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Causes of pulsus bisferiens
|
Pulsus bisferiens(2 systolic peaks) is seen in
Aortic regurgitation +/aortic stenosis
Hypertrophic cardiomyopathy
| 3 |
LV failure
|
Cardiac tamponade
|
Hypertrophic cardiomyopathy
|
Constrictive pericarditis
|
Medicine
| null |
6548a2f6-20ab-4fa9-8d60-2150686b6e20
|
single
|
Best diagnosis of pancreatic cancer (head) is by:
|
Ans. CT scan
| 3 |
Ultrasound
|
ERCP
|
CT scan
|
Angiography
|
Radiology
| null |
a2fddade-592e-41c1-ab00-06f0ec2ab174
|
single
|
"Water can perineum" is caused by:
|
(Neisseria gonorrhoeae): Ref: 227-AN 7th, 266-CPNeisseria gonorrhoeae: - The predominant manifestation in men is urethritis characterized by dysuria and a spontaneous purulent penile discharge. Chronic urethritis may lead to stricture formation. The infection may spread to the periurethral tissues, causing abscesses and multiple discharging sinuses (water can perineum)PATHOGENICITYA. Local diseaseB. Disseminated gonococcal infection1. Urethritis2. Cervicitis - only half may have symptoms of d ischarge and dysuria* Vulvovagiinitis - in prepubertal girls* Septic arthritis* Skin lesion* Tenosynovitis* Endocarditis* Osteomyelitis* Meningitis }RareComplications* PID* Anorectal gonorrhoea* Pharyngeal gonorrhoea* Ophthalmia neonatorum* Perihepatitis (Fitz Hugh Curtis syndrome)
| 3 |
E. coli
|
Enterococcus faecalis
|
Neisseria-gonorrhoeae
|
Treponemia pallidium
|
Microbiology
|
Bacteria
|
109d219e-278d-4308-b7cb-d98c07ecaa68
|
multi
|
Which of the following is the 'ordeal poison' used by tribes of Africa?
|
Physostigmine, also called eserine, is an alkaloid obtained from the Calabar or ordeal bean. The Calabar bean once was used by native tribes of West Africa as an "ordeal poison" in trials for witchcraft, in which guilt was judged by death from the poison, innocence by survival after ingestion of a bean. Ref: Taylor P. (2011). Chapter 10. Anticholinesterase Agents. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.
| 1 |
Physostigmine
|
Digoxin
|
Cocaine
|
Atropine
|
Forensic Medicine
| null |
78f19fa4-71ef-48c8-a511-0f30846d95cc
|
single
|
Eruption of lower 2nd molar occur before lower 2nd premolar; probable reason being
| null | 2 |
Crowding
|
Impaction of lower 2nd premolar
|
Premature exfoliation of primary 2nd molar
|
None of the above
|
Dental
| null |
f189fe71-68ca-44a7-a3b5-94c41523f550
|
multi
|
In which of the following conditions is a person held responsible for a crime
|
C i.e. Voluantry drunkenness
| 3 |
Alcoholic paranoia
|
Delirium tremens
|
Voluntary drunkenness
|
Dhatura intoxication
|
Forensic Medicine
| null |
4dd66238-2112-4f90-9b49-ff356b6c91be
|
single
|
A teenage boy is brought to the psychiatrist with complaint of him talking and acting strange. On examination he has auditory hallucinations, agitation and rapid incoherent speech. The duration of symptoms is unknown. Substance abuse history is also unknown. The diagnosis could be all of the following except?
|
Although patients with generalized anxiety disorder can present with restlessness or irritability, they are usually not agitated and do not have auditory hallucinations or thought disorder.
| 2 |
Schizoaffective disorder
|
Generalized Anxiety Disorder
|
Bipolar Disorder
|
Substance-induced psychotic disorder
|
Psychiatry
|
Schizophrenia Spectrum and Other Psychotic Disorders
|
3476a76c-299a-4de8-a264-f1c6035cbc53
|
multi
|
Increased B12 level is seen in all, except:
|
Answer is D (Cholestatic jaundice)
| 4 |
Cirrhosis
|
Primary hepatocellular Ca
|
Hepatitis
|
Cholestatic jaundice
|
Medicine
| null |
d5e7a75e-8a49-4151-9cb5-d4e5b19e1a86
|
multi
|
Laser uvulopharyngopalatoplasty is the surgery done for which of the following?
|
Snoring : Noisy breathing, a rough, rattling inspiratory noise produced by vibration of pendulous soft palate or occasionally of vocal cords, during sleep. Snoring indicates some obstruction in upper airway and represents a continum of the similar pathology as of Obstructive Sleep Apnea (OSA), where snoring is on one end and OSA on the other. Management of snoring without Obstructive Sleep Apnea. Uvulopalatoplasty-Laser Assisted Uvulopalatoplasty (LAUP) or Bovie-Assisted Uvulopalatoplasty (BAUP). It can be performed under Local A naesthesia in OPD. In this procedure uvula is amputated and 1 cm trenches are created in the soft palate on either side of uvula. The soft palate elevates and stiffens after healing. Uvulopalatopharyngoplasty- It is the M/C surgery performed for Obstructive Sleep Apnea. It is also very effective in treating snoring.
| 1 |
Snoring
|
Recurrent pharyngotonsilitis
|
Cleft palate
|
Stammering
|
ENT
| null |
e507b42b-225b-450c-90fc-5c173f62a091
|
single
|
The structure damaged in High Tracheostomy ?
|
Ans. is'c' i.e., First tracheal ring(Ref: Dhingra dle p' 317)High tracheostomy: Performed above the level of thyroid isthmus which lies against II, III and IV tracheal rings:Indicated in carcinoma larynx when laryngectomy is anticipated.Drawback : tracheostomy at this point violates the 1st ring of trachea and causes perichondritis of the cricoid cailage and subglottic stenosis, so it is better avoided.
| 3 |
Thyroid isthmus
|
Aoic knuckle
|
First tracheal ring
|
Recurrent laryngeal nerve
|
ENT
| null |
4b6b2771-a9a2-4d75-83e5-d14b5a374e6e
|
single
|
Which is false regarding ether?
|
Ether anaesthesia has major demerit of slow induction and slow recovery.
| 4 |
Highly inflammable
|
Causes hyperglycemia
|
Good muscle relaxation
|
Rapid recovery
|
Anaesthesia
|
Inhalational Anesthetic Agents
|
233ae435-1fc6-45c9-ac10-00a0f4eb911f
|
multi
|
Dinner fork deformity is seen in ?
|
Dinner fork deformity is seen in Colles fracture. Colles fracture is the fracture at the distal end of radius at coico cancellous junction, in adults, with typical displacement.commonest fracture of people above 40. It nearly always result from fracture on outstretched hands. C/f: The patient presents with pain, swelling and deformity of wrist.on examination tenderness and irregularity of lower end of radius is found. There may be typical dinner fork deformity. The radial styloid process comes to lie at the same level or a little higher than ulnar styloid process. Ref: Essential Ohopaedics, Maheswari & Mhaskar, 9th ed ,
| 1 |
Colle's fracture
|
March fracture
|
Lateral condyle fracture
|
Supracondylar fracture
|
Orthopaedics
|
Forearm wrist and hand injuries
|
9e35cb96-c1d1-457e-bfdf-28c0d7ca207c
|
single
|
True statement regarding postmortem hypostasis is/are -a) Also known as rigor mortisb) Starts within 8 hours of deathc) Present all over the bodyd) It is present on dependent parte) Starts as blotchy discolouration
|
Postmortem hypostasis is known as liver mortis (not rigor mortis).
It starts after 1 hour of death as small discolored (blotchy) patches.
It is present an dependent part (not all over) the body.
| 2 |
ab
|
de
|
cd
|
bd
|
Forensic Medicine
| null |
7f5a7fa3-2f29-4d81-a395-081f984889d7
|
multi
|
True about Histoplasma capsulatum -
| null | 1 |
Dimorphic fungus
|
Causative organism of moniliasis
|
Causative organism of valley fever
|
Capsulated
|
Microbiology
| null |
f251c8a4-e371-4062-a0a6-9a6ad59cedbe
|
multi
|
Common bile duct injuries are most commonly seen in
|
Bile duct injury and ligation Most benign strictures follow iatrogenic bile duct injury. Most commonly during laparoscopic cholecystectomy Incidence of bile duct injury during open cholecystectomy is 0.1-0.2 % Incidence of bile duct injury during laparoscopic cholecystectomy is 0.3-0.85 % Ref :Sabiston 20th edition Pgno :1502
| 4 |
Radical gastrectomy
|
Penetrating injuries of abdomen
|
ERCP and sphincterectomy
|
Laparoscopic cholecystectomy operation
|
Anatomy
|
G.I.T
|
712e7578-fa82-44ea-ab18-eb756d79e47a
|
single
|
A middle aged woman presented with fishy odour vaginal discharge shows 'clue cells' in a wet preparation. She probably has:
|
Clue cells are the most reliable indicators of bacterial vaginosis (BV). These vaginal epithelial cells contain many attached bacteria, which create a poorly defined stippled cellular border. The positive predictive value of this test for the presence of BV is 95 percent.Clinical criteria for diagnoses include,Homogeneous white, noninflammatory dischargeMicroscopic presence of clue cellsVaginal discharge with pH >4.5Fishy odor with or without addition of 10% potassium hydroxideThree of these 4 criteria are required to make a clinical diagnosis of bacterial vaginosis. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 3. Gynecologic Infection. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.
| 1 |
Bacterial vaginosis
|
Chlamydia trachomatis
|
Neisseria gonorrhoeae
|
Trichomonas
|
Pathology
| null |
32a63df2-70c6-47b7-91bd-4b5aa7bb92e5
|
single
|
Feature of neurogenic shock: AIIMS 14
|
Ans. Bradycardia and hypotension
| 4 |
Tachycardia and hypotension
|
Tachycardia and hypeension
|
Bradycardia and hypeension
|
Bradycardia and hypotension
|
Forensic Medicine
| null |
35d63a03-e154-4c00-8d82-0d8b4c39739a
|
single
|
Complications of aerosol steroids use include :
| null | 1 |
Oral candidiasis
|
Cushing's syndrome
|
Decreased ACTH
|
Systemic complications
|
Pharmacology
| null |
9adf71cc-77d2-4c2f-a6e8-072469a9537f
|
single
|
Most common presentation of Meckels diveculum?
|
.Presentations in Meckel's Diveiculum * Asymptomatic - in majority cases. * Severe haemorrhage most common, seen in children aged 2 years or younger (Maroon coloured blood). * Intestinal obstruction due to bands/adhesions/ intussusception. * Perforation. * Intussusception, volvulus of small bowel. * Peptic ulceration. * Diveiculitis--features mimic acute appendicitis. * Littre's hernia--It is presence of Meckel's diveiculum in hernial sac as content. It is observed in inguinal/femoral hernia. * Silent Meckel's diveiculum found during laparotomy or laparoscopy or by radioisotope study. * Carcinoid or GIST can occur in Meckel's diveiculum. ref:SRB&;s manual of surgery,ed 3,pg no 798
| 1 |
Lower GI bleeding
|
Upper GI bleeding
|
Diarrhorea
|
Abdominal pain
|
Surgery
|
G.I.T
|
2fca2616-573e-4205-b9a1-be24f49e0104
|
single
|
Koenon tumor is seen in -
|
Koenen tumors are a pathognomic feature and one of the major Gomez criteria of tuberous sclerosis complex (TSC), and usually appear after pubey in up to 50% of patients with TSC.Tuberous sclerosis complex, the preferred name for the condition previously known as tuberous sclerosis, is an autosomal dominant genodermatosis, classically presenting as facial angiofibromas, shagreen patch, periungual fibromas, and ash-leaf white macules. Koenen tumors are characterized by fibrosis with stellate shaped strands of fibroblasts and dense collagen with numerous ectatic blood vessels. so answer is option 2. tuberous sclerosis. source :
| 2 |
NF
|
Tuberous sclerosis
|
Turners syndrome
|
Sturg weber syndrome
|
Pathology
|
Endocrinology
|
a532f7ee-2bd7-442f-9924-54b7df8743de
|
single
|
Flutamide is an:
| null | 2 |
Anti–convulsant
|
Anti–androgen
|
Anti–progestin
|
Anti–oestrogen
|
Pharmacology
| null |
d85e8f89-b385-4b70-9aa6-e8a6dc09f781
|
single
|
Decidual space is obliterated by:
|
Decidual space is the space between decidua capsularis and parietalis seen in early pregnancy because the gestational sac does not fill the uterine cavity. By 14-16 weeks the gestational sacred has enlarged to fill the uterine cavity completely by 4 th month (16 weeks). Ref: Datta Observe 9e pg 22.
| 4 |
10 th week
|
12 th week
|
18 that week
|
16 th week
|
Anatomy
|
General obstetrics
|
e0865c0c-2bd9-427f-b9d9-8383078acfec
|
single
|
Which of the following anti-cancer drug is not anti-inflammatory or immunosuppressive
|
Ans. is .c' i.e., L-AsparaginaseThree anticancer drugs have bone-marrow sparing effect, i.e., they do not cause bone marrow suppression: - Vincristine, BleomYcin & L-asParaginase.
| 3 |
Methotrexate
|
Azathioprine
|
L-Asparginase
|
Cyclopohosphamide
|
Pharmacology
| null |
0ac0a77a-daa7-4a29-8bbd-2af9590e2396
|
single
|
A 70 year old patient comes with complaint of headache, nausea, tenderness over temporal region, diagnosis is?
| null | 2 |
Aneurysmal arterial dilatation with sub-intimal inflammation
|
Granulamatous inflammationwith giant cell arteritis
|
Luminol thrombosis
|
Acute organising thrombus formation
|
Medicine
| null |
5613ff1f-eb32-4637-9fa3-1c568929a669
|
single
|
Which of the following are constituents of the cranial base?
|
The cranial base includes from anterior to posterior, the ethmoid, sphenoid, and occipital bone.
| 2 |
Maxilla, mandible and cranial vault
|
Ethmoid, sphenoid and occipital
|
Palatal, nasal and zygoma
|
Frontal and parietal
|
Dental
| null |
8268c423-9d26-43ce-860f-0bc4058c9051
|
single
|
Fan shaped patterns of small intradermal veins on medial or lateral aspect of ankle is called
|
Corona phlebectasia is malleolar or ankle flare.
| 3 |
Saphena varix
|
Hyphen webs
|
Corona phlebectasia
|
Dermal flare
|
Surgery
| null |
a5b93b39-276c-4937-b58c-9cc763f9dd1c
|
multi
|
Special visceral efferent doesn’t involve
|
Ref. Gray’s anatomy. 41st edition. Page. 982
All of the spinal nerves contain both sensory and motor functions and can be organized on the basis of the functional components of each nerve.
General Somatic Afferent (GSA) fibers are related to receptors for pain temperture and mechanical receptors in the skin, muscles and joints
General Visceral Afferent (GVA) fibers are related to receptors in visceral structures
General Visceral Efferent (GVE) fibers are preganglionic autonomic fibers
General Somatic Efferent (GSE) fibers innervate skeletal muscle (these are axons of alpha and gamma motor neurons)
| 3 |
Nucleus ambiguous
|
Motor nucleus of fifth cranial nerve
|
Dorsal nucleus of tenth cranial nerve
|
Motor nucleus of seventh cranial nerve
|
Unknown
| null |
1994d3ee-02ff-4c90-8851-96cf7a553f7e
|
single
|
Which of the following is true regarding a phantom limb -
|
'Phantom limb' is a term used to describe the feeling that the limb is still present after amputation.
| 2 |
Occurs in leprosy
|
Follow amputation
|
Follow a psychiatric illness
|
After filariasis
|
Orthopaedics
| null |
db0a2265-3285-42ae-91d6-a92621dbaf27
|
multi
|
The asterisk is denoting towards which of the following structures?
|
Posterior Ribs are Horizontal and Anterior Ribs are Oblique on Chest X-ray PA view The asterisk points to right anterior 4th rib.
| 1 |
Right anterior 4th rib
|
Right clavicle
|
Right posterior 5th rib
|
Major fissure
|
Radiology
|
Radiological anatomy
|
3bc32067-7c10-454e-99f5-86d96de7a90f
|
single
|
Enzymes of glycolysis are found in:
|
All of the enzymes of glycolysis are found in the cytosol. Ref: Harper 28th edition, chapter 18.
| 1 |
Cytosol
|
Cell membrane
|
Mitochondria
|
Ribososmes
|
Biochemistry
| null |
f7e37971-ef22-4ced-8c91-60330f20d272
|
single
|
All of the following are true about corneal endothelium except:
|
Ans. Corneal decompensation occurs when cell count is decreased by 50 percent
| 2 |
Cell density is about 3000 cells/min' at bih
|
Corneal decompensation occurs when cell count is decreased by 50 percent
|
Endothelial cells contain active pump mechanism
|
Endothelium is best examined by specular microscopy
|
Ophthalmology
| null |
d7a166ef-defe-427e-9a71-096cdc501256
|
multi
|
A patient developed paraplegia. On routine examination and X-ray it was found that there are osteoblastic lesion in his spine. Most probable diagnosis is -
|
Most common tumor producing osteoblastic bone metastasis is carcinoma prostate.
| 2 |
Carcinoma thyroid
|
Ca. Prostate
|
Breast Ca.
|
Pancreatic Ca.
|
Orthopaedics
| null |
7cb46866-da1e-417c-8a6f-5b46518d75b7
|
single
|
Surgical indications in inflammatory bowel diseases are A/E :
| null | 3 |
Obstruction
|
Perianal complication
|
Extraintestinal complication
|
Stricture
|
Surgery
| null |
2cf13d2f-f38a-408d-9ae7-e758bf17a3b9
|
single
|
Good pasture's syndrome is charachterized by:
|
Answer is D (All of the above): Harrison's syndrome is typically associated with anti-GBM antibodies, crescenteric glomerulonephritis (RPGN) and diffuse alveolar haemorrhage `Good pasture's syndrome is charachterized by the combination of Diffuse Alveolar Haemorrhage (DAH) and glomerulonephritis (Crescents; RPGN) associated with anti-gomerular basement membrane (GBM) antibodies in serum or evident on immunofluorescent staining of renal or lung tissue. The sine-qua-non of Good pasture's syndrome is the demonstration of linear deposition of Ig -G - immunoglobulin (IgG) along the alveolar capillary or GBM.' - Kelly Essentials of Internal Medicine
| 4 |
Anti-GBM antibodies
|
Crescenteric glomerulonephritis
|
Diffuse alveolar haemorrhage
|
All of the above
|
Medicine
| null |
23beb36b-9e4a-4a25-9103-bdb4cd4a8464
|
multi
|
a-helix of protein is ?
|
Ans. is 'b' i.e., Secondary structure a-helix It is a spiral structure consisting of a polypeptide chain that is coiled around a longitudinal axis in a helical fashion.It is the most common secondary structure and a vast variety of proteins contain the a-helical structure.The a-helix is produced by formation of hydrogen bonds between peptide linkages three amino acid residue apa. That means hydrogen bonds are formed between the first and the fouh peptide linkages, between the second and fifth peptide linkage and so on.Each peptide linkage in the polypeptide chain paicipates in hydrogen bonding and hydrogen bonds are formed between peptide linkages of same peptide chain.There are 3.6 amino acids residues in each turn of the helix.The pitch (veical distance per turn) of the helix is 5.4 Adeg.Each hydrogen bond has nitrogen to oxygen distance (N-0) 2.8Adeg.All hydrogen bonds are paralled, i.e., in the same direction.The helix may be right-handed (coils turn in a clockwise fashion around the axis) or left handed (coils turn in anti-clock wise fashion).Right-handed helix are more stable.Right handed a-helix is the commonest secondary structure found in proteins.
| 2 |
Primary structure
|
Secondary structure
|
Teiary structure
|
Quaternary structure
|
Biochemistry
| null |
21d4fb25-6a85-4a0e-a5be-e5dc262444a7
|
single
|
Lesion in female child born to a mother treated with stilbesterol is :
|
Vaginal adenosis
| 1 |
Vaginal adenosis
|
Sarcoma Botyroides
|
Cervical erosion
|
Carcinoma endometrium
|
Gynaecology & Obstetrics
| null |
f2887abb-db29-4b36-8511-b6869344ec25
|
single
|
Distal clearance in surgery for carcinoma rectum is?
|
Ans. is 'a' i.e., 2 cm
| 1 |
2 cm
|
5 cm
|
10 cm
|
8 cm
|
Surgery
| null |
24b23c77-bfe3-4764-a0d0-68c5c84d96ad
|
single
|
Onion skin thickening of arteriolar wall is seen
|
Hyperplastic arteriosclerosis is associated with malignant hypertension in which concentric thickening of the walls and luminal narrowing leads to “onion skin like lesions”.
| 4 |
Atherosclerosis
|
Median calcific sclerosis
|
Hyaline arteriosclerosis
|
Hyperplastic arteriosclerosis
|
Pathology
| null |
171fd44c-a266-45b3-b35c-034fe6f1bb2c
|
multi
|
Which of the following is not an antioxidant?
|
Antioxidant Vitamin Vitamin E Vitamin C Beta Carotene selenium Metabolic antioxidants Glutathione: Reduced glutathione (GSH) plays a key role in the biological antioxidant enzyme system others: Ceruloplasmin, Transferrin, Albumin, Bilirubin, Haptoglobin enzymatic antioxidants (superoxide dismutase, catalase) ref satyanarayana 4th ed page 661
| 4 |
SOD
|
Vitamin A
|
Gluthione peroxidase
|
Xanthine oxidase
|
Biochemistry
|
vitamins
|
a882a9e2-928a-4352-895f-bd14143e550a
|
single
|
A 60-year-old male presents with hematuria, weight loss. Cystoscopy biopsy of the superficial lesion in bladder shows hyperchromatic nucleus, increased nuclear - cytoplasmic ratio, the lesion involves full thickness of epithelium but doesn't invade basement membrane. The diagnosis is:
|
Ans. (c) Bladder Carcinoma in situRef: Bailey 26th Edition, Page 1333* Carcinoma in situ stands when the lesion does not invade basement membrane.
| 3 |
Dysplasia
|
Metaplasia
|
Bladder carcinoma in situ
|
Micro invasion
|
Surgery
|
Urethra & Penis
|
9ac8e2f7-840a-497f-9dc6-5df7c4fd7d02
|
single
|
All of the following are features of Scleroderma are following except
|
Ans. is 'a' i.e., Diffuse periosteal reaction Skin involvement in systemic sclerosis Skin involvement is a nearly universal feature of systemic sclerosis (SSc). It is characterized by variable extent and severity of skin. Thickening and hardening. The fingers, hands, and face are generally the earliest areas of the body involved. Edematous swelling and erythema may preceede skin induration. Other prominent skin manifestations include : Pruritus in the early stages Edema in the early stages Sclerodactyly Digital ulcers Pitting at the fingeips Telangiectasia Calcinosis cutis Radiographs of the hands may reveal Soft tissue calcifications (calcinosis cutis). Resorption of the distal phalangeal tufts (acro-osteolysis). Less common radiographic findings are : Aicular erosions Joint space narrowing Demineralization The symptoms of the female and presence of antinuclear antibody points towards the diagnosis of systemic sclerosis. It is a case of systemic sclerosis or scleroderma. The clues to the diagnosis of scleroderma are : Sclerodactyly Raynaud's phenomenon Dysphagia Presence of antinuclear antibody Though systemic sclerosis is a multisystem disease, the two most distinguishing features of systemic sclerosis are: o Striking cutaneous changes Notable skin thickening. This is the most easily recognized manifestation of scleroderma. Raynaud's phenomenon This is the first manifestation of disease in almost every patients. Dysphagia Attributable to esophageal fibrosis and its resultant hypomotlity is present in more than 50% of patients. Remember, Whenever skin thickening is present along with Raynaud's phenomenon, it is almost always a case of scleroderma". These two features are not present in any other multisystem disease whose clinical features overlap with that of systemic sclerosis e.g. SLE, rheumatoid ahritis, inflammatory myopathy, Sjogren syndrome". Although skin changes and Raynaud's phenomenon are the major diagnostic clues, scleroderma is a multisystem disease that most commonly targets peripheral circulation, muscles, joints, gastrointestinal tract, lung, hea and kidney. So, the symptoms encountered in early presentation of scleroderma include musculoskeletal discomfo, fatigue, weight loss, and hea burn and dysphagia associated with gastroesophageal reflex disease (GERD). When these symptoms are accompanied by the skin thickness and Raynaud c phenomenon, diagnosis ofscleroderma should be considered. Role of autoantibodies in the diagnosis of scleroderma Autoantibodies are found in nearly every patient with scleroderma (sensitivity >95%), but they are not specific for scleroderma0. Scleroderma is associated with wide array of autoantibodies. Two ANA'S which are more or less unique to scleroderma are: Antitopoisomerase antibody (20-40%) Seen in patients with diffuse systemic sclerosis Patients with this autoantibody are more likely to havepulmonary .fibrosis and peripheral vascular disease Patients with these autoantibodies have poor prognosis Anticentromere antibody (20-40%) These autoantibodies are seen in patients with limited systemic sclerosis
| 1 |
Diffuse periosteal reaction
|
Esophageal dysmotility
|
Erosion of tip of phalanges
|
Lung Nodular infiltrates
|
Medicine
| null |
05cdd664-a4f0-4dab-8bae-0275bc288bf5
|
multi
|
A male patient 59 year old complains of multiple swellings in the neck , fever, and weight loss. General examination reveals painless lymph node enlargement in the neck and on blood investigation anaemia is revealed. Serum albumin is 32 gm/l. Lymph node biopsy shows Reed Sternberg cells.
The 5-year rate of overall survival (%) for this patient , according to The Hasenclever prognostic index for advanced Hodgkin lymphoma is:
| null | 2 |
90
|
74
|
70
|
59
|
Pathology
| null |
d5ccea7d-8ebb-465b-9d4d-a372d7f2a845
|
multi
|
The most life threatening complications of septic aboion includes :
|
None
| 4 |
Peritonitis
|
Renal failure
|
Hemorrhage
|
None
|
Gynaecology & Obstetrics
| null |
f7e99abc-d3e0-4879-91d2-30d290cbe3b7
|
multi
|
Insulin stimulated glucose transport is which type of transport-
|
Ans. is 'b' i.e., Facilitated diffusion * Glucose is transported into the cells by two mechanismsi) Facilitated diffusion By glucose transporters (GLUT)ii) Secondary active transportBy sodium dependent glucose transporter (SGLT)* Insulin increases glucose uptake by increasing the GLUT4 on the cell membrane. Thus, insulin promotes facilitated diffusion i.e. diffusion along concentration gradient (not against concentration gradient). So, option b is incorrect.
| 2 |
Simple diffusion
|
Facilitated diffusion
|
Primary active transport
|
Secondary active transport
|
Physiology
|
Endocrinology and Reproduction
|
ac9c0c2e-ef13-4f58-b465-098228477d05
|
single
|
A traveling nerve impulse does not depolarize the area immediately behind it, because:
|
When an AP is initiated at a point, the point goes into refractoriness when the Na+ entered through that point has excited the adjacent (2nd) point. so it will travel in single direction Hyperpolarization event is after the refractory period.
| 2 |
It is hyperpolarised
|
It is refractory
|
It is not self-propagating
|
The conduction is always ohodromic
|
Physiology
|
Excitation and Action Potiential
|
eaaa30e6-bd20-4070-9a56-46cd2a8e9920
|
single
|
The thyroid inhibitor with fastest mechanism of action is?
|
Though iodine is a constituent of the thyroid hormones, but still it is the fastest acting thyroid inhibitor. All the facets of thyroid function seemed to be affected by iodine. But the most impoant function of it is inhibition of the release of the thyroid hormone from the follicular cells which has been already synthesized. Thus, the enlarged gland slowly shrinks, and then, it becomes firm and less vascular.
| 1 |
Potassium iodide
|
Propylthiouracil
|
Carbimazole
|
Cholestyramine
|
Pharmacology
| null |
9bc04600-bb09-4e87-a908-889e7de20cb3
|
single
|
Cyclic AMP acts as the second messenger for:
|
Ans. D. All of theseCyclic AMP is a very important second messenger synthesized by ATP in the presence of adenylate cyclase. Here the hormones bind to the cell surface (Plasma membrane) receptors and stimulate the release of second messengers.Second MessengerHormonesc-AMPCatechol amines, ACTH, hCGADH, Calcitonin, FSH, TSH, PTH, GlucagonPhosphatidyl inositol/calciumTRH, GnRH, Oxytocin, ADH, Gastrin, CCK, Angiotensin IIKinase or Phosphatase cascadeInsulin, Prolactin, EGF, Fibroblast growth factor.
| 4 |
ADH
|
Glucagon
|
Calcitonin
|
All of these
|
Biochemistry
|
Endocrinology
|
c7fadc92-8f35-49ce-8736-4aa13954cc58
|
multi
|
In which of the following tumors alpha fetoprotein is elavated
|
Alpha fetoprotein (AFP) is a normal component of plasma protein of the human foetus secreted by yolk sac and embryonal hepatocytes which reduces 2-3 weeks after bih and persists as a low value level. Normal value is up to 10 ng/ml of plasma.It is an impoant tumour marker for HCC and more often HCC with cirrhosis (between 100-1000 ng/ml). It also increases in hepatoblastoma, non-seminomatous testicular tumours and some ovarian tumours(yolk sac tumour ).It also increases slightly in benign conditions of the liver (only upto 100 ng/ml if at all). It is useful in diagnosing omphalocele, ataxia telengiectasia, neural tube defects. Reference : page 594 SRB's manual of surgery 5th edition
| 3 |
Choriocarcinoma
|
Neuroblastoma
|
Hepatocellular carcinoma
|
Seminoma
|
Surgery
|
Urology
|
a7d7a17d-919e-4c38-a006-5c4dc0ec2e55
|
single
|
Inclusion bodies seen in progressive myoclonic epilepsy -
|
Answer- D. Lafora bodiesLafora bodies- progressive myoclonic epilepsyHirano bodies- Alzheimer diseaseBuschino bodies- lateral sclerosisLewy bodies- Parkinson's disease and Lewy body disease
| 4 |
Buschino bodies
|
Lewy bodies
|
Hirano bodies
|
Lafora bodies
|
Medicine
| null |
cecfd685-9d88-4293-aeb9-d4f9eb9fe9fa
|
single
|
Widmark's formula is used for measurement of blood levels of:
|
Widmark's a = p.r.c., a= wt of alcohol in gms in body, p= body wt in kg, c= conc. of alcohol in blood in gm/kg, r = constant (0.6 for men, 0.5 for women).
For Urine, formula is- a = 3,4p.r.q, where q is the conc. of alcohol in urine in mg/kg.
| 3 |
Benzodiazepines
|
Barbiturates
|
Alcohol
|
Tranquilizers
|
Unknown
| null |
e92adf60-8a51-420a-8983-c30b017ef2dc
|
single
|
First centre that get activated before skilled voluntary movements is?
|
ANSWER: (A) Neo cortexREF: Ganong's 22nd edition page 203Repeat from June 2011"The lateral corticospinal tract is concerned with skilled movements"See APPENDIX-15 for detailsOrigin: primary motor cortex (30%), premotor and supplementary motor area (30%) and somatosensory areas posterior to central sulcus (40%)It passes through posterior limb ofg internal capsule and then forms the pyramid of medulla Lateral corticospinal tractVentral corticospinal tract* 80% fibres cross in medulla to opposite side to form lateral corticospinal tract* Concerned with skilled movements and end directly on motor neurons in humans* Uncrossed fibres form ventral corticospinal tract* Don't cross until it reaches level of musclesGiant cells of betz are the originating cells of the tract located in primary motor cortex.
| 1 |
Neo cortex
|
Hypothalamus
|
Pons
|
Medulla
|
Medicine
|
General
|
a2cf9ac2-cb4a-4b47-889c-c1a3b1d95d27
|
single
|
The classic triad of congenital rubella includes all except -
|
Congenital rubella syndrome
Maternal viremia associated with rubella infection during pregnancy may result in infection of the
placenta and fetus.
The most important factor in the pathogenicity of rubella virus for the fetus is the gestational age at the time
of infection.
“In general, the earlier in pregnancy infection occurs, the greater the damage to the fetus. Maximum damage to the fetus occurs when infection is acquired in the first trimester of pregnancy”.
Fetus infected in the twentieth week may have isolated deafness.
Clinical manifestations
The classical triad of congenital rubella consists of cataract, deafness and congenital heart diseases.
Laboratory diagnosis
Isolation of virus in cell cultures of throat samples, urine or other secretions.
Normally, maternal rubella antibodies in the form of IgG is transferred to infants and is gradually last over a period of 6 months. Persistent beyond 1 year in an un vaccinated child suggests the diagnosis of congenital rubella.
Presence of Ig M antibodies is diagnostic.
PCR for rubella RNA
| 3 |
Cataract
|
Deafness
|
Retinitis
|
CHD
|
Microbiology
| null |
ba580b38-d60b-4acf-aabc-91a79668b598
|
multi
|
Friedlanders bacillus also known as:
|
Ans. is 'c' i.e., Klebsiella pneumoniae(Ref: Ananthanarayan, 9th/e, p. 280 and 8th/e, p. 278)"Klebsiella pneumoniae is also known as Friedlander's bacillus or Bacillus mucosus capsulatus."(Karl Friedlander, 1847-1887, German bacteriologist) - who helped discover the bacterial cause of pneumonia in 1882.
| 3 |
E. coli Pattern
|
Pseudomonas aeruginosa
|
Klebsiella pneumoniae
|
Vibrio parahemolyticus
|
Microbiology
|
Bacteria
|
00ef4002-1b87-4440-b150-7bd29f0523be
|
single
|
Which of the following can be used for self tonometry?
|
In self tonometry patient himself measures the intraocular pressure. The dynamic contour tonometer represents a potentially new technology for non-invasive and direct intraocular pressure (IOP) measurement, and has been proposed to accurately measure the true IOP irrespective of the corneal thickness. The Perkins tonometer is a type of poable applanation tonometer, which may be useful in children, anesthetised patients who need to lie flat, or patients unable to co-operate with a sitting slit lampexamination, that yields clinical results comparable to the Goldmann. Rebound tonometers determine intraocular pressure by bouncing a small plastic tipped metal probe against the cornea. The device uses an induction coil to magnetise the probe and fire it against the cornea. As the probe bounces against the cornea and back into the device, it creates an induction current from which the intraocular pressure is calculated. The device is simple and easy to use and self-use versions are available. It is poable, does not require the use of eye drops and is paicularly suitable for children and non-cooperative patients. The image above shows rebound tonometer. Diaton tonometer is a handheld device measuring IOP through the eyelid and over the sclera with no contact to the cornea & causing no discomfo to the patient.The pen-like tonometer diaton measures IOP within seconds without the need for anesthesia or sterilization.
| 2 |
Dynamic contour tonomety
|
Rebound tonometry
|
Perkins tonometry
|
Diaton tonometry
|
Ophthalmology
|
Glaucoma
|
98467279-563e-401e-a5ee-f2eb56977197
|
single
|
EDRF is
|
Endothelial cells that line the inside of blood cells could release a substance that relaxes smooth muscle (endothelial-derived relaxing factor, EDRF). CLINICAL BOX 5-7 Common Drugs That Act on Smooth Muscle Overexcitation of smooth muscle in the airways, such as that observed during an asthma attack, can lead to bronchoconstriction. Inhalers that deliver drugs to the conducting airway are commonly used to offset this smooth muscle bronchoconstriction, as well as other symptoms in the asthmatic airways. The rapid effects of drugs in inhalers are related to smooth muscle relaxation. Rapid response inhaler drugs (eg, Ventolin, albuterol, sambuterol) frequently target b-adrenergic receptors in the airway smooth muscle to elicit a relaxation. Although these b-adrenergic receptor agonists targeting the smooth muscle do not treat all symptoms associated with asthma (eg, inflammation and increased mucus), they act rapidly and frequently allow for sufficient opening of the conducting airway to restore airflow and thus allow for other treatments to reduce airway obstruction. Smooth muscle is also a target for drugs developed to increase blood flow. As discussed in the text, NO is a natural signaling molecule that relaxes smooth muscle by raising cyclic guanosine monophosphate (cGMP). This signaling pathway is naturally downregulated by the action of phosphodiesterase (PDE), which transforms cGMP into a non-signaling form, GMP. The drugs sildenafil, tadalafil, and vardenafil are all specific inhibitors of PDE V, an isoform found mainly in the smooth muscle in the corpus cavernosum of the penis (see Chapters 25 and 32). Thus, oral administration of these drugs can block the action of PDE V, increasing blood flow in a very limited region in the body and offsetting erectile dysfunction. EDRF was later identified as the gaseous second messenger molecule, nitric oxide (NO).Ref: Ganong&;s Review of medical physiology 25th edition. Page: 117
| 2 |
NO2
|
NO
|
N2O
|
SO2
|
Physiology
|
Cardiovascular system
|
750649ed-92b2-4aba-b42c-de7b7e6a71a1
|
single
|
Collection of urine sample of a patient of TB/kidney is done :
|
Ans. Is 'c' i.e. In early morning " Genitourinary tuberculosisGenitourinary tuberculosis accounts for about 15% of all extrapulmonary cases.Local symptoms predominate-Urinary frequency (MC) dysuria hematuria and flank pain are common presentations.Urinalysis gives abnormal results in 90% of cases, revealing pyuria and hematuria. The documentation of culture-negative pyuria in acidic urine raises the suspicion of tuberculosis.An IVP helps in diagnosis calcifications & ureteral strictures are suggestive findings.Culture of three morning urine specimens yields a definitive in nearly 90% of cases." -Harrison
| 3 |
24 hrs urine
|
12 hrs urine
|
in early morning
|
Anytime
|
Microbiology
|
Bacteria
|
03dc96e9-7d18-4c12-b32e-6b187b42effa
|
single
|
A person is responsible for his crime even if done under the influence of alcohol after becoming intoxicated with his own will, comes under
|
Refer the byte "Legal sections".
| 3 |
Sec 82 IPC
|
Sec 85 IPC
|
Sec 86 IPC
|
Sec 90 IPC
|
Forensic Medicine
| null |
5c6dbd4b-16eb-4f62-9026-01581579e57d
|
single
|
Which of the following is the function of MHC I and II?
|
The function of MHC molecules is to display peptide fragments of protein antigens for recognition by antigen specific T cells.
| 3 |
Signal transduction in T cells
|
Antibody class switching
|
Antigen presentation to T cells
|
Increase the secretion of cytokines
|
Pathology
| null |
57278879-fdd8-4dea-807f-9381d47b643d
|
single
|
Which of the following circumstances trigger non invasive to invasive ventilation
|
Circumstances in which non invasive positive pressure ventilation should be changed to invasive ventilation Resp arrest Rr > 35/min Sev dyspnea with use of accessory muscles and possibly paradoxical breathing Life threatening hypoxemia PaO2 <40 mm hg Or PaO2/FiO2 <200 Sev acidosis (pH <7.25 ) and hyperapnia (PaCO2 >60 mm hg ) Hypersomnolence , impaired mental status Cardiovascular complication Failure of non invasive positive pressure ventilation Other circumstances (e.g metabolic abnormalities ,sepsis , pneumonia , pulmonary embolism , barotrauma, massive pleural effusion )
| 4 |
Respiratory arrest
|
RR > 35 /min
|
Sev acidosis < 7.25
|
All of the above
|
Anaesthesia
|
Anaesthesia Q Bank
|
4310536a-4999-4b66-8153-03b59f923953
|
multi
|
Krukenberg's spindle seen in patients with pigmentary glaucoma refers to deposition of pigment on:
|
Ans. Back of cornea
| 2 |
Trabecular meshwork (gonioscopic sign)
|
Back of cornea
|
Anterior surface of the lens
|
All of the above
|
Ophthalmology
| null |
d6b1e86f-51e4-4743-9c52-a73fbb6ec419
|
multi
|
The commonest method of detection of diphtheria carriers is:
|
Schick test, method for determining susceptibility to diphtheria; it laid the basis for inoculation against the disease. A minute amount of diphtheria toxin is injected into the skin of the forearm.
Redness at the site of injection after three days indicates a positive reaction (absence of circulating antibody) or a false positive reaction (hypersensitivity to the toxin).
A positive reaction can be distinguished by use of a control injection of the same amount of heated toxin (toxoid) into the other forearm.
| 1 |
Schick test
|
Dick test
|
Casoni's test
|
Charles' test
|
Microbiology
| null |
08ce32ba-c4dd-44e3-85ca-1bb081e29b46
|
single
|
Serology of a young man shows HBsAg, however HBeAg is negative with normal levels of AST and ALT. He is asymptomatic. What is the next line of management?
|
Ans. (a) Wait and watch In hepatitis B, among previously healthy adult who present with clinically apparent acute hepatitis recovery ocurs in 99% therefore, antiviral therapy is not likely to improve the rate of recovery and is not required. In this case also patient is viually asymptomatic, so no treatment is required.
| 1 |
Wait and watch
|
Antivirus
|
Immunoglobulins
|
Liver transplant
|
Microbiology
| null |
9f112726-22f0-4ed3-b626-65884607e276
|
single
|
Micro Munro abscess is seen in
|
Munro micro abscesses are seen in psoriasis it is the collection of neutrophils in stratum corneum. IADVLtextbook of dermatology page 1041
| 2 |
Dermal tissue
|
Stratum corneum
|
Stratum basale
|
Stratum malphigi
|
Dental
|
Autoimmune skin disorders
|
bb02f6d6-386c-4f1c-a24d-6c03ed639cb0
|
single
|
Testis tumor is associated with secondary hydrocele in
|
• Approximately 5-10% of testicular tumors may be associated with hydroceles.
| 2 |
1% of cases
|
10% of cases
|
20% of cases
|
30% of cases
|
Surgery
| null |
1695ff53-84da-48c5-82ec-721fa47c4596
|
single
|
Upon Hysteroscopy which of the following cannot be seen:
|
Hysteroscopy is best for diagnosing lesions within the uterine cavity Also: Abnormal Uterine Bleeding Oligomenorrhea amenorrhea, Recurrent Pregnancy loss Endometrial carcinoma, Un-explained infeility Suspected anomalies Missing IUCDs Diagnosing intra uterine submucous fibroids, Polyps, adhesions Septums etc.
| 4 |
Tubal ostia
|
Cervix
|
Endometrium
|
Tubal patency
|
Gynaecology & Obstetrics
|
Operative Gynecology
|
3d417287-b0ee-4389-8635-b2c222cfcc22
|
single
|
A 35-year-old male develops involvements of PIP, DIP and metacarpophalangeal joints with sparing of the wrist and carpometacarpal joints. The probable diagnosis is -
|
First let me exclude the other options :
MTP joint involvement is not seen in OA.
DIP joint involvement is not seen in RA.
In pseudogout, large joints like knee, ankle are involved. Small joint are not involved.
Now we are left with psoriatic arthritis. In Psoriatic arthritis any pattern of joint involvement can be seen.
| 1 |
Psoriatic arthopathy
|
Osteoarthritis
|
Rheumatoid arthritis
|
Pseudo gout
|
Orthopaedics
| null |
15d2a5ae-cc38-4d27-9f5c-48419f3c20fe
|
single
|
Preformed toxin is impoant in food poisoning due to all, EXCEPT:
|
Food poisoning is of three types: INFECTIVE TYPE: In this type, multiplication of bacteria occurs in vivo when infective doses of microorganisms are ingested with food. Incubation period is generally 8 to 24 hours. The typical example of this type of food poisoning is by Salmonella typhimurium, S. Enteritidis, S. Heidelberg, S. Indiana, S. Newpo, S. Dublin, Vibrio parahaemolyticus, Campylobacter jejuni. TOXIC TYPE: The disease follows ingestion of food with preformed toxin. Incubation period is sho (2 to 6 hours). Eg: Staphylococcus aureus, Bacillus cereus, Clostridium botulinum. INFECTIVE-TOXIC TYPE: In this type, bacteria release the toxin in the bowel. The incubation period is 6 to 12 hours. Eg: Clostridium perfringens ETEC produce a heat-stable enterotoxin (ST) or a heat labile (LT) Cholera toxin, like enterotoxin or both. Toxin production alone may not lead to illness. The organism must initially be able to adhere to the mucosal surface of the epithelial cells of the small intestine. This adhesion is usually mediated by fimbriae that bind to specific receptors in the intestinal cell membrane. These adhesions are called colonization factor antigens (CFAs). Ref: Textbook of Microbiology by Surinder Kumar; Page-701
| 3 |
Staph aureus
|
Clostridium botulism
|
ETEC
|
B.cereus
|
Microbiology
| null |
177c83b4-2ff9-498e-97ff-353a1dcb137a
|
multi
|
A 27-year-old woman (gravida 3, para 2) comes to the delivery floor at 37 weeks gestation. She has had no prenatal care. She complains that, on bending down to pick up her 2-year-old child, she experienced sudden, severe back pain that now has persisted for 2 h. Approximately 30 min ago she noted bright red blood coming from her vagina. By the time she arrives at the delivery floor, she is contracting strongly every 3 min; the uterus is quite firm even between contractions. By abdominal palpation, the fetus is vertex with the head deeply engaged. Fetal heart rate is 130/min. The fundus is 38 cm above the symphysis. Blood for clotting is drawn, and a clot forms in 4 min. Clotting studies are sent to the laboratory. Which of the following actions can wait until the patient is stabilized?
|
The patient described in the question presents with a classic history for abruption-that is, the sudden onset of abdominal pain accompanied by bleeding. Physical examination reveals a firm, tender uterus with frequent contractions, which confirms the diagnosis. The fact that a clot forms within 4 min suggests that coagulopathy is not present. Because abruption is often accompanied by hemorrhaging, it is important that appropriate fluids (i.e., lactated Ringer solution and whole blood) be administered immediately to stabilize the mother's circulation. Cesarean section may be necessary in the case of a severe abruption, but only when fetal distress is evident or delivery is unlikely to be accomplished vaginally Internal monitoring equipment should provide an early warning that the fetus is compromised. The internal uterine catheter provides pressure recordings, which are important if oxytocin stimulation is necessary. Generally, however, patients with abruptio placentae are contracting vigorously and do not need oxytocin.
| 4 |
Stabilizing maternal circulation
|
Attaching a fetal electronic monitor
|
Inserting an intrauterine pressure catheter
|
Administering oxytocin
|
Gynaecology & Obstetrics
|
Normal Labour
|
76009247-07bb-43b4-9b1d-0b7c96dfea39
|
multi
|
Normal Brown colour of stool is due to
|
Hemoglobin from RBC undergo metabolism and produces bilirubin and biliverdin. This, in turn, conveed into urobilinogen and stercobilinogen.This urobilin and stercobilin are responsible for giving colour to urine and stool respectively.During obstructive jaundice absence of this stercobilin leads to clay colored urine(Ref: Vasudevan, textbook of biochemistry)
| 3 |
Urobilin
|
Stercobilinogen
|
Stercobilin
|
Urobilinogen
|
Physiology
|
G.I.T
|
0bb9317b-b4ad-4ced-8f2d-e2136299a51d
|
single
|
Swelling of thyroid gland, that does not move with deglutition is/are:
| null | 4 |
Retrosternal goiter.
|
Riedel's goiter.
|
Anaplastic carcinoma.
|
All of the above.
|
Surgery
| null |
7665c3cd-b3c5-4f45-b7cf-1b351388ed2d
|
multi
|
Pond's fractures are common in: AP 09
|
Ans. Children
| 1 |
Children
|
Adolescent
|
Adult
|
Old age
|
Forensic Medicine
| null |
bc64d45b-9f5a-4cc9-9421-02bf0735edfc
|
single
|
Which of the following is example of Nominal variable
|
Roll number is an identity in the class ; Hence it is an example of nominal variable OTHER EXAMPLES NOMINAL VARIABLES ORDINAL VARIABLES METRIC ABO blood grouping Rh Types of anemia Sex - male/ female etc TNM staging of cancer Hypeension classification Severity of anemia Weight Height Hb Blood sugar levels Serum cholesterol levels BMI Pulse rate Kelvin temperatures
| 2 |
Temperature
|
Roll number
|
TNM staging
|
Mid arm circumference
|
Social & Preventive Medicine
|
Biostats
|
fc5984fb-b7f4-48fb-878b-92894508fb2a
|
single
|
Which of the following is not transmitted by Arthropod-
| null | 1 |
Q fever
|
Rickettsial pox
|
Rocky mountain spotted fever
|
Relapsing feve
|
Social & Preventive Medicine
| null |
061d0e46-3678-419c-ba60-b404f563e272
|
single
|
Under the national TB programme, for a PHC to be called a PHC–R, requisite is –
|
District tuberculosis centre (DTC) is the nucleus of DTP
The function of DTC is to plan, organize and implement the DTP in the entire district, in association with general Health services.
When DTP activities (Sputum microscopy, chest X-ray, Anti-TB treatment) are introduced in an organized manner in a peripheral health institution (PHI), it is considered to be implemented PHI.
It is important that only such PHIs are selected for implementation of the programme, which are under the charge of qualified Medical officers.
| 2 |
Microscopy
|
Microscopy plus radiology
|
Radiology
|
None of the above
|
Social & Preventive Medicine
| null |
ccb94910-2d21-4679-99d5-dd7a1f1bb8f1
|
multi
|
From Ist Jan 2007 to 30th June 2007, 22 new cases of tuberculosis were repoed per 1, 65, 000 population. But during this period 120 suspected cases of TB were newly registered. What will be the incidence rate?
|
Ref:Parks 23rd edition pg 60 Incidence = (no. of new cases of specific disease during a given time period / Population at-risk during that period) x1000 Incidence rate = (22/165000)x10,00000 = 133.3 per 10lakh
| 1 |
133 per 10,00, 000 population
|
90 per 10,00,000 population
|
75 per 10,00,000 population
|
270 per 10,00,000 population
|
Social & Preventive Medicine
|
Epidemiology
|
a0b0e5bd-f2ba-4214-8b2e-7ea78f44fb43
|
single
|
All of the following constitute supraglottic cancer except:
|
The lingual surface of the epiglottis and valleculae are in the oropharynx. The glottis comprises the vocal cords and the anterior and posterior cornmissures. Subglottis is a small area extending from the lower border of the cricoids to the under surface of the vocal cords
| 4 |
Vallecula
|
Lower border of cricoid
|
Posterior commisure
|
All
|
ENT
| null |
a5f8b7de-ff51-4af4-b772-2e8d89ddc716
|
multi
|
Most common renal stone is
|
Calcium oxalate stones - 60% Phosphate stones( hydroxyapatite and brushite) - 22% Uric acid stones -7 % ,struvite 7%.Cystine stones - 2% Reference : Campbell and Walsh urology 11th edition , chapter 51 , pg no 1181
| 2 |
Triple phosphate
|
Calcium oxalate
|
Uric acid
|
Salicylate
|
Surgery
|
Urology
|
1bd5d0ae-ac90-4a00-8d52-a88b18faaf9f
|
single
|
A 40-year-old alcoholic develops cough with foul smelling sputum and fever. Chest x-ray shows an air-fluid level in the superior segment of the right lower lobe. The most likely etiologic agent is
|
(Braunwald, 15/e, p 1478.) Of the organisms listed, only anaerobic infection is likely to cause a necrotizing process. Type III pneumococci have been repoed to cause cavitary disease, but this is unusual. The location of the infiltrate suggests aspiration, also making anaerobic infection most likely. The superior segment of the right lower lobe is the one most likely to develop aspiration pneumonia.
| 4 |
Streptococcus pneumonia
|
Haemophilus influenzae
|
Legionella
|
Anaerobes
|
Surgery
| null |
af7c25ee-05ad-4202-82a1-a3387bbeced3
|
single
|
Omental bursa (lesser sac)A posteriorly perforating ulcer in the pyloric antrum of the stomach is most likely to produce initial localized peritonitis or abscess formation in the following
|
Ans. is 'a' i.e., Omental bursa BDC writes - "The posterior surface of the stomach is related to structures forming the stomach bed, all of which are separated from the stomach by the cavity of the lesser sac." Thus an ulcer on the posterior wall of stomach would perforate into the lesser sac. Also remember Most perforated ulcers are located on the anterior wall. The moality rate for perforated gastric ulcer is higher than that for duodenal ulcer. This is generally due to the gastric ulcer patients' more advanced age, increased medical comorbidities, delay in seeking medical attention, and the larger size of gastric ulcers.
| 1 |
Omental bursa (lesser sac)
|
Greater sac
|
Right subphrenic space
|
Hepato renal space (pouch of Morison)
|
Surgery
| null |
398a9955-3983-48cb-84bf-098f6a2bf585
|
single
|
Typhoid is treated by all except
|
Ans. is 'a' i.e., Erythromycin The older agents used for the treatment of typhoid were : Chloramphenicol Ampicilin Trimethoprim Sulfamethoxazole Beta lactam Parenteral - Ceftriaxone Orall - Cefixime These drugs are not used nowdays because of widespread resistance. o Nowdays the drug of choice for Typhoid all over the world is a "Fluroquinolone" (Ciprofloxacin, ofloxacin). An impoant point to remember High level of fluoroquinolone resistance (ciprofloxacin) have been repoed from India and other pas of South East Asia in S. paratyphi and S.typhi infection. Nalidixic acid resistant S.typhi (NARST) have decreased ciprofloxacin sensitivity and are less effectively treated with fluoroquinolones. The fluroquinolones should not be used as first line treatment for typhoid fevers in patients from India and other pas of South Asia with high rates of fluroquinolone resistance unless antibiotic susceptibility data demonstrates fluoroquinolone or nalidixic acid sensitivity.
| 1 |
Erythromycin
|
Ceftriaxone
|
Amikacin
|
Ciprofloxacin
|
Medicine
| null |
7f7b700d-0f77-4357-8f06-c5ed513991b0
|
multi
|
After finding a case of AFP, next step is ?
|
Ans. is 'b' i.e., Repoing of case Every case of AFP in any child under 15 years should be repoed. The number of AFP cases repoed each year is used as an indicator of a country's ability to detect polio, even in countries where the disease no longer occurs.
| 2 |
OPV vaccination
|
Repoing of case
|
Stool culture
|
Chemoprophylaxis
|
Social & Preventive Medicine
| null |
70caa4e0-f3a0-4a03-a94c-9f4018334a5c
|
multi
|
The pathological feature in Wegener&;s granulomatosis on renal biopsy
|
Wegener's granulomatosis is a necro-inflammatory lesion having 4 components granulomas of the upper respiratory tract, granulomas of the lungs, systemic vasculitis (page 403) and focal necrotizing glomerulonephritis. Ref: Harsh Mohan textbook of pathology 6th edition page 495.
| 2 |
Nodular glomerulosclerosis
|
Focal necrotizing glomerulonephritis
|
Granulomas in the vascular wall
|
Granuloma of parenchyma of kidney
|
Pathology
|
Urinary tract
|
8063ef05-61ab-44c3-9b18-5772d74782d8
|
multi
|
Antioxidant vitamin -
|
Ans. is 'd' i.e., All of the above o There are two types of antioxidant systems :-Enzymatic antioxidant systemThis includeCatalaseSuperoxide dismutase (SOD)Glutathione peroxidaseNon-enzymatic antioxidant systemThis is further subdivided intoVitamins : Vitamin E, Vitamin A & beta carotene. Vitamin C.Minerals : Selenium, Copper, Zinc, ManganeseTissue proteins : Transferrin, ferritin, lactoferrin, ceruloplasminAmino acids : Glutathione, Cysteine
| 4 |
Vitamin A
|
Ascorbic acid
|
Vitamin E
|
All of the above
|
Biochemistry
|
Vitamins
|
b5fca8e5-d540-4a39-8fd3-97c40caf5042
|
multi
|
True about Pringles maneuver:
|
PRINGLE's Maneuver Aka Total Inflow Occlusion Clamping in foramen of Winslow and we occlude the Poal triad. It controls bleeding from Poal Vein and Hepatic Aery. Bleeding is effectively controlled from Poal Vein as compared to Hepatic Aery. It doesn't control bleeding from IVC and Hepatic Vein
| 3 |
Clamping in foremen of Winslow and we occlude poal triad and IVC
|
Controls bleeding from poal vein, IVC & hepatic aery
|
Pringles maneuver is also known as total inflow occlusion
|
All are true
|
Surgery
|
Liver
|
e8feda1a-023f-44db-a08b-4b88f832f99a
|
multi
|
Test for ACL injury is -
|
Ans. is `a' i.e., Lachman ACL injury ACL is the most commonly injured ligament of knee. Most common mechanism of injury is twisting (medial rotation) with valgus injury on semiflexed knee. Often with this mechanism MCL and medial meniscus are also injured. This triple injury of ACL , MCL and medial meniscus is called O'Donghue triad. Isolated ACL can also be injured by hyperextension injury. Tests for ACL injury Following tests are used for ACL injury : - Lachman's test Pivot shift test Flexion-rotation drawer test Anterior drawer test Jerk test Loose's test Lachman's test is the most sensitive test for anterior cruciate ligament tears. It is done with the knee flexed at 20 degrees. So it can be done in acute as well as chronic injuries. (because in acute cases with hemahrosis more flexion is usually not possible so performing anterior drawer test is difficult).
| 1 |
Lachman
|
Bryants
|
Jobes
|
Hamilton
|
Surgery
| null |
af573d25-64d5-4512-b553-4bf1b2944b2f
|
single
|
True statement regarding inverse agonists is-
|
Ans. is 'b' i.e., Binds to receptor and causes opposite action o Receptors are specific binding site with functional correlate,o In relation to action through receptors, two terms are important.i) AffinityAbility of the drug to combine with the receptor.It determines the concentration of drug required to form a significant number of drug-receptor complexes.ii) Intrinsic activity (efficacy)Ability' of the drug to activate (induce a conformational change) in the receptor.Based on their intrinsic activity drugs may be divided in to :AgonistAntagonistPartial agonistInverse agonist----Have both affinity and maximal intrinsic activity.Have affinity' but no intrinsic activity.Have affinity and submaximal intrinsic activity'.Have affinity but opposite intrinsic activity' ie intrinsic activity with a minus sign. AgonistAntagonistPartial AgonistInverse Agonist----Affinity + Intrinsic Activity +Affinity + Intrinsic Activity 0Affinity - Intrinsic Activity 1/2 +Affinity' + Intrinsic Activity -
| 2 |
Binds to receptor and causes intended action
|
Binds to receptor and causes opposite action
|
Binds to receptor and causes no action
|
Binds to receptor and causes submaximal action
|
Pharmacology
|
C.N.S
|
e747fd38-74e9-4270-883d-a32d8dfe4778
|
multi
|
Fibers most susceptible to hypoxia are
| null | 2 |
A
|
B
|
C
|
D
|
Physiology
| null |
65da6574-27a0-4e7c-9053-e74314f6e594
|
single
|
In urea cycle, hydrolysis occurs during:
|
Arginase the final enzyme of urea cycle is a hydrolase i.e. it uses water to break the bond in arginine It breaks arginine into urea and ornithine Urea is transpoed to kidneys from liver blood and then excreted in urine
| 1 |
Cleavage of Arginine
|
Cleavage of ornithine
|
Formation of Argininosuccinate
|
Formation of citrulline
|
Biochemistry
|
Urea cycle
|
eacf31dc-3e08-45b2-8114-b7daad2bc9c4
|
single
|
Accumulation of lipoproteins in atherosclerosis in the form of
|
(Oxidised LDL) (499-Robbins-Pathologic basis of disease 8th)Accumulation of lipoproteins mainly LDL and its oxidized forms in the vessel wall OXIDIZED-LDL1. In ingested by macrophages through scavenger receptors distinct from the LDL receptor thus forming foam cells2. Increases monocytes accumulation in lesions3. Stimulates release of growth factors and cytokines4. Is cytotoxic to endothelial cells and smooth muscle cells5. Can induce endothelial cell dysfunctionPathogenic events in Atherosclerosis* Endothelial Injury - | vascular permeability leukocyte adhesion and thrombosis* Accumulation of lipoproteins (Mainly LDL and its oxidized forms) in the vessel wall* Monocyte adhesion to the endothelium - followed by migration into the intima and transformation into macrophages and foam cells* Plaelet adhesion* Factor release from activated platelets, macrophages and vascular wall-cells, inducing smooth muscle cell recruitment either from the media or from circulating precursors* Smooth muscle cell proliferation and ECMproduction* Lipid accumulation both extracellulary and within cells (macrophages and smooth muscle cells)Apo - B- 100 is responsible for the recognition of LDL receptor sites* Most important function of LDL is to supply cholesterol to this extrahepatic tissues. The LDL particles bind to the specific receptor pits (Identified as glycoprotein) on the cell membraneDeficiency of LDL receptors is observed in Type Ila hvperbetalipoproteinemia this disorder is associated with a very high risk of atherosclerosis (particularly coronary artery)IMPORTANT POINTS* Most common of ascending aortic aneurysm - cystic medial necrosis* Most common cause of descending aortic aneurysm and aneurysm aortic arch - Atherosclerosis.* Raised serum level of lipoprotein (a) is a predictor of Atherosclerosis (coronary and cerebro vascular disease)* In atherosclerosis, LDL is present in the LDL monocyte* In atherosclerosis, Increased LDL in monocytes- macrophages due to- LDL receptors on the macrophages* Most common cause of peripheral limb ischaemia in India is Atherosclerosis* Best predictor for future risk of cardiovascular events is hs CRP* Test for reversible cardiac ischemia is - Thallium scan* Most common change in atherosclerotic vessel is - Dystrophic calcification
| 1 |
Oxidised LDL
|
HDL
|
VLDL
|
Glycerides
|
Pathology
|
Blood Vessels
|
3ebd752f-6b6f-49ee-a354-ff4f868d5669
|
single
|
Calcium carbonate is used for
|
Ref: Katzung's, 14th ed. pg. 1089* This medication is used to treat symptoms caused by too much stomach acid such as heartburn, upset stomach, or indigestion.* It is an antacid that works by lowering the amount of acid in the stomach.* It can also be used in renal osteodystrophy with hyperphosphatemia, hypocalcemia and osteoporosis like conditions.* It can cause metabolic alkalosis (Milk-alkali syndrome)
| 1 |
Antacid
|
Renal stone
|
Metabolic alkalosis
|
Renal failure
|
Pharmacology
|
G.I.T
|
8a82bdd3-f4ab-4997-970a-7c6d7bc1b3e2
|
single
|
Hypochondriasis is?
|
Ans. is 'a' i.e., Preoccupation with fear of a serious illness Hypochondriasis* The primary feature of hypochondriasis is persistent preoccupation with excessive fear of a serious (e.g., cancer) or incurable (e.g., AIDS) disease, which is based on person's own interpretation of physical symptoms or sensation, i.e., misinterpretation of physical symptoms or sensations, for example an occasional change in heart rate will lead a person with hypochondriasis to fear of heart disease.* Therefore, Hypochondriasis is abnormal preoccupation about normal body function i.e., body functioning is normal but patient thinks it as abnormal.* The preoccupation with the presence of a feared illness persists in spite of normal medical assessment and investigations. Patient goes from one doctor to another for a consultation.* People with hypochondriasis are able to acknowledge that their fears are unrealistic (insight is present), but this intellectual realization is not enough to reduce their anxiety.* Two important facts differentiate hypochondriasis from somatization disorder : -i) Patient with hypochondriasis is preoccupied with illness, on the other hand patient with somatization disorder is occupied with symptoms.ii) Hypochondriasis patient is preoccupied with one illness (usually) while patient with somatization disorder has many (at least 8 or more) symptoms.Other options* Preoccupation with multiple symptoms - Somatization disorder* Maintaining sick role - Factitious disorder (Munchausen syndrome)* Intentional production of false or exaggerated physical symptoms - Malingering
| 1 |
Preoccupation with fear of a serious illness
|
Preoccupation with multiple symptoms
|
Maintaining sick role
|
Intentional production of false or exaggerated physical symptoms
|
Psychiatry
|
Somatoform Disorders
|
41615fb6-dd78-43be-96df-ec3200037422
|
multi
|
Daily energy requirment for reference female, who is sedentary (in Kcal) -
|
Ans. is 'a' i.e., 1900
| 1 |
1900
|
2730
|
2500
|
2850
|
Social & Preventive Medicine
| null |
603e722d-84ba-48cd-bf64-508a3a9cbacb
|
single
|
What is the most common cause of respiratory distress in newborns?
|
Transient tachypnea of the newborn is a respiratory problem that can be seen in the newborn sholy after delivery. It is caused by retained fetal lung fluid due to impaired clearance mechanisms. It is the most common cause of respiratory distress in term neonates. Ref : essential paediatrics op ghai 9edition Pg no : 210
| 4 |
Congenital pneumonia
|
Hyaline membrane disease
|
Congenital diaphragma c hernia
|
Transient tachypnea of the newborn
|
Pediatrics
|
Growth and development
|
7b9d946f-bcff-4c3a-b0aa-b771ab860a07
|
single
|
Eye of newborn is
|
Eye at bih Anteroposterior diameter of eyeball is about 16.5 mm Corneal diameter is about 10 mm Anterior chamber is shallow and angle is narrow Pupil is small and doesnot dilate fully. Lens is spherical at bih Retina is fully differentiated at bih. Macula differentiates 4-6 months after bih Myelination of optic nerve fibres has reached the lamina cribrosa Refractive status. Newborn is usually hypermetropic by +2 to +3 D Orbit is more divergent(50o) as compared to adult (45o) Lacrimal gland is still underdeveloped and tears are not secreted. Reference: A.K.Khurana; 6th edition; Page no:13
| 2 |
Emmetrophic
|
Hypermetrophic
|
Myopic
|
Astigmatic
|
Ophthalmology
|
Anatomy, Development and clinical examination
|
c7378582-71f3-4766-927d-9778bfec4b62
|
single
|
Urge to urinate begins at what volume of urine in bladder?
|
The first urge to void is felt at a bladder volume of about 150 mL, and a marked sense of fullness at about 400 mL The suppression of urge after initial experience is a manifestation of the law of Laplace. This law states that the pressure in a spherical viscus is equal to twice the wall tension divided by the radius. In the case of the bladder, the tension increases as the organ fill, but so does the radius. Therefore, the pressure increase is slight until the organ is relatively full. Ref: Ganong &;s review of medical physiology, 23rd edition, page no: 661
| 1 |
150-200 ml
|
250-400 ml
|
500 ml
|
550-600 ml
|
Physiology
|
Renal physiology
|
5efb693b-0d9f-411e-bbcb-50ac2af7ba9d
|
single
|
Frontal lobe syndrome involves
|
Frontal lobe syndrome :
Euphoria
Impaired recent memory
Flight of ideas
Attention deficit
| 4 |
Impaired recent memory
|
Emotional instability
|
Attention deficit
|
All of the above
|
Physiology
| null |
b4aa8ec3-8465-480a-98fa-b431725aff83
|
multi
|
Uterine contractions are clinically palpabel when there intensity is more than
|
Uterine contractions: Palpable when intensity exceeds 10 mm Hg Painful when exceeds 15 mm Hg
| 1 |
10 mm Hg
|
15 mm Hg
|
20 mm Hg
|
40 mm Hg
|
Anatomy
|
General obstetrics
|
3ad5ad31-40d7-4ac8-b985-e675f5a574da
|
multi
|
Which of the following agents is used for the treatment of post operative shivering?
|
Treatment of post operative shivering involves oxygen administration to prevent hypoxia, active warming and use of drugs. Pethidine at a minimum dose of 0.35mg/kg is the most effective opioid in the treatment of post anaesthetic shivering. Fentanyl, Aalfentanil and Doxapram at a dose of 0.2mg/kg is also effective. Ref: Textbook of Anesthesia for Postgraduates By T. K. Agasti, Page 387; Fundamentals of Anaesthesia By Ted Lin, 2nd Edition, Pages 70-71.
| 2 |
Atropine
|
Pethidine
|
Thiopentone
|
Suxamethonium
|
Anaesthesia
| null |
c608ba1e-f15d-48d2-bae1-80841dfdeaa2
|
single
|
Best disinfectant for endoscopes is:
|
Activated 2% alkaline glutaraldehyde is used for decontaminating flexible endoscopes.
Advantages
Relatively non-corrosive
Will kill spores with prolonged exposure (3- 10 hours).
Disadvantages
Toxic. Irritant.
Possible alternatives:
Ortho-phthalaldehyde (OPA) peracetic acid.
Chlorine dioxide (ClO2) products (such as Tristel).
Super-oxidized water (Sterilox).
Advantages of these newer agents are - rapidly sporicidal, mycobactericidal and viricidal. BUT remember - No agent is clearly superior to the others and a thorough assessment needs to be performed before an alternative agent is chosen.
| 3 |
Hypochlorite
|
Formaldehyde
|
Glutaraldehyde
|
Chlorhexidine
|
Microbiology
| null |
f6d42ad0-e944-4b75-a4f1-4cd1d279ceaf
|
single
|
A 38-year-old woman undergoes a subtotal thyroidectomy The biopsy specimen contains psammoma bodies and prominent papillae of epithelium with fibrovascular core. Nuclear region of the cells shows a groove formation, optical clearing, eosinophilic inclusions, and overlapping of nuclei
Which of the following is the most likely diagnosis?
| null | 3 |
Follicular thyroid carcinoma
|
Medullary thyroid carcinoma
|
Papillary thyroid carcinoma
|
Reidel’s thyroiditis
|
Medicine
| null |
2c64f6f2-f5c6-4996-b807-fc177c990926
|
single
|
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