question
stringlengths 1
1.57k
| exp
stringlengths 1
22.5k
⌀ | cop
int64 1
4
| opa
stringlengths 1
287
| opb
stringlengths 1
287
| opc
stringlengths 1
286
| opd
stringlengths 1
301
| subject_name
stringclasses 21
values | topic_name
stringlengths 3
135
⌀ | id
stringlengths 36
36
| choice_type
stringclasses 2
values |
|---|---|---|---|---|---|---|---|---|---|---|
Narrowest part of esophagus is at?
|
Ans. is 'a' i.e., Cricopharyngeal sphincter * The narrowest part of esophagus is its commencement at the cricopharyngeal sphincter.
| 1 |
Cricopharyngeal sphincter
|
At the Aortic constriction
|
At the crossing of left principal bronchus
|
At the diaphragmatic opening
|
ENT
|
Oesophagus
|
ea1af825-2c41-4c98-a4f4-0cfdb98fe33c
|
single
|
In methyl alcohol poisoning there is CNS depression, cardiac depression and optic nerve atrophy. These effects are produced due to:
|
Ans. (A) Formaldehyde and formic acid(Ref: Katzung 11/e p1024; KDT 8/e p422)Methyl alcohol (methanol) is metabolized to formaldehyde by alcohol dehydrogenase and then to formic acid by aldehyde dehydrogenase. These compounds are responsible for the toxicity. Formic acid can lead to coma and blindness also. Therefore, inhibitor of alcohol dehydrogenase, Fomepizole is used for treatment of methanol overdose.
| 1 |
Formaldehyde and formic acid
|
Acetaldehyde
|
Pyridine
|
Acetic acid
|
Pharmacology
|
Opioids
|
64df6148-9253-41f8-82e5-7945409a9eff
|
single
|
Selective Alpha 2a agonist is
|
Clonidine, Tizanidine are selective alpha 2 agonists. But dexmedetomidine is more selective acting on Alpha 2a receptors-cause sedation. Used as pre-anesthetic medication. Ref: H.L. Sharma 3rd ed Pg:179
| 4 |
Tizanidine
|
Terazosin
|
Yohimbine
|
Dexmedetomidine
|
Pharmacology
|
Cardiovascular system
|
2d5c47eb-e457-4521-a53e-9a5273d3b107
|
single
|
Management of Typical Febrile seizures include except
|
Sponging, paracetamol ibuprofen ,intermittent diazepam are treated for febrile seizures Most children with typical febrile seizures do not require specific treatment except for vigorous antipyretic therapy during febrile illnesses. Children experiencing excessively frequent or prolonged febrile seizures may be treated using diazepam 0.5mg/kg rectally during high fevers or prophylactically using <a href=" at standard doses.</p> Ref : Ghai pediatrics eighth edition pg no 556
| 4 |
Sponging
|
Paracetamol Ibuprofen
|
Intermittent Diazepam
|
Prophylactic phenobarbitone
|
Pediatrics
|
Central Nervous system
|
f0afd75b-f033-4749-be54-eb1135d81752
|
multi
|
Mineral with antioxidant property:
|
Ans. b (Selenium). (Ref. Harper, Biochemistry, 25th ed., 659,766)SeleniumFeaturesConstituent of glutathione peroxidaseSynergistic anti-oxidant with vitamin EEssential trace elementSelenocysteine is an L--amino acid found in a handful of proteins. As its name implies, a selenium atom replaces the sulfur of its structural analog, cysteine. The pK3 of selenocysteine, 5.2, is 3 units lower than that of cysteine. Since selenocysteine is inserted into polypeptides during translation, it is commonly referred to as the "21st amino acid."However, unlike the other 20 genetically encoded amino acids, selenocysteine is not specified by a simple three-letter codon.Trace elements TRACE ELEMENTDEFICIENCY STATESEXCESS STATES1ArsenicAcute Fatty (Yellow)liverHCCNeurologic dysfunctionGIT diseasesSkin cancerMee's linesAngiosarcoma of liverNCPF2Cadmium-Madness, paralysis agitans,3CopperGrowth failureWilson's diseaseNeutropenia CVS disordersGenu valgumMenke's kinky hair disease04ChromiumPEM, CVS diseaseArthritisDermatitisDiarroeaSeptal perforation5IodineGoiter, growth failureJod basedow phenomenonWolf chekoff phenomenon6Lead-Abdominal ColicAnaemiaBlue gum linesBasophilic stipplingConstipationConvulsionsDeliriumPeripheral neuropathy & ParalysisFailure of kidneysMetaphyseal lines7ManganeseImpaired growthAtaxiaManganese madnessParalysis agitansCVS disorders8MolybdenumGrowth failureGout bony defects Oral & esophageal carcinomaGenu valgum9Mercury-Minimota's disease Mercural erythesim (Hatter's shake)10SeleniumPEM, muscle dystrophy, CVS diseases(DCM), diarrhea, Keshan diseaseArthritis, dermatitis11AluminiumAlzheimer's diseaseOsteodystrophy12ZincNight blindnessHypogonadismImpaired wound healingAcrodermatitis enteropathicaGI irritationGrowth retardationFlaky paint dermatitis, loss of taste
| 2 |
Molybdenum
|
Selenium
|
Copper
|
Zinc
|
Biochemistry
|
Vitamins and Minerals
|
7d1b93a0-8f63-4a6a-b9a7-7415e4e063fe
|
single
|
Tall R wave in ECG represents:
|
Right ventricular hypertrophy due to a sustained, severe pressure load (e.g. due to right pulmonary valve stenosis or certain pulmonary artery hypertension syndromes) is characterized by a relatively tall R wave in lead V, (R >S wave), usually with right axis deviation.
| 3 |
Right atrial overload
|
Left atrial overload
|
Right ventricular hypertrophy
|
All of the above
|
Medicine
| null |
c0e2841e-3208-4651-b549-27d70b797b2c
|
multi
|
Best test for determining initial stage of renal insufficiency?
|
Serum creatinine REF: Harrison's Internal Medicine 17' edition chapter 274 The most impoant initial diagnostic step in the evaluation of a patient presenting with elevated serum creatinine is to distinguish newly diagnosed CKD from acute or subacute renal failure because the latter two conditions may respond to therapy specific to the disease. Previous measurements of plasma creatinine concentration are paicularly helpful in this regard. Normal values from recent months or even years suggest that the current extent of renal dysfunction could be more acute, and hence reversible, than might otherwise be appreciated. In contrast, elevated plasma creatinine concentration in the past suggests that the renal disease represents the progression of a chronic process. Even if there is evidence of chronicity, there is the possibility of a superimposed acute process, such as ECFV depletion, supervening on the chronic condition. If the history suggests multiple systemic manifestations of recent onset (e.g., fever, polyahritis, and rash) it should be assumed that renal insufficiency is pa of the acute process. From the following staging of CKD based on GFR it is clear that GFT can be even normal in initial staged of CKD Clinical action plan Stage Description GFR, mL/min per 1.73 m2 Action' 1 Kidney damage with normal or +GFR > or = 90 Diagnosis and treatment, treatment of comorbid conditions, slowing progression, CVD risk reduction 2 Kidney damage with mild +GFR 60-89 Estimating progression 3 Moderate +GFR 30-59 Evaluating and treating complications 4 Severe +GFR 15-29 Preparation for kidney replacement therapy 5 Kidney failure <15 (or dialysis) Kidney replacement (if uremia present)
| 1 |
Serum creatinine
|
Creatinine clearance
|
Glomerular filtration rate
|
Serum urea
|
Surgery
| null |
0da5e389-8450-40de-9323-28d312d96287
|
single
|
Muscle relaxant of choice in patient suffering from chronic liver disease
|
Atracurium is preferred in CLD patients since it is metabolised by Hoffmann elimination.
| 2 |
Pancuronium
|
Atracurium
|
Mivacurium
|
Vecuronium
|
Anaesthesia
| null |
cda02f98-ba04-488a-b315-7ff0faa4938c
|
single
|
The most comprehensive indicator of cost-effective analysis is
|
Cost-benefit analysis, in which benefits are compared to cost of the program. The benefits are expressed in monetary termsA cost-effective analysis is similar to cost-benefit analysis except benefits are expressed in terms of results achievedThe most commonly used outcome measure is quality-adjusted life years (QALY)Park 23e pg:871
| 3 |
Number of life years gained
|
Number of hea attacks avoided
|
QALYS gained
|
Cost per life year gained
|
Social & Preventive Medicine
|
Health education & planning
|
366154db-4d54-4a4c-a6b0-d0d655f229ed
|
single
|
True about surgical wounds are all except
|
Preoperative antibiotic prophylaxis does not significantly reduce the frequency of postoperative wound infection in clean elective general surgical operations.So the routine prophylactic use of antibiotics in clean general surgical operations is not recommended. Incision of abscess comes under diy wounds. Infection rate of clean contaminated is less than 10% Bailey and love 26th edition Pg 63
| 2 |
No antibiotics required in clean surgery
|
Incision of abscess is contaminated wound
|
Spillage of stomach content conves a clean contaminated case to a contaminated case
|
In clean contaminated wounds infections rate is < 10%
|
Surgery
|
General surgery
|
c1000c99-0563-4a2c-bd2b-0346d218fb06
|
multi
|
An investigator into the life expectancy of IV drug abusers divides a sample of patients into HIV-positive and HIV-negative groups. What type of data does this division constitute?
|
Nominal data (also known as nominal scale) is a type of data that is used to label variables without providing any quantitative value. Given question is about HIV-positive and HIV-negative groups; since there is no order of characteristic and it cannot be measured directly. So,it can't be an ordinal data or metric data respectively. It is nominal data as its division is based only on names, i.e. HIV-positive and HIV-negative groups.
| 1 |
Nominal
|
Ordinal
|
Interval
|
Ration
|
Social & Preventive Medicine
|
Variables, Scales
|
5faa05f6-8734-4439-aea9-7dc6d3a5318c
|
single
|
Working formulation in staging of non-hodgkins lymphoma is based on: March 2010
|
Ans. A: Morphology of cells The 1982 Working formulation is a classification of non-hodgkin lymphoma. It excluded the Hodgkin lymphomas and divided the remaining lymphomas into four grades (Low, Intermediate, High, and Miscellaneous) related to prognosis, with some fuher subdivisions based on the size and shape of affected cells. This purely histological classification included no information about cell surface markers, or genetics, and it made no distinction between T-cell lymphomas or B-cell lymphomas. The working formulation was widely accepted at the time of its publication but is now obsolete. It was superseded by subsequent classifications but it is still used by cancer agencies for compilation of lymphoma statistics and historical comparisons.
| 1 |
Morphology of cells
|
Cell surface markers
|
Survival characteristic of cells
|
Cellular genetics
|
Medicine
| null |
4d7c90fc-0e78-4429-834e-749cbf46ad0a
|
single
|
Which condition is associated with Congenital Adrenal Hyperplasia?
|
(B) Female pseudohermaphroditism[?]Congenital Adrenal Hyperplasia (CAH) is the most common cause of female pseudohermaphroditism & virilization, & decreased cortisol synthesis owing to reduction or loss of 21-hydroxylase enzyme function is the most common biochemical cause of CAH.ABERRANT SEXUAL DIFFERENTIATION DEVELOPMENTAL DISORDERSFemale PseudohermaphroditismMale Pseudohermaphroditism*. Congenital virilising adrenal hyperplasia of fetus*. Maternal androgen excess*. Virilizing ovarian tumor*. Iatrogenic: Treatment with androgens or certain synthetic progestational drugs*. Androgen resistance*. Defective testicular development*. Congenital 17-hydroxylase deficiencyDisorders of Embryonic Sexual Development:Hermaphroditism occurs when individuals have both ovary & testis tissue.Pseudohermaphrodites have either testes or ovaries but have accessory organs & external genitalia that are incompletely developed or inappropriate.Most common cause of female pseudohermaphroditism is congenital adrenal hyperplasia.In males, one cause is testicular feminizing syndrome in which testes are normal but there are no receptors for Testosterone.-Individual develops very female appearance but is infertile.Causes of Female Pseudohermaphroditism:Congenital Adrenal Hyperplasia (CAH):It is caused by a defect in an enzyme (21-hydroxylase) in the steroid hormone synthesis pathway in the adrenal gland. It is the most common cause of ambiguous genitalia in newborns.Causes females to be masculinized due to a deficiency of the enzyme 21- hydroxylase.It is present in about one in 15,000 newborns. It is inherited by an autosomal recessive gene.Overproduction of male hormones before birth:It is often due to adrenal gland abnormality (as described in CAH above).High levels of male hormones may also enter the placenta via the mother (when receives progesterone to prevent a miscarriage or has a hormone-producing tumor).The common cause: Congenital Adrenal Hyperplasia (CAH):95% of CAH:Hypocortisolism; Enzyme 21-hydroxylase deficiency.Increased 17-hydroxy progesterone or 17-OHP. Manifest as virilization (Clitoromegaly, acne etc.,)Cortisol substitution - less masculine & potentially fertile. May cause Addison's Crisis.Newborn female CAH - presence of ambiguous genitalia.Newborn male CAH - similar symptoms with Hypertrophic Pyloric Stenosis (HPS), to differentiate it:-CAH: Hyperkalemia, metabolic acidosis; HPS: Hypokalemia, metabolic alkalosisOther Options[?]True hermaphroditism:Glands of both the sexes must be present in the same individual (cases are very rare).Accessory sex gland is atrophic and shows no evidence of functional activity.Sex gland consists partly of ovarian & partly of testicular tissue.[?]Pseudohermaphroditism:Sex glands are of one sex while the external genitalia are of the opposite sex.[?]Female pseudohermaphroditism ovaries may descend within the inguinal canal to lie in the labia majora, and if the clitoris is hypertrophied, it may at first glance resemble the penis, and the fused labioscrotal folds resemble a rudimentary scrotum.[?]Male pseudohermaphroditism type, the testis fails to descend into the scrotum, the penis is ill developed, and as a result of extreme hypospadias, the external genitalia resemble those of the female.
| 2 |
Male pseudohermaphroditism
|
Female pseudohermaphroditism
|
Female true hermaphroditism
|
Sequential pseudohermaphroditism
|
Pediatrics
|
Endocrinology
|
15bafd0c-8349-4d62-900e-e47c0b22530b
|
multi
|
Which of these is not responsible for removal of free radicals?
|
Ans. (c) NADPH oxidase(Ref: R 9th/pg 48; 8th/pg 13,14)AntioxidantsEnzymesNon enzymes* Catalase- Present in peroxisomes Q decomposes H2 O2 Antioxidants- vitamins E, A and C glutathione in the cytosol.*. Superoxidase dismutases: O2- to H2 O2 *. Manganese-SOD, which is localized in mitochondria,*. Copper-zinc-SOD, which is found in the cytosol.Transferrin, ferritin, lactoferrin, and ceruloplasmin Q - Minimise the reactivity of metals by binding with themGlutathione peroxidase: H2 O2 +2GSH-GSSG+2H2 O*. Important indicator of the cell's ability to detoxify ROSQNADPH oxidaseOxidizes NADPH Q (reduced nicotinamide-adenine dinucleotide phosphate) and, in the process, reduces oxygen to superoxide. Q
| 3 |
Catalase
|
Superoxide Dismutase
|
NADPH oxidase
|
Glutathione peroxidase
|
Pathology
|
Cellular Pathology
|
822b83e3-02e2-40ed-b749-eae4d6989603
|
single
|
All are true about central retinal artery occlusion (CRAO) except?
|
Ans. (a) Most commonly occurs due to thromboembolism; (c) Sudden painful loss of visionRef: Kanski 7/e, p. 559, 563* Presentation is with sudden and profound loss of vision, Painless, except in Giant cell arteritis* Atherosclerosis related thrombosis at the level of lamina cribrosa is by far the most common underlying cause of CRAO, accounting for 80% cases
| 1 |
Most commonly occurs due to thromboembolism
|
Anterior chamber paracentesis is used for treatment
|
Sudden painful loss of vision
|
Occurs due to obstruction of retinal artery at the level of lamina cribrosa
|
Ophthalmology
|
Retina
|
14807146-532f-4f17-8d9e-7295353e0f97
|
multi
|
Pseudomonas exotoxin inhibits protein synthesis by inhibiting ?
|
Ans. is 'b' i.e., EF-2 Exotoxin 'A' of P. aeruginosa inhibits protein synthesis through interference with adenosine diphosphate ribosylation of elongation factor - 2. Remember Bacterial toxins inhibiting protein synthesis : Exotoxin A of P aeruginosa Shiga toxin (Shigella) Diphtheria toxin Shiga like toxin or verocytotoxin of EHEC.
| 2 |
RNA polymerase
|
EF-2
|
Transpeptidase
|
Reverse transcriptase
|
Microbiology
| null |
8cfb88de-e5af-4098-a991-95f7421e9f44
|
single
|
Filigree burn occur in -
|
FILIGREE BURNS OR ARBORESCENT OR LICHTENBERG'S FLOWERS: occur due to lightning injury These are superficial thin irregular and touous markings on the skin resemble branches of a tree the fernlike pattern of erythema in the skin usually on shoulders and flanks may develop instantly or within a few minutes CAUSES: 1. Staining may be due to lysis of hemoglobin or rupture of small blood vessels 2. They may be superficial burns producing erythema of the skin 3. Minute deposition of copper in the dermis and disappears in one or two days if survived REF: The Synopsis of Forensic Medicine and Toxicology 29th edition page no: 168
| 1 |
Lightening
|
Electrocution
|
Vitrilage
|
Infanticide
|
Forensic Medicine
|
Thermal injury
|
8ff8bad5-78b1-4fdb-b554-ff2388eb83f7
|
single
|
Wave length of UV A2 rays is
|
Ultraviolet light * Ultraviolet light (UV) is made up of: # Vacuum UVC (10-200 nm) # UVC (200-280 nm) # UVB (280-320 nm) # UVA (320-400 nm) divided into UVAII (320-340 nm) and UVAI (340-400 nm). Ref:- Review of Dermatology by Alikhan; pg num:-13
| 3 |
200nm to 280nm
|
280nm to 320nm
|
320nm to 340nm
|
340nm to 400nm
|
Dental
|
Anatomy of skin
|
c2eca0ac-9edd-4e24-b133-e07db32537d6
|
single
|
Which of the following is not a step in the ‘three step build up’ of direct filling gold?
|
A. Three step build-up for the restoration
“Tie formation”
This involves connecting two opposing point angles or starting points filled with gold with a transverse bar of gold. Such a “tie” forms the foundation for any restoration in direct gold. Of course, its resistance to displacement should be tested before proceeding to the next step.
“Banking of walls”
This is accomplished by covering each wall from its floor or axial wall to the cavosurface margin with the direct gold material. A wall should be banked in a way that will not obstruct tie formation or banking of other walls in the cavity preparation. “Banking” should be performed simultaneously on the surrounding walls of the preparation.
“Shoulder formation”
Sometimes, to complete a build-up, it is necessary to connect two opposing walls with the direct gold material. These three steps should completely fill up the cavity preparation, but the build-up should continue until the preparation is overfilled.
Ref: Marzouk .page 399
| 2 |
Tie formation
|
Stepping
|
Shoulder formation
|
Banking of walls
|
Dental
| null |
db556d10-d11f-4e2f-ba5e-5c8a290988f3
|
multi
|
Soft tick transmits –
| null | 1 |
Relapsing fever
|
KFD
|
Tularemia
|
Indian tick typhus
|
Social & Preventive Medicine
| null |
c3087429-89c2-45fc-b057-9c303ee32c3e
|
single
|
Helitrope rash is seen in:
|
Dermatomyositis
| 4 |
SLE
|
Lichen Planus
|
Pitryiasis alba
|
Dermatomyositis
|
Skin
| null |
6f056e62-98db-47ff-a6a4-68e8c8376f5b
|
single
|
Hypoglossal nerve is related to -
|
Hypoglossal nerve is a content of both digastric and carotid triangles.
| 3 |
Digastric triangle
|
Carotid triangle
|
Both
|
None
|
Anatomy
| null |
c66d007e-cf0e-43d6-80a4-aff82c4432e7
|
multi
|
Not true about content composition of an Egg is:-
|
Egg composition: - 6g - Fat - 6g - Protein - 30 mg - Calcium - 1.5 mg - Iron - 70 Kcal - Energy - 250 mg - Cholesterol Also remember, egg is Richest sources of cholesterol. Height NPU (Net protein utilization) - 96, hence known as reference protein. Poor In carbohydrates & vit c.
| 4 |
6 grams proteins
|
6 grams fat
|
1.5 mg Iron
|
150 mg Cholesterol
|
Social & Preventive Medicine
|
Proteins, Fats, Rich Sources
|
3cdb9aa3-6672-451b-9ea1-f5d72c5cbaa3
|
multi
|
Obstruction to the flow of CSF at the aqueduct of sylvius will most likely lead to enlargement of:
|
. Both lateral and third ventricles
| 4 |
All of the ventricles
|
Only lateral ventricle
|
Only fouh ventricle
|
Both lateral and third ventricles
|
Pathology
| null |
4bac1d95-0c18-458b-bd17-abaddd1e612d
|
multi
|
Pulmonary veins develops from:
|
Development of pulmonary veinsAt 27-29 days' gestation, the primitive pulmonary vein appears as an endothelial out-pouching from either the posterior superior left atrial wall or from the central pa of the sinus venosus proximal to the primordial lung venous plexus.Connection between the primitive pulmonary vein and pulmonary venous plexus occurs by 30 days' gestation.The common pulmonary vein enlarges and incorporates into the left atrium, and, normally, the pulmonary venous pa of the splanchnic plexus gradually loses its connection with the cardinal and umbilicovitelline veins.
| 2 |
6th aoic arch
|
Primitive left atrium
|
Left common cardinal vein
|
Left vitelline vein
|
Anatomy
| null |
744c1560-69dd-4ce9-9883-85985f771316
|
single
|
Which of the following are alkylating agents:
|
ALKYLATI NG AGE NTS These compounds produce highly reactive carbonium ion intermediates which transfer alkyl groups to cellular macromolecules by forming covalent bonds. The position 7 of guanine residues in DNA is especially susceptible, but other molecular sites are also involved. Alkylation results in cross linking/ abnormal base pairing/ scission of DNA strand. Cross linking of nucleic acids with proteins can also take place. >Mechlorethamine (Mustine HCL) >Cyclophosphamide >Ifosfamide >Chlorambucil >Melphalan >Thio-TEPA >Busulfan >Nitrosoureas >Dacarbazine(DTIC) ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:821,822
| 1 |
Cyclophosphamide
|
Ifosfamide
|
Paclitaxel
|
Methotrexate
|
Pharmacology
|
Chemotherapy
|
3969cd6f-11af-4e16-b478-f5c3eb751b82
|
single
|
Average gain in length in first year is
|
Length at bih- 50cms At 3 months- 60cms At 6 months- 65cms At the end of 1st yr- 75cms Hence gain in length in first year is (75-50= 25cms) Ref: Ghai,9th edition, Table 2.1
| 1 |
25cms
|
50cms
|
75cms
|
100cms
|
Anatomy
|
General anatomy
|
d3cab309-67df-43d1-931e-07423529ac6b
|
single
|
A 63-year-old woman presents with symptoms of palpitations and atrial flutter on the ECG. Which of the following is the most likely mechanism of this arrhythmia?
|
Atrial flutter is characterized by regular atrial activation with an atrial rate of > 240 beats/min. The ventricular response depends on the conduction of the AV node, usually there is 2:1 or 3:1 conduction. It is now known that the predominant mechanism for atrial flutter is right atrial macro reentry with circular activation. Atrial flutter typically originates from the right atrium and most often involves a large circuit that travels around the area of the tricuspid valve. This type of atrial flutter is referred to a typical atrial flutter. Less commonly, atrial flutter can result from circuits in other areas of the right or left atrium.
| 3 |
atrial asystole
|
atrial bigeminy
|
right atrial macro-reentry
|
AV nodal reentry
|
Medicine
|
C.V.S.
|
c12d893b-29df-4e9f-b40d-4a1e717885c3
|
single
|
Autosomal recessive disease have incidence of 1/ 250000 in a population. What is the carrier state of population?
|
.incidence is calculated as the total number new cases in a given time period divided by population at risk during that period.multiplied by 1000.so here total no of carrier states is given by 1divided by 250000 multiplied by 1000,that is 1/250. ref:park&;s textbook,ed 22,pg no 58
| 1 |
1\/250
|
1\/500
|
1\/1000
|
1\/5000
|
Social & Preventive Medicine
|
Epidemiology
|
802b374d-852f-417f-a9a0-0f2872e9807c
|
single
|
The laryngeal mask airway allows positive pressure ventilation with maximum pressure of:-
|
The LMA allows a positive pressure of 20 cm of H2O for ventilation .
| 2 |
10 cm H2O
|
20 cm H2O
|
30 cm H2O
|
40 cm H2O
|
Anaesthesia
|
Airway
|
d69d0cb7-70cb-4779-bfa8-642255db074c
|
multi
|
Elderly primi is above :
|
30 years
| 1 |
30 years
|
35 years
|
37 years
|
45 years
|
Gynaecology & Obstetrics
| null |
11e7f1db-d167-428d-81ab-31942273c6a2
|
multi
|
Shoulder pain post laparoscopy is due to
|
Laparoscopy Needle used for pneumoperitoneum : Veress needle Most commonly used gas: CO2 Flow of gas : 1L/min Intra abdominal pressure : 12-15mmHg Trocar is inseed at or just below the umbilicus penetrating skin, superficial & deep fascia, fascia transversalis & parietal peritoneum Post-laparoscopy shoulder pain is due a to CO2 retention causing irritation of diaphragm & referred pain to the shoulder through phrenic nerve Ref: Sabiston 20th edition Pgno : 394-396
| 2 |
Subphrenic abscess
|
CO2 retention
|
Positioning of the patient
|
Compression of the lung
|
Surgery
|
Urology
|
88ca5ced-be9a-4e13-89e9-5e392e51c219
|
single
|
A 20 year old primigravida is admitted with-term pregnancy and labour pains. At 4.00 AM she goes into active labor. Membrance rupture during p/v exmination showing clear liquor. A repeat p/v examination after 4 hours of good uretine contractions reveals cervical dilataion of 5 cm. What should be the next step in management :
|
Reassess for occipitoposterior position and cephalopelvic dispropoion
| 4 |
Reassess after 4 hours
|
Immediate cesarean section
|
Oxytocin drip
|
Reassess for occipitoposterior position and cephalopelvic dispropoion
|
Gynaecology & Obstetrics
| null |
aaa25c23-c516-4556-95fd-c7de66517389
|
multi
|
All of the following statements about mosquito are true except -
|
Man is the definitive host and mosquito is the intermediate host of Bancroftian and Brugian filariasis. Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 832
| 2 |
It is definitive host in malaria
|
It is a definitive host in filaria
|
Its life cycle is completed in 3 weeks
|
The female can travel upto 3 kilometers
|
Social & Preventive Medicine
|
Environment and health
|
3de6c2e1-a9d9-43a2-9e67-00d621063fc7
|
multi
|
First line of treatment of osteoporosis in postmenopausal woman?
|
Hormone replacement therapy is cornerstone in both prophylaxis and treatment of osteoporosis in menopausal women. Estrogen delays and protects against osteoporosis by 50% in all skeletal and not limited to trabecular bones of spine, wrist and upper hip. Rest of the drugs used in H for osteoporosis are natural estrogens, progesterone, tibolone and raloxifene. Bisphosphonates may be used are primary treatment in late osteoporosis in postmenopausal women Bisphosphonates include: Alendronate, Risedronate, Ibandronate, Zoledronate. These agents chemically bind to calcium hydroxyapatite in bone and decrease bone resorption by blocking the function and survival but not the formation of osteoclast.
| 1 |
Estrogen
|
Calcium and vitamin D supplementation
|
Bisphosphonates
|
Ulipristal
|
Gynaecology & Obstetrics
|
NEET Jan 2020
|
f532b438-499f-4393-a9b8-2f5ca7e40fcf
|
single
|
Medical etiquettes are between which of the following categories?
|
Medical etiquette deals with the conventional laws of couesy observed between members of the medical profession. A doctor should behave with his colleagues as he would have them behave with himself. Ethical behaviour is a self-imposed duty upon each doctor. A doctor should not criticise or denigrate the professional ability of another doctor, while dealing with a patient. Ref: The Essentials of Forensic Medicine and Toxicology by Dr. K. S. Narayan Reddy, 27th edition, Page 1.
| 1 |
Medical professionals
|
Medical professionals and pharmaceutical companies
|
Medical professionals and patients
|
Pharmaceutical companies and patients
|
Forensic Medicine
| null |
d6965863-85d6-48bc-aeb7-7c60adc057a1
|
single
|
Drugs used in GTCS is/are:
|
Carbamazepine, phenytoin are the first line drugs in GTCS. Valporate, phenobarbitone are the second choice of drugs. Alternative/add on drugs are Lamotrigine, Gabapentine, topiramate, methadone, levetiracetam. Ethosuximide is used in absent seizures. Propofol is a general anesthetic. Ref: K D Tripati 8th edition Table 30.1
| 2 |
Ethosuximide
|
Sodium-valproate
|
Lamotrigine
|
Propofol
|
Pharmacology
|
Central Nervous system
|
a8c1f063-4198-460e-9f6e-ec7dd479869b
|
single
|
Which of the following is the best parameter for monitoring septic shock?
|
Definitions of sepsis, severe sepsis, and septic shock Sepsis category Sepsis-3 2001 Sepsis CMS Sep-1 Sepsis SOFA score> 2 + suspected infection 2 of 4 SIRS criteria + suspected infection 2 of 4 SIRS criteria + suspected infection Severe Sepsis Not applicable Sepsis + organ dysfunction, hypoperfusion or hypotension Sepsis + sepsis - induced organ dysfunction Septic Shock Vasopressor requirement to maintain MAP> 65 mm Hg + Serum lactate level > 2 mmol/L in the absence of hypovolemia Sepsis induced hypotension persisting after adequate IV fluid resuscitation + presence of perfusion abnormalities or organ dysfunction Lactate > 4 mmol/L SBP <90 mm Hg. not responsive to IV fluids MAP <70 mm Hg not responsive to IV fluids
| 4 |
Central venous pressure (CVP)
|
Vasopressor requirement
|
Urine output
|
Serum lactate
|
Surgery
|
Shock
|
a60b3f09-a256-473f-874c-13843e7949b9
|
single
|
'Foification spectra' are feature of NOT RELATED-PATHOLOGY
|
.
| 4 |
Mature cataract
|
Immature cataract
|
Amaurosis Fugax
|
Migraine
|
Pharmacology
|
All India exam
|
2260a490-3872-414f-8d18-6897cc830163
|
single
|
Strength of wound after 2 months is governed by-
|
Ans. is 'a' i.e., Collagen cross linking Wound strengtho At the end of first week, wound strength is approximately 10% that of normal skin,o Strength increases rapidly over the next 4 weeks.o At the end of third months, the strength reaches a plateau of about 70 to 80% of the normal skin, a condition that may persist for life.So, (Remember following facts)o Tensile strength never reaches the normal strength of unwounded tissue (i.e., 100%).o Maximum strength is achieved by the end of 3 months.o Maximum strength is 70-80% of normal tissue.How does tensile strength change with time ?o During first 2 months it is due to excess collagen deposition.o After that it is due to structural modification of collagen, i.e., cross-linking, increased fiber size.
| 1 |
Collagen cross linking
|
Excess collagen deposition
|
Both 'a' and 'b'
|
None of the above
|
Unknown
| null |
a10086e5-7d48-47f1-93bf-bb54738e8688
|
multi
|
Agent of first choice in an acute attack of Prinzmetal's angina is:
|
Answer is B (Nitrates) "Sublingual nitroglycerine is the drug of choice" -- CMDT Nitrates decrease aeriolar and venous tone, reduce preload and afterload, and reduce the oxygen demand of the hea. Nitrates may also improve myocardial blood flow by dilating collateral channels in the presence of increased vasomotor tone, or coronary stenosis.
| 2 |
Diltiazem
|
Nitrates
|
Propranolol
|
Verapamil
|
Medicine
| null |
b9adb904-3d65-4232-bd5e-7464095fd280
|
single
|
Which of the following is a cognizable offence
|
Refer the byte "Cognizable and Non cognizable offences".
| 4 |
Ragging
|
Robbery
|
Dowry death
|
All of the above
|
Forensic Medicine
| null |
bb29358c-c5bd-44de-9783-0142725933ce
|
multi
|
A 53-year-old woman with ovarian tumor presents with breathlessness and right-sided chest pain. The chest X-ray shows obliteration of the right costophrenic angle. Diagnosis?
|
Ans. A PleurisyRef. CMDT 2019 pg. 323Ovarian tumor (Fibroma and thecoma) can be associated with a right-sided pleural effusion (Meigs syndrome). The obliteration of CP angle on X-ray is another pointer for pleural involvement of this patient.
| 1 |
Pleurisy
|
Pericarditis
|
Myocardial infarction
|
Parapneumonic effusion
|
Physiology
|
Heart, Circulation, and Blood
|
b4f809c7-5795-4539-876c-10b5edd3f088
|
single
|
All of the following statements about Philadelphia Chromosome in CML are true, except:
|
Answer is D (The Philadelphia chromosome with the oncogenic BCR-ABL gene is found on chromosome 9) The Philadelphia chromosome with the oncogenic BCR-ABL gene fusion is the truncated chromosome 22 (and not chromosome 9). The Philadelphia chromosome results from a reciprocal translocation between the ABL-1 oncogene on the long arm of chromosome 9 (region q34) and the breakpoint cluster region (BCR) on the long arm of chromosome 22(region q I I ) This reciprocal translocation, creates an elongated chromosome 9 (der 9), and a truncated chromosome 22. The oncogenic BCR-ABL gene fusion is found on the shoer derivative 22 chromosome (Philadelphia Chromosome). BCR-ABL encodes an oncogenic protein with tyrosine kinase activity (Tyrosine Kinase Inhibitors are therefore used for treatment) In agreement with the International System for Human Cytogenetic Nomenclature (ISCN), this chromosomal translocation is designated as t(9;22)(q34;q11). ABL stands for "Abelson", the name of a leukemia virus which carries a similar protein.
| 4 |
Reciprocal translocation between long arm of chromosome 9 and long arm of chromosome 22
|
The breakpoint cluster region (BCR) is located on the long arm of chromosome 22
|
The ABL gene is located on chromosome 9
|
The Philadelphia chromosome with the oncogenic BCR-ABL gene is found on chromosome 9
|
Medicine
| null |
8dc4bb7c-63cd-4f19-83c7-36fa49ca2a30
|
multi
|
Not a predisposing factor for Ca esophagus:
| null | 3 |
Diverticula
|
Human papilloma virus
|
Mediastinal fibrosis
|
Caustic ingestion
|
Surgery
| null |
c35351bf-eda3-421a-9a7f-fde7cafb99db
|
single
|
Post-styloid space of parapharyngeal space contains all, EXCEPT:
|
The parapharyngeal space is a potential space, shaped like an inveed pyramid spanning the skull base to the hyoid. The boundaries of the space are separated by the styloid process and its associated fascial attachments into the "prestyloid" and "poststyloid" compaments. The contents of the prestyloid space are the parotid, fat, and lymph nodes. The poststyloid compament is composed of CNs IX to XII, the carotid space contents, cervical sympathetic chain, fat, and lymph nodes. Ref: Schwaz's principle of Surgery 9th edition, chapter 18.
| 3 |
Cranial nerve IX
|
Cranial nerve XII
|
Parotid
|
Lymph nodes
|
Surgery
| null |
71e6cf11-8083-4e58-bf59-17374d0faf2d
|
multi
|
Which of the following is used with local anesthetics to potentiate their action?
|
Adrenaline is a vasoconstrictor that prolongs duration of local anesthetics & prevents systemic toxicity.
Sodium bicarbonate speeds the action of local anesthetics by increasing the unionized form.
| 2 |
Adrenaline
|
Sodium bicarbonate
|
Both 1 & 2
|
Dantrolene
|
Pharmacology
| null |
aed19727-76da-4f32-a5c4-35ababd97ad7
|
multi
|
8 yrs. old child presents with lethargy multiple epiphyseal breaks, wormian bones with growth retardation and mental retardation Diagnosis is?
|
Ans. is 'b' Hypothyroidism (Ref. : O.RGhai, 6/e, p 482 (5/e, p447))Presence of mental retardation, growth retardation and wormian bones clinch the diagnosis in favour of hypothyroidism.In Hypothyroidism both mental retardation * and growth retardation * are present andthe skull X-ray shows large fontanelle, wide sutures * and wormian bones *Rickets -Wormian bones are also present in rickets but mental retardation is not seen in ricketsScurvy and Hypoparathyroidism have a radically different symptomatic profile.Important causes of wormian boneHypothyroidism *Hypophosphatasia *Rickets *Cleidocranial dysplasia *Osteogenesis imperfecta *
| 2 |
Rickets
|
Hypothyroidism
|
Scurvy
|
Hypoparathyroidism
|
Pediatrics
|
Thyroid Gland
|
dc3df708-6f98-473a-9949-04b17af64089
|
single
|
All are complication of PEEP except :-
|
Positive end expiratory pressure decreases venous return and decreases cardiac output and hence blood pressure decreases and decreased perfusion so urine output can reduce. Pulmonary barotrauma is a frequentcomplicationofPEEPtherapy. Pneumothorax, pneumomediastinum, and interstitial emphysema may lead to rapid deterioration of a patient maintained on mechanical ventilation with an already compromised respiratory status. Positive end-expiratory pressure PEEP is a mode of therapy used in conjunction with mechanical ventilation. At the end of mechanical or spontaneous exhalation, PEEP maintains the patient's airway pressure above the atmospheric level by exeing pressure that opposes passive emptying of the lung. This pressure is typically achieved by maintaining a positive pressure flow at the end of exhalation. This pressure is measured in centimeters of water. PEEP therapy can be effective when used in patients with a diffuse lung disease that results in an acute decrease in functional residual capacity (FRC), which is the volume of gas that remains in the lung at the end of a normal expiration. FRC is determined by primarily the elastic characteristics of the lung and chest wall. In many pulmonary diseases, FRC is reduced because of the collapse of the unstable alveoli. This reduction in lung volume decreases the surface area available for gas exchange and results in intrapulmonary shunting (unoxygenated blood returning to the left side of the hea). If FRC is not restored, a high concentration of inspired oxygen may be required to maintain the aerial oxygen content of the blood in an acceptable range. Applying PEEP increases alveolar pressure and alveolar volume. The increased lung volume increases the surface area by reopening and stabilizing collapsed or unstable alveoli. This splinting, or propping open, of the alveoli with positive pressure improves the ventilation-perfusion match, reducing the shunt effect. After a true shunt is modified to a ventilation-perfusion mismatch with PEEP, lowered concentrations of oxygen can be used to maintain an adequate PaO2. PEEP therapy may also be effective in improving lung compliance. When FRC and lung compliance are decreased, additional energy and volume are required to inflate the lung. By applying PEEP, the lung volume at the end of exhalation is increased. The already paially inflated lung requires less volume and energy than before for full inflation. When used to treat patients with a diffuse lung disease, PEEP should improve compliance, decrease dead space, and decrease the intrapulmonary shunt effect. The most impoant benefit of the use of PEEP is that it enables the patient to maintain an adequate PaO2 at a low and safe concentration of oxygen (< 60%), reducing the risk of oxygen toxicity . Because PEEP is not a benign mode of therapy and because it can lead to serious hemodynamic consequences, the ventilator operator should have a definite indication to use it. The addition of external PEEP is typically justified when a PaO2 of 60 mm Hg cannot be achieved with an FIO2 of 60% or if the estimated initial shunt fraction is greater than 25%. No evidence suppos adding external PEEP during initial setup of the ventilator to satisfy misguided attempts to supply prophylactic PEEP or physiologic PEEP.
| 2 |
Decreased urine ouput
|
Increased blood pressure
|
Increased intracranial pressure
|
Increased intrathoracic pressure
|
Anaesthesia
|
Modes of Ventilation
|
f170bff7-4d1d-4b15-a3bd-cb2f01f99534
|
multi
|
Rate limiting step in Gluconeogenesis is catalyzed by -
|
Ans. is 'a' i.e., Fructose -1,6 phosphatase Rate limiting steps in various biochemical reactions taking place inside cells is of vital importance while formulating drugs to fight specific diseases affecting these reactions. So these rate-limiting steps are frequently asked in various entrance exams. Glycolysis - Phosphofructokinase Glycogen synthesis - Glycogen synthetase Glycogenolysis - Glycogen Phosphorylase Gluconeogenesis - Phosphoenolepyruvate; Fructose 1,6 biphosphatase TCA cycle- Isocitrate dehydrogenase Cholesterol synthesis- HMG CoA Reductase Bile acid synthesis - 7 alpha hydroxylase Fatty acid synthesis - acetyl CoA carboxylase Ketone body synthesis -HMG CoA synthetase Uric acid synthesis - Xanthine Oxidase Norepinephrine(catecholamine) synthesis- Tyrosine hydroxylase Tyrosine------->DOPA(Tyrosine hydroxylase) Acetylcholine synthesis- Uptake of choline Urea synthesis - Carbamoyl transferase Bio-chemistry facts - Rate limiting step in synthesis of bile salts: cholesterol hydroxylation= Enzyme: 7 alpha -hydroxylase - Rate limiting step in Glycolysis: Fructose 6-phosphate to fructose-1,6 biphosphate = Enzyme: phosphofructokinase (PFK) - Rate limiting step in Fatty acid synthesis: Carboxylation of Acetyl CoA: Enzyme: Acetyl CoA carboxylase (biotin dependent) - Rate limiting step in cholesterol synthesis: Mevalonate formation: Enzyme: HMG CoA reductase - Rate limiting step in HMP pathway: Glucose-6-phosphate to 6-phospho gluconolactone : Enzyme : Glucose 6-phosphate dehyrogenase - Rate limiting step in Gluconeogenesis: Fructose-1,6 bisphosphate to fructose-6-phosphate : Enzyme : Fructose -1,6 phosphatase (rate limiting step/enzyme) Reactions of gluconeogenesis o Gluconeogenesis involves glycolysis, the citric acid cycle plus some special reactions. Glycolysis and gluconeogenesis share the same partway but in opposite direction. Seven reactions of glycolysis are reversible and therefore are used with same enzyme in the synthesis of glucose by gluconeogenesis. However, three of the reactions of glycolysis are irreversible and must be circumvented by four special reactions which are unique to gluconeogenesis and catalyzed by : (1) Pyruvate carboxylaseQ, (ii) Phosphoenolpyruvate carboxykinase, (iii) Fructose-1,6- bisphosphataseQ, (iv) Glucose-6-phosphatase. These four enzymes are the key enzy mes of gluconeogenesis (or gluconeogenesis enzymes). Among these four, pyruvate carboxylase is a mitochondrial enzyme and other three are cytoplasmic enzymes. o All three irreversible steps of glycolysis should be bypassed for gluconeogenesis to occur. These three bypass steps are circumvented by four special reactions. First bypass (conversion of pyruvate into phosphoenol pyruvate): - Conversion of pyruvate into phosphoenol pyruvate takes place through two reactions. Carboxylation of pyruvate : - First, pyruvate enters the mitochondria and is converted into oxaloacetate by pyruvate carboxylase. Pyruvate carboxylase is a mitochondrial enzyme, therefore this reactions occurs in mitochondria only. Conversion of oxaloacetate to phosphoenolpyruvate : - Oxaloacetate produced in the mitrochondria cannot cross the membrane. It is first reduced to malate, which then moves across the mitochondrial membrane into the cytosol. Malate is, then, reoxidized to oxaloacetate in the cytosol. Oxaloacetate is converted to phosphoenol pyruvate by phosphoenolpyruvate (PEP) carboxykinase. Second bypass: - Conversion of fructose-1,6-bisphosphate into fructose-6-phosphate is catalyzed by fructose- 1,6-bisphosphatase (PGI 05). Its presence determines w hether a tissue is capable of synthesizing glucose (gluconeogenesis) or glycogen (glyconeogenesis (PGI 05).) not only from py ruvate, but also from triose phosphate. It is present in liver, kidney, and skeletal muscle, but is probably absent from heart and smooth muscle. C) Third bypass : - Conversion of glucose-6-phosphate to glucose is catalyzed by glucose-6-phosphatase.
| 1 |
Fructose -1,6 phosphatase
|
Glucokinase
|
Glycerol kinase
|
PDH
|
Unknown
| null |
d4673e66-388e-4872-945e-975705c59ebf
|
multi
|
Differential force concept is mainly used in
| null | 3 |
Straight wire appliance
|
Lingual appliance
|
Begg's Light wire appliance
|
Frankel appliance
|
Dental
| null |
d3a2e830-d054-4a88-bd05-b39f4ec91368
|
single
|
A patient got his SBP reduced by 10mmHg when he stood up and he gained only 8mmHg. What was the gain?
|
Correction here is = –8mmHg
Error persists even after correction = 10 – 8 = +2
Gain = Correction / Error
= –8 / +2
= –4
| 1 |
–4
|
4
|
–8
|
8
|
Physiology
| null |
f93ed265-15dd-4d3e-865f-967a2bcb91d6
|
single
|
Triage refers to?
|
Ans. is `b' i.e., Categorization of patients according to level of severity Triage consists of rapidly classifying the injured and the likelyhood of their survival with prompt medical intervention.
| 2 |
Availability of level of medical care
|
Categorization of patients according to level of severity
|
Medical personnel skill level
|
None of the above
|
Social & Preventive Medicine
| null |
a805f0bf-4422-441d-b38e-dac940be5b00
|
multi
|
Lipoprotein involved in transfer of cholesterol from tissues to Liver is?
|
ANSWER: (D) HDLREF: Lippincott's biochemistry 4th Ed page 236See previous question
| 4 |
Chylomicron
|
LDL
|
VLDL
|
HDL
|
Biochemistry
|
Cholesterol and Lipoproteins
|
e7b42c67-0ab5-4875-a782-022790026d48
|
single
|
Common dose dependant side effects of ethambutol is :
| null | 2 |
Red-urine
|
Optic neuritis
|
Nephropathy
|
Peripheral neuropathy
|
Pharmacology
| null |
0334c689-1ada-4eed-b40c-c93089815d23
|
single
|
Which type of pulmonary TB is most likely to give sputum positive -
|
Ans. is 'c' i.e., Cavitary "Sputum smears are usually positive in patients with laryngeal TB, endobronchial TB and cavitary pulmonary- TB"-- Kelley's"Patients with cavitary pulmonary TB have high bacterial load in their sputum " --Internet
| 3 |
Fibronodular
|
Pleural effusion
|
Cavitary
|
None
|
Microbiology
|
Bacteria
|
86d35c03-dcd6-4ac0-af84-a032cf248e4e
|
multi
|
Drug given for metaclopramidr induced dystonic reaction is:
|
Acute muscle dystonia caused by antiemetic-antipsycotic drugs is promptly relieved by parentral promethazine or hydroxyzine.this is based on central anti cholinergic action of the drugs. Promethazine is an first generation anti histaminic which has maximum anticholinergic activity.(ref: KDT 6/ep157)
| 2 |
Pheniramine
|
Promethazine
|
Chlorpropamide
|
Prochlorperazine
|
Pharmacology
|
Gastrointestinal tract
|
13ea4eda-a4c5-416a-8520-3400523d126e
|
single
|
Run-Amok is a feature of :
|
Ans. is 'c' ie Cannabis Run-amok: is a condition resulting from the continued use of cannabis or even its consumption for the first time.It is characterized by a frenzied desire to commit murders.A number of individuals are killed, the first ones being those against whom the assailant has some real or imaginary enmity, followed by others who are in the way, until the homicidal tendency lasts. The person may then commit suicide or surrender himself to the police.There are four important forms of cannabis used in India.They all are derived from different parts of the same plant:Bhang - derived from dried leaves & fruit shoots*Ganja - Consists of dried flowering tops*Charas - consists of resinous exudate from the leaves and stems of the plant* (also k/a hashish)Majun - its a sweetmeat made with bhang, flour, milk and butter.Active ingredient of cannabis * - Tetrahydrocannabinol (THC)*.
| 3 |
Opium
|
Dhatura
|
Cannabis
|
Alcohal
|
Forensic Medicine
|
Forensic Toxicology - Concepts, Statutes, Evidence, and Techniques
|
cfd32de0-0a9e-44b7-9a55-5b295180b6d7
|
single
|
Treatment of choice for uterine prolaspe in a 40-year- old married female with completed family?
|
Ans. C. Vaginal hysterectomy with pelvic floor repair. (Ref. Shaw Gynecology 15th/pg. 340; Novak's Gynecology 13th/pg. 290; Stenchever Gynecology 4,h/pg.580)UTERINE PROLAPSE# Woman < 20 yr old.unmarried=Sling Operation# Young Woman (20-40 yrs) of child bearing age = FothergilFs operation.# Woman > 40 yrs with completed family & not desirous of keeping childbreaing and menstrual function = Vaginal hysterectomy with pelvic floor repair.# Older women who are no longer sexually active = Le Fort's operation.A prolapse into the upper barrel of the vagina is called first degree. If the prolapse is through the vaginal barrel to the region of the introitus, it is second degree. If the cervix and uterus prolapse out through the introitus, it is called third degree or total. In total prolapse the vagina is everted around the uterus and cervix and completely exteriorized. When this occurs, the patient is in danger of developing dryness, thickening, and chronic inflammation of the vaginal epithelium. Stasis ulcers may result as edema and interference with blood supply to vaginal wall occur. These ulcers rarely become cancerous.The treatment for prolapse is:Conservative management of prolapse usually involves fitting the patient with a pessary.A. Conservative:Abdominal and perineal exercises, massage vaginal pessaryAsymptomatic prolapse does not need treatment. An exception is a woman with stress incontinence and prolapse who is about to undergo surgical bladder neck suspension.Symptomatic prolapse can be treated conservatively or surgically, depending on the individual. Pelvic muscle exercises may be of benefit to women with stress incontinence.B. Surgical: Vaginal hysterectomy with pelvic floor repairAnterior colporrhaphyPosterior colporraphy and colpoperineorrhaphyFotehrgill's repair (Manchester operation)Shirodkar's procedureLeforf s repairAbdominal sling operationsOperations for Vaginal ProlapseVaginal Hysterectomy:Operative repair for prolapse of the uterus and cervix generally involves a vaginal hysterectomy with anterior and posterior colporrhaphy. The advantage of vaginal hysterectomy is that it allows other vaginal surgery (e.g., anterior and posterior colporrhaphy or enterocele repair) to be performed at the same time, without the need for a separate incision or for repositioning the patient.F other gill Operation:This operation combines an anterior and posterior colporrhaphy with the amputation of the cervix and the use of the cardinal ligaments to support the anterior vaginal wall and bladder. In this operation, the bladder is dissected off the cervix, which is then amputated. The cardinal ligaments are sewn to the anterior cervical stump, and the posterior vagina is closed over the rest of the opening. This operation is usually performed in conjunction with an anteroposterior colporrhaphy, and it is usually done for the sake of expediency in patients who are poor surgical risks and who do not desire future fertility. The loss of the cervix may interfere with fertility or lead to incompetence of the internal cervical os. The operation has value in older women who have an elongated cervix and well-supported uterus because it is technically easier and has a shorter operative time.Manchester/Fothergill Operation -Operation of choice in third degree prolapse of uterus in patients who are poor surgical risks and who do not desire future fertility.Uteropexy (Abdominal sling operation) :In a young nullipara who desires to retain her fertility. If prolapse cannot be managed successfully with a pessary, such patients present a surgical challenge. The older abdominal uterine suspension operations (Baldy-Webster, Gilliam, ven- trofixation, or hysteropexy) do not work for patients with significant uterine prolapse. Abdominal sling operations include:# Abdominocervicopexy# Shirodker's abdominal sling operation# Khanna abdominal sling operationParavaginal Defect Repair Operation:Anterior vaginal prolapse has been treated with anterior colporrhaphy, plicating the endopelvic fascia in the midline under the bladder neck. If the anterior vaginal prolapse results from a lateral detachment of the endopelvic fascia from the lateral pelvic sidewall, however, better results will be obtained by performing a lateral repair. In this technique, the endopelvic fascia is reattached to the arcus tendineus fasciae pelvis through what is referred to as a paravaginal defect repair operation.Posterior Colporrhaphy:Repair of posterior vaginal prolapse for rectocele and enterocele is also performed vaginally using posterior colporrhaphy. In a rectocele repair, the posterior vagina is opened, the rectum is dissected away from the pararectal fascia, and the levator ani muscles are plicated over the rectum in the midline, after which the vaginal epithelium is closed. Because of concern over postoperative dyspareunia, recent modifications of posterior colporrhaphy have included site-specific repair.Le Fort's operationIn older women who are no longer sexually active a simple procedure for reducing prolapse is a partial colpocleisis. The classic procedure was described by Le Fortand involves the removal of a strip of anterior and posterior vaginal wall, with closure of the margins of the anterior and posterior wall to each other.The Goodall-Power modification of the Le Fort operation allows for the removal of a triangular piece of vaginal wall beginning at the cervical reflection or 1 cm above the vaginal scar at the base of the triangle, with the apex of the triangle just beneath the bladder neck anteriorly and just at the introitus posteriorly. This procedure works well for relatively small prolapses, whereas the Le Fort is best for larger ones.
| 3 |
Fothergill's operation
|
Abdominal Sling operation
|
Vaginal hysterectomy with pelvic floor repair
|
Ring pessary
|
Gynaecology & Obstetrics
|
Miscellaneous (Gynae)
|
3e4bb450-9e6a-4fc3-9224-04b3f3fbe4e8
|
single
|
Ectopic rest of normal tissue is known as ?
|
Ans. is 'a' i.e., Choristoma o Normally arranged tissue at a different anatomical site (ectopic site) --> Choristoma. o Abnormally arranged tissue present at normal site -->Hamaoma
| 1 |
Choristoma
|
Hamaoma
|
Pheudotumor
|
Lymphoma
|
Pathology
| null |
17d68a24-9269-4b75-89db-2951c5395621
|
single
|
A 13 years boy presented with swelling in the cheek with recurrent epistaxis. Most likely diagnosis is
|
(Angio fibroma) (230-Dhingra 4th)* Nasopharyngeal Fibroma (Juvenile nasopharyngeal angiofibroma)Clinical features* Almost exclusively in male age 10-20 years* Profuse and recurrent epistaxis *** Progressive nasal obstruction and denasal speech* Conductive hearing and serous otitis media* Mass in the masopharynx* Other clinical features like - broadening of the nasal bridge, proptosis, swelling of chest infratemporal fossa or involvement of Ilnd, Illrd , IVth Vlth cranial nerve* CT-scan of the head with contrast enhancement is now the investigation of choice* Surgical excision Transpalatinei Sublabial (Sardana's approach) is now the treatment of choice
| 1 |
Angiofibroma
|
Carcinoma nasopharynx
|
Rhabdomyosarcoma
|
None
|
ENT
|
Nose and PNS
|
be8950e6-2178-4f3c-888b-b671512ecca2
|
multi
|
Not a sign/symptom of aconite poisoning: JIPMER 12
|
Ans. Hypeension
| 3 |
Pain abdomen
|
Bradycardia
|
Hypeension
|
Diplopia
|
Forensic Medicine
| null |
408c78e5-ee21-4c3c-9c13-e62d10e92964
|
single
|
True about anal membrane
|
Before the urorectal septum has an oppounity to fuse with the cloacal membrane, the membrane ruptures, exposing the urogenital sinus and dorsal anorectal canal to the exterior. Later on, an ectodermal plug, the anal membrane, forms to create the lower third of the rectum. ref - Semantischolar.org ref - BDC vol2
| 3 |
Perforates at 6 weeks
|
Develops from anterior pa of cloacal membrance
|
Lies at proximal pa of proctodaeum
|
Covers urogenital sins
|
Anatomy
|
Abdomen and pelvis
|
4a06c844-456c-40c0-a4d0-cfd113682e58
|
multi
|
Which of the following is the predominant cell type in the intra-epithelial region of small intestinal mucosa?
|
T lymphocyte predominantly of cytotoxic phenotype (CD8+) constitute the predominant cell type in the intra epithelial region of the mucosa of intestine. The lamina propria consist of helper T cells (CD4+) and educated B cells. Ref: Robbins Pathologic Basis of Disease, 6th Edition, Page 804
| 4 |
Basophils
|
Plasma cells
|
B lymphocyte
|
T lymphocyte
|
Pathology
| null |
cec41ed3-2906-41e1-b0be-40d15d285368
|
multi
|
A 6 year old boy has presented to you with progressive muscle weakness and difficulty in walking upstairs. He has difficulty in walking and has a waddling gait. On examinations Gower's sign is present and there is hypertrophy of calf muscles. His CPK is 10,000 IU. Which of the following is the most probable diagnosis?
|
Ans. A. Duchenne Muscular hypertrophyDuchenne muscular dystrophy (DMD) is a severe type of muscular dystrophy. The symptom of muscle weakness usually begins around the age of four in boys and worsens quickly. Females with a single copy of the defective gene may show mild symptoms. The disorder is X-linked recessive. Early features include a gait abnormality, which classically is a waddling, wide-based gait with hyper lordosis of the lumbar spine and toe walking. The Gower sign is a classic physical examination finding in MD and results from weakness in the child's proximal hip muscles. The second important phase in Duchenne MD is the loss of ambulation. This usually occurs between the ages of 7 and 13 years, with some patients becoming wheelchair-bound by age 6 years. Duchenne MD is a terminal disease in which death usually occurs by the third decade of life (mostly from cardiopulmonary compromise). Other clinical findings in Duchenne MD include absent deep tendon reflexes in the upper extremities and patella (though the Tendo Achillis reflex remains intact even in the later stages of this disease), pain in the calves with activity (<30% of patients), pseudohypertrophy of the calf (60%), and macroglossia (30%).
| 1 |
Duchenne Muscular dystrophy
|
Polymyositis
|
Dermatomyositis
|
Congenital myopathy
|
Pediatrics
|
Musculo Skeletal Disorders
|
41935fc3-5202-40e2-a808-37c9bc21fe37
|
single
|
Contractile Dysfunction is the dominant feature of which of the following types of cardiomyopathies
|
Ref Harrison 19 th ed pg 1556 An enlarged left ventricle with decreased systolic function as mea- sured by left ventricular ejection fraction characterizes dilated car- diomyopathy ). Systolic failure is more marked than diastolic dysfunction. Although the syndrome of dilated cardiomyopathy has multiple etiologies, there appear to be common pathways of secondary response and disease progression.
| 1 |
Dilated cardiomyopathy
|
Restrictive cardiomyopathy
|
Hyperophic cardiomyopathy
|
Infiltrative cardiomyopathy
|
Anatomy
|
General anatomy
|
bccae052-34af-46c1-b700-23d8e4db0f26
|
single
|
Propaganda is :
| null | 3 |
Knowledge by active learning
|
Facilitates learning
|
Knowledge forced into the mind
|
Group discussion
|
Social & Preventive Medicine
| null |
02ec3507-082a-460d-b3bf-78fa99cbb8a1
|
single
|
Banana shaped gametocytes in peripheral smear are seen in infection with:
|
Banana shaped or crescent shaped gametocytes are seen in P. Falciparum.
| 3 |
Plasmodium vivax
|
Plasmodium malaria
|
Plasmodium falciparum
|
Plasmodium ovale
|
Microbiology
|
Parasitology Pa 1 (Protozoology)
|
ae930634-5a6f-478c-b147-a255b3d80c8f
|
single
|
HLA marker of bechet's syndrome ?
|
Ans. is 'c' i.e., HLA-B51
| 3 |
HLA-B27
|
HLA-DR5
|
HLA-B51
|
HLA-CW6
|
Pathology
| null |
1f9e9e15-4f2b-44ea-a07b-de68505df6c2
|
single
|
Drug of choice for night shift workers insomnia is
|
.
| 2 |
Methylphenidate
|
Modafinil
|
Amitriptyline
|
Adrenaline
|
Anatomy
|
General anatomy
|
43646b6e-74f8-4910-ba0c-b77c4d44b7b9
|
single
|
Polyhydramnios not seen in -
|
Ans. is 'b' i.e., Renal agenesis Etiology of Poivhvdrammoso Fetal anomaliesy Anencephalyy Open spina bifiday Esophageal or duodenal atresiay Facial clefts and neck massesy Hydropsfetalisy Aneuploidyo Placentay Chorioangioma of placentao Multiple pregnancyy Maternal diabetes: cardiac or renal disease.
| 2 |
Anencephalv
|
Renal agenesis
|
Hydropsfetalis
|
Chorioangioma of placenta
|
Gynaecology & Obstetrics
|
Hydramnios and Oligo Hydramnios
|
84c0252e-fd7d-4338-a85b-1bf0f3fd9283
|
single
|
Liver is divided into
| null | 1 |
8 Couinaud segments
|
7 Couinaud segments
|
9 Couinaud segments
|
10 Couinaud segments
|
Anatomy
| null |
20c49653-2a4a-4fa4-899b-bb8c2ac09edf
|
single
|
Treatment of choice of thoracic actinomycosis is:
|
Ans. is 'c' Penicillin Actinomycosis occur at different sites such as oro cervicofacial, thoracic, abdominal and pelvic.The drug of choice for all types of actinomycosis is penicillin.
| 3 |
Amphotericin B
|
Cotrimoxazole
|
Penicillin
|
Itraconazole
|
Medicine
|
Bacteriology
|
5389a7d1-c39c-487e-b45a-f6cc1b2b3bf1
|
single
|
28 yr old man presented with headache. CT head shows a low attenuation mass in left temporoparietal region which has similar density to CSF and shows no enhancement following contrast administration. Diffusion weighted MRI shows high signal. Which of the following is most probable diagnosis?
|
When there is Diffusion Restriction, DW-MRI gives a bright signal and has low apparent Diffusion Coefficient(ADC value). Lesions showing Diffusion Restriction Infarct(Acute Infarct)- IOC Abscess Medulloblastoma & Other Cellularity Tumours Epidermoid Cyst There is free diffusion of water within arachnoid cysts therefore DW-MRI is useful to differentiate b/w arachnoid and epidermoid cyst. Clinical history not suppoive of Migraine. Option D: Multiple sclerosis shows Dawson's fingers.
| 3 |
Migraine
|
Arachnoid cyst
|
Epidermoid cyst
|
Multiple sclerosis
|
Radiology
|
Neuroradiology
|
7dddda8d-03bd-473e-99e3-76e49ba99fdb
|
single
|
Treatment of lepromatous leprosy is
|
Ans. c (Rifampicin + Dapsone + Clofazimine); (Ref. Park PSM 22nd/pg. 296)Recommended regimens of chemotherapy for Leprosy in adultsFORM OF LEPROSYMORE INTENSIVE REGIMENWHO RECOMMENDED REGIMENLepromatous(multibacillary)Rifampin (600 mg/d) for 3 years plus dapsone (100 mg/d) indefinitelyDapsone (100 mg/d self-administered) plus clofazimine (300 mg once monthly for 1-2 yrs supervised; and 50 mg/d self-adm); and rifampin (600 mg once monthly undersupervision). Note: Clofazimine is unacceptable owing to discoloration of the skin, its replacement by 250-375 mg self-adm daily ethionamide or propionamide has been suggested.Tuberculoid (paucibacillary)Dapsone (100 mg/d) for 5 years Dapsone (100 mg/d, unsupervised) plus rifampin(600 mg/month, supervised) for 6 months.# ******** Duration of Rx for Multibacillary leprosy = MB blisterpacks for 12 months, within 18 months.# ******* Duration of Rx for Paucibacillary leprosy = PB blisterpacks for 6 months, within 9 months# ******Rifampin is considered the most active agent for the treatment of leprosy.# *****Dapsone inhibits bacterial folic acid synthesis & is now considered the second most active drug (after rifampin) in the treatment of leprosy.# ****Clofazimine is useful in treating dapsone-resistant leprosy and may lessen the severity of ENL.# ***Thalidomide is now approved by the FDA for treatment of ENL. This drug is sedating and extremely teratogenic and should never be taken by anyone who is or may become pregnant.# **Ethionamide with rifampin (600 mg/d) is used to treat dapsone-resistant leprosy for who cannot accept the skin- pigmentation of clofazimine.# The newer macrolide antibiotics (particularly clarithromycin), minocycline (a long-acting tetracycline), and a number of fluoroquinolones (including ofloxacin, sparfloxacin, and pefloxacin) have shown promising bactericidal activity against M. leprae. Ofloxacin and minocycline are being investigated with rifampin in short-course regimens for lepromatous disease.
| 3 |
Rifampicin + Dapsone
|
Rifampicin + Clofazimine
|
Rifampicin + Dapsone + Clofazimine
|
Rifampicin + Ofloxacin + Minocycline
|
Social & Preventive Medicine
|
Communicable Diseases
|
e8bf4b11-43e8-4f51-842c-deffb5daeda2
|
single
|
Commonest hemorrhage following head injury: KCET 13
|
Ans. Subdural hemorrhage
| 2 |
Extradural hemorrhage
|
Subdural hemorrhage
|
Intracranial hemorrhage
|
Subarachnoid hemorrhage
|
Forensic Medicine
| null |
a5aa292b-244b-4b38-bae1-b3876cff3149
|
single
|
All of the following are associated with Atrioventricular block, except:
|
Adrenal insufficiency is associated with Atrioventricular Block (Not cushing&;s syndrome). Metabolic/Endocrine Causes of AV Block: Hyperkalemia Hypermagnesemia Hypothyroidism Adrenal Insufficiency Ref: Harrison 19th edition Pg no: 1471
| 4 |
Hyperkalemia
|
Hypomagnesemia
|
Hypothyroidism
|
Cushing's syndrome
|
Medicine
|
C.V.S
|
a8fb4d9a-f7d3-409e-ad2f-fb86737748b4
|
multi
|
Mantle cell lymphoma are positive for all of the following except:
|
Parameter CLL MCL SMZL/SL VL HCL FL PLL CD5 + + - - - - CD10 - -/+ - - + -/+ CD11c -/+ -/+ + + - + CD19 + + + + + + CD20 +(dim) +(bright) +(bright) +(bright) +(bright) +(bright) CD23 + -/+ -/+ - -/+ - CD79b - + - -/+ + + FMC7 - + + + + + Smlg +(dim) +(bright) +(bright) +(bright) +(bright) +(bright) CLL: Chronic lymphocytic leukemia ; MCL: Mantle cell lymphoma; SMZL/SL VL: Splenic marginal zone lymphoma/splenic lymphoma with villous lymphocytes; HCL: Hairy cell leukaemia; FL: Folliculsr lymphoma;
| 1 |
CD 23
|
CD 20
|
CD 5
|
CD 19
|
Pathology
|
Non Hodgkin Iymphoma
|
3a60bf16-f9b8-4b10-a4c2-69b01f9c2450
|
multi
|
All are indicators of malignancy in a mammography except -
|
Answer (a) Nodular calcification
| 1 |
Nodular cacification
|
Speckled margin
|
Attenuated architecture
|
Irregular mass
|
Surgery
| null |
5365471d-9e64-4d32-b7fa-398eb078935c
|
multi
|
Substance for gluconeogenesis is
| null | 3 |
Glycogen
|
Acetyl CoA
|
Glycerol
|
Leucine
|
Biochemistry
| null |
ccd9585e-f874-49d4-9cb8-c83db1a32479
|
single
|
Methimazole differ from propylthiouracil in all except-
|
Ans. is 'c' i.e., More protein bound
| 3 |
Is secreated into milk
|
Has more volume of distribution
|
More protein bound
|
All
|
Pharmacology
| null |
e1ecb597-1892-47a4-afcb-d192f8d77286
|
multi
|
The pathological feature in wegener's granulomatosis on renal biopsy is
|
Robins..... 'The renal lesions range from a mild/early disease, where glomeruli show acute focal neorosis with thrombosis of isolated glomerulas capillary loops (focal and segmental necrotising glomerulonephritis) where as advanced glomerular lesions are characterized by diffuse necrosis and partial cell proliferation to form crescents.
Direct quote from harrison......
"Necrotising vasculitis of small arteries and veins with gramuloma formation is seen in pulmonary tissue where as granuloma formation is rarely seen on renal bipsy'.
| 2 |
Nodular glomerulosclerosis
|
Focal necrotising glomerulonephritis
|
Granulomas in the vascular wall
|
Granulomas in parenchyma of kidney
|
Pathology
| null |
932762ce-99bc-41df-ba4c-c27edb8fb411
|
multi
|
Dermatitis herpetifomis is associated with:-
|
Dermatitis herpetiformis occurs d/t gluten. HLA associated are: HLA B8 HLA A1HLA DQ2,DQ8, DR3 Psoriasis is associated with HLA CW6
| 2 |
HLA DR4
|
HLA B8, HLA DQ2 and HLA DQ8
|
HLA CW6
|
HLA DR2
|
Dental
|
JIPMER 2018
|
89e3ad1e-e099-44e7-a233-dfc7d4f237df
|
single
|
Most frequent site of metastasis in a case of Choriocarcinoma is:
|
Lungs
| 3 |
Vagina
|
Liver
|
Lungs
|
Brain
|
Gynaecology & Obstetrics
| null |
32622299-fab0-427d-ab2a-e4de7aa4dbe1
|
single
|
Mechanism of action of Tubocurarine is
|
Tubocurarine is a non depolarizing muscle relaxant that competitively blocks action of Acetylcholine on its receptors.
| 3 |
Cholinesterase inhibitor
|
Cause membrane depolarisation
|
Competitive antagonist of acetylcholine receptor
|
Inhibit opening of chloride channels
|
Pharmacology
| null |
499ee636-e78e-4200-9cf6-614704a3f536
|
single
|
All are true regarding Menetrier's disease, EXCEPT:
|
Answer is B (Exophytic growth) Menetrier's disease is characterized hr hyperophy of gastric mucosa and not hr exoph;'tic growth. Menetrier's disease Menetrier's disease is a relatively rare disorder of the stomach characterized by lar e touous mucosal folds Etiology * Etiology is unknown * Over expression of growth factors such as TGF are suggested Pathology Gross * Marked Hyperophy of gastric folds/Rugaee * Hyperophy results from hyperplasia of mucus producing cells (mucosa)Q * Hyperophy is most prominent in the body and fundus deg Histological/microscopic * Massive foveolar hyperplasia (Hyperplasia of surface and glandular mucosal cells). * Pits of gastric glands elongate and may become touous * Lamina propria may contain a mild chronic inflammatory infiltrate (Note: Although lamina propria may contain an inflammatory infiltrates, Menetrier's disease is not considered a form of gastritis Clinical picture * Protein losing enteropathy is characteristic Excessive protein is lost from the thickened mucosa into the gut which results in hypoprotenemia and edema * Gastric acid secretion is usually reduced or absent This happens because mucosal cell hyperplasia replaces most of the parietal cells. * Epigastric pain accompanied by nausea, vomiting anorexia and weight loss Ove bleeding is unusual but occult gastrointestinal bleeding may occur Differential Diagnosis DD includes conditions that may present with large gastric folds: ZES Malignancy Infiltrative disorders eg sarcoidosis Infectious etiology (CMV, Histoplasmosis, syphilis) Prognosis These is an increased risk of adenocarcinoma of stomach in adults with menetrier's disease (CSDT)
| 2 |
Protein loss
|
Exophytic growth
|
Hyperophy of gastric mucosa
|
Premalignant condition
|
Medicine
| null |
1f5b8d55-56e5-474a-b7f6-9267a7374d2e
|
multi
|
All of the following are true about Raynaud's disease except
|
Raynaud's disease is a rare disorder of the blood vessels, usually in the fingers and toes. It causes the blood vessels to narrow when you are cold or feeling stressed. When this happens, blood can't get to the surface of the skin and the affected areas turn white and blue. When the blood flow returns, the skin turns red and throbs or tingles. In severe cases, loss of blood flow can cause sores or tissue death. Primary Raynaud's happens on its own. The cause is not known. There is also secondary Raynaud's, which is caused by injuries, other diseases, or ceain medicines. People in colder climates are more likely to develop Raynaud's. It is also more common in women, people with a family history, and those over age 30 . It also shows antinuclear antibodies in blood which can be recognised by an ANA test . Ref - Davidson's medicine 23e p1035 <a href="
| 2 |
More common in females
|
Positive antinuclear antibodies
|
Most common cause of raynaud's phenomenon
|
Has good prognosis
|
Medicine
|
Immune system
|
d8611a75-1af9-44b0-af69-fcc8a709e84c
|
multi
|
An example of rigid reversible impression material is
| null | 2 |
Agar-agar
|
Impression compound
|
Alginate
|
Impression paste
|
Dental
| null |
d659b7b8-77d2-4e63-a7fc-da258432bf26
|
single
|
A patient is suspected to have vestibular shwanomma the investigation of choice for its diagnosis is -
|
MRI – MRI with gadolinium contrast is the gold standard for the diagnosis or exclusion of vestibular Schwannoma
| 2 |
Contrast enhanced CT scan
|
Gadolinium enhanced MRI
|
SPECT
|
PET scan
|
ENT
| null |
d37286f4-1e68-4aa6-b2fb-055bc5eefc87
|
single
|
Ovulation is associated with sudden rise in
|
Ovulation is associated with LH surge Ref: guyton and hall textbook of medical physiology 12 edition page number:641,642,643
| 3 |
Testosterone
|
Prolactin
|
LH
|
FSH
|
Physiology
|
Endocrinology
|
ff7ab026-b632-491a-819f-81f5dca2176e
|
single
|
All of the following changes are seen in pregnancy except :
|
CARDIAC OUTPUT: Increases from 5th week of pregnancy, reaches its peak 40-50% at about 30-34 weeks. Thereafter the CO remains static till term. CO is lowest in the sitting or supine position and highest in the right or left lateral or knee chest position. Cardiac output increases fuher during labor (+50%) and immediately following delivery (+70%) over the pre-labor values. MAP also rises. There is squeezing out of blood from the uterus into the maternal circulation (auto transfusion) during labor and in the immediate postpaum. CO returns to pre-labor values by one hour following delivery and to the pre-pregnant level by another 4 weeks time. The increase in CO is caused by: (1) Increased blood volume (2) To meet the additional O2 required due to increased metabolic activity during pregnancy. The increase in CO is chiefly affected by increase in stroke volume and increase in pulse rate to about 15 per minute. BLOOD PRESSURE: Systemic vascular resistance(SVR) decreases (-21%) due to the smooth muscle relaxing effect of progesterone, NO, prostaglandins or ANP. Reference: Dutta's Textbook of Obstetrics 7th edition page 53
| 4 |
Increased stroke volume
|
Increased cardiac output
|
Increased Intravascular volume
|
Increased peripheral vascular resistance
|
Gynaecology & Obstetrics
|
General obstetrics
|
38c32d39-8207-4c87-9e72-cc7bd7f64591
|
multi
|
The structure found in a cross-section of the thorax at T4 veebra is :
|
C i.e. Arch of aoa
| 3 |
Azygos vein
|
Brachiocephalic aery
|
Arch of the aoa
|
Left Subclan aery
|
Anatomy
| null |
16dadec7-9674-417b-bd4c-3a9bf0d46600
|
single
|
Three point relationship is reversed in all of the following conditions, EXCEPT:
|
The structures forming the three bony point around the elbow are medial epicondyle, lateral epicondyle and tip of olecranon. Normally in an elbow flexed at 90 degree these three points forms a near isosceles triangle. Base is formed by the line joining the two epicondyles. The three points lies in a straight line when the elbow is extended. The three point relation is maintained in supracondylar fracture of humerus. Three point relation is disturbed in: Elbow dislocation Fracture medial epicondyle and condyle Fracture lateral epicondyle and condyle Fracture intercondylar humerus Ref: Best Aid to Ohopedics By Pramod T. K., Pramod TK page 120.
| 3 |
Medial epicondyle fracture
|
Lateral epicondyle fracture
|
Supracondylar fracture
|
Posterior elbow dislocation
|
Surgery
| null |
cdc2f065-5402-46bf-b382-f0d7bce4df04
|
multi
|
A 40 year old female patient complains of breathlessness. Patient is pregnant (3rd trimester) and is on bed rest. This patient is under-
| null | 1 |
High risk for thrombosis
|
Low risk for thrombosis
|
Risk for primary thrombosis
|
No risk for thrombosis
|
Pathology
| null |
98264bb5-6ccd-4f94-be06-99e5c6b5ebeb
|
single
|
A 3-month-old infant is diagnosed with a membranous ventricular septal defect. A cardiac operation is performed, and the septal defect is patched inferior to the noncoronary cusp of the aorta. Two days postoperatively the infant develops severe arrhythmias affecting both ventricles. Which part of the conduction tissue was most likely injured during the procedure?
|
The bundle of His is a collection of specialized cardiac muscle cells that carry electrical activity to the right and left bundle branches. Because both ventricles are affected, this is the logical site of injury, for this bundle leads to the bundle branches supplying both ventricles. An injury either to the right or left bundle branch would affect only one ventricle. Terminal Purkinje fibers transmit the electrical activity to the greater sections of the ventricles, yet dysfunction in the terminal part of the conduction system would affect only a small section of one ventricle, not both. The atrioventricular node is a group of specialized cardiac muscle cells that serve to decrease the rate of conduction to the ventricles and is located in the region deep to the septal wall of the right atrium. The posterior internodal pathway is in the roof of the right atrium and is not involved here.
| 3 |
Right bundle branch
|
Left bundle branch
|
Bundle of His
|
Posterior internodal pathway
|
Anatomy
|
Thorax
|
427c26fd-b1a0-4a91-b494-089adb511bf8
|
multi
|
The drug NOT used in psoriasis is
|
(B) Chloroquine # TREATMENT OF PSORIASIS: Locally by Topical coaltar.> Wide spread Psoriasis: by Ultraviolet fi-spectrum alone or along with coaltar (Geockerman regimen) or Anthranil (Ingram regimen)> Methotrexate Therapy: Methotrexate is drug of choice in Very Severe form of Psoriatic arthritis & Methotrexate is indicated in Psoriatic erythroderma, Generalized pustular psoriasis, Intractable & Crippling psoriasis.> Psoralens & Ultraviolet-A phototherapy (PUVA): is successful in clearing & delaying recurrence of Chronic Psoriasis.> Etritinate, & its metabolite Acitretin, are Retinoids (Vitamin A derivatives): useful for Severe Resistant Psoriasis.> Systemic drugs useful in Psoriasis: Hydroxyurea, Razoxane & Azathioprine; Cyclosporin A and Topical Vitamin-D3
| 2 |
Psoralens
|
Chloroquine
|
Methotrexate
|
Coaltar
|
Skin
|
Miscellaneous
|
972fe014-2b06-45fd-8fce-496c2b8e1ef8
|
single
|
A 35 year old sailor from a merchant ship that has been cruising the Caribbean presents to a clinician because of painful, flocculent masses in his groin. Physical examination demonstrates multiple enlarged, abscessed lymph nodes draining through the skin indolent sinuses. The sailor describes previously having a small papular lesion on his penis that spontaneously resolved. Which of the following is the most likely diagnosis?
|
This is lymphogranuloma venereum. The only other commonly discussed sexually transmitted disease in which they can occur is chancroid. Histologically, the buboes of lymphogranuloma venereum are enlarged lymph nodes with stellate abscesses. The primary lesion is usually a self-healing papule or shallow ulcer. The causative organism is Chlamydia trachomatis. Condyloma acuminatum causes a papillary lesion and does not cause buboes. Granuloma inguinale causes a spreading ulcer and does not cause buboes. Herpes virus infection causes tiny vesicles and ulcers and does not cause buboes. Ref: Brooks G.F., Carroll K.C., Butel J.S., Morse S.A., Mietzner T.A. (2013). Chapter 27. Chlamydia Spp.. In G.F. Brooks, K.C. Carroll, J.S. Butel, S.A. Morse, T.A. Mietzner (Eds), Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e.
| 4 |
Condyloma acuminatum
|
Granuloma inguinale
|
Herpes virus infection
|
Lymphogranuloma venereum
|
Microbiology
| null |
6f802634-7d71-4d10-9c39-43a0b5f5961d
|
multi
|
Both hyperplasia and hyperophy are seen in
|
Ref,Robbins 9/e p36 The massive physiological growth of the uterus during pregnancy is a good example of hormone induced increase in size of an organ that results from both hyperophy and hyperplasia
| 2 |
Breast enlargement during lactation
|
Uterus during pregnancy
|
Skeletal muscle enlargement during exercise
|
Left ventricular hyperophy during hea failure
|
Anatomy
|
General anatomy
|
538445a6-e1bd-4ef9-a9d2-25f2bad31a6b
|
multi
|
The drug of choice for the treatment of Thyrotoxicosis during pregnancy is:
|
Ans. is 'c' i.e. propylthiouracilRef.: K.D. T. 5th/e p 232, 4th/e p 259, 260This question has been repeated several times before, remember these important pointsAll antithyroid drugs can cross placenta so risk of fetal hypothyroidism and goitre is always thereBoth carbimazole and propylthiouracil can be used during pregnancy, but propylthiouracil is the drug of choice because its greater protein binding allows low doses of propylthiouracil to be transferred across the placenta and therefore less chance of hypothyroidism.The lowest effective dose of propyl thiouracil should be given and it is often possible to stop treatment in the last trimester since TSH Receptor antibodies tend to decline in pregnancy.Radioactive iodine is C/I during pregnancyIt can destroy the fetal thyroid tissue resulting in cretinismCarbimazole and methimazole have been associated with rare cases of foetal aplasia cutis.
| 3 |
Carbimazole
|
Iodine therapy
|
Propyl thiouracil
|
Metimazole
|
Pharmacology
|
Endocrinology
|
3bd54f9d-dd9d-4a31-adbd-5c673b5f81c5
|
single
|
Which of the following is false regarding Multiple Sclerosis (MS)?
|
Multiple sclerosis is an auto immune disease of central neural system with a relapsing and remitting or progressive course. The pathologic hallmark of disease is demyelination. Myelin specific antibodies are present on degenerating myelin sheaths. Surviving oligodendrocytes paially remyelinate surviving axons, which are called as shadow plaques. Reference: Harrison's Principles of Internal Medicine, 21st edition, p2661
| 3 |
More common in women and age of onset is between 20-40 years of age
|
Risk factors include vitamin D deficiency and cigarette smoking
|
Pathological hallmark is axonal degeneration
|
HLA DRB1 in MHC class II is associated with 10% of disease risk
|
Medicine
|
All India exam
|
daf4719e-f84a-42e9-ae96-d9ed4d5bd000
|
multi
|
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.