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A 27 yr old worker fall from a roof and is brought to the emergency depament. His physical examination and computed tomography (CT) scan reveal dislocation fracture of the thoracic veebrae. The fractured body of the T7 veebra aiculates with which of the following pas of the ribs?
|
The body of veebra T7 aiculates with the head of the seventh and eighth ribs. The neck of a rib does not aiculate with any pas of the veebra. The transverse process of the veebra aiculates with the tubercle of the corresponding rib.
| 4 |
Head of the sixth rib
|
Neck of the seventh rib
|
Tubercle of the seventh rib
|
Head of the eighth rib
|
Anatomy
|
Back region
|
a276e053-4174-4fe2-a2fd-02a96a1a68e0
|
multi
|
A 50-Year-old diabetic patient presented with orbital pain, swelling and chemosis along with fever. Patient also gave history of orbital cellulitis 1 week back. O/E: - 3rd, 4th and 6th cranial nerves neuropathy Trigeminal neuropathy affecting V1 and V2 divisions The neuropathy was observed initially on left side but later right side was also affected. CT venogram of the patient Which of the following is not a tributary of the involved structure: -
|
This is a case of cavernous sinus thrombosis post orbital cellulitis meaning the septic thrombi came the superior ophthalmic vein. It is a life-threatening condition. Presents as orbital/facial pain Orbital swelling and chemosis is seen. 3rd, 4th, 5th and 6th cranial nerves are affected Occurs secondary to infection from orbital cellulitis and sinusitis CT venogram shows distended cavernous sinus with a non-fat density filling defect-likely thrombus. Pathways of spread of infection to cavernous sinus.
| 4 |
Superior ophthalmic vein
|
Superficial middle cerebral vein
|
Central vein of retina
|
Basilar plexus
|
Unknown
|
Integrated QBank
|
7c390484-f096-4222-9ea2-20112142b0e4
|
multi
|
A 54-year-old obese man was diagnosed with NIDDM 1 year earlier. He was started on glipizide and metformin. His other medications are propranolol and nifedipine for hypertension, and naproxen, which he began 2 weeks ago for severe osteoarthritis. His BP is 154/92. His BUN is 29 mg/dL and a creatinine of 1.8 mg/dL; both had been normal 1 year earlier. Which medications is most likely responsible for the increase in BUN and creatinine?
|
The use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen, may cause a usually mild renal insufficiency, possibly related to a mild interstitial nephritis or glomerulonephritis. Risk of NSAID-induced renal damage is increased in the elderly and in patients with underlying renal disease. Glipizide a second-generation sulfonylurea, may predispose patients to hypoglycemia but is not associated with renal toxicity. Metformin does not induce renal damage but should be used cautiously in patients with underlying renal damage because of the possibility of developing lactic acidosis. Neither nifedipine nor propranolol has a tendency to adversely affect the kidneys.
| 3 |
Glipizide
|
Metformin
|
Naproxen
|
Nifedipine
|
Unknown
| null |
f2778e0b-7e9e-477e-bf2f-19b0b69166c6
|
multi
|
All are true about antemoem contusion except -
|
The synopsis for forensic medicine & toxicology ,Dr k.s.narayan reddy ,28th edition ; Pg no . 108 ; In antemoem bruising ,there is swelling ,damage to epithelium ,extravasation ,coagulation & infiltration of tissue with blood & colour changes .these points are absent in postmoem bruises . Hence it is seen that there will b swelling & inflammation in antemoem bruises.No inflammation in antemoem bruise is a wrong statement .
| 2 |
Sequential color change
|
No Inflammation
|
Raized enzyme levels
|
Blood cells in surrounding tissue
|
Forensic Medicine
|
Mechanical injuries
|
8824b583-a791-4d5d-aae6-9cd4601c3819
|
multi
|
Under the Rajiv Gandhi Shramik Kalyan Yojana, in case of closure of a factory/establishment, one gets "Unemployment Allowance" for -
|
parks textbook of preventive and social medicine 23rd edition. *as per scheme ,Rajiv gandhi shramik kalyam yojna ,an insured person going out of insurable employment involuntarily ,on account of closure of a factory or establishment ,retrenchment,or permanent invalidity arising out of non-employment injury ,after rendering insurable employment and having contributed under the scheme for five or more years, is entitled to claim unemployment allowance for maximum period of 6months during his/her entire service .
| 1 |
6 months
|
9 months
|
12 months
|
18 months
|
Social & Preventive Medicine
|
Health education & planning
|
eebb9fb7-9881-4307-a2e5-a99d841a1c9f
|
multi
|
Low molecular weight dextran is contra indicated in -
|
Dextran interfere with Platelet function.
| 4 |
Foetal distress syndrome
|
Cerebrovascular accident
|
Electrical burns
|
Thrombocytopenia
|
Surgery
| null |
aae8025e-b414-4680-b0b5-13915b61e450
|
single
|
Which statement regarding delusions is true?
|
Another example is a person who is convinced that he or she is responsible for some disaster (such as fire, flood, or eahquake) with which there can be no possible connection. Delusion of mind being read: The false belief that other people can know one's thoughts. Ref ganong's review of medical physiology 25e p765
| 2 |
They are almost exclusively found in schizophrenia
|
Grandiose delusions are rarely encountered except in mania
|
They involve a disturbance of thought content
|
They involve a disturbance in perception
|
Physiology
|
All India exam
|
754433cd-1255-46ac-9361-0225bdb3d74f
|
multi
|
A most common cause of intestinal obstruction is?
|
Adhesions and bands are the commonest causes of intestinal obstruction in Western countries. In India, hernia and then adhesions are the two common causes of intestinal obstruction. Clinical features
Pain abdomen—colicky type and recurrent and episodic
Distension, vomiting
Constipation
Reduced bowel sounds on auscultation
Previous surgical scars commonly observed
Dehydration, tachycardia, hypotension.
| 4 |
Ileocaecal tuberculosis
|
Carcinoma colon
|
Intussusception
|
Adhesions
|
Surgery
| null |
6bb277fa-f6d3-46a7-a956-05f6c29b900e
|
single
|
Branched chain amino acid which is both ketogenic and glucogenic -
|
Ans. is 'b' i.e.. Isoleucine o Branched chain amino acids are leucine, Isoleucine and valine.Leucine is purely ketogenic.Isoleucine is both ketogenic and glucogenic.Valine is glucogenic.
| 2 |
Leucine
|
Isoleucine
|
Valine
|
Tryptophan
|
Biochemistry
|
Structure & Function of Protein
|
de456867-2462-4b54-9f11-06c35176b6a0
|
multi
|
Rib notching is seen in all except-like diagnosis is -
| null | 3 |
Coarctation of aorta
|
Classical blalock tausing operation
|
IVC obstruction
|
Neurofibromatosis
|
Medicine
| null |
d50545bc-2c5d-461b-9fd8-88745641fa5a
|
multi
|
78 year old male, known case of prostate cancer with multiple painful veebral metastasis. Ideal management plan would be -
|
Answer- A. Androgen ablation with Orchidectomy Only Palliative t/t is the optionl) Androgen Ablation is the first line therapyIt can be achieved by-Orchiectomy orDrugs (medical castration)2) Palliative Radiotherapy
| 1 |
Androgen ablation with Orchidectomy
|
Palliative Chemotherapy
|
Radical prostatectomy
|
TURP
|
Surgery
| null |
dc8a3ec5-2ffb-4558-815e-2f7f6d349fd8
|
multi
|
Helsinki declaration deals with ?
|
Ans. is 'd' i.e., Human experimentation The Declaration of Helsinki is a set of ethical principles regarding human experimentation developed for the medical community by the World Medical Association. It is widely regarded as the cornerstone document on human research ethics The Declaration is morally binding on physicians, and that obligation overrides any national or local laws or regulations, if the Declaration provides for a higher standard of protection of humans than the latter. Investigators still have to abide by local legislation but will be held to the higher standard.
| 4 |
MTP
|
Human organ transplantation
|
Capital punishment
|
Human experimentation
|
Forensic Medicine
| null |
ac32780f-253f-4878-bd08-18513587be9a
|
single
|
Memory cells doesn't undergo apoptosis due to presence of which growth factor:
|
Nerve growth factor [Ref: Survival of memory B lymphocytes is tightly linked to the integrity of the Bel-2 protein and is regulated by a nerve growth factor (NGF) autocrine circuit. Nerve growth factor inhibits apoptosis in memory B lymphocytes inactivation of p38 MAPK, prevention of Bcl-2 phosphorylation, and cytrochrome c release. NGF is a classical survival factor, essential for a large number of cell types, including neurons, keratinocytes, and memory B lymphocytes.
| 2 |
Platelet derived growth factor
|
Nerve growth factor
|
Insulin like growth factor
|
Fibroblast growth factor
|
Physiology
| null |
6015af1c-d7bf-4fae-bdd7-3f046dae8237
|
single
|
A 32 year old woman, gravida 4, para 3, at 39 weeks gestation comes the labor and delivery ward with painful contractions. Her prenatal course was unremarkable. Examination shows that her cervix is 5 cm dilated, 100% effaced and the fetal hea rate is in the 130s and reactive. She is given meperidine for pain control. She progresses rapidly and less than 2 hours later she delivers a 3.345Kg male fetus. The one-minute APGAR score is 1 and the infant is making little respiratory effo. Which of the following is the most appropriate next step in management?
|
Meperidine can be used as a systemic analgesia during labor. It is an opioid and readily crosses the placenta; therefore, the fetus is exposed to the medication. As an opioid, it causes respiratory depression. Neonates are at greatest risk for respiratory depression when delivery occurs approximately 2 to 3 hours after meperidine is administered to the mother. This neonate was born approximately 2 hours after maternal administration of meperidine, which makes neonatal respiratory depression likely. Naloxone is a pure opioid antagonist that displaces the opioid from its receptor sites and can help to reverse the opioid- induced respiratory depression. It has a sho duration of action so repeat doses may be necessary. Blood transfusion would not be indicated. Blood transfusions are used when there is evidence that the neonate is anemic. This neonate appears to have respiratory depression and not anemia. Therefore, naloxone, and not blood transfusion, would be indicated. Glucose should be given when there is evidence that the neonate is severely hypoglycemic. This neonate, given that its mother received an opioid 2 hours ago, is most likely to have respiratory depression from the opioid and not hypoglycemia. Sodium bicarbonate should be given to a neonate for documented metabolic acidosis. It is often used during a prolonged resuscitation. The first step for this neonate, however, would be to try to reverse the respiratory depression with naloxone. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 19. Obstetrical Anesthesia. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.
| 3 |
Blood transfusion
|
Glucose
|
Naloxone
|
Sodium bicarbonate
|
Gynaecology & Obstetrics
| null |
4240589f-4130-47af-bd69-ca8d3c599e21
|
multi
|
In alopecia areata, seen is:
|
A i.e. Exclamatory markStumps in alopecia areata form exclamation mark(2 (constriction) just above the skin surface. Exclamation mark hair is pathognomic of alopecia areataQ.
| 1 |
Exclamatory mark hair
|
Scaring
|
Fungal infection
|
Traumatic
|
Skin
| null |
bf5edf9a-bce4-43fd-a4e8-0bb5f7535f03
|
single
|
A 30 year old man presents to the emergency with complaints of muscle weakness, nausea, vomiting and fatigue. ECG showed tall peaked T waves, prolonged PR interval, wide QRS and absent P. which of the following drugs is not used in management?
|
Early ECG changes of hyperkalemia, typically seen at a serum potassium level of 5.5-6.5 mEq/L, include the following: Tall, peaked T waves with a narrow base, best seen in precordial leads. Shoened QT interval. ST-segment depression The detions to both extremes (hypo- and hyperkalemia) are related to the risk of cardiac arrhythmias. Potassium levels below 3,0 mmol/l cause significant Q-T interval prolongation with subsequent risk of torsade des pointes, ventricular fibrillation and sudden cardiac death. Beta-adrenergic activity is one of several mechanisms regulating the movement of potassium from the extracellular to the intracellular environment.This study provides convincing evidence that inhaled albuterol significantly lowers plasma potassium in patients with chronic renal failure and moderate hyperkalemia Ref Harrison 20th edition pg1769
| 1 |
Beta antagonist
|
Calcium gluconte
|
Insulin
|
Sodium bicarbonate
|
Medicine
|
Fluid and electrolytes
|
ec3749b3-32f8-4db0-8ab8-fa982c06391e
|
multi
|
Which of the following is not ionizing:
|
d) uv radiation ref: SPM Park 17th/e p.521, principal and practice of oncology 6th/e p. 195-196
| 4 |
Beta radiation
|
Alpha radiation
|
Gamma radiation
|
UV radiation
|
Radiology
|
Fundamentals In Radiology
|
d1d28552-e4f1-4c6c-a38b-862a5e13a43e
|
single
|
The most common nerve involvement is dislocation of Lunate is -
|
Dislocation of carpal bones
Dislocation of carpal bones may be of two types:-
1) Lunate dislocation
Lunate dislocate anteriorly but the rest of the carpals remain in position.
Complications may be AVN, osteoarthritis and median nerve injury.
2) Perilunate dislocation
The lunate remains in position and the rest of the carpals dislocate dorsally.
| 1 |
Median nerve
|
Anterior interosseus
|
Posterior interosseus
|
Ulnar nerve
|
Orthopaedics
| null |
c4b87217-57e9-4c76-bdfa-66840d69c5d6
|
single
|
With regards to the anorectal angle, what is true
|
Answer- A. It distributes intraabdominal forces onto the pelvic floor and plays and impoant role in continence mechanismAt rest the puborectalis muscle creates a 'sling' around the distal rectum, forming a relatively acute angle (Anorectal angle).It is 90 to 100 degrees at rest.Both the internal and external sphincters are innervated by pudendal nerve.
| 1 |
It distributes intraabdominal forces onto the pelvic floor and plays and impoant role in continence mechanism
|
It is due to the pull of the external sphincter
|
It is around 30 degrees at trest
|
The angle increases at the time of defecation
|
Surgery
| null |
a29d2f2e-dbda-43b8-bf5a-96734e11f85d
|
multi
|
True about carbohydrate absorption?
|
Ans. is 'd' i.e., Fructose absorption is not by secondary active transpoGlucose absorption Fructose absorption along the apical side is by GLUT 5 transpoer.GLUT 5 transpoer is an example of facilitated passive diffusionFructose absorption along the basolateral side is by GLUT 5 transpoer or through GLUT 2 transpoerThus Fructose absorption along both apical side and basolateral side is by facilitated passive diffusion.
| 4 |
Glucose absorption occurs independent of sodium
|
Fructose absorption occurs dependent on Na
|
Fructose absorption occurs SGLT 1
|
Fructose absorption is not by secondary active transpo
|
Biochemistry
| null |
19179914-da6a-4446-8af3-b4144c5b3317
|
multi
|
The longer and more parallel opposing walls of a cast restoration
|
The gingival-to-occlusal divergence of these preparation walls may range from 2 to 5 degrees per wall from the line of draw. If the vertical walls are unusually short, a maximum of 2 degrees occlusal divergence is desirable to increase retention potential. As the occlusogingival height increases, the occlusal divergence should increase because lengthy preparations with minimal divergence (more parallel) may present diiculties during the seating and withdrawal of the restoration.
Sturdevant Operative Dentistry 7th edition page. e97
| 1 |
The greater the retention
|
The greater the resistance
|
The greater the compressive strength
|
The greater the tensile strength
|
Dental
| null |
65a2324e-cedb-4786-9a96-a0227f1694b3
|
multi
|
The thoracic duct crosses the posterior mediastinum at the level of which veebral body
|
Thoracic duct ascents through posterior mediastinum from the level of T12 to T5.Ref: BD Chaurasia; Volume 1; 6th edition; Pg no: 285
| 1 |
T5
|
T6
|
T7
|
T8
|
Anatomy
|
Thorax
|
c0d53b88-db8d-40e5-afcc-e5859aea135b
|
single
|
Vegetations on undersurface of A.V. valves are found in
|
Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:163 Endocarditis associated with SLE (Libman-Sachs endocarditis): The vegetations are 3-4 mm in size, composed of degenerating valve tissue; functional disability is minimal; ventricular surface of the mitral valve is commonly involved; aoic valve involvement is rare; entire valve apparatus can be involved.
| 2 |
Acute rheumatic fever
|
Libman Sach's endocarditis
|
Non thrombotic bacterial endocarditis
|
Chronic rheumatic carditis
|
Medicine
|
C.V.S
|
874f9dcb-b3e3-4066-aa4e-b6383b627dc4
|
single
|
A child is below the third percentile for height. Growth velocity is normal, but chronologic age is more than skeletal age. The most likely diagnosis is:
| null | 1 |
Constitutional delay in growth
|
Genetic short stature
|
Primordial dwarfism
|
Hypopituitarism
|
Physiology
| null |
623ea61b-bb75-469c-bcfd-786022704d81
|
single
|
Uicarial lesions are best described as -
|
uicaria consists of raised erythemayous skin lesions that are markedly pruritic , evanescent and generally worsened by scratching IADVL textbook of dermatology, cutaneous vascular response, page657
| 3 |
Nonpruritic
|
Bullous
|
Evanescent
|
Macular
|
Dental
|
Dermatitis
|
8adebc43-2aff-48c5-adce-8adf65db223e
|
single
|
All of the following may be used to differentiate Central Retinal Venous Occlusion (CRVO) from Ocular Ischemic Syndrome due to Carotid Aery Stenosis, Except:
|
A i.e. Dilated Retinal Vein Central Retinal Vein Occlusion and Ocular Ischemic Syndrome due to carotid aery stenosis are both associated with dilated retinal veins and hence this feature cannot be used to distinguish these conditions. However, ophthalmic aery pressure (measured by ophthalmo dynamometry) and retinal aery pressure is usually normal in CRVO and decreased (low) in carotid aery obstruction. And to differentiate both conditions other features include presence of swollen optic disc & touous retinal veins in CRVOQ. Ophthalmodynamometry is a non invasive method of estimating ophthalmic aery pressure. Features Ocular Ishemic Syndrome (Carotid Aery Obstruction) CRVO (Non Ischaemic) (Central Retinal Vein Obstruction) Definition Ocular Ischemic Syndrome is a condition with variable spectrum of sign and symptoms resulting from chronic ocular hypoperfusion usually secondary to severe carotid aery obstruction. Pathogenesis of this syndrome is decreased aerial inflow on a chronic basis CRVO is an ocular syndromes with ocular signs and symptoms resulting from an occlusion of the central retinal vein - Ischemic : Complete obstruction (20? 25% of cases) - Non ischaemic : Incomplete obstruction (70-75% of cases) Laterality Unilateral (80%) Unilateral Age (years) 50-80 50-80 Fundus signs Veins Dilated, nontouous Dilated, touous Optic disc Normal Swollen Retinal aery perfusion pressure Decreased Normal Retinal hemorrhages Mild Mild to severe Microaneurysms Mid-periphery Variable Hard exhudates Absent unless in association with diabetes Rare Fluorescein Angiography Choroidal filling Delayed, patchy Normal Aeriovenous transit time Prolonged Prolonged Retinal vessel staining Prominent aerial staining Prominent venous staining Ophthalmodynamometry (non invasive) Ophthalmic aery pressure is usually lowQ Ophthalmic aery pressure is usually normal or elevated
| 1 |
Dilated Retinal Vein
|
Touous Retinal Vein
|
Retinal Aery Pressure
|
Opthalmodynamometry
|
Ophthalmology
| null |
09eece52-ca43-4ad0-9905-d2d2bf4557f2
|
multi
|
All of the following are preserved in a case of poisoning except
|
(B) A loop of large Intestine
| 2 |
Stomach with its contents
|
A loop of large intestine
|
Blood
|
Urine
|
Forensic Medicine
|
Misc.
|
989ee00d-4a71-4925-b7d9-4f6c458dc214
|
multi
|
Which of the following blood vessels is most commonly affected by atherosclerosis
|
Abdominal aorta especially region below the renal arteries and above the iliac bifurcation is the most commonly affected vessel.
| 3 |
Popliteal artery
|
Thoracic aorta
|
Abdominal aorta
|
Coronary arteries
|
Pathology
| null |
4dfb48dc-615f-464b-83cd-52901eeb1c27
|
single
|
Patella commonly dislocates: March 2013 (c)
|
Ans. A i.e. Laterally
| 1 |
Laterally
|
Medially
|
Superiorly
|
Inferiorly
|
Surgery
| null |
61ec9159-2e08-4c50-bb54-694106b797f6
|
multi
|
A 19-year-old man and one of his two brothers have polyuria and polydipsia since birth. Neither his sisters nor his parents are affected.For the above patient with polyuria and polydipsia, select the most likely diagnosis.
|
Nephrogenic DI can be inherited on the X chromosome. Its X-linked recessive nature means that males are predominantly affected. Only women who are homozygous are affected.
| 2 |
central diabetes insipidus (DI)
|
nephrogenic DI
|
primary polydipsia
|
osmotic diuresis
|
Medicine
|
Oncology
|
2e2abffd-fc20-45a3-ab4d-7ceb8b38b2eb
|
multi
|
Cerebellar cortex contains -
|
Ans. (b) Purkinje cellsRef.: Gray's 41sted./335-336* The cerebellar cortex contains five types of neurons: Purkinje, Granule, Basket, Stellate and Glogi Cells.
| 2 |
Pyramidal cells
|
Purkinje cells
|
Stromal cells
|
Kupffer cells
|
Anatomy
|
Cranial Cavity
|
04ac1041-647c-4018-9a1f-ef0c405aaf7d
|
single
|
In early phase division of spermatogonia by-
|
Ans. is "b' i.e., Mitosis [Ref: Principles of medical physiology p. 322J
| 2 |
Meiosis
|
Mitosis
|
Both Meiosis & Mitosis
|
Maturation
|
Physiology
|
Sex Hormones
|
4d2a872e-945c-4aa9-8021-1702151f0cba
|
multi
|
13 yr old child visit OPD with complains of not attaining menarche with karyotype 46 XX. O/E there is clitromegaly, which enzyme is likely deficient?
|
Above history point towards diagnosis of Congenital adrenal hyperplasia: - Due to deficiency of enzyme21-alpha Hydroxylase There is lack of coisol production resulting in excess of Adrenocoicotropic hormone (ACTH) production from pituitary. Features: - Enlarged clitoris Presence of penile urethra or hypospadias Associated metabolic abnormality -Salt wasting (hyponatremia, hyperkalemia) Fusion of Labia majora Lethargic hypoglycemic females. Investigations: - Karyotype is 46 XX Serum estimation Sex chromatin study reveals positive Barr body Sonographic evaluation
| 2 |
17 alpha hydroxylase
|
21 alpha hydroxylase
|
11 alpha hydroxylase
|
3 beta hydroxyteroid dehydrogenase
|
Gynaecology & Obstetrics
|
NEET Jan 2020
|
897eaa1a-efbe-44c1-90cf-524e58eeb39b
|
single
|
A malignant tumour of childhood, that metastasized to
bone most often, is:
| null | 2 |
Wiles tumour
|
Neuroblastoma
|
Adrenal gland tumour
|
Granuloma cell tumour of ovary
|
Surgery
| null |
143c538d-1aa3-4eb0-9122-9584a592deba
|
single
|
The commonest type of lung carcinoma in nonsmokers is -
|
"Adenocarcinoma is the most common type of lung cancer in women and nonsmokers". — Robbin's
Predisposing factors for lung cancer
A smoking → Most important factor associated with lung carcinoma. Two lung cancer cell types, squamous cell carcinoma and small cell carcinoma are strongly associated with cigarette smoking and are extremely rare in the absence of cigarette smoking.
High dose ionizing radiation eg. by uranium
Asbestos exposure
Radon exposure
Contact with certain chemicals and substances: such as uranium, chromium and nickel; can cause lung cancer, but this is rare.
Molecular genetics → All the previously mentioned factors cause a genetic alteration in lung cells, which accumulate and eventually lead to the neoplastic phenotype.
- Small cell cancer → Alteration in c-MYC & RB genes.
- Non-small cell cancer → Alteration in RAS & p16 genes.
- Both small and non-small cancer → p53 gene
- Squamous cell carcinomas show the highest frequency of p53 mutations.
- K-RAS mutations are seen primarily in adenocarcinoma.
- In small cell cancer, there is a high expression of the anti-apoptotic gene BCL 2 and low expression of the pro-apoptotic gene BAX.
| 3 |
Squamous cell CA
|
Small cell CA
|
Adeno CA
|
Alveolar cell CA
|
Pathology
| null |
d48e1a7d-602a-4833-8d41-11136c119401
|
multi
|
Disinfectant used for blood spills
|
Ans. is 'd' i.e. Sodium hypochloriteCommon Disinfectants for Hospital UseGroupExamples and UsageAdvantages and DisadvantagesPHENOLICSClear-soluble phenolic compounds, white fluids; 1.5% solutions; leave in contact for 1 hour.Good general purpose disinfectants, not readily inactivated by organic matter, active against wide range of organisms (including mycobacteria) but not sporicidal.HALOGENSHypochlorites (chloramine) eg "Milton", "Domestic", bleaches. Strong (2% Cl) to weak (0.02% Cl) concentrations used according to degree of blood contamination; leave in contact for 30 minutes.Cheap, effective, act by release of free chlorine, active against viruses and therefore recommended for disinfection of equipment soiled with blood (because of hepatitis risk), but rapidly inactivated by organic material and corrosive to metals.ALCOHOLSEthyl alcohol (ethanol), isopropyl alcohol (isopropanol).Good choice for skin disinfection and for clean surfaces, sometimes used in combination with iodine or chlorhexidine, water must be present for bacterial killing (i.e. 70% ethanol best), isopropanol preferred for skin and articles in contact with patient.ALDEHYDESGlutaraldehyde ("Wavicide", "Aidel"); 1% solution, leave in contact for 30 minutes.Kills vegetative organisms including mycobacteria slowly but effectively. More active, less toxic than formaldehyde, sporicidal (within 6 hours when fresh), irritant, used in alkaline solution which is stable 1-2 weeks, expensive, limited use e.g. disinfection of endoscopes.
| 4 |
Phenol
|
Glutaraldehyde
|
Ethanol
|
Sodium hypochlorite
|
Social & Preventive Medicine
|
Sterilization and Disinfection
|
803ed17e-42ea-4d00-9f7a-af0ef4da952c
|
single
|
Diagonsis of tetanus is made by :
| null | 2 |
Culture of bacteria from wound
|
Clinically
|
Four fold raise in antibody against tetanus toxin
|
Gram staining of biopsy from wound
|
Microbiology
| null |
65cfda8f-78b1-4822-984b-e5160f751b3a
|
multi
|
Normal capillar wedge pressure ?
|
Ans. is 'b' i.e., 5-10 mm HgNormal capillary Wedge pressure is 4-12mm Hg. It is a measure of left atrial pressure.
| 2 |
0-2 mm Hg
|
5-10 mm Hg
|
15-20 mm Hg
|
20-30mm Hg
|
Physiology
| null |
456cb96c-6b53-4835-9c09-cc6f27be2bdb
|
single
|
Grisofulvin is used in all except
|
B i.e. Tinea versicolor & candida Griseofulvin is ineffective topically and used systemically only for dermatophytosisQ. It is used for 4-6 monthsQ in tinea ungum (finger nail) infection. It is not active against candida, fungus causing deep mycosis and pityriasis versicolorQ. Condition DOC Systemic Fungal infection Amphotericin BQ All Dermatophytes (All Tinea execept Tinea Versicolour) GriesofulvinQ
| 2 |
Tinea Capitis
|
Tinea Versicolor Candida
|
Tinea Corporis
|
Tinea Ungium
|
Skin
| null |
16573766-007f-4af4-8d80-49dbc0c98641
|
multi
|
Which of the following is the most common renal vascular anomaly
|
Supernumerary renal aeries (two or more aeries to a single kidney) are the most common renovascular anomaly.The main renal aery may manifest early branching after originating from the abdominal aoa and before entering the renal hilum . The detection of these is significant in the evaluation of the patients for donor nephrectomy . Accessory renal aeries are distinct to supernumery aeries and commonly derived from the abdominal aoa, rarely iliac, and superior mesenteric aery in addition to main renal aery.. RIGHT SIDE :-20% Aoic origin 7.5% Renal origin 2.5% sup.mesenteric origin LEFT SIDE:-27.5% Aoic origin 10% Renal origin
| 1 |
Supernumerary renal aeries
|
Suprnumerary renal veins
|
Double renal aeries
|
Double renal veins
|
Surgery
|
Urology
|
7b43281f-222e-4cbc-b328-60eaad2e1270
|
single
|
The most common intracranial haemorrhage associated in this scenario is:
|
Ans. (B). Subdural hemorrhageThe photograph shows shaken baby syndrome.The Most common intracranial haemorrhage associated with shaking is sub dural haemorrhage.
| 2 |
Extradual hemorrhage
|
Subdural hemorrhage
|
Subarachnoid hemorrhage
|
Intracerabral hemorrhage
|
Forensic Medicine
|
Injuries
|
e10fad8b-630d-4672-82dc-fbf79c03aca3
|
single
|
In Acne rosacea, the main pathogenesis is:
|
Ans. A. UnknownAcne rosacea - Disease of unknown etiology, Papules & pustules over central face (but never over any other part of body); Telangiectasia of nose & cheeks; Facial erythema.a. Flushing reaction to hot, spicy foods & alcohol but no increased reactivity of cutaneous blood vessels to vasodilators.b. Sebum production is normal.Tit-Topical & oral antibiotics; topical metronidazole; avoidance of hot, spicy foods & alcohol.
| 1 |
Unknown
|
Increased sebum production
|
Increased reactivity of cutaneous blood vessels to vasodilators
|
Telangiectasia is present over whole face along with the exposed part of back where papules & pustules are also present
|
Skin
|
Miscellaneous
|
b15ea939-b37d-452d-beaa-c5899cb2ba12
|
single
|
Bedsore is an example of -
|
"Trophic ulcers are neurogenic ulcers which are caused by various factors such as impairment of nutrition of the tissues, inadequate blood supply and neurological deficit.
Bed sore is included in the group of "trophic ulcers"
| 2 |
Tropical ulcer
|
Trophic ulcer
|
Venous ulcer
|
Post thrombotic ulcer
|
Surgery
| null |
685cf98e-85a8-412f-ac82-816ebe8674b2
|
single
|
Chronic treatment with tamoxifen can cause carcinoma of:-
|
TAMOXIFEN Tamoxifen is effective in Estrogen Receptor (ER) positive breast carcinoma but some ER negative tumors also respond to tamoxifenQ. Potent antagonist in breast carcinoma cells, blood vessels and at some peripheral sitesQ Paial agonist in the pituitary, bone, uterus and liver (Pit Bul) Adverse Effects of Tamoxifen Hot flushes, nausea & vomiting (MC)Q Menstrual irregularitiesQ, vaginal bleeding, discharge, pruritus vulvae & dermatitis Endometrial cancerQ ThromboembolismQ CataractQ Retinal deposits & decreased visual acuityQ
| 2 |
Ovary
|
Endometrium
|
Cervix
|
Vulva
|
Surgery
|
Breast
|
b0501d36-200f-4c37-b4fb-5b0f6e49dffc
|
single
|
A patient treated for infertility with clomiphene citrate presents with sudden onset of abdominal pain and distension with ascites, the probable cause is -
|
Ans. is 'd' Hyperstimulation syndrome (Ref : Shaws 13/e, p 304, 305 (12th/e, p. 242)). History of clomiphene citrate intake and the presence of ascites abdominal pain and distension strongly suggests ovarian hyperstimulation syndrome.Hyperstimulation syndrome results from clomiphene citrate intake.Other drugs which cause hyperstimulation syndrome:FSH/LH therapy (most commonly seen with this)*.GnRHC/F of hyperstimulation syndromeAscites, hydrothoraxGastrointestinal (abdominal pain, distension).Cerebrovascular accidentsRenal failureTorsion and hemorrhage in ovarian cyst.CoagulopathyLiver dysfunctionIt must be fairly obvious to you by now why I opted for hyperstimulation syndrome.Now lets see other options.Multifetal pregnancy - Clomiphene administration causes multiple pregnancy in about 10% cases. But the symptoms and signs of multiple pregnancy are altogether different from that of the patient.Ectopic Pregnancy - It's not mentioned anywhere that clomiphene administration causes ectopic pregnancy.Uterine rupture- Clomiphene administration has no effect on uterus. ' .
| 4 |
Uterine rupture
|
Ectopic pregnancy rupture
|
Multifetal pregnancy
|
Hyperstimulation syndrome
|
Gynaecology & Obstetrics
|
Contraceptives
|
999f28e1-1f73-416a-860d-47600c080894
|
single
|
Signet ring appearance is seen in -
|
Ans. is 'b' i.e., Krukenberg tumor FeatureOvarian tumoro Call-Exner bodieso Reinke crystalloidso Psammoma bodieso Pseudomyxoma peritoneio Signet ring cellso Rokitansky's protuberanceGranulosa-theca cell tumorHilus cell tumors (pure leydig cell tumor)Serous cystadenomaMucinous cystadenomaMetastatic krukenberg's tumorsMature (benign) teratoma (Dermoid cyst)
| 2 |
Granulosa cell tumor
|
Krukenberg tumor
|
Teratoma
|
Dysgerminoma
|
Pathology
|
Female Genital Tract
|
4c81b22f-edd8-4839-a9b4-07d73ff5b5f9
|
single
|
The following is false about Atrial septal defect ?
|
Ans. is 'b' i.e., Right to left shunt o In ASD there is left to right shunt. Clinical manifestations of ASD o Patients with ASD are generally asymptomatic. o Mild effo intolerance and respiratory tract infection may occur. CHF is rare. Physical examination o Parasternal impulse Systolic thrill at 2"d left interspace. o Accentuation of S, due to loud tricuspid component. o Wide split and fixed S2. o Ejection systolic murmur at the second and third left interspaces. o Delayed diastolic murmur at the lower left sternal border. o ASD with mitral stenosis --> Lutembacher syndrome.
| 2 |
Ostium secundum most common
|
Right to Left Shunt
|
May be associated with TAPVC
|
CCF is very rare
|
Pediatrics
| null |
fb8951d5-a132-4388-88d4-42c3f3cc762d
|
multi
|
Which statement best describes the posterior compament of the thigh?
|
Adductor magnus has a hamstring poion and adductor poion and is, therefore, pa of both the medial and posterior compaments and is dually innervated by the obturator and sciatic nerves. The common hamstring origin is the ischial tuberosity. The tibial pa of sciatic nerve innervates all the muscles of the posterior compament of the thigh , with the exception of the sho head of biceps which is innervated by its common peroneal component. Its terminal divisions go on to innervate all the muscles of the leg. Biceps femoris has a long head which arises from the Ischial Tuberosity, and a sho head which arises from the distal pa of the inferolateral aspect of the femur.
| 2 |
The common origin for the posterior thigh muscles (hamstrings) is the Ischial Spine.
|
Adductor Magnus is a muscle of the posterior compament of thigh
|
All the hamstring muscles are innervated by the Obturator Nerve.
|
Both heads of Biceps Femoris take origin from the pelvis.
|
Anatomy
|
Muscles of Lower Limb
|
18daf9f3-b075-4b42-a8ab-c614326099e2
|
multi
|
Which of the following represent Fetal Haemoglobin (HBF)-
|
Ans. 'b' i.e., Alpha2 Gamma2 Fetal Hemoglobin is represented bv Alpha-2: Gamma-2 Hemoglobin chainsHemoglobinHemoblobm ChainsNormal Ad utt ValuesFetal Hemoglobin (HBF)a2g2 {Alpha 2 Gamma 2)< 2percent of Total adult HBAdult Haemoglobin (HB A)a2b2 (Alpha 2 Beta 2)- 96 percent of Total Adult HBAdult Hemoglobin (HBA,)a2d2 (Alpha2 Delta2)< 3.5perent of Total Adult HBHemoglobinBartsg4(Gamma 4)Nil
| 2 |
Alpha2Beta2
|
Alpha 2 Gamma 2
|
Alpha 2 delta 2
|
Delta 4
|
Medicine
|
Anemia and RBC Disorders
|
00fcd0b4-e348-4d09-a091-bf165979edcc
|
single
|
Starvation and diabetes mellitus can lead on to ketoacidosis which of the following features is in our of ketoacidosis due to diabetes mellitus?
|
Ketoacidosis is a high anion gap metabolic acidosis due to an excessive blood concentration of ketone bodies. Ketone bodies (acetoacetate, beta-hydroxybutyrate, acetone) are released into the blood from the liver when hepatic lipid metabolism has changed to a state of increased ketogenesis. The three major types of ketosis are: Starvation ketosis Alcoholic ketoacidosis Diabetic ketoacidosis Starvation Ketoacidosis: Occurs secondary to starvation, is due to a diminished insulin secretion, that leads to an increase in lipolysis and ketogenesis. The acidosis even with prolonged fasting is only mild to moderate. Diabetic ketoacidosis (DKA) is a state of absolute or relative insulin deficiency and is defined by the American Diabetes Association's (ADA) diagnostic criteria of Hyperglycemia , Acidosis (aerial pH Ketosis (moderate ketonuria or ketonemia) The metabolic differences between diabetes and starvation include- Insulin levels: The level of insulin is decreased in both diabetes and starvation. It is more decreased in case of diabetes (viually absent in type I diabetes). There is relative excess of glucagon in both the cases. Glucagon acts through elevation in CAMP level. Blood glucose levels: Diabetics exhibit a characteristic hyperglycemia where as in starvation the individual maintain a blood glucose level that is near to normal Ketosis: The mobilization of fatty acids from adipose tissue and hepatic ketogencsis are greater in diabetes than in starvation. As a result the ketoacidosis observed in diabetes in much more severe than that observed during starvation. Factors DKA Starvation pH | normal Plasma glucose | normal Glycosuria + + ---- Total plasma ketones || Mild | Anion gap | Mild | Osmolality | normal Ref: Lippincott's illustrated reviews Biochemistry, 2nd Edition, Page 297.
| 1 |
Increase in glucagon/insulin ratio, increased CAMP and increased blood glucose
|
Decreased insulin, increased free fatty acid which is equivalent to blood glucose
|
Decreased insulin, increased free fatty acid which is not equivalent to blood glucose
|
Elevated insulin and free fatty acid, equivalent to blood glucose
|
Biochemistry
| null |
84b181a4-0092-4a5b-aece-7a52cb51c507
|
single
|
True about Glue ear
|
Glue ear is a painless and nonpurulent effusion of middle ear cleft. It occurs due to malfunctioning of the eustachian tube and increased secretory activity of middle ear mucosa. It can be controlled by decongestants and middle ear aeration. The surgical method of correction is by myringotomy with the aspiration of fluid and grommet inseion. Ref: PL Dhingra 7th edition of Ear, Nose and Throat; Pg no 69
| 2 |
Is painful
|
Is painless
|
Radical mastoidectomy is required
|
NaF is useful
|
ENT
|
Ear
|
44db7caf-0dcd-4965-aaca-d579344ecac4
|
multi
|
Peripheral neuropathy is seen due to prolonged use of all, except -
|
Ans. is 'd' i.e., Lamivudine
| 4 |
Zalcitabine
|
Didanosine
|
Stamivudine
|
Lamivudine
|
Pharmacology
| null |
c254de43-9736-47e8-8f06-641c858fce96
|
multi
|
Which of the following is NOT an indication for blind nasal intubation?
|
Blind intubation techniques are those methods of airway management that are done without visualization of the larynx or glottis. Blind nasal intubation is contra-indicated in the presence of a base-of-skull fracture, e.g., with 'raccoon eyes' or with CSF dripping from the nose, as the endotracheal tube can enter the brain. Indications for blind nasal intubation include impossible laryngoscopy, TM joint problems or trismus due to any cause.
| 4 |
TM joint ankylosis
|
Impossible laryngoscopy
|
CSF otorrhea
|
Base of skull fracture
|
Anaesthesia
| null |
162f6cc1-648f-4c00-afb3-895c8428e37a
|
single
|
PO2 is maximum
|
Paial pressure of oxygen is maximum at the apex of the lung Ref: guyton and hall textbook of medical physiology 12 edition page number: 332,333,334
| 3 |
Base of lung
|
Posterior lobe
|
Apex of lung
|
Middle lobe
|
Physiology
|
Respiratory system
|
bfeeb50c-aeb2-4f6e-ab24-f27a6886c3a7
|
single
|
A 40 year old woman with CIN 2, next step of management?
|
Pap Class systemReagen (WHO classification)Rucha classificationBethesda classificationClass 1Negative for malignantNegativeWithin normal limitClass 2Inflammation/squamous atypia/koilcytes-Atypical squamous cells of unknown significance(ASCUS)Class 3Mild dysplasia(1/3rd of sample)CIN1LSILClass 4Moderate dysplasia(1/3rd to 2/3rd of sample)Severe dysplasia(>2/3rd of sample)Carcinoma insituCIN2,3HSILClass 5Invasive cancerInvasive cancerInvasive cancerPap smear is only a screening test. Any abnormality encountered in it should be confirmed by colposcopic biopsy.Features of abnormal pap cytology*Mosaicism*Punctuations*Abnormal dense nuclei*Granular cytoplasmIndications for colposcopy biopsy*Non visualization of the transformation zone*Obvious fungation in transformation zone*Mismatch between colposcopy and pap smear*Stage IA-1(microinvasive)Refer: Shaw&;s Textbook of Gynaecology, 15th edition, pg no: 402, 405
| 1 |
Colposcopy
|
Cyrotherapy
|
Conisation
|
Hysterectomy
|
Anatomy
|
All India exam
|
e0b5686a-ee3f-4e30-abd0-36dc5e724204
|
multi
|
A child developed diarrhoea after a tour with her parents. Suspected pathogen is Enterotoxigenic E.coli. Which among the following is TRUE about Enterotoxigenic E.coli?
|
Enterotoxigenic E.coli It is the most impoant cause of traveler's diarrhea in visitors to developing countries. Transmission is by consumption of food and water contaminated by infected human or convalescent carriers. Uncooked foods such as salads or marinated meats and vegetables are associated with the greatest risk. ETEC produce diarrhea in infants, but not commonly. There is no invasion or inflammation. The bacteria remain on the surface, where the adenylate cyclase-stimulating action of the toxins creates the flow of water and electrolytes from the enterocyte into the intestinal lumen. The mucosa becomes hyperemic but is not injured in the process. Also know: ETEC diarrhea is caused by strains of E coli that produce LT and/or ST enterotoxins in the proximal small intestine. Adherence to surface microvilli mediated by the colonizing factor (CF) pili is essential for the efficient delivery of toxin to the target enterocytes. The genes encoding the ST, LT, and the CF pili are borne in plasmids. Ref: Ray C.G., Ryan K.J. (2010). Chapter 33. Enterobacteriaceae. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e.
| 4 |
Not a common cause of travelers diarrhea
|
Commonly seen in acute watery diarrhea in infants
|
Causes diarrhea due to invasion of mucosa
|
Transmitted by feco-oral route and through fomites
|
Microbiology
| null |
1dcf6d14-730a-4afb-bcdb-8028f06a0e3b
|
multi
|
Percent change in water content according to the weight of an agar impression material in various storage media is shown in the following graph. This is least when stored in storage media shown by yellow line on graph. Yellow line represents:
| null | 2 |
Potassium sulfate
|
100% humidity
|
Water
|
Air
|
Dental
| null |
e398394d-3149-4df6-9705-60095ff72b0c
|
single
|
Among of following IUCD's which has life span for 10 years :
|
Ans. is a i.e. CuT380A
| 1 |
CuT380A
|
CuT200
|
Nova T
|
Multiload
|
Gynaecology & Obstetrics
| null |
e759f847-545b-4bc8-a938-b52b8d6d7497
|
single
|
Cause of pulsating proptosis
|
Causes of Pulsatile Proptosis Caroticocavernous fistula Aneurysms of Ophthalmic aery Transmitted cerebral pulsation from deficient orbital roof like congenital meningocele / meningo-encephalocele
| 2 |
Lymphoma
|
Caroticocavernous fistula
|
Orbital cellulitis
|
Mucocele of paranasal sinuses
|
Ophthalmology
|
Orbit and Adnexa
|
647078c9-5b77-4971-81cb-117368389ff1
|
single
|
Which of the following diseases have incubation period < 10 days -a) Cholerab) Influenzac) Plagued) Measlese) Rubella
| null | 3 |
ab
|
bc
|
abc
|
bcd
|
Social & Preventive Medicine
| null |
6db4b7d7-dcd1-48f2-ae43-e3a6cf449383
|
single
|
Color of nitrous oxide cylinder is
|
Ans. d (Blue). (Ref. Short textbook of anesthesia by Ajay Yadav, 2nd ed., 21)Colour and pressure of cylindersSr. No.Anaesthetic gasColorPressure (bar) CyclopropaneOrange52.N2OBlue543.CO2Grey504.HalothaneAmber--5.EthyleneRed--6.HeliumBrown1377.O2Black body with white shoulder1378.Entonox (50%O2+50%N2O)Blue with white shoulder1379.AirGrey with white shoulder137Colour code for vaporizer of anaesthetic agents1. Red for /ralothane} 2. Orange for enflurane(HINT: ROPY HE-IS)3. Purple for isoflurane4. Yellow for sevoflurane
| 4 |
Black with white shoulders
|
White with black shoulders
|
Grey
|
Blue
|
Anaesthesia
|
Anaesthetic Equipments
|
2ac10b4f-5334-439a-a90f-39c283ec8a19
|
single
|
Cut off value of length of cervix at 24 weeks of gestation for prediction of preterm delivery is
|
Diagnosis of preterm labor : Regular uterine contractions with or without pain Dilatation more than 2cm and 80% effacement of cervix Length of the cervix <2.5 cm and funnelling of internal os Pelvic pressure, backache ,vaginal discharge Ref: Dutta Obs 9e pg 294.
| 3 |
0.5 cm
|
1.5 cm
|
2.5 cm
|
3.5 cm
|
Gynaecology & Obstetrics
|
Abnormal labor
|
91822d89-4178-4c7f-9f3b-b4056ceb38a1
|
single
|
Presence of Epstein Barr virus in hairy Leukoplakia can be demonstrated using following methods EXCEPT -
| null | 1 |
Tzanck smear
|
Polymerase chain reaction
|
In situ hybridization
|
Electron microscopy
|
Pathology
| null |
fe1e6282-4663-4616-8fe5-b31217fca5e3
|
multi
|
After fracture of middle cranial foramen there is epiphora this is due to damage of:
| null | 4 |
Ciliary ganglion
|
Greater palatine nerve
|
Infraorbital nerve
|
None of the above
|
Surgery
| null |
57b68761-56e3-46f7-99f4-56f3cce071dc
|
multi
|
Histamine is mainly found within storage granules of mast cells but also found in other tissues like:
|
Histamine is mainly found within storage granules of mast cell but also found in other tissue
Mast cell histamine – mast cell and basophile.
Non mast cell histamine – Gastric mucosa.
| 1 |
Gastric mucosa.
|
Oral mucosa.
|
Inner epithelium.
|
All of the above.
|
Physiology
| null |
69340f98-4d1c-4c9d-9249-7cee69cb22ae
|
multi
|
Posterior superior alveolar aery is branch of
|
B i.e. Palatal branch of maxillary aery
| 2 |
Nasal branch of maxillary aery
|
Palatal branch of maxillary aery
|
Mandibular aery
|
Inferior alveolar aery
|
Anatomy
| null |
fcc78812-5acc-4291-81b0-7e4766161b54
|
single
|
Spinal shock is characterized by
|
Answer is C (Sensory loss) Current Critical Care Diagnosis and Treatment 3rd/691; Spinal shock is associated with sensory loss, areflexia and urinary retention. Spinal shock is defined as total loss of motor and sensory function below the level of lesion with areflexia, and flaccidity occurring immediately after spinal cord injury. Features of spinal shock Complete motor paralysis (loss of all voluntary movements) Flaccidity Areflexia Sensory loss with anaesthesia to all modalities Spinal shock is usually associated with Urinary Retention The urinary bladder becomes areflexic during spinal shock and urinary retention develops in most cases. Following the spinal shock phase reflex detrusor activity reappears -- Textbook of Neurogenic Bladder
| 3 |
Spasticity
|
Wasting
|
Sensory loss
|
All
|
Medicine
| null |
73631386-0cb5-459c-8aef-22313403a076
|
multi
|
Which of the following drug is alpha 2 agonist?
|
Apraclonidine - Selective alpha 2 agonist. Useful in glaucoma. Alpha agonists (Brimonidine and apraclonidine) are contraindicated in hypeensive crisis. Dipivefrin is a prodrug which is conveed into epinephrine inside ttre eyeUall, so can safely be used in hypeension. REF : katzung pharmacology : 14th ed
| 1 |
Apraclonidine
|
Timolol
|
PG analogues
|
PG analogues
|
Pharmacology
|
All India exam
|
e4d51191-a052-46d5-9df1-ddb7d90cf649
|
single
|
Objective signs of inferior alveolar nerve block are seen in
| null | 1 |
Unilateral midline between premolars & incisors
|
Bilaterally between premolar & incisors
|
Unilateral midline between 2nd molar & incisor
|
Bilateral midline between 2nd molar & incisor
|
Surgery
| null |
848d1291-f9c3-448b-951d-a5d6e85c0aa1
|
multi
|
In how much time does Hepatic glycogen storage depletes during starvation?
|
The primary role of altered metabolism during fasting is to maintain blood glucose through the synthesis (gluconeogenesis) and utilization of alternate substrates. Fasting-starvation is divided in three broad categories:?Initial stage :- Lasts upto 2-3 daysIntermediate stage :- Lasts upto 24 daysAdvanced stage:- begins after 24 days.a) Initial stage (first stage):- Liver glycogen is the first main provider of energy. But due to limited storage it can not last longe (16-18 hrs.). Fuher glucose is provided by gluconeogenesis by non-carbohydrate sources (muscle protein breakdown is increased which provides amino acids alanine and glutamine for gluconeogenesis). Utilization of alternate substrates (other than glucose) stas increasing in terminal period of this stage. Free fatty acids and ketone bodies sta rising in this stage. Glycogen is completely depleted by the end of this stage. Blood glucose is slightly decreased.The first priority of metabolism in starvation is to provide sufficient glucose to brain and other tissues that are absolutely dependent on glucose.Liver glycogen provides glucose only for a sho period. Whereas, gluconeogenesis plays an essential role in maintaining blood glucose during both sho-term and prolonged starvation.The substrate for gluconeogenesis are pyruvate, lactate (from RBCs and exercising muscles), glucogenic amino acids released from muscle protein breakdown, and glycerol released from lipolysis.b) Intermediate stage (Second stage):- Free fatty acids are the major substrates for energy production. They are derived from hydrolysis of fat (triglycerides) in adipose tissue. Ketone bodies serve as additional source of energy. As glycogen source is already depleted, the only source of glucose is increased gluconeogenesis. After sometimes muscle breakdown decreases due to decreased need of glucose as a fuel for brain which has began using ketone bodies as a source of energy.c) Advanced stage (Third stage):- When fat stores are almost exhaused, energy requirment is obtained from breakdown of tissue proteins and protein stores once again enter in stage of rapid depletion.Thus the second priority of metabolism in starvation is to preserve protein. This is accomplished by using fatty acids and ketone bodies in place of glucose as a fuel.
| 1 |
18 hrs
|
36 hrs
|
72 hrs
|
48 hrs
|
Biochemistry
| null |
d1357351-b109-454d-8912-4d87b0979744
|
single
|
Drug of choice in simple partial seizure is –
|
DOC for generalized tonic clonic seizure (Grand mal), absence seizure (Petit mal), Atonic seizure, myoclonic epilepsy → valproate.
DOC for partial seizure → carbamazepine / oxcarbazepine
DOC for status epilepticus → IV lorazepam
DOC for febrile seizures → Rectal Diazepam
DOC for seizure of eclampsia → Magnesium sulfate.
DOC for infantile spasm → Vigabatrin..
DOC for myoclonic epilepsy → Valproic acid.
| 3 |
Phenytoin
|
Valproic acid
|
Carbemazepine
|
Phenobarbitone
|
Pediatrics
| null |
ae70c008-c008-42c6-aaa3-60c0ba666c27
|
single
|
In contraction stress test, positive interpretation is:
|
C i.e. Persistent late decelerationIt is an invasive method to assess fetal well being during pregnancy, when there is alteration in FHR in response to uterine contraction. It suggests fetal hypoxia.
| 3 |
Early deceleration
|
Early acceleration
|
Persistent late deceleration
|
Variable deceleration
|
Physiology
| null |
6c65e030-c4e2-4be8-bfb4-2f76e3223270
|
single
|
A 35 yr old lady with normal PT and increased APTT. 2 years back, she was operated for cholecystectomy & did not have any bleeding episode. What is next investigation for clinical diagnosis -
| null | 2 |
Factor VIII assay
|
Anti viper venom assay
|
Platelet aggregation test
|
Ristocetin Cofactor assay
|
Medicine
| null |
b7717069-b191-47a8-a5f5-3ea62a973a5d
|
single
|
Following circulatory shock, which of the following occurs: March 2009
|
Ans. A: Acute tubular necrosisAcute tubular necrosis (ATN) is caused by lack of oxygen to the kidney tissues (ischemia of the kidneys), or by exposure to materials that are poisonous to the kidney (nephrotoxic agents).The internal structures of the kidney, paicularly the tissues of the kidney tubule, become damaged or destroyed. ATN is one of the most common structural changes that can lead to acute renal failure.ATN is one of the most common causes of kidney failure in hospitalized patients.Renal papillary necrosis is a form of nephropathy involving the necrosis of the renal papilla, which is supplied by the vasa recta.Analgesic nephropathy is a cause of renal papillary necrosis. The damage is cumulative and most patients of renal papillary necrosis would have ingested at least 20kg of analgesics in the past. The risk is higher for phenacetin and acetaminophen compared to aspirin and other NSAIDs.
| 1 |
Acute tubular necrosis
|
Acute papillary necrosis
|
Both of the above
|
None of the above
|
Pathology
| null |
94f9aa2b-464e-47e0-a788-70924e9548be
|
multi
|
A woman with a history of deep vein thrombosis seeking contraception, select the method that is medically contraindicated for that patient (SELECT 1 METHOD)
|
Oral contraceptives are the contraceptive method of choice in the motivated, healthy, monogamous young woman. If the pill is properly used, the failure rate for users is the lowest among women using a reversible method of contraception. However, the use of oral contraceptives is contraindicated in patients with a history of thrombophlebitis. Both condoms and the diaphragm, used in conjunction with spermicides, are effective contraceptives that are also effective in preventing sexually transmitted diseases and acquired immune deficiency syndrome (AIDS). The diaphragm should carefully fit in the vagina and is therefore not applicable to women with anatomic distortion of the vagina. Latex condoms should not be used in women with a known latex allergy. IUDs are associated with increased risk of salpingitis and ectopic pregnancy, and therefore should be avoided in patients with a history of pelvic inflammatory disease (PID), multiple sexual partners, or ectopic conception. Although tubal ligation may be considered in the patient with chronic obstructive lung disease, the risk of general anesthesia and surgical intervention in this patient is probably high enough to indicate a more conservative approach, such as the use of an IUD.
| 1 |
Oral contraceptives
|
IUD
|
Condoms
|
Laparoscopic tubal ligation
|
Gynaecology & Obstetrics
|
Contraceptives
|
c851b996-43d8-48a4-98e5-6bb8fe1f2b34
|
multi
|
Which hormone does not have corresponding release hormone produced in pituitary?
| null | 2 |
TSH
|
Prolactin
|
ACTH
|
FSH
|
Physiology
| null |
c56a58d6-ed86-4e5b-b8ff-87328734a2bd
|
single
|
Acute physiology and Chronic Health Evaluation (APACHE) scoring system is used as a scoring system to
|
Currently, the most commonly utilized scoring systems are the APACHE (acute physiology and chronic health evaluation) system and the SAPS (simplified acute physiology score) system. These systems were designed to predict outcomes in critical illness and use common variables that include age; vital signs; assessments of respiratory, renal, and neurologic function; and an evaluation of chronic medical illnesses. The APACHE II system is the most commonly used SOI scoring system in Noh America. Age, type of ICU admission (after elective surgery vs. nonsurgical or after emergency surgery), a chronic health problem score, and 12 physiologic variables (the most severely abnormal of each in the first 24 h of ICU admission) are used to derive a score. The predicted hospital moality is derived from a formula that takes into account the APACHE II score, the need for emergency surgery, and a weighted, disease-specific diagnostic category. ref:harrison&;s principles of internal medicine,ed 18,pg no 2196
| 3 |
To predict postoperative cardiac risk
|
To predict postoperative pulmonary complications
|
To evaluate prognosis in the critical care settings
|
To evaluate prognosis after acute myocardial infarction
|
Medicine
|
C.V.S
|
26f57489-8639-4576-9c5c-2e0495c25630
|
single
|
In Erb-Duchene paralysis, the injury is limited to the
|
ERB'S PARALYSIS:- upper plexus injury.Caused by a forceful widening of the angle between the head and shoulder which may occur by traction of the arm during the bih of a child or by fall on the shoulder.Involves upper trunk - C5, C6 roots. Leads to typical deformity in the limb- policeman's tip hand/ poer's tip hand. The arm hangs by the side, adducted and medially rotated, the forearm is extended and pronated. 1. Adduction of the arm due to deltoid paralysis.2. Medial rotation of arm-paralysis of supraspinatus, infraspinatus and teres minor.3. Extension of the elbow- paralysis of biceps brachii4. Pronation of forearm- paralysis of biceps brachi5. Loss of sensation over the outer aspect of arm due to C6 spinal nerve involvement.{Reference: vishram singh, page no. 62}
| 4 |
2nd and 3rd cervical nerves
|
3rd and 4th cervical nerves
|
4th and 5th cervical nerves
|
5th and 6th cervical nerves
|
Anatomy
|
Upper limb
|
23aefdf8-87d3-4371-8177-a620a0db407c
|
single
|
In a patient with gouty ahritis Synol fluid aspiration will show which of the following:
|
The definitive diagnosis of gout is made of examination of synol fluid or tophaceoius material with polarized light microscopy and identifying the characteristic monosodium urate crystals * Group of conditions which may be characterized by an elevation of serum uric acid (usually) * Recurrent attacks (flares) of an acute inflammatory ahritis with monosodium urate crystals demonstrated in synol fluid leukocytes * Bone and joint destruction in some cases Refer Harrison 20th/e p 2166/ maheswari 9th ed
| 1 |
Monosodium urate crystals
|
Calcium pyrophosphate crystals
|
Mononulcear leucocytosis
|
Polymorphonuclear leukocytosis
|
Anatomy
|
Joint disorders
|
ff49393f-3999-49da-9d35-3318a3e948e1
|
single
|
In fracture of penis involving rupture of tunica albuginea with intact Buch's fascia following would be noted clinically?
|
Hematoma involving only the shaft of penis.Penile fracture is the disruption of the tunica albuginea with rupture of the corpus cavernosum.Penile fracture is most commonly seen during sexual intercourse (when the rigid penis slips out of the vagina and strikes the perineum or pubic bone), however it is also seen with masturbation, rolling over or falling on the erect penis and few other conditions.Patient describes a cracking or popping sound as the tunica tears, followed by immediate loss of penile rigidity and discoloration and swelling of penile shaft.If Buch's fascia remains intact, the hematoma involves the penile shaft only. This results in typical 'eggplant' deformityIf Buch's fascia is disrupted, hematoma can extend to the scrotum, perineum & suprapubic regions.The swollen, ecchymotic phallus often detes to the side opposite the tunical tear because of hematoma and mass effect.The fracture line in the tunica albuginea may be palpable.Urethral injury may be seen with penile fracture.
| 1 |
Hematoma involving only the shaft of penis
|
Hematoma involving scrotum & perineal region
|
Penis, scrotum and abdominal wall
|
Penis scrotum & thighs.
|
Anatomy
| null |
47658341-168e-4df2-aa64-80a55d72589f
|
multi
|
Total cutaneous blood flow is
|
At rest, the cutaneous blood flow is approximately 450 ml/min in the average ... It accounts for 5% of the total body oxygen consumption.
| 3 |
1500 ml/min
|
1000 ml/min
|
450 ml/min
|
250 ml/min
|
Physiology
|
Cardiovascular system
|
2c79d676-7dac-497a-9e69-039c7965acfe
|
single
|
A 2 years old child without fever develops bone pain, vomiting and features of increased intracranial pressure following excessive meditation. The drug most likely to be responsible for this is;
|
Since vit. A is stored in liver, deficiency symptoms appear only after long- term deprivation, but vit A deficiency is quite prevalent, especially among infants and children in developing countries. Manifestations are: * Xerosis (dryness) of eye, 'Bitot' s spots', kerato- malacia (softening of cornea), corneal opacities, night blindness (nyctalopia) progressing to total blindness. * Dry and rough skin with papules (phryno- derma), hyperkeratinization, atrophy of sweat glands. * Keratinization of bronchopulmonary epithe- lium, increased susceptibility to infection. * Unhealthy gastrointestinal mucosa, diarrhoea. * Increased tendency to urinary stone formation due to shedding of ureteric epithelial lining which acts as a nidus. * Sterility due to faulty spermatogenesis,etc ESSENTIALS of medical PHARMACOLOGY SIXTH EDITION-KD TRIPATHI Page:870
| 1 |
Vitamin A
|
Phenothiazine
|
Phenytoin
|
Vitamin D
|
Pharmacology
|
Other topics and Adverse effects
|
a662d33a-5b53-43c7-b69d-c6c097a840ea
|
single
|
Granulomatous disease (s) is/are -a) Lichen planusb) Histoplasmosisc)
Sarcoidosis d) Asbestosis
| null | 3 |
a
|
c
|
bc
|
ad
|
Medicine
| null |
97ded530-2b50-496b-ad98-9ff3ea43557e
|
single
|
The selective MAO–B inhibitor out of the following is :
| null | 1 |
Selegiline
|
Clorgyline
|
Moclebemide
|
Moclebemide
|
Pharmacology
| null |
31e90270-03dd-4b53-a417-4df72adcbb39
|
single
|
A dimensionally accurate reproduction of a part of the oral cavity or extraoral facial structures that is produced in a durable hard material?
|
Cast-Positive dimensionally accurate replica of a part of oral cavity or extraoral facial structures in a durable hard dental material
Model-Positive replica of teeth, soft tissues, and related structures can be used for the construction of orthodontic and prosthetic appliances and mostly used as a diagnostic aid/display purpose/patient education
Die-Positive dimensionally accurate replica of prepared tooth
| 3 |
Model
|
Die
|
Cast
|
impression
|
Dental
| null |
5d4d29ed-5fef-4f14-a955-0fab86c612c5
|
multi
|
Visual coex is supplied by :
|
C i.e., Posterior cerebral aery Posterior cerebral aery (PCA) supply blood to occipital lobe (i.e. visual or striate coex), temporal lobe, thalamusQ lentiform nucleus, pineal & medial geniculate body, choroids plexus of inferior horn of lateral ventricle & 3rd ventricle and mid brain. Occipital lobe or visual coex is supplied by posterior cerebral aeryPosterior cerebral aery supply occipital lobe (medial & lateral surface), temporal lobe (inferolateral & medial surface) i.e., visual coex. It also supply pas of thalmus, lentiform nucleus, mid brain, pineal & medial geniculate bodies, choroid plexus of 3rd ventricle, and inferior horn of lateral ventricle.
| 3 |
Anterior cerebral aery
|
Media cerebral aery
|
Posterior cerebral aery
|
Anterior inferior cerebellar aery
|
Anatomy
| null |
99a3ff33-bb4c-485a-b83c-09beb0f20f53
|
single
|
Duval procedure in case of chronic pancreatitis involves
|
Surgical procedures in chronic pancreatitis Drainage procedure Duval procedure : Distal pancreatictomy with Roux-en-Y pancteaticojejunostomy (caudal PJ) Ref: Sabiston 20th edition Pgno : 1535
| 1 |
Distal resection of tail of pancreas with end to end pancteaticojejunostomy
|
Distal resection of tail of pancreas with longitudinal opening of duct and pancteaticojejunostomy
|
Duodenum preserving pancreatic head resection
|
Local section of pancreatic head with longitudinal pancteaticojejunostomy
|
Anatomy
|
G.I.T
|
ac44751d-b56e-4c54-a4cd-bc64abc2262f
|
single
|
Noma is
| null | 4 |
pyogenic granuloma
|
fibrous dysplasia
|
Vincent's disease
|
cancrum oris
|
Pathology
| null |
74f6cc07-b9be-48f8-bd64-23919e5adf79
|
single
|
Back washing is a recommend technique for
| null | 1 |
Rapid Sand Filter
|
Slow Sand Filter
|
Community Well
|
Domestic Filter
|
Dental
| null |
17757ca6-44e3-4087-9e54-9383416881ee
|
single
|
Following are the early causes of death in criminal aboion except?
|
Ans. is 'd' i.e., SepticemiaDeath in criminal aboionEarly CausesDelayed causesLate causesHemorrhageGeneral peritonitisHepatitisshockPelvic tetanusMeningitisvagal inhibitionPyemiaPneumonitisFat embolismSepticemiaEndocarditisAir embolismSecondary hemorrhagePulmonary embolismCervix and vagina Systemic poisoningPerforation of uterus
| 4 |
Hemorrhage
|
Vagal inhibition
|
Fat embolism
|
Septicemia
|
Gynaecology & Obstetrics
| null |
f57a2f2f-d928-4dfd-ab4f-7362eaf2e1e2
|
multi
|
A women noticed mass in her left breast with bloody discharge. Histopathology revealed duct ectasia. Treatment is?
|
Hadfield operation Duct ectasia is dilatation of lactiferous ducts often associated with periductal inflammation, the pathogenesis of which is unknown. The dilated ducts are filled with brown or green coloured secretions. These fluids cause an irritant reaction in the surrounding tissue leading to periductal mastitis or even abscess and fistula formation. This may lead in some cases to a chronic indurated mass beneath the areola, mimicking a carcinoma. Eventually fibrosis develops which may cause nipple retraction. Clinical features- Nipple discharge of any colour, abscess, mammary duct fistula, subareolar mass and nipple retraction. Treatment Antibiotic therapy may be tried but surgery is mostly required to cure this notoriously difficult condition. Surgery consists of excision of all the major ducts (Hadfield's operation)
| 4 |
Simple mastectomy
|
Microdochotomy
|
Lobectomy
|
Hadfield operation
|
Surgery
| null |
3114f02f-b3ea-4534-9de8-724d6ee65dfd
|
single
|
A deficiency of vitamin D can lead to all, except:
|
Normal vitamin D metabolism
| 2 |
Decreased gastrointestinal absorption of calcium
|
Hypercalcemia
|
Decreased renal excretion of phosphorus
|
None of the above
|
Medicine
| null |
791fcd38-d28d-44a1-9b19-0eff40de1109
|
multi
|
A 40 year old man presented with painless hematuria Bimanual examination revealed a ballotable mass over the right flank. Subsequently right nephrectomy was done and mass was seen to be composed of cells with clear cytoplasm. Areas of hemorrhage and necrosis were frequent. Cytogenic analysis of this mass is likely to reveal an abnormality of:
|
Answer is C (Chromosome-3) Presence ofpainless haematuria with balottable muss in right flank in this foy years old male suggests diagnosis of renal cell carcinoma. The most common histological variant 'clear cell carcinome' is associated with a defect in chromosome 3.
| 3 |
Chromosome 1
|
Chromosome 11
|
Chromosome 3
|
Chromosome 17
|
Medicine
| null |
e20ec4dd-3711-4d78-a898-b5645a8f6454
|
multi
|
In apoptotic permeabilization of membrane occurs in
|
Mitochondrial membrane ruptures releasing substances like cytochrome c ....which play major role in apoptosis Ref guyton and hall textbook of medical physiology 12/e pg 40
| 4 |
Nuclear membrane
|
Pytoplasmic membrane
|
Lysosome
|
Mitochondrial membrane
|
Physiology
|
General physiology
|
0cf20b46-64f6-493e-9fd3-66670f54da32
|
single
|
Most common site for avascular necrosis of femur is:
|
A i.e. Subcapital fracture Avascular necorsis & Non union are most common in subcapital type of fracture neck femur Q & least common in basal neck femur Q.
| 1 |
Subcapital
|
Transcervical
|
Trochanteric
|
Basal
|
Anatomy
| null |
73d92e39-f837-494b-a842-94a9e64da19b
|
single
|
MHC class I represented on-
|
Ans. is 'b' i.e.. All nucleated cells [Ref: Robbin's 8th/e p. 192; Ananthanarayan 7th/e p. 130}o The histocompatibility antigens (human leukocyte antigens - HLA) are cell surface antigens that induce an immune response leading to rejection of allografts.o The principal physiologic function of the cell surface histocompatibility molecules is to bind peptide framents of foreign proteins for presentation to antigen specific T celts.o The histocompatibility antigens are encoded by a closely linked multiallelic cluster of genes - Major histocompatibility complex (MHC) or Human leukocyte antigens complex (HLA complex).MHCClass IClass 11O B cellso B ceilso Langerhan's cellso Langerhans's cellso Dendritic cellso Dendritic cellso Macrophageso MacrophagesoT-cellsoT cellso Epithelial cells of thymuso Epithelial cells of thymuso Neutrophils o Hepatocytes o Kidney o Brain o HLA complex of genes is located on the short arm of chromosome 6.o It consists of three separate clusters of genes :HLA Complex (MHC complex|Class 1Class 11Class IIIo Comprising A, B and C locio 'D" region - DR, DQ, DPComplement region encodeso Responsible foro Responsible foro C,&Cj# Graft rejection# Graft versus host responseo Properdin factor B# Cell mediated cyto lysis# Mixed leucocyte reactiono Heat shock proteino Found on the surface ofoFound only on cellso TNF - ot and iall nucleated cells andof the immune system platelets
| 2 |
All cells
|
All nucleated cells
|
RBCs
|
None
|
Pathology
|
Cells and Tissues of Immune System
|
b658c464-3a01-4aff-bb68-94e41fc400ec
|
multi
|
The gene involved in GIST
|
Pathogenesis of GISTs
Approximately 75% to 80% of all GISTs have oncogenic, gain-of-function mutations of the gene encoding the tyrosine kinase c-KIT.
Approximately 8% of GISTs have mutations that activate a related tyrosine kinase, platelet-derived growth factor receptor a (PDGFRA).
Constitutively active c-KIT or PDGFRA receptor tyrosine kinases activate RAS and P13K/AKT pathways and thereby promote tumor cell proliferation.
| 1 |
C-KIT
|
BRAC-1
|
p53
|
BRAC-2
|
Pathology
| null |
e2a98706-ad45-43bc-9730-f5ad7319cf41
|
single
|
Which of the following in the natural course of disease has no reversal of the shunt
|
Ans. c. TOF Infants with acyanotic gradually become cyanotic as a result of worsening condition of the infundinular stenosis a.nd polycythemia Polycythemia develop secondary to cyanosis Hypoxic spells may develop in infants Growth retardation may be present if cyanosis is severe Brain abscess and cerebrovascular accidents rarely occur SABE is occasionally a complication Some patients, paicularly those with severe TOF develop AR Coagulopathy is a late complication of longstanding cyanosis Eisenmenger syndrome Eisenmenger syndrome was so named by Dr. Paul Wood after Dr. Victor Eisenmenger, who first described the condition in 1897. Congenital hea defects causing Eisenmenger syndrome Atrial septal defects Ventricular septal defects Patent ductus aeriosus More complex types of acyanotic hea disease
| 3 |
ASD
|
VSD
|
TOF
|
PDA
|
Pediatrics
| null |
2061e228-084c-414d-ade5-47e7d60a8ad2
|
single
|
True statement about &;total feility rate&; is
|
Total feility rate represents the average number of children a woman would have if she were to pass through her reproductive years bearing children at the same rates as the women now in each age group It gives the appropriate magnitude of completed family size Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no:489
| 1 |
Indicates approximate magnitude of completed family size
|
Numerator is 'women of child bearing age'
|
Numerator is 'all live bihs'
|
Numerator is 'married women of child bearing age'
|
Social & Preventive Medicine
|
Demography and family planning
|
58e2358e-0d06-4010-a696-1188d3fc3060
|
multi
|
Inhalational agent of choice in children:
|
A. i.e. Sevoflurane
| 1 |
Sevoflurane
|
Isofurane
|
Desflurane
|
Halothane
|
Anaesthesia
| null |
194a9466-d2fa-4259-ae01-1ada81339e75
|
single
|
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