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Wilm's tumor is associated with the following except –
| null | 4 |
Aniridia
|
Horse-shoe kidney
|
Hemihypertrophy
|
Opsoclonus
|
Pediatrics
| null |
bddd7f25-d21f-4f4d-9bb6-36352343445a
|
multi
|
Lines of zahn occur in which of the following
|
Ref Robbins 9/e p 125 thrombi often have grossly and microscopically apparent laminations called lines of zahn,these represent pale platelet and fibrin deposit altered with red cell rich layers .such laminations represent that thrombus has formed in flowing blood.their presence can be therefore distinguish antemoem thrombus from the bland non lamentated clots occuring in postmoem clot
| 4 |
Postmoem clot
|
Infract
|
Embolus
|
Coralline thrombus
|
Anatomy
|
General anatomy
|
c293cc98-fdb4-4212-8d0e-43a9b3af7ec9
|
multi
|
Gray equals
|
A i.e., 100 rads Rad (radiation absorbed dose) is energy deposited within living matter & is equal to 100 ergs/gm of tissue. Whereas, I gray is absorption of 1 joule energy by 1 kg living matter.
| 1 |
100 rad
|
1000 rad
|
10000 rad
|
All
|
Radiology
| null |
1dd4d7df-ecb1-4d67-8b86-ebe42b2db884
|
multi
|
Impression techniques are used for recording
| null | 3 |
Oral mucosal tissues
|
Dental hard tissues
|
Oral mucosal tissues and dental hard tissues
|
None of the above
|
Dental
| null |
d07b2902-2d2b-4b07-bc52-6227e394d36b
|
multi
|
Women carrying BRCA 1 gene are more likely to develop which type of breast carcinoma
|
Medullary carcinomas occur with increased frequency in women with BRCA1 mutations, although most women with medullary carcinoma are not carriers. These carcinomas uniformly lack the estrogen and progesterone receptors and do not overexpress HER2/NEU (a combination that often is referred to as triple-negative). ref : Robbins Basic Pathology, 9E,page-712
| 1 |
Medullary
|
Lobular
|
collnid
|
Secretory
|
Pathology
|
Breast
|
dbda932e-26e7-44df-8be7-eb6f76712063
|
single
|
Which of the following is not a branch of cerebral part of ICA:
| null | 3 |
Opthalmic artery.
|
Anterior cerebral artery.
|
Posterior cerebral artery.
|
Anterior choroidal artery.
|
Anatomy
| null |
dfa53286-cdab-4437-9b37-370573479e6a
|
single
|
Most wear resistant composite is:
|
Hybrid composite resin materials have a combination of small and large filler particles, to combine high filler loading with a sufficient quantity of small particles to ensure improved wear resistance and also permit adequate polishability. These materials are quite strong, polishable, and have wear resistance equivalent to amalgam.
Sturdevant Operative Dentistry 7th edition page 471
| 3 |
Traditional composite
|
Macrofilled composite
|
Hybrid composite
|
Packable composite
|
Dental
| null |
2e829113-70df-4968-8daa-8c7ccee20872
|
single
|
All ICUD's are changed every 4-5 year except:
| null | 4 |
Cu 280
|
Cu 320
|
Multiload devices
|
Progestasert
|
Gynaecology & Obstetrics
| null |
050750bf-fbc9-45b2-bcb2-9fc3b9d829ad
|
multi
|
Half of the clot retraction is completed by?
| null | 4 |
24 hrs
|
Within 2 hrs
|
Within 15 minutes
|
Within 1 hour
|
Surgery
| null |
31b9ad6f-6d7c-4aa9-b1a1-b95b5c767a00
|
single
|
Bregma is the name given to the junction of the
|
Bregma:
Bregma is the meeting point between coronal and sagittal sutures.
Seen in norma verticalis view of skull.
In foetal skull, this is the site of a membranous gap, called anterior fontanelle. It ossifies at 18 months of age.
| 1 |
Coronal and sagittal sutures
|
Frontal bone with the nasal bone
|
Lambdoid and sagittal sutures
|
Parietal & Occipital bone
|
Anatomy
| null |
30c0cabf-6865-4aca-9a52-05a53307ef3a
|
single
|
The best method to screen a 3-year-old with a sound dentition and open proximal contacts would be:
|
The American Dental Association (ADA), the American Academy for Pediatric Dentistry (AAPD), the European Academy for Pediatric Dentistry (EAPD), and other organizations have published criteria that are meant to guide the dental professional in decision-making regarding appropriate radiographic imaging (Table 2-5). These guidelines clearly state that if the patient cannot cope with the procedure, one should attempt other strategies to handle the situation. The guidelines all acknowledge that, in some cases, radiographs are not possible, in which case, one should balance the benefit against the risk even more carefully. Sometimes it is better to postpone the radiographic exposure until the patient is older or better conditioned. The guidelines also clearly state that if there are no clinical signs of pathology, the need for a radiographic assessment is up to the professional’s judgment, and that these decisions have to be made on an individual patient basis. Radiographs are never to be used for economic and screening reasons since they involve a potential health risk for the patient.
| 1 |
No radiographic assessment.
|
Bitewing Radiographs
|
Intraoral periapical radiograph
|
Occlusal radiographs
|
Dental
| null |
37d528c7-07a8-4583-8f1f-3148f6be76ae
|
single
|
Drug of choice for controlling severe pain in cancer patient is:
|
Ref: Katzung 10/e p449 Opioids like morphine can be used to treat severe pain associated with terminal cancers.
| 1 |
Morphine
|
Diclofenac
|
Ibuprofen
|
Codiene
|
Pharmacology
|
Central Nervous system
|
6e2023c6-1d32-4134-8af5-85dae800c526
|
single
|
Inversion and eversion of foot occur at which joint
|
Joint Movement Subtalar joint Inversion and Eversion of foot Ankle joint hinge - like dorsiflexion & plantar flexion of foot on leg Inferior tibiofibular joint Permits slight movements, so that lateral malleolus can rotate laterally during dorsiflexion of ankle Tibiotalar joint hinge joint contributes to plantar & dorsiflexion motion of foot
| 1 |
Subtalar
|
Tibiotalar
|
Inferior tibiofibular
|
Ankle
|
Anatomy
|
DNB 2018
|
a4883d61-0198-46e9-82df-33df29c9930c
|
single
|
Cochleate uterus is
|
Cochleate uterus: A small adult uterus with a conical cervix and a body that is small, globular, and acutely flexed. ref - pubmed.com
| 2 |
Large uterus
|
Acute anteflexion
|
Acute retroflexion
|
Large cervix
|
Anatomy
|
Abdomen and pelvis
|
cf56589e-dfb1-478a-a10d-ce3cf3ab7c9e
|
single
|
The study of tooth prints is also called as
| null | 2 |
Dermatoglyphics
|
Ameloglyphics
|
Dentinoglyphics
|
Cementoglyphics
|
Pathology
| null |
7c05e9d2-77e0-42ab-88fa-c302c6ca11e5
|
multi
|
H.parainfluenzae requires which of the following factors
|
H.influenzae, H.haemolyticus, and H.aegyptius: requires both factor X and VH.parainfluenzae, H.parahaemolyticus, and H.paraphrophilus: Requires only factor VH.aphrophilus: Doesn't require both factors(Ref: Ananthanarayan 9th edition, p328)
| 1 |
Only Factor X
|
Only Factor V
|
Both factor X and V
|
None of the above
|
Pathology
|
All India exam
|
31cf8f91-daad-41e5-a8f1-9e01d033bac5
|
multi
|
Which of the following is not a maxillary major connector:
| null | 2 |
Closed horseshoe major connector.
|
Continuous clasp.
|
Palatal plate.
|
None of the above.
|
Dental
| null |
11be9067-25b0-47c8-9662-6fa34aa50b57
|
multi
|
H type tracheo-esophageal fistula occur in
|
The H type fistula occurs in 8% of cases. Type A Oesophageal atresia without TOF (8%) Both segments communicate with trachea. 2. Type B Oesophageal atresia with proximal TOF (1%) Blind proximal segment of oesophagus connects with trachea by fistula. Distal end is blind 3. Type C Oesophageal atresia with distal TOF (84%) Distal segment of oesophagus is connected with trachea by fistula. 4. Type D- Oesophageal atresia with proximal & distal TOF. Both ends are blind & no communication (3%) 5. Type E- TOF without oesophageal atresia (4%) H- type
| 2 |
<1%
|
5%
|
8%
|
12%
|
Surgery
| null |
1901d31b-fcd9-4bef-8d76-06e646f65344
|
single
|
Autoimmune hemolytic anemia is associated with malignancy of which lineage :
|
Answer is B (B cell type) The diagnosis of typical B cell CLL should be considered in a patient presenting with an autoimmune hemolytic anemia or autoimmune thrombocvtopenia. - Autoimmune hemolytic. anemia (AIHA) and Lymphoid maliknancies Autoimune hemolytic anemias may be seen in association with Leukemias specially of the B cell CLL type and with Lymphomas especially of the Non Hodgkins type. Leukemias and AIHA Characteristically seen in association \ oh Chronic Lymphocytic Leukemia ( Typical B cell CLL) (CLL is a clonal malignancy of B cell)(2 Autoantibodies are mainly IgG type and hemolytic anemias are accordingly classified as warm antibody type Lymphomas & AIHA More commonly seen in association with Non Hodgkin's Lymphoma, but may also be Seen with Hodgkins type. Non Hodgkins(NHL)> Hodgkins (infrequent) Autoantibodies are usually IgG (warm antibodies) but cold Antibody type (IgM) hemolytic anemias may also be seen . Warm antibody type > Cold Antibody (infrequent) type
| 2 |
T cell
|
B cell
|
Pre B cell
|
Pre T cell
|
Medicine
| null |
fe2ea54d-7c13-4f0c-a2ce-6b768061c5e1
|
single
|
Left Umbilical vein becomes:
|
Ligamentum teres
| 1 |
Ligamentum teres
|
Ligamentum venosum
|
Medial umbilical ligament
|
Ligamentum aeriosum
|
Anatomy
| null |
7dabebc1-1c7e-410c-aa84-2cd0f8109f5f
|
single
|
Negative skived distribution has
|
Normal distribution has ⇒ Mean - Median = mode.
Positive skewed distribution or Right side skewed has ⇒ Mean > median > mode.
Negative / deft side skewed distribution has ⇒ Mean < median < mode.
| 3 |
Mean = median = mode
|
Mean > median > mode
|
Mode > median > mean
|
No correlation
|
Social & Preventive Medicine
| null |
42638c22-3379-4215-8bf0-bf79e1dd5d7f
|
single
|
IUCD is made up of-
|
Ans. is 'd' i.e., Polyethylane o On first look at the question, copper comes in the mind first because most commonly used name for IUCD is copper-T (Cu-T). o But copper is not the answer. o IUCD devices are usually made of polyethylene or other polymer; in addition, the medicated or bioactive IUDs release either metal ions (copper) or hormones.
| 4 |
Nickel
|
Strontium
|
Copper
|
Polyethylane
|
Social & Preventive Medicine
| null |
928ffb3a-0260-4333-a2dd-3855e758a1da
|
single
|
Intermediate hosts for toxoplasma are all except-
|
Ans. is 'c' i.e., Cat Toxoplasma gondiio Toxoplasmosis is the disease caused by infection with the obligate intracellular parasite Toxoplasma gondii.Life cvcleThere are two distinct stages in the life cycle of T gondii.1. Nonfeline stageIn this stage tissue cysts (containg bradyzoites) or sporulated oocysts are ingested by intermediate hosts (Human, mouse, sheep or pig).The cyst is rapidly digested by the acidic-pH gastric secretion releasing bradyzoites or sporozoites.These bradyzoites or sporozoites enter the small - intestinal epithelium and tranform into rapidly dividing tachyzoites (endozoites).The tachyzoites can infect and replicate in all mammalian cells except red blood cells.Tissue cysts containing many bradyzoite develop 7-10 days after systemic tachyzoite infection.These tissue cysts occur in a variety of host organs but persist principally within the CNS and muscle.2. Feline stage (sexual stage)This stage takes place in the definitive host (cat)This cycle is associated with formation of oocysts, which are excreted in cat feces,Mature oocysts contain 2 sporocysts, each with 4 sporozoites.The formation of tissue cysts in cats constitutes the other part of feline cycle.
| 3 |
Human
|
Sheep
|
Cat
|
Pig
|
Microbiology
|
Parasitology
|
7f071c44-3c3f-49ad-bd53-c772552a59ce
|
multi
|
IVP is contraindicated in –
|
Multiple myeloma is a relative contraindication for IVP.
| 1 |
Multiple myeloma
|
Kidney stones
|
Renal cyst
|
Transplanted kidney
|
Radiology
| null |
ef6e27ec-6851-4a49-a297-298e6c20ef2a
|
single
|
Which of the following is the most common complication following surgery after repair of Sprengel deformity?
|
Sprengel deformity, or congenital elevation of the scapula, associated with the restriction in the motion of the scapula and glenohumeral joint. Brachial plexus injury is the most common and severe complication following surgery for Sprengel deformity. To avoid brachial plexus injuries several authors have recommended morselization of the clavicle. Ref: Maheshwari 6e pg 224.
| 2 |
Infection
|
Brachial plexus injury
|
Mediastinitis
|
Dislocation of the shoulder
|
Orthopaedics
|
Shoulder and arm injuries
|
47524498-d41c-43bc-b803-36fdd86aadf8
|
single
|
Bell's palsy patient comes on day 3. Treatment given would be:
|
(c) Oral steroids + Acyclovir is the best answer.(Ref. Cummings, 6th ed., 2621)Antiviral has to be started within 3 days. Since the patient has presented on the 3rd day, acyclovir should also be started here along with the steroids.If the patient comes after 3 days he should be given only the steroid and vitamin B.Intratympanic steroids and vasodilators are not used for Bell's palsy.
| 3 |
Intratympanic steroids
|
Oral steroids + vitamin B complex
|
Oral steroids + Acyclovir
|
Vasodilators + vitamin B complex
|
ENT
|
Facial Nerve And Its Disorders
|
403f55b2-0949-4663-bea2-c17f0a7c2be7
|
single
|
Posterior glenohumeral instability is tested by
|
Answer: b) Jerk testSulcus Sign. Downward traction is applied to the arm while the shoulder is held in 0 degrees of abduction, neutral rotation, and 0 degrees of flexion/extension. The acromiohumeral interval is measured to assess inferior glenohumeral laxity.Rotator Interval Test. While performing the sulcus test, externally rotate the arm. Healthy patients will have a reduction of inferior translation. No reduction in acromiohumeral interval is suspicious for rotator interval capsular deficiency.Jerk Test. Start with the arm forward-flexed and adducted. Posterior-directed force will cause posterior translation in posterior instability. Moving the arm into the coronal plane may reduce the humeral head.
| 2 |
Crank test
|
Jerk test
|
Sulcus test
|
Fulcrum test
|
Orthopaedics
|
Injuries Around Shoulder
|
7c528c33-01f4-42f7-8702-e192b374e4f1
|
single
|
Most common tumor producing osteoblastic metastasis?
|
Ans. is 'c' i.e., Prostate Osteolytic bone metastases Osteoblastic bone metastasis Mixed osteolytic-osteoblastic Renal (kidney) Thyroid Ewing's sarcoma Uterine carcinoma GIT cancers & Hepatoma Wilm's tumors Myeloma Melonoma & SCC Malignant pheochromocytoma Prostate (most common) Prostate (most common) Medullary carcinoma of thyroid Osteogenic sarcoma Neuroblastoma Medulloblastoma Breast Lung (Bronchus) Urinary bladder Pancreatic Testicular Cervical Ovarian
| 3 |
Kidney
|
Lung
|
Prostate
|
Thyroid
|
Surgery
| null |
14738634-4f10-4c96-9463-c61c2654ea90
|
single
|
In benign intracranial hypeension-
|
Dural sinus thrombosis (DST) is a life threatening illness and is often overlooked but it must be considered in the differential diagnosis of a patient presenting with a significant headache. DST presents similarly to benign intracranial hypeension (BIH) with intracranial hypeension and headache. A case of a 23 year old woman with DST is described that was initially diagnosed as BIH. Brain CT scan and MRI scan should be taken to distinguish from sinus thrombosis and benign intracranial hypeension Ref Harrison20th edition pg 2455
| 3 |
here is a restriction of upgaze
|
Normal ventricles is found in 50% of cases
|
Brain scan in impoant in young woman to exclude sagittal sinus thrombosis
|
Optic nerve fenestration should be performed early before the Vision is affected
|
Medicine
|
C.N.S
|
eb5508a6-6ae5-4f6f-aae4-935f74e91b06
|
single
|
20-year-old male complaints of repeatedly changes in glasses, may result into;
|
KERATOCONUS Non -Inflammatory central corneal thinning Young male with constantly changing power of glasses with myopia & high cylinder SIGNS IN KERATOCONUS Munson sign. Enlarged corneal nerves-lower lid indentation on downgaze. Oil droplet reflex. Rizutti's sign- Acute Hydrops - aqueous accumulated in stroma Fleischer ring-Paial or complete iron deposition ring in deep epithelium encircling the base of the cone. Characteristic in eyes with keratoconus. Scissor reflex on retinoscopy (Earliest Clinical Sign) Keratometry Steep cornea. Bow tie pattern Paracentral thinning of cornea Investigation of Choice Pentacam
| 1 |
Keratoconus
|
Pathological myopia
|
Glaucoma
|
Cataract
|
Anatomy
|
FMGE 2019
|
8ad0377f-77af-4e48-8af3-ff08095575a1
|
single
|
The most common cause of SVC syndrome is -
| null | 2 |
Thrombosis
|
Extrinsic compression
|
Mediastinal lymphoma
|
Teratoma
|
Pathology
| null |
74446ec4-3d12-4b4f-8659-8e27e44fc980
|
single
|
Ketogenic amino acids are all except-
|
Ans. is 'd' i.e., Histidine o Leucine and Lysine - Pure ketogenico Tryptophan - Glycogenic and ketogenico Hitidine - Pure glucogenicGlucogenicKetogenicBoth glucogenic & ketogenico Alanineo Arginineo Aspargineo Aspartic acido Cysteineo Glutamineo Glutamic acido Glycineo Histidineo Methionineo Prolineo Serineo Threonineo Valineo Leucineo Lysineo Isoleucineo Phenylalaineo Tyrosineo TryptophanNote: According to Harper 29th/e (P-282), lysine is both ketogenic and glucogenic. But all other textbooks have mentioned it as ketogenic.
| 4 |
Leucine
|
Lysine
|
Tryptophan
|
Histidine
|
Biochemistry
|
Amino Acids Basics
|
ebed014f-ba7f-4259-898f-e105cf10757e
|
multi
|
Pehes disease etiology is?
|
Ans. is 'd' i.e., Unknown PEHE'S DISEASE (LEGG-CALVE PEHE'S DISEASE) Pehe's disease is also known as osteochondritis deformans juvenilis or Coxa piano or Pseudocoxalgia. Pehe's disease is an osteochondritis of the epiphysis of the femoral head (capital femoral epiphysis). In the disease, the femoral head becomes paly or wholly avascular and deformed. The disease occurs commonly in males in the age group of 5-10 years. Etiology of Pehe's disease Pehe's disease is the most common form of osteochondroses (osteochondroses are characterized by avascular necrosis (AVN) and defective endochondral ossification of primary or secondary ossification centers). The etiology remains unknown, but is currently accepted that the disorder is caused by an interruption of the blood supply to the capital femoral epiphysis, causing avascular necrosis. Clinical features of Pehes disease Pehes disease is common in male of age group 5-10 years. Pain in the hip, often radiating to knee. Limp (antalgic limp). Limitation of movement :- Abduction, internal rotation and extension are limited, therefore there is adduction, external rotation, and flexion deformity. Shoening of limb. Positive trendelenburg test. During the disease process, bone age is 1-3 years lower than the normal. After healing, bone age returns to normal. Radiological investigations for Pehe's disease Following radiological investigations are used : 1) X-ray hip Findings are :- Increased medial joint space Widening of femoral neck Lateral extrusion (lateral subluxation) Metaphyseal cysts and rarefaction of metaphysis Horizontal physis with speckled calcification lateral to it Fragmentation of femoral head with increased density (irregular densities in the epiphysis) 2) Bone scan May show a decrease uptake by femoral head. 3) MRI It is the investigation of choice as it can diagnose Pehes disease in early stages when X-ray is normal. MRI tells about :- Extent of area involved Sphericity of the head Subluxation of the head Thus MRI helps better in planning for management.
| 4 |
Pyogenic
|
Tubercular
|
Traumatic
|
Unknown
|
Surgery
| null |
f345c1c2-0a68-41f8-a1c8-805cb5c8f6b5
|
single
|
Which of the following drug is a direct inhibitor of clotting factor Xa?
|
Impoant ones are: - (1) Rivaroxaban (2) Apixaban (3) Edoxaban (4) Betrixaban (a) Argatroban - Direct thrombin inhibitor (synthetic non-peptide compound which binds reversibly to the catalytic site of thrombin but not to the substrate recognition site) (b) Fondaparinux - Indirect thrombin inhibitor. (d)Aspirin - Inhibit COX and thus Thromboxane A2 synthesis inhibitor
| 1 |
Apixaban
|
Argatroban
|
Fondaparinux
|
Aspirin
|
Pharmacology
|
Hematology
|
ae033be6-d5c4-4166-9299-494d9c065927
|
single
|
The drug of choice for obsessive-compulsive disorder is
|
Drug Treatment in obsessive-compulsive disorder: 1. Benzodiazepines (e.g. alprazolam, clonazepam) have a limited role in controlling anxiety 2. Antidepressants: Clomipramine (75-300 mg/day), a nonspecific serotonin reuptake inhibitor (SRI), was the first drug used effectively in the treatment of OCD. Fluoxetine (20-80 mg/day) is a good alternative to clomipramine and often preferred these days for its better side-effect profile. Fluvoxamine (50-200 mg/day) is marketed as a specific anti-obsessional SSRI drug, whilst paroxetine (20-40 mg/day) and seraline (50-200 mg/day) are also effective in some patients. 3. Antipsychotics: These are occasionally used in low doses (e.g. haloperidol, risperidone, olanzapine, aripiprazole, pimozide) in the treatment of severe, disabling anxiety. 4. Buspirone has also been used beneficially as an adjunct for augmentation of SSRIs, in some patients. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no.98
| 2 |
Imipramine
|
Fluoxetine
|
Chlorpromazine
|
Benzodiazepine
|
Psychiatry
|
Anxiety disorders stress disorders and grief
|
fa3d3fb9-34f5-44ea-b53b-469d213ba174
|
single
|
NO is released by -
|
Ans. is 'c' i.e., Endothelial cells o The most important physiological source of NO is endothelial cells.o Nitric oxide, also called endothelium-derived-relaxing factor (EDRF), is formed from amino acid arginine, by the action of the enzyme NO synthase, which is cytosolic.o NO acts as short lived biological messenger by stimulating a guanyl cyclase that produce cGMP and cGMP activates protein kinase G.o The most important actions is the relaxation of smooth muscles. The constant release of NO from endothelial cells produces vasodilatation, and basal release of NO produced by endothelial cells is a primary determinant of resting vascular tone. In GIT, NO produces relaxation of GI smooth muscles. Vasodilatation in corpora covernosa helps in penile erection.o NO inhibits platelets adhesion, activation and aggregationo Cigarette smoking decreases endogenous NO formation
| 3 |
Neutrophills
|
Macrophages
|
Endothelial cells
|
Lymphocytes
|
Pathology
|
Miscellaneous (Blood Vessels)
|
fcecec8f-25ad-4156-9f25-1d7f6f841446
|
single
|
Brunner's glands are seen in:
|
An extensive array of compound mucous glands, called Brunner's glands, is located in the submucosa of the first few centimeters of the duodenum, mainly between the pylorus of the stomach and the papilla of Vater These glands secrete large amounts of alkaline (pH 9) mucus.
| 2 |
Jejunum
|
Upper duodenum
|
Lower duodenum
|
Appendix
|
Physiology
|
Gastrointestinal System
|
031fff93-8bf1-4c64-a748-110e0dd4ec9c
|
single
|
Which of the following has both endocrine and exocrine functions?
|
Ans: a (Pancreas)Pancreas has both exocrine and endocrine functions.There are 4 distinct types of pancreatic cells in human.A cells (alpha) - GlucagonB cells (beta) - InsulinD cells (delta) - SomatostatinF cells - Pancreatic polypeptide D1 cells - VIPEndocrine pancreas secretes hormones -glucagon, insulin and somatosta-tin. Exocrine pancreas secretes digestive enzymes like trypsin, chymot-rypsin.Site and mechanism of hormone action:-Mechanism and siteHormoneAt nuclear receptorThyroid ormonesAt cytoplasmic receptorsSteroidal hormones eg:- Glucocorticoids, Mineralocortyicoids, Estrogen, Progestins.At cytoplasmic receptorsa) Direct transmembrane activation of tyrosine protein kinase -InsulinPhosphorylation cascade b) Through IP3/DAG generationVasopressin, oxytocinc) Through alteration of intracellular cAMP concentration - alteration of protein kinase A activityAdrenaline, glucagon, TSH,LH, FSH, PTHACTH, Calcitonin
| 1 |
Pancreas
|
Thyroid
|
Spleen
|
Kidney
|
Physiology
|
Endocrinology and Reproduction
|
938d09b9-d3a3-4468-bb33-0a35f5fe4590
|
multi
|
As the sample size increases standard deviation
| null | 1 |
Decreases
|
Increases
|
Remains the same
|
may increase or decrease
|
Dental
| null |
8fb5aeab-be77-45ec-992e-04e449a62ea1
|
single
|
Residual auditory defect is a common complication in meningitis caused by
|
Residual auditory defect is caused by Haemophilus meningitis .so BERA is the investigation of choice done in them. Reference: GHAI Essential pediatrics, 8th edition
| 4 |
Staphylococcus
|
Meningococcus
|
Escherichia coli
|
Haemophilus influenzae
|
Pediatrics
|
Central Nervous system
|
5a527f39-cb8f-43f5-a3c4-3515289c4346
|
single
|
Which of the following transpo processes is passive?
|
Osmosis is the movement of water molecules across a semi-permeable membrane from a region of Lower solute concentration to an area of higher solute concentration. It is passive in nature. (REF: TEXTBOOK OF MEDICAL PHYSIOLOGY GEETHA N 2 EDITION, PAGE NO - 3)
| 3 |
Co-transpo of Na+ ion and a molecule into cell
|
Exchange of K+ ion outside the cell for Na+ ion inside the cell
|
Flow of H2O through cell membrane by osmosis
|
Uptake of molecules into cell by endocytosis
|
Physiology
|
General physiology
|
f8daa68c-611b-4814-bf0a-92ef86fced84
|
single
|
If the bih weight is 3 kg by the end of one year of age. It should become:
|
Average bih weight in India: 2.8 Kg (2.7-2.9 Kg) BW doubles at 5 months, triples by 1 year and quadraples by 2 years age So, BW of 3 Kg will become 6 Kg, 9 Kg and 12 Kg at 5 months, 1 year and 2 years age respectively. Weight gain Pattern in Children Age Weight increments 0-3 months 200 grams per week 4-6 months 150 grams per week 7-9 months 100 grams per week 10-12 months 50-75 grams per week 0-1 year 7 Kg per year 1-2 years 2.5 Kg per year 3-5 years 2.0 Kg per year Ref: Park 25th edition Pgno: 578
| 2 |
6 Kg
|
9 Kg
|
12 Kg
|
15 Kg
|
Social & Preventive Medicine
|
Maternal and child care
|
189663f9-fa01-48a4-9ee0-0a330988485f
|
single
|
Dr. Shweta decided to add a progestin for 10–12 days each month to estrogen replacement therapy in menopausal women in the gynaecology OPD. Addition of progestin is recommended because the progestin:
| null | 2 |
Blocks the increased risk of myocardial infarction due to estrogen
|
Blocks the increased risk of endometrial carcinoma due to estrogen
|
Reverses vulval atrophy occurring pausal women
|
Enhances the metabolic benefits of estrogen treatment
|
Pharmacology
| null |
720779c6-45d6-40c9-a6b6-aecfd7cf80b1
|
single
|
Which of the following needle is used for irrigation?
| null | 3 |
23
|
25
|
27
|
29
|
Dental
| null |
29698650-50c9-4c4c-80ba-8b183a918425
|
single
|
"Anhedonia" means
|
Defined as the inability to experience pleasure from activities usually found enjoyableAnhedonia can be characteristic of:Mood disordersSchizoaffective disorderBorderline personality disorderSchizoid personality disorderSchizophreniaRef: Ahuja 5/e p56, 58
| 1 |
Lack of interest
|
Panic attacks
|
Phobic attack
|
Mood swings
|
Medicine
|
All India exam
|
60d6da3e-9a57-4c0f-ace7-25b96d50db98
|
single
|
All of the following show genu recurvatum, except
| null | 1 |
Perthe's disease
|
Rheumatoid arthritis
|
Poliomyelitis
|
Rickets
|
Orthopaedics
| null |
9d01e306-5d20-468a-aa74-5d4454b83ca2
|
multi
|
The role of htirnan placental lactogen is :
|
Growth of fetus
| 3 |
Stimulate milk production
|
Fetal breast development
|
Growth of fetus
|
Endocrine regulation
|
Gynaecology & Obstetrics
| null |
741abce9-8825-459c-958f-946f7a217aff
|
single
|
A 29-year-old man notes burning pain on urination with a urethral discharge that has persisted for 3 days. A sample of the exudate is positive by ELISA for Chlamydia trachomatis. The man has increasing stiffness of the knees and ankles and lower back pain 3 weeks later. A radiograph of the lumbar spine shows narrowing with sclerosis of the sacroiliac joints. One month later, he develops painful erythema of the glans penis, and the conjunctivae are red. A follow-up examination shows a slightly irregular heart rate and a murmur suggestive of aortic regurgitation. The back pain continues off and on for 5 more months. Which of the following test results is most likely to be positive in this man?
|
The combination of nongonococcal urethritis, arthritis, and conjunctivitis suggests reactive arthritis, one of the spondyloarthropathies; the changes in the spine can resemble ankylosing spondylitis and can be equally debilitating. ANCA is indicative of various forms of vasculitis, such as granulomatous vasculitis and microscopic polyangiitis. The ANA test result is positive in many autoimmune diseases, such as systemic lupus erythematosus (SLE), but it is not a feature of spondyloarthropathies. Lyme disease can include large joint arthritis, but not urethritis or conjunctivitis. Rapid plasma reagin (RPR) is a screening test for syphilis, which can include arthritis of large joints (Charcot joint) in the tertiary form, but it takes decades to develop. Rheumatoid factor is a feature of rheumatoid arthritis, which initially manifests more commonly in small joints of the hands and feet. U1-RNP is a marker for mixed connective tissue disease, which has features of rheumatoid arthritis, scleroderma, polymyositis, and SLE; arthralgias are not accompanied by joint destruction or deformity.
| 3 |
ANCA
|
ANA
|
HLA-B27 genotype
|
Anti-Borrelia antibodies
|
Pathology
|
Misc.
|
15842e21-3e92-414a-b872-80bb9e8da2e9
|
single
|
A man presents with multiple painless swelling all over the body and coffee brown patches in trunk. The condition is
|
Ans. (b) Multiple NeurofibromaRef: Bailey and Love 26th edition Page 581* Neurofibromatosis is a condition arising from Schwann cells.* 2 types are seen* 70% are Autosomal Dominant, 30% are sporadic.* NF 1 (Von Recklinghausen) is the MC type.* It is due to Gene mutation of Chromosome 17* Skin manifestation develop in early life# Multiple nodules# Lisch Nodules# Cafe au lait spots - More than 5 in numbers# Armpit of Groin Freckles
| 2 |
Multiple Lipoma
|
Multiple neurofibroma
|
Melanoma
|
Sebaceous Cyst
|
Surgery
|
Nervous System
|
d2fd4a15-aedd-420c-a8c2-2a293156850f
|
multi
|
A pre-natal USG showed bilateral hydronephrosis in a male fetus. A repeat USG scan done few days later showed bilateral hydronephrosis with full bladder with reduced amniotic fluid. Emergency Caesarean Section was conducted. What is the FIRST likely investigation for the newborn?
|
Next Step: Diagnosis by demonstration of posterior urethral valves. Posterior urethral valves, the most common obstructive urethral lesions in infants and newborns, occur only in males and are found at the distal prostatic urethra. Demonstration of urethral valves on a voiding cystourethrogram establishes the diagnosis, as does endoscopic identification of valves. 2 possible answers for this question. a) Micturating Cystourethrogram b) Endoscopic identification of valve (in an emergency) In this question answer is Micturating Cystourethrogram. However, endoscopy is better because of severe obstruction indicated by b/l hydronephrosis and oligohydramnios. It can be clubbed with endoscopic destruction of the valve. Impoant: What does USG do? 1. Ultrasonography can be used to detect hydronephrosis, hydroureter, and bladder distension in children with severe azotemia. 2. It can also detect fetal hydronephrosis, which is typical of urethral valves, as early as 28 weeks of gestation - an enlarged bladder with bilateral hydroureteronephrosis is usually present in PUV. Treatment consists of destruction of the valves, but the approach depends on the degree of obstruction and the general health of the child. Treatment consists of destruction of the valves by endoscopic incision. In a premature infant with a small urethra prohibiting transurethral resection, a temporary cutaneous vesicostomy may be required to provide drainage and improve impaired kidney function. Ref: Cooper C.S., Joudi F.N., Williams R.D. (2010). Chapter 38. Urology. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.
| 2 |
Ultrasonography
|
Micturating Cystourethrogram
|
DMSA Scan
|
Renal Doppler
|
Surgery
| null |
f70895c6-3d0f-403d-98ac-72ae983b2741
|
single
|
A patient with 8 cm x 8 cm abscess in right lobe of liver was treated with aspiration multiple times (3 times) and with systemic amebicide. Now cavity is remaining in right lobe of liver but there is nothing in the cavity. Seven days course of luminal amebicides is given. How will you follow up?
|
Ans. b. USG weekly for 1 month followed by monthly USG till 1 year (Ref: Sabiston 19/e p1445-1447; Schwartz 9/e p1115-1116; Bailey 25/e p1095; Blumgart 5/e p1016-1024; Shackelford 7/e p1471-1478)In uncomplicated cases of amebic liver abscess, follow-up is done with ultrasound.Role of ultrasound in the diagnosis and treatment follow-up of amoebic liver abscess, by K. Shamsi, A. De Schepper, F. Deckers, E. de Bergeyck, J. Van den End"Serological and clinical data in combination with these nonspecific sonographic features are sufficient for the management of ALA, obviating the need for expensive and invasive techniques in majority of the cases."- http://link. springer.com/article/10.1007%2FBF00221420?Ll=trueSabiston says "The average time to radiologic resolution is 3 to 9 months and can take as long as years in some patients. Studies have shown that more than 90% of the visible lesions disappear radiologically, but a small percentage of patients are left with a clinically irrelevant residual lesion."Most individuals with amebic liver abscess do not have concurrent signs or symptoms of colitis, and most do not have E. histolytica trophozoites in their stools.'Most individuals with amebic liver abscess do not have concurrent signs or symptoms of colitis, and most do not have E. histolytica trophozoites in their stools.' - Harrison 18/e p1683-1685Amoebic Liver AbscessCaused by Entamoeba histolytica whose cysts are acquired through the feco-oral routeQTrophozoites reach the liver through portal venous systemQ.Solitary aand more common in right lobe of liverQ.Low incidence of invasive amoebiasis in menstruating womenQMajority of patients are young men (may be due to heavy alcohol consumption)Pathogenesis:MC form of invasive disease is colitis, frequently affects the cecum and ascending colonQIn colon: Flask-shaped ulcersQ (MC site: Cecum and ascending colon)QSynchronous hepatic abscess is found in one third of patients with active amebic colitis.Clinical Features:MC symptom is abdominal painQTypical clinical picture: Patient of 20-40 years of age, with history of travel to endemic area, presents with fever, chills, anorexia, right upper quadrant painQ.Results from an obligatory colonic infection, a recent history of diarrhea are uncommonQ.\Active colitis and amoebic liver abscess rarely occur simultaneously, as a rule colonic lesions are silentQJaundice is rareQRaised PT is MC LFT abnormalityQ.Diagnosis:USG and CT are the main diagnostic modalitiesQDiagnosis is confirmed by serological testsQ (ELISA) for antiamoebic antibodies.Cultures of amoebic abscess are usually sterile or negativeQ.CXR: Elevated hemi diaphragm, right sided pleural effusion or atelectasisALA: Reddish-brown anchovy pasteQ; more reliable characteristic than color is the odour of the fluid.Treatment:Metronidazole (750 mg orally TDS X 10-14 days) is the mainstay of treatment and is curative in over 90% of patientsQ, clinical improvement is seen within 3 days.Luminal agents include iodoquinol, paromomycin and diloxanide furoateQ.The average time to radiologic resolution of abscess is 3-9 monthsQIndications of Aspiration in ALA* Diagnostic uncertaintyQ* Failure to respond to therapy in 3-5 daysQ* Pyogenic superinfectionQ* High risk of rupture (size > 5 cm. left lobe abscess)Q* PregnancyQ (Therapeutic trial with high dose Metronidazole is deemed inappropriate)Complications:Most frequent complications: Rupture into the peritoneum (MC)Q, pleural cavity, or pericardium.Size of abscess appears to be the most important risk factor for ruptureLaparotomy is indicated in cases of doubtful diagnosis, hollow viscus perforation, fistulization resulting in hemorrhage or sepsis, and failure of conservative therapy.Treatment of rupture into the pleural space: Thoracentes'QRupture into bronchi is self-limited with postural drainage and bronchodilatorsQ.
| 2 |
Stool examination only
|
USG weekly for 1 month followed by monthly USG till 1 year
|
USG weekly for 3 months followed by CT scan at 3 months.
|
USG or CT scan monthly and stool examination weekly
|
Medicine
|
Parasitology
|
529b4441-5737-4e81-8a6e-e17ab096714a
|
single
|
Placentamegaly is diagnosed on USG if size of placenta is more near:
|
Ans is d, i.e. 40 mmPlacental thickness increases by 1 mm/week. If placental thickness is more than 40 mm at term, it is called as placentomegaly
| 4 |
25 mm
|
30 mm
|
35 mm
|
40 mm
|
Gynaecology & Obstetrics
|
Fetus Placenta & Fetal Membrane
|
130108d4-1f40-48a0-92a9-aea19c2856c3
|
single
|
Gross hematuria can be seen in:
|
Patients with glomerular disease have hematuria with proteinuria. Hematuria is asymptomatic. 3-5 red blood cells in the first-voided morning urine is suspicious. Patients will not realize the microscopic hematuria, and only rarely gross hematuria present The exceptions are IgA nephropathy and sickle cell disease in both gross hematuria present. Ref: Harrison-18, P-2336.
| 3 |
IgA nephropathy
|
Sickle cell disease
|
Both IgA nephropathy and sickle cell disease
|
MPGN
|
Medicine
| null |
17b50e82-d7de-4848-b6bb-826fbf5e737f
|
multi
|
Association fibers are:
|
A i.e. Uncinate fasciculus; B i.e. Cingulum; C i.e. Superior longitudinal fasciculus
| 4 |
Uncinate fasciculus
|
Cingulum
|
Superior longitudinal fasciculus
|
All
|
Anatomy
| null |
792aee51-f569-446f-939f-e2c1d96eef94
|
multi
|
Which gland is derived from foramen caecum?
|
The site of origin of the thyroglossal duct is foramen caecum. It grows down in the midline into the neck. Its tip soon bifurcates. Proliferation of the cells of this bifid end gives rise to the two lobes of the thyroid. Ref: Textbook of Human Embryology Inderbir Singh 6th Ed Page 119.
| 2 |
Pituitary
|
Thyroid
|
Thymus
|
Parathyroid
|
Anatomy
| null |
6b18844c-4c26-4a53-b27d-6729bf10ab50
|
single
|
Which of the following causes mesenteric lymphadenitis?
|
d. All of the above(Ref: Nelson 20/e p 1405-6, 1611)Acute appendicitis, mesenteric lymphadenitis & ileocolitis have been reported in patients who have had appendectomies during C. jejuni infection.Yersinia pseudotuberculosis is most often associated with mesenteric lymphadenitis.Human Adenovirus may also cause mesenteric adenitis.
| 4 |
Adenovirus
|
Campylobacter
|
Yersinia pseudotuberculosis
|
All of the above
|
Pediatrics
|
General Considerations - Infectious Diseases
|
3066bba2-40d7-4b4a-8c56-ee0f5bce2378
|
multi
|
A diabetic patient is undergoing dialysis. Aspiration done around the knee joint would show
|
ClinicoPathologic Category Associated diseases Major Fibril protein Related precursor protein SYSTEMIC AMYLOIDOSIS Immunocyte dyscrasias with amyloidosis (primary) Multiple myeloma AL Ig light chain, l Reactive systemic amyloidosis (secondary) c/c inflammation AA SAA Hemodialysis-associated CRF Ab2m B2-microglobulin Hereditary amyloidosis AA or ATTR SAA or Transthyretin Systemic senile amyloidosis ATTR Transthyretin LOCALIZED AMYLOIDOSIS Senile cerebral Alzheimer Ab APP Endocrine Medullary ca thyroid Islets of Langerhans Type 2 DM A Cal AIAPP Calcitonin Islet amyloid peptide Isolated atrial amyloidosis AANF Atrial natriuretic factor
| 1 |
A beta 2 microglobulin
|
AA
|
AL
|
Lactoferrin
|
Pathology
|
General pathology
|
bd9752ed-fa68-455f-b7d1-14229152a123
|
single
|
Eustachian tube opens in middle ear in
|
The anterior wall is narrow due to approximation of the medial and lateral walls, and because of descent of the roof. The uppermost pa of the anterior wall bears the opening of the canal for the tensor tympani. The middle pa has the opening of the auditory tube. the inferior pa of the wall is formed by a thin plate of bone which forms the posterior wall of the carotid canal. the plate separates the middle ear from the internal carotid aery. this plate of bone is perforated by the superior and inferior sympathetic carotico tympanic nerves and the tympanic branch of the internal carotid aery. Ref BDC volume;3 6th edition
| 2 |
Floor
|
Anterior wall
|
Superior wall
|
Posterior wall
|
Anatomy
|
Head and neck
|
04b82bc6-8171-4f9b-bb18-005180eb0a58
|
multi
|
Best fertility result in-
|
Ans. is 'd' i.e., Arcuate Delivery rate and uterine malformationso The overall term delivery rate with uterine malformations is poorer and obstetrical complicaions are more common.o Arcuate uterus has the best reproductive outcome with the live birth rates similar to normal uterio The live birth rate with septate and bicomuate uterus is about 62%.o Unicornuate and didephys uterus have live birth rate of 40%.
| 4 |
Bicomuate
|
Unicomuate
|
Septate
|
Arcuate
|
Gynaecology & Obstetrics
|
Uterus
|
8a3587f7-0e3b-4989-9eb4-86f61b1a2b5e
|
single
|
FDA approved the use of modafinil as an adjunct in
|
For obstructive sleep apnea the treatment of choice: Continuous positive airway pressure.Adjunct: Modafinil which is a sympathomimetic agonist for alpha and beta receptors.Ref:
| 1 |
Sleep apnea
|
Narcolepsy
|
Depression with lethargy
|
Tourette's syndrome
|
Pharmacology
|
Respiratory system
|
a5cc8765-fc40-4231-836d-295e3290e8e2
|
single
|
A 50 years old female with 50 kg body weight suffered from burns after pressure cooker blast, involving 45% of total body surface area. How much fluid should be given in first 8 hours?
|
Resuscitation formulas Formula Crystalloid volume Colloid Volume Free water Parkland 4 mL / Kg per % TBSA None None Brooke 1.5 mL/Kg per % TBSA burn 0.5 mL/Kg per % TBSA burn 2.0 L Galveston (Pediatric) 5000 mL/m2 burned area + 1500 mL/m2 total area None None Parkland Formula: Calculates disease fluid to be replaced in first 24 hrs. 24 hrs. fluid requirement = 4 ml x Body wt. (kg) x % BSA (Burn surface Area) -Half in 1st 8 hours -Next half in subsequent 16 hours From the given question: % BSA= 45 %Body wt. (kg) = 50 kg- 4 x 50 x 45= 9,000 ml In first 8 hours = 4.5 litres
| 4 |
4 litres
|
5 litres
|
6 litres
|
4.5 litres
|
Surgery
|
Burns
|
af13a4be-e6be-4346-8901-9c59f66ca78a
|
single
|
Metabolic alkalosis leads to?
| null | 1 |
Low potassium
|
High calcium
|
Low I2 trapping by follicular cells
|
High I2 trapping by follicular cells
|
Medicine
|
Electrolyte Imbalance
|
7bc7a30a-81a7-4fba-a8cc-a1c66fa4b217
|
single
|
A 40 yr old patient with a single kidney presents with a solitary exophytic mass of 4 cm localized at its lower pole. Which amongst the following is the best recommended management option:
|
Ans is 'd' i.e. Paial nephrectomy Paial nephrectomy is the preferred surgical approach for a small ( Paial nephrectomy should be considered in the following clinical situations: Renal masses less than 4cm (T1) Localized mass in a patient with a single kidney or with compromised renal function. Synchronous bilateral renal tumors Patients with Von-Hippel-Lindau syndrome as they are at high risk of renal cancer in the contralateral kidney
| 4 |
Radical nephrectomy
|
Radical nephrectomy with dialysis
|
Radical nephrectomy with renal transplantation
|
Paial nephrectomy
|
Surgery
| null |
8aee4393-ebb1-404a-8b61-1d6c0fa2c3ad
|
multi
|
A child has respiratory distress, chest X-ray shows multiple air-filled space, the differential diagnosis is all except –
|
Congenital lobar aplasia does not produce air-filled spaces on chest X-ray. All other three options produce air-filled space on chest X-ray.
| 3 |
Congenital lung cyst
|
Congenital diaphragmatic hernia
|
Congenital lobar aplasia of lung
|
Congenital adenomatous malformation
|
Radiology
| null |
c0bf082b-4fae-46de-88d9-539ec5391c4c
|
multi
|
The long acting classical H1 antihistaminic include which of the following ?
| null | 1 |
Chlorpheniramine
|
Astemizole
|
Cetirizine
|
Clemastine
|
Pharmacology
| null |
2318fb90-bbb9-406e-8f30-811c602b8052
|
single
|
The most common disorder associated with Panic Attack is
|
(B) Post-traumatic stress disorder# 17 symptoms have been identified that make up PTSD.> These 17 symptoms are divided into three separate clusters.> Three PTSD symptom clusters, and the specific symptoms that make up these clusters, are described below.> Re-Experiencing Symptoms Frequently having upsetting thoughts or memories about a traumatic event. Having recurrent nightmares. Acting or feeling as though the traumatic event were happening again, sometimes called a "flashback."> Having very strong feelings of distress when reminded of the traumatic event. Being physically responsive, such as experiencing a surge in your heart rate or sweating, to reminders of the traumatic event.# Avoidance Symptoms: Making an effort to avoid thoughts, feelings, or conversations about the traumatic event. Making an ef- fort to avoid places or people that remind you of the traumatic event. Having a difficult time remembering important parts of the traumatic event.> A loss of interest in important, once positive, activities. Feeling distant from others. Experiencing difficulties having positive feelings, such as happiness or love. Feeling as though your life may be cut short.# Hyperarousal Symptoms> Having a difficult time falling or staying asleep.> Feeling more irritable or having outbursts of anger.> Having difficulty concentrating.> Feeling constantly "on guard" or like danger is lurking around every corner.> Being "jumpy" or easily startled. Emotional numbing symptoms are part of the avoidance cluster of PTSD symptoms. Emotional numbing symptoms generally refer to those symptoms that reflect difficulties in experiencing positive emotions.> The specific symptoms that make up the emotional numbing symptoms are: A loss of interest in important, once positive, activities. Feeling distant from others. Experiencing difficulties having positive feelings, such as happiness or love.> PTSD is characterized by recurrent and intrusive recollections of the stressful event either in flash-backs (images, thoughts, or perceptions) and/or in dreams.> There is an associated sense of re-experiencing of the stressful event.> There is marked avoidance of the events or situations that arouse recollections of the stressful event, along with marked symptoms of anxiety and increased arousal.> The other important clinical features of PTSD include partial amnesia for some aspects of the stressful event, feeling of numbness, and anhedonia (inability to experience pleasure).
| 2 |
OCD
|
Post-traumatic stress disorder
|
Depression
|
Schzophrenia
|
Psychiatry
|
Miscellaneous
|
d1cd03b9-992c-425a-a0d9-c71f6ce0e16a
|
single
|
All statement about Plummer Winson Syndrome are true except -
|
Ans. is 'a' i.e., Commonly leads to carcinoma in lower third of esophagusPlummer-Vinson syndromeo Plummer-Vinson syndrome, also known as Brown-Kelly-Paterson syndrome or sederopenic dysphagia, seen in middle aged edentulous women.o The plummer Vinsion Paterson Brown Kelly Syndrome is characterized by: -DysphagiaChronic iron deficiency anemiaAtrophic oral mucosa and glossitisBrittle, spoon-shaped fingernails (Koilonychia)o The cause of dysphagia is usually a cervical esophageal web, but abnormal pharyngeal and esophageal motility may play a role.o The syndrome eharactersticallv occurs in middle aged edentulous (without teeth) women,o It is a premalignant lesion. Approximately 10% of patient develop squamous cell Ca of esophagus, oral cavity or the hypopharynx.o As iron-deficiency anemia is a common finding, it is also known as sideropenic dysphagia.o Carcinoma develops in post-cricoid region (not in lower third esophagus).
| 1 |
Commonly leads to carcinoma in lower third of esophagus
|
Common with iron deficiency
|
Common in females
|
Premalignant
|
ENT
|
Oesophagus
|
a61a6f9f-2626-472a-be3b-3bc0bfad96c5
|
multi
|
In chronic diabetics the value of TG and VLDL are more because
|
Insulin Activates Lipoprotein lipase Inhibits Hormone sensitive lipase (HSL) In diabetic condition opposite will occur, i.e. Increased activity of hormone sensitive lipase and decreased lipoprotein lipase activity. Increased activity of hormone sensitive lipase Catabolic activity of Fatty acid in Blood
| 4 |
Increased in activity of hepatic lipase
|
Increase in peripheral function of LDL receptors
|
Increased activity of lipoprotein lipase and decreased activity of hormone sensitive lipase
|
Increased activity of hormone sensitive lipase and decreased lipoprotein lipase activity
|
Biochemistry
|
Lipoproteins
|
e31ca6c1-c52d-4e2d-8e54-a69355abfc19
|
single
|
Marcus Gunn jaw-winking phenomenon due to relation between which cranial nerves
|
(Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 505) *Marcus Gunn phenomenon (a.k.a Marcus Gunn jaw-Winking or Trigemino-oculomotor synkineses) *It is an autosomal-dominant condition with incomplete penetrance, in which nursing infants will have rhythmic upward jerking of their upper eyelid *This condition is characterized as a synkinesis: when two or more muscles that are independently innervated have either simultaneous or coordinated movements Marcus Gunn Jaw Winking Ptosis is a congenital ptosis associated with synkinetic movements of upper lid on masticating movements of the jaw. It is usually unilateral but rarely presents bilaterally. Affects males and females in equal propoion.
| 2 |
VII & VIII
|
III & V
|
V & VI
|
III & VI
|
Ophthalmology
|
Diseases of orbit, Lids and lacrimal apparatus
|
bb59f36b-bb8d-4ea8-bbb2-b107487496e6
|
single
|
In a patient of syncope the pupils are
| null | 4 |
Constricted
|
Constricted and non- reacting to light
|
Dilated-fixed and non-reacting to light
|
Dilated and fixed
|
Surgery
| null |
6ed7f105-71b2-44c1-a298-485afb6b5845
|
single
|
Nasopharyngeal carcinoma presents as -a) Epistaxisb) Mass in neckc) Headached) Vertigo
| null | 4 |
ac
|
a
|
ad
|
ab
|
ENT
| null |
b8e48688-5b8e-4933-8937-01399f3fa37c
|
single
|
Not a pa of Kangaroo Mother Care
|
Ref:Park's Text book of Preventive and Social Medicine 25th ed
| 4 |
Skin to skin contact
|
Exclusive breast feeding
|
Early discharge
|
Nutritional supplements
|
Social & Preventive Medicine
|
obstetrics,pediatrics and geriatrics
|
4575082f-0020-40f0-bd59-6492ae1048bb
|
single
|
Fungus causing hair skin and nail infection is?
|
Ans. (a) T. rubrumRef : Ananthnarayan 8/e, p 604, jawetz 24/e, ch 45 Table 45-2, Rook's 7/e, p 36.33
| 1 |
T. rubrum
|
E. floculossum
|
M. Canis
|
M. Ayouni
|
Skin
|
Dermatophytosis
|
7e48bc9e-dfc8-46bd-b3ad-7ac999ea4435
|
single
|
Exhibitionism is -
|
Exposure of one's genital organs to strangers or others is called exhibitionism.
| 1 |
Shameless exposure of genitals
|
Exhibiting one's possessions
|
A type of mania
|
Not a sexual persuasion
|
Psychiatry
| null |
8405519d-7015-4ee9-b432-6e9c312156e8
|
single
|
Rokitansky Protuberance is associated with -
|
Ans. is 'c' i.e., Dermoid cyst Rokitansky protuberanceo The inner lining of every mature cystic teratoma (dermoid cyst) contains single or multiple white shiny masses projecting from the wall toward the center of the cysts. When hair, other dermal appendages, bone and teeth are present, they usually arise from this protuberance. This protuberance is referred to as the Rokitansky protuberanceo The Rokitansky protuberance is a common site of malignant transformation.
| 3 |
Seminoma
|
Leomyoma
|
Dermoid cyst
|
Choriocarcinoma
|
Pathology
|
Characteristics and Epidemiology of Neoplasia
|
41ace6f5-aa0e-4b77-b112-8d71b7056e21
|
single
|
A 12 week anomaly scan of 29 year old lady,revealed foetal malformation. On fuher investigation it was found she had taken some vitamin supplements. Which of the following is most likely to be responsible for the foetal defects?
|
Retinoic acid is a known human teratogen. There is extreme susceptibility for teratogenicity in 3rd to 9th week. Retinoic acid causes changes in HOX gene expression. Note: Valproate also cause disruption of HOX gene expression. Ref: Robbins Basic Pathology, Edition 8, Page 256
| 1 |
Vit A
|
Vit B
|
Vit E
|
Vit C
|
Pathology
| null |
383a70ee-c802-49e5-916e-72d7a5b10dd5
|
single
|
30 year old female with partial seizure. Drug of choice:
|
Ans. (d) CarbamazepineRef. Harrison's 19th ed. / 2552* Given the choices the answer will be Carbamazepine* According to Harrisons 19th ed. the current recommendable drug for GTCS is LAMOTRIGINE > Carbamazepine
| 4 |
Phenytoin
|
Na+ valproate
|
Phenobarbitone
|
Carbamazepine
|
Pharmacology
|
Epilepsy
|
07ef5b20-2b5f-46b6-acc1-0adfdeeefe9f
|
single
|
Relaxation of which of these joints in pregnancy can cause waddling gait?
|
The joint between the two pubic bones is the pubic symphysis. It is not a stable joint. They have limited motion but do become more mobile and even separate a bit during pregnancy. The relaxation is attributed to the hormone relaxin. This is a pa of maternal adaptation for accomodation of the fetus in the pelvis during childbih There may also be separation of symphysis pubis or one of the sacroiliac synchondrosis during labour, that may lead to pain and marked difficulty in locomotion. The pain usually subsides after few days of delivery, However if it remains symptomatic, may be treated with bed rest, analgesics and pelvic binder.
| 2 |
Knee joint
|
Symphysis
|
Sacrococcygeal joint
|
Interveebral joint
|
Gynaecology & Obstetrics
|
Maternal Anatomy and Physiology
|
050ae533-8e30-4d7d-b660-cadc348e40ef
|
single
|
Pearl Index of SAHEIL
| null | 1 |
2/HWY
|
14/HWY
|
0.1/HWY
|
9/HWY
|
Social & Preventive Medicine
| null |
369ba010-d93d-4446-8f30-579f3c733b28
|
single
|
Karyotyping under light microscopy is
|
B i.e. G banding [Ref: Nagesh Rao: Human genetics
| 2 |
L Banding
|
G banding
|
C Banding
|
FUdR banding
|
Biochemistry
| null |
36e46b65-0fca-4531-b76e-57f07d869115
|
single
|
If patient is on follow up with you, after a enucleating of an painful blind eye. After you enucleating the eyeball, a proper sized aificial prosthetic why is advanced after an post operative treatment
|
After enucleation, we put orbital implants. We wait for the inflammation to subside 1.e around 10 days. If hudroxyappatite implant is to be put, it can even be done on same sitting Refer khurana 6/e p 420
| 1 |
About 10 days
|
About 20 days
|
6-8 week
|
12 -24 weeks
|
Ophthalmology
|
Diseases of orbit, Lids and lacrimal apparatus
|
7ce09486-c18f-4ba7-a318-22d3307df61d
|
multi
|
If 90% of jejunum and ilium is removed then all of the following features will be seen except -
|
Ans. is 'c' i.e., Weight gain Short bowel syndromeo Is the malabsorptive condition that arises secondary to removal of significant segments of the small intestineo The MC causes are Mesentric infarction, Crohns ds, Trauma * Changes seen in Terminal ileal resection# Resection of terminal ileum results in malabsorption of bile salts* and Vit. B12* which are normally absorbed in this region# Vit B12 Malabsorption : Megaloblastic anemia*# Bile salts malabsorption : Unabsorbed bile salts escape into colon where they stimulate fluid secretion from the colon, resulting in watery diarrhoea*.o Reduction in bile salt pool lead to steatorrhea* and malabsorption of fat soluble vitamins (due to malabsorption of fat).# Unabsorbed fatty acids bind with calcium, and thus lead to increased concentration of free oxalates (oxalates bind with calcium normally and therefore escape without intestinal absorption) Free oxalates are absorbed. Increased cone, of body oxalates lead to oxalate kidney stones*# Due to decreased bile salts in the bile : Cholesterol gall* stones result.o If the ileocecal valve is removed -# bacterial overgrowth from the colon: diarrhoea & malabsorption# decrease in intestinal transit timeo Resection of other segments# Duodenal resection may result in folate, Iron, or calcium malabsorption.# Large resection of intestine may result in gastric hypersecretion* d/t reduced hormonal inhibition of acid secretion# Increase gastric acido A massive resection may result in nutrients, water and electrolyte malabsorptiono Weight loss occurs because of malabsorption & diarrhoea
| 3 |
Steatorrhoea
|
Diarrhoea
|
Weight gain
|
Megaloblastic anemia
|
Surgery
|
Miscellaneous (Small & Large Intestine)
|
ef6930eb-9134-4709-866e-9a9b1bbc4e32
|
multi
|
All are true about Thoracolumbar fascia except -
|
Thoracolumbar fascia
- Lumbar part extends between the 12th rib and iliac crest.
- It has 3 layers
Anterior layer
Attachment - Anterior surface of the transverse process of lumbar vertebrae
Position - anterior to quadratus lumborum
Middle layer
Attachment - the Transverse process of lumbar vertebrae
Position - Posterior to quadratus lumborum but anterior to erector spinae.
Posterior layer
Attachment - the Spinous process of lumbar vertebrae
Position - Posterior surface of erector spinae.
- At the lateral margin of erector spinae, posterior and middle layers unite. Further, anterior layer joins at the later margin of quadratus lumborum. Together they form the aponeurotic origin of transversus abdominis. It also acts as the origin for internal oblique muscle.
| 3 |
Attached to spinous process of lumbar vertebra
|
Attached to transverse process of lumbar vertebra
|
The fascia lies posterior to posterior abdominal wall muscles.
|
Gives attachment to Transversus abdominis and internal oblique muscles
|
Anatomy
| null |
e3f9ddae-aadb-4426-a9b8-71dd0bc6347f
|
multi
|
Dennie–Morgan fold is seen in –
|
Denny Morgan fold is extra fold of skin beneath lower eye lid which is seen in atopic dermatitis.
| 4 |
Dermatomyositis
|
SLE
|
Psoriasis vulgaris
|
Atopic dermatitis
|
Dental
| null |
9aad3417-04c4-439f-b08b-3ffe5eac436b
|
single
|
A double aoic arch is due to persistency of the following segment:
|
Double aoic arch is the result of persistence and continued patency of the segment of the right dorsal aoa between the origin of the right seventh intersegmental aery and its junction with the left dorsal aoa. Affected infants have a characteristic inspiratory and expiratory wheeze, stridor, or crouplike cough. Echocardiography, CT, and MRI can demonstrate the anomalous anatomy. Ref: Keller B.B., Markwald R.R., Hoying J.B. (2011). Chapter 9. Molecular Development of the Hea. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e.
| 1 |
Right dorsal aoa
|
Left dorsal aoa
|
Right primitive atrium
|
Left primitive atrium
|
Anatomy
| null |
a4984b38-2122-42ea-bbb9-8d2c4fb27f39
|
single
|
Testicular tumor associated with high HCG level is?
|
Ans. is 'a i.e., Choriocarcinoma Testicular tumorTumor markersSeminoma* Placental alkaline phosphatase, keratin* Classical seminomas are negative for HCG, but 7-15% may be positive for HCGEmbryonal carcinoma* HCG, AFPYolk sac tumor* AFP, a-1 antitrypsinChoriocarcinoma* HCG
| 1 |
Choriocarcinoma
|
Seminoma
|
Endodermal sinus tumour
|
All of the above
|
Pathology
|
Male Genital Tract
|
65c6eacf-56d5-46fc-aad2-fa34d80614df
|
multi
|
A client is undergoing peritoneal dialysis. The dialysate dwell time is completed, and the dwell clamp is opened to allow the dialysate to drain. The nurse notes that the drainage has stopped and only 500 ml has drained; the amount the dialysate instilled was 1,500 ml. Which of the following interventions would be done first?
|
The first intervention should be to check for kinks and obstructions because that could be preventing drainage. After checking for kinks, have the client change position to promote drainage. Don’t give the next scheduled exchange until the dialysate is drained because abdominal distention will occur, unless the output is within parameters set by the physician. If unable to get more output despite checking for kinks and changing the client’s position, the nurse should then call the physician to determine the proper intervention.
| 3 |
Change the client’s position.
|
Call the physician
|
Check the catheter for kinks or obstruction.
|
Clamp the catheter and instill more dialysate at the next exchange time
|
Pathology
| null |
cf9e7460-3d38-48c8-b5b8-4421540bf144
|
multi
|
Nerve to pterygoid canal is formed from
|
In the anterior pa of the foramen lacerum, the greater petrosal nerve unites with the deep petrosal nerve to form the nerve of the pterygoid canal which leaves the foramen by entering the pterygoid canal in the anterior wall of the foramen lacerum. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.
| 1 |
Deep petrosal nerve + greater petrosal nerve
|
Facial nerve
|
Lesser superficial petrosal nerve
|
Lesser petrosal nerve
|
Anatomy
|
Head and neck
|
82068b66-3c13-4b3c-a225-71ac4ac0b3d2
|
single
|
The primary direct stimulus for excitation of central chemoreceptors regulating ventilation is:
|
. Ans. a. Increased H+ The primary direct stimulus for central chemoreceptors is increased H+ concentration in the CSF and brain interstitial fluid."The primary direct stimulus for central chemoreceptors is increased H+ concentration in the CSF and brain interstitial fluid. But the cone: in the brain parallels the arterial PCO2 and not arterial H+ cone. "Even though the central chemoreceptors are directly stimulated by H+ ions: the blood H+ ions are poorly permeable through the blood brain barrier and hence are not able to regulate ventilation though the central chemoreceptors. Whereas, CO2 is highly permeable to the blood brain barrier. It enters the brain, where it is hydrated to give rise to H+ and HCO2 ions. Now these H+ ions directly stimulate the central chemoreceptors to regulate the ventilation. So the central chemoreceptors respond to changes in H+ ions in the cerebrospinal fluid and brain interstitial fluid. which are brought about by change in arterial PaCO2."Chemoreceptors Regulating Ventilation* There are 2 types of chemoreceptors regulating ventilation: central chemoreceptors (located in brain stem, mainly medulla) and the peripheral chemoreceptors (aortic and carotid bodies).* They regulate ventilation by responding to increased arterial H+ cone., increased PaCO2 and decreased PaO2.Chemoreceptors Regulating VentilationCentral ChemoreceptorsPeripheral Chemoreceptors* Located in brain stem, mainly medulla* Responds to arterial PC CL* Aortic and carotid bodies* Responds to arterial PCO2 arterial PO2 and arterial H+ cone.* Peripheral chemoreceptors are stimulated by hypoxia, hypercapnia, and academia to cause hyperventilation, whereas central chemoreceptors are stimulated only by hypercapnia.
| 1 |
Increased H+
|
Increased CO2
|
Increased O2
|
Decreased CO2
|
Physiology
|
Regulation of Respiration
|
aef3c16c-d3ec-475d-9786-38786a9f8489
|
single
|
Which of the following contribute in polypeptide synthesis:
|
Enhancer is the cis-acting DNA sequence that increases the rate of inhibition of transcription of eukaryotic genes by RNA polymerase. Leader sequence: The untranslated segment of mRNA before the sta codon. Ref: Harper, 28th Edition, Page 343
| 2 |
Leader sequence
|
Enhancer
|
tRNA
|
ncRNA
|
Biochemistry
| null |
7b27473b-3778-4282-9165-989eb5e97d0f
|
single
|
Leisch nodules are seen in
|
(C) Neurofibromatosis type I # NEUROFIBROMATOSIS TYPES# TYPE 1 (NF-1) Peripheral neurofibromatosis Von Recklinghausen's disease Incidence 1 in 3 000 Gene on long arm of chromosome 17> Diagnostic criteria: Devised by National Institute of Health in 1987 Require 2 or more of the following> Cafe au lait spots 6 or more >5mm (prepubertal) >15mm (postpubertal)> Freckling Axillary or inguinal> Neurofibromas Two or more neurofibromas of any sort OR One plexiform neurofibroma> Optic glioma> Leisch nodules Two or more> Distinctive osseous lesion Sphenoid dysplasia Thinning of long bone cortex with pseudarthrosis> First degree relative with neurofibromatosis Parent, sibling or offspring# NEUROFIBROMATOSIS 2 Central neurofibromatosis Incidence 1 in 50 000 Gene on long arm of chromosome 22> Features Two types> Multiple CNS involvement Neuraxial neoplasia Meningoneuroplasia Cranial schwannoma> Bilateral acoustic neuromas Isolated Dermal lesions unusual
| 3 |
SLE
|
Rheumatoid arthritis
|
Neurofibromatosis type I
|
Ankylosing spondylitis
|
Medicine
|
Miscellaneous
|
417b1d7d-8e6a-460f-8bdb-b5382e3ab6d7
|
single
|
Which of the following best describes the mechanism of action of Colchicine in Acute Gout?
|
Colchicine produces its anti-inflammatory effects by binding to the intracellular protein tubulin, thereby preventing its polymerization into microtubules and leading to the inhibition of leukocyte migration. Colchicine-treated neutrophils develop a &;drunken walk&;. Colchicine is neither a uricosuric nor an analgesic agent, although it relieves pain in acute attacks of gout. Colchicine does not alter the metabolism or excretion of urates. Colchicine: It is an alkaloid from Colchicicum autumnalev which was used in gout since 1763. Beacause it has a narrow therapeutic window and a high rate of side effects, paicularly at higher doses it is considered as second-line therapy. Colchicine is neither analgesic nor anti-inflammatory, but it specifically suppresses gouty inflammation. Colchicine produces its anti-inflammatory effects by binding to the intracellular protein tubulin, thereby preventing its polymerization into microtubules and leading to the inhibition of leukocyte migration and phagocytosis. Colchicine-treated neutrophils develop a &;drunken walk&; It also inhibits the formation of leukotrienes B4 and IL-1b. It relieves the pain and inflammation of gouty ahritis in 12-24 hours without altering the metabolism or excretion of urates and without other analgesic effects. It is indicated for acute gout and is also used between attacks ("Inter-critical Period") for prolonged prophylaxis (at low doses) It often causes diarrhea and occasionally causes nausea, vomiting and abdominal pain. Hepatic necrosis, acute renal failure, disseminated intravascular coagulation, and seizures have also been observed. Ref: Katzung 14th edition Pgno: 660
| 2 |
Inhibition of chemotactic Factors
|
Tubulin binding and inhibition of leukocyte migration
|
Enhanced metabolism of Urate crystals
|
Enhanced excretion of Uric acid
|
Pharmacology
|
Other topics and Adverse effects
|
47068619-042b-480d-8c80-797026ce18fe
|
single
|
A S2, S3, S4 lesion bilaterally can cause which of the followingmanifestations?
|
Note the distribution of S2-S4 nerve. The S2, S3, S4 innervation, if damaged at the level of the spinal cord, is most likely to produce incontinence of bladder or bowel. Pain of the vaginal delivery arises from stimuli from the lower genital tract. These are transmitted primarily through the pudendal nerve, the peripheral branches of which provide sensory innervation to the perineum, anus, vulva, and clitoris. The pudendal nerve passes beneath the sacrospinous ligament just as the ligament attaches to the ischial spine. Sensory nerve fibers of the pudendal nerve are derived from ventral branches of the S2 through S4 nerves.... So labour will be painful but the vaginal stretching and the episiotomy may not be. Movement of the leg is mediated by L2-L4.
| 4 |
Painless menses
|
Painless Labour
|
Inability to abduct her thigh
|
Rectal incontinence
|
Gynaecology & Obstetrics
|
Labour - II
|
7faee676-e4f6-4ab5-bb44-8bba9d13334d
|
multi
|
Which of the following groups of proteins assist in the folding of other proteins ?
|
Ans-D
| 4 |
Proteases
|
Proteosomes
|
Templates
|
Chaperones
|
Unknown
| null |
adc41c6d-688b-4fb8-8607-4f2ff3b87814
|
single
|
A 60-kg, 53-year-old man with no significant medical problems undergoes lysis of adhesions for a small-bowel obstruction. Postoperatively, he has high nasogastric output and low urine output. What is the most appropriate management of his fluids?
|
This postoperative patient requires replacement of nasogastric tube losses in addition to maintenance fluids. In an otherwise healthy individual, maintenance fluids are calculated based on body weight as 4 mL/kg/h for the first 10 kg, 2 mL/kg/h for the second 10 kg, and 1 mL/kg/h for every additional kg body weight. A 60-kg man requires 100 mL of fluid per hour or 2400 mL of fluid per day. Five percent dextrose in 0.45% normal saline with or without potassium chloride (depending on renal function) would be an appropriate maintenance fluid. Both lactated Ringer and normal saline, which are isotonic, can be used to replace gastrointestinal losses.
| 4 |
Infusion of D5 0.45% normal saline at 100 mL/h
|
Infusion of D5 0.9% normal saline at 100 mL/h
|
Infusion of D5 lactated Ringer at 100 mL/h
|
Replacement of nasogastric tube losses with lactated Ringer in addition to maintenance fluids
|
Anaesthesia
|
Preoperative assessment and monitoring in anaesthesia
|
53b32500-2c72-49ce-b602-82d2d18ff5b7
|
multi
|
Which of the following statements regarding drugs used in leprosy is FALSE?
|
Acedapsone is a repository form of dapsone. Single i.m. injection of acedapsone keep on releasing the drug for 3 months. Rifampicin is used once in a month (supervised dose) for the treatment of leprosy. It prevents the emergence of resistance to dapsone. Clofazimine can result in skin pigmentation(reddish-black), discolouration of secretions and dryness of skin (icthyosis). Clofazimine has no cross-allergenicity with dapsone.
| 3 |
Single intramuscular injections of acedapsone maintain inhibitory levels of dapsone in tissues for upto 3 months
|
Monthly doses of rifampicin delay the emergence of resistance to dapsone
|
Clofazimine should not be given to patients who are intolerant to dapsone or who fail to improve during treatment with dapsone
|
Clofazimine may cause changes in the skin colour
|
Pharmacology
|
Mycobacterial Diseases (TB, Leprosy and MAC)
|
98a560ab-754c-4afe-b614-d9cd2541257f
|
multi
|
Gelles test is done in?
|
(a) OtosclerosisRef: Dhingra Text book of ENT, 6th ed., ch-4* Gelle's test It is a test of bone conduction and examines the effect of increased air pressure i n ear canal on the hearing.* Normally, when air pressure is increased in the ear canal by Siegle's speculum, it pushes the tympanic membrane and ossicles inwards, raising the intralabyrinthine pressure and causing immobility of basilar membrane and decreased hearing, but no change in hearing is observed when ossicular chain is fixed or disconnected.* Gelle's test is performed by placing a vibrating fork on the mastoid while changes in air pressure in the ear canal are brought about by Siegle's speculum.* Gelle's test is positive in normal persons and in those with sensorineural hearing loss.* It is negative when ossicular chain is fixed or disconnected.*It was a popular test to find out stapes fixation in otosclerosis but has now been super-ceded by tympanometry.
| 1 |
Otosclerosis
|
Serous otitis media
|
Traumatic hearing loss
|
Age related hearing loss
|
ENT
|
Ear
|
1c6ae11c-cf3c-4f1e-830f-bf8a228f565e
|
single
|
Antitubercular drug causing gout is: March 2005
|
Ans. B: Ethambutol Drugs causing gout/hyperuricemia include Diuretics Low-dose salicylate Cyclosporine Pyrazinamide Ethambutol Levodopa 1 Nicotinic acid Methoxvflurane
| 2 |
Streptomycin
|
Ethambutol
|
Rifampicin
|
None
|
Pharmacology
| null |
2d312243-945a-43f7-bd97-d16aa2f7b35b
|
multi
|
All of the following functions are associated with myelination except
|
The main purpose of a myelin layer (or sheath) is to increase the speed at which impulses propagate along the myelinated fiber. Along unmyelinated fibers, impulses move continuously as waves, but, in myelinated fibers, they "hop" or propagate by saltatory conduction. Myelin decreases capacitance and increases electrical resistance across the cell membrane (the axolemma). Thus, myelination helps prevent the electric current from leaving the axon. It has been suggested that myelin permits larger body size by maintaining agile communication between distant body pas.Myelinated fibers lack voltage-gated ion channels (approximately 25 mm-2) along the myelinated internodes, exposing them only at the nodes of Ranvier. Here, they are found far more abundantly (between 2,000 and 12,000 mm-2). Myelinated fibers succeed in reducing sodium leakage into the extracellular fluid (ECF), maintaining a strong separation of charge between the intracellular fluid (ICF) and the ECF. This increases sodium's ability to travel along the axon more freely. However, the sodium diffuses along the axolemma rapidly but is decremental by nature. The sodium cannot trigger the opening of the voltage-gated sodium channels as it becomes weaker. The nodes of Ranvier, being exposed to the ECF every 1 mm or so, contain large amounts of voltage-gated sodium channels and allow enough sodium into the axon to regenerate the action potential. Each time the action potential reaches a node of Ranvier, it is restored to its original action potential (+35 mV).When a peripheral fiber is severed, the myelin sheath provides a track along which regrowth can occur. However, the myelin layer does not ensure a perfect regeneration of the nerve fiber. Some regenerated nerve fibers do not find the correct muscle fibers, and some damaged motor neurons of the peripheral nervous system die without regrowth. Damage to the myelin sheath and nerve fiber is often associated with increased functional insufficiency.Unmyelinated fibers and myelinated axons of the mammalian central nervous system do not regenerate.Some studies have revealed that optic nerve fibers can be regenerated in postnatal rats. This regeneration depends upon two conditions: axonal die-back has to be prevented with appropriate neurotrophic factors, and neurite growth inhibitory components have to be inactivated. These studies may lead to fuher understanding of nerve fiber regeneration in the central nervous system.Ref: Ganong&;s review of medical physiology, 23rd edition, Page no:82
| 4 |
Decreases energy expenditure
|
Increases speed of conduction
|
Provide protective covering for the axon
|
Decreases the release of neurotransmitter from the nerve endings
|
Physiology
|
Nervous system
|
873b38c6-3583-4dba-855b-adbee5ec6552
|
multi
|
Investigation of choice to exclude intra-abdominal bleeding in hemodynamically unstable patient is -
|
Ans. is 'b' i.e., FAST Investigations to rule out abdominal injury in trauma patient* Investigations are driven by the cardiovascular status of the patient.* Blood loss into the abdomen can be subtle and there may be no clinical signs (blood is not an irritant and may not initially cause any abdominal pain). If stable, the best and most sensitive modality is a CT scan with intravenous contrast; however, in the unstable patient, this is generally not possible.A) Hemodynamically stable patient - CT with contrastB) Hemodynamically unstable -# Provision for FAST available and reliable operator - FAST# Provision for FAST unavailable and/ or unreliable operator - Diagnostic peritoneal lavage
| 2 |
Diagnostic peritoneal lavage
|
FAST
|
CT Scan
|
X Ray
|
Surgery
|
Trauma
|
ea059e62-01d7-4a3c-b30a-4b5213ceb496
|
multi
|
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