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All except one leads to delayed puberty
|
Mc Cune - Albright syndrome is characterised by precocious puberty.
| 2 |
Kallman syndrome
|
McCune-Albright syndrome
|
Turners syndrome
|
Addison disease
|
Gynaecology & Obstetrics
| null |
2345a8b4-614f-467e-9c87-dcd441b00b02
|
multi
|
Calculi is most commonly seen in:
|
Sialolithiasis is accumulation of obstructive calcifications within the glandular ductal system, more common in submandibular gland (90%) than the parotid gland (10%).
| 2 |
Minor salivary gland
|
Major salivary gland
|
Parotid gland
|
Sublingual gland
|
Surgery
| null |
9d4512fd-a31c-43d4-92ea-1c1b26fee0a7
|
single
|
Centrally acting sympatholytic agent used as antihypeensive agent is
|
Refer kDT 6/e p540 Clonidine, sold as the brand name Catapresamong others, is a medication used to treat high blood pressure, attention deficit hyperactivity disorder, drug withdrawal(alcohol, opioids, or smoking), menopausal flushing, diarrhea, and ceain pain conditions. It is used by mouth, by injection, or as a skin patch. Onset of action is typically within an hour with the effects on blood pressure lasting for up to eight hours
| 2 |
Propanolol
|
Clonidine
|
Prazosin
|
Phenoxybenzamine
|
Pharmacology
|
Cardiovascular system
|
bfbfbd89-9040-4297-a5c9-a375b9ad221d
|
multi
|
All of the following intraocular foreign bodies produce suppurative reaction except
|
INTRAOCULAR FOREIGN BODIES Reactions of the foreign body Depending upon its chemical nature following 4 types of reactions are noted in the ocular tissues: 1. No reaction is produced by the ine substances which include glass, plastic, porcelain, gold silver and platinum. 2. Local irritative reaction leading to encapsulation of the foreign body occurs with lead and aluminium paicles. 3. Suppurative reaction is excited by pure copper, zinc, nickel and mercury paicles. 4. Specific reactions are produced by iron (Siderosis bulbi) and copper alloys (Chalcosis). Ref:- A K KHURANA; pg num:-409
| 3 |
Pure zinc
|
Mercury
|
Copper alloys
|
Nickel
|
Ophthalmology
|
Ocular trauma
|
9652ca11-71a4-40a5-b481-3605f0a5d123
|
multi
|
Neonate with blotchy rash on the abdomen. Diagnosis is:
|
Ans. (c) Erythema toxicum neonatorum.* Erythema toxicum neonatorum presents in neonates with blotchy maculopapular rash with pustules. These pustules are sterile and contain eosinophils and the rash usually settles by day 10 of life.* Cutis marmorata presents with mottling which disappears when the skin becomes warmer. The mottling is likely to disappear beyond neonatal period. Persistence beyond neonatal period may be associated with hypothyroidism, trisomy 21 and Cornelia de Lange syndrome.
| 3 |
Congenital syphilis
|
Cutis marmorata
|
Erythema toxicum neonatorum
|
Milia
|
Skin
|
General
|
fa99559e-784d-4db2-9497-6ba89ba08dbe
|
single
|
Sabin fleldman dye test is used for -
|
Ans. is 'a1 i.e., Toxoplasmosis Sabin-Feldman dye testo A Sabin-Feldman dye test is a serologic test to diagnose for toxoplasmosis.o The test is based on the presence of certain antibodies that prevent methylene blue dye from entering the cytoplasm of Toxoplasma organisms.o Patient serum is treated with Toxoplasma trophozoites and complements as activator, and then incubated. After incubation, methylene blue is added.o If anti-Toxo antibodies are present in the serum, because these antibodies are activated by complements and lyse the parasite membrane, Toxoplasma trophozoites are not stained (positive result); if there are no antibodies, trophozoites with intact membrane are stained and appear blue under microscope (negative result).
| 1 |
Toxoplasmosis
|
Syphilis
|
Herpes genitalis
|
Gardenellavaginalis
|
Skin
|
Bacterial Infection of Skin
|
9a343cda-0317-47a3-a49a-f05e6cb9e0a6
|
single
|
Common site of regional enteritis is –
|
Crohn disease (Terminal ileitis or regional enteritis)
Crohn disease (CD) is an inflammatory bowel disease (IBD) which is characterized by -
Sharply delimited and typically transmural involvement of the bowel by an inflammatory process with mucosal damage.
The presence of non-caseating granulomas.
Fissuring with the formation of a fistula.
Any portion of intestine can be involved but most commonly small intestine is involved.
Small intestine → 40%
Small intestine + colon → 30%
Colon → 30%
| 3 |
Colon
|
Rectum
|
Distal ileum and colon
|
Caecum
|
Pediatrics
| null |
bd32ac66-5468-4622-a1a8-867a6f081249
|
single
|
A person was on chemotherapy for 2 week for some mediastinal tumour. Now he develops high frequency hearing loss. Most probable cause of this condition is use of:
|
Ans: A (Cisplatin) OTOTOXIC DRUGS P.LDhingra 6th/33-34Various drugs & chemical can damage the in ner ear & cause sensorineural hearing loss, tinnitus & sometimes vertigoCytotoxic drugs causing hearing loss are- nitrogen mustardfmechlorethamine), cisplatin & carboplatin"Cisplatin: Important toxicities are- renal impairment & emetogenic potential.Tinnitus, deafness, sensory neuropathy & byperuricaemia are other problem"- K.D.T 7th/861'Carboplatin: Nephrotoxicity, ototoxicity & neurotoxicity are low as compared to cisplatin"- K.D.T 7th/861Table Dhingra Ototoxic drugsA. Aminoglycoside antibiotisE. AnalgesicsStreptomycinDihydrostreptomvcinGentamicinTobramycinNeomycinKanamycinAmikacinNetilmycinSisomycinSalicylatesIndomethacinPhenylbutazoneIbuprofenF. ChemicalsAlcoholTobaccoMarijuanaCarbon monoxidePoisoningB. DiureticsFurosemideEthacrynic acidBumetanideG. MiscellaneousErythromycinAmpicillinPropranololPropylthiouracilDeferoxamineC. AntimalarialsQuinineChlonoquineHydroxychloroquineD, Cytotoxic drugsNitrogen mustard (Mechlorethamine)CisplatinCarboplatin
| 1 |
Cispiatin
|
Etoposite
|
Doxorubicin
|
Methotrexate
|
Pharmacology
|
Anti-Neoplastic Agents
|
55a1cb84-421b-4b0a-97e6-b6a1a89e37bb
|
single
|
Product of pentose phosphate pathway:
|
Pentose phosphate pathway/Phosphogluconate pathway/Hexose monophosphate shuntIt is a process that generates NADPH and pentoses (5-carbon sugars).There are two distinct phases in the pathway.- The first is the oxidative phase, in which NADPH is generated, and the- Second is the non-oxidative synthesis of 5-carbon sugars.This pathway is an alternative to glycolysis.While it does involve oxidation of glucose, its primary role is anabolic rather than catabolic.For most organisms, it takes place in the cytosol
| 3 |
ATP
|
Pyruvate
|
NADPH
|
Lactate
|
Biochemistry
| null |
96f63724-61f1-4e15-8c28-c9c4a391fde3
|
single
|
Most common cause of rubeosis iridis
|
it develops following retinal ischemia which is a common feature of:
●proliferative diabetic retinopathy
●central retinal vein occlusion
●sickle cell retinopathy
●Eale's disease
| 4 |
Tumor
|
CRAO
|
Radiation retinopathy
|
Diabetic retinopathy
|
Ophthalmology
| null |
b31af239-e53a-45e8-afc4-38dfbd2914a9
|
single
|
Most common cause of ptosis
|
*Congenital myogenic ptosis is the most common type of ptosis and is often bilateral. Ref: Clinical ophthalmology p.786
| 4 |
Myasthenia gravis
|
Paralysis of 3rd nerve
|
Idiopathic
|
Congenital
|
Ophthalmology
|
Diseases of orbit, Lids and lacrimal apparatus
|
3ff8038b-28e0-47a8-bcbc-422d1b5ec4cc
|
single
|
Least chances of cord prolapse are seen with
|
Maximum chances of cord prolapse seen in breech are in footling where as min chances in frank frank breech
| 1 |
Frank breech
|
Complete breech
|
Footling
|
Knee
|
Anatomy
|
Abnormal labor
|
6f5572d0-f3da-407c-8bb2-94dae37236b0
|
single
|
In which organelle (s) of hepatocyte, the elongation of long chain fatty acid takes placea) Endoplasmic reticulum (ER)b) Golgi bodyc) Mitochondriad) Lysosomese) Ribosome
|
Endoplasmic reticulum (E ) & i.e., Mitochondria
Elongation takes place in microsomal system (endoplasmic reticulum) and mitochondrial system.
| 1 |
ac
|
bc
|
ad
|
b
|
Biochemistry
| null |
f54e86e5-ca05-46c7-9503-f0476b06088b
|
single
|
The term erythroderma is applied when any inflammatory skin disease affects more than ___ of body surface area
|
Erythroderma is involvement of more than 90% of skin in any disorder.
| 3 |
70%
|
80%
|
90%
|
100%
|
Dental
| null |
d811a79a-4915-49f1-97ef-5ecd4cad6670
|
single
|
Which of the following statements is true regarding digital clubbing?
| null | 2 |
Clubbing always indicates heart disease
|
Clubbing is seen in pulmonary arteriovenous fistula
|
Clubbing is common in cirrhosis of the liver
|
Presence of clubbing warrants a search for sickle cell disease
|
Medicine
| null |
6fd25136-792d-41d6-b52b-daa541e4a3d5
|
multi
|
An intrauterine pregnancy of approximately 10 weeks gestation is confirmed in a 30 year old, gravida 5, para 4 woman with an IUD in place. The patient expresses a strong desire for the pregnancy to be continued. On examination, the string of the IUD is noted to be protruding from the cervical os. The most appropriate course of action is to:
|
A woman with an IUCD in place, with amenorrhea should have a pregnancy test and pelvic examination.
An intrauterine pregnancy can occur and continue successfully to term with an IUCD in place.
A. If an intrauterine pregnancy is diagnosed and IUCD strings are visible:
IUCD should be removed as soon as possible in order to prevent septic abortion, premature rupture of membranes, and premature birth. Also do an USG to know whether it is intrauterine or ectopic pregnancy.
B. If an intrauterine pregnancy is diagnosed and IUCD strings are not visible:
An ultrasound examination should be performed to localize the IUCD and determine whether expulsion has occured.
If the IUCD is present there are 3 options for management.
i. Therapeutic abortion
ii. If IUCD is not fundal in location: ultrasound guided intrauterine removal of IUCD.
iii. If IUCD is present in fundus of uterus: it should be left in place and pregnancy continued with the device left in place.
If pregnancy continues with the device in place, the patient should be warned of the symptoms of intrauterine infection like fever or flue like symptoms, abdominal cramping or bleeding.
At the earliest sign of infection, high dose intravenous antibiotic therapy should be given and the pregnancy evacuated promptly.
Note: Fetal malformations have not been reported to be increased with a device in place.
| 3 |
Leave the IUD in place without any other treatment
|
Remove the IUD to decrease the risk of malformations
|
Remove the IUD to decrease the risk of infection
|
Terminate the pregnancy because of the high risk of malformations.
|
Gynaecology & Obstetrics
| null |
fcc9075d-0fc0-4c1a-84be-fd440cf52dd1
|
single
|
First extensor compament of wrist have which of the following structures
|
Tendon of extensor carpi radialis longus and extensor carpi radialis brevis pass through the second compament of extensor retinaculum.Tendon of extensor digiti minimi passes through the sixth compament.B D Chaurasia 7th edition Page no: 137
| 1 |
Extensor pollicis brevis
|
Extensor carpi radialis longus
|
Extensor carpi radialis brevis
|
Extensor digiti minimi
|
Anatomy
|
Upper limb
|
1afe2056-678b-4871-8d40-9b0fae6cdc40
|
single
|
A 25 year old pregnant female with gestational diabetes came to OPD at 30 weeks of gestation for routine antenatal checkup. Her sugars are uncontrolled. Her fundal height was found to be 36 cm and abdominal skin appears excessively stretched and shiny. Her previous antenatal USG repos were normal. What could be the most probable diagnosis?
|
Fundal height normally correlates (in cms) with gestational age in weeks (from 16 to 36 weeks). The possible reason for increased fundal height could be : Polyhyramnios, Fibroids, Twin pregnancy, H. Mole, Big baby (Fetal macrosomia) Normal previous USGs rules out fibroid, twin pregnancy and H. Mole. According the above given case scenario the most probable cause is polyhydramnios (as the patient is a known case of gestational diabetes which is a risk factor for polyhydramnios).
| 2 |
Uterine fibroids
|
Polyhydramnios
|
Twin gestation
|
Oligohydramnios
|
Gynaecology & Obstetrics
|
Amniotic Fluid Dynamics
|
0fda7016-f3c1-423c-8f97-4f3f78cf806b
|
single
|
All of the following are criteria for irritable bowel syndrome except -
|
<p>Davidson&;s principles and practice of medicine 22nd edition. *Romelll criteria. * abdominal pain or discomfo associated with 2 or more of the following # improvement with defecation #change in frequency of stool. #change in appearance of stool </p>
| 2 |
Change in frequency of stool
|
Blood & mucus in stool
|
Change in form ofstool
|
Improves with defecation
|
Medicine
|
G.I.T
|
49676914-c70d-4fd7-b34d-50f4d0092cd7
|
multi
|
Bosniak classification is for?
|
The Bosniak classification system of renal cystic masses divides renal cystic masses into five categories based on imaging characteristics on contrast-enhanced CT. It is helpful in predicting a risk of malignancy and suggesting either follow up or treatment. Classification: Bosniak I -Simple cyst , imperceptible wall; Work up:nil; Percentage malignant: ~0% Bosniak 2 - Minimally complex, a few thin <1 mm septa or thin calcifications (thickness not measurable); non-enhancing high-attenuation (due to proteinaceous or haemorrhagic contents) renal lesions of less than 3 cm are also included in this category; these lesions are generally well marginated; Work-up: nil; Percentage malignant: ~0% Bosniak 2F - Minimally complex, increased number of septa, minimally thickened with nodular or thick calcifications there may be perceived (but not measurable) enhancement of a hairline-thin smooth septa hyperdense cyst >3 cm diameter, mostly intrarenal (less than 25% of wall visible); no enhancement; Requiring follow-up: needs ultrasound/CT follow up - no strict rules on the time frame but reasonable at 6 months; Percentage malignant: ~ 5% Bosniak 3 - Indeterminate thick, nodular multiple septa or wall with measurable enhancement, hyperdense on CT; Work-up: paial nephrectomy or radiofrequency ablation in elderly or poor surgical candidates; Percentage malignant: ~55% Bosniak 4 - Clearly malignant solid mass with a large cystic or a necrotic component; Treatment: paial or total nephrectomy; Percentage malignant: ~100%.
| 2 |
Renal tuberculosis
|
Renal cysts
|
RCC
|
VUR
|
Surgery
|
Urology
|
e8b7862d-0999-4d2c-97c4-2d3b82c91295
|
single
|
Most powerful cloning vector ?
|
Most powerful cloning vector is cosmid as largest DNA can be incorporated in cosmid.Overall, most powerful cloning vector is YAC (Yeast aificial chromosome).
| 3 |
Plasmid
|
Virus
|
Cosmid
|
Phage
|
Biochemistry
| null |
fde82106-4fad-48c2-bbc7-cc0f4206579d
|
single
|
Bacterial species seen in skin ?
|
Ans. is 'd' i.e., Propionobacterium
| 4 |
Lactobacillus
|
Streptococcus pneumonia
|
Bacterioides fragilis
|
Propionobacterium
|
Microbiology
| null |
4bc26a2f-c6a6-4f39-bf18-a82f3331f8e5
|
single
|
End-Product of the action of salivary amylase is
|
Salivary alpha-amylase hydrolyse the alpha-1,4-glycosidic linkage, so as to produce smaller subunits like maltose, isomaltose, dextrins and oligosaccharides.Ref: DM Vasudevan, page no: 39
| 2 |
Mannose
|
Maltose
|
Sucrose
|
Fructose
|
Biochemistry
|
Metabolism of carbohydrate
|
9fc7e316-3a89-4401-a1d8-c522aa165233
|
single
|
The oesophgus commences at the following level?
|
A. i.e. Lower end of Cricoid
| 1 |
Lower end of cricoid
|
C5 veebra
|
10cm from incisor teeth
|
C7
|
Anatomy
| null |
bcf3912a-d32f-4525-b5df-8659601b7120
|
single
|
33-years-old alcoholicon ATT presents with increased serum iron & increased transferrin saturation. Diagnosis?
|
Ans. (b) Sideroblastic anemia(Ref: Wintrobe's 12th/pg 847-848)This is an Alcoholic patient on Anti TB drugs (isoniazid, pyrazinamide) who presents with features of iron overload on iron studies (increased serum iron & increased transferrin saturation). These features are suggestive of sideroblastic anemia.
| 2 |
Iron deficiency anemia
|
Sideroblastic anemia
|
Megaloblastic anemia
|
Anemia of chronic disease
|
Pathology
|
Misc. (R.B.C)
|
c55c828b-8e75-4f99-b282-ce46df46a6e3
|
single
|
Endogenous chemoattractants are all except -
|
Endogenous Chemoattractants include LTB4, complement system C5, chemokines, but not integrins. Integrins are cell matrix adhesion molecules. Integrins are proteins that function mechanically, by attaching the cell cytoskeleton to the extracellular matrix (ECM), and biochemically, by sensing whether adhesion has occurred. The integrin family of proteins consists of alpha and beta subtypes, which form transmembrane heterodimers. Basic Pathology, Robbins. Page no.:36
| 2 |
C5a
|
Integrins
|
LTB4
|
IL 8
|
Pathology
|
General pathology
|
12245d56-8392-4ec1-8df5-4d5bc1c43859
|
multi
|
Nodular regenerating hyperplasia is associated with -
|
Nodular regenerative hyperplasia of the liver This is the most common cause of non-cirrhotic poal hypeension in developed countries; it is characterised by small hepatocyte nodules throughout the liver without fibrosis, which can result in sinusoidal compression. It is believed to be due to damage to small hepatic aerioles and poal venules. It occurs in older people and is associated with many conditions, including connective tissue disease, haematological diseases and immunosuppressive drugs, such as azathioprine. The condition is usually asymptomatic but occasionally presents with poal hypeension or with an abdominal mass. The diagnosis is made by liver biopsy, which, in contrast to cirrhosis, shows nodule formation in the absence of fibrous septa. Liver function is good and the prognosis is very ourable. Management is based on treatment of the poal hypeension. Ref Davidson edition23rd pg899
| 3 |
Budd-chiari syndrome
|
Alcohol
|
Drug
|
Hepatitis B
|
Medicine
|
G.I.T
|
ffb04237-eae5-47a9-8727-1bbe8b65f1e9
|
single
|
In an emergency room an alcoholic patient enters with hematemesis. On examination he has ascites with splenomegaly and gynecomastia. Etiology is
|
Ans. (b) Portal hypertension due to alcholic cirrhosisRef: Sabiston 20th edition Page 1437* Clinical features and findings suggest that the patient is a known case of Alcoholic cirrhosis with portal hypertension.* So most common cause in him is Varices bleeding
| 2 |
Portal hypertension secondary to viral hepatitis
|
Portal hypertension due to Alcoholic cirrhosis
|
Budd chiari syndrome
|
Primary sclerosing cholangitis
|
Surgery
|
Liver
|
d4d511fc-c4e3-4893-8caf-545b4184b384
|
single
|
All are true about chronic SDH except:
|
Chronic SDH Caused bysignificant trauma, can present weeks after tril injury. Most patients are symptomatic but patient can be completely asymptomatic. Treated by burr hole/craniotomy, twist drill craniostomy with subdural drains. Clinical improvement occurs when subdural pressure is close to zero, which usually occurs after almost 20 percent of the collection has been removed. Residual subdural fluid collections are common and may take upto 6 months for complete resolution. Use of a subdural drain is associated with a decreased need for repeat surgery
| 1 |
Immediate recovery after surgery
|
Presents weeks after tril injury
|
Patient can be completely asymptomatic
|
Use of a subdural drain is associated with a decreased need for repeat surgery
|
Surgery
|
JIPMER 2018
|
91c17fcd-6724-40a7-8bb2-1133611744f7
|
multi
|
Bilateral consonants are ?
|
Ans. is 'b' i.e., PbMW Pronounced or aiculated with both lips, as the consonants b, p, m, and w. Baby stas producing bilabial words by 4th month of age.
| 2 |
Pb9
|
PbMW
|
MW
|
TLMW
|
Pediatrics
| null |
d7dadb6b-7dab-41d3-b6b1-088681543ce9
|
single
|
Retention in a stainless steel crown is achieved primarily by:
| null | 4 |
Chamfer
|
Cement
|
Parallel distal and mesial walls
|
Crimping the crown to engage buccal & lingual undercuts
|
Dental
| null |
4bb6e707-29c3-460d-aa9c-0130314afabb
|
multi
|
Which of the following are antigen-presenting cells?
|
Neutrophils are one of the primary defense cells of the innate immune system. T-lymphocytes are important activators of the specific (adaptive) immune system. Macrophages are antigen presenting cells. Plasma cells produce antibodies.
| 3 |
Neutrophils
|
T-lymphocytes
|
Macrophages
|
Plasma cells
|
Dental
| null |
7abf2236-ecf7-45b4-bb29-6aa0237666a2
|
single
|
A 32-years old male with suspected neurofibroma, tosis was found to have a blood pressure of 178/110 mm Hg at a recent health fair. He complained of palpitations and excessive sweating. Today he presents to the clinic for a checkup because he has developed abdominal discomfo. His blood pressure is now recorded to be 130/80 mm Hg. Physical examination reveals multiple tumors of the oral mucosa and skin. Laboratory investigations reveal: Serum K+ : 3.8 mEq/L (N : 3.5-5.0 mEq/L) Serum Ca2+: 136 mEq/L (N : 135-145 mEq/I,) Serum Ca2+ : 9.4 mg/dL (N : 8.4-10.2 mg/dL) d 14) Genetic studies in this patient will most likely show -
|
The RET proto-oncogene encodes a receptor tyrosine kinase for members of the glial cell line-derived neurotrophic factor (GDNF) family of extracellular signalling molecules.RET loss of function mutations are associated with the development of Hirschsprung's disease, while gain of function mutations are associated with the development of various types of human cancer, including medullary thyroid carcinoma, multiple endocrine neoplasias type 2A and 2B, pheochromocytoma and parathyroid hyperplasia Ref Davidson 23rd edition pg 1057
| 4 |
N-myc amplification
|
Overexpression of C-kit
|
K-ras mutation
|
RET oncogene
|
Medicine
|
Miscellaneous
|
b28c6225-e07d-4c85-96e3-2217c38ca550
|
single
|
The gross specimen section of kidney depicts:
|
The specimen shows an enlarged kidney with cysts of varying sizes in both coex and medulla. Minimal normal kidney tissue is present and there is a complete loss of coicomedullary gradient. Choice B is ruled out as it has small shrunken kidneys. The gross specimen section of kidney depicts : Polycystic kidney Gross specimen differentiating features Very large kidneys, mass of cysts of varying sizes with no intervening parenchyma. Cysts are filled with fluid, which may be clear, turbid, or hemorrhagic
| 3 |
Renal cell carcinoma
|
Medullary cystic kidney
|
Polycystic kidney
|
Hydatid cyst
|
Medicine
|
Polycystic Kidneys
|
88cc49a8-25e9-4be1-9b02-42b460d0ca01
|
single
|
Indications of FESS
|
INDICATIONS : 1. Chronic bacterial sinusitis unresponsive to adequate medical treatment. 2. Recurrent acute bacterial sinusitis. 3. Polypoid rhinosinusitis (diffuse nasal polyposis). 4. Fungal sinusitis with fungal ball or nasal polypi. 5. Antrochoanal polyp. 6. Mucocele of frontoethmoid or sphenoid sinus. 7. Control of epistaxis by endoscopic cautery. 8. Removal of foreign body from the nose or sinus. 9. Endoscopic septoplasty. Ref: Dhingra 7e pg 477
| 1 |
Inveed papilloma
|
Nasal allergic polyposis
|
Mucocele
|
Carcinoma of maxilla
|
ENT
|
Diagnostic and operative ENT
|
1bd3b507-f689-4088-966a-436a64e7b995
|
multi
|
As compared to unfractionated heparin, low molecular weight heparins
|
Low molecular weight heparin has higher subcutaneous bioavailability. Lab monitoring is not required unlike heparin. LMWH has lower risk of osteoporosis and lower incidence of thrombocytopenia. From medical pharmacology padmaja 4th edition Page no 337, 339
| 1 |
Are absorbed more uniformly when given subcutaneously
|
Require more frequent laboratory monitoring
|
Cannot be given to patients with heparin induced thrombocytopenia
|
Predispose to a higher risk of osteopenia
|
Pharmacology
|
Hematology
|
42c5020d-6eb1-4869-ae07-99b7727b7022
|
single
|
Which of the following tendons has attachments on sustentaculum tali?
|
SUSTENTACULUM TALI:- Medial surface of calcaneum bone is concave from above downwards.The concavity is attenuated by the presence of a shelf like projection of bone, called the sustentaculum tali.The groove on the lower surface of sustentaculum tali is occupied by tendon of FHL.Medial margin is related to tendon of flexor digitorum longus. Attachments:-1. Spring ligament.2. Tibialis posterior 3. Superficial fibres of deltoid ligament.4. Medial talocalcanean ligament. Origin to medial head of flexor digitorum accessorius. {Reference: BDC 6E pg no.33}
| 2 |
Tibialis anterior
|
Tibialis posterior
|
Flexor digitorum longus
|
Flexer hallucis longus
|
Anatomy
|
Lower limb
|
a7d06fbb-754a-4758-88e6-0796ed033fa4
|
multi
|
Buttressing bone formation is a
| null | 3 |
Process which is always peripheral
|
Occurs normally
|
Occurs when excessive occlusal forces are present
|
Process which is always endosteal
|
Dental
| null |
806d6549-5ea0-4f0f-8448-95cf02f8541c
|
multi
|
Quaernary ammonium compound disinfectants are ?
|
Quaternary ammonium compounds are cationic detergents. They have microcidal and viricidal activities. They can be used for instrument disinfection and skin antisepsis.
| 2 |
Anionic
|
Cationic
|
Neutral
|
Gases
|
Biochemistry
| null |
e47d1972-5671-4f25-a80c-9377f7d1cbf7
|
single
|
In exhaled air, normal pCO2 pressure is:
|
(Refer: Ganong’s Review of Medical Physiology, 24th edition, pg no: 635)
| 2 |
36 mm Hg
|
27 mm Hg
|
40 mm Hg
|
17 mm Hg
|
Unknown
| null |
dc33294d-92d8-4d81-97f2-bca140b327b9
|
single
|
True about fluorescent antibody detection test in the diagnosis of Plasmodium falciparum are all except?
|
The diagnosis of malaria involves identification of malarial parasite or its antigens/products in the blood -
The diagnosis of malaria is confirmed by blood tests and can be divided into microscopic and nonmicroscopic tests.
1) Microscopic test
For nearly a hundred years, the direct microscopic visualisation of the parasite on the thick and/or thin blood smears has been the accepted method for diagnosis.
The careful examination of a well prepared and well-stained blood film currently remains the "gold standard" for malaria diagnosis.
2) Non-Microscopic tests
Although the peripheral blood smear examination that provides the most comprehensive information on a single test format has been the "gold standard" for the diagnosis of malaria, the immunochromatographic tests for the detection of malarial antigens developed in the past decade have opened a new and exciting avenue in the malaria diagnosis.
Immunochromatographic test for malaria antigens -
Immunochromatographic tests are based on the detection of the parasite antigens from the peripheral blood using either monoclonal or polyclonal antibodies against the parasite antigen targets.
Currently, immunochromatographic tests can target the:-
Histidine-rich protein 2 of Plasmodium falciparum
Pan malarial Plasmodium aldolase
Parasite-specific lactate dehydrogenase.
Histidine-rich protein 2 of Plasmodium falciparum (PFHRP2)
It is a water-soluble protein that is produced by the asexual stages and gametocytes of Plasmodium falciparum, expressed on the red cell membrane surface and shown to remain in the blood for at least 28 days after the initiation of antimalarial therapy.
Plasmodium aldolase
It is an enzyme of the parasitic glycolytic pathway expressed by the blood stages of P. falciparum as well as non falciparum malarial parasites.
Monoclonal antibodies against plasmodium aldolase are panspecific in their reaction and have been used in a combined Rfalciparum/P.vivax immunochromatographic tests that targets the pan malarial antigen along with PFHRP2.
Parasite lactate dehydrogenase -
The first rapid diagnostic tests were using P.falciparum glutamate dehydrogenase as antigen P.falciparum gutamate dehydrogenase were soon replaced by P. falciparum lactate dehydrogenase.
It is a soluble glycolytic enzyme produced by the asexual and sexual stages of the live parasite and it is present in and released from the parasite infected.
It has been found in all four human malarial species and different isomers of pLDH for each of the four species exist.
Other tests for malaria parasites -
Polymerase chain reaction -
Polymerase amplification can also be used to detect malarial parasites.
In travellers returning to developed countries studies based on PCR have been found to be highly sensitive and specific for detecting all species of malaria particularly in cases of low-level parasitemia and mixed infections.
The PCR test is reportedly tenfold more sensitive than microscopy.
Detection of antimalarial antibodies -
Antibodies to the asexual blood stages appear a few days after malarial infection, increase in titre over the next few weeks and persists for months or years in semi-immune patients in endemic areas where re-infection is frequent.
In non-immune patients, antibodies fall more rapidly after treatment for a single infection and are undetectable in 3-6 months.
Reinfection/relapse induces a secondary response with a rapidly increasing antibody titre.
Malarial antibodies can be detected by immunofluorescence or enzyme immunoassay. It is useful in epidemiological surveys for screening potential blood donors and occasionally for providing evidence of recent infection in non-immunes.
Intraleucocyte malarial pigment -
Intraleucocyte malaria pigment has been suggested as a measure of disease severity in malaria.
Flowcytometry
Flowcytometry and automated hematology analyzers have been found to be useful in indicating a diagnosis of malaria. In cases of malaria, abnormal cell clusters and small particles with DNA fluorescence probably free malarial parasites have been seen on automated hematology analyzers and it is suggested that malaria can be suspected based on the scatter plots produced on the analyzer.
Mass spectrometry
A novel method for the in vitro detection of the malaria parasite at a sensitivity of 10 parasites/ 1 of blood has been recently reported.
| 2 |
It is an immunochromatographic test
|
Detection of histidine rich protein 1
|
Detection of lactate dehydrogenase antigen
|
Detection of glutamate dehydrogenase antigen
|
Medicine
| null |
d8e24580-444e-4b1e-abd1-4517671caa9b
|
multi
|
A 21-year-old medical student suffered a needle stick injury. The patient has a history of illicit intravenous drugs abuse. One month later, the medical student develops jaundice. Which of the following findings would implicate hepatitis B as the etiology?
|
The presence of hepatitis B surface antigen means actively replicating virus, and in the context of the history of recent needle-stick injury, this likely represents a hepatitis B infection. During the acute episode of disease, when there is active viral replication, large amounts of HBsAg and hepatitis B virus DNA can be detected in the serum, as can fully developed virions and high levels of DNA polymerase and HBeAg. Upon resolution of acute hepatitis B, HBsAg and HBeAg disappear from serum with the development of antibodies (anti-HBs and anti-HBe) against them. The development of anti-HBs is associated with elimination of infection and protection against reinfection. Anti-HBc is detected early in the course of disease and persists in serum for years. It is an excellent epidemiologic marker of infection, but is not protective. In patients with chronic hepatitis B, evidence of viral persistence can be found in serum. HBsAg can be detected throughout the active disease process, and anti-HBs does not develop, which probably accounts for the chronicity of the disease. However, anti-HBc is detected. Ref: Ray C.G., Ryan K.J. (2010). Chapter 13. Hepatitis Viruses. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e.
| 1 |
Positive hepatitis B surface antigen
|
Positive antihepatitis B surface antibody
|
Positive antihepatitis A antibody
|
Positive antihepatitis B-core antibody
|
Microbiology
| null |
916ff9d1-16ef-4ca7-a46c-864886bc3e1d
|
single
|
MRI can detect
|
(All of the above) (6, 11-S. Bhadury 2nd essentials of radiology and imaging) (133-35-B & L 25th) Disadvantage of MRI * Very high cost of imaging * Inability to image bone and calcium * It is unsuitable for patients with cardiac pacemakers and other ferromagnetic implants. * Imaging time is long, hence movement or motion artifacts are quite likely. * Highly operator-dependent, hence requires technical expertise Fluoroscopy is particularly valuable in (a) The selection of the optimum tangential projection in encysted pleural effusion. (b) In suspected obstructive emphysema especially following inhalation of a foreign body. (c) In the assessment of diaphragmatic function (d) In the assessment of the proximity of a peripheral pulmonary lesion to the thoracic cage and pleura
| 4 |
Magnetic FB
|
Iron FB
|
Wooden foreign body
|
All of the above
|
Unknown
| null |
617af05c-59f3-48de-9f94-b4ebe0027213
|
multi
|
Characteristic lab findings of hemophilia A are –a) ↑ PTb) ↑ aPTTc) X–linked recessived) Presence of 30% of factor level express the diseasee) Increased bleeding time
|
Hemophilia A
Hemophilia A is due to deficiency offactor VIII.
Hemophilia 'A' is inherited as an X-linked recessive trait.
Factor VIII is an intrinsic pathway component required for activation of factor X.
Clinical manifestations are due to defect in coagulation system -
Large post-traumatic ecchymoses or hematoma
Prolonged bleeding after a laceration or any form of surgical procedure.
Bleeding into weight bearing joints.
Petechiae are characteristically absent (in contrast to platelet dysfunction where bleeding occurs from small vessels of the skin and mucous membrane, e.g. petechiae).
Laboratory findings
PIT
Normal PT
Normal BT
Normal platelet counts
Remember
Hemophilia B (Christmas disease) is due to deficiency of factor IX
Hemophilia B has clinical features and laboratory findings similar to haemophilia A.
| 4 |
a
|
c
|
ac
|
bc
|
Pediatrics
| null |
bead378e-5abd-4b58-a926-28f13a9a6a89
|
single
|
Complication of trauma to danger area of face -
|
Ans. is 'a' i.e., Cavernous sinus infection o The area of upper lip and the lowrer part of nose is the danger area of face. It is due to that this area is the common site of infection.o This area is drained by facial vein wrhich communicates with the cavernous sinus through the superior ophthalmic vein and pterygoid venous plexus through the emissary vein,o In case of any infection of this area it may spread to the cavernous sinus causing infection and/or thrombosis.
| 1 |
Cavernous sinus infection
|
Meningitis
|
Visual loss
|
Loss of memory
|
ENT
|
Nose and PNS
|
f0a46c0f-e551-46e6-bb1b-1ae140b5f972
|
single
|
The drugs not used for treatment of osteoporosis are -
|
A.General 1.Bedrest 2.Local heat 3.Analgesics 4.Exercise: Regular walking or other weight bearing exercise for 1 hour 3 times a week protects bone mass 5.Prevention of injury (most hip and wrist fractures are caused by falls). 6.Excessive thyroid hormone replacement therapy should be avoided. B.Antiresorptive agents 1.Oestrogen: Oestrogen 0.625 mg + Medroxyprogesterone (cyclic progestin) 5-10 mg per day 10-14 days/month. Progesterone to be added to prevent endometrial carcinoma. Transdermal oestrogen patches are used to avoid deep vein thrombosis and pulmonary embolism. Oestrogen therapy is impoant in women with premature or surgical menopause. Contraindications of oestrogen therapy are carcinoma breast or endometrial cancer, recurrent thromboembolic disease, acute liver disease and unexplained vaginal bleeding. 2.Calcium: The recommended daily calcium intake for postmenopausal women is 1,500 mg, and 1,000 mg for premenopausal women. 3.Calcitonin: Salmon calcitonin for 1-2 years increases veebral bone density and decreases the risk of veebral fracture. The usual dose is 50 IU SC per day 3 times a week. (salmon calcitonin 200 units/day as nasal spray). The side effects are nausea, flushing, and rarely allergic reactions. 4.Bisphosphonates: They specifically impair osteoclast function and reduce osteoclast number paly by induction of apoptosis. a.Alendronate 5-10 mg/day b.Risedronate 5 mg/day The prominent adverse effect is esophageal irritation and hence both should be taken with a full glass of water and the patient should remain upright for 30 min after taking the drug. c.Etidronate is given as an intermittent cyclical regimen, 400 mg orally for 2 weeks, has some efficacy against veebral fractures. 5.Selective oestrogen receptor modulators (SERMS) a.Raloxifene 60 mg/day b.Tamoxifen Both reduce bone turnover and bone loss in postmenopausal women. In addition Tamoxifen is beneficial in women at increased risk of breast cancer and Raloxifene reduces serum total and LDL cholesterol, Lp (a), and fibrinogen. C.Bone forming agents a.Fluoride--75 mg/day b.Anabolic steroids: Testosterone is used in the treatment of osteoporotic man with gonadal deficiency. D.Supplementation of Vitamin D metabolites and thiazide diuretics. R ALAGAPPAN MANUAL OF PRACTICAL MEDICINE FOUH EDITION PAGE NO-691,692
| 2 |
Biphosphonates
|
Steroids
|
Denosumab
|
Calciam
|
Medicine
|
Endocrinology
|
b27f51e1-eb0b-48cb-b9db-3756e8b8fb44
|
single
|
Which type of pelvis is associated with increased incidence of ‘face to pubis’ delivery?
|
As discussed in the text in Table 1.1 face-to-pubis delivery is common in anthropoid pelvis.
| 2 |
Gynaecoid pelvis
|
Anthropoid pelvis
|
Android pelvis
|
Platypelloid pelvis
|
Gynaecology & Obstetrics
| null |
66362243-deb3-44bf-921b-9e138e917749
|
single
|
In a survey, many children are examined and were found to have urogenital abnormalities. Which congenital anomaly is associated with increased risk of bladder carcinoma.
|
Ans is b ie Bladder exstrophy Congenital anomalies associated with increased risk of bladder cancer are: - patent urachus - exstrophy bladder - Both increase the risk for adenocarcinoma.
| 2 |
Medullary sponge kidney
|
Bladder exstrophy
|
Unilateral renal agenesis
|
Double ureter
|
Surgery
| null |
ea2485ab-d8aa-47d3-bf19-d12c864e5f8e
|
single
|
Renal osteodystrophy is due to:-
|
Renal rickets/ renal osteodystrophy - This is seen in patients with chronic renal failure. Renal rickets is mainly due to decreased synthesis of calcitriol in kidney. lt can be treated by administration of calcitriol.
Reference: Satyanarayana- Biochemistry, 3rd edition, pg-128
| 3 |
Increased synthesis of calcitriol in kidney
|
No synthesis of calcitriol in kidney
|
Decreased synthesis of calcitriol in kidney
|
Fluctuating production of calcitriol in kidney
|
Biochemistry
| null |
0dea65bf-079e-476c-8837-48fe2011586b
|
single
|
A 35 year old athlete has height 184 cm., arm span 194 cm., pulse rate 64/min., BP 148/64 mm Hg. Chest auscultation reveals long diastolic murmur over right 2nd intercostal space on routine examination. The probable diagnosis is :
|
Answer is A (A.R.): Arm span greater than height is suggestive of Marfan's syndrome. Aoic regurgitation (A.R.) is a feature associated with Marfans as well as consistent with a diastolic murmur is second right intercostal space.
| 1 |
Aoic regurgitation
|
Atrial septal defect
|
Ebstein anomaly
|
Coarctation of aoa
|
Medicine
| null |
4f2068ff-b32f-4526-8879-395802e93110
|
single
|
Active metabolite form in synthesis of fatty acid is:-
|
Staing material in FA synthesis is Acetyl CoA Acetyl CoA (2C) - Malonyl CoA -Used for FA Synthesis Malonyl CoA is the Main active metabolite used. Each time during elongation of fatty acid chain the addition of 2C carbons taking place are derived from malonyl CoA. So, it the active metabolite of fatty acid synthesis.
| 2 |
Acetyl CoA
|
Malonyl CoA
|
Stearate
|
Palmitate
|
Biochemistry
|
NEET 2018
|
766bd6df-78a7-4255-a185-cc72d3a21fb8
|
single
|
Which of the following drug needs no dose modification in TB with CRF?
|
In CRF we can give full dose of rifampicin because this drug is completely metabolize in liver
| 2 |
Ethambutol
|
Rifampicin
|
INH
|
Pyrazinamide
|
Anatomy
|
All India exam
|
62dbbcda-db62-4c45-8529-feb80388b7a2
|
single
|
A 35 years old mother of two children is suffering from amenorrhea for last 12 months. She has history of failure of lactation following 2nd delivery but remained asymptomatic thereafter. Skull X-ray shows "Empty sella". Most likely diagnosis is:
|
Amenorrhea, failure of lactation and "Empty sella" in skull X-ray give the diagnosis of Sheehan's syndrome. Ref: Current Obs and Gynae Diagnosis and Treatment 8th Edition, Page 446 ;Internal Medicine: An Illustrated Radiological Guide By Jarrah Ali Al-Tubaikh, 2010, Page 247
| 3 |
Menopause
|
Pituitary tumor
|
Sheehan's syndrome
|
Intraductal papilloma of breast
|
Gynaecology & Obstetrics
| null |
3664e5c1-e199-4119-9796-62aea6a56ffd
|
single
|
15-year-old girl presented with primary amenorrhea with orderly appearance of secondary sexual characteristics like breast and pubic hair. What is the next best step for this patient:
|
In the question the girl is 15 yrs with normal secondary sexual characteristics, she is a case of primary amenorrhea and needs evaluation (reassurance could have been given had the patient been younger than 15 years) The next impoant step would be an USG to check whether she has normal mullerian structures (uterus and tubes) and ovaries or not Hormonal studies and karyotyping are done subsequently to find out the cause.
| 2 |
Reassure
|
USG
|
HSG
|
Hormonal study
|
Gynaecology & Obstetrics
|
Normal Menstruation, Abnormal Menstruation, Menopausal Physiology and forsight of conception
|
b419265e-84d7-41ca-9228-8e27aaf8dd95
|
multi
|
Optic cup give rise to ?
|
Ans. is `b' i.e., RetinaThe inner layer of optic cup forms the main structure of the retina. From its anterior border develop pas of ciliary body and iris.
| 2 |
Lens
|
Retina
|
Cornea
|
Sclera
|
Anatomy
| null |
ad223f30-3c4a-4844-9863-0997df424bbe
|
single
|
A 6-year-old child with recurrent UI with mouth breath ing and failure to grow with high arched palate and impaired hearing should be managed by
|
The child is having recurrent UI with high arched palate and failure to grow which indicates child is having adenoids and since there is impaired hearing it means child has developed otitis media as a complication. Hence logically the child should be treated with adenoidectomy with grommet inseion. Ref:- Scott Brown; pg num:- 896-906
| 3 |
Tonsillectomy
|
Myringotomy with grommet inseion
|
Adenoidectomy with grommet inseion
|
Grommet inseion
|
ENT
|
Pharynx
|
ca80dc40-833b-474b-bcb8-ae5ceae1876f
|
single
|
Transamination reaction requires which vitamin?
|
Pyridoxal phosphate (active form of vitamin B6) is the coenzyme for transamination reactions.
| 2 |
Thiamine
|
Pyridoxin
|
Riboflavin
|
Pentothenic acid
|
Biochemistry
| null |
d5d7f477-add8-424d-a05f-7d29840c5161
|
single
|
Osgood schlatters disease involves?
|
Ans. (a) Tibial tuberosityRef.-.Apley's system of orthopaedics and fractures edited by Louis Solomon, dividwarwicky selvadurainayagam 9/e, p 575-576y 887)
| 1 |
Tibial tuberosity
|
Femoral condyle
|
Lateral malleolus
|
Medial malleolus
|
Orthopaedics
|
Avascular Necrosis
|
7092856a-2b6f-4517-a787-da7f70051b54
|
multi
|
A 28 years old male presented with diarrhea for 6 months. On examination the causative agent was found to be acid fast with 12 micrometer diameter. What is the MOST likely causative agent?
|
Cyclospora oocysts take days or weeks to become infectious, and because of this, direct person to person transmission through fecal exposure is unlikely to occur. Cyclosporiasis has been linked to waterborne and foodborne infections. Altered mucosal architecture with shoening of intestinal villi due to diffuse edema and infiltration of inflammatory cells leads to diarrhea, anorexia, fatigue, and weight loss. The duration of symptoms among untreated, non immune persons is often prolonged but ultimately self-limited, with remitting-relapsing symptoms lasting up to several weeks or months. The incubation period for Cyclospora infections is about 1 week, similar to infections with Cryptosporidium. The diagnosis can be made by detection of spherical 8- to 10-m oocysts in the stool, although routine stool ova and parasite (O+P) examinations are not sufficient. Specific fecal examinations must be requested to detect the oocysts, which are variably acid-fast and are fluorescent when viewed with ultraviolet light microscopy. All the parasites mentioned in the question cause chronic diarrhea (mostly in immunocompromised patients). All of them reveal oocyst on stool examination. In Giardiasis, parasite is also seen along with oocyst stool examination. Oocyst of all the organisms except giardia are acid fast. The diagnosis rests on the size of the oocyst. Ref: Brooks G.F., Carroll K.C., Butel J.S., Morse S.A., Mietzneron T.A. (2010). Chapter 46. Medical Parasitology. In G.F. Brooks, K.C. Carroll, J.S. Butel, S.A. Morse, T.A. Mietzneron (Eds), Jawetz, Melnick, & Adelberg's Medical Microbiology, 25e.
| 3 |
Cryptosporidium
|
Isospora
|
Cyclospora
|
Giardia
|
Microbiology
| null |
323eeeff-a9e0-4765-8e51-36fecc9a3c6b
|
single
|
Ecthyma gangrenosum in a neutropenic patient is caused by which of the following organism?
|
Ecthyma gangrenosum is a localized cellulitis with necrotizing and ulcerative evolution occurring in immunocompromised or neutropenic patients, mainly caused by Pseudomonas aeruginosa. Two pathogenic mechanisms are recognized; one occurring as the result of the presence of P. aeruginosa during bacteriemia, and the second as a primary lesion. Treatment is systemic antibiotics.
| 2 |
Fungal infection
|
Pseudomonas aeruginosa
|
Staphylococcus
|
Streptococcus
|
Skin
| null |
cd0ebcdc-c826-463f-97fc-0ed671ff8ab0
|
single
|
which of the following mumurs will increase with valsalva ?
|
HOCM REF: harrisons 21st ed
| 4 |
MR
|
VSD
|
AS
|
HOCM
|
Medicine
|
All India exam
|
983a0ac6-f6bd-457e-b272-36378d4f303f
|
single
|
Complement level is reduced in:
|
Ans. D. Membrane proliferative GNMembranoproliferative GlomerulonephritisCauses of Membranoproliferative Glomerulonephritis1. Type I Disease (Most Common)a. Idiopathicb. SLEc. Endocarditisd. Hepatitis Ce. Hepatitis Bf. Mixed cryoglobulinemiag. Cancer: Lung, breast, and ovary (germinal)2. Type II Disease (Dense Deposit Disease)a. Idiopathicb. C3 nephritic factor-associatedc. Partial lipodystrophy3. Type III Diseasea. Idiopathicb. Complement receptor deficiencyClinical Featurea. They present with microscopic to gross hematuria and selective or non - selective proteinuria depending on the severity of the disease.b. They have a poor prognosis, developing renal failure 5-10 years after diagnosis.c. Complement level is reduced
| 4 |
Minimal change
|
Membranous
|
Focal & segmental
|
Membrane proliferative GN
|
Medicine
|
Kidney
|
76e691a1-e1ed-4995-b0c6-60663d2fc493
|
single
|
The 23 valent pneumococci vaccine is recommended in all except -
|
Ans. is 'c' i.e., Children less then 2 years Pneumacoccal vaccine . There are two types of pneumococcal vaccines available : ? 1) Polyvalent (23 type) polysaccharide vaccine This polysaccharide vaccine represents the capsular antigen of 23 most prevalent serotypes. - It gives 80-90% protection which is long lasting (5 years). - It is not meant for general use, but only in persons at enhanced risk of pneumococcal infection such as those with absent or dysfunctional spleen; sickle cell disease, coeliac disease; Chronic liver or renal or lung or cardiac disease, DM, CSF leaks (meningeal disruption: dural tear) and; immunodeficiency including HIV infection. - It is not recommended in children under two years of age and those with lymphoreticular malignancies and immunosupprassive therapy. 2)Conjugate vaccine - A different pneumococcal vaccine containing pneumococcal polysaccharide coupled (conjugated) to a carrier protein (diphtheria toxoid) has been developed. - The vaccine contains the capsular polysaccharide of seven most common pneumococcal serotypes. - It can be given to children under the age of 2 years (but more than 6 weeks old).
| 3 |
CSF leak
|
Chronic cardiac disease
|
Chidren less than 2 years
|
Nephrotic syndrome
|
Microbiology
| null |
cefb8c6f-d30d-4af2-a65b-91a391c63025
|
multi
|
The drug of choice for schistosomiasis is:
|
This novel anthelmintic has wide ranging activity against Schistosomes, other trematodes, cestodes and their larval forms but not nematodes ESSENTIALS OF PHARMACOLOGY page no. 855
| 3 |
Albendazole
|
Metronidazole
|
Praziquantel
|
Triclabendazole
|
Pharmacology
|
Chemotherapy
|
a63d7667-8f01-480f-9ae8-354750e8c343
|
single
|
Most common cause of epidural abscess
|
Harrison's principles of internal medicine. * Staphylococci or gram negative organisms are the usual cause of an epidural abscess
| 1 |
Staphylococcus
|
Streptococcus
|
Gram negative bacilli
|
Microanerophilic anaerobic streptococci
|
Medicine
|
C.N.S
|
94334499-a6b2-4393-b3cc-f07406aa6bb9
|
single
|
Which one of the following is the description used for the term allodynia during pain management ?
|
Allodynia refers to perception of an ordinarily non-noxious stimulus as pain.
| 4 |
Absence of pain perception
|
Complete lack of pain sensation
|
Unpleasant sensation with or without a stimulus
|
Perception of an ordinarily non-noxious stimulus as severe pain
|
Anaesthesia
| null |
64419496-3fe2-45a0-934e-83113d927654
|
multi
|
Quinsy refers to ?
|
Ans. is 'b' i.e., Peritonsillar abscess Ouinsy (Peritonsillar abscess) Quinsy consists of suppuration outside the capsule in the area around the capsule. There is collection of pus between the capsule of tonsil and the superior constrictor muscle, i.e. in the peritonsillar area. Peritonsillar abscess is a complication of tonsillitis and is most commonly caused by group A beta - hemolytic streptococcus. Clinical features of Quinsy Clinical features are divided into :? 1) General : They are due to septicaemia and resemble any acute infection. They include fever (up to 104degF), chills and rigors, general malaise, body aches, headache, nausea and constipation. 2) Local : Severe pain in throat. Usually unilateral. Odynophagia. It is so marked that the patient cannot even swallow his own saliva which dribbles from the angle of his mouth. Patient is usually dehydrated. Muffled and thick speech, often called "Hot potato voice". Foul breath due to sepsis in the oral cavity and poor hygiene. Ipsilateral earache. This is referred pain CN IX which supplies both the tonsil and the ear. Trismus due to spasm of pterygoid muscles which are in close proximity to the superior constrictor. Examination findings The tonsil, pillars and soft palate on the involved side are congested and swollen. Tonsil itself may not appear enlarged as it gets buried in the oedematous pillars. Uvula is swollen and oedematous and pushed to the opposite side. Bulging of the soft palate and anterior pillar above the tonsil. Mucopus may be seen covering the tonsillar region. Cervical lymphadenopathy is commonly seen. This involves jugulodigastric lymph nodes. Toicollis : Patient keeps the neck tilted to the side of abscess. Treatment of peritonsillar abscess IV fluids Antibiotics : High dose penicllin. (iv benzipenicillin) is the DOC. In patients allergic to penicillin erythromycin is the DOC. Incision and drainage per orally, if the abscess does not resolve depite high dose of iv antibiotics. Tonsillectomy is done 6 weeks following an attack of quinsy (interval tonsillectomy).
| 2 |
Intra-tonsillar abscess
|
Peritonsillar abscess
|
Submandibular abscess
|
Retropharyngeal abscess
|
ENT
| null |
8af7fe0b-5f4d-43e3-a4d3-5493fbe79d69
|
single
|
In Colle's fracture, distal fragment is: March 2003
|
Ans. D i.e. All of the above
| 4 |
Shifted dorsally
|
Angulated laterally
|
Supinated
|
All of the above
|
Surgery
| null |
a889af18-37a2-4753-b59b-8dfae6fb164a
|
multi
|
X Ray view of fracture of nasal bone includes all except
|
.X-RAYS FOR NASAL FRACTURES 1. Lateral view of nasal bones : Both right and left lateral views should be taken. Fracture line and depression or elevation of the fractured segment is seen. Lower pa of nasal bones is thin and fractured more frequently. Groove for ethmoidal nerve and vessels can be seen running downwards and forwards and may look like fracture line. 2. Occlusal view of nasal bone. In this the X-ray film is held between the teeth, and central beam is projected perpendicular to the film. Both sides of the nasal pyramid are seen. Fracture line and lateral displacement of the nasal pyramid is seen clearly. 3. Waters' view. It gives end-on view of nasal arch. Fractures of right and left nasal bones and their lateral displacement can be seen. Ref: Dhingra 7e pg 494.
| 1 |
Submental view
|
Waters view
|
Occlusal view
|
Lateral view
|
ENT
|
Miscellaneous ENT
|
87687ecb-4968-458d-95ed-221c4bf94829
|
multi
|
The most common organism causing food poisoning in canned food is
|
Clostridium botulinum: strict anaerobic, cause botulism. Source of foodborne botulism is preserved food, meat and meat products, canned foods. Proteolytic varieties can digest food, which appears spoiled. The cans are often inflated and show bubbles on opening. Non-proteolytic varieties have food unchanged. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 269
| 4 |
S typhi
|
V cholarae
|
H pylori
|
C botulinum
|
Microbiology
|
Bacteriology
|
7a6595cc-e0ea-4918-a01c-a5df3532c0f3
|
single
|
A 40 year old male patient has a large, foul smelling ulcer with bright red granulation tissue over the glans penis. There was no lymphadenopathy. The most likely diagnosis is:
|
Ulcer with red granulation tissue (beafy red) and absence of lymph nodes suggests the diagnosis of granuloma inguinale or Donovanosis.
| 4 |
Syphilis
|
Chancroid
|
LGV
|
Granuloma inguinale
|
Dental
| null |
2bffc2ec-558d-497c-af18-07d18621d20d
|
single
|
Staph aureus causes -
|
Option 1 Erythrasma Cause :Corynebacterium minutissimum Appears in the folds of the skin In warm or humid climates Option 2 Chancroid/soft sore Cause : H. Ducreyi Painful lymph node, tender non-indurated and bleeding genital ulcer. Option 3 S. aureus doesn't cause acne vulgaris. Option 4 lmpetigo- 2 types :- i) Non-bullous impetigo (Impetigo contagiosum):- Caused by staphylococcus aureus ,streptococcus pyogenes. ii) Bullous impetigo:- Caused by staphylococcus aureus.
| 4 |
Erythrasma
|
Chancroid
|
Acne vulgaris
|
Bullous impetigo
|
Microbiology
|
Systemic Bacteriology Pa 1 (Gram Positive Cocci, Gram Negative Cocci)
|
d3a380fe-4e2f-4651-816b-a8f05d953939
|
single
|
Loud S1 in Mitral stenosis is caused by:
|
Answer is A (Prolonged flow through mitral valve) Loud SI in mitral stenosis results from prolonged AV flow through the mitral vain `S1 is louder i fAV flow is prolonged because of mitral stenosis' -- Harrison Reduced mobility of valve (Immobility, calcification), and Prolonged PR interval (1st degree block) are all causes of soft S1. Note: First degree block is characterized by prolonged PR interval.
| 1 |
Prolonged flow through mitral valve
|
1st degree hea block
|
Calcification of the valve
|
Immobilization of valve
|
Medicine
| null |
9c6fc46c-e497-4192-ad02-7cba6df481d0
|
single
|
Fournier's gangrene affects
|
Ref:Bailey and love 27th edition Pg no :419
| 2 |
Cheek area
|
Perineal area
|
Abdominal wall
|
Toes
|
Anatomy
|
General anatomy
|
2013e05b-3adc-4c1c-9e90-d45f43890c94
|
multi
|
In 1st trimester, all of the following can be well appreciated, except
|
Crown rump length- Ideal time to measures CRL is 7 - 10 weeks Anencephaly - Earliest anomaly to be detected on USG , can be defected earliest by 10 weeks. Nuchal translucency - sonographic marker of down syndrome / aneuploidy in 1st trimester (seen at 10-12 weeks). Hydrocephalus can be seen around 20 - 24 weeks or beyond when fetal cranium and brain stas growing and the CSF stas establishing
| 3 |
Nuchal Translucency
|
CRL
|
Hydrocephalous
|
Anencephaly
|
Gynaecology & Obstetrics
|
Diagnosis of Pregnancy
|
b5130aa2-1908-48fd-9013-19a83781750c
|
multi
|
Diastolic hea failure is impairment in the filling of the left ventricle. Which of the following is LEAST likely to occur?
|
Diastolic dysfunction is an impairment in the filling of the left ventricle ("stiff ventricle") caused by decreased compliance at a normal left atrial pressure. Systolic hea failure, which is an impairment in contractility, has a better response to positive inotropic agents. Most patients have a combination of both systolic and diastolic dysfunction.In diastolic hea failure, filling of the left ventricle is slow or incomplete (i.e., decreased compliance) unless left atrial pressures increase to maintain the ejection fraction at the expense of increasing pulmonary and systemic venous congestion. Clinical findings include dyspnea, which is the most common symptom, resulting from interstitial and pulmonary edema. Pathophysiologically, there is left atrial hypeension and pulmonary venous hypeension, leading to pulmonary congestion. Therapy is aimed at slowing the hea rate, which promotes filling of the left ventricle at low pressures. -Adrenergic blockers and calcium channel blockers are effective. Patients with diastolic dysfunction have a better survival rate than those with systolic dysfunction, because the ejection fraction is normal to slightly decreased, albeit at the expense of increased left atrial pressures.Systolic dysfunction is an impairment in contractility of the left ventricle or a defect in the ability ofmyofibrils to shoen against a load. The left ventricle loses its ability to eject blood into the aoa, so the ejection fraction (i.e., stroke volume/left ventricular end-diastolic volume) is decreased (usually < 40%); the normal ejection fraction is 80/120, or 66%, with a range of 55% to 75%. The ejection fraction is measured by echocardiography or radionuclide ventriculography. Signs of isolated systolic dysfunction include fatigue, prerenal azotemia, cool skin, and mental obtundation. The left ventricular chamber eventually dilates and patients develop fatigue, dyspnea, and peripheral edema, which are signs of right-sided hea failure. Examples of systolic dysfunction include post-myocardial infarction, ischemic injury (e.g., acute myocardial infarction), and congestive cardiomyopathy. Therapy is aimed at improving the performance of the left ventricle with the administration of positive inotropic agents and peripheral vasodilators to decrease peripheral resistance.
| 4 |
Improvement of the patient's condition with administration of calcium channel blocker
|
Decreased compliance of the hea Increased left atrial pressure
|
Increased left atrial pressure
|
Improvement of patient's condition with administration of a positive inotropic agent
|
Physiology
|
Cardiovascular system
|
7a5ad2d0-6740-4592-8fc2-de431f928f94
|
single
|
Recommended anticopper drug for Wilson's disease in paediatric patients is:
|
Recommended Anticopper Drugs for Wilson's Disease: Disease status DOC Hepatitis/cirrhosis without decompensation Zinc Mild hepatic decompensation Trientine and Zinc Moderate hepatic decompensation Trientine and Zinc Severe hepatic decompensation Liver transplantation Pediatric Zinc Pregnant Zinc Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 3189
| 2 |
Trientine
|
Zinc
|
Tetrathiomolybdate
|
d-penicillamine
|
Medicine
| null |
61336a51-530e-48f5-8661-f6c01bf6cbc2
|
single
|
Which of the following structure is present over the mediastinal surface of right lung:
|
Ans. A Azygos veinRef: Gray's Anatomy 41st ed. P 955Mediastinal Surface of Right LungOn the mediastinal surface of the right lung, you find these structures:* Azygos vein and its arch (posterior and over the root of the lung).* Vagus nerve posterior to the root of the lung.* Esophagus posterior to the root.* Phrenic nerve anterior to the root of the lung.* Cardiac impression: Related to right atrium.* Below hilum and in front of pulmonary ligament: Groove for IVC.
| 1 |
Azygos vein
|
Right thoracic duct
|
Aorta
|
Trachea
|
Anatomy
|
Thorax
|
b6b3e0f5-9915-4137-883d-6aa9ad0673d5
|
single
|
A 54 year old man is evaluated by a neurologist because of a gait disorder. When the physician passively moves the patient's right great toe upward or downward, the patient cannot accurately repo the direction of motion, although his perception of light touch and painful stimuli is unimpaired.This finding can best be explained by a lesion of which of the following structures?
|
The patient's inability to detect the position of his toe reflects a lack of conscious proprioception for this pa of his body. Conscious proprioception, discriminative touch, and vibration sense are all carried by the dorsal column/medial lemniscus system. The fact that he can still perceive light touch and painful stimuli indicates that his anterolateral system is unimpaired. In the dorsal column/medial lemniscus system, the primary neuron's cell body is located in the dorsal root ganglia and sends its projection to the cord through the dorsal roots. The fibers do not synapse in the cord, but rather ascend the cord in the dorsal columns. Fibers carrying information from the legs ascend in the fasciculus gracilis; those receiving input from the arms project in the fasciculus cuneatus. Both ascend to the caudal medulla, where they terminate in the nucleus gracilis and nucleus cuneatus, respectively. The secondary neurons originating from these nuclei cross as the internal arcuate fibers, ascend as the medial lemniscus, then synapse in the ventroposterolateral (VPL) nucleus of the thalamus. Teiary neurons from the VPL project to the ipsilateral somatosensory coex. Therefore, a lack of conscious proprioception from the right toe could result from lesions to the right fasciculus gracilis, the right nucleus gracilis, the left medial lemniscus, the left VPL, or left somatosensory coex. The right fasciculus cuneatus carries discriminative touch, proprioception, and vibration information from the upper extremities.The right lateral lemniscus , pa of the auditory system, receives input from the contralateral cochlear nuclei and from the superior olivary nuclei, and projects to the inferior colliculus.The right medial lemniscus carries discriminative touch, proprioception, and vibration information from the left side of the body. Ref: Waxman S.G. (2010). Chapter 5. The Spinal Cord. In S.G. Waxman (Ed),Clinical Neuroanatomy, 26e.
| 2 |
Right fasciculus cuneatus
|
Right fasciculus gracilis
|
Right lateral lemniscus
|
Right medial lemniscus
|
Anatomy
| null |
6c4d2a50-5f58-4579-a10a-a54986b642cd
|
single
|
Which among the following is the BEST parameter for estimation of fetal age by ultrasound in third trimester?
|
In the third trimester femur length is most accurate to estimate the gestational age. Gestational age in the first trimester is usually calculated by from fetal crown rump length. This is the longest demonstrable length of the embryo or fetus excluding the limbs and the yolk sac. Four fetal parameters routinely measured in the second and third trimester are BPD, head circumference, abdominal circumference and femoral length. In the second trimester, the best parameters for estimating gestational age are biparietal diameter and head circumference. When BPD is altered head circumference has the advantage of being shape independent and can be used as an alternative. Femoral length can also be used and is nearly as accurate as head measurements. Ref: Diagnostic Ultrasound By L. C. Gupta, page 175, Oxford Desk Reference: Obstetrics and Gynaecology edited by Sabaratnam Arulkumaran page 48.
| 1 |
Femur length
|
Biparietal diameter
|
Abdominal circumference
|
Inter-ocular distance
|
Gynaecology & Obstetrics
| null |
cc0700e1-aeea-43e1-8510-d622cfaab807
|
single
|
Which drug is not included in RNTCP regime for MDR TB -
|
Ans. is 'd' i.e., PAS Treatment of multidrug resistance (MDR) TBo MDR-TB is defined as resistance to at least both IIS H and rifampicin. Previously it was classified as Category IV under DOTS (DOTS-PLUS).o The treatment is given in two phases, the intestive phase (IP) and the continuation phase (CP). The total duration of treatment for regimen for MDR-TB is 24-27 months, depending on the IP duration,o Treatment regimen comprises :-Intensive phase (6-9 months) : Six drugs : Kanamycin (Km), levofloxacin (Lvx), ethionamide (Eto), pyrazinamide (Z), ethambutol (E), and cycloserine (Cs).Continuation phase (18 months) : Four drugs : Levofloxaxcin, ethionamide, ethambutol and cycloserine,o Total duration of treatment is 24-27 months.Treatment of extensive drug resistance (XDR) TBo XDR-TB is defined as resistance to any fluoroquinolone and at least one of the following three second-line drugs (capreomycin, kanamycin, amikacin), in addition to muitidrug resistance,o The Regimen for XDR-TB w'ould be of 24-30 months duration, with 6-12 months Intensive Phase (IP) and 18 months Continuation Phase (CP).o Regimen is :-Intensive phase (6-12 months) : Seven drugs : Capreomycin, PAS, moxifloxacin. high dose INH. clofazimine, Linezolid, amoxyclav.Continuation phase (18 months) : Six drugs : PAS, moxifloxacin, high dose INH, clofazimine, linezolid, amoxyclav.
| 4 |
Cycloserine
|
Ethionamide
|
Levofloxacin
|
PAS
|
Social & Preventive Medicine
|
Health Programmes in India
|
6dc92154-4813-4778-bf1f-2d17b3f38d6e
|
single
|
Two month old baby presented with non bilious vomiting and a palpable epigastric lump. which among the following will be investigation of choice
|
Ans) a (USG abdomen) Ref Nelson 18th ed pi555Above clinical scenario is about the classical presentation of hypertrophic pyloric stenosis.Ultrasound examination confirms the diagnosis in the majority of cases and allots an earlier diagnosis in infants with suspected disease but no pyloric mass on physical examination.Criteria for diagnosis include pyloric thickness >4 mm or an overall pyloric length >14 mm Ultrasonography has a sensitivity of ?95%When contrast studies are performed, they demonstrate an elon-gated pyloric channel, a bulge of the pyloric muscle into the antrum (shoul-der sign), and parallel streaks of barium seen in the narrowed channel, producing a "double tract sign"Hypertrophic pyloric stenosisHypertrophic pyloric stenosis occurs in 1 -3/1,000 infants in the United States. Males, (especially first-borns) are affected approximately four times as often as females. The offspring of a mother and. to a lesser extent, the father who had pyloric stenosis are at higher risk for pyloric stenosis. Pyloric stenosis develops in approximately 20% of the male and 10% of the female descendants of a mother who had pyloric stenosis. The inci-dence of pyloric stenosis is increased in infants with type B and O blood groups. Pyloric stenosis is associated with other congenital defects, in-cluding tracheoesophageal fistula and hypoplasia or agenesis of the infe-rior labial frenulum.ETIOLOGY.The cause of pyloric stenosis is unknown, but many factors have been implicated. Pyloric stenosis is usually not present at birth and is more concordant in monozygotic than dizygotic twins. Pyloric stenosis has been associated with eosinophilic gastroenteritis, Apert syndrome, Zellweger syndrome, trisomy 18, Smith-Lemli-Opitz syndrome, and Cornelia de Lange syndrome. A variable association has been found with the use of erythromycin in neonates when administered for pertussis postexposure prophy-laxis. Reduced levels of pyloric nitric oxide synthase have been found with altered expression of the neuronal nitric oxide synthase (nNOS) exon lc regulatory region, which influences the expression of the nNOS gene. Reduced nitric oxide may contribute to the pathogenesis of pyloric stenosisCLINICAL MANIFESTATIONSNonbilious vomiting is the initial symptom of pyloric stenosis. The vomiting may or may not be projectile initially but is usually progressive, occurring immediately after a feeding. The vomiting usually starts after 3 wk of age, but symptoms may develop as early as the 1 st wk of life and as late as the 5th mo. As vomiting continues, a progressive loss of fluid, hydrogen ion, and chloride leads to hypochloremic metabolic alkalosis. Serum potassium levels are usually maintained, but there may be a total body potassium deficit. Jaundice associated with a decreased level of glucuronyl trans-ferase is seen in ?5% of affected infants. The indirect hyperbiliru- binemia usually resolves promptly after relief of the obstruction.The diagnosis has traditionally been established by palpating the pyloric mass. The mass is firm, movable, ?2 cm in length, olive shaped, hard, best palpated from the left side, and located above and to the right of the umbilicus in the mid epigastrium beneath the liver edge. In healthy infants, feeding can be an aid to the diagnosis. After feeding, there may be a visible gastric peristaltic wave that progresses across the abdomen.
| 1 |
USG abdomen
|
Xray abdomen
|
Upper GI Series
|
CT abdomen
|
Pediatrics
|
Gastro Intestinal System
|
45aa358f-85b1-417a-883d-b51c4523bb55
|
single
|
Hyperlipidemia is caused by intake of ?
|
Ans. is 'b' i.e., beta-Blocker Drugs causing hvperiglyceridemia ? o Estrogen o Furosemide o Bile acid - binding resin o HIV protease inhibitors. o beta-blockers o Glucocoicoids o Retinoic acid
| 2 |
Calcium channel blockers
|
beta-blocker
|
Methyldopa
|
Reserpine
|
Pharmacology
| null |
afedb75f-9a9b-45ac-a8e9-971789abd876
|
single
|
Criminal negligence is punishable under :
|
C i.e. 304 A
| 3 |
306 IPC
|
307 IPC
|
304-A IPC
|
304-B IPC
|
Forensic Medicine
| null |
b9f9a49f-c400-4fb7-9a5a-0e679c3553c9
|
single
|
After suxamethonium 50mg, apnea persists for one hour --
|
Suxamethonium is a depolarising muscle relaxant used to rapidly gain optimal intubating conditions. It is normally metabolised within 5 minutes by plasma cholinesterase. Some patients lack this enzyme or have an altered enzyme that does not metabolise the suxamethonium as rapidly. These patients may remain paralysed for a prolonged period after a standard dose of suxamethonium and rely on renal elimination. This condition is often referred to as suxamethonium apnea
| 2 |
treatment with cholnesterase is indicated
|
Probably an atypical cholinesterase is present
|
Treatment with stored blood is indicated
|
Apnea may be due to low serum potassium concentration
|
Anaesthesia
|
Muscle relaxants
|
ca4846fd-8e49-4b20-91f8-58939d22235b
|
single
|
Which is not included in millennium development goals?
|
Ans. is 'a' i.e., Number of oral pills intake in a community The indicators included in MDG are:? 1) Prevalence of underweight children (under five years of age). 2) Propoion (%) of population below minimum level of dietary energy consumption. 3) Under-five moality rate. 4) Infant moality rate. 5) Propoion (%) of 1 year old children immunized for measles. 6) Maternal moality ratio. 7) Propoion (%) of bihs attended by skilled health persons. 8) HIV preualence among young people. 9) Condom use in high-risk population. 10) Ratio of children orphaned/non-orphaed in schools. 11) Malaria death rate per 100,000 in children (0-4 years of age). 12) Malaria death rate per 100,000 in all age groups. 13) Malaria prevalence rate 100,000 population. 14) Propoion (%) of population under-age 5 in malaria risk areas using insecticide treated bed nets. 15) Propoion (%) of population under-age 5 with fever being treated with anti-malarial drug. 16) Tuberculosis death rate per 100,000. 17) Tuberculosis prevalence rate per 100,000. 18) Propoion (%) of smear-positive pulmonary tuberculosis cases detected and put under directly observed treatment sho-course (DOTS). 19) Propoion (%) of smear-positive pulmonary tuberculosis case detected cured under directly observed treatment sho-course (DOTS). 20) Propoion (%) of population using biomass fuel 21) Propoion (%) of population with sustainable accese to an improved water source, rural. 22) Propoion (%) of population with sustainable access to an improved water source, urban. 23) Propoion (%) of urban population with access to improved sanitation. 24) Propoion (%) of population with access to affordable essential drugs on a sustainable basis
| 1 |
Number of oral pills intake in a community
|
Propoion of children underweight
|
Propoion of population using biomass fuel
|
Tuberculosis morbity and moality
|
Social & Preventive Medicine
| null |
b43b4c4d-f529-4843-b4b5-a14a3a7297b5
|
single
|
True about diabetes in pregnancy are all except:
|
Ans. is c, i.e. Insulin resistance improves with pregnancyRef. Dutta 7/e, p 282 for option a, b, 283 for option c and 285 for option d; Fernando Arias 3/e, p 440, 442, 443In pregnancy, the insulin sensitivity decreases i.e. insulin resistance increases as the gestation advances mainly due to anti insulin signals produced by placenta (mainly human placental lactogen).Congenital malformations in a diabetic mother occur within first 8 weeks of gestation when most women are just beginning prenatal care. Therefore preconceptional counselling is very essential in a diabetic motherScreening for diabetes during pregnancy is done by glucose challenges test at 24-28 weeks of pregnancy.
| 3 |
Glucose challenge test is done between 24-28 weeks
|
50 gm of sugar is given for screening test
|
Insulin resistance improves with pregnancy
|
Diabetes control before conception is important to prevent malformation
|
Gynaecology & Obstetrics
|
Medical & Surgical Illness Complication Pregnancy
|
538a0732-230c-419a-bae4-901ea6a00c2f
|
multi
|
Bone, which usually does not have a medullary cavity:
|
Clavicle is generally said to have no medullary cavity, but this is not always true Peculiarities of Clavicle:It has no medullary cavityIt is the first bone to ossify in the fetus (5th-6th week)It is the only long bone having 2 primary centers of ossification (others have only 1)It is the only long bone that ossifies in membrane and not in cailageIt is the only long bone lying horizontallyIt is the most common fractured long bone in the bodyIt is subcutaneous throughout
| 2 |
Fibula
|
Clavicle
|
Humerus
|
Ulna
|
Anatomy
| null |
ca8e3170-7f95-43a5-9807-a5fc75955fc2
|
multi
|
An 18 year old man is evaluated for possible immunodeficiency disease because of a life-long history of chronic lung infections, recurrent otitis media, and multiple episodes of bacterial meningitis. While total IgG is normal, the patient is found to have a selective deficiency of IgG2. An associated deficiency of which of the following other substances may produce anaphylaxis when blood products are given to such individuals?
|
IgG subclass deficiency is one of the more minor forms of immunodeficiency disease, and most patients with this condition who are optimally managed can expect a normal life span. The typical presentation is as illustrated in the question stem. The deficiency may involve either or both IgG2 and IgG3 with or without IgG4 deficiency. (IgG1 is the major form, and its deficiency leads to a deficiency of total IgG, and so, by definition, it is not considered a "subclass" deficiency.) A potentially clinically impoant point is that some patients with IgG2 deficiency also have IgA deficiency and may develop anaphylaxis if given IgA-containing blood products. C3 deficiency tends to produce pyogenic infections. C4 deficiency tends to produce an SLE-like syndrome. IgE deficiency can be seen in some incomplete antibody deficiency syndromes, but is usually not clinically significant. Ref: Hellmann D.B., Imboden J.B. (2013). Chapter 20. Rheumatologic & Immunologic Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow, T.G. Berger (Eds), CURRENT Medical Diagnosis & Treatment 2014
| 3 |
C3
|
C4
|
IgA
|
IgE
|
Medicine
| null |
e2206371-dadf-4c0f-83fa-9693b3cf4f6a
|
single
|
A 23 year old female has abdominal lump that is movable and painless. On exploratory laparotomy, a cystic lump is found arising from mesentery which has no lymphatic supply but has independent blood supply. What is the probable diagnosis?
|
Mesenteric Cyst More common in females Usually seen in 2nd decade. CHYLOLYMPHATIC MESENTERIC CYST ENTEROGENOUS MESENTERIC CYST Congenitally misplaced lymphatics in ileum with Afferent lymphatics only. No efferent lymphatics | The chyle will collect | Progressive increase in size of cyst independent blood supply to cyst Treatment Enucleation Duplication cysts (walled off diveicula) Origin is from diveicula / duplication SI lined by columnar epithelium, which has goblet cells that produce mucin. Collected mucin leads to cyst | Enterogenous cysts Content is mucinous(shared wall & shared vascular supply) Treatment Resection + anastomosis
| 1 |
Chylomyphatic mesenteric cyst
|
Enterogenous mesenteric cyst
|
Ectopic pregnancy
|
Pelvic abscess
|
Surgery
|
Peritoneum
|
2876e565-9217-40aa-a0df-cea302a48aa3
|
single
|
Disease imported in a country, which was not otherwise present?
|
Ans. c (Exotic) (Ref. Park PSM 22nd/pg. 90)Exotic diseaseDisease imported in a country, which was not otherwise present.Epizootic disease# Disease affecting a large number of population at the same time within a particular region or geographic area.# Epizootic disease has the potential for very serious and rapid spread.# Epizootic diseases cause serious socio-economic or public health consequences and are of major importance in the international trade of animals and animal products.Epornithic disease# An epidemic in a population of birds.# A disease affecting a large number of animals simultaneously, corresponding to "epidemic" in humans.Zoonotic disease# A disease of animals that may be transmitted to man under natural conditions (e.g., Brucellosis, Rabies, -Plague, Ringworm, Lyme disease, Tuberculosis, Cat scratch, Tick paralysis, Hanta virus, etc).# Thus these are the infectious diseases that can be transmitted between (or shared by) animals & humans.
| 3 |
Epornithic disease
|
Zoonotic disease
|
Exotic disease
|
Epizootic disease
|
Social & Preventive Medicine
|
Concept of Health and Disease
|
7dc7c16e-7af6-4857-b7aa-8f100998fff0
|
single
|
Repetitive stimulation increases pain sensation, the probable cause is
|
Repetitive stimulation causes release of chemical mediators such as histamine, bradykinin, prostaglandins etc, which increase the sensitivity of nociceptors.
| 1 |
Hyper-sensitization
|
Decreased reflex time
|
Increase in threshold of pain
|
Decreased receptor area
|
Physiology
| null |
c0b6a239-988f-4b64-9400-b05f0dda5294
|
single
|
The outer covering of diatom is made of -
|
Ans. is 'b' i.e., Silicon o The extracellular coat of diatoms has silica.o Diatoms are unicellular algae, suspended in water.o They have silicaceous cell wall (i.e. cell wall contains silica) which resist acid digestion and putrefaction,o Only live body with a circulation can transport diatoms form lung to brain, bone marrow, muscles etc.o So, presence of diatoms in brain and bone marrow indicates death due to drowning.o For detection of diatoms, bone marrow of long bones, e.g. femur, tibia, humerus or sternum is highly suitable and reliable.o As diatoms resist acid digestion, to extract them acid digestion techinique is used.o Diatoms test is negative in dead bodies thrown in water and in dry drowning.o However, diatoms test is invalid, if deceased had drunk this water before submersion or species of diatoms do not match with specimen from the site of drowning.
| 2 |
Magnesium
|
Silica
|
Hydrocarbons
|
None
|
Forensic Medicine
|
Injuries
|
ac367bf6-beb8-4f8d-a6dc-cb1fd69ca5f3
|
multi
|
Study the following table of population in a district and the average population served per doctor. Calculate the harmonic mean: AREA POPULATION SERVED PER DOCTOR POPULATION NUMBER OF DOCTORS RURAL 1000 50000 50 URBAN 500 50000 100 TOTAL 100000 150
|
Calculation of harmonic mean is as follows: (50000+50000)/(50000/100+50000/50)=667 Ref : Medical biostatistics, 1st edition pg: 118
| 3 |
500
|
567
|
667
|
750
|
Social & Preventive Medicine
| null |
ced3e25a-8dfd-4b74-9d1e-fc1949df36f7
|
single
|
The weight of the child at 3 years is usually_______ times the bih weight
|
<p> weight of new born Weight of child in nude or minimal clothing is measured accurately on a lever or electronic type of weighing scale. Spring balances are less accurate. The weighing scale should have a minimum unit of 100g. Child should be placed in middle of pan. Age Weight(kg) Bih. 3 6 months 6 (doubles) 1 yr. 9(triples) 2 yr. 12(quadruples) 3 yr. 15 4 yr. 16 At bih weight is 3 kg and at 3 years it is 15 kg ( 5 times bih weight). {Reference: GHAI essential Paediatrics}</p>.
| 3 |
3
|
4
|
5
|
7
|
Pediatrics
|
Growth and development
|
49075091-0c44-49c3-ae68-6f1b6d4050de
|
multi
|
N Methyl Glycine is known as:
|
Sarcosine/ N-methylglycine = intermediate and by-product in Glycine synthesis and degradation * Ergothionine is a thiourea derivative of Histidine, containing a sulfur atom on the imidazole ring * Betaine is N,N,N-Trimethylglycine, present in beet sugar. * Carnosine (Beta-Alanyl-L-Histidine), has Imidazole ring like Histidine, is a dipeptide molecule, made up of Beta-Alanine and Histidine. It is present in muscle and brain tissues.
| 2 |
Betaine
|
Sarcosine
|
Carnosine
|
Ergothionine
|
Biochemistry
|
Glycine Metabolism Detail
|
0bc19538-f5ed-4632-8096-418659549a1d
|
single
|
40 yrs old diabetic patient presents with round lesions for 2 weeks on abdomen. HPE shows palisading granuloma. What is the diagnosis?
|
Ans. is 'a' i.e. Granuloma annulare Points in favour are:* Diabetic patient* Annular lesions* Palisading granuloma on HPE (most important)Palisading granulomas* They are a subtype of necrotizing granuloma in which the mononuclear phagocytes at the periphery have elongated or spindle-shaped nuclei that are palisaded and arranged roughly parallel to each other and roughly perpendicular to the edge of the central necrotic zone.* Classically they are found in granuloma annulare, necrobiosis lipoidica, and rheumatoid nodule.Other conditions associated with itNon-infectious causes InfectionsInfections* Suture granuloma* Non-tuberculous mycobacteriosis* Churg-strauss disease* Cat scratch disease* Foreign body granuloma* Phaeohyphomycosis* Cutaneous T-cell lymphoma* Sporotrichosis* Wegener's granulomatosis* Cryptococcosis* Steroids* Coccidioidomycosis* Actinic granuloma* Syphilis* Scleromyxedema * Eruptive xanthoma * Cutaneous langerhans histiocytosis * Epithelioid sarcoma
| 1 |
Granuloma annulare
|
Pemphigus erythematosus
|
Leprosy
|
Tinea
|
Skin
|
Bacterial Infection of Skin
|
0b05e7b2-2a2e-4195-95d6-626ed75d96f7
|
single
|
Not a member of SAARC region
|
Members of SAARC region
Afghanistan
Bangladesh
India
Sri Lanka
Nepal
Bhutan
Maldives Islands
Pakistan
| 2 |
India
|
Africa
|
Sri Lanka
|
Afghanistan
|
Social & Preventive Medicine
| null |
d7c6c097-5e91-4e48-ae3f-1d5dbfd9f2c5
|
single
|
For Dextroelevation of the eye, muscles acting are -
|
Dextroelevation: Right superior rectus and left inferior oblique Levoelevation: Left superior rectus and right Inferior oblique Dextroversion: Right lateral rectus and left medial rectus Levoversion: Left lateral rectus and right medial rectus Dextrodepression: Right inferior rectus and left superior oblique Levodepression: Left inferior rectus and right superior oblique Ref;A.K.Khurana;6th Edition;Page no: 339
| 2 |
Right lateral rectus and left medial rectus
|
Right superior rectus and left inferior oblique
|
Right inferior rectus and left superior oblique
|
Bilateral superior recti and inferior obliques
|
Ophthalmology
|
Ocular motility and squint
|
23eb30d9-4af1-422c-9983-faafa78064de
|
single
|
Hemosiderin contains
|
Hemosiderin
It is hemoglobin derived, golden yellow to brown, granular or crystalline pigment in which form iron is stored in cells.
When there is local or systemic excess of iron, ferritin forms hemosiderin granules.
Thus hemosiderin pigment represents aggregrates of ferritin micelles.
Under normal conditions small amounts of hemosiderin can be seen in the mononuclear phagocytes of the bone marrow,
spleen and liver, all actively engaged in red cell breakdown
| 4 |
Calcium
|
Magnesium
|
None
|
Iron
|
Pathology
| null |
d23178f7-4b65-47dc-9fea-1ce9fbdd0759
|
multi
|
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