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Management plan for osteogenic sarcoma of the lower end of femur must include:
|
The usual approach in the treatment of osteosarcoma includes surgery and chemotherapy. The most frequently used effective chemotherapy agents include high-dose methotrexate, doxorubicin, cisplatin, and ifosfamide or etoposide. Radiotherapy does not play a role in the treatment of osteosarcoma as these cells are not radio sensitive. It is reserved for inoperable axial skeletal tumors and for palliation especially of painful sites. Ref: Moleculary Targeted Therapy for Childhood Cancer By Peter J. Houghton, Page 478 ; Pediatric Oncology Nursing: Advanced Clinical Handbook: Page 371 By Deborah Tomlinson, 2nd Edition, Pages 67-70.
| 4 |
Surgery alone
|
Chemotherapy + radiotherapy
|
Radiotherapy + amputation+ chemotherapy
|
Chemotherapy + Limb Salvage Surgery
|
Surgery
| null |
e2134e1c-a419-472f-86f8-20f0500ad1eb
|
single
|
At what cervical level spinal cord circumference is maximum?
|
Maximum spinal cord circumference is at level c6 BD CHAURASIA S HUMAN ANATOMY Vol1
| 3 |
C4
|
C5
|
C6
|
C7
|
Anatomy
|
General anatomy
|
bae5d9e2-2c8f-4524-8b78-13384b32f64e
|
single
|
A newborn is prone for hypothermia due to following reasons except?
|
Presence of brown fat is a protective mechanism against hypothermia in newborn babies Infants have more body surface area compared to adults which makes them prone for heat loss. In paicular, head size has the largest body surface area in the entire body In low bihweight and preterm infants, the insulatinglayer of subcutaneous fat is thin which makes them prone for hypothermia
| 4 |
More body surface area
|
Less subcutaneous fat
|
Larger head size compared to rest of body
|
Brown fat
|
Pediatrics
|
Neonatal hypothermia
|
9dbd2361-c71e-4365-96af-b57b265da946
|
multi
|
Traumatic fracture showing avascular necrosis: (PGI Dec 2007)
|
Ans. A (Femoral neck) /Ref: Maheswari 3td/40-41,270; Dahnert Radiology Review manual 5th/46-48; Chapman 4th/45-46; Apley 8th/570-571]Avascular necrosis is common in fracture of- femoral neckQ (including slipped capital femoral epiphysis(r), posterior dislocation of hip}, neck talus(r), waist scaphoid(r) & lunateQ (dislocation) - Apley 8th/570In fracture neck fern urr the more proximal the lesions, more are the chance of avascular necrosis. So subcapital fracture neck femur has maximum chance ofAVN (worst prognosis)
| 1 |
Femoral neck
|
Surgical neck of humerus
|
Body of talus
|
Cuboid
|
Orthopaedics
|
Avascular Necrosis
|
7197f6f2-eff8-48bf-81fa-f4d9eb88f692
|
single
|
True about fourth heart sound is
| null | 1 |
Occurs at end of P wave in ECG
|
Occurs at end of T wave in ECG
|
Occurs during early rapid filling phase of ventricular diastole
|
Occurs during slow ejection phase of Ventricular systole
|
Physiology
| null |
8d5ac53b-faf3-426f-a10f-fc892d01abd9
|
multi
|
A new test to measure B.P has successive reading of same person as follow: 110/70 mmHg, 128/80 mmHg, 132/70 mmHg, 160/90 mmHg. The given test has, when mean B.P =120/80mmHg.
| null | 1 |
Low validity, Low reliability
|
Low validity, high reliability
|
High validity, low reliability
|
High validity, high reliability
|
Social & Preventive Medicine
| null |
025ab57f-f74c-418e-9211-63a4036c7038
|
single
|
Common variable deficiency is due to -
|
Most patients with common variable immunodeficiency have normal or near-normal numbers of B cells in the blood and lymphoid tissues.
These B cells, however, are not able to differentiate into plasma cells.
The clinical manifestations are caused by antibody deficiency.
The feature common to all patients is hypogammaglobulinemia, generally affecting all the antibody classes but sometimes only IgG.
| 3 |
Absent B cells
|
Reduced number of B cells
|
Defective B cell differentiation
|
All of the above
|
Pathology
| null |
a2be9d60-9b0b-4ffd-b7cb-f74a53922e75
|
multi
|
All are associated with paraneoplastic syndromes except -
| null | 2 |
Cerebeller degeneration
|
Progressive multifocal leucoencephalopathy
|
Amyotropic lateral sclerosis
|
Opsoclonus myoclonus
|
Medicine
| null |
d658aff5-1518-40f9-9229-6c577b251f83
|
multi
|
The efferent limb of a myotatic reflex includes a(n):
|
The myotatic reflex is a monosynaptic, sretch reflex. The efferent limb consists of the axon of an anterior horn alpha motor neuron that innervates striated muscle fibers (effector). The afferent limb consists of a muscle spindle (receptor) and an Ia fiber (axon) of a spinal ganglion neuron.
| 1 |
Anterior horn motor neuron
|
Lateral horn visceromotor nucleus.
|
Muscle spindle.
|
Preganglionic sympathetic neuron
|
Physiology
|
Motor System
|
a1f3cb33-914c-4069-9b11-71f97dcb1308
|
single
|
Ivabridine is indicated in the management of
|
Refer kDT 6/e p 55,katzung 11e p203 Ivabradine is a bradycardia drug. It selectively blocks if sodium channel blocker and reduce hea rate by inhibiting the hyperpolarization activated sodium channel in the SA node. No other significant hemodynamic effects has been noted. It reduces and then attacked similar to Calcium channel blocker and beta blockers
| 2 |
PSVT
|
Angina pectoris
|
Cardiomyopathy
|
Irritable bowel syndrome
|
Pharmacology
|
Cardiovascular system
|
369feed3-a8cf-49da-bfe2-52f245d89573
|
single
|
Shape of nulliparous cervical canal is :
|
Transverse [Ref: BDC 4/e, Vol 2, p 359; Gray's Anatomy 38/e, p 1871; Jeffcoate's Gynaecology 6/e, p 31 Don't get confused with the answer . Question is about cervical canal & not the external os. The external os is circular in a nulliparous woman & transverse or slit like in parous women. In a nulliparous women, the cervical canal is spindle shaped or fusiform longitudinally, flattened transversely and broadest at mid level. The canal has an anterior & a posterior wall. These walls have mucosal folds resembling branches of a tree so are known as arbor vitae uteri. These folds are lost after child bih giving a conical shape to the cervical canal. So, Nulliparous External os Circular Cervical canal Fusiform longitudinally & transverse horizontally Multiparous Transverse/slit like Conical
| 2 |
Circular
|
Transverse
|
Spherical
|
Longitudinal
|
Forensic Medicine
| null |
f32fa11d-f466-4282-9777-c12122e74911
|
single
|
Which of the following nerves are affected after spinal anesthetic block
|
Spinal anesthetic block affect sensory autonomic and motor nerve
| 4 |
Motor and sensory only
|
Sensory and autonomic nerve only
|
Sensory nerves only
|
Sensory autonomic and motor nerves
|
Anaesthesia
|
Regional anaesthesia
|
37a92bb5-67ba-4f1d-8735-8aa38e00ff76
|
single
|
The UK refinement of Hannifin and Rajka criteria is used in the diagnosis of ____:
|
Ans. A. Atopic dermatitis* The UK refinement of Hannifin and Rajka criteria is used in the diagnosis of Atopic dermatitis.* The original Hannifin and Rajka criteria requires that patients have at least 3 of the 4 major criteria and 3 of the 23 minor criteria.* Consequently, Williams et al coordinated a UK working party to attempt to refine the criteria of Hannifin and Rajka into a repeatable and validated set of diagnostic criteria for atopic eczema.UK refinement of Hannifin & Rajka's diagnostic criteria of Atopic Dermatitis (Eczema)In order to qualify as a case of atopic dermatitis (eczema) with the UK diagnostic criteria, the child must have an itchy skin condition (or parental report of scratching or rubbing in a child).Plus, three or more of the following:* Onset below age of 2 years (not used if child is under 4 years)* History of skin crease involvement (including cheeks in children under 10 years)* History of a generally dry skin* Personal history of other atopic disease (or history of any atopic disease in a first-degree relative in children under 4 years)* Visible flexural dermatitis (or dermatitis of cheeks/forehead and outer limbs in children under 4 years)
| 1 |
Atopic dermatitis
|
Nummular Eczema
|
Eczema Herpeticum
|
Contact dermatitis
|
Skin
|
Dermatitis Erythema
|
6ff7f1f1-7c34-4e7a-b8fe-6d7cdf9a4214
|
single
|
Codfish veebrae are seen in: March 2004
|
Ans. B i.e. Osteoporosis
| 2 |
Osteopetrosis
|
Osteoporosis
|
Morquis syndrome
|
All of the above
|
Surgery
| null |
b25c38f6-e3b1-4112-8488-ca0f99b6a585
|
multi
|
According to IAP classification of Grade IV malnutrition, Weight-for-age of the standard (%) is _________
|
IAP classification of malnutrition Grade of malnutrition Weight-for-age of the standard (%) Normal >80 Grade I 71-80 (mild malnutrition) Grade II 61-70 (moderate malnutrition) Grade III 51-60 (severe malnutrition) Grade IV <50 (very severe malnutrition) Reference: Paediatrics; O.P Ghai; 8th edition; Page no: 97
| 4 |
71-80
|
61-70
|
51-60
|
< 50
|
Pediatrics
|
Nutrition
|
a55ca1b8-cc03-4a51-a78d-49c8a52f1797
|
single
|
The ketolide which retain activity against streptococcus pneumoniae that are resistant to macrolide is:
|
Telithromycin is useful in the setting of streptococcal pneumonia that is resistant to macrolide Ref: Harrisons, Edition-18, Page : 1138.
| 1 |
Telithromycin
|
Quinupristin
|
Lincomycin
|
Dalfopristin
|
Medicine
| null |
1325c5ff-553b-4dc6-9478-14b26206e9e3
|
single
|
indications of FESS:
|
Ans. is all [indications of Function) endoscopic Endoscopic Surgery (FESS) Nasal conditions: Indian = Inflammation of sinus (sinusitis - chronic and fungal) Prime = Polyp removal Minister = Mucocelea of frontal and ethmoid sinus Can = Choanal atresia repair Speak = Septoplasty Fluent = Foreign body removal English = Epistaxis Other conditions: Nose is separated from orbit by lamina papyracea, anterior cranal fossa by cribriform plate and pituitary by sphenoid. Hence FESS can be used in: Orbital conditions - Orbital decompression - Optic nerve decompression - Blow out of orbit - Drainage of periorbital abscess - Dacryocystorhinostomy CSF leak Pituitary surgery like trans sphenoid hypophysectomy
| 4 |
Inveed papilloma
|
Orbital abscess
|
Nasal polyposis
|
All
|
ENT
| null |
6d2eeaa7-954a-4d75-ad27-a0a258b09590
|
multi
|
HbA, AC level in blood explains -
| null | 2 |
Acute rise of sugar
|
Long terms status of blood sugar
|
Hepatorenal syndrome
|
Chronic pancreatitis
|
Medicine
| null |
04c6ad9b-5668-41bc-b4e3-901dbbfd6947
|
single
|
Hypersensitivity vasculitisis seen most commonly in
|
HYPERSENSITIVITY VASCULITIS
In hypersensitivity vasuculitis, postcapillaryvenules are the most commonly involved vessels, capillaries and arterioles are involved less frequently.
It is primarily a disease of small vessels.
It is characterized by leukocytoclasis, a term that refers to the nuclear debris remaining from the neutrophils that have infiltrated in and around the vessels during the acute stages.
| 1 |
Post capillary venules
|
Arterioles
|
Veins
|
Capillaries
|
Unknown
| null |
f32952db-07e6-4160-91e2-cc86b3147f3b
|
single
|
Which anterior will have 2nd root most commonly
| null | 1 |
Lower Canine
|
Lower Lateral Incisor
|
Upper canine
|
Upper Lateral incisor
|
Dental
| null |
5ef25e98-1620-4003-9f4d-933b0e12889e
|
single
|
The parvocellular pathway, from the lateral geniculate nucleus to the visual coex, carries signals for the detection of:
|
B i.e. Colour vision, shape, fine details 'The parvocellular pathway from layers 3-6 carries signals for colour vision, textures, shape and fine detail'.
| 2 |
Movement, depth and flicker
|
Color vision, shape and fine details
|
Temporal frequency
|
Luminance contrast
|
Ophthalmology
| null |
ab81ce5e-ccdb-49ac-af0f-8f73888767e9
|
single
|
Trench fever is caused by -
|
Ans. is 'a' i.e., Bartonella Quintana * Trench fever, also called 5-day fever or quintan fever, is caused by Bartonella quintana (Rochalimaea quintana).* The human body louce (Pediculus humans corporis) is the vector and humans is the only known reservoir.
| 1 |
Bartonella Quintana
|
Coxiella burnetii
|
Rickettsia akari
|
Rickettsia conori
|
Microbiology
|
Bacteria
|
f89e596c-23d7-454e-b9f7-2b7270f62aac
|
single
|
All are causes of Osteoporosis, except:
|
Answer is B (Hypothyroidism) Osteoporosis is seen with hypehyroidism and not with hypothyroidism. Chronic heparin therapy, thyrotoxicosis and old age are all causes of osteoporosis
| 2 |
Thyrotoxicosis
|
Hypothyroidism
|
Chronic heparin therapy
|
Old age
|
Medicine
| null |
b7218254-2d63-4ff1-abff-63b696f0ed9c
|
multi
|
Positive Rinne indicates
|
Positive Rinne`s test- AC>BC (Normal hearing, Sensorineural Hearing loss)Negative Rinne`s test- BC>AC (Conductive Hearing loss)False negative Rinne`s- Severe unilateral Sensorineural Hearing lossRef: Hazarika; 3rd ed; Pg 53
| 1 |
AC>BC
|
BC>AC
|
BC=AC
|
None of the above
|
ENT
|
Ear
|
cbdc7583-1f75-4e9e-82c8-59c5bf2d9bac
|
multi
|
Regurgitation of food back from stomach into oesophagus is prevented by
|
Regurgitation of food back from stomach into oesophagus is prevented by: (i) tone of gastro-oesophageal sphincter, (ii) negative intrathoracic pressure, (iii) pinch-cock effect of diaphragm, (iv) mucosal folds, (v) oesophagogastric angle and (vi) slightly positive intra-abdominal pressure. Ref:- Dhingra; pg num:-341
| 4 |
Pinch cock effect of diaphragm
|
Negative intrathoracic pressure
|
Oesophagogastric angle
|
All of the above
|
ENT
|
Oral cavity & Oesophagus
|
c3835a9c-5206-4195-a002-1a532ca51b85
|
multi
|
Dental papilla give rise to ?
|
Ans. is 'c' i.e., Tooth pulp The mesenchymal cell's of dental papillae forms : Odontoblasts which form dentine Tooth pulp
| 3 |
Enamel
|
Dental cuticle
|
Tooth pulp
|
None
|
Anatomy
| null |
00317043-92c0-49bc-9835-414fe4544f83
|
multi
|
Thrombophlebitis extending from thigh to involve iliofemoral vein causes
|
Answer- D. White legWhite leg (Phlegmasia alba dolens)- seen in ileofemoral thrombophlebitis.Phlegmasia alba dolens (white leg): This is characterised by aerial spasm resulting in pale, cold leg with diminished pulses, with blanching of the limb, more often seen in iliofemoral thrombophlebitis and is called milk leg of pregnancy.
| 4 |
Red leg
|
Blue leg
|
Purple leg
|
White leg
|
Surgery
| null |
0952901d-19bc-4078-b4d7-c600208c86f9
|
single
|
Burkitt&;s lymphoma shows which translocation?
|
All forms of Burkitt lymphoma are highly associated with translocation of MYC gene on chromosome 8 that lead to increased MYC protein levels.The translocation paner for MYC is usually the IgH locus (t (8;14)) but may also be the Ig kappa (t (2;8)) or lambda (t (8;22)) light chain loci. Reference : Robbins and Cotran Pathologic basis of disease.South Asia Edition volume 1.page no. 597
| 1 |
8:14
|
9:22
|
11:14
|
14:18
|
Pathology
|
Haematology
|
6344b226-4a03-4c55-8a53-def29f5690d1
|
single
|
Most common thyroid Cancer is -
|
Papillary Carcinomas are the most common form of thyroid Cancer.
| 1 |
Papillary carcinoma
|
Follicular carcinoma
|
Medullary carcinoma
|
Anaplastic carcinoma
|
Pathology
| null |
938692b4-d85e-42ab-9cd0-3490a81f105b
|
single
|
Reflex responsible for tachycardia during right atrial distension is
|
Reflex resposible for tachycardia during right atrial distension is Bainbridge reflex. Atrial Reflex Control of hea rate: The Bainbridge Reflex The stretch recceptors of the atria that elicit the Bainbridge reflex transmit their afferent signals through the vagus nerve nerves to the medulla of the brain. Then efferent signals are transmitted back through vagal and sympathetic nerves to increase hea rate and strength of hea conntraction. Bezold-Jarisch Reflex: Activation of chemosensitive vagal C fibers in the cardiopulmonary region (eg,, Juxta capillary ragion of alveoli, ventricles, atria, great veins, and pulmonary aery) causes profound bradycardia, hypotension and a brief period of apnea followed by rapid shallow breathing. Cushing Reflex: When ICP is increased, the blood supply to RVLM neurons is compromised. The local hypoxia and hypercapnia causes an increase in discharge from the neurons, producing hypeension, bradycardia and irregular respiration. The resultant rise in systemic aerial pressure tends to restore the blood flow to the medulla. REF: Guyton and Hall 13th edition PGno: 223
| 4 |
image_question
|
image_question
|
image_question
|
image_question
|
Physiology
|
All India exam
|
3835d1fa-11be-492b-aaa3-f2e013062126
|
single
|
In Wegeners glomerulonephritis characteristic feature seen is
|
This is a necrotising vasculitis characterised by specific triad . Granuloma of the lung and the upper respiratory tract . Vasculitis of small to medium sized vessels . Glomerulonephritis Robinns 9 th edition page no. 353
| 2 |
Granuloma in the vessel wall
|
Focal necrotizing glomerulonephritis
|
Nodular glomerulosclerosis
|
Interstitial granuloma
|
Pathology
|
Cardiovascular system
|
84740c43-e67a-4975-a519-76e317939b5b
|
multi
|
Preterm baby with PDA, which is the least idly findings?
|
PDA in preterm neonate
In previous explanations I have explained that chances of spontaneous closure of PDA are higher in premature infants as there is no structural abnormality. However, you should keep in mind that this fact is true when we are comparing the spontaneous closure of PDA between term and pre-term neonate. Overall, the percentage of spontaneous closure of PDA in preterm neonate is very low. To avoid confusion, I am explaining following facts in brief :-
Normal neonate :- Ductus arteriosus closes functionally within about 15 hours of birth.
FDA in term (mature) neonate :- The persistence of ductus arteriosus beyond 24 hours after birth is considered as PDA in term neonate. Spontaneous closure of PDA does not usually occur because PDA results from structural abnormality.
FDA in pre-term (pre-mature) neonate :- The ductus arteriosus in pre-term neonate is not as responsive to increased oxygen content as it is in term neonate. However, there is no structural abnormality.
Chances of spontaneous closure are very less (compared to normal term neonate).
Chances of spontaneous closure are more than the term-neonate with PDA. However, in premature neonate, where hypoxic pulmonary disease is common place, the ductus being sensitive to hypoxia, remains open.
So, it is very unlikely that spontaneous closure of PDA will occur in pre-term neonate. But chances are more when compared to term neonate with PDA (not nonnal term neonate in which ductus arteriosus closes within 15 hours of birth).
Manifestations of PDA in pre-term neonate
Apnea for unexplained reasons in an infant recovering from RDS;
A hyperdynamic precordium, bounding peripheral pulses, wide pulse pressure, and a continuous or systolic murmur with or without extension into diastole or an apical diastolic murmur, multiple clicks resembling the shaking of dice;
Carbon 'oxide retention;
Increasing oxygen dependence;
X-ray evidence of cardiomegaly and increased pulmonary vascular markings; and
Hepatomegaly
Increased pulmonary blood flow and compromised ventricular function accompanying dropping pulmonary resistance in the setting of a P A is a significant risk factor for pulmonary hemorrhage.
The greatest risk factor for NEC is prematurity. Any etiology which leads on to hemodynamic or hypoxic insult predisposes to NEC. PDA is common in preteen infants and it definitely causes hemodynamic stress and is a risk factor for development of NEC.
| 1 |
CO2 washout
|
Bounding pulses
|
Pulmonary hemorrhage
|
Necrotising enterocolitis
|
Pediatrics
| null |
d7f6d349-9b61-4571-88da-2e1a5f31a2e9
|
single
|
MRI magnet is a
|
MRI uses a Superconducting magnet which is kept cool using Helium. A superconducting MRI magnet comprises a steel cryostat with the superconducting coils immersed in liquid helium at 4.2 Kelvin (-269degC or -452degF).
| 4 |
Ferromagnet
|
Paramagnet
|
Simple magnet
|
Superconducting-magnet
|
Radiology
|
Magnetic Resonance Imaging
|
2585e290-0e06-4b09-8ea5-a42aff4e560f
|
single
|
A 35-yrs-old woman complains of attacks of breathlessness, cyanosis and flushing. Apart from occasional diarrhea she has no abdominal symptoms. Abdominal examination reveals an enlarged nodular liver. If laparotomy is done, we could expect to find:
|
History of breathlessness, cyanosis and flushing points towards carcinoid syndrome. Enlarged nodular liver means hepatic metastasis, which is essential to produce carcinoid syndrome.
Appendicular carcinoids are detected in I in ever) 200-300 appendicectomies. It is one of the commonest sites for carcinoid tumours.
Carcinoid tumours are commonly seen in appendix, small intestine, lungs, stomach etc.
Flushing, diarrhoea, wheezing, pellagra like skin lesions are the common features.
Carcinoid tumours secrete large amount of serotonin. Treatment is with somatostatin analogues like octreotide,lanreotide etc. Surgery is done whenever possible to remove the tumours.
| 3 |
An ovarian tumor
|
A multicentric hepatoma
|
An appendicular carcinoid
|
Crohn's disease
|
Unknown
| null |
14c1a3d3-8a46-4293-939e-05c78465e520
|
single
|
A common source of Staphylococcus in the hospital is
|
Staphylococci are the primary parasites of human beings and animals, colonizing the skin, skin glands and mucous membranes. The most common source of infection in human patients and carriers, animals and inanimate objects being less important. Patients with superficial infections and respiratory infection disseminate large numbers of staphylococci into the environment. About 10-30 percent of healthy persons carry staphylococci in the nose and about 10 percent in the perineum and also on the hair. The vaginal carriage is about 5-10 percent.
| 2 |
IV fluids
|
Infected wounds
|
Hands of hospital personnel
|
Bed linen
|
Microbiology
| null |
b264a4c3-98a8-4a67-9801-997e385aa3b1
|
single
|
The most common mechanism of drug resistance in staphylococci is
|
The most common mechanism of drug resistance in staphylococci is through production of beta lactamase or penicillinase, which inactivates penicillin by splitting the beta lactum ring. These are inducible enzymes which are plamid mediated. They can be transmitted by transduction or conjugation. Ref: Textbook of Microbiology; Ananthanarayanan and Panicker; 10th Edition; Page No: 202
| 3 |
Conjugation
|
Plasmids
|
Transduction
|
Translation
|
Microbiology
|
Bacteriology
|
f370fce9-a1b8-4b65-ac6b-34037c278f6e
|
single
|
Which bone pathology does patients with Maffucci syndrome and olliers disease present with?
|
Both cases present with multiple enchondromas
| 2 |
Osteochondroma
|
Enchondromas
|
Ewings sarcoma
|
Osteosarcoma
|
Pathology
| null |
5aed19c4-2720-464b-905a-6563b42357c2
|
single
|
Two groups are tested for anemia. Which test should be used ?
|
Ans. is `c' i.e., Chi-square test Observations in the given question are in the form of qualitative data (anemia present or not). Thus Chi-square test should be used. Chi square test Is used when the observation are in the form of propoions (for qualitative data) The outcome are in clear cut answers; yes or no. As in the example the HBsAg is either present or not present. In contrast when the observation is normally distributed in the population e.g blood pressure, blood sugar ; student test is used. In the example comparing the occurence of hepatitis B surface antigen in medical and dental students, use of chi square analysis is appropriate because the outcome variables are dichomatous. Students are classified by the presence or absence of HBsAg. Student t test is used when the outcome variable is normally distributed in population (for quantitative data) e.g blood pressure, blood glucose. In the example student t test is used to assess the difference between mean systolic pressure of pregnant and non pregnant women ( to know the effect of pregnancy on mean systolic blood pressure) because mean systolic blood pressure is normally distributed in the population. Every single lady has a mean systolic blood pressure. It may be low or high , but she has a value of mean systolic blood pressure. Students t test may be following types: Unpaired t test (Independent t test) : It compares the mean of two small samples: The data is unpaired from two independent sample. for example, blood sugar concentration is measured in two different group (A group of 10 patients and other group of 8 patient). To test the significance of difference between the means of the two groups, unpaired t test is used. Paired t test : It compares the mean in paired data, before and after the intervention from same sample. For example, Blood sugar level in a sample of 10 patients is measure before giving and after giving the oral hypoglycemic. In this condition paired t test is used. Chi-square test Vs Student t test In the example student t test is used to assess the difference between mean systolic pressure of pregnant and non pregnant women ( to know the effect of pregnancy on mean systolic blood pressure) because mean systolic blood pressure is normally distributed in the population. Every single lady has a mean systolic blood pressure. It may be low or high , but she has a value of mean systolic blood pressure. But suppose we change the example in a way that we make a clear cut definition of hypeension ( such as mean systolic blood pressure over 140 mm of Hg will be taken to be hypeension) and then look for hypeension among pregnant and non-pregnant women. The test now used to analyse the outcome will be chi square test since the outcomes are now in the form of dichomatous data i.e yes or no (a woman is either hypeensive or not hypeensive. This is in contrast to mean systolic blood pressure which was normally distributed among ladies; every lady had one value of mean systolic blood pressure). Analysis of Variance (ANOVA) (F test/ F ratio) ANOVA is considered as an extension of the student t test for the significance of the difference between two sample means. The student t test can be used only for making just one comparison (between two sample means), or between a sample mean and hypothesized population mean. ANOVA is used when more than one comparison is to be made (When means of more than two groups are being compared). For example, BP is measured in more than two groups of men (married, unmarried, widowed, separated and divorced). In this situation ANOVA test is best.
| 3 |
Paired T-test
|
Unpair T-test
|
Chi-square test
|
ANOVA
|
Social & Preventive Medicine
| null |
7ea19b7c-09c1-478c-99a0-536589e289d7
|
single
|
All are true about colon-rectal cancers except
|
Tumours of the left side of the colon usually present with a change in bowel habit or rectal bleeding, while proximal lesions typically present later, with iron deficiency anaemia or a mass.Iron deficiency anaemia in any man or non-menstruating woman should lead to a search for a source of bleeding from the GI tract.Emergency presentation occurs in 20% of cases and is associated with a considerably worse prognosis,Left side cancers are more common, but in recent decades the incidence of right is increasing.Ref: Bailey and love, 27e, page: 1262
| 3 |
Tumours of the left side of the colon usually present with a change in bowel habit
|
Tumours of the right side of the colon present with iron deficiency anaemia
|
Right present earlier then left sided cancers
|
Left sided cancers are more common than right
|
Surgery
|
G.I.T
|
855156f3-afd1-46f8-b714-9d229748229e
|
multi
|
Tooth whitening strip is:
|
Hydrogen peroxide used in dentistry as a whitening agent ranges in concentration between 5 and 35%.
Ref :Grossman’s endodontics,13th edition, pg no:504
| 1 |
H2O2
|
HF
|
Carbamide peroxide
|
Sodium perborate
|
Dental
| null |
6b883a02-f033-4da5-ae04-e826a890f56d
|
single
|
In an ideal restoration, gingival margin should be:
| null | 1 |
Below contact point but 1mm occlusal to gingival crest
|
Below contact point but at level of gingival crest
|
Below gingival crest
|
At contact point
|
Dental
| null |
17304376-6d26-4e05-b9a1-900636d60da7
|
single
|
A 65-year-old man with H/O 30 pack years of smoking presents with weight loss, cough with expectoration and hemoptysis for 40 days. Serum Na was found to be 124 mEq/L. Serum Ca -10 mg/dl. Chest X ray showed a hilar mass. Brush cytology and sputum was positive for tumor cells. What of the following subtypes of lung carcinoma does this this patient most likely have?
|
Hilar mass suggests either squamous cell or small cell carcinoma. Hyponatremia due to SIADH is more likely in ors of Small cell. Hypercalcemia and cavitation are more likely in ors of squamous cell carcinoma
| 3 |
Squamous cell carcinoma
|
Adenocarcinoma
|
Small cell carcinoma
|
Large cell carcinoma
|
Unknown
|
Integrated QBank
|
7b804ab3-5eea-44fd-a256-d575b37a82fb
|
multi
|
Arneth count is counting of:
|
Counting the number of neutrophils with different nuclear lobes and expressing the count as percentage of cells with different number of nuclear lobes is called Arneth count. Clinical significance: The Arneth count is useful in judging the rate of formation of neutrophils. Individuals who have a larger percentage of neutrophils with fewer lobes have a left shift which can be indicative of disease processes such as infection, malignant tumors, hemolytic crises, myocardial infarction, acidosis, etc. Individuals with a larger percentage of neutrophils with more lobes have a right shift and most commonly have diseases such as vitamin B12 or folate deficiency, chronic uremia, liver disease, etc Ref: Textbook Of Medical Physiology By Khurana Page 178
| 2 |
Lymphocytes
|
Lobes in neutrophils
|
Granules in eosinophils
|
WBC in bone marrow
|
Physiology
| null |
650bd3ce-790c-4576-98b6-4f827f1f7f9e
|
single
|
Palindromic DNA implies-
|
Ans. is 'a' i.e., Sho stretches of DNA; 'b' i.e., Recognised by specific restriction endonuclease; c i.e., Complementary strands Palindromic DNA o A DNA sequence consists of two complementry strand coiled in a double helicle structure. o A sequence of duplex DNA that is same when two strands are read in opposite direction is called Palindrome 5'-GGCC-3' 3'-CCGG-5' Figure 1 - Palindrome o These palindrome serves as the target for most restriction endonuclease. Also know Inveed repeats o In these cases, two different segments of the double helix read in the same but in opposite direction. 5' - AGAACA nnnnnnnnn TGTTCT - 3' 3' - TCTTGT nnnnnnnnn ACAAGA - 5' Figure 2 - Inveed repeats Now you must be thinking that what is the difference between palindrome and inveed repeats ? o In palindrome the sequence is same in the complementry region of two strands, ie. the strands of DNA have same sequence in opposite direction on the same segment (see fig 1) of DNA. o In inveed repeats it occurs on two different segments of DNA, i.e. it is not complementry. The intervening strands of DNA do not have same sequence in opposite direction (see fig 2).
| 4 |
Sho stretches of DNA
|
Recognised by specific restriction endonuclease
|
Codes for bacterial resistance
|
All
|
Pathology
| null |
630a2a81-123c-4f7a-8a64-f6a0cdbfb6a5
|
multi
|
"Citron bodies" and boat or leaf-shaped pleomorphic organism in an exudate is
|
Clostridium septicum: citron bodies, boat or leaf-shaped polymorphic bacilli. Motile by peritrichous flagella. Saccharolytic and produce abundant gas. Produce alpha, beta, delta and gamma toxin. Gas gangrene, Braxy or malignant edema is caused. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 260
| 3 |
Clostridium welchii
|
Clostridium edematiens
|
Clostridium septicum
|
Clostridium tetani
|
Microbiology
|
Bacteriology
|
5d8f36d4-9525-445f-a130-714a1c2f0c01
|
single
|
During the early stages of the inflammatory response, histamine induced increased vascular permeability is most likely to occur in:
|
Acute inflammation causes fluid and cells to leak out of blood vessels into the interstitial tissue because of increased permeability of postcapillary venules.
| 4 |
Arteries
|
Precapillary arterioles
|
Capillaries
|
Postcapillary venules
|
Pathology
| null |
dd0ba8de-7c14-4b87-9e7a-75ca0bc5aa8e
|
single
|
In retinal detachment –
|
In retinal detachment the fluid accumulate in subretinal space i.e., the space between neurosensory epithelium (sensory epithelium or neuroepithelium) and pigmented epithelium.
Retinoschisis Vs Retinal detachment
It has already been explained that in retinal detachment there is separation between neurosensory layer and pigmented epithelium. The separation is between pigmented epithelium and layer of rods & cones of neuroepithelium.
In Retinoschisis, there is separation within the neurosensory layer, i.e., neurosensory layer (or sensory layer) of retina splits into two layers at the level of the inner nuclear and outer plexifonn layer. Senile (degenerative) retinoschisis is a predisposing factor for primary (rheugmatogenous) retinal detachment.
| 3 |
Effusion of fluid into the suprachoroidal space
|
Retinoschisis
|
Separation of sensory retina from pigment epithelium
|
None of the above
|
Ophthalmology
| null |
b2e59d29-1b06-4566-9de9-25e5624c2aa8
|
multi
|
Specificity of a screening test is the ability of a test to detect
|
Specificity is defined as the ability of a test to identify correctly those who do not have the disease, that is &;true-negatives&;Sensitivity is defined as the ability of a test to identify correctly all those who have the disease, that is &;true-positive&;
| 4 |
True positives
|
False positives
|
False negatives
|
True negatives
|
Social & Preventive Medicine
|
Screening
|
7bbe17f4-b225-4073-b261-66c031c92225
|
multi
|
You see the newborn baby shown below for the first time in the nursery. You consult plastic and reconstructive surgery as well as the hospital's speech therapist. Understandably, the parents have many questions. Which of the following statements is appropriate anticipatory guidance for this family?
|
(d) Source: (Hay et al, pp 1047-1048. Kliegman et al, pp 1252-1253. McMillan et al, pp 469-472, 2661-2662. Rudolph et al, pp 705- 710.) The infant pictured has bilateral cleft lip and palate. The incidence in the general population is about 1:1000 live births, but occurs in about 4% of the siblings of affected infants. Evaluation for other structural and chromosomal abnormalities is indicated. Although affected infants are likely to have feeding problems initially, these problems usually can be overcome by feeding in a propped-up position and using special nipples. Complications include recurrent otitis media and hearing loss as well as speech defects, which may be present despite good anatomic closure. Repair of a cleft lip usually is performed within the first 2 to 3 months of life; the palate is repaired later, usually between the ages of 6 months and 5 years.
| 4 |
Parenteral alimentation is recommended to prevent aspiration.
|
Surgical closure of the palatal defect should be done before 3 months of age.
|
Good anatomic closure will preclude the development of speech defects.
|
Recurrent otitis media and hearing loss are likely complications.
|
Pediatrics
|
New Born Infants
|
0830b6b6-fa27-4936-ac03-ca44b3997c31
|
multi
|
Last organ to be dissected during autopsy in asphyxial death is
|
Ans. is 'a' i.e. Neck Detailed study of the neck organs is required during autopsy of asphyxia death.Cranial thoracic and abdominal organs are removed before dissecting the neck, so that, the body is drained of blood.Such draining provides a clean bloodless field for the study of neck organs and prevents any artifactual seepage of blood in soft tissues of the neck.
| 1 |
Neck
|
Head
|
Abdomen
|
Thorax
|
Forensic Medicine
|
Injuries
|
41b95dcb-b0e4-4eaa-a808-847ecf376ddf
|
single
|
Treatment of choice for sputum positive pulmonary tuberculosis detected in Ist trimester of pregnancy:
|
Sta cat. I immediately Repeat May 10
| 2 |
Defer till second trimester
|
Sta cat. I immediately
|
Sta cat. II immediately
|
Sta cat. III immediately
|
Social & Preventive Medicine
| null |
ff811171-e9f5-4425-9e00-25fc9a12cd3a
|
single
|
All are features of Acute Renal Failure (ARF) except -
| null | 4 |
Hypotension
|
Metabolic acidosis
|
Hyperkalemia
|
Hypertension
|
Medicine
| null |
1a06e92e-3f10-41cf-a9bb-4a4127439247
|
multi
|
Skirrow's medium is used for?
|
Ans. is 'c' i.e., Campylobacter jejuni . Media used for cultivation of H. Pylori are : i) Skirrow's medium Butzler's medium iii) Compy BAP medium
| 3 |
Clostridium tetani
|
Corynebacterium diphtheria
|
Campylobacter jejuni
|
Helicobactor pylori
|
Microbiology
| null |
40c37503-baa0-4e32-b4ec-6a8cd9eb0d37
|
single
|
Glycerol is an-
|
Ans. is 'a' i.e., Osmotic diuretic o Glycerol is an orally active osmotic diuretic which may be used to reduce intraocular or intracranial tension. Intravenous glycerol can cause hemolysis.
| 1 |
Osmotic diuretic
|
Purgative
|
Antidiabetic
|
Antiemetic
|
Pharmacology
| null |
259cd51e-45f9-4df9-8675-a55a0fffd25c
|
single
|
ANCA is associated with
|
• ANCA or antineutrophilic cytoplasmic antibodies are formed against certain proteins in the cytoplasm of neutrophils. Out of the given options, Wegener’s granulomatosis is most strongly associated with ANCA.
| 2 |
Henoch-Schonlein Purpura
|
Wegener’s granulomatosis
|
Rheumatoid arthritis
|
Goodpasture syndrome
|
Pathology
| null |
d0ff45ed-3b92-45c9-ac7e-e60a0d756c5f
|
single
|
Pleural effusion in rheumatoid ahritis is typically associated with the following features except
|
Ans. is 'a' i.e., Glucose > 60 mg/dl Causes of low glucose pleural fluid Malignancy Rheumatoid ahritis Empyema Hemothorax Paragonimiasis Churg strauss syndrome Lupus pleuritis (occasionally)
| 1 |
Glucose > 60 mg/dl
|
Protein > 3 gm/di
|
Pleural fluid protien to serum protein ratio of >0 .5
|
Pleural fluid LDH to serum LDH ratio of >0.6
|
Medicine
| null |
ce9dcf69-1dd8-48e9-9f8a-d074e7d111df
|
multi
|
National Population Policy was first formed in 1976. Goals of National Population Policy are the following, EXCEPT:
|
The objective of National Population Policy (NPP) 2000 is to bring the total feility rate (TFR) to replacement level by 2010. All the other options are the goals to be achieved by NPP. Ref: Park's Textbook of Preventive and Social medicine, 19th edition, Page 391.
| 4 |
Decrease IMR to below 30 per 1000 live bihs
|
Reduce MMR to below 100 per 100,000 live bihs
|
Achieve 100 per cent registration of bihs, deaths, marriage and pregnancy
|
Bring down TFR to replacement level by 2015
|
Social & Preventive Medicine
| null |
f7de6b71-c800-45bb-b434-1911f91cd74d
|
multi
|
Prothrombin Time (PT) detects deficiency of all the following clotting factors EXCEPT
|
The time required for clotting to occur is called the prothrombin time (PT). Normal PT = 15-20 seconds. Prolonged PT suggests the possibility of deficiency of factors II (prothrombin), V, VII and X. Prothrombin level is low in vitamin K deficiency and various liver and biliary diseases.
| 4 |
II
|
V
|
VII
|
VIII
|
Physiology
|
Blood Physiology
|
6c5b0f47-f468-4306-aac9-7ec8ff48ccf0
|
multi
|
Neuropsychiatric complications of HIV include all except
|
Please read on HIV and its neuropsychiatric manifestations
| 4 |
Dementia
|
Depression
|
Mania
|
OCD
|
Anatomy
|
All India exam
|
264f052e-833e-4856-87c2-1a6ff1b2348b
|
multi
|
A child comes with steroid resistant nephrotic syndrome secondary to FSGS, not responsive .to methylprednisolone. What next should be given ?
|
Ans is 'b' i.e., Oral cyclosporine o The treatment options for steroid resistant nephrotic syndrome are: (i) Calcineurin inhibitors (cyclosporine, Tacrolimus) (ii) IV or oral cyclophosphamide (iii) Levamisol (iv) Mycophenolate (v) Pulse coicosteroid o All above immunosuppressants are used along with coicosteriods (Prednisolone or methylprednisolone). o Cyclosporine and cyclophosphamide are most commonly used. o Despite these options, there is lack of consensus on first line appropriate therapy for steroid resistant nephrotic syndrome. o According to Indian Journal of pediatric (vol. 46, Jan 17, 2009) the efficacy of these durgs are (in decreasing order): Tacrolimus + Prednisolone > cyclosporine + Prednisolone > IV cyclophosphamide + Prednisolone > Pulse Corticosteroids (IV dexamethasone + oral cyclophosphamide + Prednisolne) > oral cyclophosphamide + PrednisoIon e. o So, amongst the given options, best answer is cyclosporine.
| 2 |
Oral cyclophosphamide
|
Oral cyclosporine
|
Oral mycophenolate
|
IV cyclophosphamide
|
Pediatrics
| null |
636e832d-7c15-4ac5-bb1a-df1ff76b61dc
|
single
|
Placing a ring liner approximately 3.25 mm short of the ends of the ring tends to
| null | 1 |
Produce a more uniform expansion and the expansion will not be in a vertical direction hence no distortion
|
Produce a more uniform contraction
|
Produce no change
|
Produce distortion
|
Dental
| null |
48bc634a-c1f2-43ed-8d1d-060e94cf2a24
|
single
|
Resistance to drugs in tuberculosis develops by: March 2011, March 2013
|
Ans. D: Mutation MDR-TB strains could arise as a consequence of sequential accumulation of mutations conferring resistance to single agents, or by a single step process such as acquisition of an MDR element. Resistance to common anti-TB drugs The most common mechanism of INH resistance is by mutation of the catalas-peroxidase gene so that the bacilli do not generate the active metabolite of 1NH. Rifampicin resistance is nearly always due to mutation in the repoB gene (for the beta subunit of RNA polymerase-the target of rifampin action) reducing its affinity for the drug Resistance to Pyrazinamide develops due to mutation in the pncA gene which encodes for the enzyme generating the active metabolite of pyrazinamide Classification of mutation A. By effect on structure: Small-scale mutations, such as those affecting a small gene in one or a few nucleotides, including: - Point mutations, often caused by chemicals or malfunction of DNA replication, exchange a single nucleotide for another. - These changes are classified as transitions or transversions. - Most common is the transition that exchanges a purine for a purine (A 4-, G) or a pyrimidine for a pyrimidine, (C T). - A transition can be caused by nitrous acid, base mis-pairing, or mutagenic base analogs such as 5-bromo-2 deoxyuridine (BrdU). - Less common is a transversion, which exchanges a purine for a pyrimidine or a pyrimidine for a purine (C/T A/G). - An example of a transversion is adenine (A) being conveed into a cytosine (C). - A point mutation can be reversed by another point mutation, in which the nucleotide is changed back to its original state (true reversion) or by second-site reversion (a complementary mutation elsewhere that results in regained gene functionality). - Point mutations that occur within the protein coding region of a gene may be classified into three kinds, depending upon what the erroneous codon codes for: Silent mutations: which code for the same amino acid. Missense mutations: which code for a different amino acid. Nonsense mutations: which code for a stop and can truncate the protein. - Inseions add one or more extra nucleotides into the DNA. They are usually caused by transposable elements, or errors during replication of repeating elements. - Inseions in the coding region of a gene may alter splicing of the mRNA (splice site mutation), or cause a shift in the reading frame (frameshift), both of which can significantly alter the gene product. - Inseions can be reveed by excision of the transposable element. - Deletions remove one or more nucleotides from the DNA. - Like inseions, these mutations can alter the reading frame of the gene. - They are generally irreversible Note that a deletion is not the exact opposite of an inseion: the former is quite random while the latter consists of a specific sequence inseing at locations that are not entirely random or even quite narrowly defined. Large-scale mutations in chromosomal structure, including: Amplifications (or gene duplications) leading to multiple copies of all chromosomal regions, increasing the dosage of the genes located within them. - Deletions of large chromosomal regions, leading to loss of the genes within those regions. - Mutations whose effect is to juxtapose previously separate pieces of DNA, potentially bringing together separate genes to form functionally distinct fusion genes (e.g. bcr-abl). These include: Chromosomal translocations: Interchange of genetic pas from nonhomologous chromosomes. Interstitial deletions: An intra-chromosomal deletion that removes a segment of DNA from a single chromosome, thereby apposing previously distant genes. For example, cells isolated from a human astrocytoma, a type of brain tumor, were found to have a chromosomal deletion removing sequences between the "fused in glioblastoma" (fig) gene and the receptor tyrosine kinase "ros", producing a fusion protein (FIG-ROS). The abnormal FIG-ROS fusion protein has constitutively active kinase activity that causes oncogenic transformation (a transformation from normal cells to cancer cells). Chromosomal inversions: Reversing the orientation of a chromosomal segment. - Loss of heterozygosity: Loss of one allele, either by a deletion or recombination event, in an organism that previously had two different alleles. B. By effect on function Loss-of-function mutations are the result of gene product having less or no function. When the allele has a complete loss of function (null allele) it is often called an amorphic mutation. Phenotypes associated with such mutations are most often recessive. Exceptions are when the organism is haploid, or when the reduced dosage of a normal gene product is not enough for a normal phenotype (this is called haploinsufficiency). Gain-of-function mutations change the gene product such that it gains a new and abnormal function. These mutations usually have dominant phenotypes. Often called a neomorphic mutation. Dominant negative mutations (also called antimorphic mutations) have an altered gene product that acts antagonistically to the wild-type allele. These mutations usually result in an altered molecular function (often inactive) and are characterised by a dominant or semi-dominant phenotype. In humans, Marfan syndrome is an example of a dominant negative mutation occurring in an autosomal dominant disease. In this condition, the defective glycoprotein product of the fibrillin gene (FBN1) antagonizes the product of the normal allele. Lethal mutations are mutations that lead to the death of the organisms which carry the mutations. A back mutation or reversion is a point mutation that restores the original sequence and hence the original phenotype. C. By effect on fitness In applied genetics it is usual to speak of mutations as either harmful or beneficial A harmful mutation is a mutation that decreases the fitness of the organism. A beneficial mutation is a mutation that increases fitness of the organism, or which promotes traits that are desirable. In theoretical population genetics, it is more usual to speak of such mutations as deleterious or advantageous. A neutral mutation has no harmful or beneficial effect on the organism. Such mutations occur at a steady rate, forming the basis for the molecular clock. A deleterious mutation has a negative effect on the phenotype, and thus decreases the fitness of the organism. An advantageous mutation has a positive effect on the phenotype, and thus increases the fitness of the organism. A nearly neutral mutation is a mutation that may be slightly deleterious or advantageous, although most nearly neutral mutations are slightly deleterious. D. By pattern of inheritance: The human genome contains two copies of each gene - a paternal and a maternal allele. A heterozygous mutation is a mutation of only one allele. A homozygous mutation is an identical mutation of both the paternal and maternal alleles. Compound heterozygous mutations or a genetic compound comprises two different mutations in the paternal and maternal alleles. A wildtype or homozygous non-mutated organism is one in which neither allele is mutated. (Just not a mutation) E. By impact on protein sequence A frameshift mutation is a mutation caused by inseion or deletion of a number of nucleotides that is not evenly divisible by three from a DNA sequence. Due to the triplet nature of gene expression by codons, the inseion or deletion can disrupt the reading frame, or the grouping of the codons, resulting in a completely different translation from the original. The earlier in the sequence the deletion or inseion occurs, the more altered the protein produced is. In contrast, any inseion or deletion that is evenly divisible by three is termed an in-frame mutation A nonsense mutation is a point mutation in a sequence of DNA that results in a premature stop codon, or a nonsense codon in the transcribed mRNA, and possibly a truncated, and often nonfunctional protein product Missense mutations or nonsynonymous mutations are types of point mutations where a single nucleotide is changed to cause substitution of a different amino acid. This in turn can render the resulting protein nonfunctional. Such mutations are responsible for diseases such as Epidermolysis bullosa, sickle-cell disease. A neutral mutation is a mutation that occurs in an amino acid codon which results in the use of a different, but chemically similar, amino acid. The similarity between the two is enough that little or no change is often rendered in the protein. For example, a change from AAA to AGA will encode arginine, a chemically similar molecule to the intended lysine. Silent mutations are mutations that do not result in a change to the amino acid sequence of a protein. They may occur in a region that does not code for a protein, or they may occur within a codon in a manner that does not alter the final amino acid sequence. The phrase silent mutation is often used interchangeably with the phrase synonymous mutation; however, synonymous mutations are a subcategory of the former, occurring only within exons. The name silent could be a misnomer. For example, a silent mutation in the exon/intron border may lead to alternative splicing by changing the splice site, thereby leading to a changed protein. Silent mutations occur because of the degenerate nature of the genetic code. F. Special classes Conditional mutation is a mutation that has wild-type (or less severe) phenotype under ceain "permissive" environmental conditions and a mutant phenotype under ceain "restrictive" conditions. For example, a temperature-sensitive mutation can cause cell death at high temperature (restrictive condition), but might have no deleterious consequences at a lower temperature (permissive condition).
| 4 |
Transduction
|
Conjugation
|
Transformation
|
Mutation
|
Pharmacology
| null |
34601410-63af-4fd3-8dfd-9060caa153ae
|
single
|
Guttman sign is seen in
|
Guttman sign is ipsilateral nasal stuffiness seen in stellate ganglion block.
| 3 |
Branchial plexus block
|
Supra clavicular block
|
Stellate ganglion block
|
None
|
Anaesthesia
| null |
f05df579-eddf-4f47-8245-d20ebd11474c
|
multi
|
Mean Hb values are compared in two population groups. The best test is -
|
Ans. is 'b' i.e., Unpaired T test Student t-testo Small samples do not follow normal distribution as large ones do. To overcome this problem T test was devised by W.S. Cassette whose pen name was 'student' and hence this test was called student't' test.Application of test :o It is applied to find the significance of difference between two means, when sample size is less than 30.o It is applied on a standard population either as :Unpaired 't'test: Applied when data is unpaired, i.e. when separate observations are made on individuals of two separate groups, and these need to be compared :Null hypothesis is assumedObserved diference between means of two samples is found.Standard error or difference between two means is calculated.t value is estimated. This is the ratio between points 2 and 3.Degrees of freedom are next calculatedCalculated values are compared with the 't' table values at the calculated degree of freedom (option d )P values are obtained and if it is more than 0-05, it has no significance.Paired test: Is applied to paired data, when each individual gives a pair of observations such as : when observations are made before and after the play of a factor e.g. pulse rate before and after a drug.Further, it proceeds similar to the unpaired test.Comnwinlv used Statistical testsDataQualitative(Proportions, percentage, fractions)Quantitative(mean & SD. of BP. Sugar, cholesterol etc)Large sample size < 20% of cells have expected value below 5Small sample size > 20%. of ceils have expected values below 5Two sansple group comparisonMore than 2 sample groups Sample is smallSample is large <n > 30) Cbi-square testFisher's exact testStadent 't-test'Z- testANOVA
| 2 |
Paired T test
|
Unpaired T test
|
Chi-square test
|
Fisher'stest
|
Social & Preventive Medicine
|
Statistical Tests
|
2b520b20-42d1-4101-8674-168f78114b2a
|
single
|
All are components of Behaviour sciences except-
|
Ans. is 'a' i.e., Political Science
| 1 |
Political Science
|
Anthropology
|
Sociology
|
Psychology
|
Social & Preventive Medicine
| null |
42b57ece-1513-46d6-8d84-689b1c73061b
|
multi
|
an anxiuous mother brought her 4yr old daughter to the pediatrician .the girl was passing loose stools past 20days .this was often associated with pain abdomen .stool examination showed the following organism :
|
Pathogenesis G. lamblia inhabits in the duodenum and upper ileum Trophozoites are attached to the mucosa surface by sucker, reproduced by binary fission Histology shoening of microvilli, elongation of crypts, and damaging the brush border of the absorptive cells Mechanical blockage of the intestinal mucosa, competition for nutrients, inflammation Diarrhea, abdominal pain, bloating, nausea, and vomiting CLINICAL MANIFESTATIONS incubation period :1-2 wk clinical manifestations :asymptomatic . acute infectious diarrhea, chronic diarrhea with failure to thrive and abdominal pain or cramping. Symptomatic infections occur more frequently in children than in adults. Most symptomatic patients : acute diarrhea. low-grade fever, nausea, and anorexia; intermittent or more protracted course characterized by diarrhea, abdominal distention and cramps, bloating, malaise, flatulence, nausea, anorexia, and weight loss develops treatment : metronidazole 200mg 7 days tid ref : ananathanaryana 9th ed
| 2 |
entamoeba hystolytica
|
giardia lambia
|
cryptosporidium parvum
|
e.coli
|
Microbiology
|
All India exam
|
0c4e475c-941a-4725-adea-66fb04ea79f9
|
single
|
Which of the following is not a landmark for facial nerve during parotid surgery?
|
The main methods of facial nerve trunk localisation can be divided into antegrade and retrograde. The former utilises anatomical landmarks to identify the nerve trunk after its exit from the stylomastoid foramen, which is then traced distally.Landmarks commonly used are:The inferior poion of the cailaginous canal. This is termed Conley's pointer (tragal pointer) and indicates the position of the facial nerve, which lies 1 cm deep and inferior to its tip;The upper border of the posterior belly of the digastric muscle. Identification of this muscle not only helps to mobilise the parotid gland, but also exposes an area immediately superior, in which the facial nerve is usually located;The squamotympanic fissure;The styloid process (the nerve is superficial to it);The mastoid process can be drilled and the nerve identified more proximally.Retrograde techniques rely on the identification of one of the nerve main branches (buccal in relation to the parotid duct, marginal mandibular in relation to the facial vessels, temporal branch), which is then traced proximally until the main trunk is identified.Ref: Bailey and love, page no: 790
| 1 |
Anterior belly of digastric muscle
|
Styloid process
|
Tragal pointer
|
Squamotympanic fissure
|
Surgery
|
Head and neck
|
4ac3bbc1-583b-4781-94b1-640a2021d8f1
|
single
|
Inclusion bodies are found in all except:
|
Inclusion bodies are nuclear or cytoplasmic aggregates of stainable substances, usually proteins. They typically represent sites of viral multiplication in a bacterium or a eukaryotic cell and usually consist of viral capsid proteins.
It is the most characteristic histological feature in virus-infected cells. It is of the following types:
a. Intracytoplasmic eosinophilic inclusion:
Negri bodies – Rabies
Guarnieri bodies – Variola (smallpox), vaccinia
Bollinger bodies – Fowlpox
Henderson-Peterson bodies – Molluscum contagiosum
b. Intranuclear acidophilic inclusion bodies:
Cowdry type A – Herpes, chickenpox, CMV, yellow fever
Torres bodies – Yellow fever
Cowdry type B – Poliovirus
c. Both Nuclear and cytoplasmic:
Warthin Finkeldey - Measles
d. Intranuclear basophilic inclusion bodies:
Cowdry type B - Adenovirus
| 2 |
Herpes
|
EBV
|
Poliovirus
|
CMV
|
Pathology
| null |
bbc0db27-6032-42e9-9387-a2cc84229b56
|
multi
|
All are associated with Wernicke, encephalopathy, EXCEPT:
|
Ans. is 'a' Cogwheel rigidity
| 1 |
Cog-wheel rigidity
|
Alteration in mental function
|
Vlth nerve palsy
|
Ataxia
|
Medicine
|
Nutrition
|
cdf92205-97c4-4524-bda9-225a7377bfd0
|
multi
|
For pancreatic injury true is -
|
Ans. is 'd' i.e., HRCT is investigation of choice o Pancreas being a retroperitoneal structure, peritoneal lavage is not helpful in making the diagnosis of pancreatic injury.o CT scan is the best diagnostic procedure, apart from an exploratory' laprotomy.More about Pancreatic injuryo About two-thirds are due to penetrating injuries and rest one-third due to blunt trauma,o Pancreatic injuries are usually associated with injury to other visceral organ. Isolated pancreatic injuries are rare.o In blunt injuries which are usually the result of midline upper abdominal trauma (eg. car seat belt, cycle handle), junction of the neck and body of the pancreas are most commonly injured as they are pressed against the vertebral column.o Major abdominal vascular injuries are present in more than 75% of cases of penetrating trauma."The presence of pancreatic duct injury appears to be a key factor in postoperative morbidity " SabistonAlso knowo Serum amylase levels are elevated in most patients with significant pancreatic trauma, but they are also increased in up to 90% of severe abdominal trauma patients who do not have pancreatic injury. Thus measurement of amylase at the time of hospital admission is not helpful in identifying those with pancreatic injury. On the other hand a progressive rise in serum amylase activity is a more specific indicator of pancreatic injury.Treatmento The treatment of pancreatic injury depends on its grade and extent.Minor injuries not involving a major duct may be treated nonoperatively.Moderate injuries usually require operative exploration, debridement, and the placement of external drains.More severe injuries including those with major duct injury or transection of the gland, may require distal resection or external drainage.
| 4 |
Most are iatrogenic
|
Blunt trauma most common
|
Urine amylase is diagnostic
|
HRCT is investigation of choice
|
Surgery
|
Trauma (Pancreas)
|
952e4ac2-8337-4692-b5f8-d07f24cc1673
|
multi
|
Niacin deficiency causes
|
Deficiency of niacin: A deficiency of niacin causes pellagra, a disease involving the skin, gastrointestinal tract, and CNS. The symptoms of pellagra progress through the three Ds: dermatitis, diarrhoea, dementia--and, if untreated, death. Reference: Lippincott Textbook of Biochemistry pg no. 380
| 2 |
Pigmentation
|
Diarrhea
|
Rash
|
Lactic acidosis
|
Biochemistry
|
vitamins
|
ef6c3a44-67c2-4815-ac75-306af543e853
|
single
|
Which of the following is not used to treat ADHD?
|
Dextromethorphan is a NMDA antagonist used as cough suppressant.
| 3 |
Dexamphetamine
|
Dexmethylphenidate
|
Dextromethorphan
|
Clonidine
|
Psychiatry
| null |
9e28ff9e-c036-42ce-8fd3-356b8f162456
|
single
|
Ocular symptom of Von Recklinghausen disease is
|
• NF-1 is the most common phakomatosis, affecting 1:4000 individuals, and presents in childhood.
• The gene locus is on 17q11.
| 2 |
Deformed anterior chamber with reduced angle of AC
|
Glaucoma
|
Choroidal hemangioma
|
Subretinal neovascularization
|
Unknown
| null |
cb4a8cd0-b22a-483f-ab16-f837234c1816
|
single
|
Mallampati score is done for assessing:
|
Ans. (b) Oral cavity of patient for intubation* Mallampati score, also known as Mallampati classification is used to assess the oral cavity of patient to predict the ease of intubation.* It is assessed by looking at the anatomy of the oral cavity; specifically, it is based on the visibility of the base of soft palate, uvula, fauces, and pillars.* A high Mallampati score (class 3 or 4) is associated with more difficult intubation as well as a higher incidence of sleep apnea.MODIFIED MALLAMPATI SCORING* Class I: Soft palate, uvula, fauces, pillars visible.* Class II: Soft palate, uvula, fauces visible.* Class III: Soft palate, base of uvula visible.* Class IV: Only hard palate visible
| 2 |
Size of the airway
|
Oral cavity of patient for intubation
|
Mobility of neck
|
Size of ET tube
|
ENT
|
Oral Cavity
|
68fe6e9e-38ad-4226-bbcb-b62eafa75786
|
multi
|
radiation exposure occurs in all except ?
|
fluoroscopy uses sonographic waves which is a sound wave and doesnt have radiation effect. Fluoroscopy is also an imaging tool. Allows physicians to look at various body systems. Shows movement of body pas. Also shows instruments or dye a continuing stream of x-ray images. Approximately 25-30 images per second Used in a variety of procedures Ohopedic Surgery Catheter Inseion Barium X-Rays Blood Flow Studies ref : david sutton 9th ed
| 3 |
ct scan
|
mri
|
fluroscopy
|
plain xray
|
Radiology
|
All India exam
|
bcaa93f7-4f8b-44c3-b8ac-616fd9e48420
|
multi
|
Teratoma is best describad as:
| null | 1 |
Hamartous developmental manifestation consisting of three different layers
|
Occurs most commonly in stomach and lungs
|
Originates from mesodermal tissue
|
Associated with very painful condition
|
Pathology
| null |
0f2639ce-a653-42f3-9d2e-dbfbb3c37795
|
single
|
Hypeension is not seen with :
|
Levodopa: ADVERSE EFFECTS- Most are dose-related, but are usually reversible. 1. Nausea and vomiting It occurs in almost every patient. Tolerance gradually develops and then the dose can be progressively increased. 2. Postural hypotension It occurs in about 1 I 3 of patients, but is mostly asymptomatic; some patients experience dizziness, few have fainting attacks. It is more common in patients receiving antihypeensives. ESSENTIALS of medical PHARMACOLOGY SEVENTH EDITION-KD TRIPATHI Page:428,429
| 4 |
SNRIs
|
amphetamine
|
Erythropoietin
|
L-dopa
|
Pharmacology
|
Other topics and Adverse effects
|
fd25bd4a-7636-49b6-a352-1b90c08254b9
|
single
|
Spider leg appearance in Intra venous urography is seen in-
|
Ans. is 'a' i.e., Congenital polycystic kidney diseaseRadiological appearanceo Paint - brush appearanceo Soap - bubble nephrogramo "Swiss - cheese" nephrogramo Dense persistent nephrogramo Striated nephrogramMedullary sponge kidneyHydronephrosisAdult polycystic kidney diseaseAcute ureteric obstruction, hypotensionInfantile polycystic kidneyRenal traumaAcute pyelonephritiso Sun - burst nephrogramo Crescentic deformity of calyces (wind glass sign)o "Egg in cup" appearanceo Drooping flower appearanceo Smudged papillao Infundibular stricture with focal hydrocalcicosiso Phantom / amputed calyxo Putty or cement kidneyo "Saw-toothed" or "Cork-screw" appearance of uretero "Flower-vase" curves of uretero "Spoked - wheel" appearanceo Bilateral spider leg deformityo Thimble bladdero Fish hook bladdero Sandy patcheso "Fetal - head" calcification of bladdero "Tear-drop" bladderPolycystic kidneyPolycystic kidneyPapillary necrosisEctopic ureter (Duplication anamoly)Earliest sign of renal TBRenal TBRenal TBRenal TBTB ureteritisHorse - shoe kidneyOncocytomaPolycystic kidney diseaseTubercular cystitisBPHSchistosomiasis of bladderSchistosomiasis 1 BilharziasisPelvic lipomatosisBilateral pelvic hematomaBilateral pelvic lymphadenopathyPelvic abscessIntraperitoneal bladder ruptureo Sun-burst' appearance of bladdero "Fir-tree" / "Pine-tree" / Christmas-tree" bladdero Droping flower appearance ("Drooping Lilly" sign)o Rim signExtraperitoneal bladder ruptureNeurogenic bladderEctopic ureter (Duplication anamoly)Acute complete renal artery occlusionHydronephrosis (Chronic obstruction)Acute tubular necrosisRenal vein thrombosiso Crescent signHydronephrosis
| 1 |
Congenital Polycystic Kidney Disease
|
Hydronephrosis
|
Renal stone
|
Renal cell carcinoma
|
Radiology
|
Urogenital System
|
ec8002d7-296b-49ba-8fc3-7bcac4616b97
|
single
|
A community has a population of 10,000 and a birth rate of 36 per 1000. 5 maternal deaths were reported in the current year the MMR is –
|
You should keep in mind that MMR denotes maternal mortality ratio (not maternal mortality rate).
| 2 |
14.5
|
13.8
|
20
|
5
|
Social & Preventive Medicine
| null |
d50a55b2-5b03-4667-b989-6cebcb58eb30
|
single
|
TRUE statement about aspirin is:
|
Nicotinic acid can cause flushing due to release of PGs. Premedication with aspirin decreases this complication. Aspirin can cause hypehermia in overdose. It decreases the risk of developing colon cancer.
| 2 |
In an afebrile patient acute overdose of aspirin produces hypothermia
|
Aspirin suppresses flushing associated with large dose of nicotinic acid
|
Aspirin therapy prevents granulomatous lesions and cardiac complications of acute rheumatic fever
|
Long term aspirin therapy increases the risk of developing colon cancer
|
Pharmacology
|
NSAIDs, Gout and Rheumatoid Ahritis
|
cf01f7a0-989f-407c-b66b-404dd0496a4f
|
multi
|
All of the following are the causes of relative polycythemia except:
|
Answer is D (High altitude) High altitude is associated with physiological increase in erythropoetin levels and leads to absolute polycythemia and not relative polycythemia. Relative erythrocytosis due to reduction in plasma volume alone is also known as stress or spurious erythrocytosis or `Geisbock's syndrome'
| 4 |
Dehydration.
|
Dengue haemorrhagic fever
|
Gaisbock syndrome
|
High altitude.
|
Medicine
| null |
aae9c1cb-2a87-4610-89e1-ff3fbc6bb5d9
|
multi
|
Investigation of choice in detecting small para-aoic lymph node is -
|
Ans. is 'b' i.e., CT scan
| 2 |
Ultra sound scan
|
CT scan
|
Lymphangiography
|
Aeriography
|
Surgery
| null |
c0f44b56-c2ec-49ca-87b4-59fd52fd29c6
|
multi
|
Which organ is NOT affected by Plasmodium falciparum?
|
The trophozoites of Plasmodium falciparum disappears from peripheral circulation after about 24 hrs. By then a strain specific high molecular weight antigen appears on the surface of infected red cells, associated with knob like projections on the erythrocyte membrane. Such red cells disappear from peripheral circulation and adhere to the walls of venules and capillaries in the internal organs like brain, hea, kidney, lungs, spleen, intestine, bone marrow and placenta. Ref: Paniker's textbook of parasitology, 6th ed page 80.
| 2 |
Hea
|
Liver
|
Lungs
|
Kidney
|
Microbiology
| null |
4acff987-9eb6-4135-abe2-a8105caf440c
|
single
|
A child suffering from acute diarrhoea is brought to the casualty and is diagnosed as having severe dehydration with pH of 7.23. Serum Na-125, Serum K-3, HCO3 16. The best I.V. fluid of choice is -
| null | 3 |
3% Saline
|
N/3 Saline + 10% dextrose
|
Normal saline
|
N/3 saline + 5% dextrose
|
Medicine
| null |
0b6e3ebb-5820-4976-9c98-0885729065dd
|
single
|
Both HBsAg and HBeAg are positive in
|
Ref: Park&;s Textbook of Preventive and Social Medicine 25 th Ed Pgno : 235 SEROLOGICAL PATTERNS IN HEPATITIS B HBsAg Anti-HBs Anti-HBc HBeAg Anti-HBe Interpretation + - IgM + - Acute Hepatitis B + - IgG + - Chronic Hepatitis B+ replication - + IgG - + Recovery from Hepatitis B - + - - - Vaccinated individuals
| 1 |
Acute infectious Hepatitis B
|
Chronic Hepatitis B
|
Recovery phase of Hepatitis B
|
Individuals vaccinated with Hepatitis B
|
Social & Preventive Medicine
|
Communicable diseases
|
e9912230-2e87-4de7-9eab-ab99007069bc
|
multi
|
Hypercalcemia caused by -
|
hypercalcemia can be a manifestation of a serious illness.Although hyper parathyroidism , a frequent cause of asymptomatic hypercalcemia, is a chronic disorder in which manifestations may be expressed only after months or years.The cause of hypercalcemia is numerous,but hyper parathyroidism. Hypercalcemia from any cause can result in fatigue, depression, mental confusion, anorexia , vomiting, constipation, reversible renal tubular defects, increased urination,sho PQ interval , cardiac arrhythmias. Generally, symptoms are more common at ca level >2.9-3mmol/l(Harrison 17 pg 2380)
| 1 |
Thyrotoxicosis
|
VnDiotoneation
|
Saroidosis
|
Furosemide
|
Medicine
|
Endocrinology
|
aa5c726a-6c64-4a2a-bc27-a05abd610ea7
|
single
|
Esthiomine is seen in
|
Esthiomene is seen in LGV which refers to hyperophic enlargement with ulceration of the external genitalia LGV is caused by L1 L2 L3 strain of chlamydia trachomatous L2 is most common Esthiomene is a medical term referring to elephantiasis of the female genitals. In the past the term has also referred to elephantiasis of the male genitalia. Esthiomene is generally the visible result of lymphogranuloma venereum, lymphatic infection by Chlamydia trachomatis. Esthiomene is generally the visible result of lymphogranuloma venereum, lymphatic infection by Chlamydia trachomatis. This sexually transmitted infection produces inflammation of the lymphatic channels in the female genitalia, followed by abscesses, fistulae, ulcerations, and fibrosis of the tissues. The tissues swell, sometimes severely, and the genitalia may grow to a massive size. Esthiomene can also be the result of tuberculosis when the infection takes hold in the genitalia,or of cancer or filariasis, infection with parasitic roundworms. The condition is painful and sometimes disabling. People with the condition can experience mental distress from the pain and physical deformation of their genitalia. Masses can become so large they make walking difficult. Treatment of the condition includes treatment of bacterial chlamydial infections with antibiotics such as doxycycline,or treatment of other infections present. Remaining tissue deformity can be treated with surgery such as labiaplasty to reduce the size of hyperophied labia minora. Goals of surgery include pain relief, restoration of sexual function, and cosmetic improvement Ref: Harrison 20th edition pg 1212
| 3 |
Chancroid
|
Granuloma inguinale
|
LGV
|
Syphilis
|
Dental
|
All India exam
|
10701b01-e05e-45ae-9aae-2869013b0944
|
single
|
A 6-year-old drowsy child came in emergency with history of vomiting, loose motion for 3 days. On examination he had sunken eyes, hypothermia, skin on pinching was taking 5 seconds to reve. What is your diagnosis?
|
In this case, sunken eyes and skin "goes back very slowly" (in 5 seconds) in a "lethargic" (drowsy) child, so it is a case of severe dehydration.
| 4 |
No dehydration
|
Mild dehydration
|
Some dehydration
|
Severe dehydration
|
Pediatrics
|
Disorders of Gastrointestinal System Including Diarrhea
|
86ef489e-a1ce-469a-9fc0-7027607d70a8
|
single
|
Which of the following statements about contrast in radiography is true:
|
A i.e. Ionic monomers have three iodine atoms per two paicles in solution Ionic contrast agents dissociate (ionize) in water in 2 ioins (or osmotic paicles) per molecule whereas nonionic agents do not ionize or dissociate. All monomers contain I benzene ring with 3 iodine atoms and dimers contains 2 benzene rings with 6 iodine atoms per molecule. Therefore ionic monomers have 3 iodine atoms per 2 ionic/ osmotic paicles in solutionQ and a contrast agent ratio of 3:2 (i.e. 1.5). And ionic dimers have 6 iodine atoms per 2 ionic/osmotic paicles in solution with a contrast agent ratio of 6:2 or 3:1. Nonionic agents donot ionize so they have only 1 osmotic paicle per molecule. And similarly monomers contain 3 iodine atom and dimers contain 6 iodine atoms per molecule of contrast agent. Therefore contrast agent ratio of nonionic monomers is 3:1 and nonionic dimers is 6:1. High osmolar contrast agents (HOCM) are all ionic monomersQ; whereas low osmolar contrast agents (LOCM) may be ionic dimers, and nonionic monomers or dimers (i.e. both ionic & nonionic)Q. HOCM have osmolality in range of 1500 mosmols/kg water at concentrations of 300 mg I2/ml. Whereas LOCM have osmolality which is less than half of the osmolality of HOCM (i.e. 600-700 for nonionic monomer, 560 for ionic dimer and 300 for nonionic dimer). So compred to physiological osmolality of 300 mosmols/kg water, nonionic dimers are physiologically isotonic in solution at 300 mg iodine/ml. Normal plasma osmollity is 300 mosmols/kg water at iodine concentration of 300mg/ml. So LOCM means that osmolality is lower than the HOCM (not physiological). Lowest osmolality/osmolarity is seen in non ionic dimer agents which becomes almost physiologically isotonic or iso-osmolarQ (visipaque 320 is 290 mosmol/kg and isovist 300 is 320 mosmol/kgH2O; 320 & 300 are iodine concentrations). Osmolality is propoional to the ratio of iodine atoms to the number of paicles in solution. The contrast agent with lower ratio (3:2) are HOCM and they have more paicles in solution per iodine atom (or in other words less iodine atoms per paicle). And agents with higher ratio (3:1 or 6:2 and 6:1) are LOCM. Iohexol (omnipaque) is a nonionic monomer (LOCM with 3:1 ratio)Q Iodinated contrast agents have low lipid solubility, low toxicity, low binding affinities for protein, receptor or membranes, low moleculer wt & are very hydrophilic. On iv injection b/o high capillary permeability they all are distributed rapidly into extravascular, extracellular interstitial space (except in CNS)Q but do not enter blood or tissue cells. Pharmacokinetics of all extracellular MRI contrast agents (all gadolinium except Gd-BOPTA) are similar to iodinated water soluble contrast media. They donot cross the blood brain barrier unless the barrier is disruptedQ. These agents accumulate in tissues with abnormal vascularity (inflammation & malignancy) and in regions where BBB is disrupted.
| 1 |
Ionic monomers have three iodine atoms per two paicles in solution
|
Osmolar contrast agents may be ionic or non ionic
|
Gadolinum may cross the blood brain barrier
|
lohexol is a high osmolar contrast media
|
Radiology
| null |
32a77016-8b23-49fb-81e1-fd9864ffb57c
|
multi
|
The most common type of cerebral palsy is?
|
a. Spastic(Ref: Nelson's 20/e p 2896-2899; Ghai 8/e p 581-583)Most common type of cerebral palsy is spastic diplegia in 35% cases, followed by Hemiplegia in 25% casesSpastic quadriplegia is the most severe form of CP because of marked motor impairment of all extremities and the high association with intellectual disability and seizures.
| 1 |
Spastic
|
Atonic
|
Extrapyramidal
|
Mixed
|
Pediatrics
|
Central Nervous System
|
ee6d377f-1372-4b56-8165-48b35bbe0888
|
single
|
BCR - ABL hybrid gene is present in
|
(CML) (215-HM) (315, 697-98-R) (464-Basic pathology 8,h)BCR-ABL hybrid gene - ABL gene is a non GF receptor proto-oncogene having tyrosine kinase activity. ABL gene from its normal location on chromosome 9 is translocated to chromosome 22. Where it fuses with BCR (breakpoint cluster region) gene and forms an ABL, BCR hybrid gene which is more potent in signal transduction pathway ABL-BCR hybrid gene is seen in CML and some acute lymphocytic leukaemias* n MYC-HSR - neuroblastoma* ERB-B in breast and ovarian cancersImportant oncogenes, their-mechanism of Activation and Associated Human Tumours (216-HM)TypeONCOGENEAssociated human tumours1. Growth factors (GFs)(i) PDGFGlioblastoma (ii) TGF-aSarcoma (iii) FGFCa-bowel, breast2. Receptors for GFs(i) ERB-B,Squamous cell Ca (ii) HER2 (a ERB2)Ca breast, Ovary, stomach, lungs3. Signal transduction proteins(i) RASCommon in 1/3 human tumours Ca lung, colon, pancreas, (ii) *BCR-ABLCML, Acute leukaemia4. Nuclear regulatoryMYC (Translocated)Burkitt's lymphoma(Transcription proteins)MYC (Amplified)Ca-lung, breast, colon5. Cell cycle regulatory proteinsCyclin DCa breast, liver, mantle cell lymphoma CDK4Glioblastoma, melanoma, sarcoma* * RB gene - Retinoblastoma, osteosarcoma* * BRCA 1 and 2 - Ca breast, ovary
| 4 |
Burkitt's lymphoma
|
Retinoblastoma
|
Breast carcinoma
|
CML
|
Pathology
|
Neoplasia
|
1f0ec916-79c2-4596-abab-5e5eebacca93
|
single
|
Pansystolic murmur at apex with soft first hea sound is the key sign of which one of the following ?
|
MR : The regurgitant jet causes an apical systolic murmer.Pansystolic murmer with thrill, soft S1 AR: Early diastolic murmer ASD: Systolic flow murmer over pulmonary valve, diastolic flow murmer over tricuspid valve, wide fixed splitting of S2. VSD: Pansystolic murmer usually heated best at the left eternal edge Ref: Harrison 20th edition pg 1534
| 2 |
Aoic regurgitation
|
Mitral regurgitation
|
Ventricular septal defect
|
Atrial septal defect
|
Medicine
|
C.V.S
|
55a136e5-9e46-43fb-894c-274853287a97
|
single
|
Most sensitive parameter in monitoring iodine deficiency control programme is:
|
Ans: D (Neonatal hypothyroidism) Ref: Park's Preventive and Social Medicine, 22nd edition. Pg 579Explanation:Iodine level in salt at consumption level 15 ppm.Iodine level in salt at production level 30 ppmIodine oil injection will provide protection for 4 years.Sensitive indicator for consumption of appropriate level of iodine is urine level of iodine.Any area is said to be endemic to IDD. if prevalence of goiter is >10% among general population or >5% among school going children or median iodine excretion is <100mg/I.RD.A- 150 m gram.Most sensitive parameter in monitoring iodine deficiency control programme is - Neonatal hypothyroidism.
| 4 |
Goitre
|
Urine T3.T4
|
Growth retardation
|
Neonatal hypothyroidism
|
Social & Preventive Medicine
|
Environment and Health
|
a4f0c4dd-3114-4a20-ae84-d95cdad10ea6
|
single
|
Air on either side of the bowel wall on a radiograph is called:
|
The Rigler sign, also known as the double-wall sign, is a sign of pneumoperitoneum seen on an abdominal radiograph when gas is outlining both sides of the bowel wall, i.e. gas within the bowel's lumen and gas within the peritoneal cavity. It is seen with large amounts of pneumoperitoneum (>1000 mL).
| 4 |
Air under diaphragm sign
|
Cupola sign
|
Doges cap sign
|
Rigler sign
|
Radiology
|
Gastrointestinal Radiology
|
d65af515-20e7-4ba0-af71-8cf91d3a1298
|
multi
|
In intubation which drug is used instead of succinylcholine
|
Muscle relaxants are used in intubation, which are of two types: Depolarizing muscle relaxant, i.e., Succinylcholine Non-depolarizing muscle relaxant, eg., Rocuronium, vecuronuim, Atracurium, etc
| 3 |
Doxacurium
|
Dantrolene
|
Rocuronium
|
None
|
Anaesthesia
|
Anaesthetic equipments
|
8d006fd4-5995-4ebf-bec6-0454d92d4abc
|
multi
|
Which of the following is the location of human leukocyte antigen (HLA)?
|
The human MHC (human leukocyte antigen; HLA) consists of a linked set of genes encoding major glycoproteins involved in antigen presentation. The complex locates to the sho arm of chromosome 6 and divides into three separate regions: class I, class II, and class III genes. The class I "classic" region encodes HLA-A, HLA-B, and HLA-C loci; the nonclassic or class I-related region encodes HLA-E, HLA-F, and HLA-G loci and other immunity-related genes such as CD1. The class II region (HLA-D) encodes HLA-DP, HLA-DQ, and HLA-DR loci and other genes related to antigen processing, transpo, and presentation, such as, transpoer associated with antigen processing (TAP). The class III region encodes genes for tumor necrosis factors and (TNF- and TNF-); complement factors C2, C4, and B; and the steroidogenic enzyme 21-hydroxylase. Ref: Jaume J.C. (2011). Chapter 2. Endocrine Autoimmunity. In D.G. Gardner, D. Shoback (Eds), Greenspan's Basic & Clinical Endocrinology, 9e.
| 2 |
Sho arm of chromosomes 3
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Sho arm of chromosomes 6
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Long arm of chromosomes 3
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Long arm of chromosomes 6
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Pathology
| null |
5f1d776c-4b2c-4d03-8711-e6242a39d8f4
|
single
|
In early congenital syphilis, which is not seen –
| null | 1 |
Keratitis
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Vesicular rash
|
Chorio retinitis
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Rhinitis
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Pediatrics
| null |
d1a046e5-259a-4644-9191-ae59e4fa2a05
|
single
|
Recurrent interosseous aery is a branch of -
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Ans. is 'a' i.e., Posterior interosseous aeryInterosseous recurrent aery is a branch ofposterior interosseous aery.
| 1 |
Posterior interosseous aery
|
Anterior interosseous aery
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Radial aery
|
None
|
Anatomy
| null |
789d81b0-e634-4760-b4ce-fcf6808904a2
|
multi
|
As per WHO low birth weight is defined as
| null | 3 |
Gestational age < 34 weeks
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Birth weight < 10th percentile
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Birth weight less than 2.5 kg
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Gestational age < 28 weeks
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Social & Preventive Medicine
| null |
b6b181dd-c318-4545-a1cd-ec43f81ccbd3
|
single
|
Drug used in heparin overdose -
|
Ans. is 'a' i.e., Protamine sulfate The most common adverse effect of heparin is bleeding.Protamine sulfate is an antidote of heparin. Protamine is strongly basic low molecular weight protein.Protamine sulfate is rarely needed in heparin induced bleeding because the action of heparin disappears by itself in few hours.The best management of heparin induced bleeding is whole blood transfusion to replenish the blood loss.Protamine is more commonly used when heparin action needs to be terminated rapidly.Goodman Gilman states "Mild bleeding due to heparin usually can be controlled without the administration of an antagonist. If life threatening hemorrhage occurs, the effect of heparin can be reversed quickly by slow intravenous infusion of protamine sulfate.99
| 1 |
Protamine sulfate
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Phylloquinone
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Ticlopidine
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Clopidogrel
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Pharmacology
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Anticoagulants and Coagulants
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8ee40672-2334-4469-be7c-d2a3d1516621
|
multi
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