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Ergot alkaloids are used in all except -
|
Ans. is 'c' i.e., Hypertension Uses of ergot alkaloids1. Migraineo In migraine, throbbing headache is due to dilatation of pain sensitive arteries outside the brain, i.e. extracerebral vessels.o Ergot alkaloids are vasoconstrictor (due to a agonistic action) and oppose these effects,o Ergot alkaloids used in migraine -Prophylaxis-MethysergideAcute attack-Ergotamine & dihydroergotamine2. Parkinsonismo In parkinsonism, there is degeneration of dopaminergic neurons.o Bromocriptine; an ergot alkaloid, is dopamine agonist at D2 receptor - can be used in parkinsonism.3. Hyperprolactinemiao Prolactin is under predominant inhibitory control of hypothalamus through dopamine that act on receptor of pituitary lactotroph.o Bromocriptine by D2 agonistic activity, decreases prolactin secretion.4. Acromegalyo Dopamine increases GH release in normal subjects but decreases it in acromegalics,o Bromocriptine also acts in same way due to its dopamine agonistic action.5. Dementiao Dihydroergotoxin increases cerebral blood flow and act by protecting altered brain metabolism.
| 3 |
Migraine
|
Acromegaly
|
Hypertension
|
Parkinsonism
|
Pharmacology
|
C.N.S
|
b187cde0-0d31-42ea-a84d-6b4109c0aa8f
|
multi
|
HLA B27 is positive in
|
Ref Robbins 8/e p193; Harrison 17/e p2051 ;9/e p215 The HLA complex, which is located on the sho arm of human chromosome 6, contains sequences encoding about 100 genes, most involved in the regulation of the immune response. HLA genes are classically grouped into three major classes.
| 1 |
Ankylosing spondylitis
|
Rheumatoid ahritis
|
SLE
|
Behcet syndrome
|
Anatomy
|
General anatomy
|
36b1e3a9-5596-4992-8729-3b39ac3fd97b
|
single
|
In RMNCH+A Startegy, what is plus -
|
Ans. is 'a' i.e., Adolescent health o The RMNCH+A strategy is based on provision of comprehensive care through the five pillars, or thematic areas, of reproductive, maternal, neonatal, child, and adolescent health, and is guided by central tenets of equity, universal care, entitlement, and accountability. The "plus" within the strategy focusses on :# Including adolescence for the first time as a distinct life stage.# Linking maternal and child health to reproductive health, family planning, adolescent health. HIV, gender, preconception and prenatal diagnostic techniques.# Linking home and community-based services to facility-based care.# Ensuring linkages, referrals, and counter-referrals between and among health facilities at primary (primary health centre), secondary (community health centre), and tertiary levels (district hospital).o Reduce anemia at 6% annual rate in adolescent is coverage target ( not goal) for RMNCH + A -Reproductive, maternal, newborn, child and adolescent health (RMNCH+A) stratery, 2013o In June 2012, the Government of India, Ethiopia, USA and the UNICEF convened the "Global Child Survival Call to Action : A Promise to Keep" summit in Washington, DC to energize the global fight to end preventable child deaths through targeted interventions in effective, life-saving interventions for children. More than 80 countries gathered at the Call to Action to pledge to reduce child mortality to < 20 child deaths per 1000 live births in every country by 2035. Eight months after the event, in February 2013, the Government of India held its own historic Summit on the Call to Action for Child Survival, where it launched "A Strategic Approach to Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCH+A) in India." Since that time, RMNCH+A has become the heart of the Government of India's flagship public health programme, the National Health Mission.o The RMNCH+A strategy is based on provision of comprehensive care through the five pillars, or thematic areas, of reproductive, maternal, neonatal, child, and adolescent health, and is guided by central tenets of equity, universal care, entitlement, and accountability. The "plus" within the strategy focusses on :# Including adolescence for the first time as a distinct life stage.# Linking maternal and child health to reproductive health, family planning, adolescent health. HIV, gender, preconception and prenatal diagnostic techniques.# Linking home and community-based services to facility-based care.# Ensuring linkages, referrals, and counter-referrals between and among health facilities at primary (primary health centre), secondary (community health centre), and tertiary levels (district hospital).o In developing the RMNCH+A strategy, the aim is to reach the maximum number of people in the remotest comers of the country. Guidelines and tools were developed and policies were adjusted.1) High-Priority Districts : Uniform and clearly defined criteria were used to identify 184 high-priority districts across all 29 states.2) Management tools andjob aids : The RMNCH+A 5><5 matrix identifies five high-impact interventions across each of the five thematic areas, five cross-cutting and health systems strengthening interventions, and, the minimum essential commodities across each of the thematic areas. The 5x5 matrix as shown in table, is an important tool for explaining the strategy in simple terms, organizing technical support, and monitoring progress with the states and high-priority districts.Reproductive healthMaternal healthNewborn healthChild healthAdolescent health# Focus on spacing methods, particularly PPIUCD at high case load facilities.# Focus on interval IUCD at all facilities including subcentres on fixed days.# Home delivery of Contraceptives (HDC) and Ensuring Spacing at Birth (ESB) through ASHAs.# Ensuring access to Pregnancy Testing Kits (PTK "Nischay Kits") and strengthening comprehensive abortion care services.# Maintaining quality sterilization services.# Use MCTS to ensure early registration of pregnancy and full ANC.# Detect high risk pregnancies and line list including severely anaemic mothers and ensure appropriate management.# Equip delivery points with highly trained HR and ensure equitable access to EmOC services through FRUs, Add MCH wings as per need.# Review maternal, infant and child deaths for corrective actions.o Identify villages with high numbers of home deliveries and distribute Misoprostol to selected women in 8th month of pregnancy for consumption during 3rd stage of labour; Incentivize ANMs for home deliveries.# Early initiation and exclusive breastfeeding.# Home based newborn care through ASHA.# Essential Newborn Care and resuscitation services at all delivery points.# Special Newborn Care Units with highly trained human resource and other infrastructure.# Community level use of Gentamycin by ANM.# Complementary feeding, IFA supplementation and focus on nutrition.# Diarrhoea management at community level using ORS and Zinc.# Management of pneumonia.# Full immunization coverage.# Rashtriya Bal Swasthya Karyakram (RBSK); screening of children for 4D's (birth defects, development delays, deficiencies and disease) and its management.# Address teenage pregnancy and increase contraceptive prevalence in adolescents.# Introduce community based services through peer educators.# Strengthen ARSH clinics.# Roll out National Iron Plus Initiative including weekly IFAsupplementation.# Promote menstrual hygiene. Health Systems StrengtheningCross Cutting Interventions# Cases load based deployment of HR at all levels.# Ambulances, drugs, diagnostics, reproductive health commodities.# Health education, demand promotion & behaviour change communication.# Supportive supervision and use of data for monitoring and review, including scorecards based on HMIS.# Public grievances redressal mechanism, client satisfaction and patient safety through all round quality assurance.# Bring down out of pocket expenses by ensuring ISSK, RBSK and other free entitlements.# ANMs & Nurses to provide specialized and quality care to pregnant women and children.# Address social determinants of health through convergence.# Focus on un-served and underserved villages, urban slums and blocks.# Introduce difficult area and performance based incentives.5x5 matrix for high impact RMNCH+A interventionsTo be implemented with High Coverage and High QualityGoals and Targetso The 12th Five Year Plan has defined the national health outcomes and the three goals that are relevant to RMNCH+A strategic approach are as follows :# Reduction of Infant Mortality Rate (IMR) to 25 per 1,000 live births by 2017.# Reduction in Maternal Mortality Ratio (MMR) to 100 per 100,000 live births by 2017.# Reduction in Total Fertility Rate (TFR) to 2[?]1 by 2017.o For achieving these goals, variable increase in the coverage level for key interventions are required. These are defined in the table.Coverage targets for key RMNCH+A interventions for 2017# Increase facilities equipped for perinatal care (designated as 'delivery points') by 100%.# Increase proportion of all births in government and accredited private institutions at annual rate of 5[?]6% from the baseline of 60% (SRS 2010).# Increase proportion of pregnant women receiving antenatal care at annual rate of 6% from the baseline of 53% (CES 2009).# Increase proportion of mothers and newborns receiving postnatal care at annual rate of 7[?]5% from the baseline of 45% (CES 2009).# Increase proportion of deliveries conducted by skilled birth attendants at annual rate of 2% from the baseline of 76% (CES 2009).# Increase exclusive breast-feeding rates at annual rate of 9-6% from the baseline of 35% (CES 2009).# Reduce prevalence of under-five children who are underweight at annual rate of 5[?]5% from the baseline of 45% (NFHS-3).# Increase coverage of three doses of combined diphtheria-tetanus-pertussis (DTP3) (12-23 months) at annual rate of 3-5% from the baseline of 7% (CES 2009).# Increase ORS use in under-five children with diarrhoea at annual rate of 7[?]2% from the baseline of 43% (CES 2009).# Reduce unmet need for family planning methods among eligible couples, married and unmarried, at annual rate of 8[?]8% from the baseline of 21% (DLHS 3).# Increase met need for modem family planning methods among eligible couples at annual rate of 4[?]5% from the baseline of 47% (DLH 3).# Reduce anaemia in adolescent girls and boys (15-19 years) at annual rate of 6% from the baseline of 56% and 30%, respectively (NFHS-3).# Decrease the proportion of total fertility contributed by adolescents (15-19 years) at annual rate of 3[?]8% per year from the baseline of 16% (NFHS-3).# Raise child sex ratio in the 0-6 years age group at annual of 0[?]6% per year from the baseline of 914 (Census 2011).
| 1 |
Adolescent health
|
Reproductive health
|
DPT Vaccination
|
Newborn health
|
Social & Preventive Medicine
|
Health Programmes in India
|
80688b75-8dca-4679-a39d-9545c44e9b34
|
single
|
What is deposited in Kyser-FIeischer ring -
|
Ans. is 'a' i.e., CopperKayser-FLeischer (KF) ring - Copper deposition in Chalcosis or Wilson's diseaseFleischer ring - Deposition of iron and is a sign of keratoconus
| 1 |
Copper
|
Lead
|
Mercury
|
Heme
|
Ophthalmology
|
Cornea
|
f75b679a-359b-4ea9-a6b3-aefae2cbe6ea
|
single
|
Psammoma body found in -
|
Ans is 'a' i.e. Papillary Ca Psammoma bodies found in: Ref. Papillary Ca of thyroid 8/e p1122 (7/e p1178) Serous cystadenoma of ovary 8/e 1044 (7/e p1096) Meningioma 8/e p1338 (7/e p1409) Papillary type of Renal cell carcinoma 8/e p966 (7/e p1018) Pitutary adenoma (Prolactinoma) 8/e p1103 (7e p1160) Appendiceal carcinoid (rarely) 7/e p868
| 1 |
Papillary Ca thyroid
|
Follicular Ca thyroid
|
Medullary Ca thyroid
|
Anaplastic Ca thyroid
|
Surgery
| null |
ee2e513a-9600-4ccf-a21b-5fc53c244ceb
|
single
|
In this poisoning, the vomitus is:
|
GIT symptoms with boric acid can mimics acute gastroentritis. Nausea, vomiting (bluish green), haematemesis, diarrhoea (bluish green)
| 1 |
Bluish green
|
Black
|
Brown
|
Red velvetty
|
Forensic Medicine
|
Toxicology - 1
|
67f9b675-df37-4997-85cb-e5c0b65d205d
|
single
|
High or low fistula is ano is termed according to its internal opening present with reference to
|
The anorectal ring marks the junction between the rectum and the anal canal. It is formed by the joining of the puborectalis muscle. the deep external sphincter, conjoined longitudinal muscle and the highest pa of the internal sphincter. The anorectal ring can be clearly felt digitally, especially on its posterior and lateral aspects. Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1240
| 3 |
Anal canal
|
Dentate line
|
Anorectal ring
|
Sacral promontary
|
Surgery
|
G.I.T
|
22d07568-d0cc-4d7d-976a-03421c1eb49d
|
single
|
Wobble hypothesis -regarding the variation true is:
|
B i.e., 5-end of anticodon
| 2 |
3 - end of anticodon
|
5 - end of anticodon
|
m-RNA
|
t-RNA
|
Biochemistry
| null |
d389e0b7-7190-496d-8d35-e51fad76aab8
|
multi
|
isolated conjugated hyperbilirubinemia is seen in the following conditions except-
|
Gilbe's syndrome is by far the most common inherited disorder of bilirubin metabolism . It is an autosomal recessive trait when caused by a mutation in the promoter region of the gene for UDP-glucuronyl transferase enzyme (UGT1A1), which leads to reduced enzyme expression. It can be inherited in a dominant fashion when there is a missense mutation in the gene. This results in decreased conjugation of bilirubin, which accumulates as unconjugated bilirubin in the blood. The levels of unconjugated bilirubin increase during fasting, as fasting reduces levels of UDP-glucuronyl transferase. Ref Davidson 23e p897
| 2 |
Hemolysis
|
Gilbe syndrome
|
Crigler-Najjar syndrome
|
Dubin-Johnson syndrome
|
Medicine
|
G.I.T
|
72cda82b-2bdc-4846-accb-b13ded41d111
|
multi
|
True about inverted papilloma is -
|
Ans. is 'a' i.e., It is also known as Schnedrian papilloma "Inverted papilloma of nose" -o It is also called Schneiderian papilloma, squamous papilloma or papillomatosiso It is a polypoid mass occuring on the lateral nasal wall typically in middle aged men.o The name is derived from its histologic appearance of on inverted proliferative growth patterno The significance of this lesion lies in its association with concurrent (8%) and subsequent (4%) invasive squamous cell carcinoma.
| 1 |
It is also known as Schnedrian papilloma
|
Anatomically It has an inverted appearance
|
It may cause basal cell carcinoma
|
It is commonly seen in young girls
|
Surgery
|
E.N.T.
|
382994cb-2ec5-4441-8859-0472bc8c538d
|
multi
|
Treatment of rectal prolapse in childhood is -
|
• Prolapse during childhood is best managed conservatively, the only exception is persistence of prolapse despite effective treatment of diarrhea, worm infestation and malabsorption. These cases are managed by surgery.
| 3 |
Lahaut's operation
|
Incision of prolapsed mucosa
|
Thiersch wiring
|
Ripstein operation
|
Surgery
| null |
01835b22-2e3d-4e80-a64d-26f5c29bc227
|
single
|
All are true about subacute combined degeneration of spinal cord except -
| null | 4 |
Due to deficiency of vitamin B12
|
Posterior column involvement
|
Corrticospinal involvement
|
Absent deep tendon reflexes
|
Medicine
| null |
d010c2e6-6b29-44fb-aa91-29f2d53409c9
|
multi
|
The most common and the most poorly tolerated heart disease during pregnancy is:
|
Ans. c (Aortic stenosis). (Ref. Dutta, Obstetrics, 6th ed., p 281)# Aortic stenosis has maternal mortality of 15-20% and Perinatal loss of 30%.HEART DISEASE IN PREGNANCY# The risk of fetal congenital malformations is increased by 3-10% if either parents have congenital lesions.# In mother with ASD, risk of having concordant abnormality in baby is very much high.# Most common heart disease in pregnancy is mitral stenosis.# The most common congenital heart disease during pregnancy is ASD.# Management:a) Management of first stage of labour.i) Place the patient in lateral recumbant position.ii) As a rule the quantity of infused fluid should not be more than 75 ml/hr to prevent pulmonary edema, except in Aortic Stenosis where the fluid therapy should not be restricted and the rate of infusion should be 125-150 ml/ hr.iii) Prophylaxis with antibiotics during the labour and 48 hrs after delivery is appropriate.b) Management of second stage of labourQi) Curtail the second stage of labour (ventouse is preferable to forceps as it can be applied without putting the patient in lithotomy position and thus preventing cardiac overload).ii) Withhold IV ergometrine with delivery of anterior shoulder to prevent sudden cardiac overload.iii) It is better to prefer ergometrine than oxytocin in all cases of heart disease.- Absolute indications for termination of pregnancy are primary pulmonary hypertension, Eisenmenger's syndrome.Q- In general there is no indication of Caesarean Section for heart disease except in Coarctation Of Aorta, where elective LSCS is indicated to prevent rupture of aorta or mycotic cerebral aneurysm.Qc) Epidural anaesthesia is preferable over general anaesthesia (contraindicated in AS).d) Anticoagulant therapy is not a contraindication for breast feeding.e) Barrier method is the contraception of choice, steroidal and IUCD are contraindicated.QBest time for mitral valvotomy in pregnancy with mitral stenosis is-44-18 weeks.# Mitral stenosis is especially dangerous because the tachycardia, increased blood volume, and increased cardiac output of pregnancy interact with this lesion to elevate pulmonary capillary pressure; atrial fibrillation is also common. Together, these factors increase the risk of pulmonary edema, the most lethal complication of mitral stenosis.# Mitral valvotomy can be performed during pregnancy, but open heart surgery increases the risks of abortion and fetal damage.# Prophylactic antibiotic therapy should be continued during pregnancy.# In patients with mitral stenosis, digoxin 0.25 mg/day po is used if atrial fibrillation develops.# Labor and delivery are best tolerated at full term, and close attention to analgesia and to relief of anxiety is essential.# Generally the most hazardous time is during peak cardiac output (at 20 to 34 wk).
| 3 |
Mitral stenosis
|
Mitral regurgitation
|
Aortic stenosis
|
Aortic regurgitation
|
Gynaecology & Obstetrics
|
Miscellaneous (Gynae)
|
99de6a97-2596-494d-9422-2a19d28b7ab3
|
single
|
Which of the following is true of small bowel carcinoids
|
Ans. is 'none' Lets see each option one by one Most common site: Most common site for small bowel carcinoids is ileum. About 70-87% are present within the ileum and 40-70% are within 2 ft of the ileocecal valve. Among all carcinoids most common site is GI tract 2nd most common site is respiratory tract Endocardial fibroelastosis is cardiac manifestation of carcinoid syndrome, produced due to biologically active substances (mainly serotonin) secreted by carcinoids. Endocardial fibroelastosis is fibrous involvement of the endocardium, primarily the right side of the hea. No increased risk of Ca lung is noted. Previously small cell Ca of lung and carcinoid tumors were thought to be similar representing the spectrum of neuroendocrine tumors of the lung. Recent studies using gene expression profiles have proved them to be dissimilar. Small cell lung cancers are derived from bronchial epithelium & carcinoids are derived from neural crest Carcinoid tumor location, Frequency of Metastases, and Association with the Carcinoid Syndrome Location (% of Total) Incidence of Metastases Incidence of I Carcinoid 1 Syndrome Foregut Esophagus <0.1 - ? Stomach 4.6 10 9.5 Duodenum 2.0 3.4 Pancreas 0.7 71.9 20 Gallbladder 0.3 17.8 5 Bronchus, lung, trachea 27.9 5.7 13 Midgut Jejunum 1.8 1 58.4 9 Ileum 14.9 r 9 Meckel's diveiculum 0.5 13 Appendix 4.8 38.8 <1 Colon 8.6 51 5 Liver 0.4 32.2 ? Ovary 1.0 32 50 Testis <0.1 - 50 Hindgut Rectum 13.6 3.9 -
| 4 |
Most common site is duodenum
|
It does not cause endocardial fibroelastosis
|
Increased risk of Ca lung
|
None
|
Surgery
| null |
1446f7e3-12e3-4bcd-bd82-c85a714ba064
|
multi
|
The obstruction of two or more major hepatic veins is seen in
|
Budd-Chiari syndrome It is caused by obstruction of hepatic venous outflow producing intense congestion of the liver Etiology Polycythemia rubra Vera is the most common etiology In the West, thrombosis of the major hepatic veins is more common In BCS all three major hepatic veins usually are occluded Small hepatic veins that join the retro hepatic IVC, paicularly veins draining the caudate lobe are spared Membranous obstruction of IVC is the most common cause of BCS in Japan, China, India and South Africa Infections causing BCS : Filariaisis, amebic liver abscess, aspergillosis, schistosomiasis, syphilitic gumma and hydatid disease Most common cancer associated with BCS : HCC, RCC, adrenal carcinoma and leimyosarcoma of IVC Clinical features Characterized by triad of Ascites+Hepatomegaly+ abdominal pain (Asha) Abdominal pain, abdominal distension, weakness, anorexia and jaundice Signs are massive ascites, hepatomegaly (with hyperophied Caudate lobe), wasting, abdominal venous distension, splenomegaly, jaundice and edema of thighs, legs and feet Jaundice and abdominal venous distension is more common in hepatic vein occlusion Edema of thighs, legs and feet is seen only in IVC occlusion Striking and progressive weakness occur as a manifestation in acute form but not in cirrhotic forms of BCS Ref: Schwaz's principle of surgery 10th edition Pg no : 1283-1284
| 1 |
Budd-Chiari syndrome
|
Reye's syndrome
|
Rotor syndrome
|
Crigler-Najjar syndrome
|
Anatomy
|
G.I.T
|
0e875125-369d-4715-a798-2b80280533a6
|
single
|
Sympathectomy is indicated in
| null | 4 |
Buerger’s disease
|
Atherosclerosis producing ischemia of limbs
|
Raynaud’s disease
|
All of the above
|
Surgery
| null |
f2beed25-278e-493b-8d39-a93fd47ad74d
|
multi
|
A man presents with chest pain. ECG shows ST-segment depression in leads V1-V4. Which of the following should not be given?
|
Thrombolytics like streptokinase, alteplase, reteplase are beneficial to patients with ST-elevated MI Max. benefit will be seen if they were given with 6 hours of the onset of MI Their use in ST depressed MI is contraindicated
| 2 |
Beta blocker
|
Thrombolytic
|
Morphine
|
Aspirin
|
Pharmacology
|
Cardiovascular system
|
53f5b9b3-66f7-4288-a987-aba31d43dd20
|
single
|
The antihypeensive agent that should be avoided in young females and is used topically to treat alopecia is:
|
Minoxidil is a powerful vasodilator Active metabolite of minoxidil is an opener of ATP sensitive K channels; causes vasodilatation by hyperpolarizing smooth muscle. Minoxidil is avoided in young females because it causes Hirsutism. Drugs causing Hirsutism: Phenytoin Cyclosporine Minoxidil USE OF MINOXIDIL IN ALOPECIA - Hirsutism was observed as side effect of oral minoxidil. Applied topically it promotes hair growth in male pattern baldness and in alopecia areata.
| 3 |
Hydralazine
|
Prazosin
|
Minoxidil
|
Indapamide
|
Pharmacology
|
Hypeension, Arrhythmias, Dyslipidemia
|
4c725d08-f995-4d7a-9b29-6d2da844d7c3
|
multi
|
Shoest acting non depolarizing muscle relaxant is
|
Suxamethonium (succinylcholine) is the shoest acting skeletal muscle relaxantMivacurium is the shoest acting nondepolarizing skeletal muscle relaxant.(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.139)
| 1 |
Mivacurium
|
Doxacuronium
|
Pipecurium
|
Vecuronium
|
Anaesthesia
|
All India exam
|
e89c60e7-82cf-4a17-bfd9-be302f7831a7
|
single
|
Active immunity is not acquired by:(1994)
|
Ans: c (Immunoglobulin transfer)Ref: Ananthanarayan Micro, 7lhed, p. 76 & 6th ed, p. 73
| 3 |
Infection
|
Vaccination
|
Immunoglobulin transfer
|
Sub clinical infection
|
Microbiology
|
Immunology
|
474c551b-2a04-490f-8e91-7d99918e4142
|
single
|
An HIV patient complains of visual disturbances. Fundal examination shows bilateral retinal exudates and perivascular haemorrhages. Which of the following viruses are most likely to be responsible for this retinitis-
|
This is a typical feature of Cytomegalovirus (CMV) retinitis. Pizza pie appearance of fundus in CMV retinitis.(In HIV +ve patient, if CD4+ count is <50 cells/ microlitre) Herpes simplex- type 1 : conjuctivitis and corneal ulceration. Varicella zoster-corneal ulcer and zoster opthalmicus. EBV- not associated with retinitis.
| 3 |
Herpes simplex
|
Varicella zoster
|
Cytomegalovirus
|
EBV
|
Microbiology
|
Virology (General Propeies, DNA Viruses)
|
8df91b2e-08e1-41bf-aa65-38acb2c42ba0
|
single
|
Most common cause of gangrene of foot of 30-years old farmer who is a chronic smoker
| null | 4 |
Raynaud’s disease
|
Myocardial infarction
|
Atherosclerosis
|
Thromboangitis obliterans
|
Surgery
| null |
6f9763f0-3301-4ba8-9a92-bd32b7fc1834
|
single
|
Fogo selvagem is a type of:
|
Endemic pemphigus foliaceus common in rural pas of South America, paicularly ceain states of Brazil is known as fogo selvagem (wild fire) caused by bite of black fly. Ref: Rook's textbook of dermatology, 8th edition, Pg 40.13
| 3 |
Pemphigus vulgaris
|
Pemghigus vegetans
|
Pemphigus foliaceus
|
Bullous pemphigoid
|
Skin
| null |
d27dbf35-76e9-40bc-8fdf-9222c625f1d0
|
single
|
All are aromatic amino acids EXCEPT:
|
(Lysine): Ref 49, U.S. (75- R.S. 7th)* Aromatic amino acids: Phenylalanine, tyrosine and tryptophan (with indole ring) are aromatic amino acids, Basides these histidine may also be considered this category.* Hydroxyl group containing amino acids: - Serine, Threonine, Tyrosine* Amino acids with aliphatic side chains: - Leucine, Isoleucine, Valine {Branchedchain amino acids) Glycine, Alanine* Basic amino acids: - Lysine, Arginine {with guanidine group) and Histidine {imidazole ring)* Non polar amino acids: - Alanine, laucine, Isoleucine, Valine, Methionine, Phenylalanine, tryptophan and proline
| 4 |
Phenylalanine
|
Tyrosine
|
Tryphophan
|
Lysine
|
Biochemistry
|
Proteins and Amino Acids
|
f7986f8a-eac8-4cc2-b90f-2de79c6bcd03
|
multi
|
The peak of fast EPSP or, fast IPSP is seen at what time after stimulus application:
|
Fast EPSP and fast IPSP begins 0.5 ms after the stimulus (known as latency). They peak 1-1.5 ms after the stimulus then decreases exponentially. Fast EPSP is due to influx of Na+ and or Ca++ in post synaptic neuron. Fast IPSP is due to influx of Cl- in post synaptic neuron.
| 2 |
0.5 ms
|
0.5 to 1.5 ms
|
11.5 ms
|
100-500 ms
|
Physiology
|
Introduction to Central Nervous System
|
5b4026f8-b4f7-40b9-84a9-86467664bdb1
|
single
|
Popcorn cells are seen in:
|
Hodgkin lymphoma is currently classified in the following manner:
Nodular lymphocyte-predominant Hodgkin lymphoma.
Classical Hodgkin lymphoma (comprising five histopathologic subtypes):
Lymphocyte rich
Nodular sclerosis
Mixed cellularity
Lymphocyte depletion
Unclassifiable
These names describe the most prominent histopathologic feature of each type, and specific epidemiologic and prognostic characteristics are associated with each type. Nodular lymphocyte-predominant Hodgkin lymphoma constitutes 4% to 5% of all cases of Hodgkin lymphoma in the United States. In the past, this form was probably combined with the lymphocyte-rich subtype, but the presence of the characteristic popcorn cells is a significant clue to the diagnosis.
Ref: Oral pathology Neville, 4th ed page no 554
| 1 |
Hodgkin’s lymphoma
|
Non-Hodgkin's lymphoma
|
Burkitt’s lymphoma
|
Multiple myeloma
|
Pathology
| null |
bb474165-d1bf-4450-8a52-5c97bbfc4f9d
|
single
|
Micro RNA is -
|
Ans. is 'c' i.e., Gene Silencing RNA o There is a class of genes that encode for gene-silencing RNAs, i.e. RNAs that do not encode proteins but instead inhibit gene expression (unlike mRNAs) which encode for proteinso Two important gene-silencing RNAs are :- (i) Micro RNAs, and (ii) small interfering RNAs (siRNAs). i) Micro RNAs (mRNAs)# miRNA is transcribed by RNA polymerase //. The transcription of miRNA gene produces primary miRNA transcripts, which is processed in nucleus by a RNAase called Dorsha. Dorsha acts with a nuclear double stranded RNA binding protein called DGCR 8 and converts primary miRNA transcript into pre-miRNA. Pre- miRNA is transported to cytosol by a transport protein (exportin 5). Dicer (cytoplasmic enzyme) does the additional cutting of pre-miRNA to produce mi-RNA duplex, i.e. double stranded miRNA. This double strand unwinds and one strand of this duplex is incorporated into multiprotein complex called RNA induced silencing complex (RCIS), which help in gene regulation.# Base-pairing between the miRNA strand and its target mRNA (messenger RNA) directs RISC to either cause mRNA cleavage or repress its translation. In this way, the gene from which the target was derived is silenced (at a post-transcription level).ii) Small interfering RNAs (siRNAs)# siRNAs work in similar manner as miRNA. Unlike miRNA, siRNA precursors are introduced by investigators into cells.# siRNA are becoming powerful tools for studying gene function and may in the future be used therapeutically to silence specific genes, such as oncogenes, whose products are involved in neoplastic transformation
| 3 |
Splicing RNA
|
Snurps
|
Gene Silencing RNA
|
Ribonuclease
|
Biochemistry
|
Molecular Genetics
|
15dc92b8-8da6-41eb-862d-21d0ed2db8ae
|
single
|
Concurrent list does not encompass:
|
The regulation and development of medical profession is not included in the concurrent list and instead is placed in the Union list and is controlled by the union health ministry. Ref: Park Textbook of Preventive and Social Medicine, 19th Edition, Page 730
| 3 |
Prevention of extension of communicable disease from one unit to another
|
Prevention of adulteration of food stuffs
|
Regulation and development of medical profession
|
Vital statistics
|
Social & Preventive Medicine
| null |
71a970cf-92e3-4353-9f43-497456e6ca80
|
single
|
Which of the following in halational agent sensitizes myocardium to catecholamine -
|
Ans. is 'd' i.e., Halothaneo Some inhalational agent sensitize the heart to adrenaline -->>Arrhythmias can occur Therefore these agents are contraindicated in Pheochromocytoma and along with adrenaline.o Halothane has maximum propensity .o Other agents sensitizing the heart to adrenaline are Trilene, Cyclopropane, Chloroform, Enflurane.
| 4 |
Sevoflurane
|
Isoflurane
|
Ether
|
Halothane
|
Anaesthesia
|
Miscellaneous General Anesthesia
|
4aeeec74-d9ec-47e0-829d-f0b8bf2cd56a
|
single
|
First response to decreased blood volume
|
Baroreceptor reflex is an immediate compensatory mechanism in shock. There is stimulation of aerial baroreceptors and so sympathetic output is increased leading to vasoconstriction and reflex tachycardia. Ref: Textbook of medical physiology by N Geetha, 2nd edition, page no. 184
| 1 |
Increased hea rate
|
Tachypnea
|
Hypotension
|
Disorientation
|
Physiology
|
Cardiovascular system
|
08231981-c129-4875-ac62-524833dca847
|
single
|
All are glands of eyelids EXCEPT:
|
Ans. (b) Lacrimal glandRef: A.K. Khurana 6th ed. / 386GLANDS OF EYELIDS* Meibomian glands: Also known as tarsal glands present in the stroma of tarsal plate and are arranged vertically.# They are modified sebaceous glands. Their ducts open at the lid margin. Their secretion constitutes the oily layer of tear film.* Glands of Zeis: These are also sebaceous glands which open into the follicles of eyelashes.* Glands of Moll: These are modified sweat glands situated near the hair follicle. They open into the hair follicles or into the ducts of Zeis glands.* Accessory lacrimal glands of Wolfring. These are present near the upper border of the tarsal plate.* Note: Lacrimal gland is one of the gland of lacrimal apparatus. It is NOT among the eyelid glands.
| 2 |
Glands of zeis
|
Lacrimal gland
|
Meibomian gland
|
Glands of moll
|
Ophthalmology
|
Anatomy
|
3c368377-304c-4d85-a781-f4b7132c2fe3
|
multi
|
Crowding phenomenon is seen in:
|
Crowding Phenomenon - patient is able to identify a Snellen chant character with the amblyopic eye when The character is presented in isolation. Crowding phenomenon seen in Amblyopia. Amblyopia - loss of vision in a child (<8yr) Lazy eye syndrome M/c/c of amblyopia = squint Best treatment of Amblyopia - occlusion of good eye - forces the amblyopic eye to see more and thereby develop better vision. Occlusion therapy works only when the development is plastic (i.e. during childhood) Vitamin used for treating Toxic Amblyopia - Hydroxycobalamine (misnomer - Toxic Optic Neuropathy is better used term)
| 2 |
Hypermetropia
|
Amblyopia
|
Strabismus
|
Retinitis pigmentosa
|
Ophthalmology
|
Optics and Errors of Refraction
|
c6205862-b3f2-45c9-a2dc-4adc8ccc9ebd
|
single
|
Dull appearance of mouth temperature wax indicates
| null | 4 |
Insufficient material
|
Overextension
|
Contact of the material with tissues
|
Partial contact of tissues
|
Dental
| null |
3a63cae5-8a20-42b4-a58f-e3e68860d9f4
|
single
|
All true about cephalosporins EXCEPT:
|
This 2nd generation cephalosporin was developed subsequent to the first generation compounds and are more active against gram-negative organisms, anaerobes, but none inhibits P. aeruginosa ESSENTISLS OF MEDICAL PHARMACOLOGY
| 3 |
Ceftazimide is a 3rd generation cephalosporin
|
Cefoperzone has got antipseudomonal effect.
|
Cefoxitin has got no activity against anaerobes
|
Cephalosporins act by inhibiting cell wall synthesis
|
Pharmacology
|
Chemotherapy
|
e36250c1-c8a1-45f4-974c-c57b5f992551
|
multi
|
Which of the following is false about tympanic membrane:
|
(c) Healed perforation has 3 layers(Ref. Scott Brown, 8th ed., Vol 2; 529)The TM membrane which heals by itself does not have the fibrous layer. It has 2 layers only, the outer epithelial and the inner endothelial.Rest are true
| 3 |
Cone of light is antero-inferior
|
Shrapnell's membrane is also known as pars flaccida
|
Healed perforation has 3 layers
|
TM attachment to tip of malleus handle is called umbo
|
ENT
|
Ear
|
cad6a6e9-8334-442d-909a-03e00d891a94
|
multi
|
Not true of Gall stones
|
Ans. (d) Ileal resection has no effect on gall stone formationRef: Sabiston 20th edition Page 1492 Gall stones:* Cholesterol stones are common in Ileal resection and in cases of Crohn's disease due to decreased Entero hepatic circulation and decreased Bile salts.
| 4 |
Biliary fistula is a complication gall stone
|
More common in female
|
Clofibrate therapy is a predisposing factor
|
Ileal resection has no effect on gall stone formation
|
Surgery
|
Gall Bladder & Bile Ducts
|
d4802899-bd30-4bb0-82aa-d6c71f236940
|
multi
|
All of them are true about the 4th nerve EXCEPT
|
The trochlear nerve has several features that make it unique from the other cranial nerves: Thinnest cranial nerve. Is the only nerve to exit from the dorsal surface of the brain. Is the only nerve in which all the lower motor neuron fibers decussate. Has the longest intracranial course. Has the smallest number of axons.
| 3 |
The only nerve to emerge from the dorsal aspect of brain
|
The only nerve to cross over to opposite side
|
It is the thickest cranial nerve
|
It has the fewest axons of any cranial nerve
|
Ophthalmology
|
Neuro Ophthalmology
|
77843896-46a6-4353-aa9a-5eb5fd504dbc
|
multi
|
Which of the following liners when exposed to oral fluids result in diminishment of their antimicrobial effectiveness?
|
MTA and calcium hydroxide undergo a transformation of hydroxide to calcium carbonate from exposure to carbon dioxide in the blood and oral fluids, causing their antimicrobial effectiveness to diminish.
| 3 |
MTA
|
Calcium hydroxide
|
Both
|
None
|
Dental
| null |
f53fc939-e389-47b1-bf08-e6a916e1ec8a
|
multi
|
Which of the following is the largest protein in the body that connects M line to Z line during active muscle contraction?
|
Ans. C. Titin. (Ref. Guyton & Hall's Textbook of Medical Physiology 11th/pg. 463)SarcomereThe portion of the myofibril (or of the whole muscle fiber) that lies between two successive Z discs is called a sarcomere. When the muscle fiber is contracted, the length of the sarcomere is about 2 micrometers. At this length, the actin filaments completely overlap the myosin filaments, and the tips of the actin filaments are just beginning to overlap one another.Titin# The side-by-side relationship between the myosin and actin filaments is difficult to maintain. This is achieved by a large number of filamentous molecules of a protein called titin. Each titin molecule has a molecular weight of about 3 million, which makes it one of the largest protein molecules in the body.Myosin Filament.# The myosin filament is composed of multiple myosin molecules, each having a molecular weight of about 480,000.# The myosin molecule is composed of six polypeptide chains--two heavy chains, each with a molecular wt of about 200,000, and four light chains with molecular weights of about 20,000 each.# The myosin filament is made up of 200 or more individual myosin molecules. The protruding arms and heads together are calledcross-bridges. Each cross-bridge is flexible at two points called hinges--one where the arm leaves the body of the myosin filament, and the other where the head attaches to the arm.# The total length of each myosin filament is uniform, almost exactly 1.6 micrometers. Note, however, that there are no cross-bridge heads in the very center of the myosin filament for a distance of about 0.2 micrometer because the hinged arms extend away from the center.# ATPase Activity of the Myosin Head. Another feature of the myosin head that is essential for muscle contraction is that it functions as an ATPase enzyme. As explained later, this property allows the head to cleave ATP and to use the energy derived from the ATP's high-energy phosphate bond to energize the contraction process.Actin Filament.# The actin filament is complex, composed of three protein components: actin, tropomyosin, and troponin.# The backbone of the actin filament is a double- stranded F-actin protein molecule. The two strands are wound in a helix in the same manner as the myosin molecule.# Each actin filament is about 1 micrometer long. The bases of the actin filaments are inserted strongly into the Z discs; Tropomyosin Molecules.# The actin filament also contains another protein, tropomyosin. Each molecule of tropomyosin has a molecular weight of 70,000 and a length of 40 nanometers. These molecules are wrapped spirally around the sides of the F-actin helix. In the resting state, the tropomyosin molecules lie on top of the active sites of the actin strands, so that attraction cannot occur between the actin and myosin filaments to cause contraction.Troponin and Its Role in Muscle Contraction.# Attached intermittently along the sides of the tropomyosin molecules are still other protein molecules called troponin.# One of the subunits (troponin I) has a strong affinity for actin, another (troponin T) for tropomyosin, and a third (troponin C) for calcium ions. This complex is believed to attach tropomyosin to the actin.# The strong affinity of the troponin for calcium ions is believed to initiate the contraction process.
| 3 |
Actin
|
Desmin
|
Titin
|
All of above
|
Physiology
|
General
|
67bb78da-3e2b-4c2d-9f85-e09d48462f1f
|
multi
|
A 35-year old lady presented with dysphagia>> nocturnal asthma and weight loss for 6 years. The most probable diagnosis is -
|
<P>Davidson&;s principles and practice of medicine 22nd edition #Achalasia cardia is presented with dysphagia ,episodic chest pain due to oesophageal spasm,nocturnal pulmonary aspiration, weight loss.</p>
| 1 |
Achalasia cardia
|
Lye stricture of esophagus
|
Gastroesophageal reflux diseae
|
Cancer esophagus
|
Medicine
|
G.I.T
|
a0a7ac1a-be54-48dd-9d35-aa53f7c58d5d
|
single
|
Radical neck dissection involves all except
|
Vagus nerve is not removed in Radical Neck Dissection. Structures removed in Radical Neck Dissection: Level I-V Lymph nodes, Sternocleidomastoid, Internal Jugular Vein, Spinal Accessory Nerve, Submandibular salivary gland, Tail of parotid and Omohyoid muscle. Ref: Textbook of ENT, Dhingra; 6th edition; Pg no: 388 ref img
| 3 |
Sternocleidomastoid muscle
|
Internal jugular vein
|
Vagus nerve
|
Spinal accessory nerve
|
ENT
|
Miscellaneous ENT
|
9f817221-e452-4e07-8c68-b3da0d963908
|
multi
|
Which type of amyloidosis is caused by mutation of the transthyretin protein?
|
Familial amyloid polyneuropathy (FAP) is phenotypically and genetically heterogeneous and is caused by mutations in the genes for transthyretin (TTR), apolipoprotein A1, or gelsolin. The majority of patients with FAP have mutations in the TTR gene. Amyloid deposition may be evident in abdominal fat pad, rectal, or nerve biopsies. The clinical features, histopathology, and EDx reveal abnormalities consistent with a generalized or multifocal, predominantly axonal but occasionally demyelinating, sensorimotor polyneuropathy. Must know: Familial Mediterranean fever (FMF) is the prototype of a group of inherited diseases that are characterized by recurrent episodes of fever with serosal, synol, or cutaneous inflammation and, in some individuals, the eventual development of systemic AA amyloidosis. The innate immune system, with its myeloid effector cells and germline receptors for pathogen-associated molecular patterns and endogenous danger signals, plays a predominant role in the pathogenesis of the autoinflammatory diseases Beta 2-m Amyloidosis is a frequent complication of long-term dialysis (hemodialysis or peritoneal dialysis). In fact, Beta 2-m amyloidosis is a major cause of skeletal morbidity in dialysis-dependent patients. Prions are infectious proteins that cause degeneration of the central nervous system (CNS). Prion diseases are disorders of protein conformation, the most common of which in humans is called Creutzfeldt-Jakob disease (CJD). CJD typically presents with dementia and myoclonus, is relentlessly progressive, and generally causes death within a year of onset. Misfolded prion protein (PrPSc) is associated with amyloidosis. Ref: Mueller P.S. (2007). Chapter 56. Amyloidosis. In J.B. Imboden, D.B. Hellmann, J.H. Stone (Eds), CURRENT Rheumatology Diagnosis & Treatment, 2e; Mueller P.S. (2007). Chapter 56. Amyloidosis. In J.B. Imboden, D.B. Hellmann, J.H. Stone (Eds), CURRENT Rheumatology Diagnosis & Treatment, 2e.
| 2 |
Familial Mediterranean fever
|
Familial amyloidotic polyneuropathy
|
Dialysis associated amyloidosis
|
Prion protein associated amyloidosis
|
Pathology
| null |
eef1a8ed-b3be-4f9c-add6-d41157d2a092
|
single
|
Most common cause of precipitation of renal failure in multiple myeloma is
|
(C) Hypercalcaemia # Renal failure is seen in 25% patients and hypercalcaemia is the most common cause of renal failure.> Quite often renal failure develops rapidly even at an unchanged ratio of production and serum concentration of light chains. Various factors can favour renal cast formation in myeloma patients. Dehydration, sometimes due to diuretics, reduces the glomerular filtaration rate (GFR) and causes an increase in the plasma concentration of light chains which then exceeds the capacity for reabsorption and catabolism of light chains in the proximal tubuli.> Hypercalcaemia may induce vasoconstriction followed by a decrease in GFR. Several drugs, in particular non- steroidal anti-inflammatory agents (NSAIDs), reduce renal blood flow. Radiographic contrast agents may induce acute renal failure in myeloma patients, particularly if patients are dehydrated and ionic contrast media are used.> The osteoclasts respond to osteoclast activating factors (OAF) made by the myeloma cells . leading to hypercaicaemia. Renal failure occurs in nearly 25% of myeloma patients, and some renal pathology is noted in over half. Hypercalcemia is the most common cause of renal failure. Glomerular deposits of amyloid, hyperuricemia, recurrent infections, and occasional infiltration of the kidney by myeloma cells all may contribute to renal dysfunction. However, tubular damage associated with the excretion of light chains is almost always present. Normally, light chains are filtered, reabsorbed in the tubules, and catabolized. With the increase in the amount of light chains presented to the tubule, the tubular cells become overloaded with these proteins, and tubular damage results either directly from light chain toxic effects or indirectly from the release of intracellular lysosomal enzymes. The earliest manifestation of this tubular damage is the adult Fanconi syndrome (a type 2 proximal renal tubular acidosis), with loss of glucose and amino acids, as well as defects in the ability of the kidney to acidify and concentrate the urine. The proteinuria is not accompanied by hypertension, and the protein is nearly all light chains. Generally, very little albumin is in the urine because glomerular function is usually normal.
| 3 |
Hyperurecemia
|
Infection
|
Hypercalcaemia
|
Amyloidosis
|
Medicine
|
Miscellaneous
|
75fc64f0-d253-4ae4-aec7-2c4d2f70a444
|
single
|
Presence of 1 up quark + 2 down quarks suggests the following:
| null | 2 |
Proton
|
Neutron
|
Electron
|
Positron
|
Radiology
| null |
451ab750-6028-441f-ac30-503e81a28784
|
single
|
Use of dexemditomidine ?
|
Ans. is 'b' i.e., Sedative agent for intubated patients Dexmeditomidine It is a centrally acting a-2 adrenergic agonist It is approved by F.D.A. for sho term (<24 hours) continuous IV sedation of adults who are tracheally intubated. Its use as an anaesthetic agent is not recommended but it is useful in patients with brain injury and ongoing sedation needs
| 2 |
Prolong action of LA in hypeensive patients
|
Sedative agent for intubated patients
|
Increases bioavailability of regional anaesthetic drug
|
Helps in reducing bispectral index of general anaesthetic drug with low potency
|
Anaesthesia
| null |
96419db9-e15f-48ed-9bcf-44f4c7a7f154
|
single
|
What is Kienboch's disease
|
Ans. is 'a' i.e osteochondritis of lunate [Ref. : Maheshwari 3/e p269 (2/e, p268)JOsteochondritis :These are a group of miscellaneous affections of the growing epiphysis in children and adolescents.Typically, a bony nucleus of the epiphysis affected by osteochondritis becomes temporarily softened; and while in the softened stage it is liable to deformation by pressure.Common osteochondritis *NameSite affectedPerthes disease*Pannes disease*Kienbocks disease*Osgood shlatter's disease*Sever s disease*Kohler's disease*Freibergs disease*Scheurmann's disease*Calves disease*- Femoral head (most common)*- Capitulum- Lunate bone- Tibial tubercle- Calcaneal tuberosity- Navicular bone- Metatarsal head- Ring epiphysis of vertebrae- Central bony nucleus of vertebral body* Note that this is a very important chart and must be learnt very well. I had a method to remember it. I placed them in an order of sites affected from hand to foot and then made a mnemonic for the names. Site affectedName of diseaseMnemonic(In order from hand to foot) * Lunate boneKienbock's diseaseKhaike* CapitulumPanner's diseasePaan* Ring epiphysis of vertebraeScheuermann's diseaseSupreme* Central bony nucleus of vertebral bodyCalve s diseaseCourt* Femoral headPerthe \s diseasePassed* Tibial tubercleOsgood shlatter 's diseaseOrder to* Calcaneal tuberositySever's diseaseSever* Navicular boneKohler's diseaseKohl's* Metatarsal headFrieberg's diseaseFreedom
| 1 |
Osteochondritis of lunate
|
Osteochondritis of neck of femur
|
Osteochondritis of navicular
|
Osteochondritis of tibial condyle
|
Orthopaedics
|
Bone
|
b206f377-c0bd-4bb2-b4b2-f8a1fd00c583
|
single
|
Molar concentration of oral rehydration fluid is -
|
Ans. is 'b' i.e., Potassium 20 meq
| 2 |
Sodium 30 meq
|
Potassium 20 meq
|
Bicarbonate 30 meq
|
Chloride 20 meq
|
Pediatrics
| null |
6a9c12aa-1156-4bbe-8393-bb26b3d40ba0
|
single
|
Chronic thiazide therapy causes persistent hypercalcemia due to :
|
Ans. is 'd' Hyperparathyroidism Chronic thiazide therapy causes hypercalcemia because it enhances the parathyroid mediated increase of Ca reabsorption.Note: Thiazide diuretics cause hypercalcemia where as high ceiling diuretics cause hypocalcemia.Other important side effects of Thiazide diureticsHyperuricemia *Hypokalemia* (More than high ceiling diuretics)Dilutional hyponatremia*Hyperglycemia* and Hyperlipidemia*Magnesium depletion*
| 4 |
Renal tubular acidosis
|
Fanconi's syndrome
|
Hyper vitaminosis D
|
Hyper parathyroidism
|
Pharmacology
|
Diuretic
|
a788f2d5-a6b1-4850-ba74-ffeaa99852bf
|
single
|
Methemoglobinemia is a complication following the administration of
| null | 3 |
Lignocaine
|
Lignocaine
|
Prilocaine
|
Procaine
|
Pharmacology
| null |
c3357a81-a36a-4f75-86dd-5b405e8d741b
|
single
|
Cell of origin of hairy cell leukemia is -
|
Hairy cell leukaemia is an unusual & uncommon form of B cell malignancy characterized by presence of hairy cells in the blood & bone marrow & splenomegaly.Hairy cells are abnormal mononuclear cells with hairy cytoplasmic projections which are seen in blood,bone marrow & spleen.These cells exhibit CD19,CD20 & CD22 antigen.Reference: Harsh mohan textbook of pathology 6 th edition pg no 379
| 1 |
B-cell
|
T-cell
|
NK-cell
|
Dendritic reticulum cell
|
Medicine
|
Haematology
|
b041942f-2b88-47a9-a68e-8cd47ab6bb8e
|
single
|
Precautions advised after outpatient Radioiodine (I-131) therapy are all, EXCEPT:
|
There is no such contraindication as do not use household chlorine bleaches for cleaning. Children and Pregnant Women: If there are pregnant women, infants, and children under 16 years of age in the home, arrangements should ensure that a distance >6 feet (or 2 meter) can be maintained between the patient and these occupants for the entire restricted time. Carry Treatment Card: Information card or letter at the time of treatment which show the date, type and amount of radioiodine. The card should be carried for at least 3 months following treatment. In an event of traffic accident or any other medical emergency during the ?rst week after your treatment the card should be produced. Contraception: It is advised that full feility may not occur until after 1 year, and attempts to produce pregnancy should best await a time when they are fully recovered from 131 I therapy, a period of at least 3 months. Ref: Radiation Safety in the Treatment of Patients with Thyroid Diseases by Radioiodine 131 I: Practice Recommendations of the American Thyroid Association, James C. Sisson et al.
| 3 |
Carry treatment ceificate for 90 days
|
To stay 2 meters away from children and pregnant women
|
Do not use household chlorine bleaches for cleaning
|
Use contraception for three months
|
Radiology
| null |
4c7d439d-af00-4fea-8ae0-126fb1c23926
|
multi
|
Patients with Antiphospholipid antibodies may manifest with any of the following, except:
|
Answer is D (Thrombocytosis): Refer Review Notes on Antiphospholipid Syndrome Antiphospholipid Antibody Syndrome is associated with thrombocytopenia and not thrombocytosis. The presence of thrombocytopenia does not appear to reduce thrombotic risk in patients with APS. Recurrent aerial or venous thrombosis in any tissue or organ is the most common presentation. Coomb's Positive Hemolytic Anemia may be seen in up-to 10 percent of patients with Antiphospholipid Syndrome.
| 4 |
Venous thrombosis
|
Aerial Thrombosis
|
Hemolytic Anemia
|
Thrombocytosis
|
Medicine
| null |
cf6e51c0-56b0-43bd-bb8b-cbe81c23e7a0
|
multi
|
Which irrigating solution has tissue dissolving properties
| null | 2 |
EDTA
|
Sodium Hypochlorite
|
Saline
|
Citric Acid
|
Dental
| null |
36b0eb58-51f6-4841-bcfb-f90941092730
|
single
|
Which of the following enzymes is used in Recombinant DNA research for Homopolymer tailing
|
Terminaldeoxynucleotidyltransferase catalyzes the addition of deoxynucleotides to the 3' termini of DNA. ... By use of a tailing method, which adds homopolymerdeoxynucleotide tails to denatured DNA, any double-stranded DNA fragment can be joined to a cloning vehicle Ref biochemistry satyanarayana 4e p255
| 4 |
Reverse transcriptase
|
S1 Transferase
|
Polynucleotide kinase
|
Terminal transferase
|
Biochemistry
|
Structure and function of protein
|
8b003a69-0154-4361-bba6-f168f1d9fdc6
|
single
|
Hardness number which does not depend on the ductility of metal:
|
KNOOP HARDNESS TEST (KHN)
A diamond indenting tool is used. Knoop hardness values is independent of the ductility of the material and values for both exceedingly hard and soft materials can be obtained from this test. The Knoop and Vickers tests are classified as microhardness tests. The Brinell and Rockwell tests are classified as macrohardness tests.
Mannapalli 3rd ed page no 17
| 1 |
KHN
|
VHN
|
RHN
|
BHN
|
Dental
| null |
374476b9-8b07-45d8-85db-c0b072d7517a
|
single
|
Most abundant complement in the body
|
C3 is the most abundant complement.
| 3 |
C1
|
C2
|
C3
|
C4
|
Microbiology
| null |
70fa5cb8-fa40-414d-8d91-49c59b69aa52
|
single
|
Use of oral contraceptives decreases the incidence of all of the following except:
| null | 3 |
Ectopic pregnancy
|
Epithelial ovarian malignancy
|
Hepatic adenoma
|
Pelvic inflammatory disease
|
Gynaecology & Obstetrics
| null |
95253b3b-1d0d-4c4d-b6ef-665fef41468f
|
multi
|
Which of the following is not formed sphincter of oddi complex?
|
Sphincter of oddi complex:- 1. sphincter ampullae 2. sphincter pancreaticus 3. superior choledochal sphincter 4. inferior choledochal sphincter
| 4 |
Sphincter pancreaticus
|
Sphincter ampullae
|
Superior choledochal sphincter
|
Posterior choledochal sphincter
|
Surgery
|
Bile duct
|
e09ccfa9-aea7-4ffc-82d3-5c87fd9e1d81
|
single
|
Disorders associated with vitiligo EXCEPT?
|
DISORDERS ASSOCIATED WITH VITILIGO Thyroid disease: Hypehyroidism Hypothyroidism Pernicious anemia Addison's disease Diabetes mellitus Hypoparathyroidism Myasthenia gravis Alopecia areata Morphoea and lichen sclerosis
| 1 |
Androgenic Alopecia
|
Hypothyroidism
|
Addison's disease
|
Diabetes mellitus
|
Dental
|
Hypo Pigmentary Disorders
|
029aea24-7c95-4c73-ad95-f73d65231540
|
multi
|
True signs of placental separation are all of the following. except?
|
Signs of placental separation Lengthening of cord A gush of fresh bleeding Suprapubic bulge, due to firm uterine fundus after placental separation, is the most specific sign A Flabby uterus means that the placenta is still probably stuck to the uterus and hence preventing its proper contraction
| 4 |
Fresh bleeding per vaginum
|
Firm Fundus
|
Permanent Lengthening of umblical cord
|
Round flabby uterus
|
Gynaecology & Obstetrics
|
Placenta - Types and their complications
|
ac5ec918-1927-4435-b578-9828e512ab6a
|
multi
|
A 12 year old girl presents with a 0.4 cm slightly raised strawberry coloured nodule in the skin of the abdomen below the umbilicus. It is present for many years and not changed in color or size. Diagnosis
|
Answer: c) Hemangioma (ROBBINS 9th ED, P-516)HEMANGIOMAHemangiomas are very common tumors characterized by increased numbers of normal or abnormal vessels filled with bloodMost are present from birth and initially increase in size, but many eventually regress spontaneouslyWhile hemangiomas typically are localized lesions confined to the head and neck, they can occasionally be more extensive (angiomatosis) and can occur internally.Nearly one third of these internal lesions are found in the liverMalignant transformation is rare.Capillary hemangiomasMost common typeOccur in the skin, subcutaneous tissues, and mucous membranes of the oral cavities and lips, as well as in the liver, spleen, and kidneysJuvenile hemangiomas (strawberry type hemangiomas)Juvenile hemangiomas of the newborn are extremely common and can be multiple.These arise in the skin and grow rapidly for a few months, but then fade by 1 to 3 years of age and completely regress by age 7 in the vast majority of cases.Cavernous hemangiomasComposed of large, dilated vascular channelsAs compared to capillary hemangiomas, cavernous hemangiomas are more infiltrative, frequently involve deep structures, and do not spontaneously regress.Intravascular thrombosis and associated dystrophic calcification are common.They can be locally destructive, and as a result some may require surgery.Cavernous hemangiomas are one component of von Hippel-Lindau diseasePyogenic granulomasCapillary hemangiomas that present as rapidly growing red pedunculated lesions on the skin, gingival, or oral mucosa.They bleed easily and are often ulceratedRoughly a quarter of lesions develop after trauma, reaching a size of 1 to 2 cm within a few weeks.Curettage and cautery is usually curative.Pregnancy tumor (granuloma gravidarum) is a pyogenic granuloma that occurs infrequently (1% of patients) in the gingiva of pregnant women.These lesions may spontaneously regress (especially after pregnancy), or undergo fibrosis, but occasionally require surgical excision
| 3 |
Carcinoma
|
Melanoma
|
Hemangioma
|
Lymphoma
|
Surgery
|
Neoplasia
|
d1558bab-94ad-4fac-95c5-aa2bf7cf5325
|
single
|
The following methods can be used to detect the point mutation in the beta (β)-globin gene that causes sickle cell anemia, except -
|
To detect point mutation, DNA analysis is required. While northern blot is a test for study of RNA.
Polymerase chain reaction, DNA sequencing and southern blot testing are rapid methods for DNA analysis, and can all be used to detect the point mutation in the globin gene.
| 4 |
Polymerase chain reaction with allele-specific oligonucleotide hybridization
|
Southern blot analysis
|
DNA sequencing
|
Northern blot analysis
|
Biochemistry
| null |
769f1667-dd2a-46a8-888b-13346df77ed6
|
multi
|
Treatment of choice for vocal nodule is
|
Treatment of vocal nodules Early cases of vocal nodules can be treated conservatively by educating the patient about the proper use of voice. With this treatment, many nodules in children disappear completely. Surgery is required for large nodules or nodules of long standing in adults. They are excised with precision under an operating microscope either with cold instruments or laser avoiding any trauma to the underlying vocal ligament. Speech therapy and re-education in voice production are essential to prevent their recurrence. Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 343
| 2 |
Radical excision
|
Microlaryngoscopic removal
|
Cryotherapy
|
Wait and watch
|
ENT
|
Larynx
|
8a334eb2-2f8d-4220-8530-a0c9eb456276
|
single
|
When selecting the colour of cement to use for cementing a porcelain jacket crown, the powder being tested is best mixed with:
|
Self-cured and dual-cured materials can be opaque or translucent, and those indicated for cementation of ceramic restorations are usually provided in several shades. Light-cured materials are indicated for bonding of laminated ceramic veneers (esthetic cements) or orthodontic brackets. Some esthetic resin cements used for cementation of veneers include glycerin-based, water-soluble “try-in” pastes to help with shade selection.
Reference: Craig’s 14th ed page no 289
| 1 |
Glycerin-water solution
|
Cement liquid
|
Alcohol
|
Only water
|
Dental
| null |
17dadaee-6072-4e3c-a0da-aba846929e95
|
single
|
Schneider's 1st rank symptoms seen in
|
Ku Schneider (1959) described symptoms which, though not specific to schizophrenia, were of great help in making a clinical diagnosis of schizophrenia. These are popularly called as Schneider's first-rank symptoms of schizophrenia (FRS or SFRS). He also described the second rank symptoms of schizophrenia (which were considered by him as less influenced the diagnostic criteria and classification of schizophrenia and other related psychotic disorders. First Rank Symptoms (SFRS) of Schizophrenia 1. Audible thoughts: Voices speaking out thoughts aloud or ' thought echo'. 2. Voices heard arguing: Two or more hallucinatory voices discussing the subject in the third person. 3. Voices commenting on one's action. 4. Thought withdrawal: Thoughts cease and subject experiences them as removed by an external force. 5. Thought inseion: Experience of thoughts imposed by some external force on person's passive mind. 6. Thought diffusion or broadcasting: Experience of thoughts escaping the confines of self and as being experienced by others around. 7. ' Made' feelings or effect. 8. 'Made' impulses. 9. 'Made' volition or acts: In 'made' affect, impulses and volitions, the person experiences feelings, impulses or acts which are imposed by some external force. In 'made' volition, for example, one's own acts are experienced as being under the control of some external force. 10. Somatic passivity: Bodily sensations, especially sensory symptoms, are experienced as imposed on the body by some external force. 11. Delusional perception: Normal perception has a private and illogical meaning. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 54
| 4 |
Delusion
|
Hallucination
|
Schizoid personality
|
Schizophrenia
|
Psychiatry
|
Schizophrenia and other psychotic disorders
|
02fada54-151d-4b6a-943d-c739b289be16
|
multi
|
Moth eaten alopecia is seen with -
|
Ans. is 'b' i.e., Syphilis
| 2 |
Leprosy
|
Syphilis
|
Fungal infection
|
Cylindroma
|
Surgery
| null |
58c3c98a-2205-491d-a082-e413f1e29dc0
|
single
|
Community diagnosis means
|
Community diagnosis refers to identification and quantification of health problems in a community in terms of moality and morbidity rates and ratios, and identification of their correlates for the purpose of defining those individuals or groups at risk or those in need of healthcare.Park 23e pg: 91
| 1 |
Quantifying and summarizing the impoant health problems and their associated sociodemographic characteristic in a community
|
Priority - wise listing of the common diseases seen in a community
|
Summarizing the standards of living lifestyle factors in a community
|
None of the above
|
Social & Preventive Medicine
|
Epidemiology
|
a6817d4c-51a9-4403-a5e3-bbd9b2422d60
|
multi
|
A 2-year-old child with history of fall one year back with parietal bone fracture now presented with painful and growing parietal swelling.
|
(b) Growing fracture,Ref: Growing skull fractures: classification and management. Naim-Ur-Rahman et al Br J Neurosurg. (1994)Growing Fractures:* Also known as traumatic encephaloceles or leptomeningeal cysts* Skull fractures associated with an underlying dural tear may fail to heal properly.* Enlargement of the defect is caused due to herniation of brain, or a leptomeningeal cyst, or dilated ventricles.* Neurologic symptoms may be found if associated compression of the underlying brain is present.* Occur primarily in children with age < 3 years and with diastasis greater than 3 to 4 mm.* Usually detected within one year of an acute head injury as a localized swelling or palpable skull defect that increases in size.
| 2 |
Growing scalp hematoma
|
Growing fracture
|
Subdural hygroma
|
Chronic abscess
|
Pediatrics
|
Gastro Intestinal System
|
8c405512-3ca4-4538-bacb-c15e0050eb7a
|
multi
|
Non specific esterase is positive in all the categories of AML except -
|
Ans. is 'd' i.e., M6 o FAB classification divides AML into eight types M 0 to M7. o This scheme takes into account : ? i) The degree of maturation (MO to M3) ii) The lineage of leukemic blast (M4 to M7). Class Blast cells o Myeloperoxidase negative Mo minimally differentiatedAML o Auer rods negative o Express myeloid lineage antigen o 3 % blasts myeloperoxidase positive M AML without differentiation o Auer rods positive o Full range of myeloid maturation MZ AML with maturation o Myeloperoxidase positive o Auer rods positive
| 4 |
M3
|
M4
|
M5
|
M6
|
Pediatrics
| null |
40976304-978e-4ea9-99a3-d64c3542d037
|
multi
|
NOT a content of superior mediastinum
|
Mediastinum refers to the space between two lungs in thorax. SUPERIOR MEDIASTINUM Space above 2nd costal cailage CONTENTS: thymus, arch of aoa, superior venacava, pulmonary aeries, esophagus, trachea, T1 - T4 veebra, PICA - 1, 2. INFERIOR MEDIASTINUM Space below superior mediastinum, again divided into anterior, middle and posterior mediastinum. CONTENTS: pulmonary trunk, bronchus, thymus, hea, ascending aoa, PICA 3 - 12 esophagus, descending aoa, T5 - T12 veebra. Angle between manubrium of sternum & body of sternum is called angle of louis, which is 1630.
| 1 |
Pulmonary trunk
|
Thymus
|
Left superior intercostal aery
|
Arch of aoa
|
Anatomy
|
FMGE 2017
|
d212f837-ea72-4809-ab4e-a0629006bc1a
|
single
|
A10-year-old girl present with polyuria and polydipsia with hypokalemia, hypercalciuria and metabolic alkalosis. What is the probable diagnosis?
|
Ans: (c) Bartter syndromeRef: Nelson Textbook of Pediatrics, 20th edition, Page 2534BARTTER SYNDROME (AUTOSOMAL RECESSIVE)Clinical Subtypes:Antenatal Bartter syndrome (Hyperprostaglandin E syndrome):Mutations-genes that encode the sodium potassium 2 chloride transporter NKCC2 (the site of action of furosemide) orThe luminal potassium channel ROMK - cause neonatal Bartter syndrome.Present with polyhydramnios, salt wasting and severe dehydration.Classic Bartter syndrome:Defects-genes that produce the basolateral chloride channel CIC-KbPresents milder in childhood with failure to thrive and a history of recurrent episodes of dehydration. PathogenesisDefect in sodium, chloride and potassium transport in the ascending loop of HenleHypokalemic metabolic alkalosis with hypercalciuria (similar to chronic loop diuretic use)The loss of sodium and chloride, with resultant volume contraction, stimulates the renin/angiotensin 11/ aldosterone axis.Aldosterone promotes sodium uptake and potassium secretion, exacerbating the hypokalemia.It also stimulates hydrogen ion secretion distally, worsening the metabolic alkalosis. Hypokalemia stimulates prostaglandins, which further activate the renin/angiotensin ll/aldosterone axis.Clinical Manifestations In Smaller ChildrenConsanguinity with history of polyhydramnios.Triangular facies, protruding ears, large eyes with strabismus and drooping mouth.In Older ChildrenHistory of recurrent episodes of dehydration, failure to thrive, Hypokalemic metabolic alkalosis, Urinary calcium, potassium and sodium levels - elevatedSerum renin, aldosterone and prostaglandin E levels - elevated (antenatal form)Blood pressure is usually normal, except in antenatal form - have severe salt wastingRenal function is typically normal, Ultrasound shows Nephrocalcinosis, due to hypercalciuria.Diagnosis - Based clinical presentation + laboratory findings.(Severe hypokalemia, usually <2.5mmol/L, with metabolic alkalosis. Hypercalciuria is typical)Differential Diagnosis:1. Diuretic abuse.2. Chronic vomiting - Measurement of urinary chloride (elevated - Bartter syndrome and low in patients - chronic vomiting).Treatment and PrognosisPrevent dehydration and maintaining nutritional status.Correcting hypokalemia (at very high doses)Sodium supplementation - Infants and young children.Indomethacin, a prostaglandin inhibitor, may also be effective.Long-term prognosis is generally good.Chronic hypokalemia, nephrocalcinosis and chronic indomethacin therapy can lead to chronic interstitial nephritis and chronic renal failure.GITELMAN SYNDROME (AUTOSOMAL RECESSIVE)Causes hypokalemic metabolic alkalosis, hypocalciuria and hypomagnesemia.PathogenesisDefects - in sodium chloride co-transporter NCCT, present in the distal convoluted tubule (resembles chronic thiazide diuretic use).Clinical ManifestationsPresent late in childhood with history of recurrent muscle cramps and spasms due to hypomagnesemia.No history of recurrent episodes of dehydration.Biochemical abnormalities include hypokalemia, metabolic alkalosis and hypomagnesemia.The urinary calcium level is usually very low and urinary magnesium level is elevated.Prostaglandin E secretion, Renin and aldosterone levels - normal.Diagnosis - Adolescent - with hypokalemic metabolic alkalosis, hypomagnesemia and hypocalciuria. Treatment - Correcting hypokalemia and hypomagnesemia.Liddle Syndrome:In collecting duct - gain of function mutations of the gene coding (epithelial sodium channel)Causes an inherited form of hypertension with hypokalemia and suppressed aldosteroneLoss of function mutations - pseudo hypoaldosteronism (severe sodium wasting and hyperkalemia).X (RECESSIVE)-linked nephrolithiasis (Dent disease)Mutations in the gene - voltage-gated chloride channel CLN5 (present throughout the nephron)Characterized by recurrent stone formation and progression to Fanconi syndrome.In loop of Henle - activating (severe hypoparathyroidism) and inactivating mutations (hyperparathyroidism) in the calcium receptor gene (which mediates parathyroid hormone-induced calcium uptake).ALPORT SYNDROME (AS) - (HEREDITARY NEPHRITIS)X-linked disease (85%) - Mutations in the genes coding for type IV collagen (gene - major component of basement membranes).Autosomal recessive - mutations in the COL4A3 and COL4A4 genes on chromosome 2Autosomal dominant form also occurs.Clinical Manifestations Renal manifestations:Asymptomatic intermittent microscopic hematuria.Recurrent episodes of gross hematuria occurring 1-2 days after an upper respiratory infectionProteinuria - frequently seen in males but may be absent in females.Progressive proteinuria can be severe enough to cause nephrotic syndrome.Extra renal manifestations:Bilateral sensorineural hearing loss (never congenital)Ocular abnormalities - anterior lenticonus (pathognomonic), macular flecks and corneal erosions.Rarely - Leiomyomatosis of the esophagus, tracheobronchial tree, and female genitals and platelet abnormalities.DiagnosisA careful family history+a screening urinalysis of first-degree relatives+an audiogram+ophthalmologic examination.Likely in the patient with hematuria and at least two of the followingMacular flecks, recurrent corneal erosions, GBM thickening and thinning, and sensorineural deafness.Absence of epidermal basement membrane staining for the a5 chain of type IV collagen in male hemizygotes and discontinuous epidermal basement membrane staining in female heterozygotes is pathognomonic for X-linked AS.Treatment:Progressive renal dysfunction leading to end-stage renal disease.Risk factors for progression - gross hematuria during childhood, nephrotic syndrome and prominent GBM thickening.Table for Different Electrolyte Imbalance:Combination of metabolic alkalosis, hypokalemia (high urinary losses of potassium and chloride, despite a state of relative volume depletion with secondary hyperaldosteronism), a high urine chloride level, and normal blood pressure is characteristic of Bartter syndrome, Gitelman syndrome and current diuretic use.Bartter syndrome is usually associated with hypercalciuria, and often with nephrocalcinosis.Children with Gitelman syndrome have low urinary calcium losses but hypomagnesemia as a consequence of urinary magnesium losses.
| 3 |
Gitelmann syndrome
|
Liddle syndrome
|
Bartter syndrome
|
Alport's syndrome
|
Pediatrics
|
Kidney
|
c8444346-2705-4da1-9c98-26249210a998
|
single
|
Best antagonist of morphine is –
|
Naloxone is the preferred specific antidote for morphine poisoning.
| 2 |
Nalorphine
|
Naloxone
|
Buprenorphine
|
Pentazocine
|
Anaesthesia
| null |
24806071-74e0-4121-85de-ff5dde9776a0
|
single
|
Filigree burns occur in ?
|
Ans. is 'a' i.e., Lightening Lightening burns Lightening refers to discharge of current between a negatively charged cloud and positively charged aicle on eah. During lightening, injuries result due to following mechanisms :- Direct effect of high voltage current. Heat, i.e. super heated air causing burns. Expanded and displaced air, which acts as a blast wave. Sledge hammer blow by compressed air pushed before the current (sledge hammer effect and blow death). The characteristic finding in lightening burns is filigree burns/ arborescent burns/arborescent marking/ litchenberg flower. In this burns are seen as coloured branching patterns, especially on shoulder and flanks. This branching distribution like inveed tree, does not correspond to blood vessels.
| 1 |
Lightening
|
Electrocution
|
Vitrilage
|
Infanticide
|
Forensic Medicine
| null |
606641be-d4d9-49d8-860d-91f198d9de5a
|
single
|
The most common cause for chronic cor pulmonale is
|
Answer is B (COPD): The most common cause of chronic cor puhnonale is chronic. obstructive pulmonary disease - Rubin's pathology
| 2 |
Recurrent pulmonary embolization
|
COPD
|
Cystic fibrosis
|
Bronchial Asthma
|
Medicine
| null |
3b2e0a44-2112-4cef-b514-cb60c30579fe
|
single
|
A 75-year-old thin cachectic woman undergoes a tracheostomy for failure to wean from the ventilator. One week later, she develops significant bleeding from the tracheostomy. Which of the following would be an appropriate initial step in the management of this problem?
|
The patient had a sentinel bleed from a tracheoinnominate aery fistula, which carries a greater than 50% moality rate. If the bleeding has ceased, then immediate fiberoptic exploration in the operating room is indicated. If the bleeding is ongoing, several stopgap measures can be attempted while preparing for median sternotomy in the operating room, including inflation of the tracheostomy balloon to attempt compression of the innominate aery, reintubation of the patient with an endotracheal tube, and removal of the tracheostomy and placement of the finger through the site with anterior compression of the innominate aery
| 3 |
Remove the tracheostomy and place pressure over the wound.
|
Deflate the balloon cuff on the tracheostomy.
|
Attempt to reintubate the patient with an endotracheal tube
|
Upsize the tracheostomy
|
Anaesthesia
|
Miscellaneous
|
49071582-b833-4afc-9107-7056ee5ac110
|
multi
|
A Sentinel pile indicates
|
Ans. c (Fissure in ano) (Ref. Bailey and Love Surgery 26th/1250; Ref. Q. 216 of MH-2007).SENTINEL PILE- This misnomer is given to a skin tag marking--and often containing within it--the distal end of an anal fissure, found usually in the posterior midline.
| 3 |
Internal hemorrhoids
|
Pilonidal sinus
|
Fissure in ano
|
Fistula in ano
|
Surgery
|
Anal Fissures
|
2fe65856-520a-4e00-8420-9cc2f9fa1f53
|
single
|
Which of the following is not characteristic of visceral pain -
|
• Visceral pain is poorly localized, often the pain is referred or radiating
• Pain of hollow viscus is often felt as a colic (it comes and goes to reappear again).
• Highly localized types of damage to the viscera seldom cause severe pain
• Often accompanied by vomiting and hypotension
| 4 |
Poor localisation
|
Diffuse in nature
|
High threshold
|
Very rapid adaptation
|
Surgery
| null |
e209dd0e-f3da-4b43-84a4-b03dbdd375c7
|
single
|
Hanup disease, limiting amino acid
|
It&;s an autosomal recessive disease. Absorption of aromatic amino acids from intestine as well as reabsorption from renal tubules are defective Patient improve when put on high protein diet with supplementation of niacin Hence the limiting amino acid is tryptophanRef: DM Vasudevan - Textbook of Biochemistry, 7th edition, page no: 242
| 2 |
Tyrosine
|
Tryptophan
|
Rhenylalanine
|
None
|
Biochemistry
|
Metabolism of protein and amino acid
|
621ed0e9-3152-4e80-9250-1f60f8157c68
|
multi
|
All of the following statements about Lymphoepethelioma of the parotid gland are true, except:
|
Lymphoepithelioma occur chiefly in the nasopharynx of young or middle aged persons. It also seen in the oropharynx, tongue, tonsil, parotid, nasal chamber and paranasal sinus. Ref: Shafer'S Textbook of Oral Pathology By Rajendran, 6th Edition, Pages 119-120; Epstein-Barr Virus By Erle S. Robeson, Page 60
| 1 |
Parotid gland is the most common site of Lymphoepethelioma in the Head & Neck region
|
It is associated with EBV infection
|
It is highly radiosensitive malignancy
|
It is a squamous cell carcinoma
|
Surgery
| null |
9c7ed8a1-5210-4c7a-b069-bd657d5b7f14
|
multi
|
Which of the following structure is not present in the transpyloric plane?
|
Transpyloric plane- An imaginary plane that passes at the lower border of L1 vertebra posteriorly and the tip of 9th costal cartilage anteriorly.
Structures at the Transpyloric plane
- Pylorus of stomach
- Hilum of kidney
- Beginning of duodenum
- Neck of pancreas
- Fundus of gallbladder
- Origin of the superior mesenteric vessel.
| 4 |
First lumbar vertebra
|
Fundus of gall bladder
|
Hilum of right kidney
|
Inferior mesenteric vein
|
Anatomy
| null |
505b1349-ff1c-4f9a-bd40-899cc6f5e4f9
|
multi
|
Most common benign tumour of the stomach is ?
|
Ans. is 'a' i.e., Adenoma E ihtelial nolvus are the most common benign tumor of the stomach. They are of 5 types: a) Hyperplastic (regenerative) most common type (75%), with low malignant potential b) Adenomatous second most common, with high malignant potential (should be removed when diagnosed) c) Hamaomatous d) Inflammatory with negligible malignant potential e) Hetrotopic Polyps that are symptomatic, > 2 cm, or adenomatous should be removed, usually by endoscopic snare polypectomy.
| 1 |
Adenoma
|
Lipoma
|
Hamaoma
|
Leiomyoma
|
Surgery
| null |
f9aaa62f-8d57-4c38-8c84-10d42d216f9c
|
single
|
All are true regarding myositis ossificans progressive except
|
B i.e. Progressive form of normal myosites Fibrodysplasia (Myositis) Ossificans Progressiva Patho Histology - It is a rare autosomal dominant (AD) disorder of connective tissue differentiation. - Main pathogenic mechanism is defective regulation of the induction of endochondral ossification - Intense perivascular lymphocytic infiltration into normal skeletal muscles is the earliest featureQ - The proliferating loose myxoid fibrous tissue infiltrates and replaces normally formed fibrous connective tissue and striated muscle - Numerous small blood vessels, cells immunoreactive for S -100 protein and cailagenous foci are scattered among proliferating lesion. - Endochondral ossification is a feature of maturing lesion. Only the absence of normal anatomical orientation differentiates this hetrotropic bone from normal. Otherwise it demonstrates all features of normal bone modeling (i.e., coical & trabecular organization, medullary canal, metaphyseal funneling) and remodeling (i.e., respond to weight bearing stress, resistance to fatigue fracture) - Bone morphogenetic protein - 4 (BMP - 4) is over expressed and Basic fibroblast growth factor which is an extremely potent stimulator of angiogenesis (in vivo) is elevated in urine during acute flare up stage. Clinical features - In myositis ossificans progressiva, the life expectancy is decreased and the commonest causes of death is lung diseaseQ. This autosomal dominant disease is characterized by hetrotropic ossification most commonly involving spine and congenital defomities of hand &feetQ. The disease usually stas before 6 year of ageQ - Moality in fibrodysplasia ossificans progressive (myositis ossificans progressiva) is usually related to restrictive lung disease caused by an inability of chest to expandQ. - Begins in childhood usually before age of 6 yearsQ and becomes evident with in first 10 years of life. - Primary congenital skeletal abnormality is deformity of great toeQ. The toes may be sho, in valgus, monophalangic or have abnormal shaped proximal phalanx. - Begins as painful erythematous subfascial nodule mostly located on posterior aspect of neck & back which gradually calcify & eventually ossify (hetrotropic ossification) - The hetrotropic ossification progress in a axial to appendcular, cranial to caudal and proximal to distal direction. So the most commonly involved site is neck followed by spine & shoulder girdleQ. And same is the order for limitation of motion . - Trauma in form of tripping & falling, immunization, injection or biopsy stimulates new bouts of ossificationQ, and can be catastrophic. - The ossification is irreversible, unlike other forms of hetrotropic ossification. This condition is quite different from myositis ossificans traumaticaQ. - Diaphragm, extra ocular muscles & smooth muscles are characteristically sparedQ - Limitations of jaw mobility , extremely limited chest expnsionQ, reduced lung volumes 44% of normal) but relatively preserved flow rates and scoliosis / hypokyphosis are other feature Life expectancy is decreased and premature death usually result from respiratory failure Alt restrictive lung disease and their complicationsQ or from inanition caused by jaw ankylosis.
| 2 |
Usually involve childs
|
Progressive form of normal myositis
|
Respiratory problems
|
Ankylosis
|
Surgery
| null |
8319effe-78c9-4d3f-9638-296bb6dbbdc6
|
multi
|
Meningococcal polyvalent vaccine is routinely recommended to:
|
Ans. b. All healthy children between 5-7 years of age (Ref: Park 23/e p166, 22/e p157)'Quadrivalent (polyvalent) vaccines are administered as a single dose to individuals aged >_ 2 years.'- Park 22/e p157Meningococcal VaccinesPolysaccharide VaccinesConjugate Vaccines* Available against Meningococci of serogroup A, C, W135, and Y.* Types:- Bivalent (A, C)- Trivalent (A, C, W135)- Quadrivalent (A, C, W135, Y)* Polysaccharide vaccines are administered as a single dose to persons > 2 years old* Most of these vaccines are given subcutaneously* MC reaction is 1-2 days of pain and redness at the site of injection in 4-56% of recipients* More immunogenic, induce immunogenic memory* Types:- Monovalent (A or C)- Quadrivalent (A, C, W135, Y)* Given as IM injection, preferably in deltoid muscle (or in the anterolateral aspect of thigh in children <12 months)* Monovalent Men A conjugate vaccine should be given as a single dose to individuals 1-29 years of age* For Monovalent Men C conjugate vaccine, one single IM dose is recommended for children aged > 12 months, teenagers and adults. Children 2-11 months of age require 2 doses administration at an interval of at least 2 months and a booster about 1 year thereafter.* Quadrivalent vaccines are administered as a single dose to individuals aged > 2 years.
| 2 |
Adolescents young males
|
All healthy children between 5-7 years of age
|
More than 50 years of age diabetic patients on regular insulin
|
40 years old paramedical staff working in laboratory
|
Social & Preventive Medicine
|
Meningococcal Meningitis
|
a79e7ed3-a6b8-4933-bbb6-bece2f0fee4a
|
multi
|
Drug not causing exatithematous skin eruption –
|
Drugs causing exanthematic reactions
Most common : - Ampicillin and penicillin, Phenylbutazone and other pyrazolones, Sulphonamides, Phenytoin,
Carbamazepine, Gold, Gentamicin, Meprobamate, Atropine
Less common : - Cephalosporins, Barbiturates, Thiazides, Naproxen, Isoniazid, Phenothiazines, Quinidine.
| 2 |
Phenytoin
|
Hydrocortisone
|
Ampicillin
|
Phenylbutazone
|
Dental
| null |
69623aa4-fcd6-4514-aba4-2992aa6a2dc6
|
single
|
A 34-year-old woman is seen in the emergency depament. About 5 hours previously, she began to have nausea, vomiting, abdominal cramps, and diarrhea. She then developed double vision, which prompted her to ask her husband to bring her to the emergency depament. When she is asked to go into the examining room, she stumbles. When she tries to answer questions, her voice sounds odd and she seems to mumble. Physical examination demonstrates a dry mouth, drooping eyelids, markedly diminished pupillary light reflex, a flaccid facial expression, and difficulty in opening her mouth. Within an hour, her condition has markedly deteriorated. She can no longer stand and is intubated because of difficulty breathing. Which of the following microbial species is MOST likely to have caused her condition?
|
This is a typical presentation of botulism, which is caused by the preformed toxin of Clostridium botulinum. Patients develop a progressive flaccid paralysis that can lead to death if their respiratory system is not adequately suppoed. Mentation is intact in these patients, and they do not exhibit sensory changes except for those, such as the double vision, related to failure of extra- and intraocular muscles. Note: You are probably aware that botulism can follow ingestion of home canned vegetables, fish, fruits, and condiments. You may not be aware that other vehicles that have been the source of outbreaks include commercially prepared canned foods, poultry, and dairy products; and even restaurant-prepared non-canned foods including seafood, foil-wrapped baked potatoes, chopped garlic in oil, and patty melt sandwiches. For this reason, the absence of a classic history of ingestion of home canned food should not be used to exclude the diagnosis of botulism. Treatment is suppoive. Most patients recover from foodborne botulism without sequelae. You should also be aware that C. botulinum can cause true infection coupled with toxin production in wounds and in infants. Clostridium perfringens is one of the causes of gas gangrene. Clostridium ramosum has been associated with intra-abdominal infections after bowel perforation. Clostridium septicum has complicated colorectal malignancy.
| 1 |
Clostridium botulinum
|
Clostridium perfringens
|
Clostridium ramosum
|
Clostridium septicum
|
Microbiology
| null |
d2922f51-5dda-4bf4-91ef-ab9e2cd3b182
|
single
|
The rectum measures
|
The adult rectum is approximately 12-18 cm in length and is conveniently divided into three equal pas: the upper third, which is mobile and has a peritoneal coat; the middle third where the peritoneum covers only the anterior and pa of the lateral surfaces; and the lowest third, which lies deep in the pelvis surrounded by fatty mesorectum and has impoant relations to fascial layers. Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1219
| 4 |
18 cm
|
22 cm
|
17 cm
|
15 cm
|
Surgery
|
G.I.T
|
8ec86a6a-5148-4dc4-ac54-44d96da6323c
|
single
|
Tardy ulnar neuritis may be due to
|
B i.e. Cubitus valgus deformity
| 2 |
Advanced osteo ahritis of elbow
|
Cubitus valgus deformity
|
Both of the above
|
None of the above
|
Surgery
| null |
0569ce46-9396-4e0d-94fc-e9fd04e6cca2
|
multi
|
Which of the following can be a homologous substitution for valine in hemoglobin
| null | 2 |
Isoleucine
|
Glutamic acid
|
Phenylalanine
|
Lysine
|
Biochemistry
| null |
4cd7d75c-214e-4e39-a6a5-076af6b5de7e
|
single
|
Hemorrhagic cystitis is caused by :
|
Cyclophosphamide is a prodrug and is activated by hepatic biotransformation to aldophosphamide. One of its degradation products is acrolein that is responsible for hemorrhagic cystitis (its characteristic adverse effect). This adverse effect can be decreased by vigorous hydration and by the use of mercapto ethane sulfonic acid (mesna).
| 1 |
Cyclophosphamide
|
6 Mercaptopurine
|
5 Fluorouracil
|
Busulfan
|
Pharmacology
| null |
ef463d47-ed9b-45a3-a776-1dc18fc1d685
|
single
|
In myasthenia gravis , all of the following are true except
|
Overall, women are affected more frequently than men, in a ratio of ~3:2. The cardinal features are weakness and fatigability of muscles. The weakness increases during repeated use (fatigue) or late in the day and may improve following rest or sleep. Unrelated infections or systemic disorders can lead to increased myasthenic weakness and may precipitate "crisis" The distribution of muscle weakness often has a characteristic pattern. The cranial muscles, paicularly the lids and extraocular muscles (EOMs), are typically involved early in the course of MG; diplopia and ptosis are common initial complaints. Facial weakness produces a "snarling" expression when the patient attempts to smile. Weakness in chewing is most noticeable after prolonged effo, as in chewing meat. Speech may have a nasal timbre caused by weakness of the palate or a dysahric "mushy" quality due to tongue weakness. Difficulty in swallowing may occur as a result of weakness of the palate, tongue, or pharynx, giving rise to nasal regurgitation or aspiration of liquids or food. Bulbar weakness is especially prominent in MuSK antibody- positive MG. In ~85% of patients, the weakness becomes generalized, affecting the limb muscles as well. Ref harrison 20th edition page 3232, 3233
| 4 |
Women are more frequently affected than men
|
Bulbar weakness is especially prominent inMuSK antibody- positive myasthenia gravis.
|
Unrelated infections or systemic disorders can lead to increased myasthenic weakness
|
Tongue muscles are spared
|
Medicine
|
C.N.S
|
f3e59204-457d-4011-87b1-36516fb4df3b
|
multi
|
Factor IX deficiency results in increased -
|
Ans. is 'b' i.e., PTT (Partial thromboplastin time) o Partial thromboplastin time (PTT): It tests the intrinsic and common coagulation pathways. So, a prolonged PTT can results from deficiency of factor V, VIII (factor VIIIc, Von willebrand factor), IX, X, XI, XII, prothrombin or fibrinogen.o Prothrombin time (PT): It tests the extrinsic and common coagulation pathways. So, a prolonged PT can results from deficiency offactor V, VII, X, prothrombin or fibrinogen.# Thus in common coagulation pathway defect both PT and PTT are elevatedo Activated clotting time (clotting time): It also tests the intrinsic and common coagulation system. So it is prolonged in deficiency of same factors as for prolonged PTT.o Thrombin time : It tests the conversion of fibrinogen to fibrin and is elevated in fibrinogen deficiency.o Bleeding time : this altered in platelet dysfunction.
| 2 |
PT (Prothrombin Time)
|
PTT (Partial thromboplastin time)
|
BT (Bleeding Time)
|
TT (Thrombin time)
|
Pathology
|
Bleeding Disorders
|
258afd55-3f4f-4258-afbc-3d9036965294
|
single
|
All of the following can be done with Individual as a unit except
|
Health education can be done individually BUT limitation is that the numbers we reach is really small, and health education is given to only those who come in contact with health system.
| 2 |
Drug administration
|
Health education
|
Vaccination
|
Case report
|
Social & Preventive Medicine
| null |
25d04c1f-db76-43d7-81d6-3d43525c4ab1
|
multi
|
Precursor of norepinephrine -
|
Ans. is 'b' i.e.. Tyrosine
| 2 |
Tryptophan
|
Tyrosine
|
Methionine
|
Asparagine
|
Biochemistry
|
Miscellaneous (Structure & Function of Proteins)
|
dc41df5b-b907-40f8-bbb6-9af859f92145
|
single
|
Persistent foetal lobulation of adult kidney is due to
|
In humans, embryologically, the kidneys originate as distinct lobules that fuse as they develop and grow. The lobulation of the fetal kidney is usually lost as the lobules become bonded together by the growth of new coex and the renal capsule. Persistent fetal lobulation is a normal variant seen occasionally in adult kidneys . It occurs when there is incomplete fusion of the developing renal lobules.It is often seen on ultrasound, CT or MRI as smooth indentations of the renal outline in between renal pyramids. They should be distinguished from renal coical scarring , which generally overlie the pyramids. Reference : radiopaedia.org/aicles/persistent-fetal-lobulation-of-the-kidneys
| 4 |
Congenital renal defect
|
Obstructive uropathy
|
Intrauterine infections and scar
|
Is a normal variant
|
Surgery
|
Urology
|
c1ed59db-4fb8-4dd6-8f27-56a765ef7ca8
|
single
|
CMV retinitis in HIV occurs when teh CD4 counts falls below -
|
CD4 count<100 cells/mm3 REF:<\p> MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.473 case-3
| 2 |
50
|
100
|
200
|
150
|
Microbiology
|
Virology
|
edf4875a-78ac-46fd-993a-e1af3df77cd8
|
multi
|
Drop metastases is seen in
|
Drop metastases - Dissemination through CSF giving rise to nodular masses at some distance from primary tumour. It is seen in Medulloblastoma
| 1 |
Medulloblastoma
|
Ependymoma
|
Cerebellar astrocytoma
|
Neuroblastoma
|
Pediatrics
| null |
40aeabaa-c021-4196-a644-a4134a6665c8
|
single
|
Intra epidermal Bulla is seen in :
|
Ans. is 'b' Pemphigus "Pemphigus causes intraepidermal blistering because of loosening of desm somal links b/w epidermal cells caused by immunological attack- Roxburg, 16/e
| 2 |
Pemphigoid
|
Pemphigus
|
Dermatitis Herpetiformis
|
Light reaction
|
Skin
|
Pemphigoid Group
|
480e7f93-b827-419f-b60b-7fdcc619fb6c
|
single
|
A young patient has a midline, tender swelling in neck occurring after an attack of sore throat. The diagnosis is -
|
Diagnosis in this case is subacute thyroiditis. Symptoms are more severe in acute thyroiditis with complications and acute thyroiditis is more common in children.
Just take a look of acute thyroiditis.
• Acute thyroiditis is rare and due to suppurative infection of the thyroid.
• More common in children and often is preceded by an upper respiratory tract infection or otitis media.
Etiology
The thyroid gland is inherently resistant to infection due to its extensive blood and lymphatic supply, high iodide content, and fibrous capsule.
Infectious Agents can Seed Thyroid
1. Via hematogenous or lymphatic route
2. Via direct spread from persistent pyriform sinus fistulae or thyroglossal duct cysts
3. As a result of penetrating trauma
4. Due to immunosuppression
• Streptococcus and anaerobes account for about 70% of cases.
• In children and young adults, MC cause is presence of a pyriform sinus (remnant of the fourth branchial pouch that connects the oropharynx with thyroid), such sinuses are predominantly left-sided.
• Long-standing goiter and degeneration in thyroid malignancy are risk factors in elderly.
Clinical Features
• Thyroid pain, often referred to the throat or ears, and a small, tender goiter.
• Fever, dysphagia and erythema over the thyroid.
• Systemic symptoms of a febrile illness and lymphadenopathy.
• Complications such as systemic sepsis, tracheal or esophageal rupture, jugular vein thrombosis, laryngeal chondritis, and perichondritis or sympathetic trunk paralysis may also occur.
Diagnosis
• ESR and WBC count are usually increased, but thyroid function is normal.
• FNA biopsy shows infiltration by polymorphonuclear leukocytes.
• Culture of the sample can identify the organism.
• Persistent pyriform sinus fistula should be suspected in children with recurrent acute thyroiditis. A barium swallow demonstrates the anomalous tract with 80% sensitivity.
Treatment
• Parenteral antibiotics and drainage of abscesses.
• Patients with pyriform sinus fistulae require complete resection of the sinus tract, including the area of the thyroid where the tract terminates, to prevent recurrence.
| 3 |
Acute thyroiditis
|
Thyroglossal cyst
|
Sub acute thyroiditis
|
Toxic goiter
|
Surgery
| null |
a8f94c80-04ea-4319-bb88-c28d33a26269
|
single
|
Delorme's operation is for
|
Ans. B. Rectal prolapse. (Ref. LB 25th pg. 1225)RECTALPROPLASE# It may be mucosal or full thickness (whole wall included).# Commences as rectal intussusception.# In children, the prolapse is usually mucosal an should be Rxed conservatively.# In the adults, the prolapse is often full thickness and is frequently asociated with incontinence.# Surgery is necessary for full-thickness reactla prolpase.# The operation is performed either via perineum (Thiersch operation, Delorme's operation, &/or Altemeier operation) or via the abdomen (Well's operation, Ripstein's operation, or laparosocpic approach).Rx of RECTAL PROPLASE:# An abdominal rectopexy has a lower rate of recurrence but, when the patient is elderly and very frail, a perineal operation is indicated. As an abdominal procedure risks damage to the pelvic autonomic nerves, resulting in possible sexual dysfunction, a perineal approach is also usually preferred in young men.A. Perineal approach -These procedures have been used most commonly.# Thiersch operation- This procedure, which aimed to place a steel wire or, more commonly, a silastic or nylon suture around the anal canal, has become obsolete as the suture would often break or cause chronic perineal sepsis, or both, or the anal stenosis so created would produce severe functional problems. Delorme's operation is now the preferred perineal operation.# Delorme's operation- In this procedure, the rectal mucosa is removed circumferentially from the prolapsed rectum over its length. The underlying muscle is then plicated with a series of sutures, such that, when these are tied, the rectal muscle is concertinaed towards the anal canal. The anal canal mucosa is then sutured circumferentially to the rectal mucosa remaining at the tip of the prolapse. The prolapse is reduced, and a ring of muscle is created above the anal canal, which prevents recurrence.# Altemeier's procedure- This consists of excision of the prolapsed rectum and associated sigmoid colon from below, and construction of a coloanal anastomosis.B. Abdominal approach# The principle of all abdominal operations for rectal prolapse is to replace and hold the rectum in its proper position. They are recommended in patients with complete prolapse who are otherwise in good health.# Many variations have been described: in Wells' operation, the rectum is fixed firmly to the sacrum by inserting a sheet of polypropylene mesh between them; Ripstein's operation involves hitching up the rectosigmoid junction by a Teflon sling to the front of the sacrum; many surgeons simply suture the mobilised rectum to the sacrum using four to six interrupted non-absorbable sutures - so called sutured rectopexy. Recently, the technique has been performed laparoscopically.
| 2 |
Solitary rectal ulcer
|
Rectal prolapse
|
Rectal stricture
|
Rectal carcinoma
|
Surgery
|
Rectum
|
e2994055-53ec-4b2e-b14b-ed9faa704209
|
single
|
All of the following are true about Hepcidin except
|
Hepcidin, a 25-amino acid peptide secreted by hepatic Kupffer's cells downregulates duodenal iron absorption by regulating DMT1 activity as well as other proteins in the iron-responsive pathways (e.g., FP1). Hepcidin is a negative regulator of iron absorption because mice that fail to express hepcidin have elevated body iron stores, whereas mice with enhanced hepcidin expression have profound iron deficiency. .
| 4 |
It is a 25- amino acid peptide secreted by Kupffer cells
|
Decreases duodenal absorption of iron
|
It regulates activity of transpoers DMT - 1 and ferropoin - 1
|
Mice with enhanced hepcidin expression have elevate body iron stores
|
Physiology
|
General physiology
|
b1444c09-3fa6-47dc-a3c5-7ecc5e1c5df9
|
multi
|
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