lighteval/med_mcqa · Datasets at Hugging Face

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Mc Murray's osteotomy is done for-	*Mc Murray's osteotomy and Meyer's procedure (muscle pedicle graft) are used for non-union transcervical neck fracture of femur. INDICATIONS: 1. Nonunion of femoral neck 2. Advanced osteoahritis . PREOPERATIVE PLANNING : Determination of the size of the bone wedge to be removed, the position of the seating chisel which will determine the size and angle of the blade plate to be used. AIM : o Line of weight bearing is shifted medially Shearing force at the nonunion is decreased, because the fracture surface has become more horizontal Ref: Maheshwari 9th ed pg. 136	2	Malunited interochantric fracture of femur	Nonunion transcervical neck fracture of femur	Nonunion lateral condyle fracture of humerus	Malunited supracondylar fracture of humerus	Orthopaedics	Pelvis and Hip injuries	7af4ddbb-fde0-4b78-a65b-3a07c93ff5ff	single
Pelvic Inflammatory Disease occurs least common with :	Ans. is b i.e. Condom Barrier methods (especially condom) and OCP's both protect against PID, but the protection offered by OCP's is less than that by Barrier method. "The incidence of pelvic inflammatory disease (P1D) is reduced. though it does not reach the same low level as seen with the barrier methods." As far as diaphragm is concerned, it does not protect against HIV, whereas condom does.	2	OCPs	Condom	IUCD	Diaphragm	Gynaecology & Obstetrics	null	dcf71412-6fe0-4f53-bed3-7218aa719ed2	single
Which of the following investigation is the BEST method of diagnosis of HIV in childhood?	The two tests used for diagnosing HIV infection in in children less than 18 months are detection of HIV nucleic acid (DNA or RNA) AND detection of HIV p24 antigen. Definitive diagnosis requires presence of reactive tests on two separate determinations using one of the above tests after 4 or 6 weeks and confirmed by the second test. Diagnostic testing should be done 6 weeks or longer after complete cessation of breast feeding. Infants born to HIV infected mothers will have HIV antibody until 6-18 months regardless of infection status due to transplacental passage of maternal antibody. The preferred test for infant diagnosis is detection of HIV DNA or RNA in blood, collectively referred to as nucleic acid amplification testing (NAT). Laboratory criteria for diagnosing HIV infection in children more than 18 months: Serologic testing Detection of HIV nucleic acid(DNA or RNA) Detection of HIV p24 antigen Ref: Advances in Pediatrics by Dutta By Jaypee Brothers, page 256. McFarland E.J. (2012). Chapter 41. Human Immunodeficiency Virus Infection. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.	2	CD4 cell counts	P24 antigen	ELISA	Anti HIV antibody	Pediatrics	null	c21bbb42-0e90-40a7-8781-9267736efafe	single
Active replication in Hepatitis B in fection is indicated by -	Circulating HBeAg Indicate of active intrahepatic replication REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.547	1	HBeAg	HBsAg	HBcAg	Anti-HBsAg	Microbiology	Virology	07b293e8-7712-4888-a0b4-65b032cec437	single
Which of the following types of bias can be reduced by by allowing equal interview time-	Interviewer's bias Occur when interviewer knows the hypothesis and know who the cases are. This type of bias can be eliminated by double-blinding. (refer pgno:74 park 23 rd edition)	4	Berkesonian bias	Recall bias	Selection bias	Interviewer bias	Social & Preventive Medicine	Epidemiology	f6ae6ec6-9e00-4729-af19-bff76f8b2052	multi
The most common site of hypertensive intracranial hemorrhage is:	Ans. (a) Putamen* Basal Ganglia (Putamen) is the MC site of ICH.* Of all the hemorrhages in Brain - Intracerebral hemorrhage is the MC type of hemorrhage.* The MC cause of Intracranial bleed - Hypertension	1	Putamen	Midbrain	Medulla	Cerebrum	Surgery	Nervous System	67b68177-043a-4c45-8e19-e88a95b46b5a	single
The percentage of water in Liquor Amnii is:	99%	4	42%	64%	76%	99%	Gynaecology & Obstetrics	null	89db54b1-bbea-4cc9-981c-36f828b2bd62	single
Optic cup is derived from ?	Ans. is 'a' i.e., Neural ectoderm	1	Neural ectoderm	Surface ectoderm	Mesoderm	Neural crest	Anatomy	null	51065d75-464c-4e93-b155-099fd658730f	single
Which among the following about removable space maintainers are wrong?	The compliance of the removable appliance doesn’t improve with functional or non-functional type.	3	Being tissue born, they impose less stress on the remaining teeth	By virtue of tissue stimulation they often accelerate the eruption of teeth between them	They can be functional in the truest sense, hence better patient co-operation can be expected	Easier to fabricate, requiring less chair-side time	Dental	null	73ded937-7187-4709-a756-dfec00a619a8	multi
X-ray of a young man shows hetrotopic calcification around bilateral knee joints. Next investigation would be-	null	4	Serum phosphate	Serum calcium	Serum PTH	Serum Alkaline phosphatase	Orthopaedics	null	ab397b75-922a-496e-8469-738e5e17f713	single
Which of the following is a synthetic estrogen ?	Ans. is 'd' i.e., DiethylstibestrolEstrogeno Ethinylestradiolo Diethylstibestrolo Mestranolo Hexestrolo Tiboloneo Dienestroi	4	Estrone	Estriol	Estradiol	Diethylstibestrol	Pharmacology	Sex-Hormone	71840043-e6e8-4b9b-89ea-6d2fa441babe	single
Hardy Weinberg law is related to	Hardy Weinberg law: states that the genotype frequencies in a population remain constant or are in equilibrium from generation to generation unless specific disturbing influences are introduced. Genetic equilibrium (HW law) is a basic principle of population genetics; the entire principle is based on Mendelian genetics. Deviations in HW law: HW law fails to apply in: Non-random mating (assortative mating) New mutations Genetic drift Gene flow Natural selection (mortality selection, fecundity selection) Small populations migrations Dynamic populations. HW law assumes that human population is static, large and has random mating.	2	Gene therapy	Population genetics	Human genome project	Eugenics	Social & Preventive Medicine	null	497f41d8-70cc-4cbc-9fe1-91e6aac4544f	single
The most sensitive test for the diagnosis of herpes simplex (HSV) meningitis in a newborn infant is	HSV meningitis or encephalitis is difficult to diagnose by laboratory tests as there is a low titer of virus present in the CSF. Neonatal HSV infects the child during the birth process. While culture, Tzanck smear, and even antibody tests may be useful in adults, particularly those with HSV-rich lesions, they are not useful for CSF testing. Only PCR is sensitive enough to detect HSV DNA in the CSF. Once diagnosed rapidly, HSV encephalitis or meningitis can be treated with acyclovir.	2	HSV IgG antibody	HSV polymerase chain reaction (PCR)	HSV culture	Tzanck smear	Microbiology	Virology	072855bc-5876-4c6f-811c-35259b9d55e9	single
Embryo proper is derived from which pa of morula:	Approximately 3 days after feilization, cells of the compacted embryo divide again to form a 16-cell morula (mulberry). Inner cells of the morula constitute the inner cell mass, and surrounding cells compose the outer cell mass. The inner cell mass gives rise to tissues of the embryo proper, and the outer cell mass forms the trophoblast, which later contributes to the placenta. Ref: Langman's embryology 11th edition Chapter 3.	1	Inner cell mass	Outer cell mass	Both of the above	None of the above	Anatomy	null	f9f76f1f-4394-4ab2-a9bc-8d17c584725e	multi
A 63-year-old man is noticed to have asymmetric pupils. He is completely well and has no symptoms. On examination, the left pupil is small, round, and has a brisk response to light and near stimuli (accommodation). There is also ptosis of the left eyelid, but no other ocular movement abnormality or symptoms of double vision.For the above patient with a pupillary abnormality, select the most likely diagnosis.	Horner syndrome results in a small, round pupil on one side. Light and near reaction is brisk, and response to mydriatics and miotics is normal. The affected pupil will not dilate in the dark, so darkness accentuates the anisocoria. The syndrome is often idiopathic but can be caused by neoplasm, brain stem stroke, or carotid dissection.	2	essential anisocoria	Horner syndrome	tonic pupils (Holmes-Adie syndrome)	Argyll Robertson pupils	Medicine	C.N.S.	d499e578-58a2-40c9-ae80-c99c6b719370	multi
A 67-year-old man complains of a lesion in his left eye. Physical examination reveals a triangular fold of vascularized conjunctiva growing horizontally into the cornea in the shape of an insect wing. Which of the following terms best describes this patient's lesion?	Pterygium is a fold of vascularized conjunctiva that grows horizontally onto the cornea in the shape of an insect wing (hence the name). It is often associated with a pinguecula (conjunctival lump, choice C) and frequently recurs after excision.Diagnosis: Pterygium	4	Loiasis	Onchocerciasis	Pinguecula	Pterygium	Pathology	Misc.	f46ec8fd-f343-435d-9e21-9ba5a9fcd4f2	multi
Most reliable marker for hypothyroidism:	Ans. (c) TSHRef : Harrison 19th ed. 12289* Best test for diagnosis of hypothyroidism is T.S.H (Thyroid Stimulating Hormone).* TSH can also be used for monitoring response to treatment.	3	T3	T4	TSH	Thyroxine binding globulin	Medicine	Endocrinology	01f349cd-2497-4157-8369-310075d2fcab	single
This eyes sign is most likely seen in which condition:	Ans. B. Lateral medullary syndromea. Above image shows Ptosis of right eye.b. This shows paralysis of IIIrd Nervec. Lateral Medullary syndrome (Wallenberg Syndrome) is a neurologic disorder due to ischemia of lateral part of Medulla d/t involvement of Posterior inferior cerebellar artery (PICA)d. It is characterized by ipsilateral loss of pain & temperature from face & contralateral loss from body.e. Ipsilateral Horner's Syndrome (Ptosis, Miosis, Anhidrosis)	2	Medial medullary syndrome	Lateral medullary syndrome	Optic chiasma lesion	Benedict syndrome	Medicine	C.N.S.	76236204-9d44-4a6b-88f8-52c19b002976	single
All of the following amino acids are conveed to succinyl-CoA, except	Valine, isoleucine, and methionine are conveed to succinyl CoA, whereas histidine is conveed to alpha-ketoglutarate and both are involved in the TCA cycle.	4	Methionine	Isoleucine	Valine	Histidine	Biochemistry	Metabolism of protein and amino acid	6a584592-6cf8-49c8-8bb4-a2c0c1a45233	multi
Albers schonberg disease is also known as -	Ans. is 'b' i.e., Osteopetrosis o Osteopetrosis is also known as Marble bone disease or Albers-Schonberg disease.o Paget's disease is known as Osteitis deformans,o Osteogenesis imperfecta is known as Brittle bone disease,o Osteoporosis is known as Fragile bone disease.	2	Osteoprosis	Osteopetrosis	OI	Paget's disease	Orthopaedics	Regional Disease	fa8a1316-a482-40f6-a517-843e06478a72	single
In OCP, estrogen is used in	A. i.e. (Ethinyl estradiol) (208 - Shaw 's Nth)COMBINED ORAL PILLS - usually contain a mixture of* Ethinyloestradiol or mestranol (20 to 30\|ig)* Active progestogen - 19 morsteroid* Mala D contains -0.5 mg of D- norgestrel* Mala N contains - 1 mg norethisterone (Norgestrel 0.30 mg and Ethyl oestradiol 3.0 mg)* Treatment starts fifth day of the cycle for 21 days* A new course of tablets should be commonced 7 days after the cessation of the previous course* Fixed time of the day preferably after a meal* Pregnancy rate with combined oralpill is 0.1 per 100 woman years If she forgets to take a tablet, she should take 2 tablets the following day* The majority of failure with OCP are due to the failure to take the pills regularly* In a non lactating women OCP can be started after 6 weeks of delivery*. But can be given soon after an abortion, MTP or an ectopic pregnancy H. mole, one should start on OCP only ofter serum beta hCG is negative* The progesterone of choice for emergency contraception is - Levonorgestrel**	1	Ethinyl estradiol	Norethisterone	Ethynodiol diacetate	Allyloestranol	Gynaecology & Obstetrics	Miscellaneous (Gynae)	5cfb1668-9dc6-467d-b562-0e7f9622adbd	multi
Blood group antigens belong to the class	For red blood cells, the membrane oligosaccharides that determine the antigenic natures of the ABO substances appear to be mostly present in glycosphingolipids, whereas in secretions the same oligosaccharides are present in glycoproteins. Some examples of conjugated proteins are lipoproteins, glycoproteins, phosphoproteins, hemoproteins, flavoproteins, metalloproteins, phytochromes, cytochromes, opsins and chromoproteins. so the ABO substances can be chosen as Conjugated proteins from the given options Ref: Harper's Illustrated Biochemistry, 30E (2015) Pg No. 697 chapter 53.	1	Conjugated proteins	Unconjugated protein	Simple protein	Hemoglobin binding protein	Biochemistry	Structure and function of protein	61e7afae-3300-473c-9b74-8c511b7754e8	single
Bill's bar divides:	Ans. (b) Facial nerve and superior vestibular cochlear nerveRef: Dhingra's ENT 6th ed.l 90-91* Bills bar divides the superior compartment of the internal acoustic meatus into an anterior and posterior compartment.* Anterior to Bill's bar, are the facial nerve (in the anterior superior quadrant) and nervus intermedius, and posterior to it is the superior division of the vestibular nerve (in the posterior superior quadrant).	2	Facial nerve and cochlear nerve	Facial nerve and superior vestibular cochlear nerve	Facial and inferior vestibule cochlear nerve	Superior and inferior vestibule cochlear nerve	ENT	Facial Nerve And Its Disorders	a236f205-f584-4ec7-b2b3-ff8a4bc9e61b	single
Contraceptive effect of CuT-380A lasts for how many years?	Ans. (b) 10 yearsShaw 15ih227-8Name of deviceEffective period* CuT 380A10 years* Nova T-Silver5 years* Multiload3755 years* Multiload2503 years	2	5	10	15	20	Gynaecology & Obstetrics	Non-Hormonal - Intrauterine Devices	c34231e2-75d8-4815-9b5e-6aedc87174e5	single
Stereocilia and kinocilium are present in	(B) Inner ear > A kinocilium is a special type of cilium on the apex of hair cells located in the sensory epithelium of the vertebrate inner ear. Stereocilia (or stereovilli) are apical modifications of the cell, which are distinct from cilia and microvilli, but closely related to the latter. They are found in three regions of the body: the ductus deferens, the epididymis and the inner ear.	2	Tongue	Inner ear	Nose	Eye	Physiology	Special Senses: Hearing and Equilibrium	8d07a565-697f-46c8-b7d1-282a639c4d3a	single
True about tubercular otitis media are all except	Tubercular otitis media In most of the cases, infection is secondary to pulmonary tuberculosis; infection reaches the middle ear through the eustachian tube. Perforation: Multiple perforations, 2 or 3 in number, are seen in pars tensa and form a classical sign of disease. These may coalesce into a single large perforation. Painless ear discharge: Earache is characteristically absent in cases of tubercular otitis media. Discharge is often foul-smelling because of the underlying bone destruction. (Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 81,82)	4	Spreads through Eustachian tube	Causes painless ear discharge	May cause multiple perforations	Usually affects both ears	ENT	Ear	4dd662ee-89c8-402d-b454-7ac917e250a7	multi
Which of the following is the most specific screening test for renovascular hypeension:	Answer is A (Magnetic Resonance Angiography (MRA) Magnetic Resonance Angiography (MRA) has now emerged as the most sensitive and specific screening test for Renovascular hypeension. Note: Harrison 16'h edition (old) mentions Spiral CT scan as the most sensitive and specific screening test for Renovascular Hypeension, however most recent textbooks now prefer MRA as the screening test of choice with similar or even better sensitivity and specificity than spiral CT Angiography. Screening Test Test Sensitivity (%) Specificity (%) Magnetic resonance angiography (MRA) 100 96 Spiral computerized tomography 98 94 Captopril renogram 70-93 95 Duplex Doppler ultrasonography 69-96 86-90 IVP --75 --85 Renovascular Hypeension Test Sensitivity Specificity Conventional Renal Angiography >99% >99%	1	Magnetic Resonance Angiography (MRA)	Spiral Computed Tomographic Angiography (CT Angiography)	Captopril induced Radionucleotide Scan (Captopril Renogram)	Duplex Doppler Ultrasonography	Medicine	null	13ac6b08-b090-4414-8c5f-78440a715688	single
INR in warfarin therapy is?	ANSWER: (B) 2.5REF: Harrison 18th ed chapter 118For most indications, warfarin is administered in doses that produce a target INR of 2.0- 3.0. An exception is patients with mechanical heart valves, where a target INR of 2.5-3.5 is recommended. Studies in atrial fibrillation demonstrate an increased risk of cardioembolic stroke when the INR falls to <1.7 and an increase in bleeding with INR values >4.Warfarin interferes with the synthesis of the vitamin K-dependent clotting proteins, which include prothrombin (factor II) and factors VII, IX, and X.Like all anticoagulants, the major side effect of warfarin is bleeding. A rare complication is skin necrosis. Warfarin crosses the placenta and can cause fetal abnormalities. Consequently, warfarin should not be used during pregnancy.Dabigatran etexilate, an oral thrombin inhibitor, and rivaroxaban, an oral factor Xa inhibitor are new oral anticoagulants.	2	1.5	2.5	3.5	4.5	Medicine	Bleeding and Thrombotic Disorders	6af6489a-e510-499e-af47-b416ed215340	single
Calculate the osmolarity of a solution which contains 180 gm of glucose per dl, 117 gm of Nacl per dl and 56 gm of BUN per dl-	Ans. is 'd' i.e., 70 osmol/L * One mole of osmotically active particles is called one osmole.* In case of non-dissociated solutes, one gram molecular weight of any substance contain similar number of osmotically active molecules (osmoles), thus a molar solution of glucose contains 1 osmole.* On the other hand, in case of dissociated solutes, one gram molecular weight of any substance contain the number of osmotically active molecules (osmoles) equal to the number of dissociated molecules, e.g., a molar solution of NaCl contains 2 osmoles (1 mole of Na+ and 1 mole of Cl-).* The osmolar concentration of a solution in osmole/litre is called osmolarity. When expressed in osmole/Kg of solution is called osmolality.* Normal serum osmolality is about 290 mOsm/kg.* A mole (gram molecular weight) is molecular weight of a substance in grams, e.g., molecular weight of glucose is 180, therefore one mole of glucose has 180 gm; and molecular weight of NaCl is 58-5 gm, therefore one mole of NaCl contains 58-5 gm of NaCl.1 mole of glucose = 1 gram molecular weight of glucose = 180 gm of glucose = 1 osmole of glucose1 mole of NaCl = 1 gram molecular weight of NaCl = 58[?]5 gm of NaCl = 2 osmoles of NaClComing back to question* The given solution contains:-i) 180 gm glucse per dl = 1 osmole/dl =10 osmole/Lii) 117 gm of Nacl per dl = 4 osmole/dl = 40 osmole/Liii) 56 gm if BUN per dl = 2 osmole/dl = 20 osmole/L(28 gm of BUN has one osmole)* Thus osmolarity of given solution is 70 osmole/L	4	20 osmol/L	30 osmol/L	50 osmol/L	70 osmol/L	Physiology	Kidneys and Body Fluids	53222922-d241-49e2-abc4-6372d74c97a2	single
Sex worker with discharging ulcer, gram-negative diplococci & growth on modified Thayer Martin media. Diagnosis	Information in this question are - i. Gram negative diplococci. ii. Growth on modified Thayer-Martin media. Neisseria gonorrhoeae is a gram negative diplococci and Thayer-Martin medium is the selective medium for gonococci.	1	N. gonococci	Syphilis	LGV	Chancroid	Dental	null	f3bfd1ab-04f6-4254-93ad-cd18b7fa5897	single
All of the following are pathological features associated with Crohn's disease except: March 2012	Ans: D i.e. Toxic megacolonInflammatory bowel diseasePresence of multiple, separate, sharply delineated areas of disease, resulting in skip lesions, is characteristic of Crohn's disease and may help in differentiation from ulcerative colitisNon-caseating granuloma, a hallmark of Crohn disease, are found in approximately 35% of casesSparing of interspersed mucosa, a result of the patchy distribution of Crohn disease, results in coarsely textured, cobblestone appearance in which the diseased tissue is depressed below the level of mucosaIn Ulcerative colitis, inflammation and inflammatory mediators can damage the muscularis propria and disturb neuromuscular function leading to a colonic dilatation and toxic megacolon, which carries a significant risk of perforation	4	Skip lesions	Non caseating granulomas	Cobblestone appearance	Toxic megacolon	Pathology	null	a2b9afb7-78c5-4cba-808c-ebc2107ecb3c	multi
Anxiety states can be induced by the following except	(A) Cholecystokinin # SUBSTANCE/DRUG INDUCED ANXIETY DISORDER:> The essential features of substance-induced anxiety disorder are prominent and persistent feelings of anxiety that are judged to be due to the direct physiological effects of intoxication or withdrawal from a substance. Prominent anxiety, Panic Attacks, or obsessions or compulsions predominate in the clinical picture.> Alcohol: Because alcohol has depressive properties, acute intoxication rarely involves acute anxiety or panic. However, acute alcohol withdrawal, may induce an anxiety disorder. Various degrees of subclinical anxiety ranging from panic to generalized anxiety can last for 3-12 months after cessation of drinking.> Cocaine & Psychostimulants: may produce manifestations of anxiety, most commonly during the intoxication state.> Opiates: withdrawal actually may share neurochemical characteristics with panic disorder. Also protracted anxiety during methadone withdrawal may last several weeks or months.> Cannabis: Marijuana-induced anxiety usually occurs at high doses.> Phencyclidine & Other Hallucinogens: may acutely produce anxiety & panic, depending on the individual, dose & setting.> Miscellaneous: More commonly used drugs such as caffeine & nicotine withdrawal, may also produce anxiety symptoms.> Infusion of chemicals like sodium lactate, isoproterenol & caffeine; ingestion of Yohimbine and inhalation of 5% CO2 can produce panic episodes in predisposed individuals.> Administration of oral MAOIs before the lactate infusion protects individuals from panic attack.# ANTI-ANXIETY DRUGS:> Barbiturates: Long acting, Intermediate acting, Short acting, Ultra short acting> Non-barbiturate, Non-benzodiazepine Anti-anxiety Agents: Carbamates, Piperidinediones, Alcohols, Quinazoline derivatives, Anti histamines, Cyclic Ethers, Anti psychotics, Beta blockers, Benzodiazepines> Newer drugs: Buspirone, Zopiclone, Zolpidem, Zalpelon, Other drugs	1	Cholecystokinin	Yohimbine	Sodium Lactate	Isoproterenol	Psychiatry	Miscellaneous	ddca855f-8379-4016-9830-2d75c480d96e	multi
A 16-yrs-old girl presents with bowel obstruction. Laparotomy reveals markedly enlarged para-aoic lymph nodes. Biopsy of lymph nodes exhibit a diffuse neoplastic infiltrate of small, round lymphocytes with a "starry sky" appearance on low power. The cytoplasm of some of the lymphocytes is vacuolated and fat stains are positive. You would expect the neoplastic cells to demonstrate a	The patient has Burkitt lymphoma (Lukes-Collins; small non-cleaved), which is the most common malignant lymphoma in children. Approximately one-third of all childhood lymphomas in the United States are of the Burkitt type. There is an American and a Noh American variant. The relationship of Burkitt to the Epstein-Barr virus is more secure with the Mrican than the Noh American variant. The American variant has a predilection for the jaw, while the Noh American variant is more often an abdominal mass, located in the ileocecal region, ovary, or retroperitoneum. The lymph nodes are diffusely involved with monotonous, round, non-cleaved cells with numerous mitoses (very aggressive cancer) punctuated by clear spaces with macrophages containing debris ("tingible" macrophages) giving the impression of a "starry sky appearance," the stars representing the macrophages and the black of night the lymphocytes. The neoplastic B cells have a characteristic t(8;14) translocation where the c-myc oncogene is translocated from chromosome 8 to chromosome 14. Burkitt cells contain vacuoles that contain lipid, which stains positively with oil red O. It is a high-grade lymphoma with a predilection for metastasis to the bone marrow and other organs.	4	Positive non-specific esterase stain of the cells	Positive specific esterase stain of the cells	Low leukocyte alkaline phosphatase score	t(8;14) translocation	Pathology	General pathology	522577d8-c2f2-4c60-b21d-41d67623c966	multi
Which of the following is TRUE/FALSE about weight loss? a) Psychiatric disorders are a major cause of involuntary weight loss. b) Up to 20% of all cancer deaths are caused directly by cachexia. c) Connective tissue diseases decreases metabolic demand. d) Hypehyroidism in the elderly have more prominent sympathomimetic features. e) Involuntary weight loss may be one of the earliest manifestations of Alzheimer's dementia.	Connective tissue diseases may increase metabolic demand and disrupt nutritional balance. Hypehyroidism in the elderly may have less prominent sympathomimetic features and may present as "apathetic hypehyroidism" or T3 toxicosis Ref:Harrisons Principles of Internal Medicine, 18th Edition, Pages 642- 44	4	a,b,c,d,e-True None-False	a,b,c-True & d,e-False	a,b,c,d-True & e-False	a,b,e-True & c,d,-False	Medicine	null	a0033c5a-cffd-4363-a5ae-6930d5017890	multi
In aoic dissection blood enters in -	Ans. is `b' i.e., MediaAoic dissection o Aoic dissection is a catastrophic illness characterized by dissection of blood between and along the laminar planes of aoic media.o Blood enters inside the aerial wall (in the media layer) and leads to formation of blood filled channels within the aoic wall, which often ruptures outward causing massive hemmorrhage.o The most frequent preexisting histologically detectable lesion is cystic medial degeneration.o In aoic dissection, there is an intimial tear through which the blood enters into the media.o Usually, the tear is within 10 Cms of aoic valve.o The dissecting hematoma spreads characteristically along the laminar planes of the aoa, usually between the middle and outer third.Some times, blood reruptures into the lumen distally, i.e. there is a second tear distally. So that a complete new vascular channel is formed inside the media of aoic wall --> Blood enters from proximal tear into the media and comes out into the lumen from distal tear.o This is called double - barrel aoa with a false-channel in the media.Later on this false channel becomes endothelized --> chronic dissection.	2	Intima	Media	Adventitia	Any of the above layer	Pathology	null	a4d177f3-419e-4261-a966-cc37f54e6f03	multi
CrPC 26 -	Ans. is 'a' i.e.. Division of offenceo According to Sec 26 of CrPC, 1973, Offences under the Criminal Procedure Code (hereinafter the "CrPC1') are divided into:1. Offences under Indian Penal Code (IPC) (triable by HC, Sessions Court and other court shown in the 1st Schedule to the CrPC)2. Offences under any other law (empowers HC, when no court is mentioned for any offence under any law other than IPC, to try such offences)	1	Division of offence	Division of negligence	Division of malpractice	None	Forensic Medicine	Introduction to Forensic Medicine and Medical Jurisprudence	e499a6bf-a507-4607-ba93-119a928df307	multi
Claw hand is caused by lesion involving which of the following nerves?	Claw hand or "main en griffe", is an abnormal posture of hand with hyperextension at metacarpophlangeal joints (fifth, fouh and to a lesser extent third) and flexion at interphlangeal joints. This results from ulnar nerve leisions above the elbow or injury to the lower pa of brachial plexus, producing wasting and weakness of hypothenar muscles, interossei, and ulnar (medial) lumbricals, allowing the long finger extensors and flexor to act unopposed. Ref: Essential Ohopedics by Maheshwari 3rd Edition, Page 51; A Dictionary of Neurological Signs By Andrew J. Larner, 2010.	1	Ulnar nerve	Median nerve	Radial nerve	Posterior interosseous nerve	Surgery	null	b6c6dfc7-ea00-4e01-82f1-5eb2bce7f8ba	single
The ADA specification No 1 for composition of amalgam alloy, recommends,	null	3	65% silver, 32% tin and 3% copper	49% silver, 32% tin and 19% copper	65% silver, 29% tin and 5-6% copper	None of the above	Dental	null	baf5ed68-b5c9-4a35-99e5-536c0855fc94	multi
Oestrogen causes proliferation of	Oestrogen causes proliferation of glycogen containing superficial cells and progesterone causes proliferation of intermediate cells.	2	Intermediate cells	Superficial cells	Basal cells	Both superficial and intermediate cells	Gynaecology & Obstetrics	null	d3cd64e3-0bbb-48b8-a4e9-7b3aeb66c5c8	multi
Anterior resection is done for a patient with rectal cancer. Post operatively he presents with pain. Biopsy shows involvement of muscular wall but no penetration. Out of the 13 lymph nodes, one is involved. But the high tide lymph node is not involved. Modified duke stage	Ans. (a) C1Ref Page 1209/ Schwartz 10th editionThough there were lots of named colonic cancer staging used.All are replaced by only TNM staging now.For exam point of view we still read those outdated stagings.DukesACMACDescriptionAAALimited to mucosa, N0 B1B1Penetration into Submucosa, not through Muscularis propria, N0BB2B2Penetration through Muscularis Propria, N0 B3Adherence to adjacent organs, N0CC1C1N+, Limited to bowel wall (B1) C2C2N+, Penetrates through Muscularis propria (B2) C3N+. Adherence to adjacent organs (B3)D Distant Mets* AC -- Astler Coller* MAC -- Modified Astler Coller* N0 -- Node negative* N+-Node positive* Remember Stage C means lymphnode involvement	1	C1	C2	D1	D2	Surgery	Rectum	8a2a49ca-1248-4421-ba4b-ae69c2965424	multi
WHO prognostic score for a high-risk GTN is	Modified World Health Organization Prognostic Scoring System, as Adapted by FIGO, by which women whose score is 0-6 are Considered Low Risk (Requiring Single-Agent Chemotherapy) and score of 7 or more, High Risk (Requiring Multiagent Combination Chemotherapy)Scores0123Age<40>= 40----Antecedent pregnancyMoleAboionTerm--Interval months from index pregnancy<44-67-13>= 13Pretreatment serum hCG<10001000-1000010,000-100,000>100,000Largest tumor size --3-5 cm>= 5 cm--Site of metastasesLungSpleen, liverGastrointestinalLiver, brainNo. of metastases--1-45-8>8Previous failed chemotherapy----Single drug>= 2 DrugsReference: William's Obstetrics; 25th edition, chapter 20; Gestational trophoblastic diseases	2	>= 6	>= 7	>= 10	>= 15	Gynaecology & Obstetrics	General obstetrics	de4fce81-ce14-422b-8f68-b6c276f47f83	single
A 5 yr old male child presented with H/O recurrent infections. O/E the child has rashes as shown below. Routine blood investigation reveal patient has low platelets. Which of the following diagnosis is possible?	Wiskott Aldrich syndrome Etiopathogenesis: X linked recessive disorder Defect in WASP gene (Chr Xp11) Clinical: Characterized by recurrent infections, eczema like rash & thrombocytopenia Prolonged bleeding from circumcision site Bloody diarrhea Streptococcus pneumoniae & other bacteria having polysaccharide capsules cause otitis media, pneumonia, meningitis & sepsis Investigation findings: Thrombocytopenia with small sized platelets IgM: low IgE & IgA: elevated	2	Job syndrome	Wiskott Aldrich syndrome	Measles	Henoch Schonlein purpura	Pediatrics	Paediatrics	152b8229-eba2-4177-ba44-05e87a99be79	single
A pregnant woman with severe mitral stenosis is likely to undergo failure in the anetnatal period. Best method to prevent cardiac failure in this patient is?	Balloon mitral valvuloplasty is the best treatment to prevent failure in severe MS. The ideal time for surgery would have been the interpregnancy interval, but since the patient is already pregnant, 20 - 24 weeks is the most preferable time. However in cases of severe mitral stenosis, surgery may be performed any time during pregnancy in the interest of the mother. Other treatment includes diuretics, b blockers and limited physical activity	2	T. Furosemide through out pregnancy	Balloon mitral valvuloplasty in second trimester	Digoxin for all hea patients	Admit all at 30 weeks	Gynaecology & Obstetrics	Obstetrics	d2a5f163-4988-469b-a1b8-5a67607af0cf	multi
False statement about hemoglobin structure?	Each hemoglobin molecule is made up of:- (i) Non-protein part, i.e. heme; and (ii) Globin, which has 4 polypeptide chains (2 pairs of similar polypeptide chains). Iron of hemoglobin is in the ferrous state which lies in the center of the porphyrin ring. Myoglobin and the β-subunits of hemoglobin share almost identical structures.	1	Hb has 2 polypeptide	Iron is present in ferrous state	Hb structurally similar to myoglobin	Ferrous ions are in porphyrin rings	Biochemistry	null	570edb36-2ea3-4332-9e2f-9d7a84380ae2	multi
Calcium blocking agents of use in the treatment of hypeension include	Nifedipine The overriding action of Nifedipine is aeriolar dilation, t.p.r. decreases and BP falls.Doesn&;t depress SA node or A-V conduction.Reflex sympathetic stimulation of hea predominates leading to tachycardia, increased contractility and C.O., coronary flow is increased.Its use is associated with higher moality among post-MI patients.Relaxant effect on the bladder, Nifedipine can increase urine voiding difficulty in elderly malesContraindicationsSide effectsHea failure 2nd or 3rd-degree hea blockTachycardia, flushingGI disturbancesHyperkalemia, edema, headache(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2054-2057)	4	Prazosin	Lidoflazine	Captopril	Nifedipine	Pathology	All India exam	77c8d088-aa1e-47ac-ba0a-dcf7fa6aeb6f	single
Term 'schizophrenia' was coined by:TN 06; Ranchi 10; NEET 13	Ans. Eugene Bleuler	1	Eugene Bleuler	Kraepelin	Freud	Schneider	Forensic Medicine	null	7d522951-4753-48eb-a991-e28526373fe4	single
Which of the milestone develops first –	A child enjoys watching his own image in the mirror (mirror play) by 6 months. A child crawls in the bed by 8 months. Full creeping and crawling develop by 10 months. Pincer grasps develops by 9 months.	1	Mirror play	Crawling	Creeping	Pincer grasp	Pediatrics	null	e2a52764-12ce-486f-ac9d-6658523eed8f	single
A 40-year-old lady with temporal field defects and galactorrhoea is most likely to have -	Temporal field defects in women with galactorrhoea suggests pituitary macroadenoma. Increased secretion of prolactin causes amenorrhoea, galactorrhoea and the mass effect of the tumour on the optic nerve produces headache and visual field defect.	1	Pituitary macroadenoma	Craniopharyngioma	Lactational failure	Pregnancy	Medicine	null	8b35c055-0318-4a2c-bba6-75636b5e09ef	single
The following general anaesthetic causes characteristic 'dissociative anesthesia':	The characteristic state observed after an induction dose of ketamine is known as "dissociative anesthesia," wherein the patient's eyes remain open with a slow nystagmic gaze (cataleptic state). If ketamine is administered as the sole anesthetic, amnesia is not as complete as with the benzodiazepines. Reflexes are often preserved, but it cannot be assumed that patients are able to protect the upper airway. The eyes remain open and the pupils are moderately dilated with a nystagmic gaze . Frequently, lacrimation and salivation are increased. Ref: Eilers H., Yost S. (2012). Chapter 25. General Anesthetics. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e.	3	Thiopentone	Althesin	Ketamine	Barbiturate	Anaesthesia	null	805fb388-be9b-406a-b8ab-d1c8d0c94472	single
3 year old child with red scrotal swelling which shows self resolution by next day morning and maximum in evening with positive transillumination test. Diagnosis:	Ans. (b) Congenital hydroceleRef: Bailey & Love 26th ed. /1382* Hydrocele is an accumulation of fluid in layers of tunica vaginalis.* Vaginal hydrocele: MC type. Accumulation of fluid within tunica vaginalis layers* Infantile hydrocele: doesn't necessarily appear in infants. The tunica and processus vaginalis are distended to the inguinal ring without any connection with peritoneal cavity.* Congenital hydrocele:# It is due to patent processus vaginalis which allows peritoneal fluid to move freely.# Size of hydrocele fluctuates usually related to activity# Treatment: herniotomy	2	Scrotal abscess	Congenital hydrocele	Secondary abscess	Infantile hydrocele	Surgery	Inguinal Hernias	e96c8f49-bd1c-4476-bbfa-4e468181a3be	single
A 5 year old girl came with history of progressively increasing pallor since bih and hepatosplenomegaly. Which of the following is the most relevant test for achieving diagnosis -	<p>Hb electrophoresis helps to confirm beta thalassemia (Hb F increased ,HbA2 increased ). </p><p>Reference :Harsh mohab textbook of pathology sixth edition pg no 322.</p>	1	Hb electrophoresis	Peripheral smear examination	Osmotic fragility test	Bone marrow examination	Medicine	Haematology	582ba6ec-4ad2-4166-83f4-ed9643560d45	multi
Conjunctival mucosal overgrowth over cornea-	Pterygium is a degenerative conjunctival fold which encroaches on the cornea in the palpebral area. It must be differentiated from pseudopterygium (an inflammatory fold of conjunctiva encroaching on cornea).Pterygium (L. Pterygion = a wing) is a wing-shaped fold of conjunctiva encroaching upon the cornea from either side within the interpalpebral fissure ref: A K KHURANA OPHTALMOLOGY,E4, Page-80 ref img	1	Pterygium	Pingecula	Vernal keratoconjunctivitis	Herbe's pit	Ophthalmology	Conjunctiva	3c2f22cc-ad0f-4898-8ca4-3616fd8bc167	single
A female developed ovarian hyperstimulation syndrome during the treatment of infeility. What is the MOST common cause of ovarian hyperstimulation?	Ovarian hyperstimulation syndrome (OHSS): It is a clinical symptom complex associated with ovarian enlargement resulting from exogenous gonadotropin therapy. Symptoms may include abdominal pain and distension, ascitis, gastrointestinal problems, respiratory compromise, oliguria, hemoconcentration, and thromboembolism. These symptoms may develop during ovulation induction or in early pregnancies that were conceived through exogenous ovarian stimulation. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 20. Treatment of the Infeile Couple. 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	FSH/LH therapy	GnRH drugs	Clomiphene	Danazol	Gynaecology & Obstetrics	null	e7339d15-f4f7-4ecf-8113-ea6272485cbd	single
Lymphatics of suprarenal gland drain into______ lymph nodes	Ans. b (Para-aortic nodes) (Ref BDC vol. 2 /4th/307)Lymphatics of adrenal/suprarenal gland drain into lateral/para-aortic nodes.Lymphatic Drainage of the Suprarenal Glands# The lymph vessels arise from a plexus deep to the capsule and from one in the medulla.# Most of lymphatics that leave the suprarenal glands end in superior lumbar (lateral aortic) lymph nodes.# The two main lymph node groups of the abdomen are closely related to the aorta. These comprise the pre-aortic and para-aortic groups.# The pre-aortic nodes are arranged around the three ventral branches of the aorta and consequently receive lymph from the territories that are supplied by these branches. This includes most of the gastrointestinal tract, liver, gall bladder, spleen and pancreas. The efferent vessels from the pre-aortic nodes coalesce to form a variable number of intestinal trunks that deliver the lymph to the cistema chyli.# The para-aortic nodes are arranged around the lateral branches of the aorta and drain lymph from their corresponding territories, i.e., the kidneys, adrenal, gonads and abdominal wall, as well as the common iliac nodes. The efferent vessels from the para-aortic nodes coalesce to form a variable number of lumbar trunks which deliver the lymph to the cisterna chyli.# Cisterna chyli: is a lymphatic sac that lies anterior to the bodies of the LI and L2. It is formed by the confluence of the intestinal trunks, the lumbar trunks and lymphatics from the lower thoracic wall. It reseives lymph from the abdomen and lower limbs which is then drained into beginning of L. Brachiocephalic vein.Additional Educational points:Arterial Supply of the Suprarenal Glands1. The aorta (one or more middle suprarenal arteries):2. The inferior phrenic artery (6-8 superior suprarenal arteries);3. The renal artery (one or more inferior suprarenal arteries).Venous Drainage of the Suprarenal Glands# These glands are drained mainly be a single, large suprarenal vein.# The right one drains into the IVC.# The left one joins the left renal vein.# There are also many small veins that accompany the suprarenal arteries.Innervation of the Suprarenal Glands# These glands have a rich innervation from the adjacent coeliac plexus and the greater thoracic splanchnic nerves.# These preganglionic sympathetic fibres pass through the hilum and synapse on cells in the medulla.# The suprarenal cortex receives only a vasomotor nerve supply.	2	Internal iliac	Para-aortic	Superficial inguinal	Coeliac	Anatomy	KUB & Adrenal Gland	3e028cce-7825-488a-9801-9b2851eba6a6	single
Most common nerve injured in ligation of sup thyroid artery -	The external laryngeal nerve lies in relation to superior thyroid artery. The recurrent laryngeal nerve lies close to superior laryngeal artery.	4	RLN	Facial N.	Mandibular M.	External laryngeal nerve	ENT	null	f4623db5-ce8a-4ef7-9757-a577e089590b	single
Burn caused by moist heat is known as:	null	1	Scalds.	Scars.	Ordinary burn.	None.	Surgery	null	60c99d7a-f832-4a1a-b1c9-796f9860da16	multi
In central serous retinopathy-	Ans- A Ref- Central serous chorioretinopathy is when fluid builds up under the retina. This can distort vision. The fluid leakage comes from a layer of tissue under the retina, called the choroid. There is another layer of cells called the retinal pigment epithelium (RPE). When the RPE doesn't work as it should, fluid builds up under the RPE. As a result, a small detachment forms under the retina, causing vision to become distorted. This image from an OCT scan shows how central serous retinopathy (also called central serous choroidopathy) causes a blister-like swelling in layers of the retina.	1	Often shows focal leakage on fluorescein fundus photography	A macular hole is a common end result	The image perceived by the patient on the affected side in unilateral cases is bigger than on the normal side	A dense central scotoma is the most common presentation	Unknown	null	aeef69e2-0427-4278-9325-3d03bc73f83c	single
Lens derives nutrition from	Lens being an avascular structure receives its nutrition from the aqueous like glucose salts, etc, by diffusion processRef: Parsons diseases of the eye; Under the heading lens	2	Vitreous	Aqueous	Optic aery	Ophthalmic aery	Physiology	Nervous system	00cb04ae-97ba-4b21-bb5f-786ac9857b93	single
Halofantrine is used for -	Ans. is 'a' i.e., Falciparum Malaria o It is mainly used for multidrug resistant falciparum malaria.	1	Falciparum malaria	Visceral leishmaniasis	Leprosy	Amoebiasis	Pharmacology	null	e52dcade-6f4e-4d8a-ad21-c15bdcf2acd3	single
Hormones with increased production during the day and less in nights is/are:	null	4	ACTH.	Cortisol	Insulin	All of the above.	Physiology	null	1ff76bee-8551-43b8-b596-3f84cf1e5cc4	multi
Propranolol can be used in all of the following conditions EXCEPT:	null	2	Thyrotoxicosis	Variant angina	Migraine	Hypertension	Pharmacology	null	1878b309-9716-427f-b311-f5e5d0ac034b	multi
For which of the following enzymes, thiamine pyrophosphate (TPP) acts as Cofactor	null	4	Pyruvate Dehydrogenase	Alpha Ketoglutarate dehydrogenase	Branched chain ketoacid dehydrogenase	All of the above	Biochemistry	null	29d47018-26d2-47e0-9d1e-1470d28ec9e4	multi
A 7 year old boy is referred to a specialty clinic because of digestive problems. He often experiences severe abdominal cramps after eating a high fat meal. He is worked up and diagnosed with a genetic defect resulting in a deficiency of lipoprotein lipase. Which of the following substances would most likely be elevated in this patient's plasma following a fatty meal?	After eating a high fat meal, triglycerides are processed by the intestinal mucosal cells. They are assembled in chylomicrons and eventually sent into the circulation for delivery to adipocytes and other cells. Chylomicrons are too large to enter cells, but are degraded while in the circulation by lipoprotein lipase. A defect in this enzyme would result in the accumulation of chylomicrons in the plasma. Albumin-bound free fatty acids (choice A) is incorrect because fatty acids leave the intestine esterified as triglycerides in chylomicrons. HDL is not a carrier of dietary fat from the intestine. LDL would be not be elevated in this patient after a high fat meal. However, VLDL would be elevated if the patient ate a high carbohydrate meal. In this situation, the carbohydrate would be conveed into fat in the liver and sent out into circulation as VLDL. VLDL would be unable to be degraded to LDL and, therefore, would accumulate. Ref: Botham K.M., Mayes P.A. (2011). Chapter 25. Lipid Transpo & Storage. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.	2	Albumin-bound free fatty acids	Chylomicrons	HDL	LDL	Biochemistry	null	504b69fd-13d3-4579-80a4-a6637e715040	single
The fastest dental film currently available has the speed rating of	null	3	"D" speed	"C" speed	"F" speed	"E" speed	Radiology	null	16b7dee9-fb45-4bd5-8bb7-c9af6089c51c	single
Tinel sign is indicative of	Tinel's sign : It records regeneration of nerve by Tapping on the nerve course from distal to proximal direction, tingling sensation is felt at the sprouting nerve ends till the distal course of the nerve (law of Projection)	3	Axonal conduction	Diffuse axonal injury	Axon degeneration	Muscle ischaemia	Physiology	null	97f216ae-84dc-4897-a3dc-8f4585a8e1cb	single
A 7 year old female child is brought to you with features of precocious pubey. On examination she has features of virilisation and is hypeensive. Which of the following enzyme deficiency is responsible for her condition?	The features of 11 - hydroxylase deficiency in a female are precocious pubey, hypeension, virilization etc. Also know: 1) Hypeension occurs in 17 - hydroxylase and 11 - hydroxylase deficiency 2) Male pseudohermaphroditism occurs in 17 - hydroxylase and 3b-hydroxysteroid dehydrogenase deficiency 3) Female pseudohermaphroditism is seen in 21- hydroxylase and 11- hydroxylase deficiency. Ref: Ganong, Edition 20, Page - 353	2	21 - hydroxylase	11 - hydroxylase	17 - hydroxylase	3b- hydroxy steroid dehydrogenase	Physiology	null	02eed3c7-c2dc-46b2-9039-6ac4456cb675	single
A 2.5-week-old boy is brought to pediatrics emergency depament with projectile vomiting which is non-bilious. On physical examination, firm, olive like mass is noted in the epigastric region and USG revealed the following findings. The child underwent surgical management. On week later, the child presents again with loose stools after being breastfeed. What could be the etiology of the current episode diarrhea?	The clinical symptoms, examination with USG findings of thickened pyloric muscle (>3mm) and elongated pyloric canal (>15mm) reveal the diagnosis as CHPS- congenital hyperophic pyloric stenosis. The management image represents surgical pyloromyotomy. Post surgical management - pyloric sphincter dysfunction leads to delivery of hyperosmotic chyme from stomach to small intestine, which it cannot process leading to OSMOTIC DIARRHEA. This is known as DUMPING syndrome and is responsible for the week's later symptoms.	3	Post-operative infection	Rotavirus	Dumping syndrome	Non resolution of the pre-op symptoms	Unknown	Integrated QBank	3f41c320-2535-4f7a-b0b5-42407e015b8c	single
Commonest site of meningocele is	• Herniation of meninges through a defect in the posterior vertebral arches. • Spinal cord is usually normal and assumes a normal position in the spinal canal • There may be tethering, syringomyelia, or diastematomyelia. Clinical Features • A fluctuant midline mass, that may transilluminate occurs along the vertebral column, in the lower back. • Most meningoceles are well covered with skin and pose no threat to the patient. • Anterior meningocele: Projects into pelvis through a defect in the sacrum. • Symptoms of constipation and bladder dysfunction develop due to the increasing size of the lesion. Diagnosis • Plain roentgenograms demonstrate a defect. Treatment • Asymptomatic children with normal neurologic findings and full-thickness skin covering the meningocele may have surgery delayed. • Patients with leaking CSF or a thin skin covering should undergo immediate surgical treatment to prevent meningitis.	1	Lumbosacral	Occipital	Frontal	Thoracic	Surgery	null	7f4e055e-a49f-45bc-81b4-adc0a9e45953	single
P. carini causes infection primarily in?	Pneumocystis jirovecii causes infection Primarily in Rats. Pneumocystis jirovecii (previously P. carinii) is the causative organism of Pneumocystis pneumonia paicularly among immunocompromised hosts. P. jiroveci causes PCP in human with HIV if, their CD4+ cells count below 200/uL.	1	Rats	Guinea pig	Rabbits	Humans	Microbiology	Mycology	043dd197-d08f-410a-9e68-e643a52f8c0b	single
An anganwadi worker is trained for -	-under ICDS Scheme, there is an anganwadi worker for a population of 400-800. - anganwadi worker is selected from the community itself - undergoes a training in various aspects of health, nutrition and child development for 4 months. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:903 <\p>	2	3 months	4 months	5 months	6 months	Social & Preventive Medicine	Health education & planning	b4816029-73d3-4c73-af3a-df1cddbe4fa5	single
Mycoplasmas differ from chlamydiae in that they are	Mycoplasmas lack a rigid cell wall and are bound by a triple-layer unit membrane. For this reason, they are completely resistant to the action of penicillins. Unlike the chlamydiae, they can replicate in cell-free media.	2	Susceptible to penicillin	Able to grow on artificial cell-free media	Able to cause urinary tract infection	Able to stain well with Gram's stain	Microbiology	Bacteria	0ef38e3e-5f3c-4479-b410-4dd92af8a7eb	single
Pneumatoceles often develop in children after pneumonia due to the following organism	Radiological signs are extensive in a form of massive consolidation.E.coli,Klebsiella ,staphylococcus pneumonia have pneumatoceles. Ref : Essential pediatrics,O.P.Ghai,7 th edition,pgno:355	3	Klebsiella	Streptococcus	Staphylococcus aureus	Haemophilus influenzae	Pediatrics	Respiratory system	4f07ac95-23f6-422b-a9ce-6611c5175be9	single
The following drug penetrates into caseous necrosis in TB-	Ans- B RIFAMPICIN: 1.most effective anti- tubercular drug 2.Most bactericidal antitubercular drug 3.Only bactericidal drug effective against persisters or dormant bacilli in solid caseous lesson 4.Acts on extracellular as well as intracellular organisms 5.Antitubercular drug causing rapid sputum conversion 6.Antitubercular drug causing orange discoloration of urine ISONIAZID: 1.First effective bactericidal drug used to treat tuberculosis 2.Maybe bacteriostatic at lower concentrations 3.Most toxic antitubercular drug 4.Antitubercular drug first to develop resistance STREPTOMYCIN: 1.Injectable antitubercular drug 2. Antitubercular drug contraindicated in pregnancy 3.Antitubercular drug causing vestibular damage ETHAMBUTOL 1.Antitubercular drug contraindicated in children < 6 years age 2. Antitubercular drug causing Optic neuritis(red-green color blindness)	2	INH	Rifampicin	Pyrazinamide	Streptomycin	Unknown	null	c65619f0-aeb3-46f1-8b3b-9671a864e084	single
Type I MEN involves all except-	MEN type 1 (MEN 1), which is also referred to as Wermer's syndrome, is characterized by the triad of tumors involving the parathyroids, pancreatic islets (gastrinomas, insulinomas, nonfunctioning and PPoma, glucagonoma, VIPoma) and anterior pituitary (prolactinoma, somatotrophinoma, coicotropinoma, nonfunctioning). Reference : page 2335-36 Harrison's Principles of Internal Medicine 19th edition	2	Pancreas	Adrenal	Pituitary	Parathyroid	Medicine	Endocrinology	6d072e93-1c1d-4e18-8bae-9a2c9e9ca45a	multi
Ectopic tissue in stomach is of the origin of	Pancreatic tissue outside boundaries of the pancreas without anatomic or vascular connections to the pancreas, Also called ectopic pancreas. Ectopic pancreas can be found in submucosa of stomach, duodenum or small intestine, gallbladder, spleen Reference Bailey and love&;s edition 24 page no .1120	2	Spleen	Pancreas	Liver	Kidney	Surgery	G.I.T	fa57122c-520b-4f0b-b527-aba74c9f3cc8	single
True statement about burn resuscitation -	Ans. is 'c' i.e.. Half of the calculated fluid given in initial 8 hrs. o Proper fluid management is critical to survival in a bum patient.o The hypovolemic shock in bum patient is special in the sense that the total body water remains unchanged in a burn patient. The thermal injury leads to a massive fluid shift from intravascular compartment to the extravascular compartment (interstitial -fintacellular) leading to edema formation (in both burned parts and non burned parts of body).o This fluid shift is maximum in the first 24 hrs.o Fluid resuscitation begins with an isotonic crystalloid solution- Ringer's lactate solution (RL) is the preferred solution (Normal saline should be avoided as the volumes required for resuscitation may lead to hyperchloremic metabolic acidosis). The concept behind the continuous fluid resuscitation is that the bum (and/or inhalation injury) drives an inflammatory response that leads to capillary leak; as the plasma leaks into the extravascular space, crystalloid administration would maintain the intravascular volume.The quantity of crystalloid needed for adequate resuscitation is determined by Parkland formula i.e., 4 mL/kg per % of TBS A bum. (Note that a number of formulas exist for calculating fluid needs during burn resuscitation, suggesting that no one formula benefits all patients. Parkland is one of the most commonly used formulas).Half of the calculated fluid is given in first 8 hrs and half in next 16 hrs.o Colloids are given in the next 24 hrs. The reason behind it being the observation that in the initial period, the vascular permeability is so large that even larger protein molecules leak from the capilaries. (But some workers, prefer to use colloids after 8 to 12 hrs, while there are some who use it from the very beginning),o A number of parameters are widely used to assess bum resuscitation, but the most common remain the simple outcomes of blood pressure and urine output. As in any critically ill patimt, the target MAP is 60 mitiHg to ensure optimal end-organ perfusion. Goals for urine output should be 30 mL/h in adults and 1 to 1.5 mL/kg per hour in pediatric patients.o There is no use of diuretics in bum resuscitation.o Children under 20 kg have the additional requirement as they do not have sufficient glycogen stores to maintain an adequate glucose level in response to the inflammatory' response. Specific pediatric formulas have been described, but the simplest approach is to add maintenance IV fluid with glucose supplementation in addition to the calculated resuscitation fluid with lactated Ringer's.	3	Colloid preferred in initial 24 hrs	Colloid preferred if burnt area is > 15 % of total BSA	Half of the calculated fluid given in initial 8 brs.	Urine output should be maintained at 50-60 mL/hr.	Surgery	Initial Care of the Burn Patient	abbea89c-f90f-4766-9fe2-a86f05ca5ffd	multi
Hypeension is seen with all except	levodopa Drug causing hypeension * Cocaine * MAO Inhibitors * Cyclosporine * Glucocoicoids * Oral contraceptives * Tricyclic antidepressants * NSAID, Rofecoxib * Sympathomimetics Ibuprofen, Naproxen * Clonidine withdrawl * Decongestants (pseuodephedrine) * Erytlu-opoietin Drugs causing hypotension * Theophylline * Adenosine * Morphine * Quinidine * Fosphenytoin * Amiodarone * 1L-2 * Guanethidine * Alphablockers * Beta blockers (i.v.) * Bretylium * Chlorpromazine * Glyceryltrinitrate * Clonidine * Diuretics * Calcium channel blockers	4	Erythropoietin	Cyclosporine	NSAID	Levodopa	Pharmacology	null	36e3cace-10a3-4e77-9d66-76bc1423bd24	multi
Frequency distribution is studied by	Ans. is 'a' i.e., Histogram	1	Histogram	Line diagram	Pie diagram	Ski diagram	Social & Preventive Medicine	null	62d267e2-0b0c-43ef-ae45-f18f67c06cb2	single
All are features of psychosis except ?	Ans. is 'c' i.e., Preserved contact with reality Psychosis Psychosis is a mental state involving the loss of contact with reality, causing deterioration of normal social functioning. The characteristic features of psychosis are : - Gross impairment in reality testing, i.e., loss of contact with reality. Marked disturbance in personality and behavior with impairment in social, interpersonal and occupational functioning. Marked impairment in judgement. Loss of insight (insight is an assessment of how aware the patient is of their own mental illness). Presence of characteristic symptoms like delusions and hallucinations, these are called psychotic symptoms. The major psychosis are : ? Organic psychotic disorders, e.g., Delirium, substance related psychosis, head trauma. Non-organic psychoses Major psychoses : - Schizophrenia, mood disorders (depression, mania, bipolar). Other psychotic disorders ( third psychosis): - Delusional disorders, acute and transient psychotic disorders, schizoaffective disorder Neurosis Neurosis is a general term referring to mental distress that, unlike psychosis, does not prevent rational thought and daily functioning. Characteristic features are : - Symptoms cause subjective distress to the patient. Insight is present (symptoms are recognised as undesirable). The personality and behaviour are relatively preserved as is the judgement. The contact with reality is preserved. Absence of organic causative factor Impoant neurotic disorders are Anxiety disorders (Panic), Phobia (Phobic anxiety disorder), obsessive compulsive disorder, Dissociative conversion disorder.	3	Loss of insight	Presence of delusions	Preserved contact with reality	Personality disturbances	Psychiatry	null	bf4e3d0f-cafb-4200-8921-beb13c9b3abe	multi
Most commonly injured tarsal bone ?	Ans. is 'd' i.e., Calcaneum Calcaneum is the most commonly fractured tarsal bone In 5-10% of cases fracture is bilateral Most common mechanism of injury is fall from height, often from a ladder, onto one or both heels. The calcaneum is driven up against the talus and is split or crushed. About one fifth of these patients suffer associated injuries of the spine, pelvis or hip. Calcaneal fracture is also known as Voveri fracture' Plain x-rays done for calcaneal fracture include lateral, oblique and axial views. Axial view of calcaneum is also called Hark view. CT is the investigation of choice With severe injuries and especially with bilateral fractures - it is essential to take x-ray the knees, the spine and the pelvis as well.	4	Talus	Navicular	Cunieform	Calcaneum	Surgery	null	a1307734-9b5e-4700-90d8-c6063fc1cdd4	single
Boxer's fracture is -	Ans. is 'c' i.e., 5th metacarpal fracture EponymFractures of Upper limbMontegia fracture dislocationFracture of the proximal third of ulna with radial head dislocation.Galeazzi fracture dislocationFracture of the distal third of the radius with dislocation of the distal radio-ulnar joint.Colie's fractureFracture at cortico-cancellous junction of the distal-end of radius with dorsal tilt.Bennet's fractureOblique intra-art icular fracture of the base of the 1st metacarpal.Night stick fractureIsolated fracture of the shaft of the ulna.Smith's fractureA fracture of distal end of radius at cortico-cancellous junction with ventral tilt and displacements (reverse Colle's fracture).Barton's fractureA vertical, marginal intra-articular fracture of the distal end of radius occurring with volar or dorsal displacement.Chauffeur fractureAn intra-articular oblique fracture of the styloid process of the radiusBoxer's fractureA fracture through the neck of the 5th metacarpal.	3	Radial styloid fracture	Reverse colle's fracture	5 th metacarpal fracture	1st metacarpal fracture	Orthopaedics	Fractures of Metacarpals, Phalanges, Metacarpo-Phalangeal Joints	ee1b31b7-e393-4807-890c-072f459f80e2	single
Drug of choice for treponema is:	Pencillin	1	Pencillin	Tetracycline	Azithromycin	Doxycycline	Pharmacology	null	88a1e801-313d-48c8-bdca-4451c6f3a9c2	single
Sensations of spinothalamic tract are:	Ans: a (Pain, temperature & undifferentiated touch)Ref: Ganong, 22nd ed Pg.141Dorsal column transmits:Anterior spinothalamic tract transmits:Fine touchCrude touchVibrationPressureJoint position sense Lateral spinothalamic tract transmits:Cortical sensations:PainTactile localisationTemperatureTwo point discriminationStereognosisSensory inattentionGraphaesthesia	1	Pain, temperature & undifferentiated touch	Static proprioception	Temperature only	Proprioception	Physiology	Nervous System	7bbb8f08-2700-4820-94bd-b52d4bf160db	single
Which of the following causes opening of eustachian tube	The medial fibres of tensor veli palatine are attached to the lateral lamina of the tube and when they contract they help to open the tube lumen. These fibres also called dilator tube muscles. Reference: Dhingra 6th edition.	3	Salpingopharyngeus	Levator veli palatine	Tensor veli palatine	None of the above	ENT	Ear	9e28d7df-c3b9-479b-874a-b7cef9fa1f91	multi
A young lady presented with white lacy lesions in oral cavity and her proximal nail fold has extended onto the nail bed. What is the likely diagnosis –	Presence of white lacy lesions in the oral cavity and proximal nail fold prolonged on to nail bed (pterygium) suggest the diagnosis of lichen planus.	3	Psoriasis	Geographic tongue	Lichen planus	Candidiasis	Dental	null	de00ead6-545f-4c86-9b69-97d33f48c9e7	single
Postmoem rigidity FIRST stas in which of the following organs?	Postmoem rigidity is first apparent in the smaller muscles eg eyelids and jaw, and then it becomes evident in the remainder. Typically it is seen first in the face, then it progresses to shoulders and and finally in the large muscle groups of the limbs (Nysten's rule). In the initial 30 minutes after death there is no rigidity. Between 30min and 3 hrs after death, rigidity affects the face and eye muscles. By 6hrs rigidity affects all muscle groups and remains so for 24-36 hrs after death. From the time of 24 hr onwards rigidity stas to diminish with muscles becoming flaccid again from the time of around 36 hours. Ref: Oxford Handbook of Forensic Medicine By Tim Squires, page 33.	1	Eyelids	Neck	Upper limbs	Lower limbs	Forensic Medicine	null	968ccd8d-248b-4f2f-b245-fb597e165def	single
Budd Chiari syndrome is due to thrombosis of -	null	4	Infra renal IVC	Renal part of IVC	Superior mesentric vein thrombosis	Hepatic veins	Surgery	null	80f17643-941f-4fd4-aa78-14f8084cf1fc	single
What is the GFR (mL/min per 1.73m2) of a patient who is in G4 category of chronic kidney disease	Reference: Harrison's Principles of Internal Medicine; 20th edition; Chapter 335 Chronic Kidney Disease , pg 2112	3	60-89	30 - 59	15 - 29	< 15	Medicine	C.V.S	c804ecaf-25a9-433c-bfcf-be3d596c2d4a	single
Which of the following is the least common cause of ambiguous genitalia in a female child –	Placental steroid sufatase deficiency is an X-linked disorder (affects only males) that does not lead to ambiguous genitalia in a female child. 'Placental steroid suflatase deficiency is a rare X-linked disorder and all affected fetuses are males' William's 22nd/81 Congenital adrenal hyperplasia is the most common cause of ambiguous genitalia in female child. Fetal placental aromatase deficiency and WNT-4 gene mutation cause ambiguous genitalia in female child.	1	Fetal placental steroid sulfatase deficiency	Fetal placental aromatase deficiency	Congenital adrenal hyperplasia	WNT–4 gene mutation	Pediatrics	null	fdcb8163-fd65-40a7-b2e7-f3017e189ac2	single
Molar pregnancy can be best diagnosed by	USG is the investigation of choice for molar pregnancies.	2	Clinical history & examination	Ultrasound study	Laproscopy	CT Scan	Radiology	null	81ae860a-0f78-4870-b8b9-5f54a533b966	single
Minimum time of diagnosis for manic illness: DNB 10; AIIMS 14	Ans. 1 week	1	1 week	1 month	1 year	2 years	Forensic Medicine	null	792fe63e-edec-4623-a6dc-4ca14796de86	single
All of the following metabolic process occur in the mitochondria, EXCEPT:	Fatty acid and triacylglycerol synthesis occur in the cytoplasm, but its precursor acetyl CoA is formed in the mitochondrial matrix. Beta oxidation of fatty acid occur in the matrix of the mitochondrion. Beta oxidation begins as soon as fatty acyl CoA appear in the matrix using repeated cycle of 4 steps. With each step fatty acyl CoA is broken down into new fatty acyl CoA shoened by two carbon atoms plus an acetyl CoA. Gluconeogenesis occur in the cytosol but depends on the mitochondrial compament for its staing substrate oxaloacetate. Functional compamentalisation of metabolism: Mitochondria: Beta oxidation of fatty acids Amino acid oxidation TCA cycle Urea cycle Peroxisomes: Oxidation of long chain fatty acids and D amino acids Synthesis of some lipids Cytoplasm: Glycolysis Glycogen generation and storage Fatty acid synthesis Urea cycle Gluconeogenesis Ref: Biochemistry By John W. Pelley, page 81. Biochemistry Primer for Exercise Science, 4E By Peter Tiidus, page 220, Mitochondria in Health and Disease edited by Carolyn D. Berdanier page 27.	4	Urea cycle	TCA cycle	Beta oxidation of fatty acids	Fatty acid synthesis	Biochemistry	null	d2f83333-6750-429e-9c39-49d49d15f791	multi
All of the following are features of flat type of pelvis except: (Repeat)	Ans: A (Narrow subpubic angle) Ref : Grays Anatomy 40th Ed pg.1329Explanation:All pelvic measurements display individual variation and the values quoted are means from limited surveys.Sexual and racial differences also occur.Many attempts to classify human pelves, especially female.The four most common terms used today are gynaecoid, anthropoid, platypelloid and android.GynaecoidThe gynaecoid pelvis is the traditional Western female pelvis with a heart-shaped brim and the range of measurements quoted above.Anthropoid pelvisAn anthropoid pelvis has a larger midcavity and a wide anteroposterior inlet which is oval in shapeIt is more common in women of African origin and may be associated with a 'high assimilation' pelvis where there is an additional lumbar vertebra.Platypelloid pelvisA platypelloid pelvis is flat and oval from side to side at the brimit is a contracted pelvis that is rarely seen nowadays, having previously been associated with rickets.Android pelvisAn android pelvis has a triangular brim and is the shape of a male pelvis.	1	Narrow subpubic angle	Short concave sacrum	Divergent side walls	Wide sciatic notch	Anatomy	Misc.	16a22945-f67c-4a21-a166-79f922d56219	multi
Most common site of genital tuberculosis is :	Fallopian tubes	3	Abdomen	Pulmonary	Fallopian tubes	Ovary	Gynaecology & Obstetrics	null	62075103-dca3-4de1-8bec-cd92b9c5b3b7	multi
All are the methods of Aerial blood pressure monitoring except	Cardiovascular monitoring Noninvasive Aerial Blood Pressure monitoring methods : Palpation Doppler Auscultation Oscillometry Aerial Tonometry Invasive Aerial Blood Pressure monitoring method Aerial cannulation ( eg : radial, ulnar, femoral ,etc) Pulmonary aery catheterization Central venous catheterization Cardiac output measurement Thermodilution Dye Dilution Pulse Contour Devices Esophageal Doppler Thoracic Bioimpedance Fick Principle Echocardiography Transthoracic echocardiography (TTE) Transesophageal echocardiography (TEE) Capnography : It is Non Cardiovascular monitoring method	1	Capnography	Radial aery cannulation	Oscillometry	Aerial Tonometry	Anaesthesia	Monitoring in Anesthesia	28f0d37e-ceae-419c-86fb-ad57af6abb6e	multi
Coccobacillus grown in BYCE medium is	Coccobacllus which have fatidious requirements and grow on complex media such as buffered charcoal,yeast extract (BYCE) agar,with L_cysteine and antibiotic supplements with 5%CO2 at PH_6.9, temperature 35degC and 90% humidity is legionella. Ref: anantnarayan and panikers 10 th edition	1	Legionella	Streptobacillus	Gardenella	Neisseria	Microbiology	Bacteriology	b862db84-7194-47d1-b313-574c620b216e	single
Fructose absence in semen analysis suggests:	Abnormalities Low ejaculate volume may indicate: Retrograde ejaculation Ejaculatory duct obstruction Incomplete collection Androgen deficiency Azoospermia: Testicular failure Obstruction of vas deferens Absence of fructose: Seminal vesicle agenesis or obstruction	2	Bilateral vas deferens obstruction	Seminal vesicles agenesis	Testicular failure	Prostatic urethral obstruction	Surgery	Prostate and seminal vesicles	47761127-3ba6-4f47-b49b-dc4fa6481606	single
Oschner Sherren regimen is for	Ans. b (Appendicular mass). (Ref. Bailey & Love, 25th ed., 1215)APPENDICULAR MASS# Following an attack of acute appendicitis infection is sealed off by greater omentum, caecum, terminal ileum, etc resulting in a tender, soft to firm appendicular mass.# Presence of appendicular mass is a contraindication for appendicectomy due to risk of faecal fistulae.# It is treated by Oschner & Sherren's regime, which includes:1. Aspiration with Ryle's tube to give rest to GIT.2. Bowel care (avoid purgatives).3. Charts--temperature, pulse, respiration, diameter of mass.4. Drugs--to cover all organisms.5. Exploratory laparotomy contraindicated.6. Fluid-IV (patient kept nil orally for few days).7. Swinging temperature & increased in size of mass indicate abscess.Criteria for stopping conservative treatment of an appendix mass include A rising pulse rate , Increasing or spreading abdominal pain and Increasing size of the mass	2	Appendicular abscess	Appendicular mass	Acute appendicitis	Appendicular mucocele	Surgery	Vermiform Appendix	b1c4bff6-5bc6-4606-8bc2-3775c1929959	single
An old woman, Nanda suffered stroke for which she was given alteplase. She improved considerably. To prevent the recurrence of stroke, this patient is most likely to be treated indefinitely with :	null	1	Aspirin	Warfarin	Urokinase	Enoxaparin	Pharmacology	null	b0533019-b11a-49e5-b43b-bbc96dc23fb9	single
A 35-year-old mother of two children is suffering from amenorrhea from last 12 month. She has a history of failure of lactation following second delivery but remained asymptomatic thereafter. Skull X-ray shows empty sella diagnosis is:	Ans. is c, i.e. Sheehan's syndromeRef: Williams Gynae 1st/ed, p374; Leon Speroff 7th/ed, p438; Jeffcoate 7th/ed, p582-583Here before arriving to any diagnosis lets first see the causes of:Empty Sella:* Congenital incompleteness of the sellar diaphragm.* Secondary to surgery/radiotherapy or infarction of pituitary tumor.* Secondary to infarction and necrosis of pituitary gland.Now from the given causes: either pituitary tumor or Sheehan's syndrome can cause an empty sella on X-ray.Pituitary tumours (micro/macroadenoma) are prolactin secreting tumors and hence, cause galactorrhea (not lactational failure) with amenorrhea and are so, ruled out.So, the obvious answer by exclusion is Sheehan's Syndrome.Sheehan's syndrome:* It is the syndrome which results from ischemic necrosis of most of the anterior pituitaryQ due to spasm in its arterioles occurring at the time of severe hemorrhage or shock, complicating childbirth.Clinical Features: SymptomsQ* Failure of lactation after deliveryQ* Secondary amenorrheaQ* Loss of libidoQ* Increased sensitivity to cold (hvpothyroidism)Q Remember \| Amenorrhea With failure to lactate With galactorrhea, headache and blurring of vision\| \|Think sheehan's syndrome Think prolactinoma	3	Menopause	Pituitary tumor	Sheehan's syndrome	Intraductal papilloma of breast	Gynaecology & Obstetrics	Disorders in Menstruation	f3598aa2-94b1-4f48-a9fa-f6e0fd87c3e7	single

Mc Murray's osteotomy is done for-

*Mc Murray's osteotomy and Meyer's procedure (muscle pedicle graft) are used for non-union transcervical neck fracture of femur. INDICATIONS: 1. Nonunion of femoral neck 2. Advanced osteoahritis . PREOPERATIVE PLANNING : Determination of the size of the bone wedge to be removed, the position of the seating chisel which will determine the size and angle of the blade plate to be used. AIM : o Line of weight bearing is shifted medially Shearing force at the nonunion is decreased, because the fracture surface has become more horizontal Ref: Maheshwari 9th ed pg. 136

2

Malunited interochantric fracture of femur

Nonunion transcervical neck fracture of femur

Nonunion lateral condyle fracture of humerus

Malunited supracondylar fracture of humerus

Orthopaedics

Pelvis and Hip injuries

7af4ddbb-fde0-4b78-a65b-3a07c93ff5ff

single

Pelvic Inflammatory Disease occurs least common with :

Ans. is b i.e. Condom Barrier methods (especially condom) and OCP's both protect against PID, but the protection offered by OCP's is less than that by Barrier method. "The incidence of pelvic inflammatory disease (P1D) is reduced. though it does not reach the same low level as seen with the barrier methods." As far as diaphragm is concerned, it does not protect against HIV, whereas condom does.

2

OCPs

Condom

IUCD

Diaphragm

Gynaecology & Obstetrics

null

dcf71412-6fe0-4f53-bed3-7218aa719ed2

single

Which of the following investigation is the BEST method of diagnosis of HIV in childhood?

The two tests used for diagnosing HIV infection in in children less than 18 months are detection of HIV nucleic acid (DNA or RNA) AND detection of HIV p24 antigen. Definitive diagnosis requires presence of reactive tests on two separate determinations using one of the above tests after 4 or 6 weeks and confirmed by the second test. Diagnostic testing should be done 6 weeks or longer after complete cessation of breast feeding. Infants born to HIV infected mothers will have HIV antibody until 6-18 months regardless of infection status due to transplacental passage of maternal antibody. The preferred test for infant diagnosis is detection of HIV DNA or RNA in blood, collectively referred to as nucleic acid amplification testing (NAT). Laboratory criteria for diagnosing HIV infection in children more than 18 months: Serologic testing Detection of HIV nucleic acid(DNA or RNA) Detection of HIV p24 antigen Ref: Advances in Pediatrics by Dutta By Jaypee Brothers, page 256. McFarland E.J. (2012). Chapter 41. Human Immunodeficiency Virus Infection. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.

2

CD4 cell counts

P24 antigen

ELISA

Anti HIV antibody

Pediatrics

null

c21bbb42-0e90-40a7-8781-9267736efafe

single

Active replication in Hepatitis B in fection is indicated by -

Circulating HBeAg Indicate of active intrahepatic replication REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.547

1

HBeAg

HBsAg

HBcAg

Anti-HBsAg

Microbiology

Virology

07b293e8-7712-4888-a0b4-65b032cec437

single

Which of the following types of bias can be reduced by by allowing equal interview time-

Interviewer's bias Occur when interviewer knows the hypothesis and know who the cases are. This type of bias can be eliminated by double-blinding. (refer pgno:74 park 23 rd edition)

4

Berkesonian bias

Recall bias

Selection bias

Interviewer bias

Social & Preventive Medicine

Epidemiology

f6ae6ec6-9e00-4729-af19-bff76f8b2052

multi

The most common site of hypertensive intracranial hemorrhage is:

Ans. (a) Putamen* Basal Ganglia (Putamen) is the MC site of ICH.* Of all the hemorrhages in Brain - Intracerebral hemorrhage is the MC type of hemorrhage.* The MC cause of Intracranial bleed - Hypertension

1

Putamen

Midbrain

Medulla

Cerebrum

Surgery

Nervous System

67b68177-043a-4c45-8e19-e88a95b46b5a

single

The percentage of water in Liquor Amnii is:

99%

4

42%

64%

76%

99%

Gynaecology & Obstetrics

null

89db54b1-bbea-4cc9-981c-36f828b2bd62

single

Optic cup is derived from ?

Ans. is 'a' i.e., Neural ectoderm

1

Neural ectoderm

Surface ectoderm

Mesoderm

Neural crest

Anatomy

null

51065d75-464c-4e93-b155-099fd658730f

single

Which among the following about removable space maintainers are wrong?

The compliance of the removable appliance doesn’t improve with functional or non-functional type.

3

Being tissue born, they impose less stress on the remaining teeth

By virtue of tissue stimulation they often accelerate the eruption of teeth between them

They can be functional in the truest sense, hence better patient co-operation can be expected

Easier to fabricate, requiring less chair-side time

Dental

null

73ded937-7187-4709-a756-dfec00a619a8

multi

X-ray of a young man shows hetrotopic calcification around bilateral knee joints. Next investigation would be-

null

4

Serum phosphate

Serum calcium

Serum PTH

Serum Alkaline phosphatase

Orthopaedics

null

ab397b75-922a-496e-8469-738e5e17f713

single

Which of the following is a synthetic estrogen ?

Ans. is 'd' i.e., DiethylstibestrolEstrogeno Ethinylestradiolo Diethylstibestrolo Mestranolo Hexestrolo Tiboloneo Dienestroi

4

Estrone

Estriol

Estradiol

Diethylstibestrol

Pharmacology

Sex-Hormone

71840043-e6e8-4b9b-89ea-6d2fa441babe

single

Hardy Weinberg law is related to

Hardy Weinberg law: states that the genotype frequencies in a population remain constant or are in equilibrium from generation to generation unless specific disturbing influences are introduced. Genetic equilibrium (HW law) is a basic principle of population genetics; the entire principle is based on Mendelian genetics. Deviations in HW law: HW law fails to apply in: Non-random mating (assortative mating) New mutations Genetic drift Gene flow Natural selection (mortality selection, fecundity selection) Small populations migrations Dynamic populations. HW law assumes that human population is static, large and has random mating.

2

Gene therapy

Population genetics

Human genome project

Eugenics

Social & Preventive Medicine

null

497f41d8-70cc-4cbc-9fe1-91e6aac4544f

single

The most sensitive test for the diagnosis of herpes simplex (HSV) meningitis in a newborn infant is

HSV meningitis or encephalitis is difficult to diagnose by laboratory tests as there is a low titer of virus present in the CSF. Neonatal HSV infects the child during the birth process. While culture, Tzanck smear, and even antibody tests may be useful in adults, particularly those with HSV-rich lesions, they are not useful for CSF testing. Only PCR is sensitive enough to detect HSV DNA in the CSF. Once diagnosed rapidly, HSV encephalitis or meningitis can be treated with acyclovir.

2

HSV IgG antibody

HSV polymerase chain reaction (PCR)

HSV culture

Tzanck smear

Microbiology

Virology

072855bc-5876-4c6f-811c-35259b9d55e9

single

Embryo proper is derived from which pa of morula:

Approximately 3 days after feilization, cells of the compacted embryo divide again to form a 16-cell morula (mulberry). Inner cells of the morula constitute the inner cell mass, and surrounding cells compose the outer cell mass. The inner cell mass gives rise to tissues of the embryo proper, and the outer cell mass forms the trophoblast, which later contributes to the placenta. Ref: Langman's embryology 11th edition Chapter 3.

1

Inner cell mass

Outer cell mass

Both of the above

None of the above

Anatomy

null

f9f76f1f-4394-4ab2-a9bc-8d17c584725e

multi

A 63-year-old man is noticed to have asymmetric pupils. He is completely well and has no symptoms. On examination, the left pupil is small, round, and has a brisk response to light and near stimuli (accommodation). There is also ptosis of the left eyelid, but no other ocular movement abnormality or symptoms of double vision.For the above patient with a pupillary abnormality, select the most likely diagnosis.

Horner syndrome results in a small, round pupil on one side. Light and near reaction is brisk, and response to mydriatics and miotics is normal. The affected pupil will not dilate in the dark, so darkness accentuates the anisocoria. The syndrome is often idiopathic but can be caused by neoplasm, brain stem stroke, or carotid dissection.

2

essential anisocoria

Horner syndrome

tonic pupils (Holmes-Adie syndrome)

Argyll Robertson pupils

Medicine

C.N.S.

d499e578-58a2-40c9-ae80-c99c6b719370

multi

A 67-year-old man complains of a lesion in his left eye. Physical examination reveals a triangular fold of vascularized conjunctiva growing horizontally into the cornea in the shape of an insect wing. Which of the following terms best describes this patient's lesion?

Pterygium is a fold of vascularized conjunctiva that grows horizontally onto the cornea in the shape of an insect wing (hence the name). It is often associated with a pinguecula (conjunctival lump, choice C) and frequently recurs after excision.Diagnosis: Pterygium

4

Loiasis

Onchocerciasis

Pinguecula

Pterygium

Pathology

Misc.

f46ec8fd-f343-435d-9e21-9ba5a9fcd4f2

multi

Most reliable marker for hypothyroidism:

Ans. (c) TSHRef : Harrison 19th ed. 12289* Best test for diagnosis of hypothyroidism is T.S.H (Thyroid Stimulating Hormone).* TSH can also be used for monitoring response to treatment.

3

T3

T4

TSH

Thyroxine binding globulin

Medicine

Endocrinology

01f349cd-2497-4157-8369-310075d2fcab

single

This eyes sign is most likely seen in which condition:

Ans. B. Lateral medullary syndromea. Above image shows Ptosis of right eye.b. This shows paralysis of IIIrd Nervec. Lateral Medullary syndrome (Wallenberg Syndrome) is a neurologic disorder due to ischemia of lateral part of Medulla d/t involvement of Posterior inferior cerebellar artery (PICA)d. It is characterized by ipsilateral loss of pain & temperature from face & contralateral loss from body.e. Ipsilateral Horner's Syndrome (Ptosis, Miosis, Anhidrosis)

2

Medial medullary syndrome

Lateral medullary syndrome

Optic chiasma lesion

Benedict syndrome

Medicine

C.N.S.

76236204-9d44-4a6b-88f8-52c19b002976

single

All of the following amino acids are conveed to succinyl-CoA, except

Valine, isoleucine, and methionine are conveed to succinyl CoA, whereas histidine is conveed to alpha-ketoglutarate and both are involved in the TCA cycle.

4

Methionine

Isoleucine

Valine

Histidine

Biochemistry

Metabolism of protein and amino acid

6a584592-6cf8-49c8-8bb4-a2c0c1a45233

multi

Albers schonberg disease is also known as -

Ans. is 'b' i.e., Osteopetrosis o Osteopetrosis is also known as Marble bone disease or Albers-Schonberg disease.o Paget's disease is known as Osteitis deformans,o Osteogenesis imperfecta is known as Brittle bone disease,o Osteoporosis is known as Fragile bone disease.

2

Osteoprosis

Osteopetrosis

OI

Paget's disease

Orthopaedics

Regional Disease

fa8a1316-a482-40f6-a517-843e06478a72

single

In OCP, estrogen is used in

A. i.e. (Ethinyl estradiol) (208 - Shaw 's Nth)COMBINED ORAL PILLS - usually contain a mixture of* Ethinyloestradiol or mestranol (20 to 30|ig)* Active progestogen - 19 morsteroid* Mala D contains -0.5 mg of D- norgestrel*** Mala N contains - 1 mg norethisterone** (Norgestrel 0.30 mg and Ethyl oestradiol 3.0 mg)* Treatment starts fifth day of the cycle for 21 days* A new course of tablets should be commonced 7 days after the cessation of the previous course* Fixed time of the day preferably after a meal* *Pregnancy rate with combined oralpill is 0.1 per 100 woman years* If she forgets to take a tablet, she should take 2 tablets the following day* The majority of failure with OCP are due to the failure to take the pills regularly* In a non lactating women OCP can be started after 6 weeks of delivery**. But can be given soon after an abortion, MTP or an ectopic pregnancy* H. mole, one should start on OCP only ofter serum beta hCG is negative* The progesterone of choice for emergency contraception is - Levonorgestrel**

1

Ethinyl estradiol

Norethisterone

Ethynodiol diacetate

Allyloestranol

Gynaecology & Obstetrics

Miscellaneous (Gynae)

5cfb1668-9dc6-467d-b562-0e7f9622adbd

multi

Blood group antigens belong to the class

For red blood cells, the membrane oligosaccharides that determine the antigenic natures of the ABO substances appear to be mostly present in glycosphingolipids, whereas in secretions the same oligosaccharides are present in glycoproteins. Some examples of conjugated proteins are lipoproteins, glycoproteins, phosphoproteins, hemoproteins, flavoproteins, metalloproteins, phytochromes, cytochromes, opsins and chromoproteins. so the ABO substances can be chosen as Conjugated proteins from the given options Ref: Harper's Illustrated Biochemistry, 30E (2015) Pg No. 697 chapter 53.

1

Conjugated proteins

Unconjugated protein

Simple protein

Hemoglobin binding protein

Biochemistry

Structure and function of protein

61e7afae-3300-473c-9b74-8c511b7754e8

single

Bill's bar divides:

Ans. (b) Facial nerve and superior vestibular cochlear nerveRef: Dhingra's ENT 6th ed.l 90-91* Bills bar divides the superior compartment of the internal acoustic meatus into an anterior and posterior compartment.* Anterior to Bill's bar, are the facial nerve (in the anterior superior quadrant) and nervus intermedius, and posterior to it is the superior division of the vestibular nerve (in the posterior superior quadrant).

2

Facial nerve and cochlear nerve

Facial nerve and superior vestibular cochlear nerve

Facial and inferior vestibule cochlear nerve

Superior and inferior vestibule cochlear nerve

ENT

Facial Nerve And Its Disorders

a236f205-f584-4ec7-b2b3-ff8a4bc9e61b

single

Contraceptive effect of CuT-380A lasts for how many years?

Ans. (b) 10 yearsShaw 15ih227-8Name of deviceEffective period* CuT 380A10 years* Nova T-Silver5 years* Multiload3755 years* Multiload2503 years

2

5

10

15

20

Gynaecology & Obstetrics

Non-Hormonal - Intrauterine Devices

c34231e2-75d8-4815-9b5e-6aedc87174e5

single

Stereocilia and kinocilium are present in

(B) Inner ear > A kinocilium is a special type of cilium on the apex of hair cells located in the sensory epithelium of the vertebrate inner ear. Stereocilia (or stereovilli) are apical modifications of the cell, which are distinct from cilia and microvilli, but closely related to the latter. They are found in three regions of the body: the ductus deferens, the epididymis and the inner ear.

2

Tongue

Inner ear

Nose

Eye

Physiology

Special Senses: Hearing and Equilibrium

8d07a565-697f-46c8-b7d1-282a639c4d3a

single

True about tubercular otitis media are all except

Tubercular otitis media In most of the cases, infection is secondary to pulmonary tuberculosis; infection reaches the middle ear through the eustachian tube. Perforation: Multiple perforations, 2 or 3 in number, are seen in pars tensa and form a classical sign of disease. These may coalesce into a single large perforation. Painless ear discharge: Earache is characteristically absent in cases of tubercular otitis media. Discharge is often foul-smelling because of the underlying bone destruction. (Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 81,82)

4

Spreads through Eustachian tube

Causes painless ear discharge

May cause multiple perforations

Usually affects both ears

ENT

Ear

4dd662ee-89c8-402d-b454-7ac917e250a7

multi

Which of the following is the most specific screening test for renovascular hypeension:

Answer is A (Magnetic Resonance Angiography (MRA) Magnetic Resonance Angiography (MRA) has now emerged as the most sensitive and specific screening test for Renovascular hypeension. Note: Harrison 16'h edition (old) mentions Spiral CT scan as the most sensitive and specific screening test for Renovascular Hypeension, however most recent textbooks now prefer MRA as the screening test of choice with similar or even better sensitivity and specificity than spiral CT Angiography. Screening Test Test Sensitivity (%) Specificity (%) Magnetic resonance angiography (MRA) 100 96 Spiral computerized tomography 98 94 Captopril renogram 70-93 95 Duplex Doppler ultrasonography 69-96 86-90 IVP --75 --85 Renovascular Hypeension Test Sensitivity Specificity Conventional Renal Angiography >99% >99%

1

Magnetic Resonance Angiography (MRA)

Spiral Computed Tomographic Angiography (CT Angiography)

Captopril induced Radionucleotide Scan (Captopril Renogram)

Duplex Doppler Ultrasonography

Medicine

null

13ac6b08-b090-4414-8c5f-78440a715688

single

INR in warfarin therapy is?

ANSWER: (B) 2.5REF: Harrison 18th ed chapter 118For most indications, warfarin is administered in doses that produce a target INR of 2.0- 3.0. An exception is patients with mechanical heart valves, where a target INR of 2.5-3.5 is recommended. Studies in atrial fibrillation demonstrate an increased risk of cardioembolic stroke when the INR falls to <1.7 and an increase in bleeding with INR values >4.Warfarin interferes with the synthesis of the vitamin K-dependent clotting proteins, which include prothrombin (factor II) and factors VII, IX, and X.Like all anticoagulants, the major side effect of warfarin is bleeding. A rare complication is skin necrosis. Warfarin crosses the placenta and can cause fetal abnormalities. Consequently, warfarin should not be used during pregnancy.Dabigatran etexilate, an oral thrombin inhibitor, and rivaroxaban, an oral factor Xa inhibitor are new oral anticoagulants.

2

1.5

2.5

3.5

4.5

Medicine

Bleeding and Thrombotic Disorders

6af6489a-e510-499e-af47-b416ed215340

single

Calculate the osmolarity of a solution which contains 180 gm of glucose per dl, 117 gm of Nacl per dl and 56 gm of BUN per dl-

Ans. is 'd' i.e., 70 osmol/L * One mole of osmotically active particles is called one osmole.* In case of non-dissociated solutes, one gram molecular weight of any substance contain similar number of osmotically active molecules (osmoles), thus a molar solution of glucose contains 1 osmole.* On the other hand, in case of dissociated solutes, one gram molecular weight of any substance contain the number of osmotically active molecules (osmoles) equal to the number of dissociated molecules, e.g., a molar solution of NaCl contains 2 osmoles (1 mole of Na+ and 1 mole of Cl-).* The osmolar concentration of a solution in osmole/litre is called osmolarity. When expressed in osmole/Kg of solution is called osmolality.* Normal serum osmolality is about 290 mOsm/kg.* A mole (gram molecular weight) is molecular weight of a substance in grams, e.g., molecular weight of glucose is 180, therefore one mole of glucose has 180 gm; and molecular weight of NaCl is 58-5 gm, therefore one mole of NaCl contains 58-5 gm of NaCl.1 mole of glucose = 1 gram molecular weight of glucose = 180 gm of glucose = 1 osmole of glucose1 mole of NaCl = 1 gram molecular weight of NaCl = 58[?]5 gm of NaCl = 2 osmoles of NaClComing back to question* The given solution contains:-i) 180 gm glucse per dl = 1 osmole/dl =10 osmole/Lii) 117 gm of Nacl per dl = 4 osmole/dl = 40 osmole/Liii) 56 gm if BUN per dl = 2 osmole/dl = 20 osmole/L(28 gm of BUN has one osmole)* Thus osmolarity of given solution is 70 osmole/L

4

20 osmol/L

30 osmol/L

50 osmol/L

70 osmol/L

Physiology

Kidneys and Body Fluids

53222922-d241-49e2-abc4-6372d74c97a2

single

Sex worker with discharging ulcer, gram-negative diplococci & growth on modified Thayer Martin media. Diagnosis

Information in this question are - i. Gram negative diplococci. ii. Growth on modified Thayer-Martin media. Neisseria gonorrhoeae is a gram negative diplococci and Thayer-Martin medium is the selective medium for gonococci.

1

N. gonococci

Syphilis

LGV

Chancroid

Dental

null

f3bfd1ab-04f6-4254-93ad-cd18b7fa5897

single

All of the following are pathological features associated with Crohn's disease except: March 2012

Ans: D i.e. Toxic megacolonInflammatory bowel diseasePresence of multiple, separate, sharply delineated areas of disease, resulting in skip lesions, is characteristic of Crohn's disease and may help in differentiation from ulcerative colitisNon-caseating granuloma, a hallmark of Crohn disease, are found in approximately 35% of casesSparing of interspersed mucosa, a result of the patchy distribution of Crohn disease, results in coarsely textured, cobblestone appearance in which the diseased tissue is depressed below the level of mucosaIn Ulcerative colitis, inflammation and inflammatory mediators can damage the muscularis propria and disturb neuromuscular function leading to a colonic dilatation and toxic megacolon, which carries a significant risk of perforation

4

Skip lesions

Non caseating granulomas

Cobblestone appearance

Toxic megacolon

Pathology

null

a2b9afb7-78c5-4cba-808c-ebc2107ecb3c

multi

Anxiety states can be induced by the following except

(A) Cholecystokinin # SUBSTANCE/DRUG INDUCED ANXIETY DISORDER:> The essential features of substance-induced anxiety disorder are prominent and persistent feelings of anxiety that are judged to be due to the direct physiological effects of intoxication or withdrawal from a substance. Prominent anxiety, Panic Attacks, or obsessions or compulsions predominate in the clinical picture.> Alcohol: Because alcohol has depressive properties, acute intoxication rarely involves acute anxiety or panic. However, acute alcohol withdrawal, may induce an anxiety disorder. Various degrees of subclinical anxiety ranging from panic to generalized anxiety can last for 3-12 months after cessation of drinking.> Cocaine & Psychostimulants: may produce manifestations of anxiety, most commonly during the intoxication state.> Opiates: withdrawal actually may share neurochemical characteristics with panic disorder. Also protracted anxiety during methadone withdrawal may last several weeks or months.> Cannabis: Marijuana-induced anxiety usually occurs at high doses.> Phencyclidine & Other Hallucinogens: may acutely produce anxiety & panic, depending on the individual, dose & setting.> Miscellaneous: More commonly used drugs such as caffeine & nicotine withdrawal, may also produce anxiety symptoms.> Infusion of chemicals like sodium lactate, isoproterenol & caffeine; ingestion of Yohimbine and inhalation of 5% CO2 can produce panic episodes in predisposed individuals.> Administration of oral MAOIs before the lactate infusion protects individuals from panic attack.# ANTI-ANXIETY DRUGS:> Barbiturates: Long acting, Intermediate acting, Short acting, Ultra short acting> Non-barbiturate, Non-benzodiazepine Anti-anxiety Agents: Carbamates, Piperidinediones, Alcohols, Quinazoline derivatives, Anti histamines, Cyclic Ethers, Anti psychotics, Beta blockers, Benzodiazepines> Newer drugs: Buspirone, Zopiclone, Zolpidem, Zalpelon, Other drugs

1

Cholecystokinin

Yohimbine

Sodium Lactate

Isoproterenol

Psychiatry

Miscellaneous

ddca855f-8379-4016-9830-2d75c480d96e

multi

A 16-yrs-old girl presents with bowel obstruction. Laparotomy reveals markedly enlarged para-aoic lymph nodes. Biopsy of lymph nodes exhibit a diffuse neoplastic infiltrate of small, round lymphocytes with a "starry sky" appearance on low power. The cytoplasm of some of the lymphocytes is vacuolated and fat stains are positive. You would expect the neoplastic cells to demonstrate a

The patient has Burkitt lymphoma (Lukes-Collins; small non-cleaved), which is the most common malignant lymphoma in children. Approximately one-third of all childhood lymphomas in the United States are of the Burkitt type. There is an American and a Noh American variant. The relationship of Burkitt to the Epstein-Barr virus is more secure with the Mrican than the Noh American variant. The American variant has a predilection for the jaw, while the Noh American variant is more often an abdominal mass, located in the ileocecal region, ovary, or retroperitoneum. The lymph nodes are diffusely involved with monotonous, round, non-cleaved cells with numerous mitoses (very aggressive cancer) punctuated by clear spaces with macrophages containing debris ("tingible" macrophages) giving the impression of a "starry sky appearance," the stars representing the macrophages and the black of night the lymphocytes. The neoplastic B cells have a characteristic t(8;14) translocation where the c-myc oncogene is translocated from chromosome 8 to chromosome 14. Burkitt cells contain vacuoles that contain lipid, which stains positively with oil red O. It is a high-grade lymphoma with a predilection for metastasis to the bone marrow and other organs.

4

Positive non-specific esterase stain of the cells

Positive specific esterase stain of the cells

Low leukocyte alkaline phosphatase score

t(8;14) translocation

Pathology

General pathology

522577d8-c2f2-4c60-b21d-41d67623c966

multi

Which of the following is TRUE/FALSE about weight loss? a) Psychiatric disorders are a major cause of involuntary weight loss. b) Up to 20% of all cancer deaths are caused directly by cachexia. c) Connective tissue diseases decreases metabolic demand. d) Hypehyroidism in the elderly have more prominent sympathomimetic features. e) Involuntary weight loss may be one of the earliest manifestations of Alzheimer's dementia.

Connective tissue diseases may increase metabolic demand and disrupt nutritional balance. Hypehyroidism in the elderly may have less prominent sympathomimetic features and may present as "apathetic hypehyroidism" or T3 toxicosis Ref:Harrisons Principles of Internal Medicine, 18th Edition, Pages 642- 44

4

a,b,c,d,e-True None-False

a,b,c-True & d,e-False

a,b,c,d-True & e-False

a,b,e-True & c,d,-False

Medicine

null

a0033c5a-cffd-4363-a5ae-6930d5017890

multi

In aoic dissection blood enters in -

Ans. is `b' i.e., MediaAoic dissection o Aoic dissection is a catastrophic illness characterized by dissection of blood between and along the laminar planes of aoic media.o Blood enters inside the aerial wall (in the media layer) and leads to formation of blood filled channels within the aoic wall, which often ruptures outward causing massive hemmorrhage.o The most frequent preexisting histologically detectable lesion is cystic medial degeneration.o In aoic dissection, there is an intimial tear through which the blood enters into the media.o Usually, the tear is within 10 Cms of aoic valve.o The dissecting hematoma spreads characteristically along the laminar planes of the aoa, usually between the middle and outer third.Some times, blood reruptures into the lumen distally, i.e. there is a second tear distally. So that a complete new vascular channel is formed inside the media of aoic wall --> Blood enters from proximal tear into the media and comes out into the lumen from distal tear.o This is called double - barrel aoa with a false-channel in the media.Later on this false channel becomes endothelized --> chronic dissection.

2

Intima

Media

Adventitia

Any of the above layer

Pathology

null

a4d177f3-419e-4261-a966-cc37f54e6f03

multi

CrPC 26 -

Ans. is 'a' i.e.. Division of offenceo According to Sec 26 of CrPC, 1973, Offences under the Criminal Procedure Code (hereinafter the "CrPC1') are divided into:1. Offences under Indian Penal Code (IPC) (triable by HC, Sessions Court and other court shown in the 1st Schedule to the CrPC)2. Offences under any other law (empowers HC, when no court is mentioned for any offence under any law other than IPC, to try such offences)

1

Division of offence

Division of negligence

Division of malpractice

None

Forensic Medicine

Introduction to Forensic Medicine and Medical Jurisprudence

e499a6bf-a507-4607-ba93-119a928df307

multi

Claw hand is caused by lesion involving which of the following nerves?

Claw hand or "main en griffe", is an abnormal posture of hand with hyperextension at metacarpophlangeal joints (fifth, fouh and to a lesser extent third) and flexion at interphlangeal joints. This results from ulnar nerve leisions above the elbow or injury to the lower pa of brachial plexus, producing wasting and weakness of hypothenar muscles, interossei, and ulnar (medial) lumbricals, allowing the long finger extensors and flexor to act unopposed. Ref: Essential Ohopedics by Maheshwari 3rd Edition, Page 51; A Dictionary of Neurological Signs By Andrew J. Larner, 2010.

1

Ulnar nerve

Median nerve

Radial nerve

Posterior interosseous nerve

Surgery

null

b6c6dfc7-ea00-4e01-82f1-5eb2bce7f8ba

single

The ADA specification No 1 for composition of amalgam alloy, recommends,

null

3

65% silver, 32% tin and 3% copper

49% silver, 32% tin and 19% copper

65% silver, 29% tin and 5-6% copper

None of the above

Dental

null

baf5ed68-b5c9-4a35-99e5-536c0855fc94

multi

Oestrogen causes proliferation of

Oestrogen causes proliferation of glycogen containing superficial cells and progesterone causes proliferation of intermediate cells.

2

Intermediate cells

Superficial cells

Basal cells

Both superficial and intermediate cells

Gynaecology & Obstetrics

null

d3cd64e3-0bbb-48b8-a4e9-7b3aeb66c5c8

multi

Anterior resection is done for a patient with rectal cancer. Post operatively he presents with pain. Biopsy shows involvement of muscular wall but no penetration. Out of the 13 lymph nodes, one is involved. But the high tide lymph node is not involved. Modified duke stage

Ans. (a) C1Ref Page 1209/ Schwartz 10th editionThough there were lots of named colonic cancer staging used.All are replaced by only TNM staging now.For exam point of view we still read those outdated stagings.DukesACMACDescriptionAAALimited to mucosa, N0 B1B1Penetration into Submucosa, not through Muscularis propria, N0BB2B2Penetration through Muscularis Propria, N0 B3Adherence to adjacent organs, N0CC1C1N+, Limited to bowel wall (B1) C2C2N+, Penetrates through Muscularis propria (B2) C3N+. Adherence to adjacent organs (B3)D Distant Mets* AC -- Astler Coller* MAC -- Modified Astler Coller* N0 -- Node negative* N+-Node positive* Remember Stage C means lymphnode involvement

1

C1

C2

D1

D2

Surgery

Rectum

8a2a49ca-1248-4421-ba4b-ae69c2965424

multi

WHO prognostic score for a high-risk GTN is

Modified World Health Organization Prognostic Scoring System, as Adapted by FIGO, by which women whose score is 0-6 are Considered Low Risk (Requiring Single-Agent Chemotherapy) and score of 7 or more, High Risk (Requiring Multiagent Combination Chemotherapy)Scores0123Age<40>= 40----Antecedent pregnancyMoleAboionTerm--Interval months from index pregnancy<44-67-13>= 13Pretreatment serum hCG<10001000-1000010,000-100,000>100,000Largest tumor size --3-5 cm>= 5 cm--Site of metastasesLungSpleen, liverGastrointestinalLiver, brainNo. of metastases--1-45-8>8Previous failed chemotherapy----Single drug>= 2 DrugsReference: William's Obstetrics; 25th edition, chapter 20; Gestational trophoblastic diseases

2

>= 6

>= 7

>= 10

>= 15

Gynaecology & Obstetrics

General obstetrics

de4fce81-ce14-422b-8f68-b6c276f47f83

single

A 5 yr old male child presented with H/O recurrent infections. O/E the child has rashes as shown below. Routine blood investigation reveal patient has low platelets. Which of the following diagnosis is possible?

Wiskott Aldrich syndrome Etiopathogenesis: X linked recessive disorder Defect in WASP gene (Chr Xp11) Clinical: Characterized by recurrent infections, eczema like rash & thrombocytopenia Prolonged bleeding from circumcision site Bloody diarrhea Streptococcus pneumoniae & other bacteria having polysaccharide capsules cause otitis media, pneumonia, meningitis & sepsis Investigation findings: Thrombocytopenia with small sized platelets IgM: low IgE & IgA: elevated

2

Job syndrome

Wiskott Aldrich syndrome

Measles

Henoch Schonlein purpura

Pediatrics

Paediatrics

152b8229-eba2-4177-ba44-05e87a99be79

single

A pregnant woman with severe mitral stenosis is likely to undergo failure in the anetnatal period. Best method to prevent cardiac failure in this patient is?

Balloon mitral valvuloplasty is the best treatment to prevent failure in severe MS. The ideal time for surgery would have been the interpregnancy interval, but since the patient is already pregnant, 20 - 24 weeks is the most preferable time. However in cases of severe mitral stenosis, surgery may be performed any time during pregnancy in the interest of the mother. Other treatment includes diuretics, b blockers and limited physical activity

2

T. Furosemide through out pregnancy

Balloon mitral valvuloplasty in second trimester

Digoxin for all hea patients

Admit all at 30 weeks

Gynaecology & Obstetrics

Obstetrics

d2a5f163-4988-469b-a1b8-5a67607af0cf

multi

False statement about hemoglobin structure?

Each hemoglobin molecule is made up of:- (i) Non-protein part, i.e. heme; and (ii) Globin, which has 4 polypeptide chains (2 pairs of similar polypeptide chains). Iron of hemoglobin is in the ferrous state which lies in the center of the porphyrin ring. Myoglobin and the β-subunits of hemoglobin share almost identical structures.

1

Hb has 2 polypeptide

Iron is present in ferrous state

Hb structurally similar to myoglobin

Ferrous ions are in porphyrin rings

Biochemistry

null

570edb36-2ea3-4332-9e2f-9d7a84380ae2

multi

Calcium blocking agents of use in the treatment of hypeension include

Nifedipine The overriding action of Nifedipine is aeriolar dilation, t.p.r. decreases and BP falls.Doesn&;t depress SA node or A-V conduction.Reflex sympathetic stimulation of hea predominates leading to tachycardia, increased contractility and C.O., coronary flow is increased.Its use is associated with higher moality among post-MI patients.Relaxant effect on the bladder, Nifedipine can increase urine voiding difficulty in elderly malesContraindicationsSide effectsHea failure 2nd or 3rd-degree hea blockTachycardia, flushingGI disturbancesHyperkalemia, edema, headache(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2054-2057)

4

Prazosin

Lidoflazine

Captopril

Nifedipine

Pathology

All India exam

77c8d088-aa1e-47ac-ba0a-dcf7fa6aeb6f

single

Term 'schizophrenia' was coined by:TN 06; Ranchi 10; NEET 13

Ans. Eugene Bleuler

1

Eugene Bleuler

Kraepelin

Freud

Schneider

Forensic Medicine

null

7d522951-4753-48eb-a991-e28526373fe4

single

Which of the milestone develops first –

A child enjoys watching his own image in the mirror (mirror play) by 6 months. A child crawls in the bed by 8 months. Full creeping and crawling develop by 10 months. Pincer grasps develops by 9 months.

1

Mirror play

Crawling

Creeping

Pincer grasp

Pediatrics

null

e2a52764-12ce-486f-ac9d-6658523eed8f

single

A 40-year-old lady with temporal field defects and galactorrhoea is most likely to have -

Temporal field defects in women with galactorrhoea suggests pituitary macroadenoma. Increased secretion of prolactin causes amenorrhoea, galactorrhoea and the mass effect of the tumour on the optic nerve produces headache and visual field defect.

1

Pituitary macroadenoma

Craniopharyngioma

Lactational failure

Pregnancy

Medicine

null

8b35c055-0318-4a2c-bba6-75636b5e09ef

single

The following general anaesthetic causes characteristic 'dissociative anesthesia':

The characteristic state observed after an induction dose of ketamine is known as "dissociative anesthesia," wherein the patient's eyes remain open with a slow nystagmic gaze (cataleptic state). If ketamine is administered as the sole anesthetic, amnesia is not as complete as with the benzodiazepines. Reflexes are often preserved, but it cannot be assumed that patients are able to protect the upper airway. The eyes remain open and the pupils are moderately dilated with a nystagmic gaze . Frequently, lacrimation and salivation are increased. Ref: Eilers H., Yost S. (2012). Chapter 25. General Anesthetics. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e.

3

Thiopentone

Althesin

Ketamine

Barbiturate

Anaesthesia

null

805fb388-be9b-406a-b8ab-d1c8d0c94472

single

3 year old child with red scrotal swelling which shows self resolution by next day morning and maximum in evening with positive transillumination test. Diagnosis:

Ans. (b) Congenital hydroceleRef: Bailey & Love 26th ed. /1382* Hydrocele is an accumulation of fluid in layers of tunica vaginalis.* Vaginal hydrocele: MC type. Accumulation of fluid within tunica vaginalis layers* Infantile hydrocele: doesn't necessarily appear in infants. The tunica and processus vaginalis are distended to the inguinal ring without any connection with peritoneal cavity.* Congenital hydrocele:# It is due to patent processus vaginalis which allows peritoneal fluid to move freely.# Size of hydrocele fluctuates usually related to activity# Treatment: herniotomy

2

Scrotal abscess

Congenital hydrocele

Secondary abscess

Infantile hydrocele

Surgery

Inguinal Hernias

e96c8f49-bd1c-4476-bbfa-4e468181a3be

single

A 5 year old girl came with history of progressively increasing pallor since bih and hepatosplenomegaly. Which of the following is the most relevant test for achieving diagnosis -

<p>Hb electrophoresis helps to confirm beta thalassemia (Hb F increased ,HbA2 increased ). </p><p>Reference :Harsh mohab textbook of pathology sixth edition pg no 322.</p>

1

Hb electrophoresis

Peripheral smear examination

Osmotic fragility test

Bone marrow examination

Medicine

Haematology

582ba6ec-4ad2-4166-83f4-ed9643560d45

multi

Conjunctival mucosal overgrowth over cornea-

Pterygium is a degenerative conjunctival fold which encroaches on the cornea in the palpebral area. It must be differentiated from pseudopterygium (an inflammatory fold of conjunctiva encroaching on cornea).Pterygium (L. Pterygion = a wing) is a wing-shaped fold of conjunctiva encroaching upon the cornea from either side within the interpalpebral fissure ref: A K KHURANA OPHTALMOLOGY,E4, Page-80 ref img

1

Pterygium

Pingecula

Vernal keratoconjunctivitis

Herbe's pit

Ophthalmology

Conjunctiva

3c2f22cc-ad0f-4898-8ca4-3616fd8bc167

single

A female developed ovarian hyperstimulation syndrome during the treatment of infeility. What is the MOST common cause of ovarian hyperstimulation?

Ovarian hyperstimulation syndrome (OHSS): It is a clinical symptom complex associated with ovarian enlargement resulting from exogenous gonadotropin therapy. Symptoms may include abdominal pain and distension, ascitis, gastrointestinal problems, respiratory compromise, oliguria, hemoconcentration, and thromboembolism. These symptoms may develop during ovulation induction or in early pregnancies that were conceived through exogenous ovarian stimulation. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 20. Treatment of the Infeile Couple. 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

FSH/LH therapy

GnRH drugs

Clomiphene

Danazol

Gynaecology & Obstetrics

null

e7339d15-f4f7-4ecf-8113-ea6272485cbd

single

Lymphatics of suprarenal gland drain into______ lymph nodes

Ans. b (Para-aortic nodes) (Ref BDC vol. 2 /4th/307)Lymphatics of adrenal/suprarenal gland drain into lateral/para-aortic nodes.Lymphatic Drainage of the Suprarenal Glands# The lymph vessels arise from a plexus deep to the capsule and from one in the medulla.# Most of lymphatics that leave the suprarenal glands end in superior lumbar (lateral aortic) lymph nodes.# The two main lymph node groups of the abdomen are closely related to the aorta. These comprise the pre-aortic and para-aortic groups.# The pre-aortic nodes are arranged around the three ventral branches of the aorta and consequently receive lymph from the territories that are supplied by these branches. This includes most of the gastrointestinal tract, liver, gall bladder, spleen and pancreas. The efferent vessels from the pre-aortic nodes coalesce to form a variable number of intestinal trunks that deliver the lymph to the cistema chyli.# The para-aortic nodes are arranged around the lateral branches of the aorta and drain lymph from their corresponding territories, i.e., the kidneys, adrenal, gonads and abdominal wall, as well as the common iliac nodes. The efferent vessels from the para-aortic nodes coalesce to form a variable number of lumbar trunks which deliver the lymph to the cisterna chyli.# Cisterna chyli: is a lymphatic sac that lies anterior to the bodies of the LI and L2. It is formed by the confluence of the intestinal trunks, the lumbar trunks and lymphatics from the lower thoracic wall. It reseives lymph from the abdomen and lower limbs which is then drained into beginning of L. Brachiocephalic vein.Additional Educational points:Arterial Supply of the Suprarenal Glands1. The aorta (one or more middle suprarenal arteries):2. The inferior phrenic artery (6-8 superior suprarenal arteries);3. The renal artery (one or more inferior suprarenal arteries).Venous Drainage of the Suprarenal Glands# These glands are drained mainly be a single, large suprarenal vein.# The right one drains into the IVC.# The left one joins the left renal vein.# There are also many small veins that accompany the suprarenal arteries.Innervation of the Suprarenal Glands# These glands have a rich innervation from the adjacent coeliac plexus and the greater thoracic splanchnic nerves.# These preganglionic sympathetic fibres pass through the hilum and synapse on cells in the medulla.# The suprarenal cortex receives only a vasomotor nerve supply.

2

Internal iliac

Para-aortic

Superficial inguinal

Coeliac

Anatomy

KUB & Adrenal Gland

3e028cce-7825-488a-9801-9b2851eba6a6

single

Most common nerve injured in ligation of sup thyroid artery -

The external laryngeal nerve lies in relation to superior thyroid artery. The recurrent laryngeal nerve lies close to superior laryngeal artery.

4

RLN

Facial N.

Mandibular M.

External laryngeal nerve

ENT

null

f4623db5-ce8a-4ef7-9757-a577e089590b

single

Burn caused by moist heat is known as:

null

1

Scalds.

Scars.

Ordinary burn.

None.

Surgery

null

60c99d7a-f832-4a1a-b1c9-796f9860da16

multi

In central serous retinopathy-

Ans- A Ref- Central serous chorioretinopathy is when fluid builds up under the retina. This can distort vision. The fluid leakage comes from a layer of tissue under the retina, called the choroid. There is another layer of cells called the retinal pigment epithelium (RPE). When the RPE doesn't work as it should, fluid builds up under the RPE. As a result, a small detachment forms under the retina, causing vision to become distorted. This image from an OCT scan shows how central serous retinopathy (also called central serous choroidopathy) causes a blister-like swelling in layers of the retina.

1

Often shows focal leakage on fluorescein fundus photography

A macular hole is a common end result

The image perceived by the patient on the affected side in unilateral cases is bigger than on the normal side

A dense central scotoma is the most common presentation

Unknown

null

aeef69e2-0427-4278-9325-3d03bc73f83c

single

Lens derives nutrition from

Lens being an avascular structure receives its nutrition from the aqueous like glucose salts, etc, by diffusion processRef: Parsons diseases of the eye; Under the heading lens

2

Vitreous

Aqueous

Optic aery

Ophthalmic aery

Physiology

Nervous system

00cb04ae-97ba-4b21-bb5f-786ac9857b93

single

Halofantrine is used for -

Ans. is 'a' i.e., Falciparum Malaria o It is mainly used for multidrug resistant falciparum malaria.

1

Falciparum malaria

Visceral leishmaniasis

Leprosy

Amoebiasis

Pharmacology

null

e52dcade-6f4e-4d8a-ad21-c15bdcf2acd3

single

Hormones with increased production during the day and less in nights is/are:

null

4

ACTH.

Cortisol

Insulin

All of the above.

Physiology

null

1ff76bee-8551-43b8-b596-3f84cf1e5cc4

multi

Propranolol can be used in all of the following conditions EXCEPT:

null

2

Thyrotoxicosis

Variant angina

Migraine

Hypertension

Pharmacology

null

1878b309-9716-427f-b311-f5e5d0ac034b

multi

For which of the following enzymes, thiamine pyrophosphate (TPP) acts as Cofactor

null

4

Pyruvate Dehydrogenase

Alpha Ketoglutarate dehydrogenase

Branched chain ketoacid dehydrogenase

All of the above

Biochemistry

null

29d47018-26d2-47e0-9d1e-1470d28ec9e4

multi

A 7 year old boy is referred to a specialty clinic because of digestive problems. He often experiences severe abdominal cramps after eating a high fat meal. He is worked up and diagnosed with a genetic defect resulting in a deficiency of lipoprotein lipase. Which of the following substances would most likely be elevated in this patient's plasma following a fatty meal?

After eating a high fat meal, triglycerides are processed by the intestinal mucosal cells. They are assembled in chylomicrons and eventually sent into the circulation for delivery to adipocytes and other cells. Chylomicrons are too large to enter cells, but are degraded while in the circulation by lipoprotein lipase. A defect in this enzyme would result in the accumulation of chylomicrons in the plasma. Albumin-bound free fatty acids (choice A) is incorrect because fatty acids leave the intestine esterified as triglycerides in chylomicrons. HDL is not a carrier of dietary fat from the intestine. LDL would be not be elevated in this patient after a high fat meal. However, VLDL would be elevated if the patient ate a high carbohydrate meal. In this situation, the carbohydrate would be conveed into fat in the liver and sent out into circulation as VLDL. VLDL would be unable to be degraded to LDL and, therefore, would accumulate. Ref: Botham K.M., Mayes P.A. (2011). Chapter 25. Lipid Transpo & Storage. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.

2

Albumin-bound free fatty acids

Chylomicrons

HDL

LDL

Biochemistry

null

504b69fd-13d3-4579-80a4-a6637e715040

single

The fastest dental film currently available has the speed rating of

null

3

"D" speed

"C" speed

"F" speed

"E" speed

Radiology

null

16b7dee9-fb45-4bd5-8bb7-c9af6089c51c

single

Tinel sign is indicative of

Tinel's sign : It records regeneration of nerve by Tapping on the nerve course from distal to proximal direction, tingling sensation is felt at the sprouting nerve ends till the distal course of the nerve (law of Projection)

3

Axonal conduction

Diffuse axonal injury

Axon degeneration

Muscle ischaemia

Physiology

null

97f216ae-84dc-4897-a3dc-8f4585a8e1cb

single

A 7 year old female child is brought to you with features of precocious pubey. On examination she has features of virilisation and is hypeensive. Which of the following enzyme deficiency is responsible for her condition?

The features of 11 - hydroxylase deficiency in a female are precocious pubey, hypeension, virilization etc. Also know: 1) Hypeension occurs in 17 - hydroxylase and 11 - hydroxylase deficiency 2) Male pseudohermaphroditism occurs in 17 - hydroxylase and 3b-hydroxysteroid dehydrogenase deficiency 3) Female pseudohermaphroditism is seen in 21- hydroxylase and 11- hydroxylase deficiency. Ref: Ganong, Edition 20, Page - 353

2

21 - hydroxylase

11 - hydroxylase

17 - hydroxylase

3b- hydroxy steroid dehydrogenase

Physiology

null

02eed3c7-c2dc-46b2-9039-6ac4456cb675

single

A 2.5-week-old boy is brought to pediatrics emergency depament with projectile vomiting which is non-bilious. On physical examination, firm, olive like mass is noted in the epigastric region and USG revealed the following findings. The child underwent surgical management. On week later, the child presents again with loose stools after being breastfeed. What could be the etiology of the current episode diarrhea?

The clinical symptoms, examination with USG findings of thickened pyloric muscle (>3mm) and elongated pyloric canal (>15mm) reveal the diagnosis as CHPS- congenital hyperophic pyloric stenosis. The management image represents surgical pyloromyotomy. Post surgical management - pyloric sphincter dysfunction leads to delivery of hyperosmotic chyme from stomach to small intestine, which it cannot process leading to OSMOTIC DIARRHEA. This is known as DUMPING syndrome and is responsible for the week's later symptoms.

3

Post-operative infection

Rotavirus

Dumping syndrome

Non resolution of the pre-op symptoms

Unknown

Integrated QBank

3f41c320-2535-4f7a-b0b5-42407e015b8c

single

Commonest site of meningocele is

• Herniation of meninges through a defect in the posterior vertebral arches. • Spinal cord is usually normal and assumes a normal position in the spinal canal • There may be tethering, syringomyelia, or diastematomyelia. Clinical Features • A fluctuant midline mass, that may transilluminate occurs along the vertebral column, in the lower back. • Most meningoceles are well covered with skin and pose no threat to the patient. • Anterior meningocele: Projects into pelvis through a defect in the sacrum. • Symptoms of constipation and bladder dysfunction develop due to the increasing size of the lesion. Diagnosis • Plain roentgenograms demonstrate a defect. Treatment • Asymptomatic children with normal neurologic findings and full-thickness skin covering the meningocele may have surgery delayed. • Patients with leaking CSF or a thin skin covering should undergo immediate surgical treatment to prevent meningitis.

1

Lumbosacral

Occipital

Frontal

Thoracic

Surgery

null

7f4e055e-a49f-45bc-81b4-adc0a9e45953

single

P. carini causes infection primarily in?

Pneumocystis jirovecii causes infection Primarily in Rats. Pneumocystis jirovecii (previously P. carinii) is the causative organism of Pneumocystis pneumonia paicularly among immunocompromised hosts. P. jiroveci causes PCP in human with HIV if, their CD4+ cells count below 200/uL.

1

Rats

Guinea pig

Rabbits

Humans

Microbiology

Mycology

043dd197-d08f-410a-9e68-e643a52f8c0b

single

An anganwadi worker is trained for -

-under ICDS Scheme, there is an anganwadi worker for a population of 400-800. - anganwadi worker is selected from the community itself - undergoes a training in various aspects of health, nutrition and child development for 4 months. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:903 <\p>

2

3 months

4 months

5 months

6 months

Social & Preventive Medicine

Health education & planning

b4816029-73d3-4c73-af3a-df1cddbe4fa5

single

Mycoplasmas differ from chlamydiae in that they are

Mycoplasmas lack a rigid cell wall and are bound by a triple-layer unit membrane. For this reason, they are completely resistant to the action of penicillins. Unlike the chlamydiae, they can replicate in cell-free media.

2

Susceptible to penicillin

Able to grow on artificial cell-free media

Able to cause urinary tract infection

Able to stain well with Gram's stain

Microbiology

Bacteria

0ef38e3e-5f3c-4479-b410-4dd92af8a7eb

single

Pneumatoceles often develop in children after pneumonia due to the following organism

Radiological signs are extensive in a form of massive consolidation.E.coli,Klebsiella ,staphylococcus pneumonia have pneumatoceles. Ref : Essential pediatrics,O.P.Ghai,7 th edition,pgno:355

3

Klebsiella

Streptococcus

Staphylococcus aureus

Haemophilus influenzae

Pediatrics

Respiratory system

4f07ac95-23f6-422b-a9ce-6611c5175be9

single

The following drug penetrates into caseous necrosis in TB-

Ans- B RIFAMPICIN: 1.most effective anti- tubercular drug 2.Most bactericidal antitubercular drug 3.Only bactericidal drug effective against persisters or dormant bacilli in solid caseous lesson 4.Acts on extracellular as well as intracellular organisms 5.Antitubercular drug causing rapid sputum conversion 6.Antitubercular drug causing orange discoloration of urine ISONIAZID: 1.First effective bactericidal drug used to treat tuberculosis 2.Maybe bacteriostatic at lower concentrations 3.Most toxic antitubercular drug 4.Antitubercular drug first to develop resistance STREPTOMYCIN: 1.Injectable antitubercular drug 2. Antitubercular drug contraindicated in pregnancy 3.Antitubercular drug causing vestibular damage ETHAMBUTOL 1.Antitubercular drug contraindicated in children < 6 years age 2. Antitubercular drug causing Optic neuritis(red-green color blindness)

2

INH

Rifampicin

Pyrazinamide

Streptomycin

Unknown

null

c65619f0-aeb3-46f1-8b3b-9671a864e084

single

Type I MEN involves all except-

MEN type 1 (MEN 1), which is also referred to as Wermer's syndrome, is characterized by the triad of tumors involving the parathyroids, pancreatic islets (gastrinomas, insulinomas, nonfunctioning and PPoma, glucagonoma, VIPoma) and anterior pituitary (prolactinoma, somatotrophinoma, coicotropinoma, nonfunctioning). Reference : page 2335-36 Harrison's Principles of Internal Medicine 19th edition

2

Pancreas

Adrenal

Pituitary

Parathyroid

Medicine

Endocrinology

6d072e93-1c1d-4e18-8bae-9a2c9e9ca45a

multi

Ectopic tissue in stomach is of the origin of

Pancreatic tissue outside boundaries of the pancreas without anatomic or vascular connections to the pancreas, Also called ectopic pancreas. Ectopic pancreas can be found in submucosa of stomach, duodenum or small intestine, gallbladder, spleen Reference Bailey and love&;s edition 24 page no .1120

2

Spleen

Pancreas

Liver

Kidney

Surgery

G.I.T

fa57122c-520b-4f0b-b527-aba74c9f3cc8

single

True statement about burn resuscitation -

Ans. is 'c' i.e.. Half of the calculated fluid given in initial 8 hrs. o Proper fluid management is critical to survival in a bum patient.o The hypovolemic shock in bum patient is special in the sense that the total body water remains unchanged in a burn patient. The thermal injury leads to a massive fluid shift from intravascular compartment to the extravascular compartment (interstitial -fintacellular) leading to edema formation (in both burned parts and non burned parts of body).o This fluid shift is maximum in the first 24 hrs.o Fluid resuscitation begins with an isotonic crystalloid solution- Ringer's lactate solution (RL) is the preferred solution (Normal saline should be avoided as the volumes required for resuscitation may lead to hyperchloremic metabolic acidosis). The concept behind the continuous fluid resuscitation is that the bum (and/or inhalation injury) drives an inflammatory response that leads to capillary leak; as the plasma leaks into the extravascular space, crystalloid administration would maintain the intravascular volume.The quantity of crystalloid needed for adequate resuscitation is determined by Parkland formula i.e., 4 mL/kg per % of TBS A bum. (Note that a number of formulas exist for calculating fluid needs during burn resuscitation, suggesting that no one formula benefits all patients. Parkland is one of the most commonly used formulas).Half of the calculated fluid is given in first 8 hrs and half in next 16 hrs.o Colloids are given in the next 24 hrs. The reason behind it being the observation that in the initial period, the vascular permeability is so large that even larger protein molecules leak from the capilaries. (But some workers, prefer to use colloids after 8 to 12 hrs, while there are some who use it from the very beginning),o A number of parameters are widely used to assess bum resuscitation, but the most common remain the simple outcomes of blood pressure and urine output. As in any critically ill patimt, the target MAP is 60 mitiHg to ensure optimal end-organ perfusion. Goals for urine output should be 30 mL/h in adults and 1 to 1.5 mL/kg per hour in pediatric patients.o There is no use of diuretics in bum resuscitation.o Children under 20 kg have the additional requirement as they do not have sufficient glycogen stores to maintain an adequate glucose level in response to the inflammatory' response. Specific pediatric formulas have been described, but the simplest approach is to add maintenance IV fluid with glucose supplementation in addition to the calculated resuscitation fluid with lactated Ringer's.

3

Colloid preferred in initial 24 hrs

Colloid preferred if burnt area is > 15 % of total BSA

Half of the calculated fluid given in initial 8 brs.

Urine output should be maintained at 50-60 mL/hr.

Surgery

Initial Care of the Burn Patient

abbea89c-f90f-4766-9fe2-a86f05ca5ffd

multi

Hypeension is seen with all except

levodopa Drug causing hypeension * Cocaine * MAO Inhibitors * Cyclosporine * Glucocoicoids * Oral contraceptives * Tricyclic antidepressants * NSAID, Rofecoxib * Sympathomimetics Ibuprofen, Naproxen * Clonidine withdrawl * Decongestants (pseuodephedrine) * Erytlu-opoietin Drugs causing hypotension * Theophylline * Adenosine * Morphine * Quinidine * Fosphenytoin * Amiodarone * 1L-2 * Guanethidine * Alphablockers * Beta blockers (i.v.) * Bretylium * Chlorpromazine * Glyceryltrinitrate * Clonidine * Diuretics * Calcium channel blockers

4

Erythropoietin

Cyclosporine

NSAID

Levodopa

Pharmacology

null

36e3cace-10a3-4e77-9d66-76bc1423bd24

multi

Frequency distribution is studied by

Ans. is 'a' i.e., Histogram

1

Histogram

Line diagram

Pie diagram

Ski diagram

Social & Preventive Medicine

null

62d267e2-0b0c-43ef-ae45-f18f67c06cb2

single

All are features of psychosis except ?

Ans. is 'c' i.e., Preserved contact with reality Psychosis Psychosis is a mental state involving the loss of contact with reality, causing deterioration of normal social functioning. The characteristic features of psychosis are : - Gross impairment in reality testing, i.e., loss of contact with reality. Marked disturbance in personality and behavior with impairment in social, interpersonal and occupational functioning. Marked impairment in judgement. Loss of insight (insight is an assessment of how aware the patient is of their own mental illness). Presence of characteristic symptoms like delusions and hallucinations, these are called psychotic symptoms. The major psychosis are : ? Organic psychotic disorders, e.g., Delirium, substance related psychosis, head trauma. Non-organic psychoses Major psychoses : - Schizophrenia, mood disorders (depression, mania, bipolar). Other psychotic disorders ( third psychosis): - Delusional disorders, acute and transient psychotic disorders, schizoaffective disorder Neurosis Neurosis is a general term referring to mental distress that, unlike psychosis, does not prevent rational thought and daily functioning. Characteristic features are : - Symptoms cause subjective distress to the patient. Insight is present (symptoms are recognised as undesirable). The personality and behaviour are relatively preserved as is the judgement. The contact with reality is preserved. Absence of organic causative factor Impoant neurotic disorders are Anxiety disorders (Panic), Phobia (Phobic anxiety disorder), obsessive compulsive disorder, Dissociative conversion disorder.

3

Loss of insight

Presence of delusions

Preserved contact with reality

Personality disturbances

Psychiatry

null

bf4e3d0f-cafb-4200-8921-beb13c9b3abe

multi

Most commonly injured tarsal bone ?

Ans. is 'd' i.e., Calcaneum Calcaneum is the most commonly fractured tarsal bone In 5-10% of cases fracture is bilateral Most common mechanism of injury is fall from height, often from a ladder, onto one or both heels. The calcaneum is driven up against the talus and is split or crushed. About one fifth of these patients suffer associated injuries of the spine, pelvis or hip. Calcaneal fracture is also known as Voveri fracture' Plain x-rays done for calcaneal fracture include lateral, oblique and axial views. Axial view of calcaneum is also called Hark view. CT is the investigation of choice With severe injuries and especially with bilateral fractures - it is essential to take x-ray the knees, the spine and the pelvis as well.

4

Talus

Navicular

Cunieform

Calcaneum

Surgery

null

a1307734-9b5e-4700-90d8-c6063fc1cdd4

single

Boxer's fracture is -

Ans. is 'c' i.e., 5th metacarpal fracture EponymFractures of Upper limbMontegia fracture dislocationFracture of the proximal third of ulna with radial head dislocation.Galeazzi fracture dislocationFracture of the distal third of the radius with dislocation of the distal radio-ulnar joint.Colie's fractureFracture at cortico-cancellous junction of the distal-end of radius with dorsal tilt.Bennet's fractureOblique intra-art icular fracture of the base of the 1st metacarpal.Night stick fractureIsolated fracture of the shaft of the ulna.Smith's fractureA fracture of distal end of radius at cortico-cancellous junction with ventral tilt and displacements (reverse Colle's fracture).Barton's fractureA vertical, marginal intra-articular fracture of the distal end of radius occurring with volar or dorsal displacement.Chauffeur fractureAn intra-articular oblique fracture of the styloid process of the radiusBoxer's fractureA fracture through the neck of the 5th metacarpal.

3

Radial styloid fracture

Reverse colle's fracture

5 th metacarpal fracture

1st metacarpal fracture

Orthopaedics

Fractures of Metacarpals, Phalanges, Metacarpo-Phalangeal Joints

ee1b31b7-e393-4807-890c-072f459f80e2

single

Drug of choice for treponema is:

Pencillin

1

Pencillin

Tetracycline

Azithromycin

Doxycycline

Pharmacology

null

88a1e801-313d-48c8-bdca-4451c6f3a9c2

single

Sensations of spinothalamic tract are:

Ans: a (Pain, temperature & undifferentiated touch)Ref: Ganong, 22nd ed Pg.141Dorsal column transmits:Anterior spinothalamic tract transmits:Fine touchCrude touchVibrationPressureJoint position sense Lateral spinothalamic tract transmits:Cortical sensations:PainTactile localisationTemperatureTwo point discriminationStereognosisSensory inattentionGraphaesthesia

1

Pain, temperature & undifferentiated touch

Static proprioception

Temperature only

Proprioception

Physiology

Nervous System

7bbb8f08-2700-4820-94bd-b52d4bf160db

single

Which of the following causes opening of eustachian tube

The medial fibres of tensor veli palatine are attached to the lateral lamina of the tube and when they contract they help to open the tube lumen. These fibres also called dilator tube muscles. Reference: Dhingra 6th edition.

3

Salpingopharyngeus

Levator veli palatine

Tensor veli palatine

None of the above

ENT

Ear

9e28d7df-c3b9-479b-874a-b7cef9fa1f91

multi

A young lady presented with white lacy lesions in oral cavity and her proximal nail fold has extended onto the nail bed. What is the likely diagnosis –

Presence of white lacy lesions in the oral cavity and proximal nail fold prolonged on to nail bed (pterygium) suggest the diagnosis of lichen planus.

3

Psoriasis

Geographic tongue

Lichen planus

Candidiasis

Dental

null

de00ead6-545f-4c86-9b69-97d33f48c9e7

single

Postmoem rigidity FIRST stas in which of the following organs?

Postmoem rigidity is first apparent in the smaller muscles eg eyelids and jaw, and then it becomes evident in the remainder. Typically it is seen first in the face, then it progresses to shoulders and and finally in the large muscle groups of the limbs (Nysten's rule). In the initial 30 minutes after death there is no rigidity. Between 30min and 3 hrs after death, rigidity affects the face and eye muscles. By 6hrs rigidity affects all muscle groups and remains so for 24-36 hrs after death. From the time of 24 hr onwards rigidity stas to diminish with muscles becoming flaccid again from the time of around 36 hours. Ref: Oxford Handbook of Forensic Medicine By Tim Squires, page 33.

1

Eyelids

Neck

Upper limbs

Lower limbs

Forensic Medicine

null

968ccd8d-248b-4f2f-b245-fb597e165def

single

Budd Chiari syndrome is due to thrombosis of -

null

4

Infra renal IVC

Renal part of IVC

Superior mesentric vein thrombosis

Hepatic veins

Surgery

null

80f17643-941f-4fd4-aa78-14f8084cf1fc

single

What is the GFR (mL/min per 1.73m2) of a patient who is in G4 category of chronic kidney disease

Reference: Harrison's Principles of Internal Medicine; 20th edition; Chapter 335 Chronic Kidney Disease , pg 2112

3

60-89

30 - 59

15 - 29

< 15

Medicine

C.V.S

c804ecaf-25a9-433c-bfcf-be3d596c2d4a

single

Which of the following is the least common cause of ambiguous genitalia in a female child –

Placental steroid sufatase deficiency is an X-linked disorder (affects only males) that does not lead to ambiguous genitalia in a female child. 'Placental steroid suflatase deficiency is a rare X-linked disorder and all affected fetuses are males' William's 22nd/81 Congenital adrenal hyperplasia is the most common cause of ambiguous genitalia in female child. Fetal placental aromatase deficiency and WNT-4 gene mutation cause ambiguous genitalia in female child.

1

Fetal placental steroid sulfatase deficiency

Fetal placental aromatase deficiency

Congenital adrenal hyperplasia

WNT–4 gene mutation

Pediatrics

null

fdcb8163-fd65-40a7-b2e7-f3017e189ac2

single

Molar pregnancy can be best diagnosed by

USG is the investigation of choice for molar pregnancies.

2

Clinical history & examination

Ultrasound study

Laproscopy

CT Scan

Radiology

null

81ae860a-0f78-4870-b8b9-5f54a533b966

single

Minimum time of diagnosis for manic illness: DNB 10; AIIMS 14

Ans. 1 week

1

1 week

1 month

1 year

2 years

Forensic Medicine

null

792fe63e-edec-4623-a6dc-4ca14796de86

single

All of the following metabolic process occur in the mitochondria, EXCEPT:

Fatty acid and triacylglycerol synthesis occur in the cytoplasm, but its precursor acetyl CoA is formed in the mitochondrial matrix. Beta oxidation of fatty acid occur in the matrix of the mitochondrion. Beta oxidation begins as soon as fatty acyl CoA appear in the matrix using repeated cycle of 4 steps. With each step fatty acyl CoA is broken down into new fatty acyl CoA shoened by two carbon atoms plus an acetyl CoA. Gluconeogenesis occur in the cytosol but depends on the mitochondrial compament for its staing substrate oxaloacetate. Functional compamentalisation of metabolism: Mitochondria: Beta oxidation of fatty acids Amino acid oxidation TCA cycle Urea cycle Peroxisomes: Oxidation of long chain fatty acids and D amino acids Synthesis of some lipids Cytoplasm: Glycolysis Glycogen generation and storage Fatty acid synthesis Urea cycle Gluconeogenesis Ref: Biochemistry By John W. Pelley, page 81. Biochemistry Primer for Exercise Science, 4E By Peter Tiidus, page 220, Mitochondria in Health and Disease edited by Carolyn D. Berdanier page 27.

4

Urea cycle

TCA cycle

Beta oxidation of fatty acids

Fatty acid synthesis

Biochemistry

null

d2f83333-6750-429e-9c39-49d49d15f791

multi

All of the following are features of flat type of pelvis except: (Repeat)

Ans: A (Narrow subpubic angle) Ref : Grays Anatomy 40th Ed pg.1329Explanation:All pelvic measurements display individual variation and the values quoted are means from limited surveys.Sexual and racial differences also occur.Many attempts to classify human pelves, especially female.The four most common terms used today are gynaecoid, anthropoid, platypelloid and android.GynaecoidThe gynaecoid pelvis is the traditional Western female pelvis with a heart-shaped brim and the range of measurements quoted above.Anthropoid pelvisAn anthropoid pelvis has a larger midcavity and a wide anteroposterior inlet which is oval in shapeIt is more common in women of African origin and may be associated with a 'high assimilation' pelvis where there is an additional lumbar vertebra.Platypelloid pelvisA platypelloid pelvis is flat and oval from side to side at the brimit is a contracted pelvis that is rarely seen nowadays, having previously been associated with rickets.Android pelvisAn android pelvis has a triangular brim and is the shape of a male pelvis.

1

Narrow subpubic angle

Short concave sacrum

Divergent side walls

Wide sciatic notch

Anatomy

Misc.

16a22945-f67c-4a21-a166-79f922d56219

multi

Most common site of genital tuberculosis is :

Fallopian tubes

3

Abdomen

Pulmonary

Fallopian tubes

Ovary

Gynaecology & Obstetrics

null

62075103-dca3-4de1-8bec-cd92b9c5b3b7

multi

All are the methods of Aerial blood pressure monitoring except

Cardiovascular monitoring Noninvasive Aerial Blood Pressure monitoring methods : Palpation Doppler Auscultation Oscillometry Aerial Tonometry Invasive Aerial Blood Pressure monitoring method Aerial cannulation ( eg : radial, ulnar, femoral ,etc) Pulmonary aery catheterization Central venous catheterization Cardiac output measurement Thermodilution Dye Dilution Pulse Contour Devices Esophageal Doppler Thoracic Bioimpedance Fick Principle Echocardiography Transthoracic echocardiography (TTE) Transesophageal echocardiography (TEE) Capnography : It is Non Cardiovascular monitoring method

1

Capnography

Radial aery cannulation

Oscillometry

Aerial Tonometry

Anaesthesia

Monitoring in Anesthesia

28f0d37e-ceae-419c-86fb-ad57af6abb6e

multi

Coccobacillus grown in BYCE medium is

Coccobacllus which have fatidious requirements and grow on complex media such as buffered charcoal,yeast extract (BYCE) agar,with L_cysteine and antibiotic supplements with 5%CO2 at PH_6.9, temperature 35degC and 90% humidity is legionella. Ref: anantnarayan and panikers 10 th edition

1

Legionella

Streptobacillus

Gardenella

Neisseria

Microbiology

Bacteriology

b862db84-7194-47d1-b313-574c620b216e

single

Fructose absence in semen analysis suggests:

Abnormalities Low ejaculate volume may indicate: Retrograde ejaculation Ejaculatory duct obstruction Incomplete collection Androgen deficiency Azoospermia: Testicular failure Obstruction of vas deferens Absence of fructose: Seminal vesicle agenesis or obstruction

2

Bilateral vas deferens obstruction

Seminal vesicles agenesis

Testicular failure

Prostatic urethral obstruction

Surgery

Prostate and seminal vesicles

47761127-3ba6-4f47-b49b-dc4fa6481606

single

Oschner Sherren regimen is for

Ans. b (Appendicular mass). (Ref. Bailey & Love, 25th ed., 1215)APPENDICULAR MASS# Following an attack of acute appendicitis infection is sealed off by greater omentum, caecum, terminal ileum, etc resulting in a tender, soft to firm appendicular mass.# Presence of appendicular mass is a contraindication for appendicectomy due to risk of faecal fistulae.# It is treated by Oschner & Sherren's regime, which includes:1. Aspiration with Ryle's tube to give rest to GIT.2. Bowel care (avoid purgatives).3. Charts--temperature, pulse, respiration, diameter of mass.4. Drugs--to cover all organisms.5. Exploratory laparotomy contraindicated.6. Fluid-IV (patient kept nil orally for few days).7. Swinging temperature & increased in size of mass indicate abscess.Criteria for stopping conservative treatment of an appendix mass include A rising pulse rate , Increasing or spreading abdominal pain and Increasing size of the mass

2

Appendicular abscess

Appendicular mass

Acute appendicitis

Appendicular mucocele

Surgery

Vermiform Appendix

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An old woman, Nanda suffered stroke for which she was given alteplase. She improved considerably. To prevent the recurrence of stroke, this patient is most likely to be treated indefinitely with :

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Aspirin

Warfarin

Urokinase

Enoxaparin

Pharmacology

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A 35-year-old mother of two children is suffering from amenorrhea from last 12 month. She has a history of failure of lactation following second delivery but remained asymptomatic thereafter. Skull X-ray shows empty sella diagnosis is:

Ans. is c, i.e. Sheehan's syndromeRef: Williams Gynae 1st/ed, p374; Leon Speroff 7th/ed, p438; Jeffcoate 7th/ed, p582-583Here before arriving to any diagnosis lets first see the causes of:Empty Sella:* Congenital incompleteness of the sellar diaphragm.* Secondary to surgery/radiotherapy or infarction of pituitary tumor.* Secondary to infarction and necrosis of pituitary gland.Now from the given causes: either pituitary tumor or Sheehan's syndrome can cause an empty sella on X-ray.Pituitary tumours (micro/macroadenoma) are prolactin secreting tumors and hence, cause galactorrhea (not lactational failure) with amenorrhea and are so, ruled out.So, the obvious answer by exclusion is Sheehan's Syndrome.Sheehan's syndrome:* It is the syndrome which results from ischemic necrosis of most of the anterior pituitaryQ due to spasm in its arterioles occurring at the time of severe hemorrhage or shock, complicating childbirth.Clinical Features: SymptomsQ* Failure of lactation after deliveryQ* Secondary amenorrheaQ* Loss of libidoQ* Increased sensitivity to cold (hvpothyroidism)Q Remember | Amenorrhea With failure to lactate With galactorrhea, headache and blurring of vision| |Think sheehan's syndrome Think prolactinoma

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Menopause

Pituitary tumor

Sheehan's syndrome

Intraductal papilloma of breast

Gynaecology & Obstetrics

Disorders in Menstruation

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