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Which is a lipotropic factor?
|
Agents such as choline, methionine, Betaine, inositol, etc. which have the apparent effect of facilitating the removal of fat from liver, and thus prevents accumulation of fat in Liver cells. Such substances which prevent accumulation of fat in liver are said to be 'Lipotropic' ('Lipotropic agents' or 'Lipotropins'). The phenomenon itself is called "Lipotropism". Antagonistic agents and the converse condition are "anti-lipotropic" and "anti- lipotropism" respectively.Ref: Textbook of Medical Biochemistry, Eighth Edition Dr (Brig) MN Chatterjea, page no: 458
| 3 |
HDL
|
Insulin
|
Choline
|
Carnitine
|
Biochemistry
|
Metabolism of lipid
|
e381524c-0bf3-40c9-94d1-810bc1ef1982
|
single
|
Benzodiazepines are used in treatment of somnambulism, as they-
|
Somnambulism / Sleep walking Usually seen in children. disorder of NREM sleep No treatment is required in most of the cases ,as it remits itself. BZDs are used if the symptoms are severe as the duration of Stage 2 is increased and that of Stage 3 and 4 is decreased, in which somnambulism is seen.
| 3 |
Increase the duration of NREM III and IV
|
Increase the duration of REM sleep
|
Decrease the duration of NREM III and IV
|
Decrease the duration of REM sleep
|
Psychiatry
|
Sleep Disorders
|
662c2440-a02e-401d-ad15-ad31a4f57a54
|
single
|
A person unacclimatised develops pulmonary edema
|
When they first arrive at a high altitude, many individuals develop transient "mountain sickness." This syndrome devel- ops 8 to 24 h after arrival at altitude and lasts 4 to 8 d. It is characterized by headache, irritability, insomnia, breathlessness, and nausea and vomiting. Its cause is unsettled, but it appears to be associated with cerebral edema. The low PO2 at high altitude causes aeriolar dilation, and if cerebral autoregulation does not compensate, there is an increase in capillary pressure that ors increased transudation of fluid into brain tissue. Individuals who do not develop mountain sickness have a diuresis at high altitude, and urine volume is decreased in individuals who develop the condition. High-altitude illness includes not only mountain sickness but also two more serious syndromes that complicate it: high-altitude cerebral edema and high-altitude pulmonary edema. In high-altitude cerebral edema, the capillary leakage in mountain sickness progresses to frank brain swelling, with ataxia, disorientation, and in some cases coma and death due to herniation of the brain through the tentorium. High-altitude pulmonary edema is a patchy edema of the lungs that is related to the marked pulmonary hypeension that develops at high altitude. It has been argued that it occurs because not all pulmonary aeries have enough smooth muscle to constrict in response to hypoxia, and in the capillaries supplied by those aeries, the general rise in pulmonary aerial pressure causes a capillary pressure increase that disrupts their walls (stress failure).Ref: Ganong review of medical physiology 23rd edition Page no: 619
| 3 |
19 - 21 days
|
2nd - 3rd month
|
2 - 3 days
|
6 - 7 days
|
Physiology
|
Respiratory system
|
372182d0-0871-48fd-895e-808d907d12d3
|
single
|
Change in the affective level after communication and health education means change in:
|
Ans. b (Attitude). (Ref. Park PSM 22nd/pg. 628)Communication strategies enhance learning. The ultimate goal of communication is to bring about a change in desired direction of person who receives communication.# This may be cognitive level in terms of increasing knowledge.# It may be affective in terms of change in behaviour and attitude.# It may be psychomotor in terms of acquiring new skills.# Types of learning:- Cognitive learning (Knowledge) e.g. Enumerating causes of obesity- Affective learning (Attitude) e.g. Motivating a person for blood donation- Psychomotor learning (skills) e.g. Measuring pulse rate; Arriving at differential diagnosis.ATTITUDEAn attitude has been defined as a relatively enduring organization of beliefs around an object, subject, or concept which predisposes one to respond in some preferential manner. Attitudes are acquired characteristics of an individual. They are more or less permanent ways of behaving. An attitude includes 3 components - (a), a cognitive or knowledge element (b). an affective or feeling element, and (c). a tendency to action. It has been truly said that attitudes are caught, and not taught. Once formed, attitudes are difficult to change. Social psychology is largely a study of attitudes.LEARNINGis any relative permanent change in behaviour that occurs as a result of practice or experience. It means acquiring something new - new knowledge, new tech, new skills, new fears, and new experiences. It is both conscious and unconscious.HABITSis an accustomed way of doing things. Habits are said to have 3 characteristics - (a), they are acquired through repetition (b). they are automatic (c). they can be performed only under similar circumstances.
| 2 |
Knowledge
|
Attitude
|
Skills
|
All
|
Social & Preventive Medicine
|
Health Education & Health Planning
|
8192c056-2073-4bed-8090-5a6c769b198b
|
multi
|
Which of the following is not true about plasma protein binding?
|
Ans. is 'c' i.e., There is no effect of nephrotic syndrome on plasma protein binding Plasma protein binding* Many natural substances circulate around the body partly free in plasma water and partly bound to plasma proteins, e.g. cortisol, thyroxine.* Similarly drugs circulate in protein bound and free states, and the significance is that the free fraction is pharmacologically active whereas the protein bound component is a reservoir of drug that is inactive because of this binding.* Acidic drugs generally bind to plasma albumin.* Basic drugs bind to al acid glycoprotein.* Binding to albumin is quantitatively more important.Drugs bound to plasma protein To albumin To a, acid glycoprotein* Barbiturates * Penicillins* b- blockers* Methadone* Benzodiazepines (Diazepam)* Sulfonamides* Bupivacaine* Prazosin* NSAIDS * Tetracyclines* Lignocaine* Quinidine* Valproate * Tolbutamide* Disopyramide* Verapamil* Phenytoin * Warfarin* Imipramine * In nephrotic syndrome and other conditions causing hypoproteinemia, protein binding will be altered.* Morphine is not a plasma protein bound drug ->> in nephrotic syndrome there is no effect on protein binding.
| 3 |
Free fraction of the drug is pharmacologically active
|
Acidic drugs generally bind to plasma albumin
|
There is no effect of nephrotic syndrome on plasma protein binding
|
Prazocin is bound to alpha 1 acidic glycoprotein
|
Pharmacology
|
General Pharmacology
|
8b35290e-c2b1-425a-8a8c-b2ff85b6120d
|
multi
|
Increased Gamma efferent discharge is seen in all except :
|
C i.e. Rapid & shallow breathing Gamma efferent discharge is influenced byAnxietyQ causes increased discharge so hyperactive tendon reflexes- Stimulation of skin especially by noxious agentsQ, increase y discharge to ipsilateral flexor muscle spindles while decrease to extensors. Opposite pattern (i.e., flexor, extensorT) is produced in opposite limb.- Jendrassik's maneuverQ (pulling hands apa when flexed fingers are hookded together) increases y efferent discharge
| 3 |
Jendrassik's maneuver
|
Anxiety
|
Rapid shallow breathing
|
Stimulation of skin
|
Physiology
| null |
b532c7ff-6112-4c4e-adad-b0a53b47d1c1
|
multi
|
Capsule endoscopy is used for –
|
Capsule endoscopy allows the noninvasive visualization of the mucosa throughout the small intestine. It is particularly useful in the evaluation of obscure gastrointestinal bleeding.
| 3 |
GERD
|
Motility disorder
|
Bleeding
|
None
|
Radiology
| null |
5ee3e016-2735-4582-ad4b-ef46239460d0
|
multi
|
All are functions of oxytocin except
|
Maintenance of lactation (galactopoiesis) is by prolactin. Oxytocin causes contraction of the myoepithelial cells, smooth muscle-like cells that line the ducts of the breast. This squeezes the milk out of the alveoli of the lactating breast into the large ducts (sinuses) and thence out of the nipple (milk ejection or expulsion of milk or galactokinesis). Oxytocin causes contraction of the smooth muscle of the uterus. Oxytocin may also act on the nonpregnant uterus to facilitate sperm transpo. It causes increased contraction of the smooth muscle of the vas deferens, propelling sperm toward the urethra.
| 4 |
Galactokinesis
|
Uterine contraction in non pregnant female
|
Contraction of smooth muscle of vas deferens GalactopoiesisContraction of smooth muscle of vas deferens Galactopoiesis
|
Galactopoiesis
|
Physiology
|
Endocrinology
|
705e65a1-2b59-403d-9ed9-d14c3747783e
|
multi
|
75% Lymph from breast goes to -
|
Ans. is 'a' i.e., Axillary L.N. Lymph from Breast drains into the following lymph nodes|||Axillary nodesInternal mammary or ParasternalOthers like# Receives approx 75% of the drainage & are arranged in the following groups ;# Lateral# Anterior# Posterior a Central# Inerpectoral# Apical # Supracalvicular# Cephalic (deltopectoral)# Posterior intercostals# Subdiaphragmatico Clinical importance of lymphatic drainage of the breast is that carcinoma of the breast spreads mostly along the lymphatics to the regional lymph nodes.o The axiiiary nodes are divided into three levels according to their relation to pectoralis minor muscle* Level J - inferior to the lower border of the muscleLevel 11 - immediately behind its bellyLevel III - above and adjacent to the axillary vesselso Level I & Level II lymph nodes are dissected in modified radical mastectomy. o All three levels are removed inPatey s procedure of modified radical mastectomyRadical mastectomy
| 1 |
Axillary L.N.
|
Subciavicular L.N,
|
Internal mammary' L.N.
|
Cephalic L.N.
|
Surgery
|
Clinical Presentation and Physiology
|
5ab0cc63-f4de-4288-8ed0-358a3128936a
|
single
|
An agent that activates natural killer cells and is useful in renal cell carcinoma is
|
Ref-Katzung 10/e p816 Recombinant IL-2 is used for the treatment of maligant melanoma and renal cell carcinoma
| 1 |
Aldesleukin
|
Etanercept
|
Leflunomide
|
Thalidomide
|
Anatomy
|
Other topics and Adverse effects
|
5d77a71b-f3d4-4a53-a097-62ea260115e2
|
single
|
A 45 year old farmer has itchy erythematous papular lesions on face, neck, 'V' area of chest, dorsum of hands and forearms for 3 years. The lesions are more severe in summers and improve by 75% in winters. The most appropriate test to diagnose the condition would be:
|
Patient in the question is showing features of chronic allergic contact dermatitis, as indicated by the clinical manifestations in exposed areas of the body and its exacerbation during summer season. Patch testing is done to document sensitivity to a specific antigen. In this procedure, a battery of suspected allergens is applied to the patient's back under occlusive dressings and allowed to remain in contact with the skin for 48 hrs. After removal of the dressings the area is examined for evidence of delayed hypersensitivity reactions (e.g., erythema, edema, or papulo vesicles). Ref: CURRENT Medical Diagnosis and Treatment, 2012, Chapter 6; Harrison's Principles of Internal Medicine, 18h Edition, Chapter 51.
| 1 |
Patch test
|
Skin biopsy
|
Intradermal prick test
|
Estimation of IgE levels in blood
|
Skin
| null |
32a3eee5-88b9-44d9-9db2-8d3bc08ab9fe
|
single
|
Hotspot in a hea is seen in which scan?
|
Tc 99m pyrophosphate scan is also known as myocardial infarct scan and it depicts the segments of myocardium involved with the infarction. Get deposited in the calcified changes associated with the infarction.
| 4 |
Gallium
|
Albumin labelled
|
Thallium
|
Tc pyrophosphate scan
|
Radiology
|
Nuclear medicine
|
d376e723-0667-4f66-881e-de12dda13d6d
|
multi
|
Overdose of vitamin A mainly affects _________
|
Hypervitaminosis A Common in arctic explorers who eat polar bear liver Organelle damaged in hypervitaminosis is Lysosomes Acute toxicity: Pseudotumor cerebri (headache, dizziness, vomiting, stupor, and blurred vision, symptoms that may be confused with a brain tumor) and exfoliative dermatitis. In the liver, hepatomegaly and hyperlipidemia Chronic toxicity: If intake of > 50,000 IU/day for > 3 months Weight loss, anorexia, nausea, vomiting, bony exostosis, bone and joint pain, decreased cognition, hepatomegaly progresses to cirrhosis In pregnancy, retinoids cause teratogenic effects. ref DM Vasudevan 8th ed page 457
| 3 |
Cytosol
|
Mitochondria
|
Lysosome
|
Cell membrance
|
Biochemistry
|
vitamins
|
baa50975-0734-42ee-b346-cf34011ec261
|
single
|
Which of the following condition is associated with posterior staphyloma ?
|
Staphyloma refers to localised bulging of weak and thin outer tunic of eyeball (cornea and sclera) lined by uveal tissue which shines through the thinned outer fibrous coat. Posterior staphylomas develop in eyes with myopia more than -8 D. Buphthalmos is associated with ciliary as well as equatorial staphylomas.
| 1 |
Pathological myopia
|
Uveoscleritis
|
Pseudocornea
|
Angle closure glaucoma
|
Ophthalmology
| null |
544471b1-8d38-4c78-813c-557f5c61e7ed
|
single
|
Risk of the damage of fetus by maternal rubella is maximum if mother gets infected in -
|
Ans. is 'a' i.e., 6-12 weeks of pregnancy Congenital rubella syndrome (CRS) refers to infants bom with defects secondary to intra uterine infection or who manifest symptoms or signs of intrauterine infection sometimes after birth.Rubella infection inhibits cell division and this is probably the reason for congenital malformations and low birth weight.Always remember these important points about congenital rubella infection.The fetus can be infected as well as affected in all stages of the pregnancy.The rate of infection as well as damage to the fetus is highest during first trimester.* Both the risk of infection as well as risk of damage to the fetus goes on decreasing as the pregnancy progresses, so the rate of infection and the risk of damage to the fetus is lowest in 3rd trimester.Stage of gestation (weeks) when mother gets infectedPercentage of fetuses infectedPercentage of infected fetuses damagedOverall risk of damage to fetus (percent)< 11901009011-2655372017-26330027-365300
| 1 |
6-12 weeks of pregnancy
|
20-24 weeks of pregnancy
|
21-25 weeks of pregnancy
|
32-36 weeks of pregnancy
|
Social & Preventive Medicine
|
Communicable Diseases
|
d66a4e9b-0594-4fb3-882a-fd9763210272
|
single
|
Perception of objects with out stimulus is called:
|
Ans: A (Hallucination) Ref: Ahuja, 6th ed,p. 59Perception of objects without stimulus is hallucination.DelusionAre false unshakable beliefs which are not in keeping with the patients sociocultural and educational background and not amenable to reasoning.It is a disorder of thought.Delusions in the following conditions:Depression - nihilistic delusionDelirium - transient delusionSchizophrenia - delusion of persecution/ reference/control/infidelityMania - delusion of grandeurNote: Delusions are not seen in compulsive disorder, anxiety and dementia.HallucinationsFalse perception experienced without external stimulus to the sense organs.Auditory hallucinations are the commonest in non organic psychiatric disorders.Visual hallucinations are commonest in organic psychiatric disorders.Hallucinations is involuntary, does not depend on will of observer.It occurs in inner subjective space.It is vivid sensory perception.IllusionsIllusions are misconceptions of external stimuli
| 1 |
Hallucination
|
Illusion
|
Delusion
|
Euthymia
|
Psychiatry
|
Symptoms & Signs
|
d783adff-6dfe-4979-a3a9-a833ccc1f96a
|
multi
|
Sulfonylureas act by:
|
Ans. (D) Increasing insulin secretion from pancreas(Ref: KDT 8/e p294)Sulfonylureas stimulate the release of insulin by the beta cells of the islets of Langerhans by blocking K+ channels. Glucagon secretion is also reduced by sulfonylureas, but it is a minor action.
| 4 |
Decreasing glucagon secretion from pancreas
|
Decreasing insulin secretion from pancreas
|
Increasing gluconeogenesis
|
Increasing insulin secretion from pancreas
|
Pharmacology
|
Endocrinology
|
35699b16-17f2-4771-82b1-9ed9f50ba8c6
|
single
|
All of the following nondepolarising neuromuscular blocker causes histamine release except-
|
All benzylisoquinoline nondepolarising neuromuscular blocker causes histamine release. Aminosteroid group does not release histamine. NDNB divided in three group according to duration of action - Long- acting, intermediate - acting and sho- acting. Aminosteroid Long acting Pancuronium pipecuronium Benzylisoquinoline D-tubocurane, Doxacurium Intermediate acting Aminosteroid Vecuronium Rocuronium Benzylisoquinoline Atracurium Cisatracurium Sho acting Aminosteroid Rapacuronium Benzylisoquinoline Mivavcurium * Benzylisoquinoline group causes histamine release so IV injection of these drugs can cause hypotension,tachycardia, Bronchospasm, Flushing.
| 4 |
Atracurium
|
Mivacurium
|
d-tubocurare
|
Vecuronium
|
Anaesthesia
|
Neuromuscular Blocker
|
47c0a2f6-a2c1-4130-a347-223fb6b51167
|
multi
|
X-ray shows soap bubble appearance at lower end of radius, treatment of choice is –
|
Soap bubble appearance at the lower end of radius suggests the diagnosis of giant cell tumor.
Two commonly used procedures for GCT of the distal end of the radius are :-
are ended curratage (curratage + cryotherapy + bone graft / cementing)
Wide local excision with the replacement of the excised fragment by bone graft.
| 2 |
Local excision
|
Excision & Bone grafting
|
Amputation
|
RT
|
Radiology
| null |
abdc15e2-69bb-4aef-b996-34710193cc8d
|
single
|
All are true about thymus swelling except –
|
Thymic shadow does not indent tracheal shadow. A mediastinal shadow indenting tracheal shadow should always be evaluated for a significant pathology.
Thymic swelling may cause widening of anterior mediastinum. Thymic swelling causes a sail-shaped shadow. Thymic swelling may shrink with use of steroids.
| 4 |
Widening of mediastinum on X–ray
|
Sharp border with sail like appearance
|
Steroid administration reduces size of swelling
|
Shift of trachea on X–ray
|
Radiology
| null |
7542688e-794d-4a20-b1cb-0bee79e1d840
|
multi
|
Which of the following causes vasodilation in the pulmonary circulation?
|
Substances producing pulmonary vasodilation include nitric oxide, prostacyclins, a2 and b2 adrenergic stimulation, histamine etc. Hypercapnia, hypoxy endothelin I, a1 adrenergic, angiotensin II, thromboxane produce pulmonary vasoconstriction.
| 4 |
Hypercarbia
|
Hypoxia
|
PGE
|
PGI
|
Medicine
| null |
3fc1d9c4-9531-46b0-847e-d21c6d3ae106
|
single
|
All the following agents may be used in the treatment of Aoic dissection , except
|
Ref Harrison 19 th ed pg 1641 For acute dissection, unless contraindicated, b-adrenergic blockers should be administered par- enterally, using intravenous propranolol, metoprolol, or the sho- acting esmolol to achieve a hea rate of approximately 60 beats/ min. This should be accompanied by sodium nitroprusside infusion to lower systolic blood pressure to <=120 mmHg. Labetalol a drug with both b- and a-adrenergic blocking propeies, also may be used as a parenteral agent in acute therapy for dissection.
| 2 |
Propranolol
|
Diazoxide
|
Na nitroprusside
|
Labetalol
|
Medicine
|
C.V.S
|
028b39e2-af1c-4e3d-a4fc-8ac8c694d3eb
|
multi
|
Defecation reflex is intiated by?
|
Defecation reflex initiated by distension of rectum with feces. Defecation reflex: Initiated by distension of rectum with feces. Leads to propulsive wave extending from descending colon through sigmoid colon to rectum Urge to defecate is first felt when rectal pressure increases to about 18 mm/Hg. On reaching 55 mm/Hg rectal pressure - "Rectoanal inhibitory reflex" - Internal sphincter relaxes reflexly.
| 1 |
Distension of rectum with feces.
|
Post-prandial motility in duodenum
|
Only during diseased state
|
All of the above
|
Physiology
| null |
139ac469-e7fd-4fb1-a575-dbae8b6cfa0c
|
multi
|
All of the following statements about. Wilson's disease are true, EXCEPT-
|
Answer is C (Urinary copper excretion is <100R/day) Urine copper is an impoant diagnostic too. Symptomatic patients invariably have urine copper levels > 100 p (>1.6 umol) per 24 hours. Wilson's disease is an autosomal recessive disorder It is caused by a mutation of a gene on chromosome BQ which promotes Cu excretion (ATP 7B gene) Symptomatic patients with Wilson's disease invariably have urinary copper excretion of >100 lig, per 24 hours (>1.6 innol /24 hr) Zinc is the treatment of choice for maintainance therapy in Wilson's disease Zinc is the treatment of choice in Wilson's disease for A. Initial therapy in patients with hepatitis without decompensation(2 A. Maintainance therapy B. Presymptomatic patient C. Pediatric patients D. Pregnant patients
| 3 |
It is an autosomal recessive disorder
|
Serum ceruloplasmin level is < 20 mg/dl
|
Urinary copper excretion is
|
Zinc acetate is effective as maintenance therapy
|
Medicine
| null |
4e310e3f-fa4b-46e9-a695-c6a9fb5de8e6
|
multi
|
All of the following genes are associated with establishment of left sidedness, EXCEPT:
|
Left-right-sidedness, also established early in development, is orchestrated by a cascade of genes. When the primitive streak appears, fibroblast growth factor 8 (FGF8) is secreted by cells in the node and primitive streak and induces expression of Nodal but only on the left side of the embryo. Later, as the neural plate is induced, FGF8 maintains Nodal expression in the lateral plate mesoderm, as well as LEFTY-2, and both of these genes upregulate PITX2. PITX2 is a homeobox-containing transcription factor responsible for establishing left-sidedness. Also, it is expressed on the left side of the hea, stomach, and gut primordia, and, if expressed ectopically, it results in laterality defects. Simultaneously, LEFTY is expressed on the left side of the floor plate of the neural tube and may act as a barrier to prevent left-sided signals from crossing over. Sonic hedgehog (SHH) may also function in this role as well as serving as a repressor for left-sided gene expression on the right. Ref: Langman's embryology 11th edition Chapter 35.
| 4 |
Sonic hedgehog
|
FGF 8
|
Nodal
|
None of the above
|
Anatomy
| null |
5e2f3fc5-676c-4a9f-a799-0c4744319b88
|
multi
|
Massive PPH may warrant all interventions except:
|
Thermal endometrial ablation is not used in the management of massive PPH. Mechanical methods for failed medical management: Bimanual compression Uterine packing under anaesthesia Bakri balloon: Maximun filling volume is 500 ml Shivkars Pack: Condom inflated with saline and tied to a nasogastric tube. Surgical methods for failed mechanical methods: B Lynch suture application Block sutures/multiple squares/Hayman/Cho square/Gunshella suture Uterine and ovarian aery ligation Internal iliac aery ligation Hysterectomy (if all the above fails, as a last reso) Note: Thermal endometrial ablation is used to treat abnormal uterine bleeding. Ref: Williams Ostetrics 24th edition Pgno: 482
| 2 |
Hysterectomy
|
Thermal endometrial ablation
|
Internal iliac aery ligation
|
Balloon tamponade
|
Gynaecology & Obstetrics
|
General obstetrics
|
3ce3127e-32b3-42a3-81fc-f964ba3605b3
|
multi
|
Risk of damage to the fetus by maternal rubella is maximum if a mother gets infected in
|
The first trimester of pregnancy is the most disastrous time - results in abnormalities in the infant in 85% of cases.16% in the second trimester.Bih defects uncommon after 20 weeks of gestation.Park 23e pg: 145
| 1 |
6 - 12 weeks of pregnancy
|
20 - 24 weeks of pregnancy
|
24 - 28 weeks of pregnancy
|
32 - 36 weeks of pregnancy
|
Social & Preventive Medicine
|
Communicable diseases
|
042f7257-05ce-4f87-8224-bed9c5314662
|
single
|
Which one is not converted to an active metabolite?
|
Lisinopril: It is the lysine derivative of enalaprilat; does not require hydrolysis to become active ACE inhibitor.
KEY CONCEPT:-
All ACE inhibitors are prodrugs except captopril and lisinopril. Other drugs like enalapril are converted to its active metabolite (enalaprilat) and thus are slow acting.
Reference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page no 532
| 4 |
Quinapril
|
Fosinopril
|
Benzopril
|
Lisinopril
|
Pharmacology
| null |
e2979616-aa1f-4ac1-b14d-6860deda858a
|
single
|
Compared to round PID, use of rectangular PID reduces the patient's skin surface exposed by:
|
There are several means to limit the size of the x-ray beam. First, a rectangular position-indicating device (PID) may be attached to the radiographic tube housing. Use of a rectangular PID having an exit opening of 3.5 cm × 4.4 cm (1.38 inches × 1.34 inches) reduces the area of the patient’s skin surface exposed by 60% over that of a round (7 cm) PID.
White and Pharoah's Oral Radiology Principles and Interpretation 8th edition
| 4 |
15%
|
30%
|
45%
|
60%
|
Radiology
| null |
f5e3c9af-d57a-4da1-91d3-02f8109a7e0b
|
single
|
Baroreceptor stimulation produces:
|
A i.e. Decreased HR & BP Baroreceptors are the stretch receptors in the walls of hea & blood vessels eg carotid sinus & aoic arch receptors, receptors in walls of atria at enterance of SVC, IVC & pulmonary veins and receptors in pulmonary circulation (cardio- pulmonary receptors). These are stimulated by distension of the structure in which they are located 1/t vagal innervation of hea and producing vasodilation, venodilation, a drop in BP, bradycardia & decrease cardiac outputQ.
| 1 |
Decreased hea rate & BP
|
Increased hea rate & BP
|
Increased cardiac contractility
|
All
|
Physiology
| null |
e813a615-3752-4feb-aa4f-d8c41560ce61
|
multi
|
Schizophrenia is a common presentation is which genetic disease?
|
DiGeorge syndrome (22q11.2 deletion, velocardiofacial syndrome):30% have schizophrenia when reaches adulthood.
| 2 |
Down's syndrome
|
DiGeorge syndrome
|
Klinefelter's syndrome
|
Neurofibromatosis
|
Psychiatry
|
Schizophrenia Spectrum and Other Psychotic Disorders
|
db522b44-f877-4fd6-b60a-6b1ecd7770c6
|
single
|
Laboratory diagnosis of thalassemia major are all Except
|
Diagnosis of microcytic anaemiaTestsIron deficiencyInflammationThalassemiaSideroblastic anaemiaSmearMicro/hypoNormal micro/hypoMicro/hypo with targetingVariableSI<30<50Normal to highNormal to highTIBC>360<300NormalNormalPercent<1010-2030-8030-80SaturationFerritin (mcg/L)<1530-20050-30050-300Hemoglobin patternNormalNormalAbnormalNormal
| 1 |
Normal ferritin level
|
Normal TIBC
|
Microcytic hypochromic anemia
|
High saturation percentage
|
Microbiology
|
All India exam
|
7ac4f17a-477f-4d43-bdda-e8eed4558c33
|
multi
|
All of the following are true regarding Wegener's granulomatosis except: September 2008
|
Ans. A: Affects large size blood vesselsWegener's granulomatosis is a form of vasculitis that affects the lungs, kidneys and other organs.Due to its end-organ damage, it is life-threatening and requires long-term immunosuppression.Wegener's granulomatosis is pa of a larger group of vasculitic syndromes, all of which feature an autoimmune attack by an abnormal type of circulating antibody termed ANCAs (antineutrophil cytoplasmic antibodies) against small and medium-size blood vessels.Apa from Wegener's, this category includes Churg-Strauss syndrome and microscopic polyangiitis.Cytoplasmic staining ANCAs that react with the enzyme proteinase 3 (cANCA) in neutrophils are associated with Wegener's (upto 95% of cases).If the patient has renal failure or cutaneous vasculitis, these are the most logical organs to obtain a biopsy from.On histopathological examination, a biopsy will show leukocytoclastic vasculitis with necrotic changes and granulomatous inflammation on microscopy. These granulomas are the main reason for the appellation of "Wegener's granulomatosis", although it is not an essential feature.
| 1 |
Affects large size blood vessels
|
May affect lungs and kidneys
|
Necrotizing granuloma may be seen on microscopy
|
PR3-ANCAs are present in upto 95% of cases
|
Pathology
| null |
90f415b7-8dfc-4172-9b7d-7c8d2b7ff636
|
multi
|
Fundoscopy of a patient shows chalky white optic disc with well defined margins. Retinal vessels and surrounding Retina appears normal. Which of the following is the most likely diagnosis-
|
Chalky white optic disc with well defined margins along with normal retinal vessels and surrounding retina is typical of Primary Optic Atrophy.
| 1 |
Primary Optic Atrophy
|
Post-neuritic secondary optic atrophy
|
Glaucomatous optic atrophy
|
Consecutive optic atrophy
|
Ophthalmology
| null |
2888286b-e167-4ea1-a518-8fc78752bade
|
single
|
Which fracture in children requires open reduction -
|
Some displaced epiphyseal injuries (types III and IV) are indications for open reduction.
| 1 |
Fracture tibial epiphysis
|
Fralcture shaft of femur
|
FraCture both bones forearm
|
Fracture femoral condyle
|
Orthopaedics
| null |
cbaa6099-120c-4b54-a9c6-e7f778b2b7f7
|
multi
|
Earliest reflex lost in acoustic neuroma -
|
Ans. is 'b' i.e., Corneal o Earliest nerve involved by acoustic neuroma - Vth nerve/trigeminal nerve. o The earliest manifestation of V* nerve involvement is decreased corneal sensitivity leading to loss of corneal reflex, Clinical features of acoustic neuroma o The clinical features depend on the extent of the tumor and involved structure When tumor the is still confined to the internal auditory canal Cochleovestibular symptoms are the earliest symptoms of acoustic neuroma when tumour is still confined to the internal auditory canal. The commonest presenting symptoms are unilateral deafness or tinnitus, or a combination of both. Hearing loss is retrocochlear sensorineural type. There is marked difficulty in understanding speech, out of proportion to the pure tone hearing loss, a characteristic feature of acoustic neuroma. Vestibular symptoms are imbalance or unsteadiness. True vertigo is very rare. When the tumor extends beyond 1AC and involves other structures 1cranial nerve It is the earliest nerve to be involved. There is reduced corneal sensitivity and loss of corneal reflex which is the earliest sign of acoustic neuroma. Numbness or paraesthesia of face may occur. Involvement of Vth nerve indicates that tumor is roughly 2.5 cm in diameter and occupies the CP angle. VIIth nerve:- Sensory fibers of the facial nerve are involved. There is hypoesthesia of the posterior meatal wall (Hitzelberg's sign), loss of taste, and loss of lacrimation on Schirmer's test.:- Motor fibers are more resistant. IXth and Xth nerves:- Dysphagia and hoarseness due to palatal, pharyngeal and laryngeal paralysis. Brainstem Ataxia, weakness, numbness of arms & legs, exaggerated tendon reflexes. Cerebellum Ataxia, Dysdiadochokinesia, Nystagmus. Due to raisedICT:- Headache, neusea, vomiting, diplopia due to VI* nerve involvement, and papilloedema.
| 2 |
Pupillary
|
Corneal
|
Light
|
None
|
Unknown
| null |
391dd862-29cf-4a91-bc62-165932b46423
|
multi
|
Latent squint is also known as -
|
Lateral squint is also known as "Heterophoria" It is a condition in which tendency of the eyes to dete is kept latent by fusion. Therefore, when the influence of fusion is removed the visual axis of one eye detes away. Ref : A.K.Khurana; 6th edition;Page no: 344
| 3 |
Hyperphoria
|
Exophoria
|
Heterophoria
|
Esopheria
|
Ophthalmology
|
Ocular motility and squint
|
378c5911-83b2-40b4-a067-16c5f257235b
|
single
|
Drug induced lupus can be identified by-
| null | 1 |
Anti-histone antibodies
|
Double stranded DNA antibodies
|
Antinuclear antibodies
|
Anti-SM antibodies
|
Medicine
| null |
bbc62b4a-772f-416c-9445-daeea595739a
|
single
|
Which of the following channelopathies is associated with calcium channel disorder of muscles?
|
Ans. a (Hypokalemic periodic paralysis). (Ref. Harrison medicine 15th ed., -2295, 16th ed., 2339, 2363, 2536)1.Spinocerebellar ataxia 1Trinucleotide repeat (CAC) expansion in gene.2.Episodic ataxia type 1K channel gene mutations.3.Hypokalemic periodic paralysisL- type Ca++ channelopathy.4.Hyperkalemic periodic paralysisPoint mutation sodium channel.5.Malignant hyperthermiaMutation in Ryanodine receptor gene.6.MyotoniaMutation in Cl channel gene.Educational points:Clinical Features of Periodic Paralysis and Nondystrophic Myotonias Calcium ChannelSodium Channel Potassium ChannelFeatureHypokalemic PPHyperkalemic PPParamyotoniaCongenitaAnderson's SyndromeMode of InheritanceADADADADAge of onsetAdolescenceEarly childhoodEarly childhoodEarly childhoodMyotoniaNoYesYesNoEpisodic weaknessYesYesYesYesFrequency of attacks of weaknessDaily to yearlyMay be 2-3/dWith cold, usually rareDaily to yearlyDuration of attacks of weakness2-12 hFrom 1-2 h to >1 day2-24 h2-24 hSerum K+ level during attacks of weaknessDecreasedIncreased or normalUsually normalVariableEffect of K+ loadingNo changeIncreased myotonia, then weaknessIncreased myotoniaNo changeEffect of muscle coolingNo changeIncreased myotoniaIncreased myotonia, then weaknessNo changeFixed weaknessYesYesYesYes
| 1 |
Hypokalemic periodic paralysis
|
Episodic ataxia type 1
|
Hyperkalemic periodic paralysis
|
Paralysis Spinocerebellar ataxia 1.
|
Medicine
|
Miscellaneous
|
167d630f-0b54-46da-a67c-e0fa9f8b69ff
|
single
|
All are features of Hemolytic Anemia, except:
|
Increased haptoglobulin
| 3 |
Hemoglobinuria
|
Jaundice
|
Increased haptoglobulin
|
Hemosiderinuria
|
Pathology
| null |
f4b405e4-6d82-4bb5-88ff-9216f1f0e67a
|
multi
|
Allergic bronchopulmonary aspergillosis diagnotic criteria are -a) Peripheral eosinophilia > 0.1 x 109b) Central lower lobe bronchiectasisc) Detection of Aspergillus in sputumd) Asthma is always present
| null | 2 |
c
|
bd
|
ab
|
ac
|
Medicine
| null |
d9db6b23-05b8-4210-8569-be8c62d050c6
|
multi
|
Salivary secretion is by
|
Salivary secretion is by Na+, Cl– reabsorption and K+, HCO3– secretion.
| 1 |
Na+, Cl reabsorption
|
Na+, K secretion
|
Na+, K+ reabsorption
|
Cl–, HCO3– secretion
|
Physiology
| null |
51ed2656-6bc4-4531-a959-f82a2f683ae5
|
single
|
Pilocarpine:
| null | 1 |
Lowers the intraocular pressure in glaucoma
|
Cleaved by acetylcholinesterase
|
Inhibits sweat and lacrimation
|
Causes tachycardia
|
Pharmacology
| null |
11855717-6d63-4257-bec9-7b9947d42a84
|
single
|
A 25 year old young woman has recurrent episodes of headache and sweating. Her mother had renal calculi and died after having a neck mass. The physical examination reveals a thyroid nodule but no clinical sign of thyrotoxicosis. Before performing thyroid surgery, the surgeon should order :
|
Answer is D (Serial 24 hours test for catecholamines, metanephrines and vanillylamandelic acid excretion) : Theochromocytoma, must be excluded by measurement of urinary catecholamines levels in all cases before embarking upon thyroid surgery to avoid the potential hazards. of this condition' - Bailey Essays employed for diagnosis of pheochromocytoma include those for: Vanillyl mandelic acid (VMA) Metanephrines Free catecholamines The patient in question is a case of inherited Men II a syndromes The presence of 'headache and sweating' in a patient with thyroid nodule warrants prompt investigation for a possible pheochromocytoma as pa of MEN II syndrome, more so in a patient with a positive family history (as suggested by presence of renal calculi and thyroid nodule in mother). Pheochromocytoma secrete large amounts of catecholamines, the secretion of which is fuher increased during surgery. This may result in large swings in blood pressure and arrhythmias, and increases the risk of surgical moality. Stable a adrenergic blockage is essential before embarking on thyroid surgery.
| 4 |
Measurement of thyroid hormones
|
Serial determinations of serum calcium, phosphorus protein and alkaline phosphatase
|
24-hours urine test for 5 hydroxyindoleacetic acid excretion.
|
Serial 24 hours test for catecholamines, metanephrines and vanillylamandelic acid excretion.
|
Medicine
| null |
f92677fa-aca0-4eea-b266-aeca1f864ae2
|
single
|
Pappu, 7 yrs old young boy, had a fracture of lateral condyle of the femur. He developed malunion as the fracture was not reduced anatomically. Malunion will produce -
|
Ans-A
| 1 |
Genuvulgum
|
Genu varum
|
Genu recurvatum
|
Dislocation of knee
|
Unknown
| null |
939bedc6-0368-4dd6-91a6-8ff188b59a98
|
multi
|
"TIPS" is contraindicated in
|
Main contraindication for TIPSS is poal vein occlusion,which can be due to poal vein thrombosis.Post- shunt encephalopathy is the confusional state caused by the poal blood bypassing the detoxication of the liver.TIPSS is indicated in poal hypeension associated with cirrhosis,control of variceal bleeding,etc. Reference:Bailey & Love's sho practise of surgery,25the edition,page no:1089
| 3 |
Post-shunt encephalopathy
|
Cirrhosis
|
Poal vein thrombosis
|
Variceal bleeding
|
Surgery
|
G.I.T
|
4a0eb2ed-8142-433a-9d32-36332a6b828b
|
single
|
Gastro jejunostomy is an example of -
| null | 1 |
Clean contaminated wound
|
Clean uncontaminated wound
|
Unclean uncontaminated wound
|
Unclean contaminated wound
|
Surgery
| null |
f049a14f-d912-4f0e-ac28-feb3e1d0e5a7
|
single
|
Virchow's triad includes all ,except:
|
. Venous thrombosis
| 2 |
Injury to vein
|
Venous thrombosis
|
Venous stasis
|
Hypercoagulability of blood
|
Pathology
| null |
19bb532e-b857-4cc4-b1e8-00c4b8e4cb9d
|
multi
|
A 10-year-old boy, Pappu, died of acute rheumatic fever. All the following can be expected at autopsy, except:
|
MacCallum patch/plaque is a feature of chronic rheumatic hea disease (RHD). During mitral regurgitation, where the regurgitant jet strikes back the atrial wall, results in endocardial thickening and it is called MacCallum patch or MacCallum plaques. They are described as "map-like areas of thickened, roughened, and wrinkled pa of the endocardium in the left atrium", usually associated with dilated left atrium.
| 3 |
Aschoff's nodules
|
Anitschkow cells
|
McCallum patch
|
Fibrinous pericarditis
|
Pathology
|
Rheumatic Fever
|
7d6524bd-688b-40ed-8b1e-88cc1cee2dbd
|
multi
|
Na dependent glucose transpo is /are inhibited by:
|
C i.e. Phlorhizine
| 3 |
Oubain
|
Na azide
|
Phlorhizine
|
Phloretin
|
Physiology
| null |
a4d510d4-f9f5-453f-8338-c09fcd318684
|
single
|
All of the following are associated with increased Aging, except:
|
Over expression of superoxide dismutase/catalase leads to extension of life span. Ref: Richard J. Aspinall, (2003), Chapter "Aging of The Skin", In the book, "Aging of Organs and Systems", USA, Page 54; Robbin's Basic Pathology, 7th Edition, Pages 42-44; Harrison's Principle of Internal Medicine, 17th Edition, Page 54; 'Aging' By Moody, 5th Edition, Pages 33, 34
| 2 |
Increased cross linkages in collagen
|
Increased superoxide dismutase
|
Increased accumulation of free radicals
|
Accumulated Mutations in somatic cells
|
Pathology
| null |
9f7cbdff-bb1b-418c-be45-a1200b86c61b
|
multi
|
For Rx of ventricular fibrillation in an adult, DC shock of what joules should be started with?
|
Ans. A (200 J). (Ref. Harrison, Medicine, 18th/ Ch. 233; fibg 233-11). Ref- Sustained polymorphic VT, ventricular flutter, and VF all lead to immediate hemodynamic collapse. Emergency asynchronous defibrillation is required with at least 200-J monophasic/100-J biphasic shock VENTRICULAR FLUTTER AND VENTRICULAR FIBRILLATION (VF) # These arrhythmias occur most often in patients with ischaemic heart disease. # Episodes of cardiac arrest recorded during Holter monitoring reveal that approximately three fourths of the sudden deaths are due to VT or VF. Types: # Ventricular flutter usually appears as a sine wave with a rate between 150 and 300 beats/min. # VF is recognized by grossly irregular undulations of varying amplitudes, contours, and rates. # VT originates below the bundle of His at a rate >100 beats per minute; most VT patients have rates >120 beats per minute. Sustained VT at rates <120 beats per minute and even <100 beats per minute can be observed, particularly in association with the administration of antiarrhythmic agents that can slow the rate. ECG Clues Supporting the Diagnosis of Ventricular Tachycardia # AV dissociation (atrial capture, fusion beats) # QRS duration >140 ms for RBBB type V1 morphology; V1>160 ms for LBBB type V1 morphology # Frontal plane axis -90Adeg to 180Adeg # Delayed activation during initial phase of the QRS complex # LBBB pattem-R wave in V1, V2>40 ms # RBBB pattern-onset of R wave to nadir of S >100 ms # Bizarre QRS pattern that does not mimic typical RBBB or LBBB QRS complex # Concordance of QRS complex in all precordial leads # RS or dominant S in V6 for RBBB VT # Q wave in V6 with LBBB QRS pattern # Monophasic R or biphasic QR or R/S in V1 with RBBB pattern TREATMENT: VENTRICULAR TACHY C ARDIA/FEBRILL ATION # Sustained polymorphic VT, ventricular flutter, and VF all lead to immediate hemodynamic collapse. Emergency asyn- chronous defibrillation is therefore required, with at least 200-J monophasic or 100-J biphasic shock. The shock should be delivered asynchronously to avoid delays related to sensing of the QRS complex. If the arrhythmia persists, repeated shocks with the maximum energy output of the defibrillator are essential to optimize the chance of successful resuscitation. Intravenous lidocaine and/or amiodarone should be administered but should not delay repeated attempts at defibrillation. # For any monomorphic wide complex rhythm that results in hemodynamic compromise, a prompt R-wave synchronous shock is required. Pharmacologic treatment to terminate monomorphic VT is not typically successful (<30%). Intravenous procainamide, lidocaine, or amiodarone can be utilized. Idiopathic LV septal VT appears to respond uniquely to IV verapamil administration. # VT in patients with structural heart disease is now almost always treated with the implantation of an ICD to manage anticipated VT recurrence. The ICD can provide rapid pacing and shock therapy to treat most VTs effectively # Several recent secondary prevention trials have demonstrated superior survival (3 years) in patients treated with ICDs versus amiodarone ALGORITHM: VF | | Assess ABC | | Give pericardial thump and begin CPR till defibrillator is ready | | Defibrillation with 200 J (2 J/kg in children) and repeat with 300 and 360 j (4 J/kg in children) | | Rhythm after first 3 shocks | | | | Asystole Normal rhythm VF still persists | | Intubate at once, obtain IV access and give adrenaline 1 mg IV and defibrillate with 360 J. | | If not aborted, repeat adrenaline in high dose and defibrillate with 360 J. | | If not aborted, give lignocaine/ bretyl ium/MgSO4/NaHCO3 with D-360 J. | | If no response, terminate efforts.
| 1 |
200J
|
250J
|
300J
|
360J
|
Unknown
| null |
7c15ad76-1fb3-4f8a-93b4-b885f621aa5b
|
single
|
The amount of blood lossduring each menstrual period is about :
|
35 cc
| 2 |
10 cc
|
35 cc
|
50 cc
|
100 cc
|
Gynaecology & Obstetrics
| null |
b6cd9d35-06e0-4c7c-afa0-b7e3ffc6cc14
|
single
|
Non-motile Clostridia is
|
Clostridia are motile with peritrichous flagella. Exceptions are Clostridium perfringes and Clostridium tetani type IV which are non-motile. Motility is slow and has been described as 'stately'. C.perfringens and C.butyricum are capsulated, while others are not. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 257
| 1 |
Clostridium perfringens
|
Clostridium novyi
|
Clostridium botulism
|
Clostridium difficle
|
Microbiology
|
Bacteriology
|
995d587e-1025-476d-b738-c0ee13d3352a
|
single
|
In DIC, which is not seen?
|
In the blood picture of Disseminated intravascular coagulation: Platelet count is low, Prothrombin time, thrombin time, activated paial thromboplastin time are all prolonged. Plasma fibrinogen levels are reduced, Fibrin degradation products are raised Reference textbook of Pathology 7th edition author Harsha Mohan page number 31
| 3 |
Fibrinogen decreased
|
Thrombocytopenia
|
Normal APTT
|
PT elevation
|
Pathology
|
Haematology
|
93b4be50-9120-4598-9623-07d5a983d144
|
single
|
The pathogenesis of acute proliferative glomerulo-nephritis-
|
immune complex disease in which tissue injury is primarily caused by complement activation by the classical pathway. Typical features of immune complex disease, such as hypocomplementemia and granular deposits of IgG and complement on the GBM, are seen. The relevant antigens probably are streptococcal proteins. Specific antigens implicated in pathogenesis include streptococcal exotoxin B (Spe B) and streptococcal GAPDH. Both activate the alternative complement pathway and have an affinity for glomerular proteins and plasmin. It is not clear if immune complexes are formed mainly in the circulation or in situ. Ref: Robbins basic pathology 9th edition page529
| 2 |
Cytotoxic T-cell mediated
|
Immune complex mediated
|
Antibody mediated
|
Cell-mediated (Typer IV)
|
Pathology
|
Urinary tract
|
aa3788d9-b5a2-4f5f-b19f-a3818b62886d
|
single
|
The histology of pterygium includes:
|
Ans. Elastotic degeneration
| 1 |
Elastotic degeneration
|
Epithelial inclusion bodies
|
Precancerous changes
|
Squamous metaplasia of the epithelium
|
Ophthalmology
| null |
d0c01f20-d5b4-4fac-bf43-5a15359ad589
|
single
|
True regarding pertussis vaccine is -
| null | 2 |
95% of vaccinated are protected
|
Erythromycin should be given to contacts
|
Neuroparalytic Complication is seen in 1 in 15000
|
Leucocytosis is diagnostic
|
Microbiology
| null |
b4c474c5-2330-474c-a509-ce7fa4b2bc8c
|
multi
|
Which of the following is given in induction of anesthesia?
|
ANS. A# Intravenous inducing agents in anesthesia1. Thiopentone sodium2. Methohexitone sodium3. Propafol4. Etomidate5. Benzodiazepines6. Ketamine7. Fentanyl
| 1 |
Lorazepam
|
Bupivacaine
|
Neostigmine
|
Dexmedetomidine
|
Pharmacology
|
Anaesthesia
|
a880977a-e3af-4afb-9fd8-aea31448cc55
|
single
|
Ciliary staphyloma is seen in
|
Answer: a) Absolute glaucoma (PARSON 22nd ED, P-223)STAPHYLOMA* Localized bulging of weak & thin outer tunic of eyeball (cornea or sclera), lined by uveal tissue* Anterior staphyloma> An ectasia of pseudocornea> Most common cause - sloughing corneal ulcer which perforatesIntercalary staphylomaCiliary staphylomaEquatorial staphylomaPosterior staphyloma* Located at the limbus* Lined by root of iris* May be associated with secondary angle closure glaucoma* Located upto 8mm behind limbus* Lined by ciliary body.* Bulge of sclera lined by choroid in the equatorial region (14mm behind limbus)* Bulge of sclera, lined by choroid, behind the equatorial region* Not visible externally CausesCauses:* Perforating injury* Marginal corneal ulcer* Anterior ScleritisCauses* Perforating injury* Scleritis* Absolute glaucomaCauses* Scleritis* Pathological myopia* Degenerative myopiamcc* Posterior scleritis* Perforating injury
| 1 |
Absolute glaucoma
|
Pathological myopia
|
Retinoblastoma
|
Episcleritis
|
Ophthalmology
|
Miscellaneous
|
e5ebd831-8ec6-4550-9de8-84eed370a303
|
single
|
Will's gauge is used to measure
| null | 1 |
Vertical height
|
Bi-zygomatic width
|
Inter condylar distance
|
Inter papillary width
|
Dental
| null |
9043530d-78ae-4f6f-8e09-00eecf7552a8
|
single
|
Lysozyme is present in the following secretions of the body except -
|
Lysozymes is present in tissue fluids and in nearly all secretions except cerebrospinal fluid, sweat and urine. It act by splitting ceain polysaccharide components of the cell walls of susceptible bacteria . Reference : Anathanarayan & paniker's 9th edition, pg no:80 <\p>
| 2 |
Lacrimal secretions
|
CSF
|
Saliva
|
Respiratory tract secretions
|
Microbiology
|
Immunology
|
cdb8c51b-4f7a-4d19-90e6-7cbedb3b8fbe
|
multi
|
A 54-year-old man has a total cholesterol of 272 and LDL level of 210. His therapy is initiated with dietary modification and an exercise regimen, but he is unresponsive and so is prescribed nicotinic acid (Niacin). Which of the following symptoms will this patient likely experience from this drug?
|
Niacin, or vitamin B3, is an agent that results in the following physiologic changes: LDL reductions tend to occur in 5-7 days with the maximal effect seen in 3-5 weeks; triglycerides and VLDL are reduced by 20% to 40% in 1-4 days; and HDL levels can increase by 20%. This agent is indicated as adjunctive therapy in patients with elevated cholesterol and triglycerides when diet and other nondrug therapies are inadequate. The most common adverse effect of this agent is generalized flushing with a sensation of warmth, especially in the facial area. This reaction may be so severe in some patients that they discontinue therapy. Other common adverse effects include hepatotoxicity, tachycardia, hypoalbuminemia, hyperglycemia, nausea, vomiting, hyperuricemia, glucose intolerance, pruritus, peptic ulcer disease, and dry skin.
| 2 |
Bradycardia
|
Facial flushing
|
Hypoalbuminemia
|
Hypoglycemia
|
Pharmacology
| null |
41955439-ebfc-49be-a252-3151c3b23d50
|
single
|
The following can be done in obstructive jaundice -a) Vitamin K injectionsb) Vitamin C injectionsc) Dehydration therapyd) External drainage
| null | 2 |
b
|
ad
|
ac
|
ab
|
Surgery
| null |
c20fdb05-9804-4a34-ab42-b4454b07ddd1
|
single
|
“Ivory towers of disease” is referred to?
|
Large hospitals cater to make number of patients and hence called ivory towers of disease.
| 2 |
Small health centres
|
Large hospitals
|
Private practitioners
|
Health insurance companies
|
Dental
| null |
b8ad15d9-9f40-49a1-bb24-03d40a41176a
|
multi
|
Referred ear pain may travel through all except?
|
Ans. is 'c' i.e., Abducens nerve Referred otalgia As ear receives nerve supply from Vth (auriculotemporal branch), IXth (tympanic branch) and Xth (auricular branch) cranial nerves; and from C2 (lesser occipital) and C2 and C3 (greater auricular), pain may be referred from these remote areas: 1. Via Vth cranial nerve Dental : - Caries tooth, apical abscess, impacted molar, malocclusion. Oral cavity : - Benign or malignant ulcerative lesions of oral cavity or tongue. Temporomandibular joint disorders : - Bruxism, osteoahritis, recurrent dislocation, ill-fitting denture. Sphenopalatine neuralgia Vi intensity will hear it. Therefore, if identical vibrating tuning forks are held at equal distances from both ears they are heard in both ears. However, if one tuning fork is moved closer to one ear the person hears only that fork although the other fork is still vibrating sufficiently for him to hear. In stenger test, two vibrating tuning forks are held equidistant from either ear. If the patient is claiming deafness in his left ear he will clain to hear only the fork on his right side. The fork on the left side is moved closer. If the patient is feigning deafness he will perceive only the tuning fork on the left side and will claim not to hear anything. If the patient has a genuine hearing loss on the left he will still hear the tuning fork on the right side. 2. Teal test This can be used when the patient admits to hearing bone conduction in his 'deaf' ear. The examiner stands behind the patient and applies a tuning fork to the mastoid process of his 'deaf' ear. The patient admits to a IXth cranial nerve Oropharynx : - Acute tonsillitis, peritonsillar abscess, tonsillectomy. Benign or malignant ulcers of soft palate, tonsil and its pillars. Base of tongue : - Tuberculosis or malignancy Elongated styloid process. 3.Via Xth cranial cerve : Malignancy or ulcerative lesion of vallecula, epiglottis, larynx or laryngopharynx, oesophagus. 4. Via C2 and C3 spinal nerves : Cervical spondylosis, injuries of cervical spine, caries spine.
| 3 |
Trigeminal nerve
|
Glossopharyngeal nerve
|
Abducens nerve
|
Vagus nerve
|
ENT
| null |
2442f292-3b94-4e7f-bd71-30b86f9cc5c7
|
multi
|
Pipkin fracture is defined as:
|
B i.e Posterior dislocation is common Posterior Dislocation Of Hip It is most common type of hip dislocation in adults and childrenQ. Usually this occurs in a road accident when someone seated in car is thrown forwards, striking the knee against the dashboard (dashboard injuryQ). It is the position (direction) of hip at the time of injury that decided the pattern of injury. Position of Hip at the time of Injury Patter of Injury Flexion, adduction, internal rotation Pure posterior dislocation Less flexion, less adduction (neutral or slight abduction), internal rotation Posterior fracture dislocation Hyper abduction + Extension Anterior dislocation Classification Schemes For Posterior Hip Dislocations Thompson & Epstein Type I Dislocations without or with minor fracture Type II Dislocation with a single large fracture of posterior acetabular rim. Type III Dislocation with comminution of posterior acetabular rim. Type IV Dislocation with fracture of acetahular floor. Type V Dislocation with fracture of femoral headQ Stewa And Miford Type I Dislocation without fracture Type II Dislocation with posterior rim fracture (one or more fragments), but the hip is stable after reduction Type III Dislocation with fracture of rim producing gross instability Type IV Dislocation with fracture head or neck of femur So in other words Thompson & Epstein, and Stewa & Milford are posterior dislocation injuries of hip and Pimpkin's fracture is fracture of femoral headQ (& / or neck) in posterior dislocation injuries. In posterior dislocation of hip clinical presentation is - Flexion, adduction and internal (medial) rotation deformity with shoeningQ Femoral head can be palpated posteriorly - Vascular sign of Narath is positiveQ i.e. due to posterior dislocation of hip joint the vessels fall back unsuppoed so femoral aerial pulsation, which is felt against the head of the femur will be feeble or even may not be palpable . - Due to posterior direction of displacement sciatic nerveQ and superior gluteal aery injury may occur. - It is the posterior dislocation that cause maximum shoening of limbo and is most commonly associated with sciatic nerve injuryQ Simple dislocations are mostly managed by close reduction under anesthesiaQ. Few methods of reduction are - Stimsons gravity method, Allis maneuver, Bigelow maneuver and East Baltimore lift.
| 2 |
Head of radius fracture
|
Head of femur fracture
|
Fracture dislocation of ankle
|
Fracture neck of femur
|
Surgery
| null |
306c79b0-e757-47fe-a719-be35ecb1c264
|
single
|
Amyloid present in cerebral lesions of Alzheimer's disease -
|
Ans. c (Ab) (Ref. Harrison's medicine 17th ed., Table 324-1)Amyloid Fibril Proteins and their PrecursorsAmyloid ProteinPrecursorSystemic (S) or Localized (L)Syndrome or Involved TissuesALImmunoglobulin light chainS, LPrimaryMyeloma-associatedAHImmunoglobulin heavy chainS, LPrimaryMyeloma-associatedATTRTransthyretinSFamilialSenile systemic L?TenosynoviumA2M2-microglobulinSL?Hemodialysis, JointsAA(Apo)serum AASSecondary, reactiveAApoAIApolipoprotein AlSLFamilialAorticAApoAIIApolipoprotein AllSFamilialAGelGelsolinSFamilialAlysLysozymeSFamilialAFibFibrinogen -chainSFamilialACysCystatin CSFamilialABriABriPPL, S?Familial dementia, BritishADanADanPPLFamilial dementia, DanishAA protein precursor (APP)LAlzheimer's disease, agingAPrPPrion proteinLSpongiform encephalopathiesACal(Pro)calcitoninLC-cell thyroid tumorsAIAPPIslet amyloid polypeptideLIslets of LangerhansInsulinomasAANFAtrial natriuretic factorLCardiac atriaAProProlactinLAging pituitaryProlactinomasAlnsInsulinLIatrogenicAMedLactadherinLSenile aortic, mediaAkerKerato-epitheliumLCornea; familialA(tbn)tbnbLPindborg tumorsALacLactoferrinLCornea; familial
| 3 |
L
|
AA
|
Ab
|
b-microglobulin
|
Unknown
| null |
45a77657-92ca-42bd-bc80-f6504045058b
|
single
|
Rain, a 10 yr old boy is having difficulty in learning at school. He has sho lapses of awareness with eyelid fluttering that occur every 5-10 minutes. EEG studies reveal brief 3 Hz spike and wave discharges appearing synchronously in all the leads. Which of the following drugs would be effective but has the disadvantage that it causes sedation and tolerance?
|
(Ref: KDT 6/e p411, 412) Diagnosis of the patient is petit mal epilepsy (absence seizures). Drugs effective against absence seizures are: - Ethosuximide - Valproate - Clonazepam - Lamotrigine Clonazepam is a benzodiazepine that can cause sedation and tolerance.
| 3 |
Diazepam
|
Ethosuximide
|
Clonazepam
|
Valproic acid
|
Anatomy
|
Other topics and Adverse effects
|
841cc477-9588-4571-8120-cfea5d5cf652
|
multi
|
Which of these is a Nephritic syndrome?
|
The nephritic syndrome is characterized by hematuria, oliguria with azotemia, proteinuria, and hypeension. The most common causes are immunologically mediated glomerular injury; lesions are characterized by proliferative changes and leukocyte infiltration. Acute postinfectious glomerulonephritis typically occurs after streptococcal infection in children and young adults but may occur following infection with many other organisms; it is caused by deposition of immune complexes, mainly in the subepithelial spaces, with abundant neutrophils and proliferation of glomerular cells. Most affected children recover; the prognosis is worse in adults. Rapidly progressive glomerulonephritis (RPGN) is a clinical entity with features of the nephritic syndrome and rapid loss of renal function. Nephrotic syndrome is caused by a derangement in glomerular capillary walls resulting in increased permeability to plasma proteins. The manifestations of the syndrome include: Massive proteinuria, with the daily loss of 3.5 gm or more of protein (less in children) Hypoalbuminemia, with plasma albumin levels less than 3 gm/dL Generalized edema Hyperlipidemia and lipiduria
| 3 |
Minimal change disease
|
Membranous Glomerulopathy
|
Post infectious Glomerulonephritis
|
Focal segmental glomerulosclerosis
|
Pathology
|
FMGE 2019
|
30e60139-8cf3-4480-bf33-36a29fb574d8
|
single
|
Dilution segment in nephrom is:
|
The thick LOH is viually impermeable to H20, but large amounts of Na, Cl & other ions are actively transpoed from the tubule into the medullary interstitium. Thus, fluid in thick ascending loop becomes very dilute and k/a diluting segment of the nephron. Proximal tubules: = 65% of the filtered electrolytes is reabsorbed here, along with water ( osmosis & aquaporin - 1). Descending LOH: Water absorbed AQP - 1 much less permeable to Na & urea; there by increasing the osmolarity.
| 1 |
Ascending LOH
|
Descending LOH
|
Collecting tubule
|
Proximal tubule
|
Physiology
|
DNB 2018
|
8ac9e457-4312-4848-b956-53491339b189
|
single
|
A patient receiving allopurinol requires dose reduction of:
|
Allopurinol is an inhibitor of uric acid synthesis. It acts by inhibiting the enzyme 'xanthine oxidase. This drug is commonly prescribed to a patient on anticancer therapy because destruction of cells results in increased formation of uric acid.
6-Mercaptopurine is also metabolized by xanthine oxidase. If allopurinol is administered to a patient receiving 6-MP, toxicity may occur due to increased plasma concentration of 6-MP. Therefore if both are given concurrently, dose of 6-MP should be decreased to 25% of the normal.
| 1 |
6–Mercaptopurine
|
Cyclophosphamide
|
6–Thioguanine
|
Cimetidine
|
Pharmacology
| null |
df422ca5-7fa2-4aa1-ad38-907feade58e9
|
multi
|
. A case control study is not characterized by -
| null | 4 |
Cases with the disease are compared to controls without the disease -
|
Assessment of past exposure may be blased
|
Definition of cases may be difficult
|
Incidence rates may be computed directly
|
Social & Preventive Medicine
| null |
06cb6906-e295-44f3-a58d-ee7562d03412
|
single
|
Patient came from Nagaland and shows positive test with OXK antigen. Diagnosis is?
|
Ans. is 'b' i.e., Scrub typhus Weil felix reaction . This reaction is an agglutination test in which sera are tested for agglutinins to 0 antigens of ceain nonmotile proteus strains OX - 19, OX - 2 and OX - K. . The basis of the test is the sharing of an alkali - stable carbohydrate antigen by some rickettsiae and by ceain strains of proteus, P. vulgaris OX - 19 and OX - 2 and P. mirabilis OX - K. . The test is usually done as a tube agglutination, though rapid slide agglutination methods have been employed for screening. Weil felix Reaction Disease OX-19 OX-2 OX-K Rocky Mountain spotted fever Rickettsial pox Epidemic typhus + - + + - - ? ? _ Bril - Zinsser disease +/- - ? Scrub typhus - - + Endemic typhus + - ? Trench fever - ? Q fever -
| 2 |
Trench fever
|
Scrub typhus
|
Endemic typhus
|
Epidemic typhus
|
Microbiology
| null |
4e40288c-8e5f-43a8-9db7-f46273790aa9
|
single
|
Most common site for opening of TAPVC is -
|
Ans. is 'a' i.e., Supracardiac TAPVCo Total anomalous pulmonary venous connection (TAPVC) is characterized by abnormal drainage of pulmonary veins into the right heart either by direct connection into the right atrium or into its tributarieso According to the site or level of connection of the pulmonary veins to the systemic venous system TAPVC has been classified into four typeso Type I (most common: 45%): Anomalous connection at supracardiac level (PV drains into left innominatevein or SVC)o Type II (25%): Anomalous connection at cardiac level (PV joins the coronary sinus or enter right atrium directly)o Type III (25%) : Anomalous connection at infracardiac level (PV drain into portal vein)?o Type IV (5%) : Anomalous connection at multiple levels.o In supracardiac TAPVC the pulmonary veins join to form a single trunk (common pulmonary vein) which than drain through anomalous connection
| 1 |
Supracardiac
|
Cardiac
|
Infracardiac
|
Multiple
|
Pediatrics
|
Cyanotic Congenital Heart Disease
|
2a6178fe-11c4-4de9-864c-267957962dbb
|
single
|
Mrs. S (G2 L1) presented to the hospital in labor pains. On examination she had 3 uterine contractions of 20 seconds in 10 minutes, cervical dilation 6 cm and HR 145 bpm. What is the stage of labor?
|
Ans. is a, i.e. Stage IAs discussed in chapter 7 of the book, first stage of labor is from the time when a female starts perceiving true labor pains and uptil 10 cm of dilatation.
| 1 |
Stage I
|
Stage II
|
Stage III
|
Stage IV
|
Gynaecology & Obstetrics
|
Normal Labour
|
328f2f50-d294-44d5-9405-8f8d0eac184f
|
single
|
Primary ciliary dyskinesia is associated with all except-
| null | 2 |
Sterility in males
|
Hypothyroidism
|
Sinusitis
|
Respiratory infection
|
Medicine
| null |
07561676-4347-4dfc-b948-2a44cdac8b12
|
multi
|
All are indications for surgical intervention in pyogenic liver abscess, EXCEPT:
|
Indications for surgical drainage in pyogenic liver abscess are: No clinical response after 4-7 days of drainage a catheter Multiple, large, or loculated abscess Thick walled abscess with viscous pus Concurrent intra-abdominal surgical pathology. Right lobe abscess as such is not an indication for surgical drainage to rupture into the pericardium, which is lethal. Ref: Heneghan et al. BMC Research Notes 2011, 4:80.
| 4 |
Multiple large or loculated absecc
|
Thick walled abscess with loculated pus
|
Concurrent intraabdominal surgical pathology
|
Right lobe abscess
|
Medicine
| null |
8a751e50-e8cb-4834-97d9-ab71f1ca8331
|
multi
|
A primiparous D-negative (Rh-negative) mother has just delivered a D-positive child. Administration of which of the following substances would be indicated
|
- Administration of anti-D antiserum to D-negative mother within 72hrs of delivery of D-positive child prevents maternal alloimmunization by removing fetal red cells from the maternal circulation.
| 2 |
Anti-D IgG to child
|
Anti-D IgG to mother
|
D-positive red cells to child
|
D-positive red cells to mother
|
Pathology
|
Hematopoeisis: Basic concepts
|
375d2a95-da19-4e13-8426-745d4e048d8b
|
single
|
Gene for Wilson's disease is ?
|
Ans is 'a' i.e. ATPB7 o Wilson's disease is an autosomal recessive disorder of copper metabolism caused by mutation of ATP7 B gene on the long arm of chromosome 13. ATP7 B gene encodes 'p-type' ATP responsible for copper excretion and incorporation into ceruloplasmin in the liver. The defect in ATP7 B gene results in copper accumulation in the liver (primarily) and other organs like eye and CNS.
| 1 |
ATP7B
|
B
|
C
|
D
|
Unknown
| null |
bcf3c7cf-b8b9-44bc-847b-32260a4f478b
|
single
|
Increased risk factor for carcinoma breast is
|
Risk factors of breast carcinoma Mutation of tumour suppressor genes BRCA1/BRCA2 is thought to be involved with high-risk of breast carcinoma Diet low with phytoestrogens and high alcohol intake have high-risk of breast cancer. Vitamin C reduces the risk. It is more common in nulliparous woman. Attaining early menarche and late menopause have high-risk of breast malignancy. Early child-bearing and breastfeeding reduces the chances of malignancy. Early 1st child bih reduces the risk; late first child bih after 35 years increases the risk. It is more common in obese individuals Ref; (page no;530 ) 5th edition of SRB&;S manual of Surgery.
| 1 |
BRCA1 mutation
|
Breast feeding
|
Multiparity
|
Smoking
|
Surgery
|
Endocrinology and breast
|
efbeca31-3cd5-44e0-960d-ba1a78a3f4b6
|
single
|
Digoxin is not indicated in:
|
Ans. (C) High output failure(Ref: KDT 8th/e p560, 561)Digitalis is an inotropic agent that is indicated when heart is not able to pump the blood adequately. High output failure is seen in conditions like anemia and thyrotoxicosis in which heart is already contracting vigorously. Cardiac glycosides, thus are not indicated in high output failure.
| 3 |
Atrial flutter
|
Atrial fibrillation
|
High output failure
|
PSVT
|
Pharmacology
|
C.V.S
|
68b038e7-2dab-4837-bc9d-7fabbb24cf1d
|
single
|
Treatment of metastatic disease in retinobastoma is
|
A i.e. Chemotherapy Treatment Plan of Retinoblastoma The factors influence the management include size, location & laterality of tumor, vision of affected & unaffected eye, age & health of child and any associated ocular problem such as retinal detachment, vitreous haemorrhage, neovascularization of iris & secondary glaucoma. Chemotherapy (CT) It is primary treatment option in children with bilateral retinoblastomaQ. Initial treatment in children with unilateral disease when the affected eye is believed to be salvageable. 6 cycles of Carboplatin, etopasaide & vincristine (CEV) +- cyclosporine is most common regimen. Paially regressed tumors that are still ble following the 2nd cycle of chemotherapy & any new tumors that develop during the course of chemotherapy must be treated by obliterative local therapies (cryotherapy, laser therapy, and episcleral plaque radiation therapy). Residual or recurrent vitreous seeds following chemotherapy and focal (local) treatments usually require external beam radiation therapy if eye is to be salvaged. Chemotherapy is also used to treat extraocular tumor extension at presentation, or detected on histopathology of enucleated eye, orbital tumor recurrence after enucleation, intracranial invasion by tumor & metastatic diseaseQ. Inspite of popularity of CT as the primary t/ t for RB, enucleation remains impoant option especially in - Unilateral advanced intraocular diseaseQ. - B/L for advanced disease not amenable to any eye preserving therapy. - For more severely affected eye in markedly asymmetrical bilateral cases. The principle route of exit of tumor cells from the eye is along the optic nerveQ Enucleation is usually curative in RB if an optic nerve section longer than 5mm is obtained with globe - Surgeon should attempt to obtain optic nerve section 10-15 mm long in every case. External Beam Radiation Therapy 40-50 Gy radiation (in multiple fractions of 150-200 cGy over 4-5 weeks) is given using a linear acclelerator to Eyes containing one or more tumors that involve optic disc. Eyes that show dffuse vitreous seeding. Eyes for which prior chemotherapy or local treatments such as laser therapy, cryotherapy, photocoagulation or plaque radiotherapy, failed. - Vitreous seeds generally do not respond well to , because of their relative hypoxic status. - Cataract (at least after 6 months usually after 1-1.5 years) is likely to develop. Rarely retinopathy, neovascular glaucoma, orbital bone growth arrest and second malignancy may develop.
| 1 |
Chemotherapy
|
Enucleation
|
Radiotherapy
|
Cryo
|
Ophthalmology
| null |
e00afce0-b68a-412b-8bc3-3fd8595a0073
|
single
|
Feature which differentiates true from aificial bruise is ?
|
Ans. is 'a' i.e., Round shape with irregular margins
| 1 |
Round shape with irregular margins
|
Irregular shape with regular margins
|
Swelling of surrounding area
|
Erythema of surrounding area
|
Forensic Medicine
| null |
321b1b40-42da-45e0-ae5f-db2b4277142a
|
multi
|
Not a feature of heroin {smack} withdrawal
|
Heroin or di-acetyl-morphine is about two times more potent than morphine in injectable form. Apa from the parenteral mode of administration, heroin can also be smoked or 'chased' ( chasing the dragon), often in an impure form (called ' smack' or ' brown sugar' in India). Withdrawal SyndromeThe onset of withdrawal symptoms occurs typically within 12-24 hours, peaks within 24-72 hours, and symptoms usually subside within 7-10 days of the last dose of opioid. The characteristic symptoms include lacrimation, rhinorrhoea, pupillary dilation, sweating, diarrhoea, yawning, tachycardia, mild hypeension, insomnia, raised body temperature, muscle cramps, generalised body ache, severe anxiety, piloerection, nausea, vomiting and anorexia. There are marked individual differences in the presentation of withdrawal symptoms. Heroin withdrawal syndrome is far more severe than the withdrawal syndrome seen with morphine. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 43
| 3 |
Yawning
|
Muscle cramps
|
Hypersomnia
|
Hypeention
|
Psychiatry
|
Substance abuse
|
a84b7916-b3d6-4519-a66d-f5b0b5a303d5
|
single
|
Which of the following drugs is not used topically for treatment of open angle glaucoma -
|
Acetazolamide and Methazolamide are not recommended for long term use because of their side effects. However,acetazolamide 250mg tds may be added to control IOP for sho term. Ref :Ophthalmology A K Khurana 6th edition chapter-10 page no :237
| 3 |
Latanoprost
|
Brimonidine
|
Acetazolamide
|
Dorzolamide
|
Ophthalmology
|
Glaucoma
|
8a5c5929-0368-4047-83c7-d0cbaf638f04
|
multi
|
Which of the following is not a biovar of diphtheria
|
Mcleod classification of Corynebacterium:FeaturesC.gravisC.intermediusC.mitisColony on tellurite blood agar Daisy head colovy Frog's egg colony Poached egg colony Hemolysis Variable Non hemolytic Hemolytic Glycogen & starch fermentation Positive Negative Negative Complication Paralytic & Hemorrhagic Hemorrhagic Obstruction lesion in air passage On broth medium Forms pellicle & granular deposits Granular deposits Diffuse turbidity Fouh biotype - C.belfanti
| 4 |
Gravis
|
Intermedius
|
Belfanti
|
Meningitidis
|
Pathology
|
All India exam
|
abfc4bcb-9f38-4aa8-a4c7-0217ba6d52e6
|
single
|
Cardiac dominance is based on
|
Cardiac dominance is based on the aery giving the posterior interventricular branch B D CHAURASIA&;S HUMAN ANATOMY UPPER LIMB THORAX-VOLUME1 SIXTH EDITION,Page no-265
| 2 |
Anterior interventricular aery
|
Posterior interventricular aery
|
Circumflex aery
|
None of the above
|
Anatomy
|
Thorax
|
f6b6c60d-92fa-4089-b0fd-4a7b5ee6fe8f
|
multi
|
Most common type of Benign Orbital tumour in Adults is
|
(C) Haemangioma# ORBITAL TUMORS in both age groups are mostly benign.> Most common benign orbital tumors in children are Dermoids and vascular lesions such as capillary hemangiomas, lymph-angiomas and cavernous hemangiomas.> Most common benign tumors in Adults are also blood vessel tumors such as Hemangiomas, lymphangiomas and arteriovenous malformations> Tumors of the nerves (Schwannomas), fat (Lipoma), as well as those that evolve from the surrounding sinuses (Mucocele) occur less commonly.> Orbital Malignancies in Childhood are unusual. Most common are rhabdomyosarcomas, other malignant lesions that may affect the orbit include Burkitt's lymphoma and granulocytic sarcoma. Neuroblastoma, Ewing sarcoma, Wilm's tumor, and leukemias are the more common metastatic orbital lesions afflicting children.> Most common Malignant Orbital tumors in Adults are lymphomas. Often they are initially confined to the orbit without any systemic manifestations. Direct invasion of the orbit from the surrounding skin and sinus cavities can occur from squamous and basal cell cancers. Other malignancies that arise from tissues within the orbit are less common (Hemangiopericytoma, Chondrosarcoma, Malignant neurofibroma). Metastatic orbital tumors most frequently arise from breast & prostate.
| 3 |
Lipoma
|
Dermoid
|
Haemangioma
|
Schwannoma
|
Ophthalmology
|
Miscellaneous
|
c2c10ea5-1d9b-4379-98bb-07d96d47e369
|
single
|
Most common site of perforation of tympanic membrane in ASOM is:
|
AN SWER: (B) Anterior inferior quadrantREF: Dhingra 4th edition page 62'In acute suppurative otitis media usually, a small perforation is seen in antero-inferior quadrant of pars tensa'
| 2 |
Anterior superior quadrant
|
Anterior inferior quadrant
|
Posterior superior quadrant
|
Posterior inferior quadrant
|
ENT
|
Disorders of Middle Ear (Otitis Media)
|
931f96ab-d8de-4a1e-bd44-6820b016f3bb
|
single
|
Pleural pressure at the end of inspiration is -
|
Ans. is 'b' i.e.. More negative o During quiet breathing, the intrapleural pressure fluctuates between -3 and -6 mm Hg, depending upon the phase of respiration, more negative at the end of inspiration and less negative during expiration.Intrapleural pressure (Pleural pressure)o It is the pressure between two pleural surfaces. The lung is covered with visceral pleura and the thoracic cage is lined on inside with parietal pleura. Between the two layers of pleura is a very narrow space, called the pleural cavity. Intrapleural pressure is always negative and during quiet breathing the Intrapleural pressure fluctuates between -3.8 mm Hg (- 5.0 cm water)1 to -6.0 mm Hg (-8.0 cm water).o Now let us examine why the pleural pressure is negative; more negative during inspiration, less negative during expiraion, but always negative during quiet breathing. The key to the answer is the fact that both the thoracic cage and lungs are elastic structures. Being elastic structure they both tend to recoil, but in opposite direction. The lungs have a tendency to collapse and thoracic cage has a tendency to expand. However, because of the anatomical relationships in the body, these tendencies do not normally materialize. But the tendencies do create an inward pull on the visceral pleura (by lung) and an outward pull on parietal pleura (by thoracic cage). The results of these pulls is a negative pressure in the space between the pleural surfaces, i.e., in the pleural cavity.
| 2 |
Zero
|
More negative
|
Positive
|
Less negative
|
Physiology
|
Mechanics of Respiration
|
b41484dc-ee4d-4eea-aff3-77f3542e27c0
|
single
|
Investigation of choice for gall stone
|
B i.e. USG
| 2 |
X-Ray
|
USG
|
Cholecystography
|
CAT Scan
|
Radiology
| null |
bd7e16fb-f27f-4445-9261-71868417df35
|
multi
|
Fastest acting nondepolarizing neuromuscular blocker-
|
Rocuronium has onset of action at 1mg/kg 90 seconds Rocuroniumis the muscle relaxant of choice for day-care surgery. intermediate-acting muscle relaxant with a rapid onset (90 s). Rapacuronium has onset of action 75 secs but it is not in clinical use. Rest all nondepolarising neuromuscular blocker has onset of action - 3-5 minutes
| 1 |
Rocuronium
|
Pancuronium
|
Succinylcholine
|
Mivacurium
|
Anaesthesia
|
Neuromuscular Blocker
|
b4db61f9-75ef-448b-b3dd-ea14eb0cc814
|
single
|
Estrogen replacement therapy is contraindicated in women with all except
|
Estrogen replacement therapy is not contraindicated in women with vasomotor symptoms.
| 3 |
Abnormal genital bleeding
|
Known case of breast cancer
|
Vasomotor symptoms
|
Recent thromboembolism
|
Gynaecology & Obstetrics
| null |
5ea97ded-4175-44f3-955d-475b0075684d
|
multi
|
Which of the following has a function of a peptidyl transferase?
|
Ribozymes are RNA molecules with catalytic activity. These generally involve transesterification reactions, and most are concerned with RNA metabolism (splicing and endoribonuclease). Impoant: Recently, a rRNA component has been implicated in hydrolyzing an aminoacyl ester and thus to play a central role in peptide bond function - peptidyl transferases. These observations, made using RNA molecules derived from the organelles from plants, yeast, viruses, and higher eukaryotic cells, show that RNA can act as an enzyme, and have revolutionized thinking about enzyme action and the origin of life itself. Evidence that rRNA is a Peptidyltransferase Ribosomes can make peptide bonds even when proteins are removed or inactivated Ceain pas of the rRNA sequence are highly conserved in all species These conserved regions are on the surface of the RNA molecule. RNA can be catalytic Mutations that result in antibiotic resistance at the level of protein synthesis are more often found in rRNA than in the protein components of the ribosome X-ray crystal structure of large subunit bound to tRNAs suggest detailed mechanism Ref: Weil P. (2011). Chapter 37. Protein Synthesis & the Genetic Code. 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
| 4 |
Enzymes
|
Single stranded DNA
|
Elongation Factor
|
Ribozyme
|
Biochemistry
| null |
72b0ea2f-bf7d-4000-9837-d11440e5225f
|
single
|
C.P.I.T.N is used in
| null | 4 |
Biggest population
|
Smallest population
|
Diagnostic tool
|
Screening purposes
|
Dental
| null |
c54edc04-ed36-492f-bdf9-e62447d19c0f
|
multi
|
The mesentery of the small intestine, along its attachment to the posterior abdominal wall, crosses all of the following structures except -
|
Attached border of mesentery (the root of mesentery) crosses -
Third (horizontal) part of the duodenum
Abdominal aorta
IVC
Right ureter
Right psoas major
| 1 |
Left gonadal vessels
|
Third part of duodenum
|
Aorta
|
Right ureter
|
Anatomy
| null |
bc2e2ab0-0f1a-4f80-a527-6b0e354f82fb
|
multi
|
Diffuse peritonitis in acute appendicitis is caused due to
|
Diffuse peritonitis can develop rapidly because of the underdeveloped greater omentum, which is unable to give much assistance in localising the infection. Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1209
| 1 |
Early rupture of appendix
|
Late rupture of appendix
|
Fecolith
|
Old age
|
Surgery
|
G.I.T
|
5ef1c722-e55f-4be9-9cf6-42a77c69db6f
|
single
|
Immune hydrops is associated with:
|
Hydrops fetalis is a condition when there is accumulation of fluid in at least two fetal compaments: ascites, pericardial effusion, pleural effusion or anasarca. Immune hydrops (erythroblastosis fetalis) is where hydrops occurs secondary to mother's immunity causing fetal RBC hemolysis and is almost always due to Rh incompatibility. Non immune hydrops is because of non immune causes of fetal hemolysis Cardiac conditions like hea block Infections like parvo virus (B19) Hematological cause like alpha thalassemia Gastrointestinal causes Renal causes Cystic hygroma
| 2 |
Thalassemia
|
Rh incompatibility
|
Hereditary spherocvtosis
|
Sickle cell anemia
|
Gynaecology & Obstetrics
|
RH Incompatibility
|
0952010f-8ad3-4970-958b-2ddc3d733514
|
single
|
"Sleep apnoea", is defined as a temporary pause in breathing during sleep lasting at least
| null | 4 |
40 seconds
|
30 seconds
|
20 seconds
|
10 seconds
|
Medicine
| null |
1779ca32-f3f9-4d33-8e8d-a85ca2014c59
|
single
|
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