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What age group is the most susceptible to sepsis?
|
Elderly patients are at most risk for developing sepsis because of decreased physiologic reserves and an aging immune system.
Option A: Infants may have less physiologic reserves yet they have vaccines that strengthen their immune system than the elderly.
Option B: Adolescents may not have fully mature reserves yet they have a stronger immune system than the elderly.
Option D: Adolescents may not have fully mature reserves yet they have a stronger immune system than the elderly.
| 3 |
Infants.
|
Adolescents.
|
Elderly
|
Young adults.
|
Medicine
| null |
6f9b9530-bccf-41c3-b927-2c2e2f303abc
|
single
|
The most common cause of diarrhea in children is-
|
Ans. is 'c' i.e., Rotavirus * Rotavirus is the single most common cause of diarrhea amongst children in both developed and developing world.* ETEC is the single most common cause of bacterial diarrhea amongst children in the developing world.* ETEC is the most common bacterial cause for Traveler's diarrheaQ.
| 3 |
Vibrio cholera
|
E. coli
|
Rotavirus
|
Pneumococcus
|
Pediatrics
|
Gastro Intestinal System
|
98106d5e-df46-48ae-97c0-c302d402c36e
|
single
|
Treatment of nasolacrimal duct obstruction a) Syringing b) Probing c) DCR d) Dacryocystectomy e) Antibiotic
|
All are treatment options for dacryocystitis.
| 1 |
abcde
|
abc
|
abd
|
bcd
|
Ophthalmology
| null |
79cbbd61-6b32-4ef4-b428-d1451d21c789
|
single
|
All are the predisposing factors for carcinoma esophagus except
|
Risk factors for SCC:SmokingAlcoholIngested carcinogens Chronic AchalasiaLye (caustic) ingestionLong-term ingestion of hot liquidsPlummer Vinson syndromeTylosis palmaris et plantarisHuman papilloma virusEsophageal diveiculaDeficiency: Vitamin A, zinc, molybdenumRef: Harrison; 19th edition
| 4 |
Achalasia
|
Tylosis palmaris
|
Zenker's diveiculum
|
Ectodermal dysplasia
|
Medicine
|
C.V.S
|
a0aa2d53-0535-4498-b8d9-bbaad8ed78c8
|
multi
|
Selenium is an essential component of
|
.
| 2 |
Glutathione synthetase
|
Glutathione peroxidase
|
Xanthine dehydrogenase
|
Cytochrome oxidase
|
Physiology
|
All India exam
|
d0f8dccb-d914-4c9b-94eb-a8c652929f27
|
single
|
Which of the following diagnostic procedure is not done in dilated pupil?
|
Ans. a. Gonioscopy Gonioscopy is not done in a diluted pupil. (AI1MS May 2014 repeat) Gonioscopy is done in dark room with minimum slit lamp light. Pupil contraction will falsely open up the angle. Likewise pupillary dilatation will cause crowding of the iris at angle and angle appears as closed. 'By gonioscopy angle structures are assessed, especially relationship of root of iris and trabecular meshwork in normal physiological state. To avoid pupillary contraction, it is done in dark room with minimum slit lamp light. '- Basics and Clinical Science Course, American Academy of Ophthalmology, 2012-13; Sec 10, p46
| 1 |
Gonioscopy
|
Fundus examination
|
Laser inferometry
|
Electroretinography
|
Ophthalmology
| null |
9211838f-4393-4ab1-ac70-755a9930bd3e
|
single
|
Type of force in a patient activated appliance is?
| null | 2 |
Interrupted
|
Intermittent
|
Continuous Interrupted
|
Continuous Intermittent
|
Dental
| null |
2066a252-841c-49d0-be0e-fa941534f198
|
single
|
Most potent stimulus for bile secretion is
|
Bile is secreted in two stages by the liver: (1) The initial portion is secreted by the principal functional cells of the liver, the hepatocytes; this initial secretion contains large amounts of bile acids, cholesterol, and other organic con-stituents. It is secreted into minute bile canaliculi that originate between the hepatic cells. (2) Next, the bile flows in the canaliculi toward the interlobular septa, where the canaliculi empty into terminal bile ducts and then into progressively larger ducts, finally reaching the hepatic duct and common bile duct.
| 4 |
Cholecystokinin
|
Gastrin
|
Secretin
|
Bile acid
|
Physiology
| null |
b5183db9-6f38-489f-9e63-66fba7cdb60b
|
single
|
Visual field defect in pituitary tumour with supracellar extension is
|
A i.e. Bitemporal hemianopia
| 1 |
Bitemporal hemianopia
|
Binasal hemianopia
|
Homonymous hemianopia
|
Pie in the sky vision
|
Ophthalmology
| null |
c0ebe5fd-7842-41f0-af16-7a33e4c9c858
|
single
|
MELD diagnostic score -
|
Ans. is 'a' i.e., Predicts mortality in patients waiting liver transplanto MELD (The model for end-stage liver disease) is a linear regression model based on objective laboratory values(INR, bilirubin level and creatinine level). It wras originally developed to predict mortality after TIPSS. It is used in USfor liver transplant allocation,o It is a 6 to 40 point scale.o The relative risk of mortality increases by 14% for each 1 point increase in MELD score.MELD score =3-8 1og(e) (S.bilirubin mg'dl) +11-2 log(e) (INR) + 9-6 log(e) (S. creatinine mg/dl).orMELD score = 10
| 1 |
Predicts mortality in patient waiting liver transplant
|
Higher score - less mortality risk
|
Predicts mortality risk for a 60 day period
|
It is a 4 to 60 scale
|
Surgery
|
End-Stage Liver Disease and Liver Transplantation
|
c2823123-20ce-4454-9472-4caead7285d9
|
single
|
Management of stage IIB cancer cervix is?
|
ANSWER: (B) Radiotherapy with combination with chemotherapyREF: Shaw's 13th ed p. 390TRETMENT OF CERVICAL CANCER:StageTreatmentIA1Cone or simple hysterectomy with life long follow upIA2 , IB , HaRadical hysterectomy with b/1 pelvic lymphadenectomy (wetheim s operation schauta's radical vaginal hysterectomy , mitra s modification )IIB , III, IVRadiation with or without chemotherapy
| 2 |
Radiotherapy
|
Radiotherapy with combination with chemotherapy
|
Chemotherapy
|
Hysterectomy
|
Gynaecology & Obstetrics
|
Management (Carcinoma Cervix)
|
18c00c80-b7be-4f47-aa6a-c7a2981fa3ce
|
single
|
A patient has Hemoglobin of 6gm%. Which of the following should not be administered?
|
Fresh frozen plasma should be avoided in such a situation, because FFP does not contribute in any way to increase the oxygen carrying capacity of blood. On the other hand, it will cause further dilution of the already dangerously less hemoglobin, thus further reducing the oxygen carrying capacity of blood. Thus, FFP should be the answer.
| 1 |
Fresh frozen plasma
|
Whole blood
|
Random donor platelets
|
Packed red cells
|
Surgery
| null |
80d2d1f5-1d66-417a-a66f-63457d2b9f50
|
single
|
All of the following are features of SIRS except:
|
SIRS Two or more of the following: Temperature (core) >38degC or <36degC Hea rate >90 beats/minQ Respiratory rate >20 breaths/minQ for patients spontaneously ventilating or a PaCO2 <32 mm Hg Q WBC count >12,000 cells/mm3 or <4000Q cells/mm3 or >10% immature (band) cells in the peripheral blood smear
| 4 |
WBC >11000/mm3 or <4000/mm3
|
Temperature > 38degC
|
Pulse rate >90/minute
|
Respiratory rate >24/minute and PaCO2 <22 mmHg
|
Surgery
|
Trauma
|
ab4628a9-541d-441b-9efa-b3da7ff5e79e
|
multi
|
Absolute lymphocytosis is seen in -a) SLEb) T.B.c) CLLd) Brucellosis
| null | 2 |
abc
|
bcd
|
ac
|
bd
|
Pathology
| null |
727e8a99-0d1b-4089-952d-97aefb2ef992
|
single
|
Screening procedure is best for Ca of -
|
.screening is best suited in the case of ceain disease. one among the following is carcinoma colon, the disease can be screened if it satisfies the following conditions such as, *an impoant health problem it must be *there should be a recognisable latent or early asymptomatic stage. *natural history of condition *tets that detect the disease prior to the onset of symptoms *an effective treatment. ref:park&;s textbook ,22 nd edition,pg no 131
| 2 |
Prostate
|
Colon
|
Gastric
|
None
|
Social & Preventive Medicine
|
Screening
|
0d8d840e-e7f4-4067-aa87-ef06881255f5
|
multi
|
Prolonged treatment with Isoniazid leads to deficiency of-
|
Treatment with INH can lead to Pyridoxine deficiency, hence it is given as nutritional prophylaxis alongwith TB treatment.
| 1 |
Pyridoxine
|
Thiamine
|
Pantothenic acid
|
Niacin
|
Social & Preventive Medicine
|
Respiratory Infections
|
6f11af0b-26f4-4c43-8db2-c12edeccfa83
|
single
|
The pathognomonic feature of abdominal pregnancy is :
|
Fetus appears lateral to lumbar spine on X-ray
| 1 |
Fetus appears lateral to lumbar spine on X-ray
|
Small uterus
|
Fetus easily palpable
|
Positive pregnancy test
|
Gynaecology & Obstetrics
| null |
f0bbe47c-90c3-43d6-9711-3cda6bc2a25a
|
multi
|
Design Effect' is associated with which of the following sampling techniques -
| null | 3 |
Stratified sampling
|
Systemic sampling
|
Cluster sampling
|
Simple Random Sampling
|
Social & Preventive Medicine
| null |
84ba0499-692e-4d14-bde4-f4c6faf105f9
|
single
|
Which of the following areas of brain is most resistant to Neurofibrillary tangles in Alzheimer's disease
|
Answer is C (Lateral Geniculate Body):The topographical and neuroanatomical distribution of Neurofibrillary tangles and Neuritic Plaques in the Cerebral coex of patients with Alzheimer's Disease' - Cerebral Coex (1991): (1): 103-116`Lateral geniculate body' is the least commonly affected area amongst the options provided.Weurofibrillaiy tangles are region specific occuring predominantly in the Hippocampus, Entorhinal coex and association areas of the Neocoex 'The Neuropathology of Dementia' (Cambridge) 1997/7`Not even a single neuron with Neurofibrillary Tangles (NFT) was seen in the Lateral Geniculate Bodies' -- Distribution of Alzheimer's Neurofibrillary tangles (Taken from 'Alzheimer's Disease' by George Parry (2006)/55)Neuro fibrillary Tangles (NFT): Density distribution in Alzheimer's diseaseEntorhinal coex -- Hippocampus -- Amygdala interconnections (most vulnerable)Limbic and Temporal coical areas (next most severely involved)Association areas of the neocoex Topographical Distribution of NFTs in Alzheimer's disease`The spatiotemporal pattern of progression of NFTs in Alzheimer's disease is steriotypical and predictable. Briefly, the neurofibrillary degeneration stas in the aliocoex of medial temporal lobe (entorhinal coex and hippocampus) and spreads to the associative neocoex, relatively sparing the primary sensory and primary motor and visual coex.'Enterohinal coex, Hippocampus and Associative areas of neocoex are primarily involved.Taken from 'Neuropathological Alterations in Alzheimer's Disease': Perspectives in Medicine 2011 Braak and Braak distinguished six stages to explain topographical distribution and progression of NFT.Stage IThe first NFTs consistently appear in the Transentorhinal (perihilar) region along with Entorhinal coex properStage IINFTs appear in the CA I region of the HippocampusStage IIINFTs appear in the Limbic structures such as the subiculum of H ppocampal formationStage IVNFTs appear in the Amygdala, Thalamus & ClaustrumStage VNFTs appear in all isocoical areas with the affection of Associative areasStage VINFTs appear in primary sensory, motor and visual areas (Primary sensory, motor and visual area are considered most resistant)These six stages can be summarized into three for the purpose of understanding, namely: Entorhinal, Limbic and isocoical
| 3 |
Entorhinal coex
|
Hippocampus /Temporal lobe
|
Lateral Geniculate Body
|
Visual Association area
|
Psychiatry
| null |
7e47716b-5327-4fa1-8adc-5b1236ebb7c3
|
single
|
Bunion is commonly seen at -
|
Ans. is 'a' i.e., Great toe MTP jointBuniono A hallux abducto valgus deformity, commonly called a bunion, is a deformity characterized by lateral deviation of the great toe, often erroneously described as an enlargement of bone or tissue around the joint at the head of thebig toe.o The bump itself is partly due to the swollen bursal sac or an osseous (bony) anomaly on the metatarsophalangeal joint. The larger part of the bump is a normal part of the head of the first metatarsal bone that has tilted sideways to stick out at its top.
| 1 |
Great toe MTP joint
|
Medial malleolus
|
Lateral Malleolus
|
Shin of tibia
|
Orthopaedics
|
Arthritis
|
0793ad26-b7df-4bb5-b0bc-64a4b85e4978
|
multi
|
Radiological features of left ventricular hea failure are all, except-
|
In chest radiography, the Westermark sign is a sign that represents a focus of oligemia (hypovolemia) (leading to collapse of vessel) seen distal to a pulmonary embolism (PE). While the chest x-ray is normal in the majority of PE cases, the Westermark sign is seen in 2% of patients. Ref Davidson 23rd edition pg 460
| 3 |
KerlyB lines
|
Cardiomegaly
|
Oligemic lung fields
|
peribronchial cuffing
|
Medicine
|
C.V.S
|
d404ea03-5f8e-40ea-bf52-e04215574592
|
multi
|
A menopausal woman, 55 years old, complains of post coital bleeding. What impoant cause of such bleeding should be ruled out?
|
Vaginal bleeding is the most common symptom occurring in patients with cancer of the cervix. Most often, this is post coital bleeding, but it may occur as irregular or postmenopausal bleeding. Patients with advanced disease may present with a malodorous vaginal discharge, weight loss, or obstructive uropathy. Since the patient is 55yrs of age, malignancy must be ruled out Cervical cancer is more likely to present as post coital bleeding than endometrial malignancy. Adenomyosis is a pre-menopausal presentation mostly
| 1 |
Ca cervix
|
Ca endometrium
|
Fibroid uterus
|
Adenomyosis
|
Gynaecology & Obstetrics
|
Post menopausal bleeding
|
8532f185-e6ad-42d1-bd3b-06d4617c6671
|
single
|
True statement of wilms tumor
|
Refer Robbins 9/e 479 * The first group of patients has the WAGR syndrome, characterized by Wilms tumor, aniridia, genital anoma- lies, and mental retardation. Their lifetime risk of devel- oping Wilms tumor is approximately 33%. Individuals with WAGR syndrome carry constitutional (germline) deletions of 11p13. Studies on these patients led to the identification of the first Wilms tumor-associated gene, WT1, and a contiguously deleted autosomal dominant gene for aniridia, PAX6, both located on chromosome 11p13. Patients with deletions restricted to PAX6, with normal WT1 function, develop sporadic aniridia, but they are not at increased risk for Wilms tumors.
| 2 |
Common in adult
|
Associated with deletion of chromosome 11p13
|
Associated with MIC 2 gene
|
Commonest presentation in hematuria
|
Anatomy
|
Urinary tract
|
6150935c-ed8e-4155-88f8-c6d189ccce76
|
multi
|
Congenital lactic acidosis may occur d/t defect in
|
B i.e. PDH complex
| 2 |
Pvruvate decarboxylase
|
PDH complex
|
Transketolase
|
a-ketoglutarate dehydrogenase
|
Biochemistry
| null |
b8f4cacf-8429-4fd8-b88e-925d9ce00181
|
single
|
A 67-year-old man has a long history of symmetrical small joint arthritis with deformities. He now develops shortness of breath on exertion with a dry cough, but no sputum or chest discomfort. His heart sounds have a loud P2, and the lungs have fine bibasilar crackles. Which of the following is the most likely diagnosis of the pulmonary condition associated with his arthritis?
|
In RA, pleural involvement is very common at autopsy but infrequently causes symptoms. Interstitial lung disease (ILD) is the most common manifestation of rheumatoid lung disease. RA associated interstitial lung disease (RA-ILD) is usually similar to idiopathic pulmonary fibrosis (IPF) in terms of its clinical presentation, pathology, disease spectrum, and pathogenesis. Presentation is more common at age 50-60 years, in men (M:F=2-3:1), and in association with seropositive and erosive joint disease. If pleural fluid is present, glucose levels are very low.
| 4 |
pleuritis
|
cavitating lesions
|
intrapulmonary nodules
|
interstitial fibrosis
|
Medicine
|
Respiratory
|
1a53b37c-e6cf-48bc-9928-9d19c077308f
|
multi
|
Molar ratio of sodium & glucose in WHO reduced osmolarity ORS is:
|
Ans. A. 1:1Composition of WHO recommended ORS.Constituentg/lmmol/ion Sodium chloride2.6Sodium75Glucose, anhydrous13.5Chloride65Potassium chloride1.5Potassium20Trisodium citrate dihydrate2.9Citrate10Total Osmolarity245mosmol/L
| 1 |
1:01
|
1:02
|
1:04
|
2:01
|
Pediatrics
|
Fluid & Electrolyte
|
3da3398c-3487-4de3-8f35-8869f27f3b02
|
single
|
Not a branch of posterior cord of Brachial plexus
|
Long thoracic nerve arises from the nerve root of C5-C7 and it supplies serratus anterior muscle. The axillary nerve supplies the deltoid and teres minor muscles. The thoracodorsal nerve supplies the latissimus dorsi muscle. The radial nerve supplies 3 heads of triceps brachii and 12 muscles on the back of the forearm. Mnemonic Posterior cord - ULTRA U- upper subscapular nerve L-lower subscapular nerve T-thoracodorsal R-radial nerve A-axillary nerve B D Chaurasia 7th edition Page no: 58 Fig: 4.14,page no:55 BD chaurasia 6th edition.
| 4 |
Axillary nerve
|
Thoracodorsal nerve
|
Radial nerve
|
Ulnar nerve
|
Anatomy
|
Upper limb
|
7cb66b48-e4a6-4b99-bc0c-bd344af53583
|
single
|
Congenital megacolon develops secondary to failure of -
|
Ans. is 'a' i.e., Migration of vagal neural crest cells to gut * Hirschsprung's disease (congenital megacolon) is characterised by the congenital absence of intramural ganglion cells (aganglionosis) and the presence of hypertrophic nerves in the distal large bowel.* The absence of ganglion cells is due to a failure of migration of vagal neural crest cells into the developing gut.* The affected gut is in spasm causing a functional bowel obstruction.
| 1 |
Migration of vagal neural crest cells to gut
|
Neurogenesis
|
Defecation reflex
|
External anal sphincter relaxation
|
Surgery
|
Small & Large Intestine
|
73fac785-f545-4b12-955d-da1e1530b061
|
single
|
The most important source of reducing equivalents for fatty acid synthesis in the liver is
|
HMP pathway
The main source of NADPH for lipogenesis is the pentose phosphate pathway: PPP (also called the hexose monophosphate pathway: HMP).
| 4 |
Glycolysis
|
TCA cycle
|
Uronic acid pathway
|
HMP pathway
|
Biochemistry
| null |
b367e60b-4711-4df8-925f-9e27079dd00c
|
single
|
A 42 year old female patient has abnormal uterine bleeding with mild atypical hyperplasia of endometrium. The treatment of choice is :
|
Total hysterectomy
| 3 |
Oral contraceptive pills
|
Progesterone
|
Total hysterectomy
|
Oestrogens
|
Gynaecology & Obstetrics
| null |
08edb059-cc9a-4ae2-9003-459d0e01a442
|
single
|
An 18-year-old sexually active college student presents with complaints of lower abdominal pain and irregular bleeding for five days. She has no fever. She uses oral contraceptives as method of bih control. Upon examination, the cervix is friable, there is cervical motion tenderness and adnexal tenderness. The pregnancy test is negative. She tells you that she had a similar episode two years ago. What is her risk of infeility following this second clinical episode of pelvic inflammatory disease?
|
Chlamydia trachomatis is frequently repoed bacterial sexually transmitted disease (STD). Infections of the cervix may present as a friable cervix, but are most often without signs or symptoms. Pelvic inflammatory disease (PID) caused by chlamydia often presents with milder symptoms than when it is caused by gonorrhea. Prompt treatment reduces the occurrence of long-term sequelae such as infeility, ectopic pregnancy, and chronic pelvic pain. The risk of infeility appears to be higher for chlamydial infections compared to any other STD. Screening women is impoant to reduce the risk of PID and its sequelae.
| 4 |
< 1%
|
5%
|
10%
|
20%
|
Surgery
| null |
2da49705-3f6f-4fda-8cfd-4fa2900434b7
|
multi
|
All are features of hypernatremia except
|
Ans. is 'c' i.e., Periodic paralysis Periodic paralysis, is seen in hyponatermia Clinical features of Hypernatremia :? Most patients with hypernatremia are dehydrated and have the typical signs and symptoms of dehydration. Hypernatremia even without dehydration causes central nervous system symptoms that tend to parallel the degree of sodium elevation and the acuity of the increase. Patients are irritable, restless weak and lethargic Some have high pitched cry and hyperpnea. Ale patient are very thirsty. Hypernatremia causes fever although many patients have underlying process that contributes to the fever Except for dehydration, there is no clear direct effect of hypernatremia on other organs or tissues except the brain. Complication of hypernatremia :? Brain hemorrhage is the most devastating consequence of hypernatremia. As the extracellular osmolarity increases water moves out of brain cells, resulting in decrease in brain volume. This can result in tearing of intra cerebral veins and bridging vessels as the brain moves away from the skull and the meninges. Patient may have subarachnoid, subdural and parenchymal hemorrhage. Seizure and coma are possible sequale of the hemorrhage even though seizures are more common during t/t. Thrombotic complications are common in severe hypernatremic dehydration and include stroke, dural sinus thrombosis, peripheral thrombosis and renal vein thrombosis. The intracranial tension can be increased due to hemorrhage
| 3 |
Convulsions
|
Elevated intracranial tension
|
Periodic paralysis
|
Doughy skin
|
Medicine
| null |
81cfe584-53b8-4f66-a4da-563970d83396
|
multi
|
During the course of an operation on an unstable, critically ill patient, the left ureter is lacerated through 50% of its circumference. If the patient's condition is felt to be too serious to allow time for definitive repair, alternative methods of management include
|
If time and the patient's condition permit, primary ureteral reconstruction should be carried out. In the middle third of the ureter, this will usually consist of ureteroureterostomy using absorbable sutures over a stent. If the injury involves the upper third, ureter pyeloplasty may be necessary. In the lower third, ureteral implantation into the bladder using a tunneling technique is preferred. If time does not permit definitive repair, suction drainage adjacent to the injured segment alone is inadequate; either ligation and nephrostomy or placement of a catheter into the proximal ureter is an acceptable alternative that would allow reconstruction to be performed later. The creation of a watertight seal is difficult and nephrectomy may be required if the injury occurs during a procedure in which a vascular prosthesis is being implanted (e.g., an aortic reconstructive procedure) and contamination of the foreign body by urine must be avoided.
| 1 |
Ligation of the injured ureter and ipsilateral nephrostomy
|
Ipsilateral nephrectomy
|
Placement of a catheter from the distal ureter through an abdominal wall stab wound
|
Placement of a suction drain adjacent to the injury without further manipulation that might convert the partial laceration into a complete disruption
|
Surgery
|
Urinary Tract
|
dc3bccca-2553-4045-b8bf-c405d8401ea6
|
multi
|
Propanolol is useful for all of the following except ?
|
Ans. is 'd' i.e., Paial AV block
| 4 |
Angina
|
Familial tremor
|
Hypeension
|
Paial AV block
|
Pharmacology
| null |
0b86caa7-27bd-48a7-8afd-4065dfb7073b
|
multi
|
Lipid profile in diabetes is A/E -
|
Lipid abnormalities in patients with diabetes, often termed "diabetic dyslipidemia", are typically characterized by high total cholesterol (T-Chol), high triglycerides (Tg), low high density lipoprotein cholesterol (HDL-C) and increased levels of small dense LDL paicles. Ref - davidsons 23e topic diabetes p719
| 3 |
Decreased TG
|
Increased HDL
|
increased LDL
|
decreased Cholesterol
|
Medicine
|
Miscellaneous
|
ded54d49-7694-4cae-b7f1-758e68567799
|
single
|
Cobalt forms a component of which of the following vitamins?
|
Central poion of vitamin B12 consists of four reduced and extensively substituted 'pyrrole rings' surrounding a single cobalt atom(Co). This central structure is called 'corrin ring system'. When cyanide is bound to cobalt atom is called as cyanocobalamin. Cobalt is required only as a constituent of vitamin B12. While biotin, vitamin A and tochopherol has no metal as constituent pa. Also Know: Strict vegetarians (vegans) are at risk of developing B12 deficiency. Vitamin B12 is absorbed bound to intrinsic factor, a small glycoprotein secreted by the parietal cells of the gastric mucosa. Vitamin B12 is absorbed from the distal third of the ileum receptors that bind the intrinsic factor-vitamin B12 complex, but not free intrinsic factor or free vitamin. Ref: Bender D.A. (2011). Chapter 44. Micronutrients: Vitamins & Minerals. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.
| 2 |
Biotin
|
Vitamin B12
|
Vitamin A
|
Tocopherol
|
Biochemistry
| null |
a9b8ddc0-4d77-4c5b-bdc1-572e9d6122b0
|
single
|
Which of the following estimates blood creatinine level most accurately:
|
There are two methods for estimation of Creatinine in blood: 1. Jaffe's test: In alkaline medium, Creatinine forms a red coloured tautomer of Creatinine Picrate which is measured colorimetrically. This method can be automated in auto-analysers and kinetic method can be used. Kinetic jaffe more accurate than jaffe's method. It gives falsely elevated value of creatinine due to presence of various compounds in serum 2. Enzymatic method: By employing two enzymes Creatininase or Creatinine Deaminase. It is more specific and accurate. There is no interference by Ketones, Bilirubin or Glucose. Hence measure Creatinine accurately.
| 4 |
Jaffe method
|
Kinetic jaffe method
|
Technicon method
|
Enzyme assay
|
Biochemistry
|
Enzyme uses
|
91cc4cc8-127b-4a32-8e6f-3d9d7842574a
|
single
|
Pretrematic nerve of 1st pharyngeal arch is
|
Pharyngeal Arch Nerves: Nerve of 1st arch - Mandibular division of trigeminal nerve Pretrematic nerve - Chorda tympani & greater petrosal nerves (purely sensory) of facial nerve. Nerve of 2nd arch - Facial nerve Pretrematic nerve - Tympanic branch of glossopharyngeal nerve. Nerve of 3rd arch - Glossopharyngeal nerve Pretrematic nerve - auricular branch of vagus nerve Nerve of 4th arch - Pharyngeal branch of vagus nerve Nerve of 6th arch - Recurrent laryngeal branch of vagus nerve.
| 3 |
Vagus nerve
|
Glossopharyngeal
|
Chorda tympani
|
Trigeminal
|
Anatomy
|
Neuroanatomy 3
|
bb51279c-d947-4f64-be87-5c3ca9d209fa
|
single
|
Cullen's sign:
|
(Bluish discolouration in the umbilicus) (1124-Baily & love 24th) (1140-Baily & Love 25th)Acute Pancratitis* Bluish discolouration of the flanks - Grey Turner Sign* Bluish discolouration of the umbilicus - Cullen's sign.
| 2 |
Bluish discolouration of the flanks
|
Bluish discolouration in the umbilicus
|
Migratory thrombophelebitis
|
Subcutaneous fat necrosis
|
Surgery
|
Pancreas
|
9c9cebac-7bc1-4980-92bd-0b15feb20a85
|
single
|
Neostigmine is used in the following except ?
|
Ans. is 'd' i.e., Glaucoma
| 4 |
Myasthenia gravis
|
Cobra bite
|
Atony of bladder
|
Glaucoma
|
Pharmacology
| null |
10589fdd-ca75-412e-8fc2-bdfecdd42c7e
|
multi
|
Commonest site of carcinoma colon is:
|
(Left side colon): Ref: 1177-LB (1181-B &L 25th)Adenocarcinoma of the colon: - Tumours are more common in the left colon and rectum* Microscopically the neoplasm is a columnar cell carcinoma* Macroscopically the tumour may take one of four forms (Annular, Tubular ulcer, cauliflower/ Type 4 cauliflower is the least malignant form* All carcinoma starts as benign adenoma, the so called "adenoma-carcinoma sequence"* Annular variety gives rise to obstructive symptoms and where as the others more commonly will present with bleeding.Symptoms and signs of colorectal cancer(A) Right sided tumours: Iron deficiency anemia, abdominal pain(B) Left sided tumours: Rectal bleeding, alteration in bowel habit, tenesmus obstruction(C) Metastatic disease: Jaundice, ascitis, hepatomegaly, other symptoms and signs from rare sites of metastasis.
| 2 |
Right side colon
|
Left side colon
|
Transverse colon
|
Caecum
|
Surgery
|
Small & Large Intestine
|
01cfe167-cc1e-44a4-b670-41f1e93a230c
|
single
|
A patient on atracurium develops seizures due to accumulation of ?
|
Ans. is `b' i.e., Laudanosine
| 2 |
Didanosine
|
Laudanosine
|
Methylated Atracurium
|
Sulfated Atracurium
|
Anaesthesia
| null |
226ed050-93d4-4010-9cc0-3484d0ecae51
|
single
|
Amino acids secreted in cystinuria are all except
|
Amino acids excreted in cystinuria are (COLA): cysteine, ornithine, lysine, and arginine
| 2 |
Ornithine
|
Histidine
|
Arginine
|
Lysine
|
Biochemistry
| null |
6a8d7f3b-3eb2-4b74-b437-672c00496481
|
multi
|
The bacterial drug resistance in tuberculosis results from :
|
Resistance to INH occurs due to point mutation in inhA or katG genes.
Resistance to rifampicin occurs due to point mutation in rpoB genes.
Resistance to ethambutol is due to mutations resulting in overexpression of the embB gene.
| 4 |
Transduction
|
Transformation
|
Plasmid mediated
|
Mutation
|
Pharmacology
| null |
d0939a48-a8ef-4d90-b10a-2992b34c1260
|
single
|
Air in the biliary tract is seen in all except –
|
Gallstone ileus, carcinoma gall bladder and endoscopic papillotomy can cause pneumobilia (air in biliary tract)
Ascending cholangitis (not sclerosing cholangitis) can cause pneumobilia.
| 2 |
Gall stone ileus
|
Sclerosing cholangitis
|
Carcinoma gall bladder
|
Endoscopic papillotomy
|
Radiology
| null |
9be82345-6469-4395-a7f7-cc663b338d06
|
multi
|
Which of the following is not a part of the growth relativity hypothesis?
|
Growth relativity refers to growth that is relative to its displaced condyles from actively relocating fossae. John C Voudouris introduced this concept to explain the possible effect of functional appliances on condyle and the resulting growth. The main foundations of growth relativity hypothesis are:
Displacement of condyle.
Nonmuscular viscoelastic tissue stretch.
Force transduction beneath the fibrocartilage of the glenoid fossa and condyle add new bone formation.
Textbook of craniofacial growth, Sridhar Premkumar
| 4 |
Displacement of condyle
|
Nonmuscular viscoelastic tissue stretch
|
Force transduction beneath the fibrocartilage
|
Functional loading
|
Dental
| null |
d155b111-219a-4d41-b502-95d661b21a76
|
single
|
The internal thoracic artery is a branch of -
|
Ans. is 'b'i.e., Subclavian artery Internal thoracic arteryo It arises from 1st part of subclavian artery and descends through anterior ends of upper six intercostal spaces lying 1[?]25 cm lateral to sternal margin.o It divides into two terminal branches, musculophrenic and superior epigastric in 6th intercostal spaceo Branches of internal thoracic artery are:-i) Mediastinal branchesii) Pericardial branchesiii) Sternal branchesiv) Pericardiophrenic branchesv) Anterior intercostal arteries (in upper six spaces)vi) Perforating branchesvii) Two terminal branches, musculophrenic and superior epigastric.
| 2 |
Arch of aorta
|
Subclavian artery
|
Superior epigastric artery
|
Thyrocervical trunk
|
Unknown
| null |
13433959-080b-422a-b41f-d24f89b4c568
|
single
|
Which of the following enzyme does not catalyse reversible step in glycolysis?
|
Enzymes of glycolysis - a process which converts 6 carbon glucose to 3 carbon unit pyruvate & lactate - are present in cytoplasm. Whereas, complete oxidation of glucose (to CO2 & H2O) requires mitochondrial enzymes (of TCA cycle).
Out of total 9 enzymes used in glycolysis,
3 enzymes - hexokinase, phosphofructokinase (PFK-1) and pyruvate kinase are used in irreversible steps.
6 enzymes - phosphohexose isomerase, aldolase, glyceraldehyde-3-phosphate dehydrogenase, 1, 3-bisphosphoglycerate kinase, phosphoglyceromutase and enolase are used in reversible steps.
2 enzymes used in energy utilizing steps are - hexokinase (using 1 ATP) and phosphofructokinase / PFK-1 (using 1 ATP). This energy consumption is for 1 molecule of glucose.
3 enzymes used in energy producing steps are - glyceraldehyde-3-phosphate dehydrogenase (producing 2 NADH = 5 ATP), 1, 3-bisphosphoglycerate kinase (producing 2 ATP) and pyruvate kinase (producing 2 ATP). This energy production is for 1 molecule of glucose or 2 molecules of glyceraldehyde-3-phosphate.
| 1 |
PFK
|
Enolase
|
Phosphoglyceromutase
|
Glyceraldehyde-3-phosphate dehydrogenase
|
Biochemistry
| null |
58309cf9-059f-4fda-8328-1585b78e323e
|
multi
|
Dysthymia is -
|
Mild depression with the chronic course (≥ 2 years) is called dysthymia.
| 1 |
Chronic mild depression
|
Chronic severe depression
|
Bipolar disorder
|
Personality disorder
|
Psychiatry
| null |
daedf45e-0361-477c-8714-348be4213845
|
single
|
Side effects of a drug arise due to interactions of the drug to molecules other than the target.These effects of the,drug can be minimized by its high:
|
If a drug is more specific in action, it acts only in that paicular organ so no systemic side effects will be seen and targeted cancer therapy using nanopaicles is also bases on this approach Ref; KD Tripathi pharmacology 7 th edition (page no; 84)
| 1 |
Specificity
|
Solubility
|
Affinity
|
Hydrophobicity
|
Pharmacology
|
General pharmacology
|
21e56d44-14a0-4b52-a74e-cb8316f3a657
|
single
|
Nephrotic syndrome is characterized by all except -
|
NEPHROTIC SYNDROME Nephrotic syndrome is a constellation of features in different diseases having varying pathogenesis; it is characterized by findings of massive proteinuria (more than 3.5 g/day), hypoalbuminemia, edema, hyperlipidemia, lipiduria, and hypercoagulability. Pitting edema: Does not distinguish nephritic from nephrotic syndrome. Ref: Textbook of pathology Harsh Mohan 6th edition page 660
| 2 |
Hypoalbuminemia
|
Hypolipidemia
|
Lipiduria
|
Proteinuria > 3.5 gm per 1.73 m2 per 24 hours
|
Pathology
|
Urinary tract
|
23b712db-35c8-4075-994e-80aa1b1021d5
|
multi
|
Bence jones proteins are best described as -
|
Bence Jones protein are the light chains of immunoglobulins and so may occur in kappa and lambda forms. - found in multiple myeloma. identified by unique propey of coagulation when heated to 50degC but redissolving at 70degC. REF:Anathanarayan & paniker's 9th edition, pg no:99 <\p>
| 3 |
chains
|
g chains
|
Kappa & Lambda chains
|
Fibrin split products
|
Microbiology
|
Immunology
|
71cfbe13-71c9-4523-ade7-a14277354a6c
|
single
|
Which of the following HLA types is associated with rheumatoid ahritis 135?
|
HLA B27-Ankylosing spondylitis HLA DR4-Rheumatoid ahritis HLA B8-myasthenia gravis Ref: Textbook of Microbiology Baveja 5th ed Pg 135
| 2 |
HLA B27
|
HLA DR4
|
HLA B8
|
HLA DP
|
Microbiology
|
Immunology
|
93cb871c-0fe8-4a34-87b1-390ba768860c
|
single
|
The maximum concentration of potassium delivered central line is
|
In adults, the preferred concentration central line is 20 mEq/100 ml. The maximum concentration for fluid restricted patients is 20 mEq/50 ml. Ref Davidson 23rd edition pg 345
| 1 |
20 mmol/L
|
40 mmol/L
|
60 mmol/L
|
80 mmol/L
|
Medicine
|
Fluid and electrolytes
|
6f567d4f-2f0d-4963-9068-6b0736ae2ab9
|
single
|
Sensory afferent fibres from the fallopian tubes ascend to :
|
Nerve supply in the pelvis : Perineum,vulva,lower vagina organ spinal segments Nerves 1 Perineum,vulva,lower vagina S2-4 pudendal,inguinal,genitofemoral,posterofemoral cutaneous 2 Upper vagina, cervix, lower uterine segment, posterior urethra, bladder trigone, uterosacral and cardinal ligaments,rectosigmoid, lower ureter S2-4 Pelvic parasympathetics 3 Uterine fundus, proximal fallopian tubes, broad ligament, upper bladder, caecum, appendix, terminal large bowel T11-12. L1 sympathetic hypogastric plexux 4 Outer 2/3rds of fallopian tubes, upper ureter T9-10 sympathetics aoic and superior mesentric plexus 5 Ovaries T9-10 sympathetics renal and aoic plexus and celiac and mesentric ganglia 6 Abdominal wall T12-L1 T12-L1 L1-2 Iliohypogastric Ilioinguinal Genitofemoral Shaw's textbook of Gynaecology 16th edition page no 22
| 2 |
T 8
|
T 10
|
L 2
|
L 4
|
Gynaecology & Obstetrics
|
Anatomy of the female genital tract
|
562f9cc0-1d7d-4bc7-8142-f16bc839ba68
|
multi
|
Which is not true about indication of exchange transfusion ? (Not a criteria for exchange transfusion)
|
Double volume exchange tranfusion (DVET) should be performed if the total serum bilirubin(TSB) levels reach to age specific cut off for exchange transfusion or th infant shows signs of bilirubin encephalopathy irrespective of TSB levels .For < 28 wk gestation, TSB cut off is 11-14 mg/dl. For 28 to 29 wks, 30 to 31 wks and 32 to 33gestation, cut off is 12-14, 13 - 16 and 15-18 mg/dl respectively . For 34 wks of gestation, cut off is 17-19 mg /dl. Reference : page 172 Ghai Essential Pediatrics 9 th edition
| 4 |
Cord bilirubin is 5 mg% or more
|
Cord Hb is 10 mg% or less
|
Rate of bilirubin increase is > 0.5 mg%
|
Total bilirubin 10 mg/dl
|
Pediatrics
|
New born infants
|
fe6db237-9317-4bec-8742-aee0cb39820d
|
multi
|
Parathyroid autotransplantation is done in which of the following muscle?
|
Parathyroid auto transplantation is done in 2 muscles Sternocleidomastoid muscle Brachioradialis of non-dominant hand SCM Brachioradialis Indication: Accidental removal of PT gland while performing a thyroidectomy. | A small amount of the PT gland is auto-transplanted into SCM muscle. Indication: Hyperparathyroidism due to parathyroid adenoma (or) Parathyroid hyperplasia. | A sub-total parathyroidectomy is performed and a small amount of PT gland is implanted into brachioradialis muscle of non-dominated hand. Transplanted site is marked with silk suture or clip for easy identification
| 1 |
Brachioradials
|
Biceps
|
Triceps
|
Saorius
|
Surgery
|
NEET 2019
|
95bb47ef-49c9-424e-8844-8e1eb215454a
|
single
|
A 35-year-old woman is observed to have CIN grade III on colposcopic biopsy. T/t includes:a) Cold knife conizationb) Simple hysterectomyc) Radical hysterectomyd) Lap assisted hysterectomye) LEEP
| null | 4 |
abcd
|
bcde
|
acde
|
abde
|
Gynaecology & Obstetrics
| null |
8c14a7bd-16a1-48be-965a-5e90e40103c6
|
single
|
All are true about Sjogren syndrome except -
|
Primary Sjogren's syndrome (PSS) is characterised by lymphocytic infiltration of salivary and lacrimal glands, leading to glandular fibrosis and exocrine failure. The typical age of onset is between 40 and 50, with a 9 : 1 female-to-male ratio. The disease may occur with other autoimmune diseases (secondary Sjogren's syndrome Ref Davidsons 23e p1038.
| 4 |
Interstitial nephritis Subcutaneous fibrosis
|
Lack of tear
|
Xerostomia
|
More common in male
|
Medicine
|
Immune system
|
2f062862-3caa-40d0-a988-f664cd41561d
|
multi
|
In Staphylococci, plasmids encoding beta-lactamase are transmitted by :
|
Beta-lactamase are encoded by plasmids that can be transferred with the help of bacteriophage (transduction) in staphylococci and by transformation in Pneumococci.
| 2 |
Conjugation
|
Transduction
|
Transposon
|
Transformation
|
Pharmacology
| null |
4253613b-17b5-49cc-a452-f379e3e48dc7
|
single
|
A 28-year-old woman having limited cutaneous scleroderma for the last 10 years complains of shortness of breath for last one month. Pulmonary function tests (PFT) are as follow -What is the most likely diagnosis in this case?
| null | 2 |
Interstitial lung disease
|
Pulmonary artery hypertension
|
Congestive heart failure
|
Bronchiectasis
|
Medicine
| null |
90511905-109e-4714-bde1-242f78113523
|
single
|
Symptomatic spinal injury without any radiological evidence most commonly found in:
|
Ans. a. Children (Ref: www.ncbi.nlm.nih.gov/pubmed/17006044 www.orthopaedicsone.com/pages/viewpage action? pageId=27689773)Symptomatic spinal injury without any radiological evidence most commonly found in children.'Following trauma, the commonly used radiological investigations, plain radiographs and computed tomography (CT) studies do nor rule out injury to the spinal cord. This is especially true for children, as an entity known by the acronym SCIWORA (spinal cord injury without radiological abnormality) exists and the changes may be picked up only on magnetic resonance imaging (MRI). Early treatment (within 6 hours) with high dose methylprednisolone improves the outcome.'- www.ncbi.nlm.nih.gov/pubmed/17006044SCIWORA (Spinal Cord Injury Without Radiologic Abnormality)SCIWORA originally referred to spinal cord injury without radiographic or CT evidence of fracture or dislocationQPrognosis of SCIWORA is actually better than patients with spinal cord injury and radiologic evidence of traumatic injuryQ.Defined as 'objective signs of myelopathy as a result of trauma' with no evidence of fracture or ligamentous instability on plain spine radiographs and tomographyQPrevalence:Mostly in pediatric population (range: birth to 16 years old)Inherent elasticity in pediatric cervical spine can allow severe spinal cord injury to occur in absence of X-ray findingsQCommon in cervical and thoracic regionQ; Rare in lumbar regionMechanism of Injury:MVA (motor vehicle accident)FallSports injury: Football, Diving, Wrestling, GymnasticsPathogenesis:Hyperextension injury to spine whose vertebral canal diameter is already compromised by spondylosisQ has a high risk of cord injuryExcessive anterior buckling of ligamentum flavum into canalQ, already compromised by posterior vertebral body osteophytes, probably is the cause of central cord syndromePathophysiologic MechanismsDirect spinal cord injury (traction)Direct spinal cord compression (extreme flexion/ hyperextension)Indirect spinal cord injuryVascular/ischemic injuryDiagnosis:SCIWORA is mainly a diagnosis of exclusion.In children, after trauma, paucity of movement of both legs, inability to bear weight on legs, and inability to pass urine, not able to sit without supportQ.Examination:Gross hypotonia in the lower limbs. 0/5 power and areflexia.Abdominal reflex, cremasteric, and anal reflex are absent.Palpable bladder and urine could be expressed out on abdominal pressure.No meningeal or cerebellar signsWork up:Plain radiographs of the entire spinal column maybe consideredCT scan of suspected level of neurological injuryMRI of the suspected region of neurological injury may show- hemorrhage and edemaQSSEPs (somatosensory evoked potentials):Not used diagnosticallyHelpful for follow up; obtained within 24 hours of admission and compared in follow up analysisTreatmentExternal immobilization of the spinal segment of injury for up to 12 weeksAvoidance of 'high-risk' activities for up to 6 monthsGradually increase range of motion once deficits have resolvedHigh-dose steroids in SCIWORAMethylprednisolone bolus of 30 mg/kg IV within 8 hours of injury, followed by infusion at 5.4 mg/kg/hr for the next 23 hours beneficial in improving the outcomeQOutcome at 6 weeks and 6 months better when drug given over 48 hoursQ, according to recent study.Prognosis:MRl of region of neurologic injury may provide useful prognostic information about neurologic outcome following SCIWORAQ.Poor Prognosis is seen inChildren <8 years old have worse prognosisDelay in onset of neurologic symptomsDeterioration of neurologic symptomsRecurrent injury
| 1 |
Children
|
Elderly
|
Teenagers
|
Young adults
|
Radiology
|
Advanced Neurospinal Imaging
|
00e42802-41f1-40ac-ae50-e31a2c98757f
|
single
|
Nasopharyngeal angiofibroma of stage II is treated with
| null | 4 |
Radiotherapy
|
Chemotherapy
|
Concurrent chemo-Radiation
|
Surgery
|
ENT
| null |
4a739fdf-0f61-4e45-8087-0dd308d58c5c
|
single
|
A 22-year-old nulliparous woman has recently become sexually active. She consults you because of painful coitus, with the pain located at the vaginal introitus. It is accompanied by painful involuntary contraction of the pelvic muscles. Other than confirmation of these findings, the pelvic examination is normal. Of the following, what is the most common cause of this condition?
|
This patient presents with vaginismus, defined as involuntary painful spasm of the pelvic muscles and vaginal outlet. It is usually psychogenic. It should be differentiated from frigidity, which implies lack of sexual desire, and dyspareunia, which is defined as pelvic and/or back pain or other discomfort associated with sexual activity Dyspareunia is frequently associated with pelvic pathology such as endometriosis, pelvic adhesions, or ovarian neoplasms. The pain of vaginismus may be psychogenic in origin, or may be caused by pelvic pathology such as adhesions, endometriosis, or leiomyomas. Treatment of vaginismus is primarily psychotherapeutic, as organic vulvar or pelvic causes (such as atrophy, Bartholin's gland cyst, or abscess) are very rare.
| 2 |
Endometriosis
|
Psychogenic causes
|
Bartholin's gland abscess
|
Vulvar atrophy
|
Gynaecology & Obstetrics
|
Contraceptives
|
6e698c4e-b8fe-4413-8212-d54d2eb9a1fc
|
multi
|
First line of intervention in symptomatic varicoceles is -
|
Ans. is 'a' i.e., Embolization * Operation is not indicated for an asymptomatic varicocele.* When the discomfort is significant, then embolisation of the gonadal veins is the usual first line intervention.* If this is not possible, or if the varicocele recurs (as it does in around 20 per cent after embolisation), then surgical ligation of the testicular veins is the appropriate treatment, although recurrence can occur even after such surgery.
| 1 |
Embolization
|
Conservative management
|
Ligation of testicular vein
|
Orchidectomy
|
Surgery
|
Testis & Scrotum
|
3b3fbeb0-569e-4d8b-9c3b-bdf512d7b51d
|
single
|
The normal pH of the saliva is about
| null | 3 |
5.5
|
9.5
|
7.5
|
8.5
|
Dental
| null |
0250a3c1-95d5-4a43-aef7-0cc295c3f408
|
single
|
Initial drug of choice in a child with status epilepticus:
|
a. Lorazepam(Ref: Nelson's 20/e p 2831-2856, Ghai 8/e p 557-561)Initial drug given in Status epilepticus in a child is a short acting Benzodiazepine like Lorazepam or Midazolam, to abort the seizures
| 1 |
Lorazepam
|
Phenobarbitone
|
Valproate
|
Phenytoin
|
Pediatrics
|
Central Nervous System
|
cbbdb94a-9b8a-40d1-9ee1-a3088c327148
|
single
|
Which of the following is not the new entity added in the proposed ICD-11?
|
Ans. D Schizophreniform disorderOlfactory Reference Disorder is characterized by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only slightly noticeable to others. Individuals experience excessive self-consciousness about the perceived odour, often with ideas of reference (i.e., the conviction that people are taking notice, judging, or talking about the odour).
| 4 |
Olfactory reference disorder
|
Compulsive sexual behavior disorder
|
Complex post-traumatic stress disorder
|
Schizophreniform disorder
|
Psychiatry
|
Miscellaneous
|
7afd6ae2-0ef2-43a4-af9d-4173f83720d4
|
single
|
Normal amount of pleural fluid is approximately
|
Normally, no more than 15 ml of serous, relatively acellular, clear fluid lubricates the pleural surface.
Increased accumulation of pleural fluid is called pleural effusion
| 2 |
5ml
|
15 ml
|
50 mL
|
100m1
|
Pathology
| null |
cb54634c-4792-4b47-afdd-4b6d172e995d
|
single
|
Which among the following is implicated in causing Parkinson
|
Manganese, carbon monoxide, methanol, cyanide are known to cause Parkinson's
| 3 |
Carbon dioxide
|
Ethanol
|
Manganese
|
Zinc
|
Medicine
| null |
51ea0a51-0a90-47da-9a9b-15289248f537
|
single
|
Hemolytic anaemia is seen most commonly due to
|
Pyruvate kinase deficiency is an inherited disorder that affects red blood cells, which carry oxygen to the body&;s tissues. People with this disorder have a condition known as chronic hemolytic anemia, in which red blood cells are broken down (undergo hemolysis) prematurely, resulting in a shoage of red blood cells (<a href=" Specifically, pyruvate kinase deficiency is a common cause of a type of inherited hemolytic anemia called hereditary nonspherocytic hemolytic anemia. In hereditary nonspherocytic hemolytic anemia, the red blood cells do not assume a spherical shape as they do in some other forms of hemolytic anemia.</p>
| 1 |
Pyruvate kinase
|
Phospho fructokinase I
|
Phospho fructokinase II
|
Pyruvate dehydrogenase
|
Biochemistry
|
Metabolism of carbohydrate
|
0a41db89-6e71-4fca-9010-d87395329ef3
|
single
|
Which of the following has the highest biological value?
|
Biological value of a protein is defined as the ratio between amount of nitrogen retained: nitrogen absorbed during a specified time expressed as percentage. Egg has a biological value of 100 compared to 85 of meat and 75 of milk. Biological value of 100 indicates that all of the protein is retained by the body. Biological value of animal proteins like egg, milk, meat or fish is higher than vegetable proteins like proteins from wheat, maize, green grams, peanuts or beans.
| 1 |
Egg
|
Soyabean
|
Milk
|
Meat
|
Social & Preventive Medicine
| null |
1aa6ef3b-7bfa-423c-bb93-a649201c4fe1
|
single
|
Bones, stones, abdominal groans and psychiatric oveones' are features of
|
The early descriptions of patients with primary hyperparathyroidism were dominated by those with osteitis fibrosa cystica. Brown tumours of the long bones and associated subperiosteal bone reabsorption, distal tapering of the clavicles and the classical 'salt and pepper' erosions of the skull were typical findings. Over 80% of patients had associated renal stones, significant neuromuscular dysfunction and muscle weakness.This led to the traditional mnemonic that patients with PHPT presented with 'bones, stones, abdominal groans and psychiatric oveones'.Currently, most of the patients might be asymptomatic.Ref: Bailey and Love 27e pg: 825
| 3 |
Hypehyroidism
|
Hypothyroidism
|
Hyperparathyroidism
|
Hypoparathyroidism
|
Surgery
|
Endocrinology and breast
|
81b9e6f1-4163-4be5-a410-a779f4780097
|
single
|
Hypercalcemia is not seen in:
|
Answer is D (Vitamin A deficiency). Hypercalcemia is seen with Vit. A intoxication (not deficiency) due to associated high bone turnover. Causes of hypercalcemia: Parathyroid related Vitamin D related * * * Primary hyperparathyroidism Q Lithium therapy Q Familial hypercalciuric hypercalcemia * * * Vitamin D intoxication Increased 1, 25 (OH), D eg. SarcoidosisQ; other granulomatous ds. Idiopathic hypercalcemia of infancy Malignancy related Associated high bone turnover * Solid tumor with metastasis (Breast) * HypehyroidismQ * Solid tumor with paraneoplastic syndromes * hnmobilizationu (Carcinoma Breast/Lung /Kidney etc.) * ThiazidesQ * Hematological malignancies: * Vitamin A intoxicationQ Multiple myelomaQ / Lymphoma / * Paget 's disease Leukemia Associated With Renal FailureQ * Pheochoromocytoma (rare) * Severe secondary hyper-parathyroidism * MEN syndromes * Aluminum intoxication * Milk Alkali syndrome
| 4 |
Lithium therapy
|
Chronic renal failure
|
Multiple myeloma
|
Vitamin A deficiency
|
Medicine
| null |
87b02de7-7c40-4274-b8d5-cc3e0db45dee
|
single
|
Muscle contraction following nerve impulse involves following steps expect
|
Acetylcholine is the neurotransmitter in the NMJ Ref: Ganong's Review of Medical Physiology 26th edition
| 2 |
Action potential across nerve muscle junction (NMJ)
|
Dopamine release at NMJ
|
Release of calcium form sarcoplasmic reticulum
|
Calcium initiates attractive forces between actin and myosin filament
|
Physiology
|
Nervous system
|
b599db57-a077-4770-a8e0-de81187870da
|
multi
|
Normal epidermal turnover time is?
|
Ans. is 'd' i.e., 4 weeks Epidermal turn over time* Epidermis renews itself continuously by cell division in the deepest layer, the basal layer. It is the continuously multiplying layer. The basal cells show mitosis and each basal cell multiplies and produces keratinocytes which moves up, the so called epidermal proliferation unit (Basal cell plus keratinocytes produce by it).* Time taken by keratinocytes to move from basal layer to the stratum corneum and then desquamate so that it can be replaced by new crop is known as epidermal turn over time. In normal skin it is about 4 weeks. It can be as low as 6-8 days in psoriasis.
| 4 |
1 week
|
2 weeks
|
3 weeks
|
4 weeks
|
Skin
|
Anatomy of Skin
|
88a1abb8-1db8-4f89-bb13-468bb0485d34
|
single
|
Rosettes found at the lid margin are a feature of:
|
Ans. Ulcerative blepharitis
| 2 |
Squamous blepharitis
|
Ulcerative blepharitis
|
Both of the above
|
None of the above
|
Ophthalmology
| null |
4698e5e1-5dca-41b2-a610-b1c5f7a0f7f4
|
multi
|
Diagnostic procedure for postmenopausal bleeding
|
Gold standard is hysteroscopic directed endometrial sampling. Next, best is endometrial aspiration as it gives a global endometrial sample by viue of suction. D and C and EB should never be done to diagnose the cause of postmenopausal bleeding. The most common cause overall is senile endometritis and the most common malignant cause is endometrial cancer
| 2 |
Endometrial aspiration
|
Hysteroscopic guided biopsy
|
Dilatation and curettage
|
Ultrasound
|
Anatomy
|
All India exam
|
667203da-b8b4-4abb-9572-7c47b1b26e3f
|
single
|
Which of the following is not an AB 5 toxin-
|
Ans. B. Pertussis toxin.a. Pertussis toxin is a 105 kDa protein composed of six subunits:b. S1 (A subunit) and B subunit consisting of S2, S3, (2) S4, and S5.c. Pertussis toxin is the most important virulence factor- helps it to evade phagocytes by inhibiting their phagocytic function and helps the bacterium to bind host cells.
| 2 |
Cholera toxin
|
Pertussis toxin
|
Shiga toxin
|
Heat labile toxin
|
Microbiology
|
Bacteria
|
00d85ee6-c564-48d5-ab5c-2ffc44b88059
|
single
|
Which of the following is true of mumps –
|
"Aseptic meningitis may develop before, during, after or in the absence of parotids." - Harrison 17th/e-1220
About other options
Mainly parotid glands are involved, but sublingual and submaxillary glands may also be involved.
The patient is infectious 4-6 days before the onset of swelling.
Sterility after mumps orchitis is rare.
| 3 |
Salivary gland involvement is limited to the parotids
|
The patient is not infectious prior to clinical parotid enlargement
|
Menigoencephalitis can precede parotitis
|
Mumps orchitis frequently leads to infertility
|
Pediatrics
| null |
f6537c7c-e2a6-40c9-aabe-699d98bc9de6
|
multi
|
Most common organ involved in blunt abdominal trauma is
|
.repeated
| 2 |
Liver
|
Spleen
|
Pancreas
|
Stomach
|
Surgery
|
Trauma
|
5c57f2cd-727b-436d-8fc1-0ac90fea8090
|
single
|
At which one of the following age period a child can remove front opening garment ?
|
Ans. is 'b' i.e., 36 months o A child can dress or undress himself completely by 3 years.
| 2 |
24 months
|
36 months
|
48 months
|
60 months
|
Pediatrics
| null |
db4e46c8-329b-4b57-9e78-8ad0cedcd003
|
single
|
Lateral border of cubital fossa is formed by-
|
Ans. is 'b' i.e., BrachioradialisCubital FossaLateral boundryBrachioradialisMedial boundryPronater teresBaseLine joining the two epicondyles of humerusApexPoint joining lateral and medial boundriesFloorBrachialis, supinatorRoofSkin, superficial fascia (containing medial cubital vein, lateral and medial cutaneous nerve of forearm), deep facia, bicipital aponeourosis
| 2 |
Pronator teres
|
Brachioradialis
|
Supinator
|
Brachialis
|
Anatomy
|
Arm and Cubital Fossa
|
46819a87-30e1-41ea-b2f7-6889b9de2908
|
single
|
Maternal serum Alpha Feto Protein (MSAFP) is raised in all the following conditions except :
|
Down's syndrome
| 4 |
Spina bifida
|
Multiple pregnancy
|
Omphalocele
|
Down's syndrome
|
Gynaecology & Obstetrics
| null |
6a0270c9-a207-4c3c-9f4b-c69e50479a8b
|
multi
|
Red velvety appearance of stomach and crimson plus of lower esophagus seen in which poisoning
|
Internal findings There may be lines of redness running along the walls and sub-mucous hemorrhages. stomach mucosa shows red velvety appearance. There may be ulceration in the pyloric region. Mucous membrane of the lower end of esophagus shows congestion and inflammation called crimson plus. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 421
| 4 |
Mercury
|
Zinc
|
Lead
|
Arsenic
|
Anatomy
|
Poisoning
|
65fe7d83-6871-4075-a7fe-98c907deb003
|
single
|
Which of the following organs is the most common site of origin of the tumour associated with the Zollinger-Ellison syndrome
|
Gastrin producing endocrine tumour is often found in the duodenal loop,although it also occurs in the pancreas,especially in the head. Bailey & Love ,26th, 1055.
| 1 |
Duodenum
|
Lymph nodes
|
Spleen
|
Pancreas
|
Surgery
|
G.I.T
|
e0c0ca44-5332-4bcc-be6a-d2adddeb6048
|
single
|
By Fick's first law of diffusion, rate of simple diffusion is NOT propoional to:
|
Fick's first law for diffusion: Rate of simple diffusion = - D.A X /d Minus sign indicates downhill transpo D - Diffusion coefficient A - surface area available for diffusion C1 - C2 is the concentration gradient of the diffusing substance d - diffusion distance or thickness of the membrane through which the substance is diffusing. Simple diffusion occurs by viue of kinetic energy of the molecules, and hence is directly propoional to the temperature. However, in the case of Fick's law for describing the rate of simple diffusion, temperature is held constant (same) on either side of the membrane. Hence, in the context of this MCQ, the answer is temperature.
| 2 |
Surface area
|
Temperature
|
Concentration gradient
|
Thickness of the membrane
|
Physiology
|
General Physiology
|
0a869a73-e67a-46cf-a2f5-92ef41d153cf
|
single
|
Broca's motor speech area is present in
|
Broca&;s area 44 is in the frontal lobe immediately in front of the inferior end of motor coex ( which is inferior frontal gyrus). Ref: Ganong&;s review of medical physiology;23rd edition; pg:297
| 4 |
Superior temporal gyrus
|
Precentral gyrus
|
Post central gyrus
|
Inferior frontal gyrus
|
Physiology
|
Nervous system
|
a5e93d2f-63e6-41a7-a281-f342fccba1f7
|
single
|
If aerobic glycolysis uses Glycerol-3-Phosphate shuttle, How many net ATPs are produced?
|
The inner mitochondrial membrane is impermeable to NADH. Therefore, the NADH produced in the cytosol cannot directly enter the mitochondria. It enters mitochondria indirectly with the help of shuttles. e.g glycerol phosphate and malate shuttles. ATP yield in Aerobic glycolysis and Glycerol phosphate shuttle: Total ATP = 4 ATP + (-2 ATP) + 3 ATP = 5 ATP
| 2 |
2 ATP
|
5 ATP
|
7 ATP
|
3 ATP
|
Biochemistry
|
Link reaction
|
f3c51954-fa78-4bdd-a1e0-6fe370a9c4b0
|
single
|
The first costochondral joint is a -
|
Costochondral junctions are primary cartilaginous joint (synchondrosis).
| 4 |
Fibrous joint
|
Synovial joint
|
Syndesmosis
|
Synchondrosis
|
Anatomy
| null |
083da935-95d5-408a-8ca0-c3470bf9b7d2
|
single
|
Casal's necklace is seen in deficiency of: September 2012
|
Ans: B i.e. Niacin The Casal collar or Casal necklace is a clinical sign in which there is erythematous pigmented skin rash in the distribution of a broad collar (dermatomes C3 and C4). It is seen in patients with pellagra.
| 2 |
Vitamin A deficiency
|
Niacin
|
Vitamin B12 deficiency
|
Iron deficiency anemia
|
Social & Preventive Medicine
| null |
f6c037a8-31d3-4ef5-8a1b-6bad84b26d9a
|
single
|
. Treatment of stage III B carcinoma cervix is:
|
As discussed in the preceeding text, best treatment for stage III B of invasive cancer is chemoradiation. Since this option is not given – we will go for next best option, i.e. Radiotherapy
Generally from stage II B-IV A when radiotherapy is given - external beam pelvic radiation precedes brachytherapy. But again since we don’t have this option, we are going for vice versa (which is not incorrect).
| 4 |
Wertheim procedure
|
Schauta's procedure
|
Chemotherapy
|
Intracavitary Brachy therapy followed by external beam RT
|
Gynaecology & Obstetrics
| null |
860570b3-f14f-4311-b40a-c3880cd14233
|
single
|
Sporulation occurs in which phase of bacterial growth curve:
|
Lag phase - Adaptation phase to culture media |sed Accumulate nutrient size Log(2)n - Exponential es in number Stationary phase - Sta of Accumulation of toxic metabolites = Dead Live -Sporulation occur in stationary phase (S-S) Decline: Complete accumulation of Toxin metabolites
| 1 |
Stationary phase
|
Lag phase
|
Log phase
|
Decline phase
|
Microbiology
|
FMGE 2019
|
cfaaca3e-bede-4b28-bf2a-c43009c718b3
|
single
|
Burr cell is seen in
|
Ref Tejinder Singh 1/e p38, robbins 9/e pg 418 Other causes of microangiopathic hemolytic anemia include malignant hypeension, systemic lupus erythematosus, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, and disseminated cancer. The morphologic alterations in the injured red cells (schistocytes) are striking and quite characteristic; "burr cells," "helmet cells," and "triangle cells" may be seen Burr Cell Uremia at 40x Magnification.Uremia is a condition in which urea and other nitrogenous substances accumulate to an abnormally high level in the blood. ... Some cases of uremia have also been associated with abnormal red blood cells, such asechinocytes, which are often better known asburr cells.
| 1 |
Uremia
|
Hepatocellular carcinoma
|
Gastric carcinoma
|
Ovarian cancer
|
Anatomy
|
Haematology
|
894473e3-cbdf-490e-a342-cffca235895d
|
single
|
Which among the following is the shoest peptide?
|
Angiotensinogen is a 452-amino-acid-long protein, which is produced by the liver. Angiotensin I, comprising the first 10 amino acids of angiotensinogen, is produced by cleavage of a leucine-valine bond by renin. The 10-amino-acid angiotensin I is completely inactive but is subsequently conveed to the eight-amino-acid peptide hormone, angiotensin II. This reaction is catalyzed by angiotensin-conveing enzyme (ACE). Angiotensin II can also be conveed to a seven-amino-acid angiotensin III. Vasopressin or AVP is a nonapeptide. Ref: Lorenzo A.J. (2012). Chapter 18. The Urinary System. In L.W. Janson, M.E. Tischler (Eds), The Big Picture: Medical Biochemistry.
| 1 |
Angiotensin-III
|
Vasopressin
|
Angiotensin-II
|
Angiotensin-I
|
Biochemistry
| null |
732f1524-159a-41e7-bb20-080bbd5b1f27
|
single
|
Most accurate measurement of extracellular fluid volume (ECF) can be done by using :
|
Ans. is 'c' i.e. Inulin First let's see different types of body fluid.Extracellular fluid - It is a general term for all the body fluids outside the cells.It consists ofInterstitial fluidPlasmaLymphCerebrospinal fluidIntracellular fluidPortion of total body fluid which are within the cell membranesMeasurement of body fluid volumesExtracellular fluid volume -It is most accurately measured by Inulin*It can also be measured bymannitol*sucrose*Plasma volume- It is measured byEvan's blue*Albumin labelled with radioactive iodine*Total body fluid - It can be measured byD2O* (most frequently used)Tritium oxide*Amino pyrine*Interstitial fluid volume and intracellular fluid volume cannot be measured directly. These volume are calculates by.Interstitial fluid volume = ECF - plasma volumeIntracellular fluid volume = Total body fluid - Extracellular fluidAlso Remember Distribution of body fluid volume*Total body water = 60% of body weight = 42 L in a 70 kg man.I CF = 40% of body weight = 28 L in a 70 kg manECF = 20% of body weight = 14L in a 70 kg manInterstitial fluid = 15% of body weight = 10.5 L in a 70 kg manBlood volume = 8% body weight = 5.5 L in a 70 kg manPlasma volume = 5% of body weight = 3.5 L in a 70 kg man
| 3 |
Sucrose.
|
Mannitol.
|
Inulin.
|
Aminopyrine
|
Physiology
|
Body Fluids
|
13c8d765-001b-4f1f-bb78-e3c14947d9cf
|
single
|
All are used in treating spasmodic dysmenorhoea except :
|
Bromocriptine
| 1 |
Bromocriptine
|
Ibuprofen
|
Mefanamic acid
|
Norethisterone and Ethinyl estradiol
|
Gynaecology & Obstetrics
| null |
691809c6-04c4-4db1-b52a-7bec6f31fd6b
|
multi
|
Which does not contribute to enterobiliary fistula
|
Internal biliary fistula Cholecystoduodenal fistula(72-80%) are MC biliary enteric fistulas followed by cholecysticolic fistula (8-12%). Etiology Calculous biliary tract disease (90%). Duodenal ulcer(6%) Neoplasm, trauma, Parasitic infestation and congenital anomalies (4%) Ref : Sabiston 20th edition Pgno :1507
| 1 |
Gastric ulcer
|
Duodenal ulcer
|
Carcinoma gallbladder
|
Gallstones
|
Anatomy
|
G.I.T
|
dfbb8c3c-fa44-49d9-93c5-33df90b83a26
|
multi
|
Ability of stem cells to cross barrier of differentiation to transform into a cell of another lineage expressing the molecular characteristics of different cell type with the ability to perform the function of the new cell type is referred as:
|
Stem cell is defined as a cell with a unique capacity to produce unaltered daughter cellsand to generate specialized cell types (potency). Once cells are differentiated, their phenotypes are stable. However, tissue stem cells, which are thought to be lineage-committed multipotent cells, possess the capacity to differentiate into cell types outside their lineage restrictions called trans-differentiation or stem cell plasticity). For example, hematopoietic stem cells may be conveed into neurons as well as germ cells.
| 3 |
De differentiation
|
Re differentiation
|
Trans-differentiation
|
Sub differentiation
|
Pathology
|
Genetics
|
894e6a3d-6e39-4d9b-868a-7c74d2f48246
|
single
|
Metoclopramide is useful for all except -
|
Ans. is 'a' i.e., Motion sickness o Metoclopramide can be used as an antiemetic in postoperative, drug induced, disease associated, radiation sickness, but is less effective in motion sickness. o It should not be used to augment lactation. Though the amount secreted in milk is small, but suckling infant may develop loose motions, dystonia, myoclonus.
| 1 |
Motion sickness
|
Chemotherapy induced vomiting
|
Antiemetic
|
All
|
Pharmacology
| null |
08a216c1-8ffc-47a0-b0b1-146e5260b570
|
multi
|
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