1-a7a3-069c6fd957f4
|
single
|
Bird beak sign on barium swallow is seen in?
|
Ans. is 'a' i.e., Achlasia cardia * "Bird beak appearance on barium study is seen in achlasia cardia.Important esophageal signs on radiographySignConditionRat tail appearance of esophagusEsophageal carcinomaMega-esophagus (sigmoid esophagus)"Bird beak" appearanceHurst phenomenonAchlasia cardiaYo-Yo motion of barium"Corkscrew" appearance (esophageal curling)Rosary-bead/sheikh kebab configurationChain of bead appearanceDiffuse esophageal spasm
| 1 |
Achlasia cardia
|
Carcinoma esophagus
|
Hiatus hernia
|
Nut cracker esophagus
|
Radiology
|
G.I.T.
|
b49ae60e-2315-4d7c-956f-c9b7ec9a7900
|
multi
|
Dietary fibre contain
|
Dietary fibre contains remnants of plant cells resistant to hydrolysis by the enzymes of alimentary canal. Fibre is basically composed of 2 categories : 1. Water insoluble components. 2 . Warer soluble components. 1. Water insoluble : Cellulose, Hemicellulose, Lignin 2. Water soluble : Pectins, Mucilagesn, Gums.
| 2 |
Collagen
|
Pectin
|
Proteoglycans
|
Starch
|
Biochemistry
|
nutrition and digestion
|
5da3755d-a022-43e2-a3b2-5ba815a25453
|
single
|
All the follow ing are used in theTreatment of Enuresis except
|
(D) Spironolactone# Enuresis:> Primary Nocturnal Enuresis (PNE) is when a child has not yet stayed dry on a regular basis. Secondary Nocturnal Enuresis is when a child or adult begins wetting again after having stayed dry.> Treatment options with high success rates> Waiting Almost all children will outgrow bedwetting. For this reason, urologists and pediatricians frequently recommend delaying treatment until the child is at least six or seven years old.> Bedwetting alarms Physicians also frequently suggest bedwetting alarms which sound a loud tone when they sense moisture. This can help condition the child to wake at the sensation of a full bladder.> DDAVP (Desmopressin) Desmopressin tablets are a synthetic replacement for antidiuretic hormone, the hormone that reduces urine production dur ng sleep. Desmopressin is usually used in the form of Desmopressin acetate, DDAVP. Patients taking DDAVP are 4.5 times more likely to stay dry than those taking a placebo. The drug replaces the hormone for that night with no cumulative effect.> Tricyclic antidepressants Tricyclic antidepressant prescription drugs with anti-muscarinic properties have been proven successful in treating bedwetting, but also have an increased risk of side effects. These drugs include Amitriptyline, Imipramine and Nortriptyline.
| 4 |
Desmopressin
|
Imipramine
|
Nortrptiline
|
Spironolactone
|
Psychiatry
|
Miscellaneous
|
364e3825-113e-416b-95af-964ffd40906a
|
multi
|
Plasrnacytoid lymphomas may be associated with -
|
Plasmacytoid lymphoma is lymphoplasmacytic lymphoma.Its a B cell neoplasm in adults.Most commonly the plasma cell component secretes monoclonal IgM,often in amount sufficient to cause a hyperviscosity syndrome, Waldenstrom macroglobulinemia Ref:Robbins and Cotran Pathologic basis of disease.South Asia Edition-9; volume 1.page no.598,601
| 2 |
IgG
|
IgM
|
IgA
|
IgE
|
Pathology
|
Haematology
|
ce188f27-01b6-44bd-a870-9a97b11a9c10
|
single
|
An 18 yrs old boy comes to the eye casualty with history of injury with a tennis ball. On examination, there is no perforation but there is hyphema. The most likely source of the blood is
|
.
| 2 |
Iris vessels
|
Circular iridis major
|
Sho posterior ciliary vessels
|
Circular iridis major
|
Physiology
|
All India exam
|
08930aeb-0d78-4b89-9dba-a9b60c0fa018
|
multi
|
Which of following is not a permanent mucosal fold?
|
Gastric rugae of the stomach and longitudinal folds in the mucosa of upper rectum and colon are temporary mucosal folds and are obliterated by distension. Whereas, plica circularis of the small intestine, crescentic mucosal folds of cystic duct (spiral valve of Heister), transverse (horizontal) rectal folds (Houston's valves or plica transversalis) and permanent longitudinal rectal columns or folds (found in the lower rectum and anal canal) are permanent mucosal folds.
| 2 |
Spiral valve of Heister
|
Gastric rugae
|
Plica circularis
|
Transverse rectal fold
|
Anatomy
| null |
48cda159-bf92-4072-89e6-6d5fc58b500d
|
single
|
The Hb level is healthy women has mean 13.5 g/dl and standard detion 1.5 g/dl, what is the Z score for a woman iwht Hb level 15.0 g/dl-
|
Ref:Parks 23rd edition pg 849 Z score = (individual value - mean) / SD =(15-13.5)/1.5= 1
| 4 |
9
|
10
|
2
|
1
|
Social & Preventive Medicine
|
Biostatistics
|
b6ec14d6-ece8-42de-9649-e8bc78c451e8
|
single
|
True about Wegener's granulomatosis is
|
Triad of WG: a. Acute necrotizing granulomas of respiratory tract b. Necrotizing or granulomatous vasculitis of small to medium-sized vessels c. Focal necrotizing often crescentic GN
| 4 |
Large vessel vasculitis
|
Granulomas in GBM
|
Nephrosclerosis
|
Focal necrotizing GN
|
Physiology
|
All India exam
|
01f2b1fc-f248-4385-afef-4ee09b93044d
|
multi
|
True about GIST all except -
|
Ans. is 'a' i.e., Most common in duodenum o Gastrointestinal stromal tumors (GISTS) are the most common mesenchymal tumor of the GI tract and are most frequently located in the stomach (60%-70%).o In 1983, Mazur and Clark coined the term GIST to indicate a distinctive subgroup of GI mesenchymal tumor, which could be classified neither as neurogenic nor as smooth muscle derived tumor. Historically, they were presumed to have smooth muscle origin and classified as leiomyomas, leiomyoblastomas, and leiomyosarcoma, o They are considered to originated from the interstitial cell of Cajal, an intestinal pacemaker cells,o Almost all GISTs (and almost no smooth muscle tumors) express c-KIT (CD117) or the related PDGFRA, as well as CD34. Kit is a transmembrane tyrosine kinase receptor, the ligand for which is stem cell factor. The Kit protein is detected by immunohistochemistry and can reliably distinguish GISTs from true smooth muscle neoplasms. (Note that almost all smooth muscle tumors (and almost no GISTs) express actin and desmin.o KIT is used not only for diagnosis but also for targeted therapy of GISTs. Imatinib, a tyrosine kinase inhibitor, is widely used in the treatment of advanced and metastatic GISTs and has been recently employed in the neo adjuvant and adjuvant set-up with encouraging results.o Surgical resection of the localized GIST is the mainstay therapy, as a resection of tumor renders only a chance of cure. The primary goal of surgery is complete resection of the disease with negative margins,o GISTs are resistant to both chemotherapy and radiotherapy. Therefore until the advent of Imatinib, there was no effective treatment available for the unresectable or metastatic GISTs. The development of Imatinib mesylate has revolutionized the management of this disease.o Imatinib mesylate (formerly referred to as STI 571, GleevecTM) is a 2-phenvlpyrimidine derivative that blocks binding of ATP to ABL tyrosine kinases including c-Kit, c-ABL, bcr-ABL, and the platelet-derived growth factor receptor (PDGFRA). Imatinib was developed as a PDGFR inhibitor. The efficacy of Imatinib mesylate as a tyrosine kinase inhibitor was first assessed in chronic myeloid leukemia (CML), which is associated with mutation in bcr- ABL tyrosine kinase similar to the role of KIT in GIST,o Prognosis in patients with GIST tumors depends mostly on tumor size and mitotic count, and metastasis,o GISTs metastasize through hematogenous route. Usual sites are intra-abdominal, either to the liver, omentum, or peritoneal cavity. (Ref: Devita's Oncology 8/e).Most common site for GIST is stomachy Stomach 60-70%y Small intestine 20-30%y Esophagus, colon, rectum <10%o It is a well circumscribed slow growing tumor that usually does not invade adjacent viscera,o Necrosis and ulceration can occur causing pain and bleeding,o FDG PET is the investigation of choice to see the response to imatinib therapy.
| 1 |
Most common in duodenum
|
Necrosis and ulceration present
|
PET is used to assess response to therapy
|
Well circumscribed
|
Surgery
|
Small Intestine - Small Bowel Tumors
|
748a6a2a-862d-418e-91a1-26a672867b2f
|
multi
|
Oligohydramnios is associated with :
|
Etiology of oligohydramnios: Intrauterine growth restriction Post-term pregnancy Premature rupture of membranes Drugs like ACE inhibitors and prostaglandin inhibitors Renal anomalies Renal Agenesis Infantile polycystic kidney disease urinary tract obstruction (refer pgno:216 Sheila 2nd edition)
| 2 |
Neural tube defects
|
Renal agenesis
|
Postmature bih
|
Premature bih
|
Gynaecology & Obstetrics
|
General obstetrics
|
5b1e2c8f-6fe1-444e-a1de-b6d98369d52d
|
single
|
The property of an index to measure what is intended to measure is known as
| null | 1 |
Validity
|
Reliability
|
Quantifiabitity
|
Sensitivity
|
Dental
| null |
22e99b89-e3e5-41a5-b495-1bd2f46a53a7
|
single
|
Schaumann bodies are seen in
| null | 1 |
Sarcoidosis
|
Chronic bronchitis
|
Asthma
|
Syphilis
|
Pathology
| null |
0c9e0ae9-ef66-4743-a3b2-f2d1c6ba6d76
|
single
|
Dantrolene acts on -
|
Ans. is 'a' i.e., Raynodine receptor Dantroleneo Dantrolene is a directly acting skeletal muscle relaxant,o Mechanism of actionNormally excitation (depolarization of end plate) is coupled with contraction by Ca+2 - Excitation contraction coupling.Dantrolone acts on Ryanodine receptors (RyR) Calcium channels in sarcoplasmic reticulum of skeletal muscles and prevents their depolarization triggered opening - no release of intracellular Ca+2 - No excitation contraction coupling - No contraction.That means muscle contraction is uncoupled from depolarization of the membrane.o Dantrolene is DOC for malignant hyperthermia.It can also be used inNeuroleptic malignant syndrome.To reduce spasticity in UMN disorders, hemiplegia, paraplegia, cerebral palsy and multiple sclerosis.Muscular weakness is the dose limiting side effect.Other side effects are sedation, malaise, light headedness, troublesome diarrhoea and liver toxicity.Remembero Quinine also acts as directly acting muscle relaxant.o It increases refractory period and decreases excitability of motor end plates,o It can be used in nocturnal leg cramp.
| 1 |
Raynodine receptor
|
Cannabinoid receptor
|
Both of the above
|
None of the above
|
Pharmacology
|
C.N.S
|
04ae743d-edd2-4c91-8b2b-09cd1d4b8abf
|
multi
|
A study revealed lesser incidence of carcinoma colon in pure vegetarians than non-vegetarians by which it was concluded that b-carotene is protective against cancer. This may not be true because the vegetarian subjects may be consuming high fibre diet which is protective against cancer. This is an example of:
|
Ans is 'c' i.e. Confounding factor In an epidemiological study, in addition to the exposures that the study is investigating, there may be other factors that is associated with the exposure and independently affects the risk of developing disease. If the prevalence of these other factors differ between groups being compared, they will distort the observed association between the disease and exposure under study. These distorting factors are called confounding factors or variables. In the study given, protective factor is being studied. But as high fibre content of vegetarian food is protective against CA colon, it can confound or distort the observed protective role of b-carotene present in vegetarian food. Thus this is an example of confounding factor. Causal association: There are 2 types- 1. One to one causal relationship - Two variables are causally related if a change in one variable is followed by a change in the other. So when the disease is present, the factor must also be present. In the given study causative factor is not being studied rather preventive factor is being studied.Multifactorial causation - There can be multiple factors acting independently or cumulatively to produce a disease (non-communicable). As stated above causal factors are not being observed in this study so both causal association and multifactorial causation are ruled out.Common association is not an epidemiological term, it is just a casual term.
| 3 |
Multifactorial causation
|
Causal association
|
Confounding factor
|
Common association
|
Social & Preventive Medicine
|
Epidemiology
|
ec8fc07c-0015-4884-9964-31f03ca97e05
|
multi
|
Which drug is contraindicated in patients allergic to sulphonamides -
|
Ans. is 'c' i.e., Zonisamideo Zonisamide is a sulfonamide medication used for the treatment of seizures. It has been associated with severe skin reactions, those typically seen with sulfa reactions. This medication should not be used in sulfa-allergic patients.
| 3 |
Brizolamide
|
Brimonidine
|
Zonisamide
|
Bimatoprost
|
Pharmacology
|
Anti Microbial
|
d265d7a1-607b-4905-a015-1339dcd259de
|
multi
|
The best prognosis in carcinoma stomach is with:
|
Ans. (a) Superficial spreading typeRef: Sabiston 20th Edition, Page 1214* Good prognosis is superficial spreading type and bad prognosis is Linitis Plastica type.
| 1 |
Superficial spreading type
|
Ulcerative type
|
Linitis plastic type
|
Polypoidal type
|
Surgery
|
Stomach & Duodenum
|
6fc126b0-6828-4da0-966e-efd2c3a7ade0
|
single
|
The fouh hea sound is caused by?
|
A fouh hea sound is common in persons who derive benefit from atrial contraction for ventricular filling as a result of decreased ventricular wall compliance and increased resistance to ventricular filling. For example, a fouh hea sound is often heard in older patients with left ventricular hyperophy.Ref: Guyton and Hall textbook of medical physiology 13th edition. Page:284
| 3 |
Closureiof the aoic and pulmonary valves
|
Vibrations inihe ventricular wall during systole
|
Ventricula filling
|
Closure of the mitral and tricuspid valves
|
Physiology
|
Cardiovascular system
|
558b14f9-4957-46e1-92b3-7adf57f5324f
|
multi
|
Thyroid carcinoma with pulsating vascular, skeletal metastasis is
| null | 1 |
Follicular
|
Anaplastic
|
Medullary
|
Papillary
|
Surgery
| null |
25d210a2-6a0c-430a-942a-248bc7919f82
|
single
|
True about IgM is: September 2005
|
Ans. B: Primary response IgM is the immediate antibody that is produced once a human body is exposed to bacteria, virus or a toxin.Their demonstration in the serum indicates recent infections. IgG is found throughout the body, mainly in most of the bodily fluids, while IgM is found mainly in the blood and lymphatic fluids. Antibodies formed in primary response are predominantly IgM and in the secondary response is IgG. IgM is temporary and disappears after a few weeks. It is then replaced by IgG.
| 2 |
Mediates Prausnitz-kustner reaction
|
Primary response
|
Transpoed across placenta
|
Secondary response
|
Microbiology
| null |
e3a2b302-676f-4aff-bde1-f31483b53c29
|
multi
|
All are macrophages except-
|
Mononuclear macrophages
o Blood macrophages → Monocytes
o Tissue macrophages → Histocytes
o Lung → Alveolar macrophages
o Brain → Microglia
o Liver → Kupjfer cells
o Bone → Osteoclasts
o Kidney → Mesangial cells
| 3 |
Histocytes
|
Kupffer cells
|
Lymphocytes
|
Osteoclasts
|
Pathology
| null |
c76761cd-9a9d-4b90-8410-4cdecd713a6e
|
multi
|
Ascent of horse shoe shaped kidney is prevented by
|
Initialy in IUL(intrauterine life) kidneys are present in iliac fossa , Kidney has to reach the level of renal aery which is prevented by inferior mesenteric aery which is a branch of abdominal aoa. Fusion of right and left kidney occurs to form a U shaped structure at the level below inferior mesenteric aery.
| 2 |
Superior mesenteric aery
|
Inferior mesenteric aery
|
Superior mesenteric vein
|
Inferior mesenteric vein
|
Anatomy
|
GIT 1
|
97000d9e-e725-4572-8597-9cbbc54fa298
|
single
|
Males who are sexually underdeveloped with rudimentary testes and prostate glands, sparse pubic and facial hair, long arms and legs and large hands and feet are likely to have the chromosome complement of:
|
Klinefelter syndrome. Extra X chromosome, so they are 47 XXY or 46XY/47 XXY mosaics. Male phenotype Hypogonadism | Secondary sexual characteristics Dispropoionately long arms and legs.
| 3 |
45, XYY
|
46, XY
|
47, XXY
|
45, X0
|
Pathology
|
Genetics
|
f8132a7a-ba13-4503-bd2a-e8f41ce4c27f
|
multi
|
Which among the following drugs is used in ectopic pregnancy?
|
Ans c Ref Williams Obstetrics page 247Tanaka & associates first used methotrexate to treat an interstitial preg-nancy and then it has been used successfully with ectopic pregnancy. Patient selectionInitial S. B hcg < lOOOmlU/ml-minimum failure rate size-ectopic mass<3.5cmFetal cardiac activity is a relative contraindication to medical therapy.RegimenSingle dose-50mg/m2 IM, follow up with serum b hcg2 doses- 50mg/m2 IM on day 0 & 4Variable dose Mtx Img/m2 IM on 1,3,5,7With leucoverin on 2,4,6,8
| 3 |
Mifepristone
|
Misoprostol
|
Methotrexate
|
Oxytocin
|
Surgery
|
Miscellaneous
|
2ff372ab-4f2c-4723-9e8d-657cfce91928
|
single
|
Features seen in a patient with chronic vomiting are all EXCEPT: March 2013
|
Ans. C i.e. Metabolic acidosis
| 3 |
Hyponatremia
|
Hypochloremia
|
Metabolic acidosis
|
Hypokalemia
|
Medicine
| null |
15a6c23b-148e-41d2-9c8a-91d24e175a93
|
multi
|
Antrochoanal polyp opens In which meatus:
|
Ans: A Middle Meatus Ref: Dhingra's ENT 6th ed./ 173-75* ANTROCHOANAL POLYP most commonly seen in children. They are unilateral, usually arises from the mucosa of maxillary antrum near its accessory ostium comes out of it & grows in the chonna & nasal cavity.* Maxillary sinus opens into the middle meatus.
| 1 |
Middle meatus
|
Superior meatus
|
Inferior meatus
|
Sphenoethmoidal recess
|
ENT
|
Nose and PNS
|
79cc1c4c-8b01-43eb-a7a6-4c103cdee3c7
|
single
|
MHC restriction is a pa of all except -
|
. Autoimmune disorder
| 4 |
Antiviral cytotoxic T cell
|
Antibacterial helper T cell/cytotoxic cells
|
Allograft rejection
|
Autoimmune disorder
|
Pathology
| null |
61965558-3501-4df7-a6ec-214bff214b60
|
multi
|
A young female presents with history of dyspnoea on exeion. On examination, she has wide, fixed split S2 with ejection systolic murmur (IIINI) in left second intercostal space. Her EKG shows left axis detion. The most probable diagnosis is :
|
Answer is C (Ostium primum atrial septal defect) Wide fixed splitting of S2 with ejection systolic murmur in left 2" intercostal space points towards the diagnosis of atrial septal defect.. Presence of left axis detion indicates an ostium primum 4SD. Clinical picture in ASD : Sounds S1Accentuated (Loud) S2 wide fixed split Q Murmur Shunt murmur : is absent i.e. there is no murmur as a result of shunt Flow murmurs: murmurs present are due to increased flow of blood through respective valves Tricuspid valve: Delayed diastolic Pulmonary valve ECG Ostium Q Left axis primum detion Ostium Q Right axis secundum detion + RVH
| 3 |
Total anomalous pulmonary venous drainage
|
Tricuspid atresia.
|
Ostium primum atrial septal defect.
|
Ventricular septal defect with pulmonary aerial hypeension.
|
Medicine
| null |
33b324cc-c1ee-4da4-a4b3-e04badd5b16b
|
single
|
At what gestation does the switchover from fetal to adult hemoglobin synthesis begin -
|
Ans. is 'b' i.e., 36 weeks Fetal Hb - (a2, g2)Adults Hb - (a2, b2,)During the initial fetal life, the major hemoglobin synthesized in the body is fetal hemoglobin, because in fetus, the chain synthesized predominantly is the g chain.b chain is present in only trace amount in early embryosThe rate of synthesis of g and b chains and the amount of HbA and HbF are inversely related during intrauterine stageAs the age of the fetus increases, the synthesis of b chains and the amount of adult hemoglobin in the blood increasesAt 36 weeks of gestational age the rate of synthesis of b chain exceeds that of g chain. This is called switch overWhat exactly is switch over?Switch over is the point at which the rate of synthesis of b chain exceeds the rate of synthesis of g chain.Don't confuse it with the concentration of hemoglobin remember that despite having higher rate of synthesis of bchains it is not HbA, but HbF. which is present in treated concentration when switch over occurs.When does it begin and end?* Switch over occurs at 36th gestational week, so that may be taken as the beginning of switch over and after that b chains remains the predominant chain synthesized.
| 2 |
30 weeks
|
36 weeks
|
7 days postnatal
|
3 weeks postnatal
|
Pediatrics
|
Hematopoietic System
|
9d605aab-94ce-4382-9815-2568eab76ab9
|
single
|
A 40-year old male with diabetes presents with vitreous hemorrhage. What is the cause?
|
Ans. b. Neovascularization at disc (Ref: Kanski 5/e p447-449; Khurana 4/260-262, 3rd/256-258; Parson's 21/307, 20/e p294-299)In diabetic retinopathy, neovascularization caused by vasculoformative substance elaborated by hypoxic retinal tissue in an attempt to revascularize retina, seen especially at disc (neovascularization of disc), bleeds due to leaky blood vessels and leads to vitreous haemorrhage." Bleeding from newly formed vessels (neovascularization) is the most common cause of spontaneous vitreous hemorrhage in diabetic adults. Proliferative new leaking vessels usually arise from retinal veins. Sudden vitreous contractions tear the fragile new vessels, causing vitreous hemorrhage. Most diabetic vitreous hemorrhage occur during sleep, probably because of an increase in blood pressure secondary to early morning hypoglycemia or to REM sleep."Diabetic RetinopathyMicroangiopathy, which affects the retinal pre-capillary arterioles, capillaries and venules.It causes microvaseular and macrovascular occlusionQ.Microvascular OcclusionMacrovascular OcclusionA-V shunt formationQNeovascularizationQRetinal hemorrhageQRetinal edemaQ* Associated with significant capillary occlusion, referred as intraretinal microvascular abnormalities (IRMA)QCaused by vasculoformative substance elaborated by hypoxic retinal tissue in an attempt to revascularize retina. It may be:* NVD: New vessels at the discQ (optic nerve head)* NVE: New vessels elsewhere (along the course of major blood vessels)Q* Rubeosis iridis: new vessels on the irisQ* Dot and blot shapedQ arise from venous end* Flame shapedQ arise from precapillary arterioles* Hard exudatesQ, yellow waxy lesions with distinct margins often arranged in rings (circinate exudates)* Soft exudates (cotton wool spots)Q
| 2 |
Posterior retinal detachment
|
Neovascularization at disc
|
Central retinal vein occlusion
|
Trauma to central retinal artery
|
Ophthalmology
|
Vitreous Haemorrhage Vitrectomy
|
9b2866c8-75b3-4be9-8a13-8dccc8e55906
|
single
|
Satiety centre is located at-
|
Ans. is 'a' i.e., Ventromedial nucleus of hypothalamus * Satiety center - Ventromedial nucleus of hypothalamus.* Feeding center - Lateral nucleus of hypothalamus.
| 1 |
Ventromedial nucleus of hypothalamus
|
Dorsomedial nucleus of hypothalamus
|
Peritrigonal area
|
Lateral nucleus
|
Physiology
|
Nervous System
|
cabfbdd5-b098-4a4d-8807-f73e04c77435
|
single
|
Best radiological view for diagnosis of fracture scaphoid is:
|
Ans. Oblique
| 3 |
Anteroposterior
|
Lateral
|
Oblique
|
Any of the above
|
Radiology
| null |
013c95d9-483d-4172-a023-73e2050918f5
|
multi
|
Type-I hyperlipoproteinemia is characterized by:-
|
Hyperlipoproeinemia Type Increased plasma lipoproteins Increased plasma lipid (most) Probable metabolic defect I Chylomicrons Triacyglycerols Deficiency of lipoprotein lipase IIa LDL Cholesterol Deficiency of LDL receptors IIb LDL and VLDL Triacylglycerols and cholesterol Overproductionn of apo-B III IDL Triacylglycerols and cholesterol Abnormality in apo-E IV VLDL Triacylglycerols Overproduction of TG V Chylomicrons and VLDL Triacylglycerols -
| 4 |
Elevated LDL
|
Elevated lipoprotein lipase
|
Elevated cholesterol
|
Elevated triglycerides in plasma
|
Biochemistry
|
NEET 2019
|
92fbce18-2b62-4001-abae-12e22e785956
|
single
|
Earliest finding in diabetic nephropathy
|
Diagnosis and screening of Diabetic nephropathy Microalbuminuria is the presence in the urine of small amounts of albumin, at a concentration below that detectable using a standard urine dipstick. Ove nephropathy is defined as the presence of macroalbuminuria (urinary albumin > 300 mg/24 hrs, detectable on urine dipstick). Microalbuminuria is a good predictor of progression to nephropathy in type 1 diabetes. It is a less reliable predictor of nephropathy in older patients with type 2 diabetes, in whom it may be accounted for by other diseases, although it is a potentially useful marker of an increased risk of macrovascular disease. Ref - Davidsons 23e p779
| 4 |
Shrunken kidney is hallmark
|
Fibrin caps
|
Elevated serum Creatinine
|
Urine albumin > 300mg/ 24 hrs
|
Medicine
|
Endocrinology
|
c29ecf5f-4f5c-4dda-92ed-3164a9c42f20
|
multi
|
All of the following drugs are commonly used in regimens against H. pylori except -
|
<p>Davidson&;s principles and practice of medicine 22nd edition. *Drugs used amoxicillin,clarithromycin,metronidazole for 7 days. *Amoxicillin ,omeprazole,bismuth subcitrate and tetracycline.</p >
| 1 |
Oxytetracycline
|
Amoxicillin
|
Bismuth subcitrate
|
Omeprazole
|
Medicine
|
G.I.T
|
f4c4b6a0-8935-4f76-8800-fce01c0ac9bc
|
multi
|
According to Pugh's classification moderate to severe hepatic insufficiency is managed by ?
|
Ans. is 'c' ie. Ohoptic liver transplantation Child-Pugh's classification is used to assess the status of pt. of liver cirrhosis. A liver cirrhotic pt. having variceal bleeding or ascites can be controlled by shunt surgery only if he falls in ChildPugh's 'A' class (or some pts. of B class). Moderate to severe grade liver insufficiency can only be managed by liver transplantation.
| 3 |
Sclerotherapy
|
Conservative
|
Ohotopic liver transplantation
|
Shunt surgery
|
Surgery
| null |
d6745d76-60f4-47ed-a803-26404156c0d8
|
single
|
A patient on total parenteral nutrition for 20 days presents with weakness, veigo and convulsions. Diagnosis is
|
Clinical features for complications of Parenteral Nutrition Hypomagnesemia Weakness, muscle cramps and tremors Marked neuromuscular and CNS hyperirritability with jerking and nystagmus Hyperkalemia Interferes with neuromuscular function to produce muscle weakness which may progress to flaccid paralysis and hypoventilation if respiratory muscles are involved Hypercalcemia Fatigue, depression,mental confusion, lethargy Anorexia, nausea, vomiting, constipation and polyuria Ref: Harrison's 19th edition Pgno :88-97
| 2 |
Hypermagnesemia
|
Hypomagnesemia
|
Hypercalcemia
|
Hypocalcemia
|
Anatomy
|
General surgery
|
f9ef78ff-387c-440c-acb0-35554c2681dc
|
single
|
Following are the laboratory tests for the diagnosis of vestibular dysfunction except ?
|
Ans. is 'd' i.e., Gelle's test Vestibular system The vestibular system contributes to balance and to the sense of spatial orientation. It is a sensory system that provides the leading contribution about movement and sense of balance. It includes the labyrinth (semicircular canals and otolith : utricle & sacules) of the inner ear and is situated in the vestibulum in the inner ear. The symptoms of vestibular dysfunction are veigo, dizziness and Unbalance.
| 4 |
Electronystagmography
|
Optokinetic test
|
Galvanic test
|
Gelle's test
|
ENT
| null |
58804170-9187-4c4a-b762-20200e9dc6c0
|
multi
|
The antiepileptic Drugs Which does not produce enzymes induction is:
|
Ref: KDT 6/e p27,408 Most anticonvulsants are enzyme inducers except valproate (inhibitor).
| 2 |
Phenobarbitone
|
Sodium valproate
|
Phenytoin sodium
|
Carbamazepine
|
Pharmacology
|
Central Nervous system
|
dd9d5a74-43b9-488f-b87f-662573c4f21a
|
single
|
Which immunogloblin is least impoant in human being -
|
Ans. is 'b' i.e., lgD
| 2 |
IgE
|
IgD
|
IgG
|
IgA
|
Microbiology
| null |
f1a4f99e-deae-4199-927f-60e8e9db4f5b
|
single
|
Mutton fat keratic precipitate is seen in -
|
Ans. is 'b' i.e., Granulomatous uveitis o Mutton fat keratic precipitate and Busacca's nodule are seen in granulomatous uveitis,o KPs are proteinaceous cellular deposits occuring at the back of cornea (corneal endothelial deposits).Keratic precipitates (KPs)o KPs are proteinaceous cellular deposits occurring at the back of cornea (corneal endothelial deposits). Keratic precipitates are formed by the aggregation of polymorphonuclear cells, lymphocytes, and epitheloid cells. In the setting of uveitis, the bimicrosopic appearance of KP may yeild important diagnostic clues for the identification of the underlying inflammatory disorder :-Mutton fat KP Large, yellowish KPs, are characteristic of granulomatous uveitis. These are composed of epitheloid cells and macrophages. They are large, thick fluffy; lardaceous KPs, having a greasy or waxy appearance.Small or medium KPs (granular KPs):- These are composed of lymphocytes and are characteristic of non- granulomatous uveitis. These are small, round and whitish precipitatesRed KPs Composed of RBCs and inflammatory cells. These are seen in hemorrhagic uveitis.Old KPs :- In healed uveitis. The above described KPs shrink, fade, become pigmented and irregular in shape with crenated margins.
| 2 |
Posterior uveitis
|
Granulomatous uveitis
|
Non-granulomatous uveitis
|
Choroiditis
|
Ophthalmology
|
Uveal Tract
|
0e56aa27-d39d-47f6-ba88-2461c8f736ad
|
single
|
True about propofol:
|
B i.e. Can be used in porphyria
| 2 |
Indicated in egg allergy
|
Can be used in porphyria
|
It is of barbiturate group
|
All
|
Anaesthesia
| null |
7964717f-bd91-45b1-a0a0-a4722409ac57
|
multi
|
Which set of fatty acids is most effective increasing the cholesterol levels?
|
Lauric (12:0), myristic (14:0), and palmitic (16:0) acids raise cholesterol levels and are found primarily in animal fat and dairy products. Palmitic acid, the fatty acid that most effectively raises serum cholesterol levels, is also the major fatty acid found in palm and coconut oils. Stearic acid and fatty acids that have fewer than 10 carbon atoms tend not to raise cholesterol levels. Polyunsaturated fatty acids such as linoleic and linolenic and oleic acid (an w-9 monounsaturated fatty acid found as approximately 70% of the total fatty acid in olive oil and 55% in canola oil) tend to lower cholesterol levels. Ref : Biochemistry by U. Satyanarayana 3rd edition Pgno : 287
| 2 |
Linoleic and linolenic
|
Myristic and palmitic
|
Butyric and stearic
|
Oleic and palmitic
|
Biochemistry
|
Metabolism of lipid
|
c690cbb9-8e89-4248-9468-f98b90763206
|
single
|
Posterior cord of brachial plexus is formed by?
|
Ans. is 'd'i.e., Dorsal divisions of upper, middle & lower trunks
| 4 |
Ventral division of upper trunk
|
Dorsal division of upper trunk
|
Ventral divisions of upper, middle & lower trunks
|
Dorsal divisions of upper, middle & lower trunks
|
Anatomy
| null |
877400a4-3e18-4da1-bf20-6c5a52597a9f
|
single
|
Which is not a side effect of dapsone ?
|
Ans. is 'b i.e., Myopathy Adverse effects of dapsone The most common adverse effect of dapsone is hemolytic anaemia (Patients with G-6-PP deficiency are more susceptible). Second most common adverse effect is methemoglobinemia. Other side effects are - Nausea, anorexia, headache, paresthesia, drug fever, mental symptoms, rashes, fixed drug eruption, hypermelanosis (Pigmentation), phototoxicity, exfoliative dermatitis, hepatitis, agranulocytosis, lepra reaction and sulfone syndrome, infectious mononucleosis like syndrome.
| 2 |
Hemolytic anemia
|
Myopathy
|
Hepatitis
|
Infectious mononucleosis type syndrome
|
Pharmacology
| null |
b7726f76-73a4-43d2-9897-4ef39ef86e60
|
single
|
Which of the following statement about the nerve supply of palate is NOT TRUE?
|
"Greater or anterior palatine branches of pterygopalatine ganglion supplies hard palate and lateral wall of the nose while the lesser or middle and posterior palatine nerve supply the soft palate and tonsils". All the muscles of the soft palate except tensor veli palatini are supplied by pharyngeal plexus (fibers of the plexus are derived from the cranial pa of the accessory nerve through the vagus nerve) Tensor veli palatini is supplied by mandibular nerve. Ref: Snell's Anatomy 8/e, Page 781-85 ; BDC 4/e, Vol.III, Page 210-13, 237
| 3 |
Pharyngeal plexus supply muscles of soft palate
|
Tensor veli palatini is supplied by mandibular nerve
|
Anterior branch of pterygopalatine ganglion supplies soft palate
|
Middle and posterior lesser palatine nerves supply soft palate and tonsil
|
Anatomy
| null |
d6a05495-26cf-495f-b727-901061b6b1d2
|
multi
|
True about criggler najjar type-II syndrome is ?
|
Ans. is 'a' i.e., Diglucuronide deficiency
| 1 |
Diglucuronide deficiency
|
Recessive trait
|
Kernicterus is seen
|
Phenobarbitone not useful
|
Pediatrics
| null |
ebaef986-3ac2-446c-a316-10fda1fc1e6a
|
multi
|
A 45-year-old farmer complains of headache. Neurologic examination reveals pronator drift and mild hemiparesis on the right side. The patient's eyes and head are turned to the left side, and papilledema is visible on the left side. The lesion is most likely in which of the following coices?
|
Pronator drift and hemiparesis are frontal lobe signs. - Frontal eye field -> area no 8. Controls: Lateral conjugate gaze. Destruction - results in turning of the head and eyes toward the side of the lesion. Stimulation - results in contralateral turning of the eyes and head.
| 1 |
Frontal
|
Insular
|
Occipital
|
Parietal
|
Anatomy
|
Development of nervous system and cerebrum
|
a76f5d22-7c83-4d92-917e-e8dd523e4a91
|
single
|
30 years old female presents in gynaec OPD with complaints of recurrent aboions and menorahagia. Her USG showed 2 sub-serosal fibroids of 3 x 4 cm on anterior wall of uterus and fundus, which is best line of management:-
|
Laparoscopic myomectomy is best treatment for such young infeile patients, but it requires subserosal pedunculated fibroids and surgical expeise. Hysterectomy is advisable in patients who had completed their family. Myolysis is myoma coagulation with laparoscopic lasers. (Nd- YAG) or bipolar needle & used in perimenopausal patients. UAE is newer intervention for fibroid management in surgically unfit high risk patients, but it causes decreased feility & carries risk of placental insufficiency and uterus rupture in subsequent pregnancy.
| 3 |
TAH with BSO
|
Myolysis
|
Myomectomy
|
Uterine aery embolisation (UAE)
|
Surgery
| null |
bc2461f8-6784-4deb-ab7f-faba9da7e2d4
|
multi
|
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