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What is indicated by the arrow in the contrast X-ray abdomen?
|
A large, benign-appearing gastric ulcer protrudes medially from the lesser curvature of the stomach.Features suggesting benign gastric ulceroutpouching of ulcer crater beyond the gastric contoursmooth rounded and deep ulcer cratersmooth ulcer mound malignant gastric ulcerdoes not protrude beyond the gastric contour irregular and shallow ulcer crater
| 1 |
Gastric ulcer
|
GIST
|
Carcinoma stomach
|
Gastric polyp
|
Surgery
|
G.I.T
|
a8694082-1388-45fe-a7c6-c554da1b11f1
|
single
|
Capgras syndrome is -
|
Ans. is 'b' i.e., Delusion of double o Capgras syndrome is delusion of double.The delusional misidentification syndrome LDSM)o DSM is characterized by misidentification delusions of other or self. Four main syndromes are differentiated : -Capgras syndrome (Delusion of double) Patient falsely sees a familiar person as a complete stranger who is imposting on him as a familiar person.Fregoli syndrome (illusion de fregoli) : - The patient falsely identifies stranger as familiar person.Syndrome of subjective double : - The patients own self is perceived as being replaced by a double.Syndrome of intermetamorphosis : - A false belief that a person can transform into another person.o These syndrome most commonly appear in schizophrenia. Other causes axe Alzheimer syndrome, head injuries, and delusional disorders,
| 2 |
Sharing of delusion
|
Delusion of double
|
Erotomania
|
Hypochondriacal delusions
|
Psychiatry
|
Symptoms & Signs
|
c85be7db-00a2-4050-8701-d75f9946e988
|
single
|
The lingual bar connector should be located at least how many millimeters below the gingival margin?
| null | 2 |
2
|
4
|
6
|
8
|
Dental
| null |
45b72887-8cc2-47a8-ab30-0eb36fad4d90
|
single
|
Present "General feility rates" ?
|
Ans. is 'a' i.e., 84
| 1 |
84
|
118
|
128
|
138
|
Social & Preventive Medicine
| null |
1238de64-18b9-4fd1-8376-bcc1f62826bb
|
single
|
A common cause of Primary hyperparathyroidism is
| null | 2 |
Multiple parathyroid adenomas
|
Solitary parathyroid adenoma
|
Adrenal hyperplasia
|
Ectopic PTH production
|
Medicine
| null |
42c9fdcb-94aa-4074-ab3b-83dfe1589e68
|
single
|
Vit k helps in gamma-carboxylation of following AA
|
Vitamin k plays a role in gama carboxylation of glutamate containing proteins It is a posttransilational modification Ref:Guyton and Hall textbook of medical physiology 12th edition,page number: 20,21,22
| 1 |
Glutamate
|
Aspaate
|
Glycine
|
Alanine
|
Physiology
|
General physiology
|
d629b9dd-5d44-4a3f-8eb3-03fa03383201
|
single
|
Infantile polycythemia is seen in –
|
In pediatrics, polycythemia is usually secondary to chronic hypoxia.
Secondary causes of pediatric polycythemia
Cyanotic congenital heart disease o Brain tumor (Cerebellar hematzgioma)
Chronic pulmonary disease --> Cystic fibrosis o Cushing disease
High altitude o Hydronephrosis
Renal tumor
Causes of neonatal polycythemia
Twin-twin transfusion o Trisomy 93,18 or 21
Maternal-fetal transfustion o Adrenogenital syndrome
Chronic intrauterine hypoxia o Neonatal Graves disease
Delayed clamping of umblical cord o Hypothyroidism
Infant of diabetic mother o Beckwith-wiedemann syndrome
Infant of a hypertensive mother or these on propranolol
| 1 |
Cerebellar haemangioma
|
Retinoblastoma
|
Hepatoblastoma
|
All
|
Pediatrics
| null |
9512507e-717f-4509-aab8-db9288f39bb1
|
multi
|
Not a feature of CBD stone:
|
Ans. (d) Septic shock* Septic Shock happens only when Charcot's triad of Cholangitis is not properly managed* Charcot's triad + Septic Shock + Altered mental Status = Reynauld's Pentad
| 4 |
Pain
|
Fever
|
Jaundice
|
Septic shock
|
Surgery
|
Gall Bladder & Bile Ducts
|
a38a457c-ccf3-41f8-8f91-453da431cbf2
|
single
|
True about intracellular receptor
|
Interacellular receptors are mainly present on nuclear surface They are eeceptors for peptide hormones Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:540,541,542
| 1 |
Mainly on nuclear surface
|
Estrogen does not act on it
|
GH acts on it
|
Vitamin E act on these
|
Physiology
|
General physiology
|
17069d9d-fe16-46e5-aafa-f006a941cc8c
|
multi
|
Which of the following is supplied by the abdominal aorta?
|
Normally the lung tissue is not supplied by aorta. But, when an abnormal lung tissue persists from the embryonic life, this tissue is known as a sequestrated lung tissue. It may be covered by its own pleura when existing outside the lung, or may lie within the lung. The blood supply to this tissue is by an abnormal branch from aorta.
| 3 |
Accessory lung lobes
|
Bronchopulmonary segment
|
Sequestrated lung tissue
|
Base of lung
|
Anatomy
| null |
d455534c-591e-4dea-ae47-5273ccefdc3a
|
single
|
Pulse steroid therapy can be given in -
|
Ans. is 'd' i.e., All the above Pulse Steroid therapy* Pulse therapy means the administration of suprapharmacologic doses of drugs in an intermittent manner to enhance the therapeutic effect and reduce the side effects.* In context of corticosteroids, pulse therapy refers to discontinuous i.v. infusion of high doses of the medication, arbitrarily defined as treatment with more than 250 mg prednisone or its equivalent per day, for one or more days.* There are no guidelines on the frequency or timing of administration of the i.v. pulses; which therefore includes single boluses, daily boluses given for 3 days in a row, or on alternate days for up to 12 days.* The agent most commonly used for corticosteroid pulse therapy is methylprednisolone.Indications for high dose intravenous steroid therapySystemCommonly indicated inInfrequently used inMusculoskeletal diseasesRheumatoid arthritisJuvenile rheumatoid arthritisPsoriatic arthritisAnkylosing spondylitisCollagen vascular diseasesSystemic lupus erythematosusSystemic dermatomyomyositisSevere forms of vasculitisSystemic sclerosisKawasaki diseaseHenoch schonlein purpuraRenal diseasesSteroid resistant nephrotic syndromeCrescentic glomerulonephritisVasculitis with active nephritisAcute allograft rejectionSteroid sensitive nephrotic syndromeLupus nephritisDermatologic diseasesPemphigus vulgarisBullous dermatitis herpetiformisSevere psoriasisAlopecia totalisSevere Stevens-Johnson syndromePyoderma gangrenosumVitiligo with rapidly progressive diseaseExfoliative dermatitisOphthalmic diseasesOptic neuritisUveitis in multiple sclerosisCorneal allograft rejectionTraumatic optic neuropathyVogt - koyanagi-Harada diseasePosterior segment uveitis in behcet's diseaseHematologic disordersAcquired (autoimmune) hemolytic anemiaIdiopathic thrombocytopenic purpuraAutoimmune hemolytic anemiaAcquired aplastic anemiaNeurological diseasesAcute disseminated encephalomyelitisAcute exacerbations of multiple sclerosisMyasthenia gravis
| 4 |
Pemphigus vulgaris
|
Acute renal allograft rejection
|
Optic neuritis
|
All the above
|
Pharmacology
|
Miscellaneous (Pharmacology)
|
dc677ee1-37f5-40a6-b3b2-76a952a9d4d6
|
multi
|
Which of the following is true about xeroderma pigmentosa?
|
Ans. is 'd' i.e., DNA repair defect Xeroderma pigmentosaA. Molecular defect: - Exposure to UV rays damages DNA due to production of convalent linkages between adjacent pyrimidines (pyrimidine dimmers). Normally the damaged DNA is repaired by excision and repair. In xeroderma pigmentosa the repair of UV damaged DNA is defective. It is an autosomal recessive disorder.B. Clinical features: - Photosensitivity, multiple freckles, hypopigmented macules, xeroderma. There is increased risk of skin malignancy (Basal cell carcinoma, Squamous cell carcinoma, malignant melanoma). Most patients die before the age of 20 years (Premature death).
| 4 |
Autosomal dominant
|
Good long term prognosis
|
Purine dimmers
|
DNA repair defect
|
Skin
|
Miscellaneous
|
dd1f2fff-3db8-4de4-b648-06ed851c7820
|
multi
|
About papillary carcinoma what is true
|
Papillary thyroid cancer is most common thyroid cancer and has the best prognosis. Not commonly encapsulated. Spreads commonly by lymphatic route. Irradiation is the impoant risk factor . Iodine deficieny is a impoant risk factor for follicular cancer. Source : Sabiston 20th edition Pg : 902
| 3 |
Often encapsulated
|
Prognosis bad
|
Lymph node metastases is common
|
Iodine deficiency is a impoant risk factor
|
Surgery
|
Endocrinology and breast
|
f50f1167-5879-45a4-a9cb-dfef4229c659
|
multi
|
When ohotoludine reagent is added to water and if free chuirine is present, what colour will be produced?
|
Ans. is 'b' i.e., Yellow
| 2 |
Pink
|
Yellow
|
Green
|
Red
|
Social & Preventive Medicine
| null |
c07dce71-e024-4048-9652-9fbc331d0828
|
single
|
TRUE/FALSE about pulmonary embolism: McConnell sign is seen in CT pulmonary angiography as a filling defect. Westermark sign is area of regional oligemia seen on x-ray. Polo mint sign is seen in echocardiography as regional motion abnormality. IOC in pregnant patient is V/Q scan. Chang sign is abrupt change in diameter of right descending pulmonary aery.
|
Pulmonary thromboembolism - Hampton hump sign- Peripheral wedge-shapedarea of infarction - Westermark sign - Pulmonary oligemia - Pallas sign - Prominence of descending right pulmonary aery - Fleischner sign- Prominence of main pulmonary aery - Chang sign - abrupt change in caliber of the descendingright pulmonary aery - IOC for Pulmonary thromboembolism - CT Angio (MDCT with contrast) - In iodine allergies and pregnancy IOC for pulmonary thromboembolism - V/Q Scan - Gold standard for PTE - Pulmonary Angiography POLO MINT SIGN - The polo mint sign is a description given to a venous thrombosis on contrast-enhanced CT imaging. When viewed in the axial plane, a thin rim of contrast persists around a central filling defect due to thrombus.
| 1 |
FTFTT
|
FTTFT
|
FTTTT
|
FFTFT
|
Radiology
|
Radiology Q Bank
|
876e8ee0-9852-449b-a3c0-5c63321ee412
|
multi
|
A serious adverse effect seen with zoledronate is?
|
Zoledronate Intravenous 3rd generation bisphosphonateseffective in the management of hypercalcemia Rapid normalization of S. Ca2+ S/E - Severe hypocalcemia Renal toxicity, Osteonecrosis of the jaw
| 4 |
Anterior uveitis
|
Ventricular fibrillation
|
Peptic ulcer
|
Acute renal failure
|
Pharmacology
|
Osteoporosis, Sex Hormones and OCPs
|
8112d770-523d-4866-bcb7-08324cdca5e9
|
single
|
Which of the following HPV type is most carcinogenic -
|
Ans. is 'c' i.e., 16 * High risk HPV: HPV-16, 18, 31, 33 & 45 - associated with cervical cancer.* Low risk HPV: HPV- 6 & 11 - associated with precursor lesions CIN* HPV-5 & 8 - associated with squamous cell cancer in patients with epidermodysplasia verruciformis.
| 3 |
6
|
11
|
16
|
3
|
Microbiology
|
Virology
|
84072ff9-f01e-4194-ad29-ee1b2922d4b7
|
single
|
Oral lesions of secondary syphilis includes all EXCEPT
| null | 3 |
Snail track ulcers
|
Mucous patches
|
Chancre of tongue
|
Hutchinson's wart
|
Pathology
| null |
1ad30097-42be-447d-8346-5f81acd51b37
|
multi
|
Best antihypeensive drug used in pulmonary hypeension is:
|
Ans: D. Bosentan(Ref Harrison 19/e p1659, 18/e p2079)Treatment of Pulmonary Aerial HypeensionEndothelin-Receptor AntagonistsBosentan & ambrisentan are approved for the treatments of Bosentan is contraindicated in patients who are on cyclosporine or glyburide concurrently.Phosphodiesterase-5 InhibitorsSildenafil and tadalafil are approved for the treatment of PAHMC side effect is headacheNeither drug should be given to patients who are taking nitro vasodilators.ProstacyclinsIloprost is approved inhalation for PAHdeg.Epoprostenol is approved as a chronic IV treatment of PAH.Treprostinil, an analogue of epoprostenol, is approved for PAH and may be given intravenously, subcutaneously, or inhalation.The intravenous prostacyclins have the greatest efficacy as treatments for PAH and are often effective in patients who have failed all other treatments.Lung TransplantationLung transplantation is considered for patients who, while on an intravenous prostacyclin, continue to manifest right hea failure.
| 4 |
Digoxin
|
Furosemide
|
Amlodipine
|
Bosentan
|
Pharmacology
| null |
34fe54b8-8be6-4af9-be37-35fc69f5b564
|
single
|
All are liver glycogenosis except?
|
Ans. is 'd' i.e., Pompes disease
| 4 |
Von Girke disease
|
Hers disease
|
Type IIi glycogenosis
|
Pompes disease
|
Pediatrics
| null |
76c132d1-2b23-4bbc-81f8-a8d3ce9176a6
|
multi
|
Evaluation of screening test is by -
| null | 4 |
Sensitivity
|
Specificity
|
Predictive value
|
All the above
|
Social & Preventive Medicine
| null |
112776a0-47f1-4ab7-b459-f70fd2b849ac
|
multi
|
"Rosette-shaped cataract" is seen in:
|
Ans. A. Trauma. (Ref Parsons' diseases of Eye 21th/pg. 383)WOUNDS OF THE LENS:If the trauma to lens is small, the entry of aqueous causes a localized cloudiness in its vicinity and, irrrespective of the site of the wound, opacities in the form of feathery lines appear in the posterior cortex, which later develop into a rosette- shaped cataract resembeling that of early concussion cataract. The Rx of traumatic cataract associated with penetrating wounds, especially if complicated with vitreous loss, is by the use of vitrectomy instrument. Adequate steps are important to control the infection and inflammation with antibiotics and topical steroids. Two special infections - Clostridium welchii and tetani should be noted.
| 1 |
Trauma
|
Diabetes Mellitus
|
Hypertension
|
Complicated cataract
|
Ophthalmology
|
Lens
|
6da9aa3b-78ee-416d-b874-1d8ee4d3bcdc
|
single
|
Which of the following is best associated with lumefantrine
|
Refer KDT 6/e p795 Like halofantrine, lumefantrine, is also used for the treatment of malaria
| 3 |
Antimycobacterial
|
Antifungal
|
Antimalarial
|
Antiamoebic
|
Pharmacology
|
Chemotherapy
|
43060827-dd95-4c5f-b09e-a6dfbbba493c
|
single
|
Regarding testicular tumour, the following are false except -
|
Seminomas are well known to be one of the most radiosensitive tumors
About other options
Option (a) : Commonest malignancy in older males is → Prostate cancer
Option (c) : Stage I Nonseminomas (including teratomas) are t/t by surgery alone and show a high cure rate (>95%)
Option (d) : Chemotherapy shows a good response in advance stage testicular tumors.
| 2 |
They are commonest malignancy in older man
|
Seminomas are radiosensitive
|
Only 25% of Stage 1 teratomas are cured by surgery alone.
|
Chemotherapy rarely produces a cure in those with metastatic disease
|
Surgery
| null |
e45af944-0b8d-443c-8246-7c007f7a01cf
|
multi
|
Skeletal Muscle relaxant of choice in Liver and Hepatic Failure is:
|
Atracurium
| 3 |
Gallamine
|
Thiopentone
|
Atracurium
|
Lignocaine
|
Anaesthesia
| null |
360a6ef6-dc96-4890-946b-a65d23c5660a
|
multi
|
A 56 year old Type II diabetic presents with complaints of swelling in the left ankle with effusion but only minimal pain. X-rays show severe osteopenia with bone destruction, extensive osteophytosis and loose bodies. The management of this patient includes all the following except:
|
Swelling in the ankle with effusion, minimal pain together with the given x-ray findings suggests the diagnosis of neuropathic joint disease or charcot's joint. Total ankle replacement is an absolute contraindication in the management of charcot's joint. Ref: Total Ankle Ahroplasty By Hintermann, 2005, Page 92; Apley's System of Ohopaedics and Fractures By Louis Solomon, 9th Edition, Chapter 5, Pages 98, 99
| 3 |
Resting and Splinting
|
Aspiration and Compression bandage
|
Total Ankle Replacement
|
Ankle ahrodesis
|
Surgery
| null |
75a93852-8268-45f4-aab5-ea31beace58b
|
multi
|
"Blow out" fracture of orbit involve -
|
These generally result from blunt trauma to the orbit by a large object such as a cricket ball, tennis ball, human fist. The force of the blow causes a backward displacement of the eyeball and an increase in the intraorbital pressure; with a resultant fracture at the weakest point of the orbital wall. Usually this point is the orbital floor , but this may be the medial wall also. Ref: Parson's 22 nd edition , page no. 499
| 1 |
Floor
|
Medial wall
|
Lateral wall
|
Roof
|
Ophthalmology
|
Ocular trauma
|
053fb9e9-274b-4b71-9299-f2335317243d
|
multi
|
Kamino bodies are seen in
|
Kamino bodies are the eosinophilic globules seen in Spitz nevus( it is benign melanocytic nevus, a type of skin lesion, affecting the epidermis and dermis)
| 4 |
Lichen planus
|
Hailey-Hailey disease
|
Lichenoid tissue reaction
|
Spitz nevus
|
Dental
|
Hyper Pigmented Disorders
|
74b0a4e1-460e-4f81-88cc-adac83549d8e
|
single
|
Calcification in necrotic tissue is called -
|
Amyloidosis is the extracellular deposition of insoluble protein fibrils.
AL- Primary systemic amyloidosis
AA- Secondary amyloidosis
AF- Familial
Aβ2M- In ESRD
Diagnosed by abdominal fat pad aspiration showing apple green birefringence by polarized light microscopy with Congo red stain
High ESR, High ALP
Serum Immunofixation electrophoresis (SIFE), UIFE-sensitive to detect light chains (Lamda more common)
Kidneys- most common involved. Nephrotic range proteinuria, azotemia seen Heart- second common organ; restrictive cardiomyopathy, low voltage complexes in ECG, sparkly appearance on ECHO heart
Peripheral sensory neuropathy, carpal tunnel syndrome
Large tongue, raccoon-eye sign-Factor X deficiency^ bleeding)
Treatment- AL- Melphalan. dexamethasone, lenalidomide & bortezomib;
HDM/SCT- Autologous stem cell transplantation after high-dose melphalan
High BNP. pro-BNP, troponin T & I in cardiac involvement, used for prognosis too.
AA Amyloidosis: secondary to chronic infections - tuberculosis, SABE or inflammatory conditions like RA, IBD, Castleman's disease
Treat the primary disease, TNF & IL -1 antagonist.
The new drug - Eprodisate for renal AA
AF Amyloidosis: AD, mutant TTR (transthyretin/prealbumin)
° Peripheral & autonomic neuropathy
° Cardiac conduction defects
• Aβ2M/ Amyloidosis: associated with ESRD. on hemodialysis
Carpal tunnel syndrome, joint effusions, cystic bone lesions
Decreases with stopping dialysis
| 1 |
Dystrophic calcification
|
Metastatic calcification
|
Calcinosis
|
Tumoral calcicosis
|
Pathology
| null |
d93c9065-02c5-4c98-9fa9-003bf34faaa7
|
multi
|
Conjunctival epithelium is –
|
The epithelial lining of the conjunctiva is stratified non-keratinized epithelium, the thickness of which vary from region to region maximum at limbal conjunctiva (8 to 10 layered) and minimum at tarsal conjunctiva (2 layered).
| 3 |
Pseudostratified
|
Stratified columnar
|
Stratified non keratinized squamous
|
Transitional
|
Ophthalmology
| null |
695dc9cb-b1ba-4b87-912a-22868187ec6f
|
single
|
Stye is inflammation of ?
|
Ans. is 'a' i.e., Zeis' gland
| 1 |
Zeis' gland
|
Meibomian gland
|
Glands of Manz
|
Lacrimal glands
|
Ophthalmology
| null |
06872bfd-110a-4dda-9a42-da9a234aad1e
|
single
|
Which among the following is the abductor of vocal cord, paralysis of which could lead to suffocation?
|
Posterior cricoarytenoid is the sole abductor of vocal cords and bilateral paralysis may lead to the adduction of vocal cords and suffocation. The posterior cricoarytenoid muscle causes the muscular process of the arytenoid to be pulled posteriorly and toward the opposite arytenoid. The vocal process, in turn, is pulled laterally, causing the abduction of the vocal cord.
| 1 |
Posterior cricoarytenoid
|
Cricothyroid
|
Lateral cricoaretynoid
|
Interarytenoid
|
ENT
| null |
8c24f09d-a3a5-4d0c-9724-1c042b2777fc
|
single
|
In which of the following intensive management of diabetes needed except-
|
Ans is option 4 - DM with acute neuropathy. Cardiovascular disease is increased in patients with diabetes but there is no evidence to suggest that improved glycemic control with intensive management reduces cardiovascular complications in DM Indications for intensive DM management are:- Healthy adults with either type 1/2 diabetes Purposeful therapeutic attempt to avoid or lessen microvascular complications All pregnant women Management of labile disease patients who had kidney transplantation for diabetic nephropathy. Ref Harrison 19 /2427
| 4 |
Autonomicneuropathycausing postural hypotension
|
Pregnancy
|
Post kidney transplant in diabetic nephropathy
|
DM with acute MI
|
Medicine
|
Endocrinology
|
77d8f097-e30b-4a8c-9143-40e2e4d58567
|
multi
|
A patient is presenting to the emergency room with abrupt onset of motor symptoms. The neurology resident is unable to correlate the presentation and a concrete neurological diagnosis. It also appears that the patient is not very concerned about his own symptoms. This is called:
|
1. La belle indifference Inappropriate attitude of calm or lack of concern about one's disability Seen in Dissociative or conversion disorders 2. Labile Affect Rapid and abrupt changes in emotion largely unrelated to external stimuli most commonly seen in mania 3. Affective blunting Severe reduction in the intensity of affect seen in Schizophrenia 4. Incongruent affect Patient may be feeling depressed or describe a depressive theme but do so with laughter, smiling and no suggestion of sadness seen in schizophrenia In the above question, the neurology resident is unable to correlate the presentation indicating conversion disorder and the patient is not very concerned towards his own symptoms indicating La belle indifference.
| 2 |
Labile affect
|
Labelle indifference
|
Affecting blunting
|
Incongruent affect
|
Psychiatry
|
Neurotic, Stress Related and Somatoform Disorders
|
9e41b83d-64bb-422e-bc29-cd29fb1f31b5
|
multi
|
Maximal reduction in gastric acidity is achieved by:
|
Truncal vagotomy and antrectomy is procedure of choice for recurrent duodenal ulcers with lowest recurrence rate.
| 2 |
Truncal vagotomy and pyloroplasty
|
Truncal vagotomy and antrectomy
|
Paial gastrectomy
|
Highly selective vagotomy
|
Surgery
|
Stomach & Duodenum
|
477dcb2f-72ee-4eea-9e4f-8b50e1ff6f00
|
single
|
False about p53 is-
|
p53 is the protein produced by TP53, guardian of human genome. It stimulates cells for DNA repair and in anti onco genic.Basic Pathology, Robbins. Page no.:185
| 4 |
It is present on chromosomes 17
|
It causes cell cylce arrest in G1
|
53 KDa
|
Non mutated wild p53 is associated with neoplasm in childhood
|
Pathology
|
General pathology
|
475fd648-1e4b-448d-8fa3-d8abd430bdd6
|
multi
|
Conjunctival mucosal overgrowth over cornea?
|
Ans. is 'a' i.e., Pterygium Pterygium Pterygium is a non-cancerous (non-neoplastic) growth of conjunctiva, characterized by a wing-shaped fold of conjunctiva encroaching upon the cornea from either side within the interpalpebral fissure. Pterygium is always situated in the palpebral apeure. Pathologically Pterygium is a degenerative and hyperplastic condition of conjunctiva. The subconjunctival tissue undergoes elastotic degeneration and proliferates as vascularized granulation tissue under the epithelium, which ultimately encroaches the cornea. The corneal epithelium, Bowman's layer and stroma are destroyed. Etiology & Clinical features Pterygium is more common in people with excess outdoor exposure to sunlight (UV rays), dry heat, high wind and abundance of dust. Therefore it is more common in those who work outdoors. Clinically it presents as a triangular fold of conjunctiva encroaching the cornea in the area of palpebral apeure, usually on the nasal side. Other findings are stocker's line (deposition of iron) Ptergyium is an asymptomatic condition in the early stages, except for cosmetic intolerance. Visual disturbance or corneal astigmatism may occur. Visual disturbances are due to encroachment of pterygium on pupillary area or corneal astigmatism. Occasionally diplopia may occur due to limitation of ocular movements. Treatment Asymptomatic pterygium which is not progressive is best left alone. Surgical excision is the only satisfactory treatment and is indicated for : - 1) Cosmetic reasons, 2) Continued progression threatening to encroach onto the pupillary area (once the pterygium has encroached pupillary area, wait till it crosses on the other side), 3) Diplopia due to interference in ocular movement.
| 1 |
Pterygium
|
Pingecula
|
Vernal keratoconjunctivitis
|
Herbe's pit
|
Ophthalmology
| null |
06931592-2319-42fb-b2cf-c1b620754799
|
single
|
The latent period in distraction osteogenesis is
| null | 2 |
4-6 weeks
|
5-7 days
|
6-8 months
|
4 months
|
Surgery
| null |
a85ad6a8-de38-4629-9a37-f765969980a4
|
single
|
The instrument used in
|
REF : SHAW GYNECOLOGY
| 1 |
laparoscopic sterilization
|
removal of ectopic
|
myomectomy
|
Endometrial polypectomy
|
Gynaecology & Obstetrics
|
All India exam
|
ab315004-d2a6-4272-ba8d-08ac3948bb97
|
single
|
Patient presents with inability to conve pyruvate to Acetyl CoA. Which of the following can be given in treatment:-
|
PDH COMPLEX - three enzymes (1 ) pyruvate dehydrogenase (E1), (2) dihydrolipoyl transacetylase (E2) (3) dihydrolipoyl dehydrogenase (E3) FIVE COENZYME - VITAMIN B1 , B2 , B3 , B5 , COA, LIPOIC ACID Any oxidative decarboxylation reaction in body require vitamin B1 so here answer is the vitamin b1
| 2 |
Vitamin B3
|
Thiamine B1
|
Free fatty acids
|
Biotin
|
Biochemistry
|
JIPMER 2018
|
2874488b-b00a-42f5-95ff-56b3c491c698
|
single
|
Earliest change in atherosclerosis is
|
A. i.e. (Fatty streaks) (385- 86 - Harsh Mohan 5th) (349 - Basic pathology 8th)ATHEROSCLEROSIS - is an intima- based lesion organized into a fibrous cap and an atheromatous (gruel- like) core and composed by smooth muscle cells, endothelial cells inflammatory cells, lipids and necrotic debris* Atherosclerosis is a slowly evolving lesion usually requiring many decades to become significant. However acute plaque changes {eg rupture, thrombosis or hematoma formation) can rapidly precipitate clinical sequalae (so-called - Clinical Horizon)* Early lesions in the form of diffusal internal thickening, fatty streaks and gelatinous lesions*** Earliest light microscopic changesin MI is- Waviness of the fibres***Morphological features, pathogenic events and clinical complications* Most common cause of aortic aneurysm is - Athero sclerosis*** Most common site for MI is - Anterior wall of left ventricles*** Granulation tissue appears in acute MI - At 1 weeks*** Calcification of the aortic valve is seen in - Aortic stenosis** Me - Collum's patch is diagnostic of - Rheumatic endocarditis*** Osier's node, Janueway and Roth spot seen in Subacute Bacterial endocarditis*** Most common change in atherosclerotic vessel is - Dystrophic calcification* Atherosclerosis LDL is present in LDL monocytes**
| 1 |
Fatty streaks
|
Fibrofatty plaque
|
Calcification
|
Gelatinous lesions
|
Pathology
|
Blood Vessels
|
b489644c-4245-4ad8-9ff5-d7f31f2d4d77
|
single
|
Lynch syndrome is associated with cancers of the
|
Ref Harrison 17/e p575; Robbins 8/e p821- 822; 9/e p 810 Lynch syndrome is an autosomal dominant disorder it is called as hereditary non polyposis colon cancer It is caused because of defective DNA repair genes leading to micro satellite instability There is increased chances of multiple cancer such as colorectal cancer, endometrial,ovarian stomach, ureter, brain, small intestine,hepatobiliary tract, skin
| 4 |
Breast ,colon, ovary
|
Breast , endometrium, ovary
|
Breast ,colon,endometrium
|
Colon,endometrium ,ovary
|
Anatomy
|
General anatomy
|
63cc582b-f4a0-41fb-956b-435a13a691d0
|
single
|
In indirect ophthalmoscopy the examining eye is made:
|
Ans. Myopic
| 1 |
Myopic
|
Hypermetropic
|
Emmetropic
|
None of the above
|
Ophthalmology
| null |
dfc1776a-2e89-423b-a2b9-92920ec49749
|
multi
|
Morbilliform eruptions is seen in
|
A morbilliform rash is a rose-red flat (macular) or slightly elevated (maculopapular) eruption, showing circular or elliptical lesions varying in diameter from 1 to 3 mm, with healthy-looking skin intervening seen in toxic shock syndrome Ref Harrison20th edition pg 1334
| 4 |
Rubella
|
Scarlet fever
|
Mumps
|
Toxic shock syndrome
|
Dental
|
Bacterial infections
|
dd53bca2-4e50-4d8b-bc48-66addc37a5e4
|
single
|
Bence - Jones are laboratory finding of
| null | 2 |
Paget's disease
|
Multiple myeloma
|
Malignant melanoma
|
Fibrous dysplasia
|
Pathology
| null |
dac5a3f6-cd8f-4183-95bf-7d3c1f49f88b
|
single
|
Human developmental index includes all except:
|
PQL I ( physical quality of life index) HDI ( human development index) 1) Literacy rate 1) Literacy rate 2) Infant moality rate 2) Income 3) Life expectancy at 1 year of age 3) life expectancy at bih. 4) 0<PQ LI < 100 4) 0< HDI < +1
| 4 |
Adult literacy rate
|
Per capita income
|
Life expectancy
|
Infant moality rate
|
Social & Preventive Medicine
|
JIPMER 2019
|
dc0a8889-6a6f-4fb7-b17e-26319ca4620b
|
multi
|
Risk factor for malignant melanoma all the following are risk factors fore malignant melanoma except
|
Answer- D. HPV infectionrisk factor for malignant melanoma is exposure to (UV radiation)Dysplastic nevus (DN) syndrome; 5-10% risk of forming superficial spreading mil*o^u.Xeroderma pigmentosumHistoryon nonmelanoma skin cancer (NMSC)Family history of melanoma (high risk)Congenital nevi
| 4 |
Giant congenital nevi
|
Family history melanoma
|
Exposure to UV light
|
HPV infection
|
Surgery
| null |
872967c3-a644-4647-8288-bb759bba7213
|
multi
|
Which of the following findings most strongly indicates a sizable intra-abdominal hemorrhage in a ruptured ectopic pregnancy?
|
Symptoms and signs of Ectopic pregnancy - "Classical" cases are characterized by variably delayed menstruation followed by slight vaginal bleeding or spotting. With rupture, there is usually severe lower abdominal and pelvic pain that is frequently described as sharp, stabbing, or tearing, while the patient may also present with hypotension, tachycardia, or even shock The posterior vaginal fornix may bulge because of blood in the rectouterine cul-de-sac, or a tender, boggy mass may be felt to one side of the uterus. Symptoms of diaphragmatic irritation, characterized by pain in the neck or shoulder, especially on inspiration, develop in women with sizable intraperitoneal hemorrhage.
| 1 |
Shoulder pain
|
Nausea and vomiting
|
Heavy vaginal bleeding
|
Unilateral lower abdominal pain
|
Gynaecology & Obstetrics
|
Ectopic Pregnancy (Hello ! Where are you ?)
|
d9340ff1-3c31-45b1-930f-afe996808aac
|
single
|
Dusehene muscular dystrophy true -
|
Ans. is 'c' i.e., Universal increase in creatine kinase Duchenne and Becker's muscular dystrophy are X-like recessive.o So expression of gene is essentially confirmed in males.o Females are affected only if X-chromosome carrying the normal allele is lost or inactivatedo Becker is milder form with late onset and slow progression,o In duchenni, onset is early with deloyed misection.o Pseudohypertrophy of calf muscle, glutei, deltiod,o Gower sign may positive at age of 3 year,o Cardiac involvement started at 10 year of age.o Histopathology shows diffuse degeneration & regeneration of muscle fibre,o Serum CPX are markedly high.
| 3 |
Autosomal dominant
|
Onset at second decade of life
|
Universal increase in creatine kinase
|
Normal cardiac muscle fibre.
|
Pediatrics
|
Disorders of Muscle and Muscular Dystrophies
|
bd920415-1ca2-4054-a36a-13d1f3c34d58
|
multi
|
Patient presenting with marked loin pain, tenderness and pyrexia shows nonspecific findings on IVP but on US reveals a heterogeneous mass with posterior acoustic enhancement and central necrosis and internal debris. CT shows marginal enhancement with air densities within. The likely diagnosis is:
|
Renal abscess Presence of air, rim enhancement on CT and posterio acoustic enhancement in a focal mass with acute clinical history is suggestive of an abscess.
| 3 |
Emphysematous pyelonephritis
|
Pyonephrosis
|
Renal abscess
|
Acute pyelonephritis
|
Surgery
| null |
c16e023e-e083-4c1b-aa2b-914ffeac6278
|
single
|
Posterior relation of neck of pancreas ?
|
Ans. is 'b' i.e., Origin of poal vein
| 2 |
IVC
|
Origin of postal vein
|
Aoa
|
Common bile duct
|
Anatomy
| null |
cebedd08-5ffd-47b6-ba96-fc80f73fe93d
|
single
|
Ketamine should be avoided in:
|
Ketamine should be avoided in hypeension,CCF, cerebral hemorrhage,increased intra cranial tension, psychiatric disorders and pregnancy before term. Ketamine causes increase in HR,CO and BP. From padmaja 4th edition Page no 196
| 1 |
The presence of increased aerial pressure
|
Pregnancy
|
Hypovolemic shock
|
Asthmatic
|
Pharmacology
|
Anesthesia
|
1a9686f5-ac75-4b43-8170-5d748e371302
|
single
|
Characteristic radiological feature of fibrous dysplasia
|
Ans is 'c' i.e. Ground glass appearance "In long bones, the fibrous dysplastic lesions are typically well-defined, radiolucent areas with thin cortices and a ground-glass appearance "- HarrisonFibrous DysplasiaIt is characterized by the replacement of normal lamellar cancellous bone by an abnormal fibrous tissue that contains small, abnormally arranged trabeculae of immature woven bone.It may affect one bone (monostotic form) or several bones (polyostotic form).The monostotic form is the most common and is usually diagnosed in patients between 20 and 30 years of age without associated skin lesions. The polyostotic form typically manifests in children <10 years of age and may progress with age. Monostotic fibrous dysplasia most commonly affects the femur--particularly the femoral neck--as well as the tibia and ribs.Polyostotic fibrous dysplasia most commonly affects the maxilla and other craniofacial bones, ribs, and metaphyseal or diaphyseal portions of the proximal femur or tibia.Radiographic FindingsIn long bones, the fibrous dysplastic lesions are typically well-defined, radiolucent areas with thin cortices and a ground-glass appearance. The articular ends are usually spared.Involvement of facial bones usually presents as radiodense lesions, which may create a leonine appearance (leontiasis osea).TreatmentThere is no established effective treatmentIV bisphosphonate therapy- Improvement in bone pain and partial or complete resolution of radiographic lesions have been reported after IV bisphosphonate therapySurgical stabilization is used to prevent pathologic fracture or destruction of a major joint space and to relieve nerve root or cranial nerve compression or sinus obstructionComplicationsMost common complication is pathologic fractureShepherd's crook deformity - If fracture occurs at the femoral neck, it commonly leads to a deformity called "shepherd's crook"Expanding bone lesions may cause pain, deformity and nerve entrapment.Sarcomatous transformation of either form of fibrous dysplasia is extremely rare, but it may occur spontaneously or, more commonly, after radiation therapyAssociated Disorders Albright-McCune SyndromeIt includes:polyostotic fibrous dysplasiaendocrine hyperfunction (pseudo-precocious puberty)abnormal pigmentationThe most common Endocrinopathy assoc. with Albright McCune syndrome is isosexual pseudo-precocious puberty in girls.Other less common endocrine disorders include thyrotoxicosis, Cushing syndrome, acromegaly, hyperparathyroidism, hyperprolactinemia, and pseudo-precocious puberty in boys.Much more common in girls (Male Female ratio-1:10)* The cafe au lait spots seen in Albright-McCune syndrome have characteristically irregular ragged borders (commonly called "coast of Maine" borders), as opposed to the smoothly marginated borders ("coast of California") of the spots seen in neurofibromatosis.Mazabraud Syndrome It includes:polyostotic fibrous dysplasia andsoft-tissue myxomas
| 3 |
Thickened bone matrix
|
Cortical erosion
|
Ground glass appearance
|
Bone enlargement
|
Orthopaedics
|
Bone Tumour
|
e0bd1f9c-a3ec-4386-8bfe-6fafca5eed42
|
single
|
All of the following are the known causes of osteoporosis except -
|
Osteoporosis It refers to reduction ofbone mass per unit volume (loss of matrix and defective mineralisation) (Fig. 9.47). Aetiology 1.Involutional 2.Endocrinological 3.Gastrointestinal 4.Haematological 5.Rheumatological 6.Collagen vascular Normal bone Type I (postmenopausal) and Type II (senile) Hypehyroidism Hyperparathyroidism Diabetes mellitus Hypogonadism Cushing's syndrome Malnutrition Malabsorption Anorexia nervosa Multiple myeloma Mastocytosis Rheumatoid ahritis Marfan's syndrome Ehler-Danlos syndrome Osteogenesis imperfecta Osteoporosis Fig. 9.47 Anticonvulsants Steroids Vitamin A Alcohol Heparin Furosemide Thyroid hormone in excessive doses Lithium GnRH agonist Cyclosporin Cytotoxic drugs 8.Cigarette smoking 9.Glucocoicoid therapy 10.Hypogonadism 11.Alcoholism 12.Renal disease 13.GI/Hepatic disorders. Bone forming agents a.Fluoride--75 mg/day b.Anabolic steroids: Testosterone is used in the treatment of osteoporotic man with gonadal deficiency. R ALAGAPPAN MANUAL OF PRACTICAL MEDICINE FOUH EDITION PAGE NO-690
| 1 |
Fluorosis
|
Hypogonadism
|
Hypehyroidism
|
Hyperparathyroidism
|
Medicine
|
Endocrinology
|
971b31fa-9ef7-4e2d-86bd-bbf64b79e9a8
|
multi
|
If CVS sampling is done at 9 - 10 weeks what will happen-
|
Ans. is 'c' i.e., limb defect o When CVS performed at less than Id weeks of gestation there is a high incidence of limb reduction defects.Chorionic villus sampling (CVS)o Performed for prenatal diagnosis of genetic disorderso It is carried out transcervically between 10 - 12 weeks and transabdominally from 10 weeks to term.o Complications - fetal loss, oromandibular or limb deformities, and vaginal bleedingo When CKS performed at less than 10 weeks of gestation there is a high incidence of limb reduction defects.
| 3 |
NTD
|
Fetal loss
|
Limb defect
|
Vaginal bleeding
|
Unknown
| null |
44fdd172-0713-4d10-b023-669b7545f8a7
|
single
|
Which of the following can be given in hepatic as well as in renal failure
|
Atracurium and Cis-atracurium are the muscle relaxants of choice in both liver and renal failure. Atracurium is inactivated by Hoffman's elimination and alkaline ester hydrolysis. Cis-atracurium is eliminated by Hoffman's elimination. Hence atracurium and cis-Atracurium duration of action is not altered in patients with hepatic or renal insufficiency or hemodynamic compromise .Therefore, preferred muscle relaxants for such patients as well as for neonates and elderly.
| 1 |
Atracurium
|
Vecuronium
|
Pancuronium
|
Mivacurium
|
Anaesthesia
|
Muscle relaxants
|
faa4bbf6-9985-40be-acf7-972e5597dc46
|
single
|
Patisiran was approved by FDA recently for
|
It is a double stranded small interfering ribose neuclic acid ( si RNA) formulated in the form of a lipid complex. used in the treatment of polyneuropathy
| 4 |
Filariasis
|
Peripheral Neuropathy
|
Neuropathy of diabetes
|
Neuropathy of amyloidosis
|
Pharmacology
|
All India exam
|
82a028d1-ce52-42e7-849e-8a01e63c154b
|
single
|
Which of the following infection is diagnosed by aldehyde test?
|
Formol-gel test or (Napier's aldehyde test) and Chopra's antimony test are useful in the diagnosis of chronic kala-azar. The gel-test is performed by the addition of two drops of commercial formalin to 2 ml of patient's serum in a test tube; the mixture is shaken and allowed to stand at room temperature. If there is opacification and solidification of the serum within 20 minutes, it denotes a positive reaction. It often occurs within a month or two after having the disease. Other lab findings of Leishmaniasis for its diagnosis: Progressive leukopenia with mononuclear increase is most characteristic Demonstration of the parasite in the peripheral blood, spleen, liver, or bone marrow is diagnostic The complement fixation test Leishmanian skin test or Montenegro test Ref: Achars Textbook Of Pediatrics By Swarna Rekha Bhat (ed.), 4th edition, Page 309.
| 2 |
Fasciola hepatica
|
Leishmania
|
Toxoplasma
|
Toxocara canis
|
Microbiology
| null |
d158f534-d70c-4631-abb1-a6f9e598e5fc
|
single
|
NOT a feature of post-traumatic stress disorder: AI 08; JIPMER 13; NIMHANS 14
|
Ans. Hallucinations
| 4 |
Hyperarousal
|
Emotional numbing
|
Flashbacks
|
Hallucinations
|
Forensic Medicine
| null |
2848b5f5-ef35-4d50-9d95-da87203e02aa
|
multi
|
Most common cause of death after Total Hip Replacement is- DELETE
|
*Thromboembolic disease is the most common cause of death after total hip replacement. REF:Ref:Ohopaedics secrets 3rd/e p.34
| 4 |
Infection
|
Pneumonia
|
Anemia
|
Thromboembolism
|
Anatomy
| null |
c14fc7ab-6363-4c58-a9b8-7782dc090887
|
single
|
Myeloid sarcoma, which is tumor mass consisting of myeloid blasts occurring at anatomic sites other than bone marrow, are often characterized by chromosome aberrations all, EXCEPT:
|
In AML Patients may present with symptoms from a myeloid sarcoma that is a tumor mass consisting of myeloid blasts occurring at anatomic sites other than bone marrow. This rare presentation, often characterized by chromosome aberrations may precede or coincide with AML. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 908
| 4 |
Monosomy 7
|
Trisomy 8
|
inv (16)
|
t (15;17)
|
Medicine
| null |
17e5e135-0eb4-4a32-9899-54bc469f698f
|
multi
|
Most common manifestation of mumps in adult males -
|
Ans. is 'c' i. e., Orchitis o Orchiyid is the most common manifestation of mumps among postpubertal males
| 3 |
Aseptic meningitis
|
Encephalitis
|
Orchitis
|
Sinusitis
|
Social & Preventive Medicine
|
Communicable Diseases
|
85b05ce2-1cb9-4da2-a4e0-6034bee16db2
|
single
|
Metabolites in HMP shunt are all except
|
Glycerol-3 phosphate
Glyceraldehyde-3-phosphate is produced (not glycerol-3-phosphate).
Metabolites in HMP shunt
Oxidative phase:- Glucose-6-phosphate → 6-phosphogluconate → Ribulose-5-phosphate.
Non-oxidatative phase :- Xylulose-5-phosphate, Ribose-5-phosphate, sedoheptulose-7-phosphate, erythrose-4-phosphate, fructose-6-phosphate, glucose-6-phosphate, glyceraldehyde-3-phosphate.
| 1 |
Glycerol–3 phosphate
|
Sedoheptulose–7 phosphate
|
Glyceraldehyde–3 phosphate
|
Xylulose–5 phosphate
|
Biochemistry
| null |
b4317e14-387d-4032-b86e-c27a21639fb8
|
multi
|
SGLT 2 is found in
|
It is present in kidney SGLT1 is present in intestine They actively absorbe glucose
| 4 |
Liver
|
Intestine
|
Spleen
|
None of the above
|
Anatomy
|
General anatomy
|
f276b35c-83c8-42de-8c34-68d0329b4a1a
|
multi
|
Ultrasound and radionuclids studies are primary imaging modalities used for assessment of -
| null | 4 |
Renal trauma
|
Renovascular hypertension
|
Renal tuberculosis
|
Renal transplant
|
Medicine
| null |
ad291cf5-89ce-40cf-88ef-e0830ca191d9
|
single
|
Not true about Vi polysaccharide vaccine of typhoid:
|
Ans. is. 'c' i. e., Given at bih
| 3 |
Single dose is given
|
Revaccination at 3 years
|
Given at bih
|
Given subcutaneously
|
Microbiology
| null |
c454c3ed-9180-479f-8ed2-1ffb834effb8
|
multi
|
Which of the following statement regarding C-reactive protein is false?
|
The gene for CRP is on chromosome 1. CRP is an abnormal protein which appear in blood in response to inflammatory cytokines such as IL 6. It is one of the most sensitive acute pahse reactant. It is elevated following severe trauma, bacterial infections, inflammation, surgery or neoplastic proliferation.
| 3 |
It is increased in pneumococcal infection
|
It is an acute phase substance
|
The gene for the protein is on Chromosome 14
|
Can be raised after a surgery
|
Biochemistry
| null |
136e8831-2c48-4e01-a30b-583115426c0d
|
multi
|
Investigation of choice for intramedullary SOL is –
|
Investigation of choice for intramedullary space occupy lesion is MRI.
| 1 |
MRI
|
USG
|
CT
|
X–ray
|
Radiology
| null |
c7b10481-5688-4f04-b912-fff8d4488f5d
|
single
|
Which of following is the most common site for extranodal lymphoma?
|
Although extranodal lymphomas can arise in viually any tissue they di so most commonly in the GI tract paicularly the stomach.(ref Robbins 9th/773)
| 2 |
Esophagus
|
Stomach
|
Intestine
|
Skin
|
Anatomy
|
Haematology
|
32ef2e58-2536-4169-b85b-dbd020a3b965
|
single
|
A surgical resident has accidently given an intra aerial injection of thiopental sodium to a patient on the ward. The arm has blanched below the level of the injection. Which of the following is NOT recommended for the management?
|
The recommendation in such a scenario is to leave the needle in the aery and to inject a vasodilator like papaverine. A brachial plexus block or stellate ganglion block will cause vasodilatation and decrease the ischemia. In case of extravascular injection infiltrate with hyaluronidase 1500 IU dissolved in 1 ml through the cannula. Ref: Oxford handbook of clinical specialities, 8th Edition, Page 620.
| 1 |
Immediately remove the needle and apply warm towel
|
Perform a brachial plexus block on the affected side
|
Give IV heparin
|
Give analgesics
|
Surgery
| null |
feb137ac-a60d-488e-b78b-8867ae657ea2
|
single
|
Sympathectomy of the kidney results in which of the following responses?
|
The kidney is innervated primarily by the sympathetic nervous system and as such, regulates the contraction of the smooth muscle surrounding the afferent and efferent aerioles of the glomerulus. Sympathetic stimulation to the efferent glomerular aerioles causes the constriction and increases the filtration rate, leading to an increase in urinary output. Similarly, with the loss of sympathetic innervation, such as due to sympathectomy of the kidney, relaxation of tone of the afferent aerioles occurs and the filtration rate increases which results in an increased urine output. Decreased urine output may result from the restriction of the afferent aerioles, leading to a decrease in glomerular filtration rate. Ref: Eaton D.C., Pooler J.P. (2009). Chapter 1. Renal Functions, Anatomy, and Basic Processes. In D.C. Eaton, J.P. Pooler (Eds), Vander's Renal Physiology, 7e.
| 4 |
No change to the glomerular filtration rate, nor to the urine output
|
Decreased urine output
|
Reduction of glomerular filtration rate and decreased urinary output
|
Increased urine output
|
Physiology
| null |
dcc5b065-cf8e-47b4-9c02-b671e65a3bf9
|
single
|
Prophylactic therapy should be started against Pneumocystis carinii pneumonia in AIDS patients with CD4 counts below :
| null | 3 |
< 50/microL
|
< 150/ microL
|
< 200/ microL
|
< 400/ microL
|
Pharmacology
| null |
2052beff-a5e8-4155-a18a-741d3c565690
|
single
|
Reversible injury in myocardium occurs at ?
|
Ans. is 'b' i.e., 30 minuteso The metabolic rate of the hea is high, and its stores of substrate are low.o So, hea is critically dependent on a continuous supply of oxygen and nutrients.o Ischemia of myocardium induces profound functional, biochemical and morphological consequences.o Myocardial function is more sensitive to ischemia (loss of contractility occurs within 60 seconds) than myocardialstructure (irreversible injury occurs in 20-40 minutes, thus myocardial necrosis begins at approximately 30 minutesafter coronary occlusion.Key events in ischemic cardiac myocytes Feature TimeOnset of ATP depletion SecondsLoss of contractility < 2 minutesATP reduced to 50% 10 minutesATP reduced to 10% 40 minutesIrrversible injury 20-40 minMicrovascular injury > 1 hr
| 2 |
2 minutes
|
30 minutes
|
2 hours
|
5 hours
|
Pathology
| null |
55cfde3d-274a-42bb-a068-20da8f4808df
|
single
|
Radial tuberosity provides attachment to -
|
Ans. is 'b' i.e., Biceps brachii (Ref: Elsevier's integrated anatomy Vol 2 p 30).An anterior, rough poion of tubercle - For inseion of tendon of biceps brachii.A posterior smooth poions of tubercle - Bursa interposed between tendon & bone..
| 2 |
Brachialis
|
Biceps brachii
|
Triceps
|
Coracobrachialis
|
Anatomy
| null |
70e2a739-d582-4b77-b767-b543fcb438ed
|
single
|
Pack year means
|
(B) 20 cigarettes per day for 1 year# A pack-year is a quantification of cigarette smoking.> 1 pack-year is equal to smoking 20 cigarettes (1 pack) per day for 1 year, or 40 cigarettes per day for half a year, and so on.> Number of pack-years = (packs smoked per day) * (years as a smoker).
| 2 |
10 cigarettes per day for 1 year
|
20 cigarettes per day for 1 year
|
40 cigarettes per day for 1 year
|
50 cigarettes per day for 1 year
|
Social & Preventive Medicine
|
Miscellaneous
|
e3a32ec2-d0de-4659-a2b0-81c9159ccb89
|
single
|
Asbestosis is usually related to -a) Small cell carcinoma lungb) Large cell carcinoma lungc) Mesotheliomad) Squamous cell carcinoma lung
| null | 1 |
cd
|
bc
|
bd
|
ac
|
Medicine
| null |
ed9c0080-fa15-4d8c-810e-91e2ef9384a0
|
multi
|
A person presents with following parameters PCO3- 30 mm of Hg, P02- 105 mm of Hg, pH-7.45 is having paially compensated
|
Ans. d. Respiratory alkalosis In the question, pH is 7.45 and PCO, is 30 mm Hg. Overall change is slightly alkaline. Respiratory change is also alkaline. So the diagnosis is respiratory alkalosis Acid Base Disorders pH < 7.35 is acidosis; pH >7.45 is alkalosis 1degchange in HCO3 is termed as Metabolic (Normal HCO3= 22-30 mEq/I) If change in HCO3is in keeping with the pH (i.e. if there is acidosis and HCO3-is decreased) the problem is metabolic one. If change in HCO3 is opposite with the pH (i.e. if there is acidosis and HCO3 is increased or normal) the problem 1deg change in CO2 is termed as Respiratory (Normal CO2= 35-45 mEq/1) If change in CO, isin keeping with the pH (i.e. if there is acidosis and CO, is increased) the problem is respiratory. If change in CO, is in opposite with the pH (i.e. if there is acidosis and CO, is decreased or normal) the problem is termed as compensatory respiratory
| 4 |
Metabolic acidosis
|
Metabolic alkalosis
|
Respiratory acidosis
|
Respiratory alkalosis
|
Medicine
| null |
1f0da2f2-10dc-4bf0-a16e-771fae428505
|
multi
|
All of the following can cause SLE like syndrome except-
| null | 2 |
INH
|
Penicillin
|
Hydralazine
|
Sulphonamide
|
Medicine
| null |
1fe0ce4f-d2d3-47fa-96d4-64981ca1e805
|
multi
|
What is true of fetal hematopoiesis in the course of pregnancy?
|
Fetal hematopoiesis: yolk sac - fetal liver - fetal bone marrow. The first fetal erythrocytes are nucleated and macrocytic. MCV is 180 fL and normally decreases to 105 to 115 fL. As the fetus grows, the blood volume in fetoplacental circulation increases. The fetalhemoglobin concentration increases from 12 gm/dL in mid pregnancy to 18 gm/dL at term. The retic count decreases to about 4 to 5 % at term. The RBC life span increases to 90 days at term.
| 3 |
Rise in MCV
|
Rise in reticulocyte count
|
Rise in Hemoglobin content
|
Decrease in blood volume
|
Gynaecology & Obstetrics
|
Fetal circulation
|
3832949a-347d-4b43-8323-ab3e4d425e31
|
multi
|
Most effective HDL raising drug is:
|
Niacin is the most effective HDL raising drug currently available. Niacin is the only drug currently available that lowers Lipoproteinp(a), and can be considered as an addition to a statin in patient with elevated Lp(a). Statins have a modest HDL-raising effect (5-10%). Fibrates are the most effective drugs available for reducing triglyceride levels and also raise HDL-C levels modestly. Omega three fatty acids are also effective in raise HDL level. Ref: Harrisons principles of internal medicine, 18th edition, Page: 3161
| 2 |
Omega three fatty acids
|
Niacin
|
Fenofibrate
|
Rosuvastatin
|
Medicine
| null |
fb99a431-7486-4fbf-8292-587afc4cc765
|
single
|
True about tubercular otitis media are all except?
|
Ans. is 'd' i.e., Usually affects both ears Tubercular otitis media Tuberculosis of middle ear is a comparatively rare entity usually seen in association with or secondary to pulmonary tuberculosis, infection reaches the middle ear through eustachian tube. The rare modes of infection are through hematogenous spread from tubercular focus in lung, tonsils, cervical lymph nodes; or due to ingestion of infected cow's milk. It usually affects children and young adults. Clinical features Generally, tuberculosis of middle ear is unilateral. It is characterized by painless otorrhoea which fails to respond to the usual antimicrobial treatment. There is painless watery otorrhea. Single or multiple perforation of tympanic membrane. There may be multiple perforations in the early stages, but they coalesce into a large tympanic membrane perforation accompanied by a pale granulation tissue. Periauricular fistulae, lymphadenopathy and facial palsy are infrequent findings. Late complications include facial paralysis, labyrinthitis, postauricular fistulae, subperiosteal abscess, petrous apicitis and intracranial extension of infection.
| 4 |
Spreads through eustachian tube
|
Causes painless ear discharge
|
May cause multiple perforations
|
Usually affects both ears
|
ENT
| null |
f6d39c29-05cd-4d87-9ed4-ac4ca6eaa910
|
multi
|
Cranial pa of accessory nerve supplies all palatal muscles, EXCEPT?
|
The cranial root of the accessory nerve is smaller than the spinal root. It exits the skull through the jugular foramen and unites for a sho distance with the spinal root. Its fibers innervate the pharyngeal and palatal muscles, except tensor veli palatini.
| 3 |
Palatoglossus
|
Palato pharyngeus
|
Tensor veli palatini
|
Tensor veli tympani
|
Anatomy
| null |
e4a9431a-217d-4db2-8b48-16b67a67694f
|
multi
|
Storage form of thyroid hormone -
| null | 3 |
Tri-iodo tyrosine
|
Tri - iodo tyronine
|
Thyroglobulin
|
Di-iodo thyrosine
|
Medicine
| null |
f607be04-93c1-4cd9-8b21-6f28f460dc26
|
single
|
Which of these can be safely stopped before an abdominal surgery
|
Refer CMDT6 2014/45 All antihypeensives should be continued in preoperative period except ACE inhibitors ,angiotensin receptor blockers and diuretics ACE inhibitors and ARBs should be stopped 24 hrs before surgery to prevent intraoperative hypotension Diuretics should be stopped once the patient is kept NPO to prevent intraoperative volume depletion and electrolyte abnormalities
| 1 |
ACE inhibitors
|
Beta blockers
|
Statins
|
Steroids
|
Pharmacology
|
Anesthesia
|
c8fe0982-44dd-4bee-ac49-746231ec93f2
|
single
|
Incision used in thyroidectomy
| null | 2 |
Barking incision
|
Collar incision
|
Kocher incision
|
Koebner incision
|
Surgery
| null |
39d9d781-e0ef-4c65-a29a-bb136223b21a
|
single
|
The bodies of spine are biconcave and are called "codfish spine" most commonly seen in:
|
Codfish Veebra is seen in 1. Osteoporosis > Osteomalacia 2. Sickle cell disease 3. Hereditary spherocytosis 4. Homocystinuria 5. Renal osteodystrophy 6. Osteogenesis imperfecta 7. Gaucher's disease
| 2 |
Scurvy
|
Osteomalacia
|
Fluorosis
|
Hyperparathyroidism
|
Orthopaedics
|
Metabolic Disorders of Bone
|
51aefe67-8701-44ee-abc5-5b5971e3e5c9
|
multi
|
Percentage of pheochromocytoma that are bilateral is:
|
Pheochromocytomas often are called the 10 percent tumor because 10% are bilateral, 10% are malignant, 10% occur in pediatric patients, 10% are extra-adrenal, and 10% are familial. Ref: Schwaz's principle of surgery 9th edition, chapter 38.
| 3 |
<1%
|
1-5%
|
10%
|
25%
|
Surgery
| null |
b4abffe6-3a0d-455b-a855-03bacb936ad6
|
single
|
Fredrich's ataxia is caused by -
|
Ans. is 'b' i.e., Expanded trinucleotide repeat o Freidrich ataxia is an autosomal recessive disorder.o It is caused by loss of Junctional mutation in frataxin gene (FxN) gene.o Frataxin gene is located on chromosome 9ql3.o Majority of patients have an expanded trinucleotide repeat in intron 1 of both alleles of frataxin gene.
| 2 |
Point mutation
|
Expanded trinucleotide repeat
|
Missense mutation
|
Inversion
|
Medicine
|
Ataxic Disorders
|
decbd81a-47be-4b5a-9922-41cb1429c5c3
|
single
|
Left sided sixth nerve palsy would lead to -
|
Left sided 6th nerve palsy lead to diplopia in left sided gaze. The abducens nerve is a nerve that controls the movement of the lateral rectus muscle in humans, responsible for outward gaze. It is also known as the abducent nerve, the sixth cranial nerve, sixth nerve Ref khurana 6/e
| 4 |
Accommodation paresis of left eye
|
Ptosis of left eye
|
Adduction weakness of left eye
|
Diplopia in left gaze
|
Ophthalmology
|
Ocular motility and squint
|
d9deb788-6d10-4fa7-9050-7de9e14514a6
|
single
|
Polymer of fructose
|
Ans. c (Inulin) (Ref. Ganong.-23rd/Ch. 38. 26th/pg. 105).Substances Used to Measure GFRIn addition to the requirement that it be freely filtered and neither reabsorbed nor secreted in the tubules, a substance suitable for measuring the GFR should be nontoxic and not metabolized by the body. Inulin, a polymer of fructose with a molecular weight of 5200 that is found in dahlia tubers, meets these criteria in humans and most animals and is extensively used to measure GFR. Radioisotopes such as 51Cr-EDTA are also used, but inulin remains the standard substance. In practice, a loading dose of inulin is administered intravenously, followed by a sustaining infusion to keep the arterial plasma level constant. After the inulin has equilibrated with body fluids, an accurately timed urine specimen is collected and a plasma sample obtained halfway through the collection. Plasma and urinary inulin concentrations are determined and the clearance calculated. The GFR in a healthy person of average size is approximately 125 mL/min.CLASSIFICATION OF IMPORTANT SUGARS AldosesKetosesTrioses (C3H6O3)GlyceroseDihydroxyacetoneTetroses (C4H8O4)ErythroseErythrulosePentoses (C5Hl0O5)RiboseRibuloseHexoses (C6H12O6)GlucoseFructoseHexoses of Physiologic ImportanceSugarSourceImportanceClinical significanceD-GlucoseFruit juices. Hydrolysis of starch, cane sugar, maltose and lactoseThe "sugar" of the body. The sugar carried by blood, and the principal one used by the tissuesPresent in the urine (glycosuria) in diabetes mellitus owing to raised blood glucose (hyperglycemia)D-fructoseFruit juices. Honey,Hydrolysis of cane sugar and of insulin (from the Jerusalem artichoke)Can be changed to glucose in the liver and so used in the bodyHereditary fructose intolerance leads to fructose accumulation and hypoglycemiaD-GalactoseHydrolysis of lactoseCan be changed to glucose in the liver and metabolized. Synthesized in the mammary gland to make the lactose of milk. A constituent of glycolipids and glycoproteinsFailure to metabolize leads to galactosemia and cataractD-Mann- OseHydrolysis of plant mannans and gumsA constituent of many glycoproteins Pentoses of Physiologic ImportanceSugarWhere foundBiochemical importance D-RiboseNucleic acidsStructural elements of nucleic acids and coenzymes, eg, ATP, NAD, NADP, flavoproteins. Ribose phosphates are intermediates in pentose phosphate pathway D-RibuloseFormed in metabolic processRibulose phosphate is an intermediate in pentose phosphate pathway D-ArabinoseGum arabic. Plum and cherry gumsConstituent of glycoproteins D-XyloseWood gums, proteoglycans, glycosaminoglycansConstituent of glycoproteins D-LyxoseHeart muscleA constituent of a lyxoflavin isolated from human heart muscle L-XyluloseIntermediate in uronic acid pathwayFound in urine in essential pentosuria DisaccharidesSugarSourceClinical significanceMaltoseDigestion by amylase or hydrolysis to starch.Germinating cereals and malt LactoseMilk, may occur in urine during pregnancy.In lactase deficiency, malabsorption leads to diarrhoea and flatulenceSucroseCane, and beet sugar. Sorghum.Pineapple carrot roots.In sucrase deficiency, malabsorption leads to diarrhoea and flatulenceTrehaloseFungi and yeasts.The major sugar of insect hemolymphGlucose Is one of the main hexoses absorbed from GIT, derived principally from dietary STARCH.
| 3 |
Dextrose
|
Cellulose
|
Inulin
|
Glycogen
|
Biochemistry
|
Carbohydrates
|
9709175a-cc64-478d-b489-3ae8e3ae584e
|
single
|
Global eradication of smallpox was done on:
|
Ans. (b) 8th May 1980* Last indigenous case of Smallpox in India: 77th May 1975* Last case of Smallpox in India: 24th May 1975* India declared Smallpox-free: 23 April 1977* Last case of Smallpox globally: 26th October 1977 (Somalia)* Actual last case of smallpox : 1978* Global eradication of Smallpox: 8th May 1980
| 2 |
26th Oct 1977
|
8th May 1980
|
17th March 1980
|
17th April 1977
|
Social & Preventive Medicine
|
Miscellaneous
|
eb8ad812-82e8-405f-a493-85cc7a3627ef
|
multi
|
The HIV virus can be transmitted by the following routes, except -
| null | 2 |
Homosexual contact
|
Intact skin
|
Maternofoetal
|
Needle prick
|
Surgery
| null |
bbe52684-9774-4d93-bc0a-dbc472a9d111
|
multi
|
Natural light causes all except
|
Organ of Coi - A specialized structure located on the inner surface of the basilar membrane of the cochlea containing hair cells thattransmit sound vibrations to the nerve fibers.Ref: Ganong&;s review of medical physiology; 24th edition; page no: 200
| 2 |
Vitamin D synthesis
|
Destroys organ of coi
|
| Bilirubin level
|
Melanin synthesis
|
Physiology
|
Endocrinology
|
23fd9fcf-a6cb-4dc4-b18b-2a20502d749e
|
multi
|
Indicator of Remote contamination of water
|
Bacteriological Indicators of Water Quality E Coli: Best indicator. Ideally water should be coliform free except large urban water supplies where up to 5% contamination is acceptable if samples are taken up to 1year. For this screening test used is presumptive coliform count, MPN (Most Probable Number) and multiple tube test. Diagnostic test is EIJKMAN'S test. Faecal streptococci: Best tells recent contamination Clostridium perfringens: Best tells remote contamination
| 2 |
Fecal Streptococci
|
Clostridium Perfirengens
|
E. Coli
|
Salmonella Typhi
|
Social & Preventive Medicine
|
Water
|
2c5e5b38-2122-42bb-bd07-9ccaa7ef3a3f
|
single
|
Vocal cord is lined by which of the following epithelium
|
The epithelium of the mucous membrane of the larynx is ciliated columnar epithelium except for the vocal cords and upper pa of the vestibule where it is of stratified squamous type
| 2 |
Cuboid
|
Stratified squamous
|
Stratified columnar
|
Pseudo ciliated columnar
|
Anatomy
|
General anatomy
|
ea3a3676-f9ff-4613-a472-824008ea8e8c
|
single
|
Waist to hip ratio which indicates obesity in men?
|
Ans. is 'd' i.e., > 1.0Waist-Height ratio (WHtR): It is the best indicator of cardiovascular risk. It is independent of age and sex. Cut-off value is 0.5.
| 4 |
> 0.5
|
0.85
|
> 0.93
|
> 1.0
|
Social & Preventive Medicine
| null |
f0b19d32-f049-4fc5-b068-fa224e40cb9d
|
single
|
Type of sampling shown in Figure is
|
Ans- A Simple random sampling Ref - Review: Simple Random Sampling Do you remember how simple random sampling works? Visually, it's just numbering each individual and randomly selecting a certain number of them. Here's the image we used in the previous section: Stratified Sampling Stratified sampling is different. With this technique, we separate the population using some characteristic, and then take a proportional random sample from each. A stratified sample is obtained by separating the population into non-overlapping groups called strata and then obtaining a proportional simple random sample from each group. The individuals within each group should be similar in some way. Visually, it might look something like the image below. With our population, we can easily separate the individuals by color. Once we have the strata determined, we need to decide how many individuals to select from each stratum. (Man, that's a weird word!) The key here is that the number selected should be proportional. In our case, 1/4 of the individuals in the population are blue, so 1/4 of the sample should be blue as well. Working things out, we can see that a stratified (by color) random sample of 4 should have 1 blue, 1 green, and 2 reds. Example 1 One easy example using a stratified technique would be a sampling of people at ECC. To make sure that a sufficient number of students, faculty, and staff are selected, we would stratify all individuals by their status - students, faculty, or staff. (These are the strata.) Then, a proportional number of individuals would be selected from each group. Systematic Sampling A systematic sample is obtained by selecting every kth individual from the population. The first individual selected corresponds to a random number between 1 and k. So to use systematic sampling, we need to first order our individuals, then select every kth. (More on how to select k in a bit.) In our example, we want to use 3 for k? Can you see why? Think what would happen if we used 2 or 4. For our starting point, we pick a random number between 1 and k. For our visual, let's suppose that we pick 2. The individuals sampled would then be 2, 5, 8, and 11. In general we find k by taking N/n and rounding down to the nearest integer. For another take, watch this YouTube video: Example 2 Systematic sampling works well when the individuals are already lined up in order. In the past, students have often used this method when asked to survey a random sample of ECC students. Since we don't have access to the complete list, just stand at a corner and pick every 10th* person walking by. * Of course, choosing 10 here is just an example. It would depend on the number of students typically passing by that spot and what sample size was needed. Cluster Sampling Cluster sampling is often confused with stratified sampling, because they both involve "groups". In reality, they're very different. In stratified sampling, we split the population up into groups (strata) based on some characteristic. A cluster sample is obtained by selecting all individuals within a randomly selected collection or group of individuals. In essence, we use cluster sampling when our population is already broken up into groups (clusters), and each cluster represents the population. That way, we just select a certain number of clusters. With our visual, let's suppose the 12 individuals are paired up just as they were sitting in the original population. Since we want a random sample of size four, we just select two of the clusters. We would number the clusters 1-6 and use technology to randomly select two random numbers. It might look something like this: Example 3 One situation where cluster sampling would apply might be in manufacturing. Suppose your company makes light bulbs, and you'd like to test the effectiveness of the packaging. You don't have a complete list, so simple random sampling doesn't apply, and the bulbs are already in boxes, so you can't order them to use systematic. And all the bulbs are essentially the same, so there aren't any characteristics with which to stratify them. To use cluster sampling, a quality control inspector might select a certain number of entire boxes of bulbs and test each bulb within those boxes. In this case, the boxes are the clusters. Convenience Sampling Other methods do exist for finding samples of populations. In fact, you've seen some already. Probably the most common is the so-called convenience sample. Convenience samples are just what they sound like - convenient. Unfortunately, they're rarely representative. Think of the radio call-in show, those people in the shopping malls trying to survey you about your purchasing habits, or even the voting on American Idol! Here's a specific example. It's a poll on beliefnet.com, titled "What Evangelicals Want". All online polls use, by nature, convenience sampling. According to the article, "The poll was promoted on Beliefnet's web site and through its newsletters." Only those evangelicals who visit this particular web site and actually answer the survey are included. Beware any poll result taken with convenience sampling. Multistage Sampling Often one technique isn't possible, so many professional polling agencies use a technique called multistage sampling. The strategy is relatively self-explanatory - two or more sampling techniques are used. For example, consider the light-bulb example we looked at earlier with cluster sampling. Let's suppose that the bulbs come off the assembly line in boxes that each contain 20 packages of four bulbs each. One strategy would be to do the sample in two stages: Stage 1: A quality control engineer removes every 200th box coming off the line. (The plant produces 5,000 boxes daily. (This is systematic sampling.) Stage 2: From each box, the engineer then samples three packages to inspect. (This is an example of cluster sampling.) The US Census also uses multistage sampling. If you haven't already (you should have!), read Section 1.4 in your text for more details. Summary Here's a visual summary of the four main sampling strategies: Simple Random: Stratified: Systematic: Cluster:
| 1 |
Simple random sampling
|
Systematic random sampling
|
Stratified random sampling
|
Cluster random sampling
|
Unknown
| null |
ee90209d-d3bb-44a2-9cad-d490fc4190c7
|
single
|
All of the following statement about heparin are true except -
|
Ans. is 'd' i.e., Causes hypokalemia o Heparin can cause alopecia o Heparin does not cross placenta ---> nonteratogenic o Heparin releases lipoprotein lipase from vessel wall. o Heparin causes hyperkalemia (not hypokalemia).
| 4 |
Causes alopecia
|
Non teratogenic
|
Releases lipoprotein lipase
|
Causes hypokalemia
|
Pharmacology
| null |
2ef8597a-6554-49a8-8f90-02af98342283
|
multi
|
Which of the following syndromes is best associated with congenital hea disease
|
Holt oram charge association syndrome is a autosomal dominant disease characterized by Cardiac lesion( ostium secundum ASD,VSD,TOF, pulmonary stenosis), coloboma, choanal atresia,genital hypoplasia,ear abnormalities,growth retardation due to TBX5 mutation Lesch nyhan syndrome/ juvenile gout is associated with self mutilation of hand & feet,intelluctal disability,early death Rasmussen syndrome is chronic focal encephalitis character used by seizure,hemiparesis,aphasia,dementia Leopard / noon an syndrome ,there will be Lentigines,Electrocardiographic conduction anomaly,Ocular hypeelorism, Pulmonary stenosis,Abnormal genitalia,Retarded growth & Deafness Ref : Ghai essential of pediatrics, eighth edition, p.no:401
| 3 |
Lesch-Nyhan syndrome
|
Rasumussen syndrome
|
Holt oram syndrome
|
LEOPARD syndrome
|
Pediatrics
|
C.V.S
|
9b665f12-83c2-4229-83e6-7d720dcb0dc4
|
single
|
A patient has complaint of seeing coloured holoes in the evening and blurring of vision for last few days with normal 10P ?
|
Ans. is 'a' i.e., Prodromal phase of acute angle closure glaucoma Features of latent PACG (Prodromal stage) are :? Shallow anterior chamber Occasionally complain of halos around light Sometimes slight-haziness or blurring of vision Normal 10P It is the only phase of glaucoma, where IOP pressure is normal at all the time. Whereas in incipient stage, there is recurrent elevation of IOP by predisposing factors like dim light.
| 1 |
Prodromal phase of acute angle closure glaucoma
|
Acute angle closure glaucoma
|
Chronic glaucoma
|
Epidemic dropsy
|
Ophthalmology
| null |
00f452c1-800d-4eda-991c-a23ca463c3dc
|
single
|
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