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End–tidal CO2 is increased to maximum level in –
|
The unanticipated doubling or tripling of end tidal CO2 is the earliest & most sensitive indicator of malignant hyperthermia. The earliest signs seen during anesthesia are masseter muscle rigidity (MMR), tachycardia, & hypercarbia.
| 2 |
Pul. embolism
|
Malignant hyperthermia
|
Extubation
|
Blockage of secretion
|
Anaesthesia
| null |
23afbe22-dbed-4b1f-820e-be119089ab26
|
single
|
Number of air changes in a drawing room per hour should be at least
| null | 3 |
5-Apr
|
4-Mar
|
3-Feb
|
6-May
|
Social & Preventive Medicine
| null |
9503559c-b468-4e9a-9f8f-18e2661dc4ba
|
single
|
About mallory weiss sydrome true is -
|
Answer is 'd' i.e. Seen in alcoholics
| 4 |
Gastrointestinal reflux
|
Obesity
|
Tumour at gastroesophageal junction
|
Seen in alcoholics
|
Surgery
| null |
9a2b3dfc-1b93-413e-8719-fc2641e4d5ce
|
multi
|
Which of the following is done for the quick diagnosis of Erythrasma ?
|
Ans is'd i.e. Wood's lamp examination(Ref. IADVL text book of dermatology 3d/e p. 236).Erythrasma is caused by infection by Coryneform bacteria.Wood's lamp examination is a commonly used test to diagnose Erythrasma.Lesion shows coral red fluorescence dre to coproporphyrin III production by the bacteria.
| 4 |
Biopsy
|
KOH examination
|
Culture and sensitivity
|
Wood's lamp examination
|
Skin
| null |
5c031a04-9536-43f6-9436-242dd64b4b35
|
single
|
Breast cancer mainly spreads to the vertebrae via -
|
Ans. is 'c' i.e., Batsons venous plexus o Three principal groups of veins are involved in the venous drainage of the thoracic wall and the breast:1) Perforating branches of the internal thoracic vein,2) Tributaries of the axillary vein, and3) Perforating branches of posterior intercostal veins.o Metastatic emboli traveling through any of these venous routes will pass through the venous return to the heart and then be stopped as they reach the capillary bed of the lungs, providing a direct venous route for metastasis of breast carcinoma to the lungs.o The vertebral plexus of veins (Batson's plexus) may provide a second route for metastasis of breast carcinoma via veins. This venous plexus surrounds the vertebrae and extends from the base of the skull to the sacrum. Venous channels exist between this plexus and veins associated with thoracic, abdominal, and pelvic organs. These vessels provide a route for metastatis emboli to reach the skull, vertebrae, ribs, pelvic bones, and central nervous systemo Metastasis of breast cancer to bone, and especially to thoracic vertebrae, is common due to the direct connection between the intercostal veins draining the breast and the internal vertebral plexus also known as Batson's plexus. In 1940 Batson found that dye injected into the breast of female specimens could be recovered in the vertebral veins.
| 3 |
Arterial route
|
Direct Invasion
|
Batsons venous plexus
|
Via Axillary lymph nodes
|
Surgery
|
Breast Cancer - Prognosis and Follow-Up
|
35406ea8-cd0d-498a-ac66-86ea5caf7012
|
single
|
Females with vaginal atresia are characterized by all except
|
Vaginal atresia doesnot become apparent until menarche.
| 4 |
Lack lower portion of vagina.
|
Normal external genitalia.
|
Normal pubertal maturation.
|
Becomes apparent in 1st decade.
|
Gynaecology & Obstetrics
| null |
1df10b32-8693-4ea8-a1a2-b85dd6206ebe
|
multi
|
RPR is done for diagnosis of:
|
Ans. is. 'b' i. e., Syphilis
| 2 |
Malaria
|
Syphilis
|
Leishmaniasis
|
None
|
Microbiology
| null |
9c9d0bbd-37cb-4ff5-a4b4-53b130cba896
|
multi
|
A 34-year-old male patient visits a physician with complaints of fatigue, weight loss, night sweats, and "swollen glands." The physician also observes that he has an oral yeast infection. Which of the following tests would most likely reveal the cause of his problems?
|
A male patient with the presentation as outlined (fatigue, weight loss, and lymphadenopathy) must be tested for antibodies to HIV. While other antibody tests may be relevant after the primary diagnosis, they must be considered after HIV is ruled out. Ceainly, infectious mononucleosis is a possibility, but its occurrence in this age group is not as frequent as HIV. Patients are tested first by an ELISA screening test. If this test is positive (X2), then a confirmatory Western blot is performed. A Western blot separates the immune response into antibody production for specific components of the virus, that is, envelope, gag, and so foh. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition
| 3 |
A test for CD8 lymphocytes
|
A human T-lymphotropic virus type I (HTLV-I) test
|
An HIV ELISA test
|
A test for infectious mononucleosis
|
Microbiology
|
Immunology
|
edeb15ef-d929-446a-be93-bcf5bae8d98f
|
single
|
Pantothenic acid is associated with following moiety
|
Pantothenic acid is called vitamin B5 It is ised to synthesis co enzyme A in body Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:20,21,22
| 1 |
coenzyme A
|
Carboxyl
|
Hydroxyl
|
H+
|
Physiology
|
General physiology
|
cc767573-2be8-4ca3-bb2e-40b371119c69
|
single
|
The following drug shows antiepileptic activity
|
(D) All of the above# Felbamate is an anticonvulsant drug used in the treatment of epilepsy.> It is used to treat partial seizures (with and without generalization) in adults and partial and generalized seizures associated with Lennox-Gastaut syndrome in children.> However, an increased risk of potentially fatal aplastic anemia and/or liver failure limit the drugs usage to severe refractory epilepsy.> As with many anticonvulsants, the precise mechanism is unknown.lt has an effect on GABA receptor binding sites.lt may also work as a NMDA receptor antagonist.> Molindone is a therapeutic antipsychotic, used in the treatment of schizophrenia. It works by blocking the effects of dopamine in the brain, leading to diminished psychoses. It is rapidly absorbed when taken by mouth.lt is sometimes described as a typical antipsychotic,and sometimes described as an atypical antipsychotic.Molindone may be used with caution in people with Epilepsy.> Gabapentin is a pharmaceutical drug, specifically a GABA analogue. It was originally developed for the treatment of epilepsy, and currently is also used to relieve neuropathic pain.
| 4 |
Felbamate
|
Gabapenitine
|
Molindone
|
All of the above
|
Psychiatry
|
Miscellaneous
|
7437a77d-8bab-476e-8c98-a64805098182
|
multi
|
A most common cause of amoebic lung abscess is -
|
Amoebic lung abscess is a result of direct spread of infection from liver to lung.
The infection spreads directly through the diaphragm.
The most common area of the lung involved is right lower lobe.
The amoebic liver abscess ruptures and then it can involve any of the following structures.
Right lung (Most commonly)
Right pleural cavity
Left Lung
Pericardium
Peritoneal cavity
Also know
"Pleuropulmonary involvement is seen in 20-30 % of cases and is the most frequent complication of Amoebic liver abscess"- Harrison
| 1 |
Direct extension from liver
|
Hematogenous spread
|
Lymphatic spread
|
By inhalation
|
Surgery
| null |
73720a8a-75a8-448b-bae3-5087ac90e865
|
single
|
The inguinal canal is NOT bounded posteriorly by -a) Transversalis fascia b) Internal oblique tendonc) Conjoint tendond) Lacunar ligament
|
Inguinal canal- Posterior wall formation
- Medial 2/3- Conjoint tendon and reflected part of inguinal ligament
- Whole- Fascia transversalis, extraperitoneal connective tissue, parietal peritoneum.
| 1 |
bd
|
ab
|
acd
|
bcd
|
Anatomy
| null |
551e6d05-4c64-42a3-8483-4573819ad08c
|
single
|
Single base pair substitution is related to which of the following?
|
The term RFLP (Restriction Fragment Length Polymorphisms) refers to single base pair substitutions in germ line DNA of different individuals that either destroys or creates new recognition site for a given restriction enzyme. PCR is used to amplify a specific region of a DNA strand (the DNA target). FISH is atechnique used to identify the presence of specific chromosomes or chromosomal regions through hybridization (attachment) of fluorescently-labeled DNA probes to denatured chromosomal DNA. Southern blotting combines transfer of electrophoresis-separated DNA fragments to a filter membrane and subsequent fragment detection by probe hybridization.
| 1 |
RFLP
|
PCR
|
FISH
|
Southern blot
|
Biochemistry
| null |
e7131807-11ed-474f-b332-083cc186113a
|
single
|
An investigator is studying a potential new antiarrhythmic. Eighty healthy test subjects are receiving various doses of the drug. Adverse effects and the drug’s pharmacokinetics are assessed
Which of the following steps in the drug development process does this represent?
| null | 2 |
New drug application (NDA)
|
Phase I
|
Phase II
|
Phase Ill
|
Social & Preventive Medicine
| null |
ae8b3fb4-6e64-435b-a36e-030e14ff00be
|
multi
|
A 45-year-old woman undergoes an uneventful laparoscopic cholecystectomy for which she receives 1 dose of cephalosporin. One week later, she returns to the emergency room with fever, nausea, and copious diarrhea and is suspected of having pseudomembranous colitis. She is afebrile and has no peritoneal signs on abdominal examination. She has a mild leukocytosis with a left shift. Which of the following is the appropriate initial management strategy?
|
Treatment of C difficile colitis is metronidazole for firstline therapy and oral vancomycin as a second-tier agent. Recurrence appears in up to 20% of patients. Indications for surgical treatment are intractable disease, failure of medical therapy, toxic megacolon, and colonic perforation; surgical therapy consists of subtotal colectomy with end ileostomy. The diagnosis can be made by either detection of the characteristic appearance of pseudomembranes on endoscopy or detection of either toxin A or toxin B in the stool. Anti-diarrheal agents are contraindicated in suspected C difficile colitis as they may prolong the infection.
| 4 |
Administration of an antidiarrheal agent
|
Exploratory laparotomy with left hemi-colectomy and colostomy
|
Exploratory laparotomy with subtotal abdominal colectomy and ileostomy
|
Administration of oral metronidazole
|
Anaesthesia
|
Preoperative assessment and monitoring in anaesthesia
|
eacad337-89b4-4982-baab-52289987b348
|
single
|
Antidote of choice for Belladonna poisoning -
|
Ans. is 'c' i.e., Physostigmineo Antidote of choice for belladonna (atropa belladonna or atropine) poisoning - Physostigmine.PoisonAntidotesAcetominaphen (paracetamol)N-Acetyl cysteineNitrites, cyanidesAmyl nitrite + sodium nitrite + sodium thiosulphateOrganophosphates (anticholinesterase)Atropine and oximesDigoxinDizibind or digoxin immune FabEthylene glycol, methanol, ethanolFomipizoleHeroin (opioids)Naloxone or nalmefene or naltrexoneBenzodiazepineFlumazenilDhatura/ atropine / antihistaminicsPhysostigmineActue iron poisoningDeferoxamineAcute arsenic poisoningDimercaprol / BALOxalic acidCalcium gluconateStrychinineShort acting barbituratesNote: Cooper sulphate is a poison itself, but it is used as an antidote in phosphorus poisoning.
| 3 |
Disulfiram
|
Atropine
|
Physostigmine
|
Flumazanil
|
Forensic Medicine
|
Forensic Toxicology - Concepts, Statutes, Evidence, and Techniques
|
b898becc-c6e5-4275-837a-e2bd4b839932
|
single
|
All of the following are true about amebic liver abscess except:
|
Ans. a. Trophozoites in stool are essential for clinical diagnosis
| 1 |
Trophozoites in stool are essential for clinical diagnosis
|
Mostly asymptomatic
|
More common in males than females
|
Rarely affects brain, eye and skin
|
Microbiology
| null |
059d0b20-b800-42af-97b6-6b44a9b598ae
|
multi
|
In superficial second degree burns, re-epithelialisation occurs around:
|
Characterstics of Superficial Second Degree Burns Involve upper layer of dermis ( Papillary dermis) Erythematous BLISTERS are seen Blanch on touch Painful Heals without scarring in 7-14 days
| 2 |
<1 week
|
2 weeks
|
3 weeks
|
4 weeks
|
Surgery
|
Burns
|
196d9f9b-de52-4822-952e-b26445e892d7
|
single
|
A 20 years old nulliparous women is an oral contraceptives pills. She is currently diagnosed as having pulmonary tuberculosis. Which antituberculous drug decreases the effect of OCPs?
|
Because rifampin potently induces CYPs 1A2, 2C9, 2C19, and 3A4, its administration results in a decreased t1/2 for a number of compounds, including: HIV protease and non-nucleoside reverse transcriptase inhibitors Digitoxin Digoxin Quinidine Disopyramide Mexiletine Tocainide Ketoconazole Propranolol Metoprolol Clofibrate Verapamil Methadone Cyclosporine Coicosteroids Coumarin anticoagulants Theophylline Barbiturates Oral contraceptives Halothane Fluconazole Sulfonylureas It leads to therapeutic failure of these agents, with potentially catastrophic consequences. Ref: Gumbo T. (2011). Chapter 56. Chemotherapy of Tuberculosis, Mycobacterium Avium Complex Disease, and Leprosy. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.
| 4 |
INH
|
Pyrazinamide
|
Ethambutol
|
Rifampicin
|
Gynaecology & Obstetrics
| null |
7c12692e-244e-48ce-a11a-0425063f84f2
|
single
|
Initial drug of choice in a child with status epilepticus
|
Prompt treatment with benzodiazepines is the first-line treatment of status epilepticus, but many patients will need additional treatment with additional medications including phenytoin, valproic acid, phenobarbital, or levetiracetam. The Neurocritical Care Society's guideline states that benzodiazepines remain the "emergent initial therapy" of choice based both on available evidence and expe consensus. When possible, intravenous benzodiazepine administration is preferred. However, formulations exist for buccal, intranasal, intramuscular, and rectal administration, and these should be administered if intravenous access cannot be rapidly established. The American Epilepsy Society's guideline concludes that intravenous lorazepam and diazepam are efficacious at stopping seizures lasting at least five min and that rectal diazepam, intramuscular midazolam, intranasal midazolam, and buccal midazolam are probably effective at terminating seizures lasting at least five minutes . Reference: GHAI Essential pediatrics, 8th edition
| 1 |
Lorazepam
|
Phenobarbitone
|
Valproate
|
Phenytoin
|
Pediatrics
|
Central Nervous system
|
915f4dec-f6e4-412d-89aa-7efa5c092fe4
|
single
|
Marquios disease not seen is
|
Morquio syndrome is an inherited disease of metabolism in which the body is missing or doesn&;t have enough of a substance needed to break down long chains of sugar molecules called glycosaminoglycans (formerly called mucopolysaccharides).SymptomsAbnormal development of bones, including the spineBell-shaped chest with ribs flared out at the bottomCoarse facial featuresKnock-kneesLarge head (<a href=" spaced teeth</a>
| 2 |
Corneal opacity
|
Mental retardation
|
Stunted growth
|
Absent clavicle
|
Biochemistry
|
Metabolism of carbohydrate
|
73564a51-b790-4540-8d90-68e603dccc9f
|
single
|
Corneal dystrophies are –a) Macularb) Granularc) Latticed) Moorense) Fuchs
|
Macular, granular and lattice dystrophies are stromal corneal dystrophies. Fuch's dystrophy is posterior (endothelial) corneal dystrophy.
| 4 |
bcde
|
abcd
|
acde
|
abce
|
Ophthalmology
| null |
7945820f-3d40-44d6-8968-1b422397529e
|
single
|
Leaving the capsule behind in cataract surgery is advantageous because it –a) Prevents cystoid macular edemab) Decreases endothelial damagec) Progressively improves visiond) Decreased chance of retinal detachmente) Decreased chance of endophthalmitis
|
First keep in your mind that any of the described complication can occur with either ICCE or ECCE. However, ECCE (leaving capsule behind) decreases the chances of many complications. Complications decreased by ECCE are :-
Vitreous prolapse & loss
Endophthalmitis
Cystoid macular edema
Aphakic glaucoma
Fibrous & endothelial ingrowth
Retinal detachment
Neovascular glaucoma
Corneal endothelial damage
Anterior uveitis
So, almost all complications are decreased by ECCE except for after cataract, which occurs with ECCE.
Once again I remind that any of the complications can occur with ECCE, but the chances are reduced.
| 4 |
abcd
|
bcde
|
acde
|
abde
|
Ophthalmology
| null |
81010c36-8dcd-478b-bf13-d3a649aec32d
|
single
|
Pointing index sign is seen in ---- nerve palsy -
|
Pointing index (oschner's clasp test) is seen in high median nerve palsy.
| 3 |
Ulnar
|
Radial
|
Median
|
Axillary
|
Orthopaedics
| null |
30219f05-b601-4049-b263-3d542307a77f
|
single
|
Investigation of choice in upper GI bleeding is
|
"Upper endoscopy is the test of choice in patients with UGIB" "Whenever GI haemorrhage is thought to derive from a source proximal to the ligament of Treitz, or whenever the issue is in doubt, the first invasive diagnostic maneuvre should be upper GI flexible endoscopy. This technique has a diagnostic accuracy of approximately 95% and an overall complication rate of less than 1%. Endoscopy also allows a qualitative assessment of bleeding rate, provides prognostic information regarding rebleeding potential, and offers numerous therapeutic interventions for specific lesions" - maingot's 10/e, p 291 Other investigations for Upper GI bleedingAngiography (Celiac axis angiography) it is rarely used, when upper endoscopy is unavailable or nonrevealing and the bleeding site still thought to be proximal to the ligament of Treitz. it also has the potential for therapeutic intervention by embolization of the feeding vessel. Barium study "Barium contrast radiography is no longer peinent to the diagnosis of acute hemorrhage. It should be reserved for those patients with chronic or intermittent bleeding that probably is due to an ulcer or mass lesion." Ref : CSDT 13/e p494 , Harrison 17/e p259
| 3 |
Ba swallow
|
X-ray
|
Endoscopy
|
Ultrasound
|
Anatomy
|
G.I.T
|
763d8dcf-72d2-42d9-86f6-f5cfdf83ab08
|
multi
|
Jack stone calculi is seen in which anatomic part -
| null | 4 |
Prostate
|
Kidney
|
Ureter
|
Bladder
|
Surgery
| null |
a078459f-30bc-43e9-81db-3960d111c6a4
|
single
|
A rapid method of chromosome identification in intersex is -
|
Ans is a. ie. FISH * The above-mentioned site writes about FISH- * "FISH can be used in interphase cells to determine the chromosome number of one or more chromosomes as well as to detect some specific chromosome rearrangements that are characteristic for certain cancers. The primary advantage of interphase FISH is that it can be performed very rapidly if necessary, usually within 24 hours, because cell growth is not required.* A good example is the Aneuploid Screen test which is performed on amniotic fluid cells when there is a strong clinical indication for one of the common trisomies. The sample nuclei are denatured and hybridized with DNA probes for chromosomes 13, 18, 21, X, and Y and results usually obtained within 24 hours. Routine Cytogenetics is included with an Aneuploid Screen to confirm the results or detect any abnormalities not detected by interphase FISH."Fluorescent IN SITU Hybridization (FISH)Fluorescent In Situ Hybridization (FISH) is a relatively new technology utilizing fluorescently labeled DNA probes to detect or confirm gene or chromosome abnormalities that are generally beyond the resolution of routine cytogenetics. The sample DNA (metaphase chromosomes or interphase nuclei) is first denatured, a process that separates the complementary strands within the DNA double helix structure. The fluorescently labeled probe of interest is then added to the denatured sample mixture and hybridizes with the sample DNA at the target site as it reanneals (or reforms itself) back into a double helix. The probe signal can then be seen through a fluorescent microscope and the sample DNA scored for the presence or absence of the signal.FISH can be used in metaphase cells to detect specific microdeletions beyond the resolution of routine cytogenetics or identify the extra material of unknown origin. It can also help in cases where it is difficult to determine from routine cytogenetics if a chromosome has a simple deletion or is involved in a subtle or complex rearrangement. In addition, metaphase FISH can detect some of the specific chromosome rearrangements seen in certain cancers.Microdeletion Syndromes Currently Diagnosable with FISHCri-du-Chat * Kallman SyndromeMiller-Dieker Syndrome * Williams SyndromeSmith-Magenis Syndrome * Wolf-HirschhornSteroid Sulfatase Deficiency * Prader-Willi/Angelman SyndromeDiGeorge/Velo-Cardio-Facial/CATCH-*22/Shprintzen SyndromeSingle-stranded conformation polymorphism (SSCP)SSCP is the electrophoretic separation of single-stranded nucleic acids based on subtle differences in sequence (often a single base pair) which results in a different secondary structure and a measurable difference in mobility through a gel.The mobility of double-stranded DNA in gel electrophoresis is dependent on strand size and length but is relatively independent of the particular nucleotide sequence. The mobility of single strands, however, is noticeably affected by very small changes in sequence, possibly one changed nucleotide out of several hundred. Small changes are noticeable because of the relatively unstable nature of single-stranded DNA; in the absence of a complementary strand, the single strand may experience intrastrand base pairing, resulting in loops and folds that give the single strand a unique 3D structure, regardless of its length. A single nucleotide change could dramatically affect the strand's mobility through a gel by altering the intrastrand base pairing and its resulting 3D conformation (Melcher, 2000).Single-strand conformation polymorphism analysis takes advantage of this quality of single-stranded DNA. SSCP analysis offers an inexpensive, convenient, and sensitive method for determining genetic variationThe SSCP analysis method detects point mutations by analyzing their unique electrophoretic mobility that results from small changes in the variant's nucleotide sequences.Polymerase chain reaction is a sensitive and rapid method for amplifying a specific DNA sequence.
| 1 |
FISH
|
PCR
|
SSCP
|
Karyotyping
|
Unknown
| null |
31abfa6a-9836-457e-9f3d-db319fc2e842
|
single
|
Which one of the following statements about EEG is true?
|
(A) Alpha rhythm is most marked at parieto-occipital area # Alpha Rhythm > In adult humans who are awake but at rest with the mind wandering and the eyes closed, the most prominent component of the EEG is fairly regular pattern of waves at a frequency of 8-12 Hz and an amplitude of 50-100 uV when recorded from the scalp.> This pattern is the alpha rhythm.> It is most marked in the parieto-occipital area, though it is sometimes observed in other locations.> A similar rhythm has been observed in a wide variety of mammalian species.> In the cat it is slightly more rapid than in the human, and there are other minor variations from species to species, but in all mammals the pattern is remarkably similar
| 1 |
Alpha rhythm is most marked at parieto-occipital area
|
Beta rhythm is most marked at region below mastoid
|
In REM sleep, patient is awake
|
EPSP and IPSP of the cortical cells acting as dipoles
|
Physiology
|
Nervous System
|
701d25c4-c8ad-4273-8baa-ffa96d680b9a
|
multi
|
The vasodilator involved in autoregulation of the coronary blood flow is:
|
NO and adenosine both fit as the probable candidates. However, single best response would be adenosine, and NO could be taken as the mediator of the adenosine action. As per the Berne's hypothesis: When myocardial O2 demand increases (as during increased hea rate) -> increased breakdown of ATP in the myocardial cells -> ATP conveed to ADP, AMP, and finally adenosine -> adenosine leaks out of the cells, reaches the vessels, and causes vasodilation & increases blood flow. At low concentrations ~ adenosine acts the release of NO At higher concentrations ~ adenosine acts directly on the ATP-sensitive K+ channels in the VSMC of the coronary vessels.
| 3 |
NO
|
ACh
|
Adenosine
|
CO2
|
Physiology
|
Circulation
|
4040a79f-7c7e-4a58-9b65-464ab8076b30
|
single
|
Which one of the following enzymes provides a link between glycolysis and the citric acid cycle?
|
PDH complex consist of 3 Enzymes and 5 Coenzymes
Three enzymes are:
Pyruvate Dehydrogenase bound to Thiamin Diphosphate
Dihydrolipoyl Transacetylase, the prosthetic group is oxidised Lipomide
Dihydrolipoyl Dehydrogenase, contains FAD.
Coenzymes (very important)
Thiamine Diphosphate (TDP)
Lipomide
Coenzyme A
FAD
NAD
Key Concept:
Pyruvate Dehydrogenase which converts pyruvate to acetyl CoA provides a connecting link between glycolysis and citric acid cycle.
| 4 |
Lactate dehydrogenase
|
Pyruvate Kinase
|
Citrate synthase
|
Pyruvate dehydrogenase
|
Biochemistry
| null |
c41356f4-8a47-4f6b-be6b-7fe60bed1c9e
|
single
|
Most common cause of knock knee
| null | 3 |
Osteo-arthritis
|
Rheumatoid arthritis
|
Idiopathic
|
Trauma
|
Orthopaedics
| null |
06790194-a415-4f7d-b5f4-3ef0248f6afc
|
single
|
A 30-year-old male HIV positive on antiretroviral therapy has pain in right hip region. Flexion, abduction and external rotation deformity of right hip for 2 months, what is the most likely diagnosis?
|
(b) TB hip in HIVAVN hip in HIVIncidenceMore CommonLess CommonDeformityFABER-stage of synovitis may be prolonged on treatment, then subsequently with onset of arthritis - FADIRLimitation of abduction and internal rotation so initially position is adduction and external rotation (opposite to movements limited) and than subsequently with onset of arthritis FADIR Unilateral (usually)Bilateral (usually)
| 2 |
Avascular necrosis
|
TB hip
|
Transient synovitis
|
Septic arthritis
|
Orthopaedics
|
TB of the Hip, Knee, Other Joints
|
0f038565-7dc2-4457-9637-c3f6c18011af
|
single
|
A 32 year old male is diagnosed of having acute myeloid leukemia. His total WBC count was less than normal initially. Which of the following factor has a bad prognosis in AML?
|
Prognostic factors of acute myeloid leukemia (AML): Advancing age is associated with a poorer prognosis, in pa because of its influence on the patient's ability to survive induction therapy. The leukemic cells in elderly patients more commonly express the multidrug resistance 1 (MDR1) efflux pump that conveys resistance to natural product-derived agents such as the anthracyclines. Patients with t(15;17) have a very good prognosis, and those with t(8;21) and inv(16) a good prognosis, while those with no cytogenetic abnormality have a moderately orable outcome. Patients with a complex karyotype, t(6;9), inv(3), or -7 have a very poor prognosis. Among patients with hyperleukocytosis (>100,000/L), early central nervous system bleeding and pulmonary leukostasis contribute to poor outcome with initial therapy. Karyotypes include monosomy chromosome 5 or chromosome 7 have 78% of relapse rate. Ref: Wetzler M., Marcucci G., Bloomfield C.D. (2012). Chapter 109. Acute and Chronic Myeloid Leukemia. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
| 1 |
Monosomies of chromosomes
|
Young age
|
Patients with t(15;17)
|
Low WBC count
|
Pathology
| null |
7ece8365-8305-49ae-9aff-d8dd268172ce
|
multi
|
All of these are true about GnRH analogues used in treatment of endometriosis , EXCEPT?
|
GnRH is given continuously to downregulate and suppress pituitary gonadotropins and cause atrophy of endometriotic tissue. The risk of osteoporosis increases after prolonged use as the estrogen mediated osteoblastic action stops while the estrogen independent osteoclast action continues Add back therapy is given to reduce the risk of hypoestrogenic side effects like osteoporosis, hot flushes, vaginal dryness, urogenital atrophy. Drugs include: progesterones, low dose estrogens, tibolone Discontinuation causes recurrence within a year in upto 50 % cases Commonly used GnRH agonists are: Leuprolin Naferelin Goserelin Buserelin
| 2 |
Continuous administration causes downregulation of pituitary gonadotropins
|
The risk of osteoporosis decreases with prolonged use as the estrogen mediated osteoblastic action continues
|
Add back therapy includes estrogens
|
Discontinuation causes recurrence
|
Gynaecology & Obstetrics
|
Endometriosis, Adenomyosis
|
9d2b5496-a9ca-43db-93a8-3a2cb8e419a7
|
multi
|
Final common metabolism of atracurium, mivacurium and succinylcholine are by:
|
Ans: c (Hydrolysis) Ref: KDT, 6 ed, p.25, 345; Harper 27 ed, p.96The final common pathway in the metabolism of all the three involves hydrolysis by an esterase.The cleavage of a drug molecule by taking up a water molecule; occurs in liver, intestine, plasma and other tissues.E.g.: choline esters, lignocaine, procaine, procainamide, pethidine, oxytocin, atracurium, mivacurium.Atracurium:1) Usually inactivated by spontaneous nonenzymatic degradation (Hoffman elimination)2) One small fraction is eliminated by hydrolysis by cholinesterase.Mivacurium:Shortest acting competitive blocker, rapidly metabolised by plasma cholinesterases.Succinvlcholine:Shortest acting depolarizing muscle relaxant which is hydrolysed by plasma pseudocholinesterase to succinyl monocholine and then succinic acid and choline.Action lasts only for 3-5 min. It causes phase 2 blockade.Classification of enzymes:A. Oxidoreductases:i) Dehydrogenases- removes hydrogen by coenzymes.ii) Oxidases- remove H2 and form H2O2.iii) Reductases-iv) Peroxidases-v) Catalasesvi) Oxygenase-monooxygenasedioxygenaseB. Transferases:Transfer one group from substrate to another.TransketolaseTransaldolaseKinases (transfer phosphate group from ATP to substrate)TransaminasePhosphorylaseC. Hydrolases:Cleavage of a molecule by taking up a water molecule1. Phosphatase2. Glycosidases3. EsterasesD. Lyases:Add or remove small molecules like water,ammonia, CO2e.g.:1) decarboxylase2) synthases- ALA synthase.3) aldolase4) fumaraseE. Isomerases:i) Epimerasesii) Mutasesiii) RacemasesF. Ligases:1. Ligation of two molecules at the expense of high energy phosphate bond. eg:synthetases2. CarboxylasesRemember:Carboxylases are ligases but decarboxylases are lyases.Synthetases are ligases but synthases are lyases
| 3 |
Conjugation
|
Reduction
|
Hydrolysis
|
Acetylation
|
Pharmacology
|
Anaesthesia
|
2b38cab7-bf9c-4de7-af88-3910153c80b2
|
single
|
A 24 year old male presents with altered sensorium and rapid shallow breathing. ABG shows:pH 7.2, sodium 140, bicarbonate 10 and chloride 98. Probable diagnosis is -
|
usually happens because your body doesn't have enough insulin. Your cells can't use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones and, if the process goes on for a while, they could build up in your blood. That excess can change the chemical balance of your blood and throw off your entire patients with type 1 diabetes mellitus and develops when insulin levels are insufficient to meet the body's basic metabolic requirements. DKA is the first manifestation of type 1 DM in a minority of patients. Insulin deficiency can be absolute (eg, during lapses in the administration of exogenous insulin) or relative (eg, when usual insulin doses do not meet metabolic needs during physiologic stress) The therapeutic goals of DKA management include optimization of 1) volume status; 2) hyperglycemia and ketoacidosis; 3) electrolyte abnormalities; and 4) potential precipitating factors. The majority of patients with DKA present to the emergency room. Therefore, emergency physicians should initiate the management of hyperglycemic crisis while a physical examination is performed, basic metabolic parameters are obtained, and final diagnosis is made. Several impoant steps should be followed in the early stages of DKA management: collect blood for metabolic profile before initiation of intravenous fluids; infuse 1 L of 0.9% sodium chloride over 1 hour after drawing initial blood samples; ensure potassium level of >3.3 mEq/L before initiation of insulin therapy (supplement potassium intravenously if needed); initiate insulin therapy only when steps 1-3 are executed. Ref Harrison 20th edition pg 980
| 2 |
Renal tubular acidosis
|
DKA
|
Ethylene glycol poisoning
|
Amphetamine toxicity
|
Medicine
|
Toxicology
|
3339d8b4-40ed-4043-aa68-ef0e4d266df7
|
multi
|
The Colposcopic features suggestive of malignancy are all except :
|
White epithelium
| 4 |
Condyloma
|
Vascular atypia
|
Punctation
|
White epithelium
|
Gynaecology & Obstetrics
| null |
21c41da0-ff71-43c8-a381-250d293278ab
|
multi
|
A 25-year-old woman presents to the emergency department with symptoms of nausea and vomiting of 2 days duration. She is not on any medications and was previously well until now. The physical examination is normal except for a postural drop in her blood pressure from 110/80 mm Hg supine to 90/80 mm Hg standing. Her serum electrolytes are sodium 130 mEq/L, potassium 3 mEq/L, chloride 90 mEq/L, bicarbonate 30 mEq/L, urea 50 mg/dL, and creatinine 0.8 mg/dL. Which of the following electrolytes is most likely to be filtered through the glomerulus but unaffected by tubular secretion?
|
Urea is filtered at the glomerulus, and thereafter, any movement in or out of tubules is a passive process depending on gradients, not secretion. Reabsorption of urea in the distal tubule and collecting duct, when urine flow is reduced, results in the disproportionate elevation of urea nitrogen over creatinine in prerenal azotemia.
| 4 |
potassium
|
sodium
|
bicarbonate
|
urea
|
Medicine
|
Oncology
|
bf6fabc7-a2e1-40e3-a651-560dd4db2b6a
|
multi
|
Henoch Schnolein Purpura may rarely cause -
| null | 1 |
Intussuception
|
Volvulus
|
Atrial fibrillation
|
Hernia
|
Surgery
| null |
7c6d1e8e-7198-4fa8-8fb5-2e9b7b870193
|
single
|
All of the following are contrast radiographs except:
| null | 2 |
Arthrography
|
Tomography
|
Sialography
|
Arthrotomography
|
Radiology
| null |
d6c4a62b-f438-41ec-9a93-78516fad6926
|
multi
|
Definitive treatment of hypermagnesemia is?
|
Hemodialysis REF: Harrison's 17th ed chapter 346 HYPERMAGNESEMIA: TREATMENT Successful treatment of hypermagnesemia generally involves identifying and interrupting the source of magnesium and employing measures to increase magnesium clearance from the BCF. Use of magnesium-free cathaics or enemas may be helpful in clearing ingested magnesium from the gastrointestinal tract. Vigorous IV hydration should be attempted, if appropriate. Hemodialysis is effective and may be required in patients with significant renal insufficiency. Calcium, administered IV in doses of 100-200 mg over 1-2 h, has been repoed to provide temporary improvement in signs and symptoms of hypermagnesemia.
| 3 |
Calcium gluconate
|
IV fluids
|
Hemodialysis
|
Exchange resins
|
Surgery
| null |
5eea33c5-89e6-48b1-a14a-e6d523152b82
|
single
|
Which of the following is not true of polymethylmethacrylate?
|
PMMA is a transparent resin of water-like clarity that is transparent to light in the visible and ultraviolet range down to a wavelength of 250 nm. It is a hard resin with a Knoop hardness number of 18 to 20 KHN. It has a tensile strength approximately 60 MPa, a density of 1.19 g/cm3 and a modulus of elasticity of approximately 2.4 GPa.
It is also extremely stable: it does not discolor in ultraviolet light and it exhibits remarkable aging properties. It is chemically stable to heat below 125°C, softens at 125°C, and can be molded as a thermoplastic material. However, above 125°C, PMMA begins to depolymerize and forms methylmethacrylate monomer, MMA, and at approximately 450°C, 90% of the polymer will have depolymerized.
Reference: PHILLIPS’ SCIENCE OF DENTAL MATERIALS, 12th ed page no 108
| 4 |
Knoop hardness number 18 to 20
|
Tensile strength of 60 MPa
|
Density of 1.13 g/cm3
|
Modulus of elasticity of 3.4 GPa
|
Dental
| null |
9b6a828b-4539-4cc3-b14d-bb9c346cfe55
|
multi
|
Kaplan Meier method is used for -
| null | 1 |
Survival
|
Prevalence
|
Incidence
|
Frequency
|
Social & Preventive Medicine
| null |
9e305080-8ea1-4494-abe0-2ed57d3ae128
|
single
|
Most common organism involving allograft transplant:
|
Ans. (c) VirusesRef: Bailey 26th edition, Page 1415* Most common infection in allograft transplant--Viral infection* Risk of infection is the greatest during first 6 months* Chemoprophylaxis is important for high-risk patients* Cytomegalovirus is a major problem* Most common malignancy after transplant: Post-transplant lymphoproliferative disorder > skin cancers (squamous cell cancer)
| 3 |
Bacteria
|
Fungi
|
Virus
|
Parasite
|
Surgery
|
Transplantation
|
9a688eae-f889-421b-9cda-15557746caa0
|
multi
|
A young boy presents with dark patches with itching. On rubbing there is appearance of wheal. Diagnosis is -
|
Ans is 'b' i.e. Urticaria pigmentosa Urticaria pigmentosao Urticaria pigmentosa (also known as "Generalized eruption of cutaneous mastocytosis (childhood type)) is the most common form of cutaneous mastocytosiso Urticaria pigmentosa is most common in children. It can also occur in adultso Urticaria pigmentosa occurs when there are too many mast cells in the skin.o Urticaria pigmentosa is a characterized by patches of darker skin and very bad itching. Hives can develop when these skin areas are rubbed (Darier's sign). It's caused by the release of histamine from the mast cells.o Adults or adolescents are more likely to have uncommon symptoms like diarrhea, tachycardia, nausea or vomiting, fainting, dizziness, headache.
| 2 |
Addison's disease
|
Urticaria pigmentosa
|
Chronic idiopathic urticaria
|
Erythema multiforme
|
Skin
|
Eosinophilic Dermatoses
|
4e953881-b544-4fbf-ba88-72940d60d9e1
|
single
|
True about western blot:
|
A i.e. Separation of proteins are based on mass; B i.e. SDS-PAGE electrophesis is used for separation; C i.e. Enzyme linked antibodies are used
| 4 |
Separation of proteins are based on mass
|
SDS-PAGE electrophesis is used for separation
|
Enzyme linked antibodies are used
|
All
|
Medicine
| null |
2f9b182a-225c-4da0-ad8b-5a32eacb6fff
|
multi
|
Adult polycystic kidney disease is-
|
Ans. is 'a' i.e., Autosomal dominant Summary of Renal cvstic disease InheritancePathologic featuresClinical features of ComplicationsTypical outcomeAdult polycystic kidney diseaseAutosomaldominantLarge multicystie kidneys, liver cysts, berry aneurysmsHematuria, flank, pain, urinary tract infection, renal stones, hypertensionCronic renal featureBeginning -------- 40-60 yrChildhood polycystic kidney diseaseMedullary sponge kidneyAutosomal recessiveNoneEnlarged cystic kidneys at birthMedullary cysts on excretory urographyHepatic fibrosisHematuria, urinary tract infection, recurrent renal stonesBoningSample cystsNoneSingle or multiple cysts in normal-sized kidneysMicroscopic hematuriaBenignAcquired renal cystic diseaseNoneCystic degeneration in end-stage kidney diseaseHemorrhage, ervthrocytosis, neoplasiaDependence on dialysisAutosomal dominant fAduIti polvcvstic kidney diseaseo ADPKD is a hereditory disorder characterized by multiple expanding cysts of both kidneys that ultimately destroy the renal parenchyma and cause renal failure.o The cysts initially involves only portions of nephrons, so renal function is retained about the fourth or fifth decade of life (option e).Geneticso The pattern of inheritance is autosomal dominant with high penetrance,o Mutations occurs in one of the following gene.PKDI gene on chromosome 16 that encodes polycystin 1-In 85% of cases.PKD2 gene on chromosome 4 that encodes polycystin 2.o The PKDI gene encodes a protein named polycystin-1. It has been localized to tubular epithelial cells, particularly those of the distal nephron. At present, its presise function is not known, but it contains domains that are usually involved in cell-cell and cell- matrix interact]ons.The PKD2 gene productpoIveystin-2 is localized to all segments of the renal tubules and is also expressed in many extrarenal tissues. Recent evidence indicates that polycystin-2 may act as a Ca2+ permeable cation channel and that a basic defect in APKD is a disruption in the regulation of the intracellular Ca2+ levels.Pathologyo The disease is universally bilateral,o Both the kidney are grossly enlarged,o Multiple cysts cover the surface of the kidney.o The cysts contain straw coloured fluid that may become hemorrhagic.o The cysts are distributed evenly throught the cortex and medulla.o Cysts may also present at extrarenal locations, e.g. liver, spleen, pancrease, ovary.Extrarenal anomalies seen in patients with adult polvcvstic kidney disease.CystsBerry aneurysmColonic diverticulaMitral valvea) Liver (M. C. Site)(Present in 5-10%) Prolapseb) Spleen c) Pancreas d) Ovaries
| 1 |
Autosomal dominant
|
Autosomal recessive
|
X-linked
|
Mitochondria
|
Pathology
|
Chronic and Cystic Diseases
|
ac93f9e6-92c4-4101-814c-5df35ddcf937
|
single
|
Imiquimod is used in treatment of anogenital was acts mainly as:-
|
Topical immunomodulation with imiquimod 5% cream is used for treatment of: genital was superficial basal cell carcinoma actinic keratoses Acts on Toll-like receptor 7 (TLR-7). This is a cell surface receptor found on cells of monocyte lineage. Interaction of TLR-7 with ligands activates a signalling pathway, leading to release of large amounts of interferon-a, IL-12, TNF-a and other potent cytokines. S/E: irritation, discomfo and occasionally erosion at the point of application with a small risk of causing vitiligo-like depigmentation.
| 3 |
Antifungal
|
Antiviral
|
Immunomodulator
|
Keratolytic
|
Dental
|
Viral infections
|
0b5420bb-e890-44d3-86e1-4640003da84a
|
single
|
The key enzyme in urea synthesis is -
|
Ans-B
| 2 |
Urease
|
Carbamoyl phosphate synthase-I
|
Arginase
|
Ornithine
|
Unknown
| null |
570ebcb6-fe07-4408-8fb9-9336de01a08e
|
single
|
Ovulation is presumed to have occurred if progesterone level is __________ on day 21
|
Ovulation can be safely assumed to have occurred if progesterone level exceeds 3 ng / mL on cycle day 21.
| 2 |
0.3 ng / mL
|
3 ng / mL
|
30 ng / mL
|
300ng / mL
|
Gynaecology & Obstetrics
| null |
30934853-dd57-4372-86ec-91a17451882c
|
single
|
A 37-year-old obese female presents with pain in her left wrist and abnormal sensations, numbness, burning and tingling in her left thumb, index, and middle fingers and some part of ring finger. The pain is severe and wakes her up at night. She works as a typist and pain increases with typing all day. Nerve conduction studies reveal nerve compression. Which of the following additional clinical findings would be present in this patient?
|
Answer: b) Inability to oppose the thumb to other digits.Patient is suffering from "carpal tunnel syndrome".It is a medical condition in which the median nerve is compressed as it passes through the carpal tunnel deep to the flexor retinaculum at the wrist.The patient's occupation as typist may have predisposed the patient to this condition.MEDIAN NERVE "labourer's nerve" (C5, C6, C7, C8, T1)Formed from the branches of medial and lateral cord of brachial plexus.No branches to axilla & arm.Sensory SupplyPalmar aspect:- Lateral half of Palm & Lateral 31/2 fingers with their nail bedsDorsal aspect: - distal part of later 31/2 fingers Motor SupplyForearm: All flexors except flexor carpi ulnaris and medial half of flexor digitorum profundusHand: Ist two lumbricals (1st & 2nd lumbricals), thenar muscles except adductor pollicis (Supplied by ulnar nerve)Injuries to Median nerve:At elbowPointing Index (detected by Oschner clasping test)Simian/Ape thumb deformity (Thenar muscles wasted)Pen testAt wrist: Abduction & Opposition of thumb is lost.Median Nerve- Commonly injured in cut injury at flexor retinaculum.Commonly gets involved in entrapment neuropathy (carpal tunnel syndrome)Tests of median nerve lesion:Tinel's sign- percussion of flexor retinaculum -> tingling sense in the distribution of median N.Phalen's test- hyperextension/ flexion aggravates pain & paresthesiaCuff compression test of Gilliatt & Wilson- BP cuff is inflated above systolic BP-> aggravates pain & paresthesia.CARPAL TUNNEL SYNDROMEMost common upper extremity compressive neuropathyNeuropathy caused by compression of the median nerve within the carpal tunnel.The floor of the tunnel is formed by the volar radiocarpal and intercarpal ligaments.The transverse carpal ligament forms the roof of the tunnel.9 long flexors of the wrist and fingers and median nerve run within this spatially limited and relatively rigid tunnel.Etiology: PRAGMATICP-PregnancyR-Rheumatoid arthritisA-Arthritis degenerativeG-Growth hormone abnormalities (acromegaly)M-Metabolic (gout, diabetes myxedema, etc)A-AlcoholismT-Tumorsl-ldiopathicC- Connective tissue disorders (e.g. amyloidosis).Thus, any increase in pressure within the tunnel compresses the injury-prone median nerve.A decrease in thenar muscle strength occurs, along with a numbness or a decrease in the sensibility of the palmar surface of the radial 3 1/2 digits, especially the middle and index fingers.Initial stage:Dull pain in the arm at night (brachialgia paresthetica nocturna)Wakes the patient from sleep and can be relieved by shaking and massaging the armsStiff & uncoordinated fingers for a short time after the patient wakes up in the morningAdvanced stage:Abnormal sensations (paresthesia) developSense of touch is impaired, mainly in the thumb and index finger.The Phalen wrist flexion sign or Phalen maneuver is positive in carpal tunnel syndrome.Inability to oppose the thumbs.Emaciation of thenar eminenceParesthesia, hypoesthesia, or anesthesia of lateral three and a half digits.Sensation in the central palm remains unaffected.TESTS:Provocative testing includes Phalen's test, Tinel's test at the wrist, or the carpal tunnel compression test (Durkan's test).The carpal tunnel compression test is generally regarded as the most sensitive.The most predictable sensory test to evaluate carpal tunnel syndrome is the Semmes-Weinstein monofilament test.
| 2 |
Atrophied adductor pollicis.
|
Inability to oppose the thumb to other digits.
|
Flattened hypothenar eminence
|
Paresthesia of thenar eminence
|
Orthopaedics
|
Peripheral Nerve Injuries
|
779280a9-db83-49b6-b7f8-c21229b633c4
|
multi
|
Which of the following is a characteristic feature on culture of Streptococcus pneumoniae organism?
|
These findings are used to identify Streptococcus pneumoniae. Optochin sensitivity is used to differentiate the viridans streptococci (resistant) from S. pneumoniae (sensitive). Another test used to identify S. pneumoniae is the Quellung reaction. The only medically impoant optochin-sensitive organism that gives a positive Quellung reaction is S. pneumoniae. Beta-hemolytic colonies that are bacitracin-resistant on blood agar is seen with Streptococcus agalactiae. Beta-hemolytic colonies that are inhibited by bacitracin on blood agar is seen with Streptococcus pyogenes. Catalase-negative organisms that hydrolyze esculin in 40% bile and 6.5% NaCI is seen with Enterococcus faecalis. Also Know: Pneumococci possess polysaccharide capsules of more than 85 antigenically distinct types. With type-specific antiserum, capsules swell (quellung reaction), and this can be used to identify the type. Another impoant surface component of Str. pneumoniae is a teichoic acid in the cell wall called C-substance (also known as C-polysaccharide). It is medically impoant not for itself, but because it reacts with a normal serum protein made by the liver called C-reactive protein (CRP). CRP is an "acute-phase" protein that is elevated as much as 1000-fold in acute inflammation Ref: Levinson W. (2012). Chapter 15. Gram-Positive Cocci. In W. Levinson (Ed),Review of Medical Microbiology & Immunology, 12e.
| 1 |
Alpha-hemolytic colonies inhibited by optochin on blood agar and lysed by bile
|
Beta-hemolytic colonies that are bacitracin-resistant on blood agar
|
Beta-hemolytic colonies that are inhibited by bacitracin on blood agar
|
Catalase-negative organisms that hydrolyze esculin in 40% bile and 6.5% NaCI
|
Microbiology
| null |
cc9e0284-58f7-4a82-8003-edb12f136a32
|
single
|
A person had an episode of dengue serotype 1, after 2 years with serotype 2. What will be effect of this episode?
|
Ans. b. Increased chances of DHFPATHOGENESIS OF DENGUE VIRUSPrimarily dengue infection occurs when a person is infected with dengue virus for the first time with any one serotype.Months to years later, a more severe form of dengue illness may appear (Called secondary dengue infection) due to infection with another second serotype which is different from the first serotype causing primary infection.The severity of secondary dengue infection occurs due to a unique immunological phenomenon called antibody dependent enhancement (ADE), i.e. non-neutralizing antibody produced against the first serotype will combine, cover and protect the second serotype from host immune response.ADE is remarkably observed when serotype 1 infection followed by serotype 2, which also claims to be the most severe form and prone to develop into Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS).Serotype 2 is more apparently more dangerous than other serotype.
| 2 |
Mild ds d/t neutralizing abs present
|
Increased chances of DHF
|
No chances of DHF
|
No effect on present illness
|
Medicine
|
Infection
|
341786bd-a17e-4abc-a616-8bae05f8c64a
|
single
|
Insane paresis is associated with -
|
Ans. is 'a' i.e., Syphilis General paresis of insane Is a form of neurosyphilis, peaks in incidence 10 to 20 years after untreated Treponemapalliduminfection.It often stas with subtle cognitive and emotional changes, such as problems with concentration and irritability, and, if untreated, can lead to memory loss, confabulation, anomia, apraxia, or pseudobulbar palsy. The disease may mimic any psychiatric disorder, as well.One-half of the patients with neurosyphilis manifest dementia, of whom one-fouh of patients have prominent psychiatric manifestations, such as depression, paranoia, psychosis, or mania.A worsening of symptoms during the first 24 hours after the initiation of antibiotic treatment has been termed the Jarisch-Herxheimer reaction. With disease progression, there is loss of muscle tone, fine motor control, seizures, spasticity, and, eventually, paralysis and death.
| 1 |
Syphilis
|
Leishmaniasis
|
Yellow fever
|
Nesseria meningitis
|
Pathology
| null |
c55c1526-4fce-4d10-bed4-7462834321f2
|
single
|
A two-month-old infant is brought to the hospital emergency with marked respiratory distress. On examination, the infant has cyanosis and bilateral crepitations. Hea rate is 180/min, respiratory rate 56/min and the liver span 7.5 cm. The child has had repeated episodes of fever, cough and respiratory distress since the time of bih. Cardiovascular examination reveals a grade III ejection systolic murmur in left parasternal area and the chest X-ray reveals cardiomegaly with a narrow base and plethoric lung fields. What is the most likely diagnosis ?
|
Ans. is 'b' i.e., Transposition of great aeries
| 2 |
Congenital methemoglobinemia
|
Transposition of great aeries
|
Cystic fibrosis
|
Tetralogy of Fallot
|
Pediatrics
| null |
f5d4b052-c522-43ce-80bc-c0943ab336ff
|
multi
|
Facilitated diffusion is characterized by all except
|
This process is called passive transpo orfacilitated diffusion, and does not require energy. The solute can move "uphill," from regions of lower to higher concentration. This process is called active transpo, and requiressome form of chemical energy. Ref ganong's review of medical physiology 25e p102
| 3 |
Vmax
|
Competitive inhibition
|
Requires energy
|
Specificity
|
Physiology
|
All India exam
|
0bf4c9ba-9892-45df-9bbe-44fcdfcf6825
|
multi
|
Which of the following is an enrichment media: September 2009
|
Ans. D: All of the above Culture media may be classified into several categories depending on their composition or use. A chemically-defined (synthetic) medium is one in which the exact chemical composition is known. A complex (undefined) medium is one in which the exact chemical constitution of the medium is not known. Defined media are usually composed of pure biochemicals off the shelf; complex media usually contain complex materials of biological origin such as blood or milk or yeast extract or beef extract, the exact chemical composition of which is obviously undetermined. A defined medium is a minimal medium if it provides. only the exact nutrients (including any growth factors) needed by the organism for growth. A selective medium is one which has a component(s) added to it which will inhibit or prevent the growth of ceain types or species of bacteria and/or promote the growth of desired species. A culture medium may also be a differential medium if allows to distinguish between different types of bacteria based on some observable trait in their pattern of growth on the medium. Thus a selective, differential medium for the isolation of Staphylococcus aureus, contains a very high concentration of salt (which the staph will tolerate) that inhibits most other bacteria, mannitol as a source of fermentable sugar, and a pH indicator dye. From clinical specimens, only staph will grow. S. aureus is differentiated from S. epidermidis (a nonpathogenic component of the normal flora) on the basis of its ability to ferment mannitol. Mannitol-fermenting colonies (S. aureus) produce acid which reacts with the indicator dye forming a colored halo around the colonies; mannitol non-fermenters (S. epidermidis) use other non-fermentative substrates in the medium for growth and do not form a halo around their colonies. MacConkey's medium shows up lactose fermenters as pink colonies An enrichment medium contains some component that permits the growth of specific types or species of bacteria, usually because they alone can utilize the component from their environment. For example, Alkaline peptone water and Monsour's taurocholate Tellurite peptone water for vibrio cholera and Selenite F broth for dysentery bacilli.
| 4 |
Alkaline peptone water
|
Monsour's taurocholate Tellurite peptone water
|
Selenite F broth
|
All of the above
|
Microbiology
| null |
612842c4-4aea-40a5-995c-64ee33be65c4
|
multi
|
Which prostaglandin is used in NSAID induced ulcer?
|
Ans. is 'a' i.e., Misoprostal o Misoprostol (PGE1 analogue) is used for prevention and treatment of NSAID induced ulcer, but DOC is PPI.
| 1 |
Misoprostol
|
Carboprost
|
Miazapine
|
Miprinone
|
Pharmacology
| null |
707dcf60-d95e-4736-b2ef-3f89a79f5acd
|
multi
|
Which one of the following is not true regarding fibrolamellar carcinoma?
|
Unlike HCC, fibrolamellar Ca is not associated with HBV infection. Fibrolamellar carcinoma characteristically manifests as a large hepatic mass in adolescents or young adults. Most patients present in the 2nd or 3rd decade of life. Cirrhosis; elevated a-fetoprotein levels; and typical risk factors for hepatocellular carcinoma such as viral hepatitis, alcohol abuse, and metabolic disease are typically absent.
| 3 |
Seen in young adults
|
Better prognosis than HCC
|
Associated with HBV infection
|
Elevated AFP is not seen
|
Medicine
| null |
5ec3f0d8-b40d-40e1-af26-0415d7e3a17b
|
multi
|
35 year old female diagnosed to have hyper thyroid disorder. Her thyroid follicle lined by
|
Normal thyroid follicle - simple cuboidal Hyper thyroid follicle - simple columnar Hypo thyroid follicle - simple cuboidal
| 1 |
Simple columnar
|
Simple squamous
|
Simple cuboidal
|
Ciliated columnar
|
Anatomy
|
Epithelial tissue
|
ce4ede3c-e2ef-4eb3-9d30-f4e14e239d29
|
single
|
Drugs used for treating schizophrenia are chiefly:March 2010
|
Ans. D: AntipsychoticAntipsychotics have been a mainstay of therapy for schizophrenia since the introduction of chlorpromazine in the mid-1950s, which revolutionized treatment.Atypical/second generation antipsychotic drugs, such as riseperidone, olanzapine, quetiapine. Aripiprazole, and ziprasidone, are more commonly used than the older typical/first generation antipsychotics such as trifluoperazine and haloperidol, in acute stages.Atypical antipsychotics are also useful when negative symptoms are prominent, e.g. in chronic schizophrenia.
| 4 |
Antimaniac
|
Antidepressant
|
Antihistaminics
|
Antipsychotic
|
Psychiatry
| null |
82b7f1df-6e0f-4d28-ba55-c38b362ea12f
|
single
|
Most common glial tumor
|
Astrocytomas are the most common tumours among all other gliomas .....and in astrocytoma infiltrating type has an occurrence of 80 percent of all cases. REF : Robbins and cotrans , 9e , pg : 1306
| 2 |
Ependymomas
|
Astrocytoma
|
Meningioma
|
Neurofibroma
|
Pathology
|
Endocrinology
|
ff137b47-fab2-4256-93f1-b29156af3c4e
|
single
|
The malunion of supracondylar fracture of the humerus most commonly leads to:
|
Ans. is 'b' i.e. Cubitus varus Repeat Q no. 146 Dec 1997Malunion is the most common complication of a supracondylar fracture and results in a cubitus varus deformity also k/a Gun stock deformity.Although cubitus varus is cosmetically unsightly, it does not have any significant functional disability, so it is corrected surgically only for cosmetic reasons.* Treatment is supracondylar corrective osteotomy (French osteotomy)
| 2 |
Flexion deformity
|
Cubitus varus
|
Cubitus valgus
|
Extension deformity
|
Orthopaedics
|
Supracondylar Fracture
|
fb0c3e9f-8d53-411e-a2f1-e2a1b0e4143e
|
single
|
A good indicator of the availability, utilization and effectiveness of health care services in a country is?
|
Ans. is 'c' i.e., Infant moality rate o IMR is considered a sensitive index of health services as it reflects maternal care, perinatal care, child rearing practices, nutritional practices, and socioeconomic conditions in which people live as well as availability, effectiveness and utilization of health care services. "IMR is universally regarded not only as a most impoant indicator of health status of a community but also of the level of living of people in general and effectiveness of MCH services in paicular. "
| 4 |
Maternal moality rate
|
Hospital bed occupancy rate
|
Infant moality rate
|
DALY's
|
Social & Preventive Medicine
| null |
5b6b3244-eac6-476d-aedf-78c76558209e
|
single
|
Following are complications of chicken pox except
|
Chicken pox is caused by varicella zoster virus ,a DNA virus of Herpes virus family . It is present in respiratory secretions and skin lesions of an affected child . The poal of entry is the respiratory tract. Secondary bacterial infections of skin lesions is fairly common and occasionally result in necrotising fascitis . Neurologic complications include meningoencephalitis,acute cerebellar ataxia,tranvserse myelitis,landry-guillain-barre syndrome and optic neuritis.other complications include purpura fulminans,cns vasculitis leading to stroke, Auto immune thrombocytopenic purpura and reye syndrome, progressive varicella syndrome is a dreaded complication of pox characterised by continued development of lesions,hemorhagic lesions, coagulopathy and visceral organ involvement including hepatitis,pneumonia and encephalitis. Reference: Essential paediatrics,op ghai, 9 th edition, pg no: 210 & 211
| 3 |
Meningitis
|
Pneumonia
|
Enteritis
|
Reyes Syndrome
|
Pediatrics
|
Infectious disease
|
95658a39-3e66-484f-b531-3270a186e3eb
|
multi
|
One day after a casual sexual encounter with a bisexual man recently diagnosed as antibody-positive for HIV, a patient is concerned about whether she may have become infected. A negative antibody titer is obtained. To test for seroconversion, when is the earliest you should reschedule repeat antibody testing after this sexual encounter?
|
Persons at high risk for infection by human immunodeficiency virus (HIV) include homosexuals, bisexual males, women having sex with a bisexual or homosexual paner, intravenous drug users, and hemophiliacs. Antibody titer usually becomes positive 6 to 12 weeks after exposure, Because of occasional delayed appearance of the antibody after initial exposure, it is impoant to follow up patients for 1 year after exposure.
| 3 |
1 to 2 weeks
|
16 to 20 weeks
|
6 to 12 weeks
|
12 to 15 weeks
|
Gynaecology & Obstetrics
|
Genital Tract Infections (Too hot to handle!)
|
1e668d12-42d8-46a0-ad34-866efa8fc690
|
single
|
when Va/Q is INFINITY , it means
|
V/Q IS INFINITY WHEN DEAD SPACE IS 0 REF : HARISSONS 21ST ED
| 2 |
The pO2 of alveolar air is 159mmHg and PCO2 is40mmHg
|
paial pressure of alveolar gas is same as deadspae
|
Paial pressure of O2 and CO2 are equal
|
ALL TH E ABOVE
|
Medicine
|
All India exam
|
064492f8-cfba-44e7-a4a5-a60c13c8dba8
|
multi
|
Dose of levonorgestrel used for emergency contraception:-
|
Levonorgestrel is Doc for emergency contraception 0.75 mg tablets ( 2 tablets) 12 hrs apa. 1.5 mg tablet ( 1 tablet ) within 72 hrs. This is the only method of emergency contraception approved for use by Drug Controller of India Note:- IUCD - used up to 5th day after intercourse.
| 2 |
0.75 mg within 72 hours
|
1.5 mg within 72 hours
|
1.5 ug within 72 hours
|
3 ug within 72 hours
|
Gynaecology & Obstetrics
|
Contraceptives
|
e1ef9aef-429f-45a4-a9eb-19807aa66db4
|
single
|
pANCA positive vasculitis is
|
Answer- b. Churg - Strauss syndromePANCATypically found in:MicroscopicpolyangiitisChurg-StrausssyndromeIdiopathiccrescenticglomerulonephritisGoodpasteur'ssyndrome.pANCA's are also associated with ceain non-vasculitic entities such as ceain rheumatic and nonrheumatic autoimmune diseases, Inflammatory bowel diseases, ceain drugs. Infections such as endocarditis and bacterial airway infection in patients with cystic fibrosis
| 2 |
Wegener's granulomatosis
|
Churg - Strauss syndrome
|
Polyaeritis nodosa
|
All of the above
|
Medicine
| null |
4e27c57c-40a7-4841-827b-f0560e36c9c3
|
multi
|
Earliest feature in Multiple sclerosis is -
| null | 1 |
Optic neuritis
|
Inter nuclear ophthalmologia
|
Ataxia
|
Weakness
|
Medicine
| null |
2c03b258-facc-42ef-a418-97f077c372f6
|
single
|
Who proposed the nasal septum "theory of craniofacial growth"?
| null | 4 |
Mass
|
Sicher
|
Vander Linden
|
Latham
|
Dental
| null |
101bc391-d7cc-4c5c-8c31-486118d845b1
|
single
|
Transmission of HIV infection from infected mother to child occurs most commonly during -
|
Ans. is 'c' i.e.. During labour
| 3 |
Antenatal stage
|
Before delivery
|
Duringlabour
|
During lactation
|
Gynaecology & Obstetrics
|
Infectious Diseases
|
7df2a179-3988-4abb-bfae-5291b328f2e0
|
single
|
The position adopted for tonsillectomy is also adopted for this procedure. -
|
The position of a patient during tonsillectomy is Rose's position, i.e. patient lies supine with head extended by placing a pillow under the shoulder.
Rose's position is used in the ENT for : Tonsillectomy, Adenoidectomy, Tracheostomy.
| 3 |
Direct laryngoscopy
|
Bronchoscopy
|
Tracheostomy
|
Indirect laryngoscopy
|
ENT
| null |
d36d0bd1-4055-4ee9-a1b4-9e463214e39b
|
single
|
Ectopia lends is a feature of:
|
Ans. d (All of the above)CAUSES OF LENS DISLOCATIONDiseases that can be associated with subluxation or dislocation of the lens# Sharp and in particular blunt injuries (globe contusion)# Metabolic disorders- Marfan syndrome- Homocystinuria- Weil-Marchesani syndrome- Hyperlysinemia- Sulfite oxidase deficiency- Ehlers-Danloss syndrome- Osteogenesis imperfect- PEX syndrome, others# Overstretching of the zonular fibers by excessive corneal and / or scleral stretching- High myopia- Hydrophthalmos- Megalocornea- Staphyloma# Other causes/associations- Congenital aniridia- Mandibulofacial dysplasia- Focal dermal hypoplasia- Syphilitic uveitis- Retinitis pigmentosa- Hypermature cataract- Intraocular tumors (especially ciliary body melnoma) IncidenceManifestationDirection of the lens subluxation/ luxationOther features to noteOcular traumaVery frequentAny, mainly younger age m>>fVariable (any direction possible)Traumatic retinal detachment, traumatic secondary glaucomaPEX syndromeVery frequentOlder age m=fUsually anterior or posteriorPEX glaucoma PEX iridopathy and keratopathyIdiopathic lens dislocationNot rareUsually younger age m=fVariable Lens dislocation in high myopiaNot rareUsually younger age m=fVariableRhegmatogenous retinal detachmentMarfan syndromeNot rareyoungerage m=fUsually temporosuperior, less often naso-superiorRefer to cardiologist (caution; aortic aneurysm), arachnodactylyHomocystinuriaRareyounger age m=f(Nasal) Downward, often vitreous spaceOften spherophakia,a tendency for vascular thrombosisWeil-Marchesani syndromeRareYounger age m=fDownward, forwardOften small, spherical lens, small stature, brachycephaly
| 4 |
Marfan's syndrome
|
Homocystinuria
|
Weil-marchisani syndrome
|
All of the above
|
Ophthalmology
|
Lens
|
28c2976d-cba8-49ce-b6c8-c852cc16fc6a
|
multi
|
Onset of post spinal headache is usually at___ hours after spinal anesthesia
|
Post spinal headache or post dural puncture headache has onset usually on second or third day post procedure. It is an occipital type of headache, aggravated on sitting and relieved in recumbent position
| 3 |
0-6
|
12-Jun
|
Dec-72
|
72-96
|
Anaesthesia
|
Regional anaesthesia
|
2627c8d8-8ac6-4ff3-b662-c2b4cde86285
|
multi
|
Indira Gandhi Matritva Sahyog Yojana is for ?
|
Ans. is d i.e., > 19 years old o The Indira Gandhi Matritva Sahyog Yojana (IGMSY) is a flagship program of the government of India introduced in 2010 under the Ministry of Women and Child Development. o It is a conditional cash transfer scheme that targets pregnant and lactating women 19 years of age and older who have two children. Its goal is to paly compensate them for wage-loss during childbih and childcare and to provide conditions for sale delivery and good nutrition and feeding practices.
| 4 |
> 65 years old
|
> 50 years old
|
> 30 years old
|
> 19 years old
|
Social & Preventive Medicine
| null |
0ad0e571-b849-41ff-b6ef-13305fc2e36a
|
single
|
All of the following may be causes of precocious puberty in girls except –
|
Congenital 21 hydroxylase deficiency causes precocious puberty in male due to excess of androgens.
In female, it results in virilization.
| 4 |
Hypothalamic harnartoma
|
Mc Cuone Albright syndrome
|
Granulosa cell tumor of human ovary
|
Congential 21–α hydroxylase deficiency
|
Pediatrics
| null |
26995a41-bf7c-408c-a73c-3fa2b01ccba0
|
multi
|
Phencyclidine is also known by all except
|
Phencyclidine - other names - Cadillac, Peace pill, Rocket fuel, Hog, Goon, Angel dust, Super grass - It is used as psychedelic and hallucinogen. - LSD - White lightening - Phencyclidine also causes Dissociative Anaesthesia.
| 4 |
Cadillac
|
Peace pill
|
Rocket fuel
|
White lightning
|
Forensic Medicine
|
Toxicology - 1
|
2c53a5ef-6e32-4ffb-994f-35424d563e35
|
multi
|
Death caused by exclusion of air from the lungs by means other than compression at neck and drowning.
|
Suffocation literally means to die as a result of not being able to breath or to have difficulty in breathing. Deprivation of oxygen can be by one of the following ways. By lack of oxygen in the atmosphere, so called environmental suffocation. From obstruction of air passages by means other than Compression of neck and drowning Red: TEXTBOOK OF FORENSIC MEDICINE AND TOXICOLOGY KRISHNAN VIJ FIFTH EDITION PAGE 112
| 1 |
Suffocation
|
Strangulation
|
Traumatic asphyxia
|
Sexual asphyxia
|
Forensic Medicine
|
Asphyxia
|
7f9cd7d7-7dc5-4a79-8ad6-778b3bbd2860
|
single
|
Which of the following is classified under Grade II acute cholecystitis according to the Tokyo Consensus Guidelines?
|
Tokyo Consensus Guidelines for severity grading of acute cholecystitis: Grade I (mild) acute cholecystitis Acute cholecystitis in a healthy person with no organ dysfunction and mild inflammatory changes in the gallbladder Grade II (moderate) acute cholecystitis Associated with any one of the following:1. Elevated WBC count (>18000/mm3)2. Palpable tender mass in the right upper abdominal quadrant3. Duration of complaints >72 hours4. Marked local inflammation (gangrenous cholecystitis,pericholecystic abscess, hepatic abscess, biliary peritonitis,emphysematous cholecystitis) Grade III (severe) acute cholecystitis Associated with any one of the following: 1. CVS dysfunction- Hypeension requiring treatment with dopamine/norepinephrine 2. Neurological dysfunction- Decreased level of consciousness 3. Respiratory dysfunction- PaO2/FiO2 ratio <300 4. Renal dysfunction- Oliguria; creatinine >2.0mg/dL 5. Hepatic dysfunction- PT-INR >1.5 6. Haematological dysfunction- Platelet count <100000/mm3
| 4 |
Presence of multiorgan dysfunction
|
WBC count > 11000/mm3
|
Mild local inflammation
|
Duration of complaints >72 hours
|
Surgery
|
Gallbladder
|
3d45e4d8-2b08-4ee8-8e56-30bcce99cb0d
|
single
|
Not true about Fuch's corneal dystrophy -
|
Fuchs dystrophy is frequently seen as a slowly progressive bilateral condition affecting females more than males, usually between fifth and seventh decade of life. Primary open angle glaucoma is its common association.Reference:Comprehensive ophthalmology,AK Khurana,4th edition,page no.118
| 3 |
Glaucoma is its common association
|
Endothelial dystrophy
|
Unilateral condition
|
Occurs in old age
|
Ophthalmology
|
Cornea and sclera
|
1c98ce11-3f3a-4f84-bf1c-b5518dfbe104
|
multi
|
A lesion of the optic radiation involving the Meyer's loop causes -
|
Meyer's loops are the inferior most fibres of optic radiation. Damage to inferior fibres cause superior quadrantanopia.
| 2 |
Homonymus hemianiopia
|
Superior quadrantanopia
|
Inferior quadrantanopia
|
Central scotoma.
|
Ophthalmology
| null |
06c1ca64-051c-40f7-b1b7-ac2f722873ca
|
single
|
300 diseased people were made to undergo a test of which only 60 were positive. 40 people were found to be false positive for the test. The positive predictive value of the test is:
|
Ans: b (60/100)Ref: Park, 20th ed. Pg. 126 19 ed., Pg. 119Screening test resultsDiagnosisTotalDiseasedNot diseasedPositiveNegativea (True positive)c (False negative)b (False positive)d (True negative)a+bc+dTotala+cb+da+b+c+dSensitivity = a/ (a+c) x 1 (X)Specificity = d/ (b+d) x 1 (M)Predictive value of positive test= a/ (a+b) x 100Predictive value of a negative test = d/ (c+d) x 100Percentage of false negatives = c/ (a+c) x 100Percentage of false positives = b/ (b+d) x 100Sensitivity is the ability of a test to identify correctly all those who have the disease that is "true positive". A screening test which is very sensitive has few "false negatives".Specificity is the ability of a test to identify correctly those who do not have the disease that is true negatives. A screening test which is very specific has few "false positives".
| 2 |
40/100
|
60/100
|
40/300
|
240/300
|
Social & Preventive Medicine
|
Biostatistics
|
78829adf-46e6-4c37-b03c-d75e60228987
|
multi
|
Barrette's oesophagus is diagnosed by
|
(B) Intestinal metaplasia # Barrett's esophagus is a serious complication of GERD.> In Barrett's esophagus, normal tissue lining the esophagus changes to tissue that resembles the lining of the intestine(columnar epithelium).> Barrett's esophagus is marked by the presence of columnar epithelia in the lower esophagus, replacing the normal squamous cell epithelium--an example of metaplasia.
| 2 |
Squamous metaplasia
|
Intestinal metaplasia
|
Squamous dysplasia
|
Intestinal dysplasia
|
Pathology
|
Misc.
|
7cebf49d-d714-4b53-948c-6941d92615c1
|
single
|
A 50-year-old HIV seropositive male presented to the ER with multiple episodes of generalized tonic-clonic seizures. Patient is not on HAA. CD4 count was done and it was 45/ microL. O/E, Mildly arousable Disoriented No nuchal rigidity or focal neurological deficits Gadolinium enhanced MRI and MR spectroscopy were conducted. Which is the most appropriate drug to be given in the above condition: -
|
This is a case of cerebral toxoplasmosis in the setting of HIV-AIDS. MRI shows a number of lesions in the brain parenchyma with surrounding edema - suggestive of toxoplasmosis. Increased lipid peak and decreased choline peak on spectroscopy differentiates it from primary CNS lymphoma. Patients of HIV with CD4 count < 100/ microL - risk of toxoplasmosis Causes encephalitis. Combinations approved are: - 1st choice - Pyrimethamine + Sulphadiazine Alternative -Trimethoprim + Sulphomethoxazole
| 3 |
Caspofungin
|
Streptokinase
|
Pyrimethamine + Sulphadiazine
|
Voriconazole
|
Unknown
|
Integrated QBank
|
9d177b62-78e0-4e70-a310-e59f02e78bd1
|
multi
|
The recent treatment of short bridle passable stricture of urethra in the penile and bulbous urethra is-
|
Campbell says “The data show that strictures at the bulbous urethra that are < 1.5 cm in length and not associated with dense, deep spongiofibrosis (i.e. straddle injuries) can be managed with internal urethrotomy, with a 74% moderately long-term success rate.”
• Internal urethrotomy refers to any procedure that opens the stricture by incising it transurethrally .
• Internal urethrotomy is done for short, soft, passable, bulbar stricture.
• The urethrotomy procedure involves incision through the scar to healthy tissue to allow the scar to expand (release of scar contracture) and the lumen to heal enlarged.
• MC complication of internal urethrotomy is recurrence of stricture.
• The data show that strictures at the bulbous urethra that are < 1.5 cm in length and not associated with dense, deep spongiofibrosis (i.e. straddle injuries) can be managed with internal urethrotomy, with a 74% moderately long-term success rate .
| 2 |
Internal urethrotomy with Thompson-Walker's urethrotome
|
Optical internal urethrotomy
|
Syme's operation
|
Wheelhouse operation
|
Surgery
| null |
83ad01f1-b286-42af-b1aa-8c7e904157d8
|
single
|
Passavant ridge is formed by:
|
Some fibres of the palatopharyngeus muscle (arising from palatine aponeurosis) sweep horizontally backwards and join the upper fibres of the superior constrictor muscle to form a U-shaped muscle-loop in the posterior pharyngeal wall underneath the mucosa, which is pulled forward during swallowing to form the Passavant ridge.
| 2 |
Tensor veli palati and superior constrictor
|
Palatopharyngeus and superior constrictor
|
Palatopharyngeus and inferior constrictor
|
Palatoglossus and superior constrictor
|
Anatomy
| null |
1bff6b22-ba6d-44f2-89a6-65638ba21b7b
|
single
|
Which of the following structures develops from all the three germ layers?
| null | 3 |
Soft Palate
|
Mitral valve
|
Tympanic membrane
|
Tooth
|
Anatomy
| null |
be570a13-ec95-4cbf-a0da-9931f2567a4e
|
multi
|
An 8-yr old boy presents witha gadually progessing swelling and pain since 6 months over the upper tibia. On X-ray there is alytic lesion with scleotic margins in the upper tibial metaphysis. The diagnosis is
|
Lytic lesions with sclerotic margins in the upper end of tibia in an 8 yr old boy suggests the diagnosis of Brodie&;s abscess. lytic lesions with sclerotic margins are seen in: simple bone cyst brodie&;s abscess osteoblastoma chondroblastoma. ref : maheswari 9th ed
| 3 |
Osteogenic carcinoma
|
Osteoclastoma
|
Brodie's abscess
|
Ewing's sarcoma
|
Anatomy
|
Skeletal infections
|
0a5ca683-cbae-451a-b6cc-4f6c6a3aedb5
|
multi
|
Treatment of paracetamol toxicity is
|
Ans. is 'd' i.e., N - acetyl cysteine Paracetamol poisoning* It is a potent hepatic toxin. A small part is converted by a liver enzyme into N - acetyl-p-benzoquinoneimine.* Glutathione and other sulphydryl compounds detoxify this substance, but in overdose NABP accumulates and causes severe centrilobular liver necrosis.* Large doses act on brain stem and cause rapid death.Symptoms:* Within a few hours - anorexia, nausea, vomiting, abdominal pain, diaphoresis, hypotension, tachycardia and dyspnoea.* After one to two days, the discomfort disappears.* After 2 to 4 days there is vomiting, jaundice, hepatic pain, bleeding, hypoglycaemia, confusion, coma, metabolic acidosis and coarse flapping tremor of hands (asterixis).* There may be cardiac arrhythmias, haemorrhagic pancreatitis, disseminated intravascular coagulation, etc.* Death usually occurs in 3 to 4 days.Treatment:i) Gastric lavage.ii) Activated charcoal.iii) N-acetylcysteine (NAC) is a specific antidote and has maximum efficacy if used within 8 hours.
| 4 |
Alkaline diuresis
|
Hemoperfiision
|
Dialysis
|
N - acetyl cysteine
|
Forensic Medicine
|
Toxicology
|
300cb9b0-312f-4b8a-90c9-f3041dacaae1
|
single
|
Laryngospasm under anaesthesia can be relieved by:
|
Suxamethonium is depolarizing relaxant, used to revert the spasm under anaesthesia.
| 4 |
Aminophylline
|
Salbutamol
|
Terbutaline
|
Succinylcholine
|
Unknown
| null |
b8ec0b81-230f-40e1-b585-55a30bdd78ca
|
single
|
Bisecting angle technique is based upon?
|
The bisecting-angle technique is based on a simple geometric theorem, Cieszynski’s rule of isometry, which states that two triangles are equal when they share one complete side and have two equal angles.
Dental radiography applies the theorem as follows. The receptor is positioned as close as possible to the lingual surface of the teeth, resting in the palate or on the floor of the mouth.
The plane of the receptor and the long axis of the teeth form an angle with its apex at the point, where the receptor is in contact with the teeth along an imaginary line that bisects this angle and directs the central ray of the beam at right angles to this bisector.
This forms two triangles with two equal angles and a common side (the imaginary bisector). Consequently, when these conditions are satisfied, the images cast on the receptor theoretically are the same length as the projected object. To reproduce the length of each root of a multirooted tooth accurately, the central beam must be angled differently for each root.
Ref: ORAL RADIOLOGY Principles and Interpretation, Stuart C. White, Michael J. Pharoah Edition 7 page no 94,95
| 3 |
Mara principle
|
SLOB rule
|
Rule of isometry
|
Convergence
|
Radiology
| null |
641510f7-93f1-40a0-bd0c-9d6044f47f0a
|
single
|
Postpaum tubectomy in a hea disease patient is done at
|
Sterilization should be considered with the completion of the family at the end of first week in the puerperium under local anaesthesia throught abdominal route by minilap technique. If the hea is not well compensated the husband advised for vasectomy.
| 2 |
48 hours
|
1 week
|
2 weeks
|
Immediately
|
Gynaecology & Obstetrics
|
Medical, surgical and gynaecological illness complicating pregnancy
|
2f1cce80-9fe2-4c5f-a5b4-d4a2f46f33cb
|
single
|
Liver synthesises all except
|
Immunoglobulins are synthesized by the B-lymphocytes.
| 4 |
C3 complement component
|
Haptoglobin
|
Fibrinogen
|
Immunoglobulin
|
Physiology
|
Gastrointestinal System
|
6819e3f3-6aed-4979-b434-04f594904d40
|
multi
|
Hereditory spherocytosis is due to deficiency of-
|
HS is caused by diverse mutations that lead to an insufficiency of membrane skeletal components. The pathogenic mutations most commonly affects ankyrin, band 3, spectrin, or band 4.2. Ref :Robbins pathologic basis of disease ; south east asia edition ;pg:633
| 1 |
Ankyrin
|
Actin
|
Selectin
|
Integrin
|
Pathology
|
Haematology
|
f414fef7-dc13-4a20-b880-51185526dd37
|
single
|
How many incisions are used in the divided system approach of pars planavitrectomy?
|
It has the advantage of smaller instruments,easy handling,improved visualisation REF:khurana,pg no 261
| 3 |
1
|
2
|
3
|
4
|
Ophthalmology
|
Miscellaneous
|
9ee8fa23-f62d-4493-993e-6526d68fa6da
|
single
|
Commonest dislocation of elbow -
|
Ans. is 'b' i.e.. Posterior o The elbow dislocation is nearly always poserior or posterolateral.o In posterior elbow dislocation, elbow is flexed with exaggerated prominence of the olecranon.Dislocation of elbowo Dislocation of the elbow is usually caused by a heavy fall onto the outstretched hand.o The dislocation is nearly always posterior or posterolateral, i.e., radius & ulna are displaced backward or backward & laterally, relative to humerus.o There may be an associated fracture of the coronoid process of the ulna, or of the radial head, capitulum or medial epicondyle.Clinical presentationo Severe pain in elbow writh gross restriction of movement.o Bowstring sign or Bowstringing of triceps : - Triceps tendon becomes prominent,o The three bony point relationship is reversed and olecranon is above the intercondylar line,o Elbow is flexed, w ith an exaggerated prominence of olecranon.Treatmento Closed reduction under anaesthesia followed by immobilization in above elbow slab in 90deg of flexion for 3 weeks is the treatment of choice.o If closed reduction is failed, open reduction is indicated.Complicationso Complications are common and may be divided into early and lateEarly complicationsVascular injury :- Brachial artery may injured. It may result in compartment syndrome and Volkmann's ischemic contracture.Nerve injury:- Median and ulnar nerve injuryLate complicationsStiffnessMyositis ossificansUnreduced dislocationRecurrent dislocation
| 2 |
Anterior
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Posterior
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Both same
|
Medial
|
Orthopaedics
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Dislocation of Elbow Joint
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cc8de638-acd6-4011-9a54-2969fcc35f87
|
multi
|
Branching posterior spoke like cataracts (Propeller) are seen in:
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Ans. Fabry's disease
| 2 |
Down's syndrome
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Fabry's disease
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Neuro fibromatosis
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Atopic keratoconjunctivitis
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Ophthalmology
| null |
166c68fd-6d20-47a8-85c1-dafacc2dcae1
|
single
|
All of the following drugs are non-selective Beta blockers EXCEPT:
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Non-selective beta blocker are propranolol, sotalol, timolol. Non-selective beta blockers with additional alpha blocking propey are labetalol and carvedilol. From essential of medical pharmacology K D Tripati 7th edition page no 144
| 4 |
Propanolol
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Timolol
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Sotalol
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Carvedilol
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Pharmacology
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Autonomic nervous system
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1faab49d-83a7-48fd-bef4-e4dc6a19f831
|
multi
|
which of the following SNRI used in the management of stress urinary incontinence
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SNRI * IMPOANCE Dual antidepressant like TCA but better than TCA has it has no dryness of mouth, hypotension, sedation * MECHANISM Inhibits the reuptake of both serotonin and dopamine * DRUGS VENLEFEXINE DESVENLEFEXINE DULOXETINE * USE Duloxetine===PAIN ASSOSIATED WITH DIABTIC NEUROPATHY and STRESS URINARY INCONTINENCE Milnacipran===Fibromyalgia * SIDE EFFECTS DIASTOLIC HYPEENSION DELAYED ORGASM WITHDRAWL SYNDROME ON DISCONTINUATION, hence should not be abruptly stopped. To try slow tapering Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition. 955
| 4 |
brofromine
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citalopram
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nefazodone
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duloxetine
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Psychiatry
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Pharmacotherapy in psychiatry
|
e38db850-66e2-4705-9368-04d84aa8247a
|
single
|
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