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Which of the following enzymes is involved in the urea cycle?
|
Argininosuccinate synthase links aspartate and citrulline via the amino group of aspartate and provides the second nitrogen of urea.
| 3 |
Asparginase
|
Glutaminase
|
Argininosuccinate synthetase
|
Glutamate dehydrogenase
|
Biochemistry
| null |
18413285-5ca7-4e41-9ea0-4ce3968cc147
|
single
|
Vector for Trypanosoma Cruzi is
|
Transmission is by rubbing of reduviid bugs.
| 2 |
Tse - Tse fly
|
Reduvid bug
|
Sand fly
|
Black fly
|
Microbiology
| null |
dd0260d7-0605-42e7-8ada-b0fd78528701
|
single
|
'V' Wave in JVP is due to-
|
Ans. is 'c' i.e., Closure of tricuspid valveJugular venous pressure (JVP)* The variations in right atrial pressure are transmitted to the jugular veins, producing three positive waves (a, c and v) and two negative waves/descents (x and y).1) a-wave : It is presystolic 'positive' wave due to right atrial contraction (right atrial systole).2) x-descent: It a 'negative' wave due to right atrial relaxation.3) c-wave: This 'positive' wave is produced by bulging of tricuspid valve into right atrium during isovolumetric contration of right ventricle.4) v-wave: It 'positive' systolic wave resulting from increase in blood volume in vena cava during systole, when tricuspid valve is closed.5) y-descent (diatolic collapse): This 'negative' wave is due to tricuspid valve opening and rapid inflow ofbood into right ventricle.
| 3 |
Right atrial contraction
|
Right atrial relaxation
|
Closure of tricuspid valve
|
Isovolumetric relaxation
|
Physiology
|
Heart, Circulation, and Blood
|
241047cf-05aa-46c9-be97-933351fb0cbd
|
single
|
Most common organism which can contaminates crowded army camps is ?
|
Ans. is 'c' i.e., Neisseria meningitidis Epidemics of Neisseria meningitidis usually occur in closed crowded conditions like jails or army camps.
| 3 |
Klebsiella
|
E. coli
|
Neisseria meningitidis
|
Staphylococcus
|
Microbiology
| null |
bd86be75-46f2-437b-9080-043a91e49109
|
single
|
The chromosomal complement in persons with Klinefelter's syndrome is: March 2011
|
Ans. D: 47, XXY Genetic analysis reveals the karyotype of klinefelter's syndrome to be 47 XXY Klinefelter syndrome/ 46 or 47, XXY/ XXY syndrome It is a condition with an extra X chromosome. Because of the extra chromosome, individuals with the condition are usually referred to as "XXY Males", or "47, XXY Males" Klinefelter syndrome is the most common sex chromosome disorder in males and the second most common condition caused by the presence of extra chromosomes. The condition exists in roughly 1 out of every 500-650 males but many of these people may not show symptoms. Principal effects include hypogonadism and reduced feility. Turner syndrome/Ullrich-Turner syndrome/Gonadal dysgenesis It encompasses several conditions in human females, of which monosomy X (absence of an entire sex chromosome, the Barr body) is most common. It is a chromosomal abnormality in which all or pa of one of the sex chromosomes is absent (unaffected humans have 46 chromosomes, of which two are sex chromosomes). Normal females have two X chromosomes, but in Turner syndrome, one of those sex chromosomes is missing or has other abnormalities. In some cases, the chromosome is missing in some cells but not others, a condition referred to as mosaicism or 'Turner mosaicism'. Occurring in 1 in 2000 -1 in 5000 phenotypic females. There are characteristic physical abnormalities, such as Sho stature, Broad chest, - Low hairline, - Low-set ears, and - Webbed necks. Girls with Turner syndrome typically experience gonadal dysfunction (non-working ovaries), which results in amenorrhea (absence of menstrual cycle) and sterility. Concurrent health concerns are also frequently present, including congenital hea disease, hypothyroidism, diabetes, vision problems, hearing concerns, and many autoimmune diseases. Finally, a specific pattern of cognitive deficits is often observed, with paicular difficulties in visuospatial, mathematical, and memory areas Down syndrome/trisomy 21 Down syndrome is a chromosomal condition characterized by the presence of an extra copy of genetic material on the 21st chromosome, either in whole (trisomy 21) or pa (such as due to translocations). The incidence of Down syndrome is estimated at 1 per 733 bihs It is statistically more common with older parents due to increased mutagenic exposures upon some older parents' reproductive cells. Down syndrome is associated with some impairment of cognitive ability and physical growth, and a paicular set of facial characteristics. Individuals with Down syndrome tend to have a lower-than-average cognitive ability, often ranging from mild to moderate disabilities. The average IQ of children with Down syndrome is around 50, compared to normal children with an IQ of 100. A small number have a severe to high degree of intellectual disability Individuals with Down syndrome may have some or all of the following physical characteristics: - Microgenia (an abnormally small chin), - An unusually round face, macroglossia (protruding or oversized tongue), - An almond shape to the eyes caused by an epicanthic fold of the eyelid, Upslanting palpebral fissures (the separation between the upper and lower eyelids), Shoer limbs, - A single transverse palmar crease (a single instead of a double crease across one or both palms), - Poor muscle tone, and - A larger than normal space between the big and second toes. Health concerns for individuals with Down syndrome include a higher risk for congenital hea defects, gastroesophageal reflux disease, recurrent ear infections that may lead to hearing loss, obstructive sleep apnea, thyroid dysfunctions, and obesity.
| 4 |
45, XO
|
47, XXX
|
46, XY
|
47, XXY
|
Gynaecology & Obstetrics
| null |
00cb8783-7769-4c3a-ad21-42cb46a31d9b
|
single
|
Which of the following drug has uricosuric action?
|
Amlodipine, losaan & fenofibrate have mild uricosuric action. Benzbromarone is new uricosuric drug.
| 2 |
Nifedipine
|
Amlodipine
|
Atenolol
|
Carvedilol
|
Pharmacology
|
All India exam
|
f389f572-ef42-4718-9881-ab1d8123514e
|
single
|
Sun ray fungus is
|
Actinomyces colonies form fungus-like branched networks of hyphae. The aspect of these colonies initially led to the incorrect assumption that the organism was a fungus and to the name Actinomyces, "ray fungus" Ref : Ananthanarayana textbook of Microbiology 9th edition Pgno : 391
| 1 |
Actinomyces irraeli
|
Chromoblastomycosis
|
Streptomyces griseus
|
Cryptococcus
|
Microbiology
|
mycology
|
3c9ec1c6-93ed-4f9f-bc6b-94b4881561ed
|
single
|
Rosenthal's syndrome is seen in deficiency of factor ?
|
Ans. is 'd' i.e., XI
| 4 |
II
|
V
|
IX
|
XI
|
Surgery
| null |
55e924f7-41f9-4127-99d8-d1e4fa1fa299
|
single
|
Commonest site of Atopic dermatitis is?
|
D i.e. Antecubital fossa
| 4 |
Scalp
|
Elbow
|
Trunk
|
Ante cubital fossa
|
Skin
| null |
572964fa-fb6b-4c8a-849e-3e45a1584e41
|
single
|
A person who may be impotent with one paicular woman is called :-
|
Quoad hoc : A person who may be impotent with one paicular woman Frigidity: Failure of a female to respond to sexual stimulus; aversion on the pa of a woman to sexual intercourse; failure of a female to achieve an orgasm (anorgasmia) during sexual intercourse. Atavistic form is a historical approach used to explain criminal behaviour, which is based on the biological factors. - proposed by Lombroso in the 1870s - suggests that some people are born with a criminal personality (e.g. it is innate) that is a throwback to a previous more primitive ancestor.
| 1 |
Quoad hoc
|
Frigidity
|
Atavistic form
|
None of the above
|
Forensic Medicine
|
Impotency, Virginity, pregnancy & aboion
|
59d8a59b-a814-4653-b1fa-7708420fdfc4
|
multi
|
Besides stimulation of M3 receptors located on endothelial cells, the main mechanism of vasodilatory actions of acetylcholine includes which of the following?
|
Most of the blood vessels contain cholinergic M3 receptors but no parasympathetic nerve supply.
Exogenously administered ACh can stimulate M3 receptors and result in vasodilation.
Stimulation of M3 receptors increases the production of NO (endothelium-derived relaxing factor; EDRF) that causes smooth muscle relaxation resulting in vasodilation.
Vasodilation also may arise indirectly due to inhibition of NA release from nerve endings by ACh.
If endothelium is damaged, ACh can stimulate receptors on vascular smooth muscle cells resulting in vasoconstriction.
| 2 |
Decrease in endothelin by acetylcholine released from cholinergic nerves in blood vessels
|
Inhibition of norepinephrine release from adrenergic nerve endings
|
Stimulation of vascular smooth muscle cells
|
Effects on autoregulation particularly in coronary vascular beds.
|
Pharmacology
| null |
45640eed-6506-4a0b-8d5b-1b72ee765d71
|
single
|
Deaths from lactic acidosis in diabetes mellitus is associated with therapy with which one of the following-
|
Ans. is 'c' i.e., Phenformin
| 3 |
Metformin
|
Tolbutamide
|
Phenformin
|
Glipizide
|
Pharmacology
| null |
76d913c7-a8b0-4e04-b31e-9a649838fcd4
|
single
|
5 yr old boy was presented to the OPD by his mother with complaints of pain in the perineal region on examination of sample taken with nitric acid from his peri'anal region showed yellow crystal of what is the test done
|
Barberio's test : Basis Detection of Spermin Procedure A few drops of Barberio's reagent when added to spermatic fluid produces crystals of sperm in picrate needle shaped rhombic & yellow color ref : narayanareddy
| 2 |
Teichmann's test
|
Barberios test
|
Takayama test
|
Florence
|
Forensic Medicine
|
All India exam
|
23694d08-9127-41f5-bf3c-25c806ccd5af
|
single
|
The adaption stage of a pedicle soft tissue graft takes
| null | 3 |
0-3 days
|
1-3 days
|
0-4 days
|
1-2 days
|
Dental
| null |
b2bba04b-19c2-4676-9c37-8bfc72954100
|
single
|
Which of the following is the chronic complication of malaria?
|
Unarousable Coma / cerebral malaria, convulsions
Renal Impairment
Noncardiogenic pulmonary edema
Liver Dysfunction
Hypoglycemia
Metabolic acidosis/acidemia
Hematological abnormality like hemoglobinuria, normocytic anemia, bleeding, DIC
Other complications like jaundice, extreme weakness, hyperparasitemia, impaired consciousness
Hypotension/shock.
| 4 |
Pneumonia
|
Nephrotic syndrome.
|
Splenomegaly
|
Both 2 and 3
|
Microbiology
| null |
993be72b-c8ec-4580-bfd4-bb9532e5c265
|
multi
|
Epididymis is covered by:
|
The epididymis is invested by tunica vaginalis, somewhat less closely applied than it is to the testis, except at its posterior margin. Ref: Gray's anatomy 40th edition, Chapter 97.
| 1 |
Tunica vaginalis
|
Tunica vsaculosa
|
Tunica albuginea
|
None of the above
|
Anatomy
| null |
81f92ad6-d057-481c-a9f1-af9eae5b2f2e
|
multi
|
Bile is concentrated in the gall bladder to _________ times
| null | 1 |
10-May
|
15-Oct
|
20-30
|
40-50
|
Surgery
| null |
77772f67-f7d5-4172-b4d3-ef4bb44f3671
|
multi
|
1st product of tryptophan catabolism is?
|
ANSWER: (A) KynerunineREF: Harper's 27th ed ch: 29Tryptophanisdegradedto amphibolic intermediatesvia thekynurenine-anthranilate pathway. Tryptophan oxygenase (tryptophan pyrrolase) opens the indole ring, incorporates molecular oxygen, and forms N-formylkynurenine.Hydrolytic removal of the formyl group of AT-formylkynurenine, catalyzed by kynurenine formylase, produces kynurenine. Since kynureninase requires pyridoxal phosphate, excretion of xanthurenate in response to a tryptophan load is diagnostic of vitamin B6. deficiency.Hartnup disease reflects impaired intestinal and renal transport of tryptophan and other neutral amino acids.
| 1 |
Kynerunine
|
Bradykinin
|
PAF
|
Xantheurenate
|
Biochemistry
|
Amino Acid Metabolism
|
a1aec7e2-4e0e-4cd4-bafe-a6fbc633827b
|
single
|
All of the following drug is CYP3A inhibitor except aEUR'
|
Saquinavir Drug metabolism Drug metabolism is divided into two genera! categories of phase I and phase II transformation reactions. Phase I This involves structural alteration of drug typically by processes involving oxidation, hydrolysis and reduction. - Phase I reactions introduce functional groups in drugs. - Reactions carried out by phase 1 enzymes usually lead to inactivation of an active drug. Phase II Phase II reactions usually involve conjugation reactions (glucuronidation, suftation, methylation). - Phase 11 reactions produce a metabolite with improved water solubility and increased molecular weight which serves to facilitate the elimination of the drug from the tissue. Most phase I reactions are carried out by P 450 family of isozymes The cytochrome P-450 (CYP450) enzymes are found primarily in the gut and liver. Their name is derived from their characteristic of maximal absorption at wavelength of 450 nm. The cytochrome P 450 is a large superfamily of "haem" proteins. All enzymes in the superfamily contain a molecule of haem. The cytochrome P 450 isoenzymes are also indicated by the letter "CYP" (from cytochrome P 450) followed by number denoting a ,family group, then a subfamily letter and then a number for the individual enzyme within the family. Thus, CYP3A4 is Family Subfamily No. of the individual enzyme within the family The "CYP" isoenzymes have many features that give them great variability in action, both within and among individual. The CYP's have a tremendous capacity to metabolize a large number of structurally diverse chemicals. This is both due to multiple forms of CYP's and the capacity of a single CYP to metabolize many structurally distinct chemicals.. In contrast to other enzymes of the body which are highly specific, CYP's are promiscuous in nature i.e. they catalyze large no of substrates. - This unsual feature of extensive overlapping substrate specificities by the CYP's is one of the underlying reasons for the predominance of drug -- drug interactions. - When two coadministered drugs are both metabolized by a single CYP, they compete for binding to the enzymes active site. - This can result in the inhibition of the metabolism of one or both of the drugs, leading to elevated plasma levels of the drug. Induction and inhibition of CYP's is also an impoant source of drug-drug interactions. Some drugs can also inhibit CYP's independently of being substrates for CYP's. - For example ketoconazole is a potent inhibitor of CYP3A4 and other CYPS and coadministration of ketoconazole with other drugs such as the HIV viral protease inhibitors reduce the clearance of those drugs and increases their plasma concentration and the risk of toxicity. Some drugs are CYP inducers that can induce not only their own metabolism but also induce metabolism of other coadministered drugs. CYP3A is the most abundant, clinically significant group of cytochrome P-450 isoetzzymes. The CYP3A group is composed of four major isoenzymes CYP3A3 - CYP3A4 - CYP3A5 - CYP3A7 Among these CYP3A4 is the most common and is implicated in the majority of drug interactions. - However since these enzymes are so closely related (having as much as 97% sequence homology they often are referred to collectively by the subfamily name CYP3A). Upto 60% of the liver's total cytochrome P-450 is CYP3A and nearly 50% of all clinically relevant medications are metabolized by CYP3A. CYTOCHROME SUBSTRATES INDUCERS INHIBITORS CYP3A Alprazolani, Astetnizole Atorvastatin, Carbatnazepine, Cisapride Cyclosporine, Diltiazem, Losaan, lovastatin, Midazolam, Nifedipine, Sinzvastatin, Terfenadine, Theophylline Carbamazepine, Ethanol, Phenobarbital, Phenytoin, Rifampin Cinzetidine, Clarithromycin, Cyclosporine, Diltiazenz, Erythromycin, Fluoxetine, Fluvexamine, Grapefruit juice 1111' Protease inhibitors, Itraconazole, Ketoconazole, Nifedipine, Verapantil Verapanzil About protease inhibitors "All of the antiretroviral protease inhibitors are substrates and inhibitors of CYP3A4 with ritonavir having the most pronounced inhibitory effect and saquinavir the least". - It is notewohy that the potent CYP3A4 inhibitory propeies of ritonavir have been utilized to clinical advantage by having it "boost" the levels of other agents when given in combination. An impoant point Ritonavir is an enzyme inducer with chronic (repeated) administration. Ritonavir Acute administration Enzyme inhibitor Chronic administration Enzyme inducer (p. 64 Katzung 11 "'/e)
| 4 |
Erythromycin
|
Itraconazole
|
Ritonavir
|
Saquinavir
|
Pharmacology
| null |
e17373cf-39c2-45db-bdfa-e5a348d4b6b0
|
multi
|
Which of the following benign tumor can be caused by prolonged use of oral contraceptive pills?
|
Adenomas have been repoed with prolonged use of OC pills and though they are benign, rupture of a hepatoma can be fatal. Because the hormones are metabolized in the liver, chronic liver diseases and recent jaundice contraindicate the use of pills. Also, Gall bladder function may be adversely affected. Gall stones are repoed with OCP use, but not Gall bladder carcinoma
| 1 |
Hepatic adenoma
|
Thyroid adenoma
|
Fibroadenoma
|
Myoma
|
Gynaecology & Obstetrics
|
Contraceptives
|
eabe0bed-a199-4591-8962-1f2927727bf2
|
single
|
P. Carni causes infection of primarily ?
|
Ans. is 'a' i.e., Rats . Although the organisms within the pneumocystis genus are morphologically very similar, they are genetically diverse and host specific --> P jirovecii infects humans, where as Pcarinii infects rats.
| 1 |
Rats
|
Mice
|
Humans
|
Rabbits
|
Microbiology
| null |
dbbc2bdc-0856-48de-b7d9-6ea0ea6c77fb
|
single
|
One month old baby is referred for failure to thrive. On examination there are features of congestive cardiac failure. Femoral pulses are feeble compared to brachial pulses. The likely diagnosis is
|
In coarctation of aoa there will be radiofemoral delay. Ghai essential of pediatrics, eighth edition, p.no:432
| 1 |
Coarctation of aoa
|
Patent ductus aeriosus
|
Congenital aoic stenosis
|
Congenital aoa-iliac disease
|
Pediatrics
|
C.V.S
|
de199236-369f-4bf9-a78f-1fc0236c4a46
|
single
|
Which of the following compound antagonizes the actions of insulin
|
Ans. (b) Growth hormone(Ref: Ganong, 25th ed/p.434)Growth hormone is a diabetogenic hormone. It causes hyperglycemia. It antagonizes the action of insulin
| 2 |
Neuropeptide Y
|
Growth hormone
|
Substance P
|
Vasoactive intestinal peptide
|
Physiology
|
Endocrinology and Reproduction
|
086faef5-bd98-44e3-b6b6-5d52b9ee7a23
|
single
|
Atrial fibrillation may occur in all of the following conditions, except?
|
Causes of Atrial fibrillation: Rheumatic heart disease (MS and MR), Nonrheumatic mitral valve disease, Hypertensive cardio-vascular disease, dilated cardiomyopathy, atrial septal defect, Coronary heart disease, Thyrotoxicosis, Acute alcohol excess and alcohol withdrawal.
| 2 |
Mitral stenosis
|
Hypothyroidism
|
Dilated cardiomyopathy
|
Mitral regurgitation
|
Medicine
| null |
c4bdb5eb-326b-4356-a259-ef4439c30e1d
|
multi
|
All are circular DNA EXCEPT:
|
Nuclear REF: Jawetz's 24th edition chapter 7 The Eukaryotic Genome The genome is the totality of genetic information in an organism. Almost all of the eukaryotic genome is carried on two or more linear chromosomes separated from the cytoplasm within the membrane of the nucleus. Eukaryotic cells contain mitochondria and, in some cases, chloroplasts. Within each of these organelles is a circular molecule of DNA that contains a few genes whose function relates to that paicular organelle. Most genes associated with organelle function, however, are carried on eukaryotic chromosomes. Many types of yeast contain an additional genetic element, an independently replicating 2-m circle containing about 6.3 kbp of DNA. Such small circles of DNA, termed plasmids, are frequently encountered in the genetics of prokaryotes. The small size of plasmids renders them amenable to genetic manipulation and, after their alteration, may allow their introduction into cells. Therefore, plasmids are frequently called upon in genetic engineering.
| 1 |
Nuclear
|
Plasmid
|
Mitochondrial
|
Yeast
|
Biochemistry
| null |
33a07857-94f5-4b67-8486-9cb00f97a968
|
multi
|
Ovarian reserve tests are :
|
FSH Extra Edge : Recently Mullerian Inhibiting Substance - MIS (also known as Antimullerian Hormone - AMH) has been investigated as a marker for ovarian reserve and for ovarian responsiveness to stimulation. It is produced by the Granulosa cells of preantral, and small antral follicles and inhibits the initiation of primordial follicle growth. The serum levels of MIS in women with normal cycles declines with age and becomes undetectable by the time of menopause. As the ovarian primordial follicle count decreases, the serum MIS concentration also decreases, making this hormone an ideal candidate for the early detection of ovarian reserve depletion.
| 2 |
LH
|
FSH
|
Plasma progesterone
|
Endometrial biopsy
|
Gynaecology & Obstetrics
| null |
7c3dfc4e-8768-4a09-8569-9ad322bf1eef
|
single
|
The National Health Policy 2002 target to be achieved by the year 2010 is -
|
National health policy goals to be achieved by the year 2010 reduce moality by 50% on account of TB ,malaria and other vector and waterborne diseases Reduce prevalence of blindness to 0.5% Reduce IMR to 30/1000 and MMR to 100/lakh Increase utilization of public health facilities from current level of <20% to>75%(refer pgno:873 park 23rd edition)
| 4 |
Eradication of polio and yawsd
|
Elimination of leprosy
|
Achieve zero level growth of HIV\/AIDS
|
Reduce infant moality rate 30\/1000 live bihs
|
Social & Preventive Medicine
|
Health care of community & international health
|
b3afd3c2-be78-462d-a101-0dca23e56bc3
|
single
|
Cornerstone treatment of dengue fever with warning signs without shock or hemorrhage is:
|
Ans. (B) IV fluids(Ref: Harrison's Principle of Internal Medicine 20th Ed; Page No-1508)The mainstay treatment for a patient of dengue with warning signs is IV fluids.The main pathology in dengue is plasma leakage resulting in intravascular volume depletion and thereby shock. So, the supportive management with continuous infusion of crystalloid IV fluids remains the primary modality of treatment in these patients. And often patients respond well to supportive management.Platelet transfusion is limited to patients with severe thrombocytopenia (<10,000/mm3) and active bleedings.Cryoglobulins are not preferred treatment modality in dengue.Clinical PearlsWarning Sign of Severe DengueIt occur 3-7 days after 1st symptoms in conjunction with a decrease in temperature (below 38degC/100degF) and include:#Severe abdominal pain#Persistent vomiting#Rapid breathing#Bleeding gums#Fatigue#Restlessness and#Blood in vomitThe next 24-48 hours of the critical stage can be lethal; proper medical care is needed to avoid complication and risk of death.In patient management is advised to all patient of dengue with warning signs.
| 2 |
Platelet transfusion
|
IV fluids
|
Cryoglobulins
|
Antivirals
|
Medicine
|
Blood
|
a4f08bb2-7c2f-407e-b8af-ec1957d9db09
|
single
|
Central dot sign on CT SCAN -
|
Ans. is 'a' i.e., Caroli's disease o Central Dot sign on CT or USG is seen in (i) Caroli's disease (most common cause); (ii) Prebiliary cysts; (iii) Obstructive jaundice; and (iv) Periportal lymphedema.
| 1 |
Caroli's disease
|
Primary sclerosing cholangitis
|
Polycystic liver disease
|
Liver hamartoma
|
Radiology
|
Abdominal Radiography
|
e70f15db-f225-4980-b729-a57f09039d65
|
single
|
An enlarging, conical "cutaneous horn" that has been present for more than a year projects 0.5 cm from a 0.7-cm base on the left lateral cheek of the face of a 58-year-old farmer. This lesion is excised, and microscopic 'examination shows basal cell hyperplasia. Some of the basal cells show nuclear atypicalities. This is associated with marked hyper keratosis and parakeratosis. Which of the following lesions best accounts for these findings?
|
Actinic keratosis occurs on sun-exposed areas and is considered a precursor of squamous cell' carcinoma. When the atypical basal cells occupy the entire thickness of the epidermis, the lesion transforms into a carcinoma in situ. The presence of a hyperkeratotic layer is characteristic. Occasionally, so much keratin is produced that a "cutaneous horn" is formed. A verruca vulgaris may also be a raised lesion, but it is usually more pebbly, and there is no squamous atypia. Superficial epidermal cells show vacuolation or koilocytosis. A keratoacanthoma is a dome-shaped nodule with a central keratin-filled crater, that is surrounded by epithelial cells. Microscopically, it may mimic a squamous cell carcinoma. A dysplastic nevus is typically a flat, pigmented lesion. A seborrheic keratosis can be raised, but it usually appears as a coinlike plaque
| 4 |
Verruca vulgaris
|
Keratoacanthoma
|
Dysplastic nevus
|
Actinic keratosis
|
Surgery
| null |
6a9a033e-f908-4e74-9b9e-06e28e0425bc
|
single
|
As Per WHO 2017 Global Recommendation, the latest addition to the treatment of postpaum hemorrhage is:
|
The latest update in treatment of postpaum hemorrhage (PPH) as per WHO 2017 Global recommedations is the early use of intravenous tranexamic acid (a competitive inhibitor of plasminogen activation) is recommended in all cases of PPH. PPH is leading cause of maternal morbidity worldwide and in India. WHO 2012 recommendations included a conditional recommendation to use TXA for treatment of PPH when uterotonics fail to control the bleeding or the bleeding is thought to be due to trauma. In 2017, WHO updated its 2012 PPH treatment recommendations to include use of TXA for treatment of PPH. WHO 2017 Global recommendation, latest addition to the treatment of PPH: Early use of intravenous tranexamic acid (TXA) within 3 hours of bih for women with clinically diagnosed postpaum (PPH) TXA should be used in all cases of PPH, regardless of the cause TXA should be administered at a fixed dose of 1g in 10 ml (100 mg/ml) IV at 1 ml per minute (i.e., administered over 10 minutes), with a second dose of 1 g IV bleeding continues after 30 minutes. TXA should be adminstered an IV route only for treatment of PPH. WHO recommendations for the prevention and treatment of Postpaum haemorrhage (2012) Oxytocin (10 IU, IV/IM) is the recommended uterotonic drug for the prevention of PPH. Intravenous oxytocin alone is the recommended uterotonic drug for the treatment of PPH. If oxytoxin is unavailable, other injectables uterotonics (ergometrine/methylerogometrine or the fixed drug combination of oxytocin and ergometrine) or oral misoprostol (600 microgm) is recommended. Late cord clamping (performed after 1 to 3 minutes after bih) is recommended for all bihs Controlled cord traction is the recommended method for removal of the placenta in caesarean section Ref: World Health Organisation
| 4 |
Late cord clamping is recommended for all bihs
|
Oxytocin 10 U IV/IM is the recommended uterotonic drug in the prevention of PPH
|
Intravenous oxytocin alone is the recommended uterotonic drug for the treatment of PPH
|
Early use of intravenous tranexamic acid is recommended in all cases of PPH
|
Gynaecology & Obstetrics
|
General obstetrics
|
9a16c1ef-4dd1-4ec5-89fc-7c65d9650d5f
|
multi
|
As per WHO guidelines, iodine deficiency disorders are endemic in the community when prevalence of goitre in school age children is more than –
| null | 2 |
1%
|
5%
|
10%
|
15%
|
Social & Preventive Medicine
| null |
2cc1ed58-d6cb-4d39-aae7-bf587e640b80
|
single
|
Popliteal aery pulsations are difficult to feel because
|
Popliteal aery is difficult to feel.It is palpated better in prone position with knee flexed about 40-50 degree,to relax the popliteal fascia.It is felt in the lower pa of the fossa over the flat posterior surface of upper end of tibia.In upper end of the fossa,aery is not felt as there is no bony area in intercondylar region. Refer page no173 of SRB's manual of surgery 5 th edition.
| 3 |
It is not superficial
|
It does not cross prominent bone
|
It is not superficial and does not cross prominent bone
|
Its pulsation are weak
|
Surgery
|
Vascular surgery
|
6f7841ff-5df7-4bae-905b-5bbab9550381
|
single
|
Tamsulosin, a adrenoceptor antagonist has affinity for which of the following receptors?
|
Ans. A. AlaVarious types a blockers of and their advantages in BPHa. Prazosin over Phenoxybenzamineb. Prazosin (selective a1 blocker) have better tolerability (less tachycardia and hypotension) over nonselective blockers.c. Doxazosin and Terazosin over Prazosind. Terazosin and doxazosin are long-acting drugs that need once a day dosing. But they need dose titration to minimize first dose hypotensione. Tamsulosin over Doxazosinf. Tamsulosin has minimal hypotension due to a1A selective blockade. But it causes increased ejaculatory dysfunction.g. Alfuzosin over all othersh. Therefore, there was a need for a long-acting selective a1 blocker that did not require dose titration, had minimal side effects on BP and ejaculatory function. This was provided by Alfuzosin
| 1 |
a I A
|
a I D
|
None of the above
|
Both (A) and (B)
|
Pharmacology
|
A.N.S.
|
3ffef023-a094-45ab-83e3-ea4161d5ae8a
|
multi
|
Which of the following is NOT a characteristic feature of sepsis?
| null | 4 |
Temperature > 38 degrees C or <36 degrees C
|
Heart rate > 90/min
|
WBC count > 12000/mm2
|
Respiratory rate 14-18/min
|
Medicine
| null |
d798118e-bef2-49c3-b8f8-c682b721baa2
|
single
|
In idiopathic basal ganglia calcification, structure most often calcified
|
Structure most often calcified - Globus pallidus.
| 3 |
Caudate nucleus
|
Putamen
|
Globus pallidus
|
Striatum
|
Radiology
| null |
e6405a7b-24d9-480c-acab-acb9f95e3400
|
multi
|
In a 3-year old child which of the following is the most common cyst located in midline of neck:
| null | 1 |
Thyroglossal cyst
|
Branchial cyst
|
Lymphangiocele
|
Cystic hygroma
|
Surgery
| null |
57190b91-96c4-4783-994d-9aef7cbc5ea7
|
single
|
post dural (Spinal) puncture headache is due to:
|
Headache is due to of CSF and can be treated with analgesics. Post-dural-puncture headache (PDPH) is a complication of puncture of the dura mater (one of the membranes that surround the brain and spinal cord). ... It is a common side-effect of spinal anesthesia and lumbarpuncture. From padmaja 4th edition Page no 205
| 1 |
Seepage of CSF
|
Fine needle
|
Toxic effects of the drugs
|
Traumatic damage to nerve roots
|
Pharmacology
|
Anesthesia
|
52cde8c1-8405-49ad-8dc4-c9b06218e6f8
|
single
|
Foetal lung maturity is assessed by ____________
|
The presence of surfactant in amniotic fluid is evident of fetal lung maturity. L/S ratio determines the relative concentration of surfactant. L/S ratio is lecithin to sphingomyelin ratio and should be more than 2. There is an increased risk of respiratory distress syndrome when this ratio is less than 2. Reference : page 516 Textbook of Obstetrics Sheila Balakrishnan 2nd edition
| 1 |
L/S ratio
|
Billirubin content of amniotic fluid
|
Ultrasound
|
Amniocentesis
|
Pediatrics
|
New born infants
|
0fcac7f0-4763-43e3-8763-59b53f6c3574
|
single
|
Which of the following is not a differential for solitary pulmonary nodule
|
Causes for solitary pulmonary nodule:Granulomatous1. Tuberculoma - more common in the upper lobes and on the right side. Well-defined; 0.5-4 cm. 25% are lobulated. Calcification frequent. 80% have satellite lesions 2. Histoplasmoma - in endemic areas (Mississippi and the Atlantic coast of USA). More frequent in the lower lobes. Well-defined. Seldom larger than 3 cm. Calcification is common and may be central, producing a target appearance. Satellite lesions are common. 3. Others - e.g. coccidioidomycosis, cryptococcosis. Malignant tumours 1. Lung cancer - usually > 2 cm. Accounts for less than 15% of all solitary nodules at 40 years; almost 100% at 80 years. Radiological appearances suggesting malignancy include: recent appearance or rapid growth (review previous CXRs); size greater than 4 cm; the lesion crosses a fissure; ill-defined margins; umbilicated or notched margin (if present it indicates malignancy in 80%); corona radiata (spiculation),peripheral line shadows. Calcification is rare (but seen in up to 10% at CT). 2. Solitary metastasis - accounts for 3-5% of asymptomatic nodules. 25% of pulmonary metastases may be solitary. Most likely primary tumours are breast, sarcoma, seminoma and renal cell carcinoma. 3. Rare malignant lung tumours - pulmonary blastoma, pulmonary sarcoma, plasmacytoma, atypical carcinoid.Benign tumours1. Carcinoid tumour - 'typical' carcinoids account for majority (90%) of cases and tend to be more benign than atypical (accounting for 10%) tumours. However, the spectrum of biological behaviour is wide ranging, from benign to frank small cell carcinoma. Typical carcinoids are generally central whereas atypical tumours tend to be peripheral. 2. Hamaoma - 96% occur over 40 years. 90% are intrapulmonary and usually within 2 cm of the pleura. 10% cause bronchial stenosis. Usually < 4 cm diameter.Well-defined.Lobulated rather than smooth. Calcification in 30%, although incidence rises with the size of the lesion (in 75% when > 5 cm). Calcification may have a 'pop-corn' configuration, craggy or punctate.Infectious/inflammatory1. Pneumonia - especially pneumococcal. 2. Hydatid - in endemic areas. Most common in the lower lobes and more frequent on the right side.Well-defined.1-10 cm. Solitary in 70%.May have a bizarre shape. Rupture results in the 'water lily' sign. 3. Rounded atelectasis - typically a sequela of an exudative (inflammatory) pleural effusion. Mass associated with adjacent smooth pleural thickening and parenchymal bands giving rise to 'comet tail' appearance. 4. Wegener's granulomatosis - solitary nodules in up to one-third of patients but more commonly multiple 5. Sarcoidosis* - a solitary lung nodule (simulating malignancy) is rare but recognized. 6. Organizing pneumonia - can masquerade as a (malignant) solitary pulmonary nodule Congenital1. Sequestration - may be intralobar (more common; acquired abnormality probably secondary to chronic lung suppuration; no separate pleural covering; venous drainage into pulmonary veins) or extralobar (rare; congenital lesion with separate pleural covering; venous drainage into systemic circulation). Majority in the left lower lobe; next most common site is the right lower lobe, contiguous with the diaphragm. Well-defined,round or oval. Diagnosis confirmed by identification of the mass and its blood supply. 2. Bronchogenic cyst - majority are mediastinal or hilar but occasional bronchogenic cysts are intrapulmonary (even more rarely: diaphragmatic, pleural or pericardial). Most intrapulmonary/ bronchogenic cysts are central (perihilar) and may have a systemic aerial supply. Round or oval.Smooth-walled and well-defined.3. Intrapulmonary lymph node - usually solitary, small (< 2 cm), well-defined and discovered incidentally at CT in mid/lower zones. Vast majority within 2 cm of visceral pleura.Accounting for around 20% of all incidentally-detected solitary nodules.Vascular1. Haematoma - peripheral, smooth and well-defined. 2-6 cm. Slow resolution over several weeks. 2. Aeriovenous malformation - 66% are single. Well-defined, lobulated lesion. Feeding or draining vessels may be demonstrable. Calcification rare. Pulmonary angiography previously the gold standard for diagnosis but now supplanted by multidetector CT(Ref: Chapman and Nakielny's Aids to Radiological Differential Diagnosis 6thEtd, page no.81)
| 4 |
Tuberculosis
|
Hamaoma
|
Bronchial adenoma
|
Neurofibroma
|
Radiology
|
All India exam
|
da48c7db-838a-48ef-9d31-0bf416f08c9b
|
single
|
Treatment of choice for bipolar disorder is
|
ithium was introduced by JOHN F CADE it is used in treatment of MANIA it is a liver friendly drug it has to be used in caution with people with deranged renal parameters if the patient is on lithium, he should be warned about of intake of other meds like NSAIDS, ACE inhibitors , as it may result in toxicity if a patient develops lithium toxicity, the TREATMENT OF CHOICE IS HEMODIALYSIS Reference: p.565 chap 15.1 Depression and Bipolar Disorder
| 3 |
Fluoxetine
|
Imipramine
|
Lithium
|
Chlorpromazine
|
Psychiatry
|
All India exam
|
5005f639-4cf4-4b0e-a557-82e28978f76d
|
single
|
Miliary mottling seen in – a) TBb) Sarcoidosisc) Silicosisd) P. carinii pneumonia
|
Causes of Miliary mottling :-
Infection :- Bacterial (TB, Brucellosis, Bronchopneumonia, Melioidosis), viral (varicella I chicken pox), Fungal (Histoplasmosis, Coccidiodomycosis, blastomycosis, cryptococcosis).
Cardiac :- Mitral stenosis, Pulmonary edema, multiple pulmonary infarct.
Pneumoconiosis :- Coal worker pneumoconiosis, silicosis.
Neoplastic :- Lymphangitis carcinomatosis, alveolar cell Ca., lymphoma, leukemia, metastasis.
Allergic :- Loeffler's syndrome, tropical eosinophilia.
Others :- IPF, RA, Sarcoidosis, Histocytosis-X, HMD, Haemosiderosis
| 1 |
abc
|
bc
|
acd
|
bcd
|
Radiology
| null |
6db9da72-1bd8-47df-9f23-2c9fb057aeea
|
single
|
True about small cell lung cancer -a) Bone marrow is uncommonly involvedb) Destruction of alveolar cellsc) Peripheral in locationd) Treatment is chemotherapy
| null | 3 |
c
|
d
|
bd
|
ac
|
Medicine
| null |
7b97c169-5003-402c-8dc4-15dce59dd46d
|
multi
|
Axillary aery occlusion affects all EXCEPT:
|
Suprascapular aery "Suprascapular aery is a branch of thyrocervical trunk of the subclan aery, not axillary aery" Branches of axillary aery: The branches of the axillary aery are superior thoracic, thoraco-acromial, lateral thoracic, subscapular, anterior and posterior circumflex humeral. The Suprascapular aery usually arises from the thyrocervical trunk of the subclan aery
| 2 |
Post circumflex humeral.
|
Suprascapular aery
|
Subscapular aery
|
Superior thoracic aery
|
Anatomy
| null |
2ff4dce4-592a-4be9-8a16-b764004bef0a
|
multi
|
All of the following stains are used for fat except?
|
Ans. is 'b' i.e., Congo red * Congo red is not used in lipid staining. It is used in the staining of amyloid protein.* Stain used for lipids (fatty acids)are Oil red O, Osmium tetroxide, sudan black and sudan III & IV.
| 2 |
Oil red O
|
Congo reds
|
Sudan black
|
Osmium tetroxide
|
Pathology
|
Histo Pathology
|
4ee64154-08e4-434e-b2c8-05d1904392f0
|
multi
|
Which of the following is a marker for Langerhans cell histiocytosis?
|
The proliferating Langerhans cells in Langerhans cell histiocytosis are HLA-DR positive and express the CD1 antigen. Ref: Robin's Basic Pathology, 7th Edition, Page 441.
| 1 |
CD 1a
|
CD 10
|
CD 30
|
CD 56
|
Pathology
| null |
660ecab0-6481-4284-b67d-baf53ebec48b
|
single
|
The lung disease caused by inhalation of sugarcane dust is known as(MH' 2001; 2005)
|
Ans. b (Bagasosis) (Ref Text book of PSM by Park 22nd/ 751)Pneumoconiosis is a respiratory illness caused by inhalation of (respirabale dust) dust particles of 0.5 to 3 micron.0ByssinosisBy inhalation of cotton fibres - Monday morning fever is presentBagassosisBy inhalation of sugar cane dust - organism - Thermoactinomyces sacchariAsbestosisBy inhalation of asbestos - X-ray - ground glass appearanceSilicosisBy inhalation of silica particles- X-ray - snow storm appearanceFarmer's lungBy inhalation of hay or grain dust - organism - micropolyspora faeniFew more:Immune complex disease (type III = Arthus reaction)Responsible Specific antigensFarmer's lung from moldy hayThermoactinomyces vulgaris or Micropolyspora faeniHypersensitivity pneumonitis from forced-air equipment = Pandora's pneumonitis with heating/humidifying/ air conditioning systemsThermophilic actinomycetesBird-fancier's lung, pigeon breeder's lung from protein in bird serum/excrements/feathers--Mushroom worker's lung from mushroom compostThermoactinomyces vulgaris or Micropolyspora faeniBagassosis from moldy sugar cane in sugar mill contaminationThermoactinomyces sacchari/vulgaris and Micropolyspora faeniMalt worker's lung from malt dustAspergillus clavatusMaple bark disease from moldy maple bark in saw millCryptostroma corticaleSuberosis from moldy cork dustPenicillium frequentansSequoiosis from redwood dustGraphium species
| 2 |
Byssinosis
|
Bagassosis
|
Pneumoconiosis
|
Asbestosis
|
Social & Preventive Medicine
|
Occupational Health
|
e1949ff2-20fe-43a3-903c-c52680f74938
|
single
|
Kaar singh committee recommendations are related to: March 2010
|
Ans. C: Framework of health services at peripheral level
| 3 |
No private practice
|
Measures to improve effectiveness of National Malaria Eradication programme
|
Framework of health services at peripheral level
|
Concept of primary health care
|
Social & Preventive Medicine
| null |
01bbb230-5e20-40ee-b1a7-4a77eedb15a7
|
single
|
Most common site of Brain metastasis is?
|
Ref: Bailey and Love 26th edition, P 614The leading cause of brain metastasis is lungs > Breast>MelanomaTissue of origin for brain metastases (approximate).OriginPercentageLung40Breast15Melanoma10Renal/GU10Other Unknown25
| 1 |
Lung cancer
|
Head and neck cancer
|
Prostate cancer
|
Breast cancer
|
Pathology
|
Breast
|
4b651a79-7db1-4b99-9975-975f33ef4d0e
|
single
|
Most common cause of Vertebra plana
|
Vertebra plana:
Uniform collapse of a vertebral body into a thin, flat disc.
M/c cause - Eosinophilic granuloma.
| 1 |
Eosinophilic granuloma
|
Leukemia
|
TB
|
Metastasis
|
Radiology
| null |
c67645da-be45-485f-a7b5-87c882d4a6c1
|
single
|
The 3 major divisions of Planning Commission are all Except:-
|
PLANNING COMMISSION OF INDIA:- Set up by Government of India in 1950. Consists of: Chairman Deputy chairman 5 members. 3 major divisions: General secretariat Technical divisions Programme advisors.
| 1 |
Executive division
|
General secretariat
|
Technical divisions
|
Programme advisors
|
Social & Preventive Medicine
|
Definitions and Concepts in HP
|
b1ffd157-919d-4adf-b969-09df848a5e33
|
multi
|
A young female presents with the history of spontaneous abortions and secondary amenorrhea since then. FSH 6 ILI/mL. What is the most probably cause of amenorrhea?
|
Ans. D. Uterine synechiaeFSH within normal limit rules out other options. Recurrent spontaneous abortions supports the answer.Asherman Syndrome* Intrauterine synechiae is also known as Asherman syndrome.* This condition occurs due to vigorous uterine curettage in early pregnancy which may lead to scarring that interferes with normal endometrial growth and shedding.* Asherman syndrome is classified as mild, moderate, or severe depending upon the degree and extent of adhesion.* The patients present with secondary amenorrhea, hypomenorrhea, and infertility or habitual abortions.* Hysteroscopy confirms uterine synechiae, type (flimsy or fibrous) and extent of adhesions.Treatment: Reformation of adhesions is prevented by insertion of IUCD for 3 months and giving estrogen cyclically (21 days) for 3 months to developendometrium.
| 4 |
Ovarian failure
|
Pituitary failure
|
Fresh pregnancy
|
Uterine synechiae
|
Gynaecology & Obstetrics
|
Disorders in Menstruation
|
e3d7cc18-bd2e-451b-8a71-89b1800becd0
|
single
|
Baholin's gland is located in
|
The Baholin's glands are two pea-sized compound racemose glands located slightly posterior and to the left and right of the opening of the vagina. They secrete mucus to lubricate the vagina and are homologous to bulbourethral glands in males. Ref - BDC 6e vol2 pg 393
| 3 |
Ischiorectal fossa
|
Rectovesical pouch
|
Superficial perineal pouch
|
Deep perineal pouch
|
Anatomy
|
Abdomen and pelvis
|
5afae86e-a601-4e41-9678-e2fc6edc02c5
|
single
|
A 37-year-old man suffers a traumatic injury to the axilla that damages the thoracodorsal nerve. Which of the following movements of the arm or scapula could be affected in this patient?
|
Adduction o Latissimus dorsi is supplied by the thoraco-dorsal nerve. o Latissimus dorsi help us in scratching the opposite scapulai.e., it leads to adduction, extension & medial rotation at the shoulder joint
| 2 |
Abduction
|
Adduction
|
Flexion
|
Lateral rotation
|
Surgery
| null |
bf4b30bc-019e-4277-9b69-802c21487cd2
|
single
|
Frequency of tuning fork used to test vibration sense is
|
(C) 512 hZ # TUNING FORK TESTS: These tests are performed with tuning forks of different frequencies such as 128, 256, 512,1024, 2048 and 4096 Hz, but for routine clinical practice, tuning fork of 512 Hz is ideal.> Forks of lower frequencies produce sense of bone vibration while those of higher frequency have a shorter decay time and are thus not routinely preferred.> Tuning Fork Tests: Rinne test Weber Test Absolute bone conduction test Schwabach's test, Benign test, Gelle's test
| 3 |
128 Hz
|
256 HZ
|
512 hZ
|
1024 Hz
|
Medicine
|
Miscellaneous
|
b2fd87c0-2572-4cdf-9650-142c79fc3c3c
|
single
|
All of the following characteristic pattern seen in Brown Sequard syndrome; except:
|
Brown-Sequard syndrome: Hemisection of the spinal cord characterized by: damage to ascending sensory (dorsal column pathway, ventrolateral spinothalamic tract) descending motor (coicospinal tract) pathways The lesion to fasciculus gracilus or fasciculus cuneatus leads to ipsilateral loss of discriminative touch, vibration, and proprioception below the level of the lesion. The loss of the spinothalamic tract leads to contralateral loss of pain and temperature sensation beginning one or two segments below the lesion. Damage to the coicospinal tract produces weakness and spasticity in ceain muscle groups on the same side of the body.
| 3 |
Ipsilateral weakness
|
Ipsilateral loss of position and vibration
|
Ipsilateral loss of pain and temperature
|
Contralateral loss of pain and temperature
|
Physiology
|
Nervous System
|
bcda50cc-8bba-4754-b7bb-b629e9266b75
|
multi
|
1 becquerel is equal (Disinegration/sec) to:
|
D i.e. 1 Becquerel (Bq) or disintegration per second is the SI unit of radioactivity wherea Curie (Ci) is non-SI unit of radioactivity. The rate of radioactive decay of a sample is called radioactivity. SI unit of activity is the Bequerel (Bq), defined as one nuclear disintegration per secondQ. The Curie (Ci) is defined as 3.7x1010 disintegrations per second, thought to be the number of disintegrations found in 1 gin of radium.
| 4 |
3.7x1010
|
2.7x1010
|
1.7x1010
|
1
|
Radiology
| null |
83ab7455-1944-494c-bbb7-b2980dcb859c
|
single
|
Nerve damaged in radical mastoidectomy is
|
Facial nerve is involved in radical mastoidectomy Facial paralysis is the complication Ref: Dhingra 7e pg 460
| 1 |
Facial nerve
|
Cochlear nerve
|
Vestibular nerve
|
Mandibular nerve
|
ENT
|
Miscellaneous ENT
|
bc05ff3d-f2c6-4455-8805-a0e513d414a4
|
single
|
Kallmans syndrome is associated with all of the following except
|
When congenital GnRH deficiency is associated with anosmia or hyposmia (an absent or grossly impaired sense of smell), the disorder is known as Kallmann&;s syndrome. Two genetic mutations associated with Kallman&;s Syndrome : KAL gene - X - linked inheritance (Xp22.3) encoding anosmin - 1. Gene encoding FGFR1 (Fibroblast growth factor - 1 receptor) - autosomal dominant form. Anosmin - 1 is a neural adhesion molecule that promotes migration of GnRH neurons and olfactory neurons, from the olfactory placode into the hypothalamus during embryonic development. REF : Shaw book of gynecology 9th Ed.
| 2 |
Amenorrhea
|
Excess stimulation of the HPO axis
|
Genetic mutation
|
Anosmia
|
Gynaecology & Obstetrics
|
All India exam
|
e6bacbd0-7361-4b17-ac70-11f1331c941d
|
multi
|
True about Apoptosis are all except?
|
Ans. (a) Inflammation is presentRef: Robbin's pathology 9th ed. /52-55Since in apoptosis the dead cell is rapidly cleared, before its contents have leaked out, therefore cell death by this pathway does not elicit an inflammatory reaction in the host.
| 1 |
Inflammation is present
|
Chromosomal breakage
|
Clumping of chromatin
|
Cell shrinkage
|
Pathology
|
Apoptosis
|
726d1102-439e-4dc6-ad84-285e4e075354
|
multi
|
Which of the following management procedures of acute upper gastrointestinal bleed should possibly be avoided ?
|
Ans. is (a) i.e. Intravenous Vasopressin Though vasopressin can be used in acute variceal bleeding, it should possibly be avoided because of its side-effects. Management of acute G.I. bleeding - After the initial general management of the patient, the fuher management depends upon the cause of the bleeding. From the option given in the question it is clear that the examiners have enquired about the management of variceal bleeding.
| 1 |
Intravenous vasopressin
|
Intravenous b-blockers
|
Endoscopic sclerotherapy
|
Balloon tamponade
|
Surgery
| null |
f16bdfea-c0e2-4091-9ecd-2e2646041dc3
|
multi
|
Which of the following is a die hardener
|
Die hardeners arc materials used to reinforce the surface of a die so as to make it more resistant of abrasion and scratching.
Die hardeners used with gypsum dies:
• Cyanoacrylate
• Silver plating
• Addition of die hardeners to gypsum
| 1 |
Cyanoacrylate.
|
Potassium sulphate.
|
Sodium chloride.
|
Resin
|
Dental
| null |
9a298c74-b60c-4d68-9cf1-e1cfb505a8f0
|
single
|
Hospital acquired infection of surgical wound is mostly by
| null | 2 |
Doctor
|
Instruments
|
Patient
|
Air borne
|
Social & Preventive Medicine
| null |
b7967306-e15b-4ad1-94bd-5d3e70faba38
|
single
|
The neo-adjuvant chemotherapy indicated in oesophageal carcinoma
|
Treatment of CA esophagus High-grade dysplasia (Tis) or T1a Endoscopic mucosal resection Localised advanced cancer T1: Vagal sparing or transhiatal or minimal invasive esophagectomy with limited LN dissection T2 and T3: Neoadjuvant Chemoradiation + surgery Cervical SCC or Non-ideal candidate for resection : Definitive chemoradiation Locally advanced cancer Chemoradiation (+- surgical resection in T4a) Metastatic disease Definitive chemoradiation (for involved distant LN or metastatic disease) Malignant TEF Coated SEMS (Self expanding metallic stents) Chemotherapy regimen : Epirubicin + Cisplatin + 5-FU Ref: Shackelford 7th edition Pgno : 438-448
| 1 |
Cisplatin
|
Doxorubicin
|
Mitomycin C
|
5-FU-Leucovarin
|
Surgery
|
Urology
|
654ddf7e-ca66-4a05-a632-6f1d8cd29786
|
single
|
Commonest position of the appendix is:
|
Ans. B RetrocoecalRef: BDC, 6thed. vol. II pg. 269-70* Most common position of vermiform appendix is retrocaecal, (12 O'clock- 65%) followed by pelvic (4 O'clock position).Types of appendix and their relative positionAppendixPositionPrevalence /commentRetrocaecal12 O' clock65%; most commonPelvic4 O' clock30%; 2nd most commonSubcaecal6 O' clock2.5%; points towards midinguinal pointPreileal2 O' clock or splenic1 %; points towards spleen & lie infront of ileumPostileal2 O' clock or splenic0.5%; point towards spleen & lie behind ileumParacolic11 O' clock
| 2 |
Paracoecal
|
Retrocoecal
|
Pelvic
|
Subcoecal
|
Anatomy
|
Abdomen & Pelvis
|
f44c0e2d-a570-4620-8f3f-80cf8c711579
|
single
|
Following strain used is ?
|
This is a form of supravital staining in which cells are stained while living. It takes two days from reticulocytes to become RBC
| 2 |
Methyl violet
|
Brilliant cresyl blue
|
Sudan black
|
Indigo carmine
|
Unknown
| null |
4126ebd8-11d1-4cb5-bb67-b7213edf14d0
|
single
|
Beta lactam antibiotics are all except :
| null | 4 |
Amoxicillin
|
Aztreonam
|
Ceftriaxone
|
Vancomycin
|
Pharmacology
| null |
8fd6cda1-413d-43ed-b7e7-1d9ad1fe6785
|
multi
|
The formation of 25-hydroxycholecalciferol takes place in the -
| null | 1 |
Liver
|
Kidney
|
Intestines
|
Pancreas
|
Medicine
| null |
95356b5e-1fe5-4abd-a149-2b8960ae88a9
|
single
|
Which of the following ganglia does not contain postganglionic parasympathetic neurons?
|
The celiac ganglion is a sympathetic preveebral (collateral) ganglion that contains postganglionic neurons. In parasympathetic system(cranial pa) there are four small peripheral ganglia - ciliary, pterygopalatine, submandibular and otic
| 1 |
Celiac
|
Ciliary
|
Otic
|
Pterygopalatine
|
Anatomy
|
Neuroanatomy 3
|
c0754223-0fca-47c7-98ad-aeb43668bb07
|
single
|
EB virus belongs to which group :
| null | 2 |
Retrovirus
|
Herpes virus
|
RNA virus
|
Pox virus
|
Microbiology
| null |
78bc0e93-1a79-4607-80ad-aaa685ef996f
|
single
|
Vitamin D analogue calcitriol is useful in the treatment of:
|
Vitamin D3 analogues - Naturally occurring, active metabolite of vit.D3 - 1,25-Dihydroxyvitamin D3 (calcitriol) 3 synthetic analogues: -calcipotriol -1,24-Dihydroxyvitamin D3 (Tacalcitol) and -1,25-Dihydroxyvitamin D3 (Maxacalcitol), effective when applied topically in Psoriasis
| 2 |
Lichen planus
|
Psoriasis
|
Pemphigus
|
Leprosy
|
Dental
|
Psoriasis
|
33911ec5-e06f-4b60-af48-d6345cfd046b
|
single
|
Bullet that leaves a visible mark in its flight so that person can see the path is: AI 10
|
Ans. Tracer bullet
| 2 |
Tandem bullet
|
Tracer bullet
|
Dum-dum bullet
|
Incendiary bullet
|
Forensic Medicine
| null |
02d585d1-0737-4f92-839f-2c08fd53ceac
|
single
|
Angular vein infection commonly causes thrombosis of:
|
Ref : Dhingra 7e pg 226.
| 1 |
Cavernous sinus
|
Sphenoid sinus
|
Petrosal sinus
|
Sigmoid sinus
|
ENT
|
Nose and paranasal sinuses
|
77efb8e6-67ba-440b-981e-8d9ea50c33f7
|
single
|
The most accepted method for treatment of a myopic with refractive error of 2D is:
|
Ans. Spectacles
| 1 |
Spectacles
|
Contact lens
|
Radial keratotomy
|
Excimer laser
|
Ophthalmology
| null |
07b59098-814b-4a22-816b-29bb63218525
|
single
|
All are true for plemorphic adenoma except?
|
Answer is 'd' i.e. None Pleomorphic adenomas arise most commonly in the parotid gland. These form majority (-80-90%) of tumors of the parotid gland. Pleomorphic adenomas are less common in the submandibular glands & sublingual glands; relatively rare in the minor glands. Pleomorphic adenomas are benign tumors derived from a mixture of ductal (epithelial) and myoepithelial cells, and therefore show both epithelial and mesenchymal differentiation (hence k/a mixed tumor) Although benign, it has the potential to turn malignant k/a carcinoma ex pleomorphic adenoma or malignant mixed tumor. The incidence of malignant transformation increases with the duration of the tumor Signs & symptoms suspicious of malignant transformation a) rapid growth b) pain c) paresthesias d) facial weakness e) skin invasion and fixation of mastoid tip.
| 4 |
Arises from parotid
|
May turn into malignant
|
Minor salivary glands involved
|
None
|
Surgery
| null |
490d478b-f8d3-4158-aea2-e5ddd9f0fcf5
|
multi
|
What is the dose of Testosterone in Hvpogonadal male?
|
(C) 75 - 100 mg IM/week # RECOMMENDED REGIMENS FOR ANDROGEN REPLACEMENT:> Testosterone esters are administered typically at doses of 75-100 mg intramuscularly every week or 150-200 mg every 2 weeks.> One or two 5-mg nongenital testosterone patches can be applied daily over the skin of the back, thigh, or upper arm away from pressure areas.> Testosterone gel typically is applied over a covered area of skin at a dose of 5-10 g daily; patients should wash their hands after gel application.> Bioadhesive buccal testosterone tablets at a dose of 30 mg typically are applied twice daily on the buccal mucosa.
| 3 |
25 -50 mg IM/week
|
50- 75 mg IM/week
|
75 - 100 mg IM/week
|
150 - 200 mg IM/week
|
Medicine
|
Miscellaneous
|
429d6a27-ea53-4267-91cf-1ff264f2c7be
|
single
|
A 25 year old patient presents in coma with GCS of 5 and extensor posturing after a bike accident. Which of the following will the best management of the patient?
|
Ans. (c) Burr Hole surgeryThe image shows presence of extra-dural haemorrhage due to presence of biconvex lenticular opacity. Due to risk of brain herniation leading to death best management will be burr hole surgery.
| 3 |
Hypertonic saline
|
Thrombolysis
|
Burr hole surgery
|
Hemi-Craniectomy
|
Surgery
|
Head Injury
|
ce864269-3322-4730-ba37-40122cffc203
|
single
|
Bone affection in scurvy is due to which of the following
|
The most clearly established function of vitamin C is the activation of prolyl and lysyl hydroxylases from inactive precursors, allowing for hydroxylation of procollagen. Inadequately hydroxylated procollagen cannot acquire a stable helical configuration or be adequately cross-linked, so it is poorly secreted from the fibroblasts. Those molecules that are secreted lack tensile strength, are more soluble, and are more vulnerable to enzymatic degradation.collegen is required for osteoid matrix formation. Reference: Robbins basic pathology, pg no:301
| 2 |
Poor mineralization of the osteoid tissue
|
Defective osteoid matrix formation
|
Defective calcification in osteoid
|
Increased degradation of osteoid tissue
|
Pathology
|
Pediatrics, environment and nutrition
|
b67f9cfc-054d-4506-b906-a25b6b10dfa9
|
single
|
Proper lip support for complete denture is provided primarily by:
|
Proclination of maxillary anterior teeth and the surrounding denture base simulating the gingiva provided for the bulk for lip support in complete denture.
| 2 |
Convex surface of labial flange
|
Facial surface of teeth and simulated gingiva
|
Thickness of border in the vestibule
|
Festooned carvings on facial surface
|
Dental
| null |
7796653c-9636-4929-905c-cede33a43282
|
single
|
Wahin-Finkeldey giant cells are seen in ?
|
Ans. is 'a' i.e., Measles Wahin-Finkeldey cells are multinucleated giant cells. These cells are pathognomic of measles and are found in lymphoid organs, lung and sputum.
| 1 |
Measles
|
Rubella
|
Influenza
|
Rickettsial pox
|
Pathology
| null |
452b32d0-660d-4874-a328-f58187bbe37b
|
single
|
Which is not a complication of PUVA therapy:
|
D. i.e. Exfoliation
| 4 |
Premature aging of skin
|
Cataracts
|
Skin cancers
|
Exfoliative
|
Skin
| null |
dc03fa19-2d86-43a8-8424-d893a4f84137
|
single
|
In humans, coex of hair is usually:
|
Ans. 4-10 times broader than the medulla
| 3 |
Double that of medulla
|
Same as medulla
|
4-10 times broader than the medulla
|
Thin in comparison to medulla
|
Forensic Medicine
| null |
5b283abc-63cf-484b-8ccf-99fb17b62473
|
multi
|
Babu a 19 yrs old male has a small circumscribed sclerotic swelling over diaphysis of femur; likely diagnosis is -
|
Well circumscribed sclerotic swelling over diaphysis of a long bone (femur) in a 19 years old suggests the diagnosis of osteoid osteoma.
| 4 |
Osteoclastoma
|
Osteosarcoma
|
Ewing sarcoma
|
Osteoid osteoma
|
Orthopaedics
| null |
b980d490-1142-43c2-8f70-7a93567c9980
|
multi
|
Most common cause of bleeding in children
|
Most common cause of nose bleeding in children - Trauma to the little's area. Fingernail trauma is common. Ref : Dhingra 7e pg 197.
| 1 |
Nose picking
|
Hypeension
|
Tumor
|
None
|
ENT
|
Nose and paranasal sinuses
|
b716a255-31db-4844-8847-9709792215a9
|
multi
|
The 'Search lines' to detect fracture line on occipitamental radiographic view of midfacial skeleton fracture was described by
| null | 2 |
Rene Lefort and Guerin
|
McGrigor and Campbell
|
Andreason and Ravn
|
Rowe and Williams
|
Surgery
| null |
635fa2e1-c126-4728-a019-69294dea43ad
|
single
|
A 35 year old lady complains dysphagia, Raynaud's phenomenon, sclerodactyly. Investigations show antinuclear antibody. The likely diagnosis is ?
|
Ans. is 'b' i.e., Systemic sclerosiso Dysphagia, Raynaud's phenomenon, sclerodactyly in 35 years old lady suggest the diagnosis of systemic sclerosis (see above explanations).I think option 'b' needs some explanation here.Mixed connective tissue diseaseo Patients having the co-existence of features suggestive of SLE, polymyositis, Rheumatoid ahritis and systemic sclerosis.
| 2 |
Systemic lupus erythematosis
|
Systemic sclerosis
|
Mixed connective tissue disorder
|
Rheumatoid ahritis
|
Pathology
| null |
f3c76544-299e-4b66-96b0-cacc483f3cbd
|
single
|
Serum amylase level is raised in all except:
|
Answer is C (Appendicitis) Appendicitis is not associated with raised amylase levels. Pancreatitis, Ruptured ectopic and salivary gland lesions including blocked salivary duct are all associated with raised amylase levels. Pancreatic Disease Pancreatitis Pancreatic trauma Acute Pancreatic carcinoma Chronic: ductal obstruction Complications of pancreatitis (i) Pancreatic pseudocyst (ii) Pancreatogenous ascites (iii) Pancreatic abscess (iv) Pancreatic necrosis Non pancreatic Disorders 1. Renal insufficiency 4. Macroamylasemia 2. Salivary gland lesions 5. Burns A. Mumps 6. Diabetic ketoacidosis B. Calculus 7. Pregnancy C. Irradiation sialadenitis 8. Renal transplantation 3. "Tumor" hyperamylasemia 9. Cerebral trauma A. Carcinoma of the lung 10. Drugs morphine B. Carcinoma of the esophagus C. Breast carcinoma, ovarian carcinoma Other Abdominal Disorders Biliary tract disease: cholecystitis, choledocholithiasis Intraabdominal disease Perforated or penetrating peptic ulcer Intestinal obstruction or infarction Ruptured ectopic pregnancy Peritonitis Aoic aneurysm Chronic liver disease Postoperative hyperamylasemia
| 3 |
Blocked salivary duct
|
Ruptured ectopic
|
Appendicitis
|
Pancreatitis
|
Medicine
| null |
82206379-00af-4662-b226-6dff390b75d7
|
multi
|
A 30-year-old man who was recently staed on haloperidol 30mg/day developed hyperpyrexia, muscle rigidity, akinesia, mutism, sweating, tachycardia and increased blood pressure. The investigations showed increased VVBC count, increased creatinine phosphokinase. There is no history of any other drug intake or any signs of infection. The most likely diagnosis is:
|
B i.e. Neuroleptic malignant syndrome
| 2 |
Drug overdose
|
Neuroleptic malignant syndrome
|
Drug induce Parkinsonism
|
Tardive dyskinesia
|
Psychiatry
| null |
9b1532fe-85c1-4a99-87d4-ef4707e7f84d
|
single
|
Best radiographic view for fracture of C1, C2 veebrae is -
|
Best radiographic view for fracture of C1, C2 veebrae is - odontoid view
| 2 |
AP view
|
Odontoid view
|
Lateral view
|
Oblique view
|
Radiology
|
Skeletal system
|
fc479a79-fa1a-4a92-9d65-ebf711952c1a
|
single
|
A child presents with antimongoloid slant, pulmonary stenosis, sho stature, and undescended testis. The likely diagnosis is _____
|
The child presenting with the antimongoloid slant, pulmonary stenosis, sho stature, and undescended testis is suggestive of Noonan syndrome. Noonan syndrome: Autosomal-dominant disorder (12q) Male or female with Turner phenotype; normal karyotype Clinical features: Down-slanting palpebral fissure (antimongoloid slant) Pectus carinatum Hypeelorism Cryptorchidism Low levels of clotting factor 11 and 12 Leukemia (Juvenile chronic myelogenous leukemia) Moderate mental retardation in 25% Cardiac abnormality: Most common is pulmonary valve stenosis Hyperophic cardiomyopathy Atrial septal defect Coarctation of aoa Sho stature, webbed neck, low set ears, cubitus valgus: Similarities with Turner syndrome Ptosis, micrognathia, Clinodactyly, delayed pubey Difference between Noonan syndrome and Turner&;s syndrome: Noonan syndrome Turner Syndrome Normal karyotype (46XX/46XY) 45,XO(60%) Most common hea disease: Valvular pulmonary stenosis Most common hea disease: Bicuspid aoic valve 25% have mental retardation Mental retardation rare Genitourinary: Genitourinary: Female: Feile, delayed pubey Female: Infeile, Streak ovaries Male: Infeile due to cryptorchidism No males Ref: nelson textbook of pediatrics 21st edition Pgno: 669,2995
| 2 |
Hypoparathyroidism
|
Noonan syndrome
|
Klinefelter syndrome
|
XYY sex chromosome
|
Pediatrics
|
Genetic and genetic disorders
|
4cd4038f-1419-4123-9c59-96086b3d9114
|
single
|
Which of the following is consistent with a decision to perform a cerclage?
|
The treatment of the apparently incompetent cervix is surgical and consists of reinforcing the weak cervix by some kind of purse-string suture.It is best performed after the first trimester, but before cervical dilatation of 4 cm, if possible.Bleeding, infection and uterine contractions are contraindications to surgery
| 2 |
Uterine contractions
|
Cervix dilated to 3 cm
|
Uterine bleeding
|
Gestation of 26 weeks
|
Microbiology
|
All India exam
|
64166740-bbae-4efb-8508-2733a310e1ac
|
single
|
Symptoms of sinusitis are all except -
| null | 4 |
Blood stained rhinorrhoea
|
Facial edema
|
Nasal blockage
|
Diplopia
|
ENT
| null |
b6ed8e46-a0e9-4a11-9944-ec63642d3bac
|
multi
|
Aqueous humor has lower concentration of:
|
Protein content of aqueous humor is much less than that of plasma. The ocular tissue surrounding the aqueous humor (especially the cornea and lens) take up glucose from aqueous humor; glycolysis by these tissues results in higher pyruvate and lactate (and lower glucose) in aqueous humor. L-ascorbic acid content of aqueous humor is 10-50 times higher as compared to plasma. (However, no ocular defects have been noted in prolonged scurvy.) The aqueous humor contains moderately high amounts of hyaluronic acid; it is kept in the depolymerized state by hyaluronidase present in the ciliary body
| 2 |
Lactate
|
Protein
|
Hyaluronic acid
|
L-ascorbic acid
|
Physiology
|
Special Senses
|
fdd764bc-f21c-423d-bc71-3076e3cafebe
|
single
|
Which of the following groups of amino acids produce a common component of the TCA cycle?
| null | 3 |
Alanine, isoleucine, leucine, lysine
|
Serine, asparagine, glycine, glutamate
|
Isoleucine, valine, methionine
|
Proline, leucine, tryptophan
|
Biochemistry
| null |
6e223f32-23df-4fc2-8084-f6450bb031f8
|
single
|
Most common enzyme deficiency leading to childhood hypeension is -
|
Ans. is 'c' i.e., 11-Beta hydroxylase o Salt retention and hypeension is seen in 17-a hydroxylase deficiency and I 1-p hydroxylase deficiency. 1 I -I hydroxylase deficiency is more common. 17-a hydroxylase deficiency is an uncommon form of congenital adrenal hyperplasia.
| 3 |
17-Alpha hydroxylase
|
21-Beta hydroxylase
|
11-Beta hydroxylase
|
All
|
Pediatrics
| null |
05f47914-b763-4340-9cb0-2fe68735b974
|
multi
|
A patient with abdominal injury presents to the emergency department with signs of signs of peritonitis and shock. Airway and breathing were secured and IV fluids were started with 2 large bore cannulas. The next line of management should be
|
Treatment for abdominal injury includes Emergency laparotomy.
Indications include
Frank haemoperitoneum
Significant diagnostic peritoneal lavage
Haemodynamically unstable patient
U/S or CT scan shows significant intra-abdominal injuries
| 2 |
FAST
|
Exploratory Laparotomy under general anesthesia
|
Insertion of abdominal drain followed by laparotomy
|
Laproscopy
|
Surgery
| null |
eaf7b45b-5e8b-45f4-a261-dfc3b4f3ca83
|
single
|
Aeriolar dilators used in the treatment of CHF
|
Nifedipine is a calcium channel blocker. Enalapril is an ACE inhibitor. Prazosin is alpha 1 blocker. Hydralazine is an aerial dilator and potassium channel opener (REF.Essentials of medical pharmacology KD TRIPATHI 8 Edition)
| 1 |
Hydralazine
|
Nifedipine
|
Prazosin
|
Enalaprin
|
Pharmacology
|
Cardiovascular system
|
06f5d802-77ed-4901-a216-750a81cf1c8b
|
single
|
Which of the following is not lined by non-keratinized stratified squamous epithelium?
|
.
| 4 |
Hypopharynx and laryngopharynx
|
Oesophagus
|
Cornea
|
Tympanic membrane
|
Pathology
|
All India exam
|
2bfb0500-de92-4909-bab9-18962ca3e827
|
single
|
Diabetic ischemic maculopathy is characterized by all except ?
|
Ans. is `b' i.e., Mild visual loss Ischaemic diabetic maculopathy It occurs due to microvascular blockage. Clinically it is characterised by marked visual loss with microaneurysms, haemorrhages, mild or no macular oedema and a few hard exudates. Fluorescein angiography shows areas of non-perfusion which in early cases are in the form of enlargement of foveal avascular zone (FAZ), later on areas of capillary dropouts are seen and in advanced cases precapillary aerioles are blocked.
| 2 |
It occurs due to microvascular blockage
|
Mild visual loss
|
Areas of non perfusion are evident on fluorescein angiography
|
Microaneurysms and hemorrhages are seen
|
Ophthalmology
| null |
84ab753b-a399-4c3f-b0de-1913405346d9
|
multi
|
A 13 year old boy presents with swelling in the cheek with recurrent epistaxis. Most likely cause is -
| null | 1 |
Angiofibroma
|
Ca Nasopharynx
|
Rhabdomyosarcoma
|
None
|
ENT
| null |
e12466b1-6fd9-406e-be59-61db7d167f86
|
multi
|
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