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All of the following are seen in the Horner&;s syndrome, except
|
Ref: BD Chaurasia&;s HUMAN ANATOMY, Volume 3, 4th edition. Horner&;s syndrome is characterized by (a) Ptosis i.e. drooping of the upper eyelid); (b) miosis (i.e. constriction of the pupil); (c) anhydrosis (i.e. loss of sweating on that side of the face); (d) enophthalmos (i.e. retraction of the eyeball); (e) loss of the ciliospinal reflex (i.e. pinching the skin on the nape of the neck) does not produce dilatation of the pupil (which normally takes place). Horner&;s syndrome can also be caused by a lesion within the central nervous system anywhere at or above the first thoracic segment of the spinal cord involving sympathetic fibres. Horner&;s syndrome is due to involvement of sympathetic pathways in the medulla.
| 3 |
Drooping of upper eyelid
|
Enophthalmos
|
Dilated pupil
|
Loss of sweating of same side of face
|
Anatomy
|
Head and neck
|
1c559380-2c85-4a10-af21-766ca41dcc15
|
multi
|
What is the cause of sudden death in a patient who recently underwent maxillary sinus irrigation?
|
ANSWER: (A) Air embolismREF: Ear, Nose, and Throat Diseases: With Head and Neck Surgery By Walter Becker 3rd edition, http ://emedicine.medscape.com/article/862030-over vie wComplications of non-endoscopic drainage procedures can be minor or severe. The most common complication is failure to enter the sinus because of improper positioning of the trocar, incomplete penetration of the sinus mucosa, or the presence of a hypoplastic antrum. Epistaxis may occur because of laceration of the nasal mucosa or preexisting coagulopathies necessitating packing. Severe complications include orbital injury, air embolism, and death secondary to injection of air into the sinus.
| 1 |
Air embolism
|
Maxillary artery thrombosis
|
Septicemia
|
Meningitis
|
ENT
|
Paranasal Sinuses
|
abd8308c-1ff7-45fc-8eef-70dfd0c7dd55
|
single
|
Which of the following is not true about resuscitation in burns patient?
|
Ans. is 'c' i.e., Quantity of crystalloid needed is calculated using the parkland formula-6m/Kg body weight per % of the total body surface area burnt * Proper fluid management is critical to survival in a burn patient.* The hypovolemic shock in burn patient is special in the sense that the total body water remains unchanged in a burn patient. The thermal injury leads to a massive fluid shift from intravascular compartment to the extravascular compartment (interstitial + intracellular) leading to edema formation (in both burned parts and non burned parts of body)* This fluid shift is maximum in the first 24 hrs.* Fluid resuscitation begins with an isotonic crystalloid solution - Ringer's lactate solution (RL) is the preferred solution (Normal saline should be avoided as the volumes required for resuscitation may lead to hyperchloremic metabolic acidosis). The concept behind the continuous fluid resuscitation is that the burn (and/or inhalation injury) drives an inflammatory response that leads to capillary leak; as the plasma leaks into the extra vascular space, crystalloid administration would maintain the intravascular volume.# The quantity of crystalloid needed for adequate resuscitation is determined by Parkland formula i.e. 4 mL/kg per % of TBSA burn. (Note that a number of formulas exist for calculating fluid needs during burn resuscitation, suggesting that no one formula benefits all patients. Parkland is one of the most commonly used formulas)# Half of the calculated fluid is given in first 8 hrs and half in next 16 hrs.* Colloids are given in the next 24 hrs. The reason behind it being the observation that in the initial period, the vascular permeability is so large that even larger protein molecules leak from the capillaries. (But some workers, prefer to use colloids after 8 to 12 hrs, while there are some who use it from the very beginning)* A number of parameters are widely used to assess burn resuscitation, but the most common remain the simple outcomes of blood pressure and urine output. As in any critically ill patient, the target MAP is 60 mmHg to ensure optimal end-organ perfusion. Goals for urine output should be 30 mL/h in adults and 1 to 1.5 mL/kg per hour in pediatric patients.* There is no use of diuretics in burn resuscitation.* Children under 20 kg have the additional requirement that they do not have sufficient glycogen stores to maintain an adequate glucose level in response to the inflammatory response. Specific pediatric formulas have been described, but the simplest approach is to add maintenance IV fluid with glucose supplementation in addition to the calculated resuscitation fluid with lactated Ringer's.
| 3 |
Ringers lactate is the preferred crystalloid solution
|
Fluid shift from intravascular to extravascular compartment in the burns patient is maximum in the first 24 hrs
|
Quantity of crystalloid needed is calculated using the parkland formula - 6m/Kg body weight per % of the total body surface area burnt
|
Target mean arterial pressure in resuscitation is 60 mmHg
|
Surgery
|
Burns
|
d71db149-bada-4ab4-ba67-ad0bd262a48b
|
multi
|
A drug having narrow therapeutic range is
|
Therapeutic range is bounded by the dose which produces a minimal therapeutic effect and the dose which produces a maximal acceptable adverse effect.
Example of the narrow therapeutic range are lithium, Phenytoin.
| 1 |
Lithium
|
Sertraline
|
Reboxetine
|
Dothiepin
|
Pharmacology
| null |
3c7dbf53-ea02-4669-9461-592ef6ddb55f
|
single
|
Concentration of sodium in mOsm/l in low osmolar ORS is?
|
Concentration of sodium in low osmolar ORS is 75 mOsm/l Osmolarity reduced to avoid possible adverse effects of hypeonicity on net fluid absorption by reducing the concentration of glucose and sodium chloride in the solution . Ref: PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition pg 224
| 2 |
45
|
75
|
90
|
60
|
Social & Preventive Medicine
|
Communicable diseases
|
43ce74a3-479b-41e5-befa-1397c6cb4512
|
single
|
A patient with Pink color skin & mucosa , bitter almond smell from breath and frothy discharge. The cause of death is
|
Characteristic of Cyanide poisoning : patient present with Tachypnoea followed by bradypnoea, Cyanosis is generally a late finding and usually does not occur until circulatory collapse and tachycardia are evident. Brick-red colour of skin and mucous membranes is said to be characteristic. The skin feels cold and clammy to the touch patient also have CNS manifestation like Headache, anxiety, agitation, confusion, convulsions, and coma. Pupils are often dilated
| 3 |
H2S poisoning
|
CO poisoning
|
HCN poisoning
|
OPC poisoning
|
Forensic Medicine
|
Toxicology - 2
|
a692f27b-a58d-4add-bb56-37fcbf1548d1
|
single
|
Aminoacyl t-RN A is required for all except :
|
A i.e. Hydroxyproline
| 1 |
Hydroxyproline
|
Methionine
|
Cystine
|
Lysine
|
Biochemistry
| null |
1caf2649-e9df-46db-9f8e-8e62bf15abbd
|
multi
|
A 25 year old male collage student present to emergency after road traffic accident.patient is in state of shock and breath sounds are decreased on side of chest trauma (left side).normal heart sound ,no elevated JVP and dull note on percussion. diagnosis?
|
Patient with chest trauma in shock without elevated JVP suggest massive Hemothorax.
| 3 |
Tension pneumothorax
|
Cardiac tamponade
|
Massive Hemothorax
|
None
|
Medicine
| null |
63a621d6-024b-4734-87a0-baaa469610bb
|
multi
|
Which of the following prokinetic drugs produces extrapyramidal side effects?
|
(Ref: KDT 6/e p643, 644) Metoclopramide and domperidone act by blocking D2 receptors. Metoclopramide can cross BBB whereas domperidone cannot. Therefore, metoclopramide can produce extra-pyramidal adverse effects while domperidone is devoid of it. Cisapride acts as 5HT4 agonist. It can cause torsades de pointes.
| 1 |
Metoclopramide
|
Cisapride
|
Domperidone
|
All of the above
|
Pharmacology
|
Other topics and Adverse effects
|
dbe77d7d-5232-43c6-95d3-91645b8ccb12
|
multi
|
As compared to a routine case-control study, nested case-control study avoids problems (in study design) related to -
| null | 1 |
Temporal association
|
Confounding bias
|
Need for long follow up
|
Randomization
|
Social & Preventive Medicine
| null |
f36ee235-74bf-4eac-bb48-5e38a9791654
|
single
|
Drug not useful in hypeensive emergency is
|
Refer kDT 6/e p554 Indapamide is thiazide like diuretics, having mild diuretic effect, not used in emergency situation Indapamide is a thiazide-like diuretic drug generally used in the treatment of hypeension, as well as decompensated hea failure. Combination preparations with perindopril
| 2 |
IV Hydralizine
|
Indapamide
|
Sublingual nifedipine
|
Sodium nitroprusside
|
Pharmacology
|
Cardiovascular system
|
e9604d54-abc8-4ae3-a2bf-00a816c69ca7
|
single
|
Feature of 3 degree burn:
|
Answer- C. Whole dermis destroyedThe whole of the dermis is destroyed of the burns.Clinically, they have a hard, leathery feel, The appearance can vary from that similar to the patient's normal skin to charred black depending upon the intensity of the heat. . There is no capillay return after, thrombosed vessels can be seen under the skin.These burns are completely anaesthetised: a needle can be stuck deep into the dermis without any pain or bleeding.
| 3 |
Pain present
|
Transudation of fluid present
|
Whole dermis destroyed
|
Erythematous in appearance
|
Surgery
| null |
e6842e7e-5fb7-4225-a8ee-42389d341a20
|
single
|
Dowry death is covered under which section of IPC?
|
ANSWER: (B) 304-BREF: Parikh 6th edition page 4.162, 8.2, 4.56Repeat from December 2010Repeat (***)304-B: Dowry death:Where the death of a woman is caused by any bums or bodily injury or occurs otherwise than under normal circumstances within seven years of her marriage and it is shown that soon before her death she was subjected to cruelty or harassment by her husband or any relative of her husband for, or in connection with, any demand for dowry, such death shall be called "dowry death" and such husband or relative shall be deemed to have caused her death.Whoever commits dowry death shall be punished with imprisonment for a term which shall not be less than seven years but which may extend to imprisonment for life.
| 2 |
304-A
|
304-B
|
176
|
302
|
Forensic Medicine
|
Law & Medicine, Identification, Autopsy & Burn
|
851d95bb-751d-4430-9c5a-2f9bb6645584
|
single
|
What is this mode of treatment called as?
|
Ans. D. Gallows tractionThe figure shows the child put on Gallows traction that is used to treat a patient less than 2 years' old who lands up with a fracture of shaft of femur.
| 4 |
Russell's traction
|
90-90 traction
|
Buck's traction
|
Gallows traction
|
Orthopaedics
|
Injuries Around the Thigh & Knee
|
ce6f5e08-1c24-4e3b-afe0-0a2205aba5c3
|
multi
|
Flavoproteins are component of which complex of respiratory chain:
|
Flavoproteins are impoant components of Complexes I and II. The oxidized flavin nucleotide (FMN or FAD) can be reduced in reactions involving the transfer of two electrons (to form FMNH2 or FADH2), but they can also accept one electron to form the semiquinone. Ref: Harper 28th edition, chapter 13.
| 3 |
Complex I
|
Complex II
|
Both of the above
|
None of the above
|
Biochemistry
| null |
cd4e2071-3b55-4104-989f-3394b7d691b0
|
multi
|
Cause of Farmer's lung -
|
Ans. is 'b' i.e., Grain dust Farmer's lung is caused by Hay or grain dust
| 2 |
Cotton dust
|
Grain dust
|
Sugarcane dust
|
Iron
|
Social & Preventive Medicine
| null |
455f6d03-f83f-4117-92fd-514735c0c58a
|
single
|
Complement attaches to immunoglobulin at -
|
Antigen is attached to Fab region Complement and ADCC(antibody dependent cellular cytotoxicity) attachment are through Fc region. The constant region of the heavy chain has many biological functions. It is responsible for activation of the complement, binding to cell surface receptors, placental transfer, and many other biological activities. The amino-terminal half of the light or heavy chain, consisting amino acids, is known as variable or V regions (VL in light chains and VH in heavy chains).These antigen-binding sites are responsible for specific binding of antibodies with antigens. The high specificity of antibodies is primarily due to the presence of these hypervariable regions.
| 4 |
Aminoterminal
|
Fab region
|
Variable region
|
Fc fragment
|
Microbiology
|
Immunology Pa 1 (Immune Response, Antigen-Antibody Reactions, Hypersensitivity, Structure of Immune System, Immunodeficiency Disorders)
|
20776185-d5b8-40e4-88c1-5bd3dc265aa9
|
single
|
Chalazion of lid is:
|
Chronic lipogranulomatous inflammation
| 3 |
Caseous necrosis
|
Chronic nonspecific inflammation
|
Chronic lipogranulomatous inflammation
|
Liposarcoma
|
Ophthalmology
| null |
7320942f-f3ef-4b06-9616-672d76c3016e
|
single
|
Which of the following receptors mediate the release of ACTH by Vasopressin?
|
Vasopressin acts on V3 or V1b receptors to release ACTH.
| 3 |
V1a
|
V2
|
V3
|
V4
|
Pharmacology
| null |
c0821d72-5e27-4d28-97f0-6fa91813ef88
|
single
|
Causes of Psedoahrosis is all of the following except -
|
Pseudoahrosis is pseudo joints * it can be seen after a fracture - non union of a fracture may be painless if pseudojoint forms between fracture ends. *it can be idiopathic *can be seen in neurofibromatosis *congenital pseudoahrosis of tibia - rare condition , in 50-90% cases neurofibromatosis is present * in established cases - Boyd dual onlay graft is the treatment of choice in patients with street fracture. REF:textbook of ohopedics, John ebnezer, 4th edition ,pg.no.501
| 3 |
Idiopathic
|
multiple compound Fractures
|
Osteomyelitis
|
Neurofibromatosis
|
Orthopaedics
|
Pediatric orthopedics
|
b295fb04-908a-4906-82fa-3172a419c559
|
multi
|
Prophylaxis for migraine
|
K.D Tripathy essentials of medical pharmacology 7th edition . *Drugs for prophylaxis of migraine are beta blockers(propranalol ),TCA(amitriptyline ), calciumchannelblockers(flunarizine),anticonvulsants (valproate),5HT antagonist. Ref Harrison20th edition pg 2234
| 2 |
Sumitriptan
|
Amytriptiline
|
Nifidipine
|
Diazepam
|
Medicine
|
C.N.S
|
8e4d1aa5-eb83-4026-b73c-6683ea09530b
|
single
|
Most common size of osteoma ?
|
Ans. is 'd' i.e., Aryepiglotic folds Inlet of larynx It is an oblique opening bounded : - Anteriorly : - Free margins of epiglottis On the sides : - Aryepigloftic folds Posteriorly : - Interarytenoid folds Vestibular folds (False vocal cords) Two folds of mucous membrane extending anteroposteriorly across the laryngeal cavity. It contains vestibular ligament, a few fibres of thyroarytenoides muslce and mucous glands. Vocal folds (Vocal cords or true vocal cords) Two pearly-white sharp fibroelastic bands extending from the middle of thyroid angle to vocal process of arytenoids They are formed by reflection of the mucosa over vocal ligaments. They have stratified squamous epithelium with no submucous layer. Their blood supply is poor and are almost devoid of lymphatics, this gives vocal cord a pale apperance. Vocal cords along with the upper pa of the vestibule is the only pa of laryngeal mucous membrane which is lined by epithelium of stratified squamous type. Elsewhere in the larynx epithelium of the mucous membrane is ciliated columinar type. Glottis (rima glottidis) It is the opening between the true vocal cords (anteriorly). It is the narrowest pa of larynx in adults. Rima vestibuli It is the space between two vestibular folds.
| 4 |
Frontal sinus
|
Ethmoid sinus
|
Maxillary sinus
|
Aryepiglotic folds
|
ENT
| null |
689f27bc-1e5e-47d4-b88d-d5abd8860a56
|
single
|
25 yr old male having fever & malaise since 2 weeks, ahritis of ankle joint and tender erytematous nodules over the shin. Diagnosis is:
|
A i.e. Erythema nodosum
| 1 |
Erythema nodosum
|
Hansen'sdisease
|
Weber- Christian disease
|
Nodular Vasculitis
|
Skin
| null |
3332268d-d683-4245-93d9-45e855118cbb
|
single
|
Pancreatic Cancer is caused by:
|
Clonorchis infection causes the bile duct and pancreatic cancer. Ref: Harrison's Principles of Internal Medicine, 15th Edition, Page 591, 1247 ; CMDT, 2002, Page 1504
| 2 |
Fasciola
|
Clonorchis
|
Paragonimus
|
None
|
Microbiology
| null |
e6013c5e-1518-4d23-90b3-94fd5be1670d
|
multi
|
Commonest complication of Trans-cervical fracture of femur is
|
C i.e. Avascular necrosis
| 3 |
Non union
|
Malunion
|
Avascular necrosis
|
All of the above
|
Surgery
| null |
53f122af-848a-42e7-a275-7c91010592c5
|
multi
|
True statement about case fatality rate is -
|
Ref: Parks 23rd edition pg 58 it is a propoion. It represents killing power of a disease. It is simply the ratio of deaths to cases.
| 2 |
It is ratio
|
It is a propotion
|
Numerator is always constant
|
Numerator and denominator are separate entities
|
Social & Preventive Medicine
|
Epidemiology
|
1915083f-939a-45be-8657-be5f791f9ec0
|
multi
|
HbH is characterized by
|
Answer- A. Deletion of three alpha genesHbH disease- Deletion of three alpha genes (--/-alpha)- hemolytic anemia
| 1 |
Deletion of three alpha genes
|
Deletion of three alpha and one beta gene
|
Deletion of two alpha and two beta genes
|
Deletion of four alpha genes
|
Medicine
| null |
dcde993a-cec8-4c38-b86e-3954f1595339
|
single
|
Not a complication of gallstones
|
Effects and complications of Gallstones In Gallbladder In Bile duct In intestine Silent stones Acute cholecystitis Chronic cholecystitis Mucocele Empyema Perforation Gangrene Carcinom Obstructive jaundice Cholangitis Acute pancreatitis Gall stone ileus Ref: Sabiston 20th edition Pgno : 1492-1493
| 2 |
Mucocele
|
Diveiculosis
|
Acute cholangitis
|
Empyema of the gallbladder
|
Anatomy
|
G.I.T
|
63485541-8ba6-44ff-909c-c0d8843ce4b2
|
multi
|
A 22 year old woman is evaluated in the emergency for a 3 day h/o dark urine and abdominal distension. O/E: normal mental status, icterus present, hea and lungs normal, Hematocrit: 26, Reticulocytes: 5%, Platelets: 1.3 lakhs, Alk.Phos: 30 units/L, ALT: 110 units/L, AST: 220 units/L, Total bilirubin:13mg% (Direct:4 mg) HBsAg positive and Hepatitis 'A' &'C' negative. Urine drug screen negative. USG abdomen shows a nodular appearing liver and enlarged spleen. Which is the most likely diagnosis?
|
Points in or of diagnosis of Wilson's disease- Low hematocrit of 26% and increased reticulocyte count: hemolysis of RBC due to excess intracellular copper. Unconjugated jaundice due to hemolysis and defective conjugation in liver due to hepatocyte damage. Mild elevation of enzymes unlike acute viral hepatitis where gross elevations in enzyme values Nodular liver with splenomegaly indicating a chronic process. Poal hypeension has already developed in the patient. Hepatitis B positivity in the question was given to confuse you, since it can be an incidental finding. Points against the diagnosis of acute viral hepatitis Jaundice with mild elevation of AST/ALT Nodular enlarged liver Enlarged spleen ALSO KNOW: A prognostic index for wilson diseasecalculated by Nazer (score range 0-12) based on serum bilirubin, serum AST, and prolongation in prothrombin time. KING'S COLLEGE CRITERIA:(were developed to determine which patients with fulminant hepatic failure (FHF) should be referred for liver transplant.)
| 4 |
Acetaminophen intoxication
|
Acute viral hepatitis
|
Primary biliary cirrhosis
|
Wilson disease
|
Medicine
|
Liver
|
bed78849-a1b1-4cec-a517-cbda2e0c24ee
|
single
|
Lid retraction is a side effect of wof anti- glaucoma drug
|
Brimonidine:- This clonidine congener is more a2 selective and more lipophilic than apraclonidine. mech of action:- It lowers i.o.t. by 20-27% by reducing aqueous production and by increasing uveoscleral flow. Peak effect on i.o.t. occurs after 2 hours. Side effects:- Allergic conjunctivitis, mydriasis, eyelid retraction, conjunctival blanching followed by hyperemia, dry mouth, sedation and a small fall in BP have been noted. Ref:- kd tripathi; pg num:-154
| 2 |
Latanoprost
|
Brimonidine
|
Brinzolamide
|
Pilocarpine
|
Pharmacology
|
Autonomic nervous system
|
2fbf239b-0b27-4880-89ea-aadcfb7c8482
|
single
|
Green blue postmoem discoloration is seen in which poisoning -
|
The colour of postmoem hypostasis in hydrogen sulphide poisoning is bluish green. It is an asphyxiant which inhibits cytochrome oxidase. Dr.Narayana Reddys Synopsis of Forensic Medicine and Toxicology 27th edition pg. 76,313.
| 4 |
Cyanide
|
Carbon monoxide
|
Phosphorous
|
Hydrogen sulphide
|
Forensic Medicine
|
Death and postmortem changes
|
65e1d43d-6041-4ecf-9187-9dcfe7668f24
|
single
|
Pudendal nerve supplying motor pa to external sphincter is derived from :
|
S2-S3 roots There are two sphincters of the urethraa. Internal urethral sphincter (also k/a sphincter vesicae)- it is involuntary in nature- made up of smooth muscle- supplied by sympathetic nerves, from lower thoracic & upper lumbar segments of spinal cordb. External urethral sphincter (also k/a sphincter vesicae)- it is voluntary in nature- made up of striated muscle fibres- supplied by the perineal branch of the pudendal nerve (derived from spinal nerves S2,S3 & S4) - it controls the membranous urethra and is responsible for the voluntary holding of urine.
| 4 |
L5-S1 roots
|
51-S2 roots
|
L2-L3 roots
|
S2-S3 rootsPHYSIOLOGY
|
Anatomy
| null |
3d9428d6-baae-416c-93f6-f8e06ba155fa
|
single
|
A male 45 year old presents to the clinic for routine checkup. He is a known case of hypertension and is under treatment. The clinician advises him to have a balanced diet involving which of the following fatty acids?
|
Long chain ω3 fatty acids such as alpha-linolenic (ALA) (found in plant oils), eicosapentaenoic (EPA) (found in fish oil) and docosahexaenoic (DHA) (found in fish and algal oils) have anti-inflammatory effects, perhaps due to their effects in promoting the synthesis of less inflammatory prostaglandins and leukotrienes as compared to ω6 fatty acids. In view of this their potential use as a therapy in severe chronic disease, where inflammation is a contributory cause is under intensive investigation. Current evidence suggests that diets rich in ω3 fatty acids are beneficial, particularly for cardiovascular disease, but also for other chronic degenerative diseases such as cancer, rheumatoid arthritis, and Alzheimer disease.
| 1 |
ω3 fatty acids
|
ω6 fatty acids
|
ω9 fatty acids
|
Fatty acids need not be taken at all
|
Biochemistry
| null |
2e68a778-d1ca-4b97-95d4-3eff0a883076
|
multi
|
All the following are long-acting reversible contraceptives except
|
Long-Acting Reversible ContraceptivesSeveral contraceptive methods are as effective as sterilization but are completely reversible. All have the impoant advantage of being "forgettable," that is, little is required of the user after the method is begun, very much in contrast to methods like the condom that must be used with each act of intercourse, or the OC, which must be taken daily.These forgettable methods have pregnancy rates in typical use of less than 2 per 100 woman-years, are effective for at least 3 months without attention from the user, and are among the safest methods. They include the injectable progestins, depot medroxyprogesterone acetate (DMPA) and norethindrone enanthate, the etonogestrel and levonorgestrel subdermal implants, copper-containing intrauterine devices such as the copper T380A and the levonorgestrel-releasing intrauterine system.Reference: Novak's gynaecology; 14th edition; Chapter 10; Family planning
| 1 |
OC pills
|
Injectable progestins
|
Implants
|
Intrauterine devices
|
Gynaecology & Obstetrics
|
Contraception
|
04b78d01-d21c-41cb-8421-a0eea77a1f29
|
multi
|
All of the following statements about Menetrier's disease are true Except:
|
Answer is B (Usually increased acid secretion) Gastric acid secretion is usually reduced or absent because of replacement ofparictal cells' Harrison's Menetrier's disease carries an increased risk of developing adenocarcinoma of stomach (premalignant) is associated with a protein losing enteropathy and may be confused with Zollinger Ellison Syndrome as ZES also presents with large gastric folds.
| 2 |
It is a premalignant condition
|
Usually increased acid secretion
|
May be confused with Zollinger Ellison Syndrome
|
Associated with Protein losing enteropathy
|
Medicine
| null |
b216589b-1eef-485b-8bb9-b5570e3945b4
|
multi
|
Fleischer ring is due to
|
(Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 194)Some confusion exists between Fleisher rings and Kayser-Fleischer (KF) ring. Kayser-Fleischer (KF) rings are caused by copper deposits and are indicative of Wilson's disease, whereas Fleischer rings are caused by iron deposits and are indicative of keratoconus.
| 1 |
Iron deposition
|
Copper deposition
|
Aluminum deposition
|
Molybdenum Deposition
|
Ophthalmology
|
Cornea and sclera
|
d6e430b8-6eb9-4470-8c3f-d637fdbdf125
|
single
|
Investigation of choice for detection and characterization of interstitial lung disease is:
|
Ans. is 'c' ie high Resolution CT Scan (Ref: CT and MR imaging of whole body, Haaga, 4/e, p838; Sutton, 7/e, p33)HRCT is the investigation of choice for interstitial lung disease.HRCT can even delineate the lung parenchyma down to the level of the secondary pulmonary lobule.Also Remember * Principles of HRCT*Thin sections (collimation) - 1 to 2 mm.High spatial resolution reconstruction algorithm (eg the bone algorithm).Small field of view just large enough to encompass the region of interest.
| 3 |
MRI
|
Chest X-ray
|
High resolution CT scan
|
Ventilation perfusion scan
|
Radiology
|
Imaging of Interstitial Lung Disease
|
fc884ed1-638f-46cf-ad25-8a5647e999a3
|
single
|
SLE mitral and tricuspid valve vegetations are?
|
Ans. is 'b' i.e., Libmann sach's disease Endocarditis of Systemic Lupus Erythematosus (Libman-Sach's Disease)Mitral and tricuspid valvulitis with small, sterile vegetations, called Libman-Sach's endocarditis, is occasionally encountered in systemic lupus erythematosus.Due to the use of steriods, the incidence of this complication has been greatly reduced.The lesions are small (1 to 4 mm in diameter), single or multiple, sterile, pink vegetations with a way (verrucous) appearance located on the undersurfaces of the atrioventricular valves, on the valvuar endocardium, on the chords, or on the mural endocardium of atria or ventricles.
| 2 |
Salmon patch
|
Libmann sach's disease
|
Janeway lesions
|
Oslers nodes
|
Pathology
| null |
ace5bbec-f996-4bf9-9964-79cc6560709b
|
single
|
Sympathetic system has adrenergic nerve endings at all sites except-
|
Ans. is 'b' i.e., Blood vessels in skeletal muscles * Sympathetic adrenergic fibers are those which secrete endogenous catecholamines {either adrenaline, norepinephrine / nor-adrenaline or dopamine}* Some sympathetic fibers do not secrete catecholamines but secrete acetylcholine -i) Sweat glandsii) Blood vessels in skeletal muscles Sympathetic fibers | | | Adrenergic Cholinergic | |||||Nor-adrenalineDopamineAdrenaline* Sweat glands* Most postganglionic sympathetic supply* Mesentric & renal vessels* Adrenal medulla* Blood vessels in skeletal muscles
| 2 |
Heart
|
Blood vessels in skeletal muscles
|
Eye
|
None
|
Physiology
|
Nervous System
|
eb9df620-ee30-4b6b-9b5a-b4f007916efb
|
multi
|
Low calcium level will cause:
| null | 4 |
Hyper excitability of wrist muscle
|
Weak heart action
|
Tetany
|
All of the above
|
Physiology
| null |
793c0eba-4498-4e5b-985b-f07cf38e736f
|
multi
|
Which of the following is the lateral curve position of the body in strychnine poisoning?
|
In strychnine poisoning, Convulsions are most marked in antigravity muscles resulting in hyperextension (opisthotonus). Sometimes, the spasm of the abdominal musclesmay bend the body forward (emprosthotonus) or sideways (pleurosthotonus). Ref: Krishnan vij ; 5th ed; Page no: 522
| 3 |
Emprostotonus
|
Opisthotonus
|
Pleurosthotonus
|
All of the above
|
Forensic Medicine
|
Poisoning
|
2e43c736-7cf0-4f62-ae48-192398ab22f3
|
multi
|
In a patient PO2 is 85 mmHg, PCO2 -- 50mmHg, pH is 7.2 and HCO3 is 32 meq/1 is suffering from :
|
Answer is A (Respiratory acidosis with compensatory metabolic alkalosis) Because primary respiratory component is causing acidosis and metabolic component is compensatory by producing alkaosis, the acid base disorder is Respiratory acidosis with compensatory metabolic alkalosis. STEP 1 : What is the pH. Normal pH pH of patient Inference Is it acidosis or alkalosis 7.35 - 7.45 7.2 Decreased pH Acidosis STEP II : What component is primary and what is compensatory Parameter Inference Is change towards acidosis or alkalosis Is change in keeping with change in pH Final Inference pCO3 = 50mm Hg increased acidosis Yes Primary component is (Respiratory component) (pH=7.2 = Acidosis) respiratory (acidosis) HCO3- = 32 mmHg increased Alkalosis No Metabolic component is (metabolic component) (pH=7.2 = Acidosis) compensatory (alkalotic) STEP III : Final deduction Because the primary component is respiratory and the metabolic component is compensatory the acid base disorder is respiratory acidosis with compensatory metabolic alkalosis.
| 1 |
Respiratory acidosis with compensatory metabolic alkalosis
|
Respiratory acidosis with compensatory metabolic acidosis
|
Metabolic acidosis
|
Metabolic alkalosis
|
Medicine
| null |
d71146b4-071c-42b4-80c9-4258e0debcd5
|
single
|
Infant orthopedics in a cleft patient is done at the age of:
|
In patients with a bilateral cleft, the premaxillary segment is often displaced anteriorly while the posterior maxillary segments are lingually collapsed behind it. If this distortion is severe, surgical closure of lip, will become extremely difficult. So orthodontic intervention to reposition the segments and to bring the protruding premaxillary segment back into the arch may be needed to obtain a good surgical repair of lip. This is achieved by "infant orthopedics".
Infant orthopedics was pioneered by Burston. In a child with bilateral cleft, the maxillary segment requires two movements i.e., lateral expansion and posterior reposition. This movement is accomplished by a Light elastic strap across anterior segment. In infants, the segments can be repositioned surprisingly, quickly and easily, so that the period of active treatment is only a few weeks at most. If pre-surgical movement of maxillary segment is needed, this typically would be done beginning at 3 to 6 weeks of age, so that the lip closure could be carried out approximately 10 weeks. A passive plate similar to an orthodontic retainer is then used for a few months after lip closure.
| 2 |
1 - 2 weeks
|
3 - 6 weeks
|
9 - 12 weeks
|
12 - 15 weeks
|
Dental
| null |
78070997-83cc-49a4-9080-9910ad43daaf
|
single
|
PUFA consumption is associated with-
|
Ans. is 'b' i.e., Lowering of serum cholesterol, lowering of LDL cholesterol "Diet rich in polyunsaturated essential fatty acids have been repoed to reduce the serum cholesterol and low density lipoprotein".
| 2 |
Lowering of serum cholesterol, rise in LDL cholesterol
|
Lowering of serum cholesterol, lowering of LDL cholesterol
|
Rise in serum cholesterol, rise in LDL cholesterol
|
Rise in serum cholesterol, lowering of LDI, cholesterol
|
Social & Preventive Medicine
| null |
8377c0d6-560e-4db3-bd23-c4a18ece1873
|
single
|
During incision & drainage of ischiorectal abscess, which nerve is/are affected/injured:
|
B i.e. Inferior rectal nerveThrough a posterior horse shoe shaped recess both ischiorectal fossae are connected behind the anal canal; so a unilateral abscess may become bilateral.During dissection of ischio rectal fossa, inferior rectal, pudendal, posterior scrotal or labial nerve & vessels along with perforating branches of S2-S3 and perineal branches of S4 nerve may get damaged.
| 2 |
Superior rectal nerve
|
Inferior rectal nerve
|
Superior gluteal nerve
|
Inferior gluteal nerve
|
Anatomy
| null |
485269be-72f3-472a-af47-d3a07a0fe6f7
|
single
|
Long acting insulin is:
| null | 3 |
Lente
|
Semilente
|
Ultralente
|
Lispro insulin
|
Pharmacology
| null |
9b223aca-a8d4-4537-b4e8-0e4fa9762227
|
single
|
Best surgical approach in accessing retrosternal goiter is:
|
Ans. (a) CervicalRef: Bailey and Love 27th Edition, Page 811Mediastinal goiter can be divided into* Primary - Only <1% of mediastinal goiters, arising from ectopic thyroid tissue in mediastinum with blood supply from mediastinal vessels.* Secondary - Majority of mediastinal goiters due to extension of thyroid from neck with blood supply from thyroid arteries.Treatment:* Mediastinal goiter can be removed by Neck incision most of the times except in few cases like suspected thyroid cancers, Primary mediastinal goiters and previous neck surgeries.
| 1 |
Cervical
|
Sternal
|
Intercostal
|
VATS
|
Surgery
|
Thyroid Gland
|
0edbda7f-5fbe-4784-977d-87cf1895a6fb
|
single
|
Common fungus causing corneal ulcer is
|
Aspergillus causes respiratory diseases, disseminated aspergillosis in brain, kidney and hea, and superficial infection like sinusitis, otomycosis and mycotic keratitis. Sporothrix causes sporotrichosis - nodular ulcerative disease of the skin and subcutaneous tissue. Mucor causes pulmonary and gastrointestinal mucormycosis. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition
| 1 |
Aspergillus
|
Mucor
|
Fusarium
|
Sprothrix
|
Microbiology
|
mycology
|
86de3105-4bf7-45ed-bdac-d332d59d9b4c
|
single
|
A 17 year old girl had been taking a drug for treatment of acne for the last 2 years, which has lead to pigmentation. Which drug could it be?
|
Minocycline is most commonly used for acne among tetracyclines The main effect of Minocycline- Hypersensitivity, Skin rashes, uicaria, glossitis, pruritus ani Complete cross-sensitization is exhibited by different tetracyclines. tetracyclines also cause Superinfection -They cause marked suppression of the resident flora. Though mouth, skin or vagina may be involved, intestinal superinfection by Candida albicans is most prominent The tetracycline should be discontinued at the first sign of superinfection and appropriate therapy instituted. Doxycycline and minocycline are less liable to cause diarrhoea, because only small amounts reach the lower bowel in the active form. ESSENTIALS of medical PHARMACOLOGY SEVENTH EDITION-KD TRIPATHI Page:735,736,737
| 2 |
Doxycycline
|
Minocycline
|
Azithromycin
|
Chlorpromazine
|
Pharmacology
|
Other topics and Adverse effects
|
58d7a603-4092-4a36-88b0-80c08055aa4d
|
single
|
8.Mikulicz cell and russel bodies are characteristic of:
|
Rhinoscleroma: chronic granulomatous disease caused by gram negative bacteria klebsiella rhinoscleromatis. Mikulicz or foam cells and russell bodies found in plasma cells. Ref.Dhingra 6/e p 156
| 1 |
Rhinoscleroma
|
Rhinosporidiosis
|
Plasma cell disorder
|
Lethal midline granuloma
|
ENT
|
Nose and paranasal sinuses
|
07948005-5fa3-447d-bf4f-6b1347fd43d0
|
single
|
Left gastric vein drains into:
|
B i.e. Poal vein-Left and right gastric veins drain directly into the poal veinQ.- Poal vein is formed by union of superior mesenteric & splenic veins behind the neck of pancreasQ at the level of L2 veebrae and runsupwards with bile duct & hepatic aery (related anteriorly)(2 and inferior i'ena cava (related posteriorly)Q
| 2 |
Inferior vena cava
|
Poal vein
|
Directly into splenic vein
|
Splenic vein through sho gastric vein
|
Anatomy
| null |
1c9f7e3b-8ace-425d-94bf-f7cf15f01309
|
single
|
A 35-year-old patient on USG shows 3 x 4 cm clear ovarian cyst on right side. Next line of management is;
|
A simple unilocular cyst measuring less than 5 cm can be observed with repeat ultrasound and CA-125 every 3 months.Many resolve in 6 months.A persistant cyst calls for its removal laparoscopically or by laparotomy.Aspiration of the cyst is contraindicated because of low yield of malignant cells and possibility of spread of malignancy if the cyst proves malignant histologically.Many perform bilateral oophorectomy and hysterectomy. SHAW&;S TEXTBOOKOF GYNECOLOGY,Pg no:388,15th edition
| 3 |
Laparoscopy
|
OC pUls
|
Wait and watch
|
Ca-125 estimation
|
Gynaecology & Obstetrics
|
Gynaecological oncology
|
13893789-1dd0-4bf9-b638-ee2d17754aed
|
single
|
'Slapped cheeks' appearance is seen in:
|
C i.e. Erythema infectiosum
| 3 |
Roseloa infantum
|
Erythema subitum
|
Erythema infectiosum
|
Erythema multiforme
|
Skin
| null |
c1410003-3cef-4fc0-8057-6f7c2965d22c
|
single
|
Homocystein is not associated with ?
|
Ans. is 'c' i.e., Hearing lossElevated level of homocysteine (hyperhomocysteinemia) is associated with -Thrombosis, coronary aery disease & stroke. Osteoporosis & fracture.Neuropsychiatric manifestations. Developmental delay.Visual disturbances.
| 3 |
Coronary aery disease
|
Fracture
|
Hearing loss
|
Neuropsychiatric manifestations
|
Biochemistry
| null |
6e73b5bb-4523-401e-92ef-216036bc9334
|
single
|
Most common type of Bening overian tumour during pregnancy is :
|
Simple serous cystoid
| 1 |
Simple serous cystoid
|
Mucinous cystoid
|
Teratoma
|
Papillary cystadenoma
|
Gynaecology & Obstetrics
| null |
e6479a98-6f84-4e4e-81c4-9852d5a81e43
|
single
|
All of the following are features of musculocutaneous nerve injury at axilla except:
|
MUSCULOCUTANEOUS NERVE INJURY Musculocutaneous nerve supplies coracobrachialis, the biceps brachii and the brachialis, Continued into the forearm as the lateral cutaneous nerve of the forearm. Injury-loss of flexion of elbow, supination of forearm sensory loss on lateral aspect of forearm. Damaged in shoulder dislocation.
| 1 |
Loss of flexion of shoulder
|
Loss of flexion at elbow
|
Loss of supination of forearm
|
Loss of sensation on radial side of forearm
|
Orthopaedics
|
Peripheral Nerve Injury
|
983ca8a4-eaf6-4c80-a4cc-b58d1e8a1de3
|
multi
|
Decreased vascularity of fibroid is seen with
|
GnRH analogues used for 6months reduce the size by 50-80%. It is also useful in reducing the vascularity besides size preoperatively and thus causing amenorrhoea which restores hb level. Ref:shaw's textbook of gynaecology;15th edition; Pg :359
| 1 |
GnRH agonist
|
Danazol
|
Mifepristone
|
Clomiphene citrate
|
Gynaecology & Obstetrics
|
Uterine fibroid
|
7b64d838-2c0f-4a0c-bf41-a17660f44872
|
single
|
Treatment of osteoporosis includes -
|
General 1.Bedrest 2.Local heat 3.Analgesics 4.Exercise: Regular walking or other weight bearing exercise for 1 hour 3 times a week protects bone mass 5.Prevention of injury (most hip and wrist fractures are caused by falls). 6.Excessive thyroid hormone replacement therapy should be avoided. B.Antiresorptive agents 1.Oestrogen: Oestrogen 0.625 mg + Medroxyprogesterone (cyclic progestin) 5-10 mg per day 10-14 days/month. Progesterone to be added to prevent endometrial carcinoma. Transdermal oestrogen patches are used to avoid deep vein thrombosis and pulmonary embolism. Oestrogen therapy is impoant in women with premature or surgical menopause. Contraindications of oestrogen therapy are carcinoma breast or endometrial cancer, recurrent thromboembolic disease, acute liver disease and unexplained vaginal bleeding. 2.Calcium: The recommended daily calcium intake for postmenopausal women is 1,500 mg, and 1,000 mg for premenopausal women. 3.Calcitonin: Salmon calcitonin for 1-2 years increases veebral bone density and decreases the risk of veebral fracture. The usual dose is 50 IU SC per day 3 times a week. (salmon calcitonin 200 units/day as nasal spray). The side effects are nausea, flushing, and rarely allergic reactions.4.Bisphosphonates: They specifically impair osteoclast function and reduce osteoclast number paly by induction of apoptosis. a.Alendronate 5-10 mg/day b.Risedronate 5 mg/day The prominent adverse effect is esophageal irritation and hence both should be taken with a full glass of water and the patient should remain upright for 30 min after taking the drug. c.Etidronate is given as an intermittent cyclical regimen, 400 mg orally for 2 weeks, has some efficacy against veebral fractures. 5.Selective oestrogen receptor modulators (SERMS) a.Raloxifene 60 mg/day b.Tamoxifen Both reduce bone turnover and bone loss in postmenopausal women. In addition Tamoxifen is beneficial in women at increased risk of breast cancer and Raloxifene reduces serum total and LDL cholesterol, Lp (a), and fibrinogen. C.Bone forming agents a.Fluoride--75 mg/day b.Anabolic steroids: Testosterone is used in the treatment of osteoporotic man with gonadal deficiency. D.Supplementation of Vitamin D metabolites and thiazide diuretics. R ALAGAPPAN MANUAL OF PRACTICAL MEDICINE FOUH EDITION PAGE NO-691,692
| 1 |
Conjugated equines estrogen
|
Estradiol valerate
|
Raloxifene
|
Biphosphonate
|
Medicine
|
Endocrinology
|
7f4bf372-b80d-4b46-899f-5e4994d3e71b
|
single
|
Lymphatics of suprarenal gland drain into which lymph nodes
|
Venous drainage flows directly into the inferior vena cava on the right side and into the left renal vein on the left side. Lymphatics drain medially to the aoic nodes. Each adrenal gland is composed of two distinct pas: the adrenal coex and the adrenal medulla. The coex is divided into three zones. Ref - BDC 6e vol2 pg328
| 2 |
Internal iliac
|
Para-aoic
|
Superficial inguinal
|
Coeliac
|
Anatomy
|
Abdomen and pelvis
|
804cd6c6-5995-4ed4-9f49-c0e1565001c2
|
single
|
Which type of gout is seen in a patient who is on treatment of CML?
|
Secondary gout is related to medications or conditions that cause hyperuricemia, such as the Myeloproliferative diseases or their treatment. Causes of secondary gout: Lymphoproliferative/myeloproliferative disorders Chronic hemolytic anemias Secondary polycythemia Severe exfoliative psoriasis Gaucher's disease Cytotoxic drug High purine diet
| 1 |
Secondary gout
|
Pseudogout
|
Acute gout
|
Primary gout
|
Anatomy
|
FMGE 2019
|
1c54bb92-91e3-4550-9028-535454a1cc68
|
single
|
All of the following is true except aEUR'
|
In Brutons aganunaglobulinemia opsonisation is not affected [Ref : Harrison 171h/e p. 381; Bobbin's 7"Ve p. 60, 61, 62, 210, 591 During phagocytosis there is rapid respiratory burst which is brought about by rapid burst in the activity of NADPH oxidase. Increased NADPH oxidase activity leads to increased oxidative proesses and there by increased production of superoxide anion (02-) Superoxide is then conveed to hydrogen peroxide (1-1,02) free radical. The 11,0, generated by NADPH oxidase system is not able to kill the bacteria itself However, the azurophilic , granules of the neutrophils contain the enzyme myeloperoxidase (MPO) which in presence of halide such as Cl? conves H202 to hypochlorite (HOCI). Hypochloth'e (HOCI) is a potent antimicrobicidal agent that destroys microbes by halogenation. The H20,- MPO - halide system is the most efficient bactericidal system in neutrophils. Chediak higashi syndrome It is an autosomal recessive disorder. Chediak higashi syndrome is caused due to mutation in the LYST gene. This gene provides instructions for making a protien known as lysosomal trafficking regulator. This protein plays a role in transpo of materials into lysosomes. Lysosomes contain several enzyme. They use these enzymes to kill various microorganism, break down several toxins. During phagocytosis, lysosomes fuse with phagosome, forming phagolysosome. Once the phagolysosomes are formed, lysosomes secrete enzymes to kill the bacterial. Mutation in the LSYT protein disrupts the size, structure and function of lysosomes. Lysosomes cannot fuse with phagosome to form phagolysosome. Thus this syndrome is a disease with impaired bacteriolysis due to impaired phagolysosome formation. As a result, most people with chediak higashi syndrome have repeated and persistent infections, staing in infancy or early childhood. These infections are life threatening. Besides, the granules of lysosomes, the secretory / storage granules of various other cells are also affected. The other cells involved are ? - Melanosotnes of melanocytes - Dense bodies of platelets - Granules of schwann cells In pigment cells called melanocytes the melanosome become abnormally large so there is reduced production of melanin. Thus people with chediak Higashi syndrome have occulocutaneous albinism i.e the colour (-)f skin, hair and eye is reduced. Abnormality in platelets produce bleeding disorders. Defective granules in schwann cells lead to neurological symptoms e.g. peripheral neuropathy. More on chediak higashi syndrome Most children with chediak Higashi syndrome ultimately reach a stage of the disorder known as accelarated phase (lymphoma like stage). This severe phase of the disease is thought to be triggered by viral infection (E.B.virus). In the accelarated phase, defective white blood cells divide uncontrollably and invade many of the body's organs. The accelarated phase is associated with fever, episodes of abnormal bleeding, overwhelming infections and organ failure. They are usually life threatening and lead to death. Bruton's agammaglobulinemia Bruton's agammaglobulinemia is an X-linked disease that occurs mainly in males. It is caused due to defect in the gene Bruton's tyrosine kinase. Bruton's tyrosine kinase plays a crucial role in B cell maturation as well as mast cell activation. Defect in Bruton's tyrosine kinase leads to failure of maturation of B cells. B cells cannot mature beyond pro B cell stage. In the absence of mature B cell, patient lacks lymphoid tissue and fails to develop plasma cells, (the cells that produce antibodies). Thus there is absence of immunoglobulins of all classes in Bruton's agammaglobulinemia. Germinal centres, where B cells proliferate and differentiate are poorly developed, in all lymphoid tissues including the .spleen, tonsils, adenoids, peripheral lymph nodes. Peyer patches in the intestine are small or absent. Clinical features Patients with Bruton's agammaglobulinemia do not manifest any symptoms till 6 months of life (due to the presence-of maternal antibodies). These patients are susceptible to infections with capsulated bacterias because antibody response is vital to kill encapsulated bacterias. Antibodies help in opsonization of encapsulated bacterias such as staphylococcus aureus, 11 ifluenzae, streptococcus pneumoniae. The polysaccharide capsule that surrounds the encapsulated bacteria is a potent virulent agent. It protects the bacteria from phagocytosis. These bacterias can only be phagocytosed when they are opsonised (coated) with specific proteins (opsoni us). Opsonized (coated) bacterias become attractive targets for phagocytes because phagocytes express high affinity receptors for opsonins. The major opsonins present in the body are IgG antibody and C3b complement. In Bruton's agammaglobulinemia antibodies are absent therefore opsonisation is defective.
| 3 |
NADPH oxidase acts superoxide ions
|
Chediak-Higashi syndrome is due to defective phagolysosome
|
In Brutons agammaglobulinemia opsonisation is not affected
|
Myeloperodixase action is mainly due to OCIaEUR'
|
Pathology
| null |
6b6cccca-623a-4172-a35e-83d5a298eeb6
|
multi
|
Etomidate is not used for long term infusion because?
|
Ans. is 'a' i.e., Results in adrenal suppression * Etomidate suppresses corticosteroid synthesis in the adrenal cortex by reversibly inhibiting 11 b-hydroxylase, which coverts 11-deoxycortisol to cortisol and by a relative minor effect on 17a - hydroxylase.* There is decreased synthesis of adrenal corticoids with increase in precursors 11-deoxycortisol and 17-hydroxyprogesterone.* ACTH secretion increases due to loss of feedback inhibition.* Using a continuous etomidate infusion for sedation of critically ill trauma patients in intensive care units has been associated with increased mortality due to adrenal suppression.* The mortality of patients exposed to a continuous infusion of etomidate for more than 5 days increased from 25% to 44%, mainly due to infectious causes such as pneumonia.* Vit 'C' supplementation restores cortisol levels to normal after use of etomidate.About other options* It produces little cardiovascular and respiratory depression - Agent of choice for cardiovascular surgeries (bypass, aneurysms, valve surgery). Etomidate is most cardiostable inducing agent. Coronary perfusion pressure is maintained when it is used with fentanyl.* Similar to thiopentone & propofol, etomidate is cerebroprotective - Decreases cerebral blood flow, metabolism, oxygen consumption and ICT.* Superficial thrombophlebitis and pain may occur on IV injection but intraarterial injection is not associated with local or vascular complications.
| 1 |
Results in adrenal suppression
|
May cause vasospasm
|
Results in cardiac arrhythmias
|
May cause increase in ICT
|
Anaesthesia
|
Complications Of Anaesthesia
|
089ca4d0-f249-4734-96ec-652d20d39ef8
|
single
|
Transovarian transmission of infection occurs in – a) Fleasb) Ticksc) Mosquitoesd) Sandfly
| null | 4 |
a
|
c
|
ac
|
bc
|
Social & Preventive Medicine
| null |
6d8b2c66-6fe7-4680-a09d-f1893b8d8c34
|
single
|
All cause malabsorption except:
|
Ascaris lumbricoides
| 2 |
Giardiasis
|
Ascaris lumbricoides
|
Strongyloides
|
Capillaria phillipinesis
|
Microbiology
| null |
d41a207b-a226-4a5f-a6e4-972a5d5a9698
|
multi
|
In twin pregnancy, treatment of choice when first baby is in transverse lie is :
|
Cesarean section
| 2 |
Home delivery
|
Cesarean section
|
High forceps
|
Low forceps after external rotation
|
Gynaecology & Obstetrics
| null |
ab0d86f1-d204-450a-a575-4e04e8cadd3a
|
single
|
Fibroblast proliferation is stimulated by?
|
“TFG-β is practically always involved as an important fibrogenic agent” - Robbins
• The most important fibrogenic mediator (causing fibrosis) is transforming growth factor- β. It induces the proliferation of fibroblasts, endothelial cells and specialized fibrogenic cells. It is chemotactic for fibroblasts, neutrophils, macrophages, lymphocytes and smooth muscle cells.
| 1 |
TGF-β
|
IFN-γ
|
TNF-α
|
IL-10
|
Pathology
| null |
8ed42b51-771a-4308-897e-d1ff1ab594f7
|
single
|
One of the following features can be used to define contracted pelvis:
|
Minimal/Critical diameters of the Pelvis: If any of the following diameter is less than critical diameter, Pelvis is said to be contracted
| 1 |
Transverse diameter of inlet is 10 cm
|
AP diameter of inlet is 12 cm
|
Platypelloid pelvis
|
Gynaecoid pelvis
|
Gynaecology & Obstetrics
| null |
0de041cf-97f7-4e3c-8837-e13ee37c4bd2
|
single
|
Which of the following statements about cysticercosis is true?
|
Human cysticercosis is acquired by ingesting T. solium tapeworm ova, from either contaminated fingers or food . The larvae are liberated from eggs in the stomach, penetrate the intestinal mucosa and are carried to many pas of the body, where they develop and form cysticerci, 0.5-1 cm cysts that contain the head of a young worm. They do not grow fuher or migrate. Common locations are the subcutaneous tissue, skeletal muscles and brain . Ref Harrison20th edition pg 1057
| 3 |
The causative agent is Echinococcus granulosus
|
The definitive host is man
|
Human cysticercosis is transmitted by the ingestion of ova
|
Levamisole is the treatment of choice
|
Medicine
|
Infection
|
97b2b716-3926-45d5-99d8-a8e4cbe0f9d1
|
multi
|
A 9-year-old male comes in for a routine physical examination. The pediatrician notices that the right testis is enlarged and without tenderness. The examination reveals following finding: This fluid most likely occupies which space?
|
The image shows the classical finding of transillumination seen in hydrocoele. A- Epididymis B- Cremasteric layer C- Tunica vaginalis D- External spermatic fascia This patient most likely has a hydrocele, which is a fluid collection in the tunica vaginalis. This is a congenital condition formed when the testis descends through the inguinal canal together with some peritoneum. Peritoneal fluid sometimes accumulates in this space.
| 4 |
D
|
A
|
B
|
C
|
Unknown
|
Integrated QBank
|
211f0245-cf52-4913-8117-5ba3af588bc9
|
single
|
All are true about Neisseria gonorrhoeae except ?
|
Ans. is 'a' i.e., Gram positive cocci Gonocci are gram negative diplococci. Urethral stricture may occur as a complication of gonococcal urethritis. Gonococci may extend to seminal vesicle and epididymis, along the urethra. For uncomplicated gonorrhea, single dose of ceftriaxone is DOC.
| 1 |
Gram positive cocci
|
Cause stricture of urethra
|
Involves seminal vesicles and spreads to epididymis
|
Drug of choice is ceftriaxone
|
Microbiology
| null |
554cdf09-5e8c-4f45-a1cb-1b7913ff8376
|
multi
|
A 27 years old male unable to perform Sexual activity is:-
|
Spectrum of Disease: Disease - Any abnormal condition of an organism that Impairs function of a person. Impairment - Loss of anatomical / physio/ psycho function. Disability - Unable to carry out ceain activities considered normal for his age,sex etc. Handicap - Unable to perform social role.
| 3 |
Disease
|
Impairment
|
Disability
|
Handicap
|
Social & Preventive Medicine
|
Other Key Definitions & Concepts
|
c6445719-5cd7-4136-b658-27bb32fcf7f3
|
single
|
Jame Lind is related to the discovery of
|
James Lind was a pioneer of naval hygiene in the Royal Navy. By conducting the first ever clinical trial, he developed the theory that citrus fruits cured scurvy. He argued for the health benefits of better ventilation aboard naval ships, the improved cleanliness of sailors&; bodies, clothing and bedding, and below-deck fumigation with sulphur and arsenic. He also proposed that fresh water could be obtained by distilling sea water. Ref : Park&;s Textbook of Preventive and Social Medicine; 23rd edition
| 1 |
Prevention of scurvy
|
Etiology of scurvy
|
Pathogenesis of scurvy
|
Diagnosis of scurvy
|
Social & Preventive Medicine
|
Concept of health and disease
|
3d156181-a516-430e-a8b2-d2d8fe565b1c
|
single
|
Manifestations of vitamin C deficiency are
|
In Vitamin C deficiency, bones are tender and the infant is reluctant to move his limbs, which are kept in a frog-like position. This may be mistaken for paralysis. Page 127, Ghai essential pediatrics; 6th edition
| 1 |
Pseudoparalysis
|
Sabre tibia
|
Epistaxis
|
Craniotabes
|
Pediatrics
|
Nutrition
|
0162fdf3-b7a4-4a23-87a6-121a84c48fd5
|
single
|
20% loss of blood is supplemented by
|
(A) Colloids & Crystalloids > Ideally, blood loss should be replaced with crystalloid or colloid solutions to maintain intravascular volume (normovolemia) until the danger of anemia outweighs the risks of transfusion. At that point, further blood loss is replaced with transfusions of red blood cells to maintain hemoglobin concentration (or hematocrit) at that level.> For most patients, that point corresponds to a hemoglobin between 7 and 10 g/dL (or a hematocrit of 21-30%). Below a hemoglobin concentration of 7 g/dL, the resting cardiac output has to increase greatly to maintain normal oxygen delivery
| 1 |
Colloids & Crystalloids
|
Cryoprecipitate
|
Plasma
|
Packed calls
|
Surgery
|
Miscellaneous
|
f4dee825-2659-4583-9df8-91630accd927
|
multi
|
Discoloration after death is first seen in?
|
Ans. is 'a' i.e., Dependent parts o It is seen on dependent parts of the body, therefore site depends upon position of body after death:1) In supine: On posterior dependent portion of body. But not seen on back of shoulder blades, buttocks and back of calves due to contact flattening, i.e. toneless capillaries are compressed and occluded by weight and pressure of body.2) In hanging: Dependent lower half of both lower limb and upper limb (i.e. lower half of leg with feet and lower half of forearm with hands), and external genitalia.3) In drowning: Head and upper half of body as head being the heaviest part becomes the dependent part. It does not develop in running water due to constantly changing position of the body.
| 1 |
Dependent parts
|
Scalp
|
Face
|
Arms
|
Forensic Medicine
|
Identification of Dead and Mass Disaster
|
c2a18062-813e-44ee-87d9-c28821d55bd2
|
single
|
Titration of the dose of a drug with the response can be done with which of the following routes of Administration
|
Ref-KDT 6/e p9 Inhalation anaesthetic agents like hello than are used in the clinical practice by titration of dose with response
| 3 |
Sublingual
|
Transdermal
|
Inhalation
|
Subcutaneous
|
Anatomy
|
Other topics and Adverse effects
|
26c7f51f-3710-40a8-96cb-528d3c03b020
|
single
|
Amount of ORS given in 4 KG children with diarrhea :
|
The family should be provide with at least two days worth of ORS packets.
WHO recommends, in addition to infants continued to be breastfed, that children older than six months be given some food before being sent home, which helps to emphasize to parents the importance of continuing to feed the child during diarrhea.
Body wt = 4 kg.
Requirements 75 ml/kg.
So total requirements 75x4 = 200 ml.
| 1 |
200 ml
|
300 ml
|
400 ml
|
800 ml
|
Unknown
| null |
e22aeb7a-d244-474d-8827-3939d2030ab6
|
single
|
Inner ear is present in which bone -
|
Inner ear lies within the petrous part of temporal bone.
Ref. Turner 10/e, p 228; BDC 4/e, Vol. III p 264
| 2 |
Parietal bone
|
Petrous part of temporal bone
|
Occipital bone
|
Petrous part of squamous bone
|
ENT
| null |
29c30dae-7f20-481b-92e2-75bb64c9bdfd
|
single
|
Testmentary capacity refers to -
|
Ref:The essential of forensic medicine and toxicology Dr.K.S NARAYAN REDDY 32nd edition pg no 468 Testamentary capacity is a mental ability of a person to make a will . Will denotes any testamentary document ( S.31, IPC ) .the requirments for a valid wills are as follows a written and propersly signed and witnessed document must exist . the testattor must be major and of sound dispossing mind at the time of making a will. force undue influence or dishonest representation of facts should not have been applied by others
| 1 |
Ability to make a valid will
|
Criminal liability
|
Right to vote
|
Ability to give evidence
|
Forensic Medicine
|
Special topics
|
63a9bd06-5413-4860-885c-2eb5db403df5
|
single
|
Ludwig's angina is -
|
Ans. is 'c' i.e., Infection of submandibular space o Caldwell-Luc operation is a process of opening the maxillary antrum through canine fossa by sublabial approach and dealing with the pathology inside the antrum.o In this surgery, antrum is reached through a incision in gingivolabial sulcus (from lateral incisor to 2nd molar) and then opening of antrum in this area.o During the surgery a noso-antral window is made through the inferior meatus so that after the surgery, packing of sinus can be removed through this window.
| 3 |
Unstable angina
|
Prizmetal's angina
|
Infection of submandibular space
|
Infection of retropharyngeal space
|
ENT
|
Head & Neck Infections
|
71720670-52bc-40eb-a59a-e4c54e7fb37c
|
single
|
Epispadias is associates with:
|
Epispadias is a rare type of malformation of the penis in which the urethra ends in an opening on the upper aspect (the dorsum) of the penis. Ref: CDST, 12th Edition, Page 631; Urology by Macfarlane, 4th Edition, Page 252; Bailey and Love's Sho Practice of Surgery, 25th Edition, Page 1363; Visual Handbook of Pediatrics and Child Health: The Core By Stephen Ludwig, Page 602; Oxford American Handbook of Urology By David M. Albala, Leonard G. Gomella, Allen F. Morey, John P. Stein, Page 562
| 2 |
Bifid pubic symphysis
|
Chordee
|
Anal atresia
|
Intestial obstruction
|
Surgery
| null |
152c4e58-2747-4b8a-9868-2b28a0904d2e
|
single
|
Nicoladini's Branham sign is seen in
|
Nicoladini's Branham sign is seen in arteriovenous fistula, wherein compression proximal to AV - fistula results in bradycardia.
| 4 |
Aortic dissection
|
Buerger's disease
|
Aneurysm
|
AV - Fistula
|
Surgery
| null |
afd204cd-959e-43c7-94fd-d2c26f9b74a1
|
single
|
Drug remaining in the body after 3 half lives is:
| null | 1 |
12.50%
|
75%
|
87.50%
|
94%
|
Pharmacology
| null |
96273169-1b6c-4fc6-950a-4922adc2fc85
|
single
|
Which of the following is positive in Follicular lymphoma
|
* Burkitt lymphoma and Follicular lymphoma arises from Germinal center B cell * Mantle cell lymphoma arises from Naive B cell * Hairy cell leukemia and extranodal marginal zone lymphoma arises from Memory B cell Translocation In :- * Burkitt lymphoma t (8:14) * Follicular lymphoma t (14:18) * Mantle zone lymphoma t(11:14) * Marginal Zone lymphoma t(11:18) CD23 is negative in Mantle cell lymphoma Ref:- Robbins Basic Pathology 9th Edition; Pg num:- 468,469
| 1 |
Bcl 2
|
Bcl 6
|
Bcl 1
|
None of the above
|
Pathology
|
Haematology
|
251ddabd-685a-4090-a471-4977be2c25c1
|
multi
|
The most common etiological agent for acute bronchiolitis in infancy is:
|
Acute bronchiolitis is a serious acute lower respiratory infection in infants affecting children between 1 and 6 months of age. It is most commonly caused by Respiratory syncytial virus. Other causative organisms includes Parainfluenza virus 3, 1 and 2, adenovirus, influenza virus and rarely Mycoplasma pneumonia. Ref: Essential Pediatrics, 6th Edition By O P Ghai, Pages 352-4; Nelson's Essential of Pediatrics, 17th Edition, Pages 1415-16.
| 4 |
Influenza virus
|
Para influenza virus
|
Rhinovirus
|
Respiratory syncytial virus
|
Pediatrics
| null |
5f5ea52d-dbce-4a0f-9264-a5e017710917
|
single
|
Not a pa of bony labyrinth
|
BONY LABYRINTH:The bony labyrinth consists of three pas(a)Cochlea anteriorly (b)Vestibule,in the middle (c)Semicircular canals posteriorly REF.,BDC VOL.3
| 3 |
Cochlea
|
Vestibule
|
Utricle
|
Semicircular canal
|
Anatomy
|
Head and neck
|
cc5eba50-ad47-4a99-a074-9f0f20112a53
|
single
|
Which of the follow ing is a zoonotic disease -
|
Ans. is 'a' i.e., Hydatid cyst important zoonoses1. Bacterial - Anthrax, Brucellosis, Omithoses, Q-fever, Leptospirosis, TB, Plague, Tularemia, Salmonellosis.2 Viral - Cowpox, Monkeypox, Eastemequine, encephalitis, Ross river fever, Yellowr fever, Japanese encephalitis, Lassa fever. Rabies.Protozoal - Leishmaniasis, Toxoplasmosis, Trypanosomiasis, Babesiosis.Helminthic - Clonorchiasis, Fasciolopsis, Schistosomiasis, Echinococus (hydatid disease), Taeniasis, Trichinellosis.
| 1 |
Hydatid cyst
|
Malaria
|
Filariasis
|
Dengue fever
|
Social & Preventive Medicine
|
Communicable Diseases
|
081c1e01-06c5-4fa4-bcc7-90663eca2aa0
|
single
|
Coracoid process is
|
Coracoid process is directed forwards and slightly laterally. It is bent finger like. It is atavistic type of epiphysis. B D Chaurasia 7th edition Page no : 9
| 4 |
Pressure epiphysis
|
Traction epiphysis
|
Aberrant epiphysis
|
Atavistic epiphysis
|
Anatomy
|
Upper limb
|
65fa7669-e10d-4d84-9890-3672b6c7c0e6
|
single
|
"Egg shell" calcification in hilar nodes suggest
|
Silicosis
| 2 |
Asbestosis
|
Silicosis
|
Berylliosis
|
Baritosis
|
Radiology
| null |
3575e0bd-c8ec-4757-94b8-287f4649693f
|
single
|
Howel-Jolly bodies may be seen after -
|
Ans. is 'b' i.e., Splenectomy Chronic Manifestations of splenectomy include :Marked variation in size and shape of erythrocytes - anisocytosis / poikilocytesHowell - Jolly bodies : nuclear remnantsHeinz bodies : denatured haemoglobingBasophillic stipplingOccasional nucleated erythrocyte in peripheral bloodHowell-Jolly bodies are smooth round remnants of nuclear chromatin seen in erythrocytes in conditions like :o Megaloblastic anemia o After Splenectomy o Hemolytic anemia
| 2 |
Hepatectomy
|
Splenectomy
|
Pancreatectomy
|
Cholecystectomy
|
Pathology
|
Hemolytic anemia
|
2638d190-43f5-4647-9a4b-277ddb60c612
|
single
|
Mammary gland is which type of gland :
|
Apocrine glands pinches off the Apex of the cell. Ref: IB Singh textbook of histology 6e pg 54.
| 1 |
Apocrine
|
Mesocrine
|
Endocrine
|
Exocrine
|
Anatomy
|
General anatomy
|
6097ef06-6fe1-4ef1-a729-d46d0da8b622
|
single
|
Nerve most commonly injured in the dislocation shown below is:
|
Ans. A. Axillary nerve* The attitude here is one of Inferior dislocation of shoulder- Limb is abducted, by the side, forearm reaching forehead (Salute position) and most common nerve injured in shoulder dislocation is Axillary nerve.* The diagnosis is made clinically by absence of sensations on lateral aspect of forearm (Regimental batch sign)
| 1 |
Axillary nerve
|
Ulnar nerve
|
Median nerve
|
Radial nerve
|
Orthopaedics
|
Peripheral Nerve Injuries
|
d68f0240-b5b7-4d67-bba2-2aabee4ec630
|
single
|
What is the fastest, safest and most effective to sterilize a metal impression tray with a solder that melts at a temperature above 175°C?
| null | 2 |
Filtration
|
Autoclaving
|
Dry heat sterilization
|
Soakig in 2% glutaraldehyde
|
Surgery
| null |
6a403c9f-b928-4724-8995-4ad3d0afe640
|
multi
|
Which of the following is an example of a bone that is independent phylogenetically but is now fused with another bone?
|
Ativastic epiphysis is a phylogenetically independent bone which gets attached to the host bone secondarily to recieve nutrition. Eg are coracoid process of scapula, posterior tubercle of talus or trigonum. Classification of epiphysis : Pressure epiphysis : head of femur and humerus. Traction epiphysis : trochanter of femur and tubercle of humerus. Ativastic epiphysis : coracoid process of scapula, posterior tubercle of talus or trigonum.
| 3 |
Trocanter of femur
|
Tubercle of humerus
|
Coracoid process of scapula
|
Anterior tubercle of talus
|
Anatomy
| null |
e5b95952-0d3d-48c4-8640-55e861cc21f6
|
multi
|
Sistrunk's operation is done for?
|
Ans. b (Thyroglossal fistula) (Ref. Bailey and Love 26th/pg. 702) THYROGLOSSAL DUCT CYSTS Embryology # The thyroid gland descends early in fetal life from the base of the tongue towards its position in the lower neck with the isthmus lying over the second and third tracheal rings. # At the time of its descent, the hyoid bone has not been formed and the track of the descent of the thyroid gland is variable passing in front, through or behind the eventual position of the hyoid body. # Thyroglossal duct cysts represent a persistence of this track and may, therefore, be found anywhere in or adjacent to the midline from the tongue base to the thyroid isthmus. Clinical Features # Classically, the cyst moves upwards on swallowing and notably with tongue protrusion but this may occur with other midline cysts, such as dermoid cysts, as it merely indicates attachment to the hyoid bone. Treatment # Treatment must include excision of the whole thyroglossal tract which involves removal of the body of the hyoid bone and the suprahyoid tract through the tongue base to the vallecula at the site of the primitive foramen caecum together with a core of tissue on either side (Sistrunk's operation).
| 2 |
Parotid fistula
|
Thyroglossal fistula
|
Thyroglossal abscess
|
Branchial fistula
|
Unknown
| null |
47db36b5-ce78-4f11-b404-3412e98698b2
|
single
|
Which direct retainer is indicated in the case of an isolated, mesially inclined molar?
| null | 2 |
1/2 and 1/2 clasp
|
Ring clasp
|
Bar clasp
|
C-clasp
|
Dental
| null |
d594ede4-5571-4681-910a-b8f6300a1f66
|
multi
|
With each quiet inspired breath, the fraction of alveolar air getting replaced would be:
|
At the end of a quiet expiration, the volume of air remaining in the lung is functional residual capacity (FRC). The volume of FRC = 2300 mL. This is the existing alveolar air. With next quiet breath, about 500 mL (TV) is inspired. Of this, 150 mL stays in the dead space and 350 mL air will reach alveoli. This 350 mL air (with oxygen) will replace 350 mL alveolar air (containing CO2) to be mixed with dead space air and exhaled out. Out of 2300 mL of existing alveolar air, 350 mL air is getting replaced. 350/2300 = (approx.) 1/7th fraction.
| 3 |
1/2 (half)
|
1/3rd
|
1/7th
|
1/10th
|
Physiology
|
Respiratory System Pa 1
|
e7d7ea18-823a-4e05-89cc-129882954d09
|
single
|
All of the following preparations of insulin are rapid and sho-acting EXCEPT:
|
Insulin glargine is a long-acting biosynthetic insulin. The onset of action is delayed. It acts for around 24hrs and action stas after 1- 1 30hr ultrasho acting are used for emergency purposes like diabetic ketoacidosis. glargine is not useful in this case (REF. Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 261)
| 3 |
Lispro
|
Aspa
|
Glargine
|
NPH
|
Pharmacology
|
Endocrinology
|
51c6c637-ec34-45c3-b6fd-3db93078f0f0
|
multi
|
which of the following drug is used in ECT
|
HISTORY * Medunna ====IM injection of camphor to induce seizures * Ugo cerletti and lucio bini==== ECT in a catatonic patient INDICATIONS * DEPRESSION SUICIDAL IDEAS-------------- first choice * CATATONIC SCHIZOPHRENIA * SCHIZOPHRENIA * MANIA * ELECTRODE PLACEMENT * Most commonly used=== bi fronto temporal * More cognitive side effects==bi fronto temporal * Less cognitive side effect======bi frontal * SIDE EFFECTS * RETROGRADE AMNESIA * BODY ACHE * MEDICATIONS USED IN THE PROCEDURE * ANAESTHETIC======Thiopentone / ethosuximide * MUSCLE RELAXANT====Succynyl choline CURARE IN PSEUDOCHOLINEESTERASE DEFICIENCY * ANTICHOLINERGIC=====Atropine CONTRA INDICATIONS * NO ABSOLUTE Contra indication * RELATIVE -----------------Brain tumour / arrythmia Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 1065
| 1 |
atropine
|
labetalol
|
clonazepam
|
cefixime
|
Anatomy
|
Treatment in psychiatry
|
5c3dc44e-fdce-4a6f-876e-a8eb995eb145
|
single
|
Which is not a germ cell tumour
|
Epithelial Ovarian Tumour Histologic typeSerousMucinousEndometroidClear cell" mesonephroid BrennerMixed epithelial Undifferentiated UnclassifiedCellular type Endosal pineal Endocervical Endometrial Mullerian TransitionalMixedAnaplastic Mesothelioma etc.
| 3 |
Dysgerminoma
|
Teratoma
|
Granulosa theca cell tumour
|
Embryonal cell carcinoma
|
Gynaecology & Obstetrics
|
Gynaecological oncology
|
8c495548-030c-473c-9d11-365e20c449ad
|
single
|
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