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Female menstrual cycle is diagnosed by
| null | 1 |
Sex steroid profile
|
Basal body temperature
|
Vaginal cell cytology
|
Cervical mucus test
|
Medicine
| null |
9b8efdec-6066-4ae4-9246-7408d64319a2
|
single
|
HIV infects which of the following cells?
|
Ref: Textbook of Microbiology, 8th edition, .4 nanthna ray an and Paniker, Page 572Explanation:Infection is initiated by HIV after contact with a suitable host cell, namely the T-helper cell or CD4 lymphocyte.Receptor for HIV is - CD4 antigen borne primarily on CD4+ (helper/inducer) T lymphocyte, for which the cheinokine co-receptor involved is- CXCR4.HIV also infects Macrophages, the chemokines co-receptor involved is- CCR5.Rare hereditary conditions involving mutation of CCR5 (32 base pair deletion in the ORF-d32) -- Genetic resistance to acquiring HIV infection, delay AIDS onset or LTNPs (Long Term Non-Progressors).Cell Types Infected by HIV and Chemokine Co-receptorCD4+ T-helper cells - CXCR4.Macrophages - CCR5.Dendritic cells.
| 2 |
NK cells
|
T-helper cells
|
T suppressor cells
|
Plasma cells
|
Microbiology
|
Human Immunodeficiency Virus
|
1849ad68-5bee-4287-8105-ad56af89fbe7
|
single
|
If blindness is surveyed using schools as compared to population surveys, then estimation of prevalence of blindness will have ?
|
Blindness situation in India
Estimated prevalence of blindness in India (total) : 11.2 per 1000 population.
Estimated prevalence of blindness in India (0-14 years) : 0.1 per 1000 population.
Estimated prevalence of blindness in India (15-49 years) : 0.6 per 1000 population.
Estimated prevalence of blindness in India (50+ years) : 77.3 per 1000 population.
So if schools are used where only refractive errors generally constitute blindness (that too very few are actually blind i.e. <6 / 60) As compared to population (where age-related cataract constitute as major cause of blindness), it would lead to underestimation of prevalence of blindness in the country.
| 2 |
Overestimation
|
Underestimation
|
Remains same
|
None of them is used for evaluation
|
Social & Preventive Medicine
| null |
fea0ac50-cd25-4dd9-b58a-d01fb90b00ab
|
multi
|
Subacute sclerosing panencephalitis is a late neurological complication associated with infection due to:
|
a. Measles virus(Ref: Nelson's 20/e p 1542-1547', Ghai 8/e p 213-214)Subacute sclerosing panencephalitis (SSPE) is a chronic complication of measles with a delayed onset & fatal outcome.
| 1 |
Measles virus
|
Mumps virus
|
Rubella virus
|
Parainfluenza virus
|
Pediatrics
|
General Considerations - Infectious Diseases
|
51823b8b-2f6c-4d3b-af7c-bec6e5f81610
|
single
|
Ectopic rest of normal tissue is known as?
|
Ectopic rest of normal tissue is choristoma.
Abnormally arranged tissue present at normal site is hamartoma.
| 2 |
Hamartoma
|
Choristoma
|
Lymphoma
|
Teratoma
|
Pathology
| null |
55037697-46b2-458c-8d6d-8c68e26b3479
|
single
|
True about use of NSAIDs in Abnormal uterine bleeding is all except
|
NSAIDs are taken only during menstruation.
| 4 |
Prostaglandins have role in pathogenesis of endometrial dysfunction.
|
Women lose 90 % of menstrual blood volume in first 3 days, so NSAIDs are used just prior to onset.
|
Reduce menstrual blood loss by 25%.
|
Commenced just prior to start of menses and continued upto day of ovulation (day 14).
|
Gynaecology & Obstetrics
| null |
286d561d-c359-445b-81e4-d5988163d2c5
|
multi
|
The influenza virus has -
|
Influenza virus
Belong to orthomyxoviridae → Envelope, RNA virus
Contain single stranded RNA which is segmented → 8 pieces
There are three viral subtypes
1. Type A → Causes all pandemics and most of the epidemics
2 Type B → Can cause epidemics
3. Type C → Causes endemic infection
Three types of influenza viruses are circulating in world →A(H1N1), A(H3N2) and B
A new type has been recognized →A (H5N1)
Source of infection → Case or subclinical case
Mode of transmission → Droplet infection by respiratory route
Incubation period → 18-72 hours
Clinical manifestations
Most infections are subclinical
Fever, headache and myalgia
Respiratory → coughing
There is no viremia
Complications
Pneumonia → M.C. by str. pneumoniae
Worsening of COPD
Encephalitis
Reye’s Syndrome→ with type B virus
GB. Syndrome
GI Symptoms (gastric flu)→ Type B virus
Laboratory diagnosis
Most commonly, the diagnosis is established by the use of rapid viral tests that detect viral nucleoprotein or neuraminidase.
| 4 |
5 segments of SS RNA
|
8 Segments of ds DNA
|
8 segments of ssDNA
|
8 segments of ssRNA
|
Microbiology
| null |
8a6617e0-d44c-42f1-9e25-ed481dbc9b61
|
single
|
A 26yr old female presented with complaints of coloured
halos, matted and sticky eyelids since 3 days. On examination,
visual acuity was normal. Most common organism causing
this condition is
|
The Clinical scenario gives the diagnosis of Acute mucoopurulent conjunctivitis which is most commonly caused by Staphylococcus aureus.
| 3 |
Gonococcus
|
Pneumococcus
|
Staphylococcus aureus
|
Streptococcus hemolyticus
|
Ophthalmology
| null |
979a9e8a-1975-488a-9059-335f889b484a
|
single
|
The following antibiotic accentuates the neuromu-scular blockade produced by pancuronium:
|
(Ref: KDT 6e p721, 722) Aminoglycosides (like streptomycin and gentamicin) can accentuate the neuromuscular blockade produced by competitive blockers (like pancuronium). Mechanism of neuromuscular blockade produced by aminoglycosides is the inhibition of presynaptic release of ACh.
| 1 |
Streptomycin
|
Erythromycin
|
Penicillin G
|
Chloramphenicol
|
Pharmacology
|
Other topics and Adverse effects
|
7c033913-6f4c-4aeb-868d-950630aa1e76
|
single
|
Chemical name for estasy is -
|
Ecstasy is a designer drug used in rave paies Drugs Street names MDMA(3,4-methylenedioxymethamphetamine) Ecstasy, X, M,rolls GHB (gamma-hydroxybutyrate) G, liquidecstasy, soap Flunitrazepam (Rohypnol) Mexicanvalium, circles Ketamine (Ketalar) K, Special K,jet Ref: Rave drugs, Wikipedia.
| 1 |
MDMA
|
MDHA
|
EDHA
|
MDAM
|
Forensic Medicine
|
Poisoning
|
64259c17-e644-4ef7-885c-6847df151587
|
single
|
Which is NOT used in treatment of heroin dependence
|
SYMPTOMATIC DETOXIFICATION Patients withdrawal symptoms is treated with suppoive care Anti-spasmodic for abdominal cramps Anti-diarrheal for diarrheas Anti-emetics for vomiting Sedatives for reduction of anxiety Clonidine 0.1mg four times a day Antispasmodic Sedatives AGONIST ASSOSIATED DETOXIFICATION Methadone====== it's a long acting opioid thus it has less abuse potential, as it acts on the mu receptor and results in respiratory depression as it has risk of abuse and respiratory depression it is used only by the practioner who has a license to prescribe methadone Bupenorphine (suboxone) It has paial agonist in mu receptor; thus, it has high affinity, less efficacy, slow dissociation. Thus, they have ceiling effect and hence there is no risk of respiratory depression and less chance of abuse ANTAGONIST ASSOSIATED DETOXIFICATION If we use suppoive measures or agonist associated detoxification it results in 14 days and by the time to move from an opioid state to non-opioid state, during which the patient may lapse again. To overcome that there is a method rapid detoxification where the patient is given naltrexone to drive away the opioid and to make the patient unaware of the withdrawal symptoms the patient is placed under anesthesia. This method of naltrexone+ anesthesia used detoxification is called ultra-rapid detoxification Ref.Kaplon and Sadock, synopsis of psychiatry, 11 th edition, pg no.681
| 1 |
Disulfiram
|
Buprenorphine
|
Clonidine
|
methadone
|
Anatomy
|
Substance abuse
|
7655dc1d-c44c-40c8-a460-e8e74e4efde5
|
single
|
Best source of vitamin D -
|
Ans. is 'a' i.e., Fish liver* Though vitamin D is synthesised when UV B photons strike 7 dehydrocholesterol of malphigian layer of skin epidermis, vitamin D is still considered as an essential micronutrient because Vitamin D produced from sunlight is not sufficient. Hence we are dependent on vitamin D supplementation in the diet.* Natural dietary sources of vitamin D include:1. Fish cod liver - 2200IU/200Calorie2. Herring fish - 2000 IU/200C3. Salmon Fish - 900 IU/200C4. Fortified milk -300 IU/200C5. Unfortified milk - 100 IU/200C6. Egg Yolk-68IU/200 C
| 1 |
Fish liver
|
Egg yolk
|
Milk
|
Papaya
|
Biochemistry
|
Vitamins and Minerals
|
21336a15-1cd3-43b5-a965-fd9696a04076
|
single
|
Which of the following beta blocker doesn't cause bradycardia?
|
Ans. A. PindololPindolol is beta blocker with intrinsic sympathomimetic activity. These drugs themselves activate beta 1/2 sub maximally.
| 1 |
Pindolol
|
Labetalol
|
Bisoprolol
|
Atenolol
|
Pharmacology
|
A.N.S.
|
d14a0ee5-29ed-4948-92b8-de5989da96fa
|
single
|
All are true of tinea Versicolor except -
|
Ans-ATinea VersicolorCausative agent: Pitryrosporuni orbiculare (Malassezia furfur)It is a superficial fungal infection of the skin caused by Malassezia furfur and related fungiThe yeast phase was known as Pityrosporum orbiculare (round); Pityrosporum ovale (oval)Now the genus Pityrosporum is considered invalidM. sympodialis - most common on normal skinM.globosa-most commonly associated with tinea versicolorPredisposing factors:Warm and humidClimate of tropicsPregnancySerious underlying disease,Immunocompromised hostBoth hyper and hypopigmented lesions are seenFine branny powdery scales are seen (Candle grease sign or coup doggie sign)Diagnosis:KGH mount; Spaghetti and meatball appearanceCultureWood's lamp examination: Gold to orange fluorescenceTherapyTopical; 2.5% Selenium sulphideSystemic; Ketoconazole, Itraconazole, Flucanozole - Single oral doseOther fungal infectionsDermatophytes I ringworm - superficial fungal infections by three genera- all affect the skin: Microsporum affects hair while epidermophvton affects nailsTrichophyton - affects skin, hairs, nails (remember as tri-all three structures affected)Most common cause of dermatophyte infectionTrichophyton rubrumMicrosporum - affects skin and hairEpidermophvton - affects skin and nailsCandidiasis - most common causative agent is Candida albicansOther species- C.glabrata, C.parapsilosis. C.tropicalis- rarely pathogenic
| 1 |
Drug of choice is griseofulvin
|
The causative agent is Malassezia furfur
|
Wool lamp shows yellow fluorescence
|
KOH mount shows meatball and spaghetti appearance
|
Unknown
| null |
7bb9f675-d495-49e4-bab0-71b92be96346
|
multi
|
The antibody iso-type associated with the mucosal immune system
|
(A) IgA # Mucosa-associated lymphoid tissues lining the gut are known as gut-associated lymphoid tissue or GALT. The tonsils and adenoids form a ring, known as Waldeyer's ring, at the back of the mouth at the entrance of the gut and airways.> The mucosal immune system contains a distinctive repertoire of lymphocytes> Secretory IgA is the antibody isotype associated with the mucosal immune system> Most antigens presented to the mucosal immune system induce tolerance.> The mucosal immune system can mount an immune response to the normal bacterial flora of the gut> Polymeric IgA and IgM are synthesized throughout the gut by plasma cells located in the lamina propria and are transported into the gut by immature epithelial cells located at the base of the intestinal crypts.> Secreted IgA and IgM bind to the mucus layer overlying the gut epithelium where they can bind to and neutralize gut pathogens and their toxic products
| 1 |
IgA
|
IgD
|
IgE
|
IgM
|
Microbiology
|
Misc.
|
5d9acfe7-a925-4c3b-85ce-41510a105419
|
single
|
Associated with objective tinnitus?
|
Ans. is `d' i.e., Glomus tumor Tinnitus Tinnitus is ringing sound or noise in the ear. The characteristic feature is that the origin of this sound is within the patient. Two types of tinnitus have been described : ? a. Subjective I. Otologic II . Non-otologic Impacted wax Disease of CNS Fluid in the middle ear Anaemia Acute and chronic otitis media Aeriosclerosis Abnormally patent eustachian tube Hypeension Meniere's disease Hypotension Otosclerosis Hypoglycaemia
| 4 |
Meiners disease
|
Acoustic neuroma
|
Ear wax
|
Glomus tumor
|
ENT
| null |
51ca3ca9-3660-4d58-972f-2249ba78c626
|
single
|
A baby is born with a flat facial profile, prominent epicanthal folds, and simian crease. She vomits when fed, and upper GI studies demonstrate gas in the stomach and duodenal bulb. Which of the following cardiovascular abnormalities might this child also have?
|
The disease is Downs syndrome (trisomy 21). In addition to mental retardation and the characteristic physical findings described in the question stem, duodenal atresia is fairly common, as evidenced by the "double bubble" sign (gas in the stomach and duodenal bulb) on x-ray. These children are also likely to have various cardiac anomalies; endocardial cushion defect is the most common.Note:Atrial septal defect is one of the most common genetic defects in the general population, but is less common than endocardial cushion defect in patients with Down syndrome.Berry aneurysms, also known as saccular aneurysms, are typically located in the circle of Willis on the ventral surface of the brain. They occur more frequently in patients with adult polycystic disease. Rupture can produce subarachnoid hemorrhage.Coarctation of the aoa occurs more commonly in females with a 45, XO genotype (Turner syndrome). Ref: Brown D.W., Fulton D.R. (2011). Chapter 83. Congenital Hea Disease in Children and Adolescents. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e.
| 4 |
Atrial septal defect
|
Berry aneurysm
|
Coarctation of the aoa
|
Endocardial cushion defect
|
Pathology
| null |
f38ff689-8eef-404e-a89a-223a15dd3b3d
|
single
|
Intestinal hypomotiiity is seen in all of the following except -
| null | 4 |
Diabetes
|
Parkinsonism
|
Amyloidosis
|
All of the above
|
Medicine
| null |
883e7dfc-8227-440c-aa19-546ef56bb4c1
|
multi
|
Western blot is used for?
| null | 3 |
DNA
|
RNA
|
PROTEINS
|
mRNA
|
Biochemistry
| null |
e7fb0e44-25f2-4aac-918a-0b03eac7c2ed
|
single
|
Discase imported to a country for first time
| null | 1 |
Exotic disease
|
Epidemic
|
Endemic
|
Hyper endemic
|
Social & Preventive Medicine
| null |
1572e63d-7309-44b4-9bb4-9e3d0b032599
|
single
|
In colour perimetry the smallest field of vision is with:
|
Ans. Green object
| 1 |
Green object
|
Blue object
|
Yellow object
|
Red object
|
Ophthalmology
| null |
ac4ea426-1b00-486d-a8f2-d83a343b2482
|
multi
|
Hyperkalemia is not caused by:
|
Hyperkalemia is caused by angiotensin-conveing enzyme inhibitors, angiotensin-II receptor blockers, direct renin inhibitors, nonsteroidal anti-inflammatory drugs, calcineurin inhibitors, heparin, aldosterone antagonists, potassium-sparing diuretics. salbutamol causes hypokalemia ESSENTIALS of medical PHARMACOLOGY SIXTH EDITION-KD TRIPATHI Page:757,758
| 1 |
salbutamol
|
ACE Inhibitors
|
Cyclosporine
|
GM-CSF
|
Pharmacology
|
Other topics and Adverse effects
|
32ceed6a-007e-40e0-a8ae-f8c234a4da9b
|
single
|
A 32-year-old woman is confirmed as being 6 weeks pregnant. She feels well, and has no past medical history. This is her second pregnancy; the first pregnancy was uncomplicated and she delivered at term, but the baby was anemic due to beta-thalassemia. She is now worried that the current pregnancy may also be affected. Which of the following methods is most likely to establish an accurate prenatal diagnosis?
|
Chorionic villus sampling in the first trimester with deoxyribonucleic acid (DNA)-based diagnosis has a high degree of accuracy. Cord blood electrophoresis is suitable for screening high-risk infants at birth.
| 3 |
fetal ultrasound at 12 weeks
|
cord blood electrophoresis
|
chorionic villus sampling
|
buccal mucosal cytology of both parents
|
Medicine
|
Blood
|
461fbebe-e634-49d7-9def-3efef404d40c
|
multi
|
Immume complex mediated gloomerular damage is seen in all except -
| null | 2 |
Membranoproliferative GN
|
Good pasture's syndrome
|
Crescentric GN
|
Focal segmental GN
|
Medicine
| null |
5f5b4b00-32ab-4764-bbf4-d4af945946fc
|
multi
|
Which of the following features is shared in common between lymphocyte - rich and lymphocyte predominant types of Hodgkin&;s lymphoma -
|
Classical RS cells are difficult to find in lymphocyte predominance type but it is frequently present in lymphocyte rich type. About 40% of lymphocyte rich type is associated with EBV.But lymphocyte predominance is not associated with EBV RS cells in lymphocyte predominance is CD20 positive. But RS cells in lymphocyte rich type isCD2O negetive. Both type have very good prognosis. Reference : Robbins and Cotran Pathologic basis of disease.South Asia Edition volume 1.page no. 609
| 4 |
Paucity of diagnostic RS cells
|
EBV is associated
|
RS cells are CD 20 positive
|
Good prognosis
|
Pathology
|
Haematology
|
ca2310fd-5feb-4f7e-bd4f-f3fde2503666
|
single
|
This patient was a former smoker and was being treated for essential hypertension, hypercholesterolemia, and hyperuricemia. Oral examination during the three follow up visits are being shown What is the most likely diagnosis of the tongue involvement?
|
Ans. A. Geographic tongue* Geographic tongue, also known as benign migratory glossitis and migratory stomatitis, is the correct answer.* The changing lesions are suggestive of a geographic map (hence geographic tongue) with pink continents surrounded by whiter oceans.* It is a recurrent, benign, usually asymptomatic, inflammatory condition, of unknown etiology, of the tongue, affecting nearly 2% of the general population.* Geographic tongue typically presents with migratory red lingual patches, which are irregularly shaped erythematous patches bordered by a white keratotic band. Tongue lesions exhibit central erythema because of atrophy of the filiform papillae of tongue epithelium.* Lesions may last days, months, or years. THE LESIONS DO NOT SCAR.* It being a benign asymptomatic condition, therefore requires no treatment.
| 1 |
Geographic tongue
|
Oral candidiasis
|
Lichen planus
|
Oral hairy leukoplakia
|
Medicine
|
Miscellaneous
|
33d0bce1-5d8b-43d4-8ec7-c6a14d5b691c
|
single
|
True about Herpangina ; Except
| null | 3 |
Occurs in epidemics
|
Site specific (Occurs on pharynx)
|
Severe form than HSV
|
Gingivitis is absent
|
Pathology
| null |
1c5f56a8-cd47-46fb-a483-535e99f20a32
|
multi
|
Death sentence can be awarded by
|
The sessions cou is usually located at district headquaers. It can only try cases which have been committed by a Magistrate S.193, Cr.P.C. It can pass any sentence authorised by law, but a Death sentence passed by it must be confirmed by the High cou.S.28.(2) and S.366, Cr.P.C. District Cou deals with civil cases REF: The Synopsis of Forensic Medicine and Toxicology 28th edition page no: 4.
| 4 |
First class magistrate
|
Cheif judicial magistrate
|
Second class magistrate
|
Sessions cou
|
Forensic Medicine
|
Medico legal procedures
|
d01d1a8e-f747-41b2-a326-76ef39bff209
|
single
|
35 year old mother of two children is suffering from amenorrhea from last 12 month. She has a history of failure lactation following second delivery but remained asymptomatic thereafter. Skull X-ray shows empty sella diagnosis is :
|
Ans. is c i.e. Sheehan's Syndrome Friends, here before arriving to any diagnosis lets first see the causes of : Empty Sella : Congenital incompleteness of the sellar diaphragm. Presentation : Women present with : * Galactorrheadeg Features of hypogonadism : Men present with : * Impotence Loss of libido Infeility. In both sexes they can cause : Cavernous sinus syndrome consisting Raised serum prolactin levels X-Ray sella shows space occupying lesion. Investigations : In all cases of hyperprolactinemia : - MRI should be performed - TSH levels should be measured. Management : Microadenoma with no desire of feility : Asymptomatic patients with microadenomas rarely progress to macroadenomas managed conservatinely. If patient has osteopenia. (due to hypoestrogenemia caused by TProlactin levels) estrogen replacement or OCP's. Monitor patients with regular serial prolactin levels and MRI (every 12 months). 216 * Secondary to Surgery / Radiotherapy or infarction of pituitary tumor. * Secondary to Infarction and Necrosisof pituitary gland. Now from the given causes : either pituitary tumor or Sheehans syndrome can cause an empty sells on x Ray. Pituitary Tumours (Micro / Macro adenoma) cause galactorrhoea (not lactationat failure) with amenorrhea and are so, ruled out. - So, the ObVious answer me by exclusion is Sheehan's Syndrome. Sheehan's syndro: It is the syndrome which results from ischaemic necrosis of most of the Anterior Pituitarydeg due to spasm in its aerioles occurring at the time of severe hemorrhage or shock complicatingchildbih. Only the anterior pituitary is affected because in paurient woman, blood supply to the pituitary gland is modified to the advantage of the posterior lobe and disadvantage of the anterior lobe so, when spasm occurs, posterior lobe is protected. When 75% of Anterior pituitary is destroyed, manifestations of Sheehan's syndrome appear and when 95% is destroyed -- fully developed Simmonds syndrome is seen. Hormones of Anterior Pituitary are affected in order of frequency = GH, FSH and LH, TSH and ACTH. Clinical Features : SymptomsQ Failure of lactation after deliverydeg Secondary amenorrhoeadeg Loss of libidodeg Increased sensitivity to cold (hypothydroidism)deg Signs : Absence of axillary sweatingdeg 1 Loss of axillary and pubic hairdeg Signs of adrenal coical failure Decrease in skin pigmentationdeg I Anemia due to lack of pituitary erythropoeitic factor Weakness, lethargydeg Hypothermiadeg Hypoglycemiadeg (due to decreased insulin tolerance)deg Hypothyroidismdeg All genital organs show atrophy, uterus is smaller than in postmenopausal womendeg as there is decrease in FSH, LH $ estrogen Although dormant ovaries retain their ova till menopausedeg Lab investigation : FSH LH TSH ACTH 1deg Oestrogens J.deg Urinary 17 keto steroids ,1,deg Management : The treatment of Sheehan's syndrome includes : Life long hormone substitute including estrogen,
| 3 |
Menopause
|
Pituitary tumor
|
Sheehan's syndrome
|
Intraductal papilloma of breast
|
Gynaecology & Obstetrics
| null |
d4937bcf-d334-44cf-a913-5498bf259150
|
single
|
Post Traumatic stress syndrome is due to
|
D i.e. Major life threatening events
| 4 |
Head Injury
|
CVD
|
Minor Stress
|
Major Life threatening events
|
Psychiatry
| null |
d9ea0f70-05a4-4cb4-a7fc-5def9ce80413
|
single
|
Not a feature of de Quervain's disease :
| null | 1 |
Autoimmune in etiology
|
↑ESR
|
Tends to regress spontaneously
|
Painful & associated with enlargements of thyroid
|
Surgery
| null |
c3902821-8aeb-4fd3-90fa-531955dffa6d
|
single
|
March fracture is ?
|
Ans. is 'a' i.e., Neck of 2nd metatarsal Metatarsal stress fractures are common in distance runners and ballet dancers. The second metatarsal neck is the most likely site for stress fracture, but all metatarsals are susceptible. March fracture, also known as fatigue fracture or stress fracture of metatarsal bone, is the fracture of the distal third of one of the metatarsals occurring because of recurrent stress. It is more common in soldiers, but also occurs in hikers, organists, and even those, like hospital doctors, whose duties entail much standing. March fractures most commonly occur in the second and third metatarsal bones of the foot.
| 1 |
Neck of 2nd metatarsal
|
Neck of 3' metatarsal
|
Shaft of 4th metatarsal
|
Head of 5th metatarsal
|
Surgery
| null |
c1bd0380-2db2-48fe-b0bf-0423bb7deaf3
|
single
|
Streptolysin 'O' acts through-
| null | 2 |
N- muraminidase
|
Teichoic acid
|
Muramic acid
|
Cytochrome oxidase
|
Medicine
| null |
5eda3d3d-ec62-4743-9a60-f20057eab7ee
|
single
|
Raynolds-Braude phenomenon is shown by:
|
Ans. a (Candida albicans). (Ref. Ananthanarayan, Microbiology/ 6th/pg.576)RAYNOLDS-BRAUDE PHENOMENON (Germ tube formation) is a rapid method of identifying Candida albicans based on ability to form germ tubes within 2 hours on incubation in human serum at 37degC.CANDIDA ALBICANS# Yeast like fungus# Pseudomycelia# Diabetes is the most common predisposing factor# Normal inhabitants of skin and mucosa# Produces creamy-white, smooth colonies with yeast odour on Sabouraud's media# Forms Chlamydospores on com meal agar at 20degC# Treatment:- Local-nystatin,- Disseminated - Amphotericin, 5-Flurocytocin, clotrimazole.Opportunistic systemic mycotic infections include:SR. NO.FUNGUSMICROBIOLOGICAL FEATURESCLINICAL MANIFESTATIONS1AspergillusSeptate hyphae & sterigmataOtomycosis is most common.Rhinocerbral aspergillosis is particularly seen in diabetics.ABPA2MucorBroad non-septate mycelia without rhizoids, branched sporangiophoresNasal & PNS mucormycosis3PenicilliumBrush like conidia, chain of sporesIn HIV infected patients4RhizopusNon-septate mycelia with rhizoids-5AbsidiaiInvasive disease
| 1 |
Candida albicans
|
Mucor
|
Cryptococcus
|
Aspergillus
|
Microbiology
|
Mycology
|
ad08379e-e0cb-4525-8951-14130f4a417e
|
single
|
Which type of abnormality in sexual development has best prognosis?
|
Ans. a. Congenital adrenal hyperplasia (Ref: Navak's 15/e p1029. 14/e p1023-1026)Congenital adrenal hyperplasia is a type of abnormality in sexual development, which has best prognosis.'Congenital adrenal hyperplasia can be managed by supplying enough glucocorticoids to suppress excess androgen production. The deformity in genitalia (enlarged clitoris, fusion of labia minora) can be corrected surgically. Newborn screening methods to detect CAH and efforts to treat CAH in utero have improved the prognosis. Women with CAH can get pregnant and have healthy infants.'21-Hydroxylase Deficiency (Congenital Adrenal Hyperplasia)The classic form of 21 -hydroxylase deficiency (21-OHD) is the most common cause of CAH.It has an incidence between 1 in 10.000 and 1 in 15,000 and is the most common cause of androgenization in chromosomal 46,XX females.Affected individuals are homozygous or compound heterozygous for severe mutations in the enzyme 21-hydroxylase (CYP21A2).This mutation causes a block in adrenal glucocorticoid and mineralocorticoid synthesis, increasing 17-hydroxyprogesterone and shunting steroid precursors into the androgen synthesis pathwayQ.Increased androgen synthesis in utero causes androgenization of the female fetus in the first trimesterQ.Ambiguous genitalia are seen at birth, with varying degrees of clitoral enlargement and labial fusionQ.Excess androgen production causes gonadotropin-independent precocious puberty in males with 21-OHDQ.Presymptomatic diagnosis of classic 21-OHD is now made by neonatal screening tests forincreased 17-hydroxy progesteroneQ in many centers.Treatment: Congenital Adrenal Hyperplasia:Acute salt-wasting crises require fluid resuscitation, IV hydrocortisone, and correction of hypoglycemia.Once the patient is stabilized, glucocorticoids must be given to correct the cortisol insufficiency and suppress ACTH stimulation, thereby preventing further virilization, rapid skeletal maturation, and the development of polycystic ovariesQ.Girls with significant genital androgenization due to classic 21-OHD usually undergo vaginal reconstruction and clitoral reductionQ (maintaining the glans and nerve supply).Androgen insensitivity syndrome (AIS):A condition that results in the partial or complete inability of the cell to respond to androgensQ.The unresponsiveness of the cell to the presence of androgenic hormones can impair or prevent the masculinization of male genitalia in the developing fetus, as well as the development of male secondary sexual characteristics at puberty, but does not significantly impair female genital or sexual developmentQ.As such, the insensitivity to androgens is clinically significant only when it occurs in genetic malesQ (i.e. individuals with a Y-chromosome, or more specifically, an SRY gene).Clinical phenotypes in these individuals range from a normal male habitus with mild spermatogenic defect or reduced secondary- terminal hair, to a full female habitus, despite the presence of a Y-chromosome.Androgen insensitivity syndrome is the largest single entity that leads to 46, XY undermasculinized genitaliaQ.Management of AIS is currently limited to symptomatic management; no method is currently available to correct the malfunctioning androgen receptor proteins produced by AR gene mutationsQ.Areas of management include sex assignment, genitoplasty, gonadectomy in relation to tumor risk, hormone replacement therapy, genetic counseling, and psychological counseling.Mixed Gonadal Dysgenesis:A condition of unusual and asymmetrical gonadal development leading to an unassigned sex differentiation.A number of differences have been reported in the karyotype, most commonly a mosaicism 45, X/ 46, XY.The phenotypical expression may be ambiguous, intersex, or male, or female pending the extent of the mosaicism.It has been pointed out that the gonads may not be symmetrical, thus the development of the Mullerian duct and Wolffian duct may be asymmetrical, too.Because of the presence of dysgenetic gonadal tissue and Y chromosome material, there is a high risk of the development of a gonadoblastoma, thus removal of the gonads is usually indicated.True hermaphroditism:A medical term for an intersex condition in which an individual is born with ovarian and testicular tissue.There may be an ovary underneath one testicle or the other, but more commonly one or both gonads is an ovotestis containing both types of tissue.There are no documented cases in which both types of gonadal tissue function.Encountered karyotypes are 47XXY, 46XX/46XY, or 46XX/47XXY, and various degrees of mosaicism.There has yet to be a documented case where both gonadal tissues function (Bad reproductive potential); contrary to rumors of hermaphrodites being able to impregnate themselves.
| 1 |
Congenital adrenal hyperplasia
|
Mixed gonadal dysgenesis
|
Androgen insensitivity syndrome
|
True hermaphroditism
|
Gynaecology & Obstetrics
|
Sex Intersexuality
|
398bd0cf-b321-457a-b994-0d1c7a8f3484
|
multi
|
Mangled Extremity Severity Score (MESS) includes all of the following, EXCEPT:
|
The mangled extremity severity score (MESS) is a scoring system that can be applied to mangled extremities and help to determine which mangled limbs will eventually go for amputation and which can be salvaged. This system grades the injury on the basis of 4 categories: skeletal or soft tissue injury, limb ischemia, shock and the patient's age.
| 3 |
Shock
|
Ischemia
|
Neurogenic injury
|
Skeletal injury
|
Surgery
| null |
63ab39bb-0ba6-4413-92f0-58a4829bd677
|
multi
|
hich of the following is not true about Neisseria gonorrhoea -
|
Ans. is. 'd'i.e., All the strains are highly sensitive to penicillin . Penicillin is ineffective in treatment of gonorrhoea as most of the strains are resistant to penicillin because penicillnase producing N. gonorrhoeae (PPNG) have spread widely. . Ceftriaxone is the drug of choice for gonococcal infections. . All other options have been explained earlier.
| 4 |
It is an exclusive human pathogen
|
Some strains may cause disseminated disease
|
Acute urethritis is the most common manifestation in males
|
All strains are highly sensitive to penicillin
|
Microbiology
| null |
1deffe6a-7bd3-49d8-a9ea-3b5a34d15fd8
|
multi
|
Toxigenicity of C. diphtheria is determined by-
|
Ans. is 'a' i.e., Elek's gel ppt test
| 1 |
Elek's gel ppt test
|
Aselole's reaction
|
Nagler's reaction
|
All
|
Microbiology
| null |
1f02a77e-bf57-4a86-8462-eb54ee09c779
|
multi
|
WHO regime for paucibacillary leprosy:
|
A i.e. 100 mg Dapsone daily + Rifampcin 600 mg monthly
| 1 |
100 mg Dapsone daily + Rifampcin monthly (600 mg)
|
Dapsone daily + Rifampcin daily
|
Dapsone + Rifampcin + Clofazemine daily
|
Rifampcin + Clofazamine daily
|
Skin
| null |
3f08e433-0293-4c73-b9fc-03b96639714a
|
single
|
For cardiopulmonary resuscitation in neonates ratio of chest compression to ventilation is
|
Ans: b (3:1) Ref: Nelson, 18th ed,p. 389; 17th ed,p. 280Chest compression-ventilation relationship Neonate1-8 years> 8 yearsCompression rate120At least 100100Compression to ventilation ratio3:15:115:2Pulse checkUmbilical arteryBrachialcarotidQuestion is a direct pick from the above Table in Nelson.
| 2 |
2:01
|
3:01
|
4:01
|
5:02
|
Pediatrics
|
New Born Infants
|
d333793c-8111-400f-8158-bb0389d55e14
|
single
|
In a programme, results analyzed in comparison to cost is known is -
|
- cost effective analysis express the benefits in terms of results achieved rather than monetary terms. - more promising tool for application in the health field. Reference : Park&;s textbook of preventive and social medicine, 23rd edition, pg no:871 <\p>
| 3 |
Cost benefit analysis
|
Management by objectives
|
Cost-effective analysis
|
Cost utility study
|
Social & Preventive Medicine
|
Health education & planning
|
4466b912-0544-4ea4-84dd-6e7fb4b2bdd0
|
single
|
Medullary chemoreceptors are sensitive to ?
|
Ans. is 'a' i.e., H+ in CSFThe primary direct stimulus for central chemoreceptors is increased H+ concentration in the CSF and brain interstitial fluid.Central chemoreceptors These receptors are located in a chemosensitive area on the ventral surface of the medulla near the exit of the ninth and tenth cranial nerves. The primary stimulus for the central chemoreceptors is an increase in the hydrogen ion concentration. Stimulation of central chemoreceptors by increased hydrogen ion concentration leads to excitation of the respiratory neurons, thereby producing an increase in the rate and depth of respiration.Although the primary stimulus for central chemoreceptors is an increase in hydrogen ion concentration, in actual practice the physiological stimulus is an increase in PCO2. The reason is that hydrogen ions cannot cross blood - brain barrier. Therefore, a change in the blood hydrogen ion concentration does not change the hydrogen ion concentration in the immediate vicinity of the chemosensitive neurons (i.e., in CSF and brain interstitial fluid). On the other hand, CO2 being lipid soluble can easily cross blood brain barrier. It enters the brain, where it is hydrated to give rise to fr and HCO2- ions. Now these H' directly stimulate the central chemoreceptors.Thus, central chemoreceptors are directly stimulated by an increase in H+ concentration in CSF and brain inerstitial tissue, which is brought about by change in aerial PCO2 (PaCO2).
| 1 |
H+ in CSF
|
CO2 in CSF
|
H+ in blood
|
CO2 in blood
|
Physiology
| null |
2844913a-8d04-47fd-b326-3a904562da34
|
single
|
↑Ca2+ in Ca lung is seen in Ca –
| null | 2 |
Adeno
|
Squamous
|
Small cell
|
Large cell
|
Medicine
| null |
5691e211-0c3b-4827-94d0-d71dc2267a31
|
multi
|
ELISA is performed on a population with low prevalence. What would be the result of performing double screening ELISA tests -
|
The specificity of ELISA can be increased by carrying out ELISA in a row (series) using different HIV markers.
When screening test is used in a series mode : -
↑ Specificity
↑ PPV
↓ Sensitivity
| 3 |
Increased sensitivity and positive predictiv value
|
Increased sensitivity and negative predictive value
|
Increased specificity and positive predictive value
|
Increased specificity and negative predictive value
|
Social & Preventive Medicine
| null |
e7605d32-5332-4bf7-8d5d-ae7579379496
|
single
|
A most common complication of lateral condyle humerus fracture -
|
Amongst the given options, nonunion is the most common complication.
| 2 |
Malunion
|
Nonunion
|
VIC
|
Median nerve injury
|
Orthopaedics
| null |
12cd2125-d273-4db4-a67f-79740fb7a37a
|
single
|
CT scan of the head should be performed before lumbar puncture in all of the following conditions except?
|
Neuroimaging should be done prior to LP in the following patients: 1. Altered level of consciousness 2. Focal neurological deficit 3. New onset seizure 4. Papilledema 5. Immunocompromised state These patients are at increased risk of potentially fatal cerebellar or tentorial herniation following lumbar puncture.
| 1 |
Hypeension
|
Immunocompromised state
|
Kernohan Woltman sign
|
Low GCS score
|
Radiology
|
CT SCAN
|
c3734db2-c9e5-4976-86b6-c4c630537922
|
multi
|
Which of the following is a vector for Dengue fever?
|
Aedes aegypti:Principle vector of Dengue virusesAlso an efficient vector of the Yellow fever and Chikungunya virusesBreeds near human habitation, using relatively fresh waterUsually inhabits dwellings and bites during the dayRef: Harrison's 17/e p1230
| 1 |
Aedes aegypti
|
Culex
|
Anophelous
|
Mansonia
|
Medicine
|
All India exam
|
6691c11f-8282-45d7-a761-81d386d9fbf7
|
single
|
Post-transplant cytomegalovirus infection may cause
|
Overall, 30% of all infections contracted in the posttransplant period are viral. The most common viral infections are DNA viruses of the herpesvirus family and include cytomegalovirus (CMV), Epstein-Barr virus, herpes simplex virus, and varicella zoster virus. CMV infections may occur as either primary or reactive infections and have a peak incidence at about 6-week post-transplant. The classic signs include fever, malaise, myalgia, arthralgia, and leukopenia. CMV infection can affect several organ systems and result in pneumonitis; ulceration and hemorrhage in the stomach, duodenum, or colon; hepatitis; esophagitis; retinitis; encephalitis; or pancreatitis. The risk of developing posttransplant CMV depends on donor-recipient serology, with the greatest risk in seronegative patients who receive organs from seropositive donors. Pyelonephritis, cholecystitis, intraabdominal abscesses, and parotitis are caused by bacterial infections or GI perforation and not primarily by CMV infection.
| 2 |
Pyelonephritis
|
GI ulceration and hemorrhage
|
Cholecystitis
|
Intraabdominal abscess
|
Surgery
|
Transplantation
|
76e78c3c-2d2b-47af-bddb-e4e72efb2c56
|
single
|
SIte of bleeding after cataract surgery is
|
After cataract surgery, posterior ciliary vessels are the common sites of bleeding. Ref AK khurana 6/e p 215
| 4 |
Anterior choroidal vessels
|
Posterior choroidal vessels
|
Anterior ciliary vessels
|
Posterior ciliary vessels
|
Ophthalmology
|
Lens
|
6a8afd9f-ef28-4869-978e-70f971f433ae
|
single
|
Rain drop pigmentation is caused by ?
|
Ans. is 'd' i.e., ArsenicHomosexual
| 4 |
Clofazimine
|
Dapsone
|
Minocycline
|
ArsenicHomosexual
|
Skin
| null |
3747847c-acfb-4d0b-9429-648a5f9cdb22
|
single
|
Most common genetic play in Neisseria infection is
|
Ans. is 'c' i.e., Complement deficiency Complement deficiency and neisserial infections The complement system is an essential component of the innate immune defence against infection by Neisseria (N. Meningitidis and N. gonorrhoeae). People who lack or have a deficiency in complement mediated bactericidal activity are most susceptible to neisserial diseases. Terminal complement component (C5 through C9) deficiencies and deficiencies of the alternative pathway (Properdin, C3,Factor D) have a strong effect on susceptibility to, as well as severity of, neisserial infections. Deficiency of terminal complement (C, - C9) component :- Deficiency of one of the terminal components that compose membrane attack complex (MAC) predisposes patients to infection with Neisseria meningitidis or Neisseria gonorrhoeae. However, N. meningitidis infection is more common. Deficiencies of terminal pathway :- Deficiencies in components of alternative pathway, namely properdin, C3 and factor D, have been associated with increased susceptibility, almost exclusively, to meningococcal infection (amongst Neisseria).
| 3 |
Male gender
|
HLA b27
|
Complement deficiency
|
IgA deficiency
|
Microbiology
| null |
62bb8d2b-1bf0-47ee-939c-98468048c3f5
|
single
|
Disease usually not seen in a country but brought from abroad is:
|
Exotic: Disease usually not seen in a country but brought from abroad. OTHER OPTIONS Zoonotic: A disease which is transmitted to man from animals e.g. Rabies, plague. Epidemic: when disease has exceeded it's normal expectancy. Endemic: Constant or continuous presence of a disease in a population.
| 4 |
Endemic
|
Epidemic
|
Zoonotic
|
Exotic
|
Social & Preventive Medicine
|
FMGE 2018
|
918769b8-6f41-4655-985c-5210421f4ee6
|
multi
|
Kinky hair desease is disorder where an affected child has peculiar white stubby hair, does not grow, brain degeneration is seen and dies by age of two years. Mrs A is hesitant about having children because her two sisters had sons who had died form kinky hair disease. Her mother's brother also died of the same condition. Which of the following is the possible mode of inheritence in her family -
|
Ans. is 'a' i.e., X-linked Recessive o The clues in this question are ? Only males are manifesting disease. Females are acting as carriers -3 sisters sons had suffered from the disease. o Both these are features of X-linked recessive disorders. X-linked disorders o Except for a few conditions, all X-linked disorders are X-linked recessive. o As male has only one X-chromosome, the male with affected gene on X-chromosome will always manifest the disease. o On the other hand, female has 2 X-chromosomes, heterozyogous female will be carrier because of expression of normal allel on the other X-chromosome. o Note ---> Female with Turner syndrome (only one 'X' chromosome) can manifest X-linked recessive disorders. o 50% boys of the carrier mother will be affected. o All daughters of affected father will become carrier, i.e. affected father will transmitt the defective X chromosome to all the daughters. o Father will not transmitt the disease to son as boys do not inherit X-chromosome from father. About other options o In X-linked dominant disorder the females will also manifest the disease. o In autosomal dominant and autosomal recessive disorders, both males and females are affected.
| 1 |
X-linked recessive
|
X-linked dominant
|
Autosomal recessive
|
Autosomal dominant
|
Pathology
| null |
579af071-3a43-41d0-98d2-7f3e24254c80
|
single
|
Quarantine is related to>
|
Ans. is 'b' i.e. Maximum incubation period Quarantine - has been defined as The limitation of freedom of movement of such well person or domestic animals exposed to communicable disease for a period of time no longer than the longest usual incubation period of the disease in such a manner to prevent effective contact with those not so exposed. "Also KnowIsolation -- It is the oldest communicable disease control measure.- It is defined as "separation for the period of communicability of infected persons or animals from others, as to prevent or limit the direct or indirect transmissions of the infectious agent from those injected to those who are susceptible, or who may spread the agent to others"In contrast to isolation, quarantine applies to restriction on the healthy contacts of an infectious disease. *
| 2 |
Minimum incubation period
|
Maximum incubation period
|
Serial interval
|
Generation time
|
Social & Preventive Medicine
|
Infectious Disease Epidemiology
|
981df750-5180-45e2-9b58-77bf87420bbe
|
single
|
Insulin resistance in liver disease is due to
|
Refer Robbins page no Insulin resistance is defined as the failure of target tissues to respond normally to insulin. It leads to decreased uptake of glucose ik muscle reduced glycolysis and fatty acid oxidation I'm the liver and inability to suppress hepatic gluconeogenesis
| 2 |
Decreased insulin resistance
|
Steatosis
|
Hepatocyte dysfunction
|
Decreased C peptide level
|
Anatomy
|
General anatomy
|
de0a1c9c-c45b-40fe-a29d-d1daee690e75
|
single
|
Gastrospleenic ligament is due to peritoneal reflection of which aery ?
|
Ans. is 'b' i.e., Sho gastric aery
| 2 |
Splenic aery
|
Sho gastric aery
|
Pancreatic aery
|
Common hepatic aery
|
Anatomy
| null |
7cc567e3-97cd-4f17-9ff7-523ff1f0c8d6
|
single
|
Which of the following antifungal is used in cancer chemotherapy?
|
Flucytosine is used as a pyrimidine antagonist which is a prodrug and is conveed to 5 FU.Ref: KD Tripathi 7th ed; Pg: 791
| 1 |
Flucytosine
|
Amphotericin B
|
Voriconazole
|
Ketoconazole
|
Pharmacology
|
Chemotherapy
|
59412113-6f99-4575-9d03-11266c14ace8
|
single
|
Herbe's pit is seen in: September 2006 March 2013 (c)
|
Ans. D: Chlamydial conjunctivitis Later structural changes of trachoma are referred to as "cicatricial trachoma". These include scarring in the eye lid (tarsal conjunctiva) that leads to distoion of the eye lid with buckling of the lid (tarsus) so the lashes rub on the eye (trichiasis). These lashes will lead to corneal opacities and scarring and then to blindness. Linear scar present in the sulcus subtarsalis is called Arles line (named after Carl Ferdinand von Arlt). In addition, blood vessels and scar tissue can invade the upper cornea (pannus). Resolved limbal follicles may leave small gaps in pannus (Herbe's Pits).
| 4 |
Vernal conjunctivitis
|
Atopic conjunctivitis
|
Gonococcal conjunctivitis
|
Chlamydial conjunctivitis
|
Ophthalmology
| null |
5a0dc312-f364-4ed3-a12a-29cadf0c62e1
|
single
|
Blow out fracture of orbit involves
|
Ans. (c) Inferior wallRef; Kanski 7/e, p. 873Blow out fracture is typically of the orbital floor, it may also involve the medial wall but always as a secondary involvement.
| 3 |
Medial wall
|
Superior wall
|
Inferior wall
|
All the walls
|
Ophthalmology
|
Ocular Trauma
|
97655fef-4be3-49bb-821e-2a0fa47cad48
|
multi
|
Spring catarrh may be associated with:
|
Ans. Keratoconus
| 2 |
Anterior subcapsular cataract
|
Keratoconus
|
Interstitial keratitis
|
All of the above
|
Ophthalmology
| null |
aa398ff2-f8b4-46f7-867d-1ecd6910dfba
|
multi
|
Drug used in Benign Prostatic Hypertrophy is?
|
ANSWER: (B) a, antagonistsREF: KDT 7th ed p-135, Goodman and Gillman's 11th ed page 172,173,183
| 2 |
a1agonist
|
a1. antagonist
|
a2, agonist
|
a2 antagonist
|
Pharmacology
|
Anti Adrenergic System
|
d4beb2a7-c9f6-4e9b-af92-c78653348762
|
single
|
Which drug should not be given in pregnancy ?
| null | 2 |
Labetalol
|
ACE inhibitors
|
Hydralazine
|
Methyl dopa
|
Pharmacology
| null |
e57b2b69-0b1f-40e3-96ad-4ffd9bad3ff9
|
single
|
Ratio of O2 : N2O in Entonox is –
|
Entonox contain equal amount (50/50) of N2O and O2.
| 1 |
50:50:00
|
60:40:00
|
40 : 60
|
25 : 75
|
Anaesthesia
| null |
88010ae4-1b9a-44e9-9ef6-46a0fb5d1efc
|
single
|
Treatment of Asherman's syndrome is :
|
D + C with IUCD inseion
| 2 |
D C
|
D + C with IUCD inseion
|
Hysterectomy
|
Hysterotomy
|
Gynaecology & Obstetrics
| null |
188bc66d-ebc3-4c36-b92d-6f35ccbdfdee
|
single
|
All of the following statements regarding disposal of biomedical waste are true, except
|
Blue bag contents are disposed by autoclaving/microwaving/chemical treatment and destruction shedding.
Yellow bag contains category No. 1, 2, 3, & 6 wastes. Category No 1 contains human anatomical waste (option a is correct)
Red bags are used for disposal of microbiology waste from laboratory cultures, stocks of microorganisms etc (Cat -3) and hence may be a source of contamination.
Black bag contains category No 5, 9 and 10 wastes. Category 9 contains incineration ash which is disposed in multiple landfill (option c is correct.)
| 4 |
Human Anatomical Waste is disposed in a Yellow bag
|
Contents from a Red bag may be a source of contamination
|
Black bags are used for disposal of ash from incineration
|
Blue bags contents are disposed in secured landfill
|
Social & Preventive Medicine
| null |
94b68531-a09d-47fe-ae00-d85d5328338a
|
multi
|
Peusis toxin acts by all of the following mechanisms except ?
|
Ans. is 'c' i.e., Increased calcium release from saroplasmic reticulum Peusis toxin . Peussis toxin is an exotoxin that has A and B subunits. . B subunit binds to the target cells whereas A subunit acts on the target. . First, the peussis toxin itself gets activated by glutathione and ATP. . Once the toxin gets activated it activates cell membrane bound G proteins. . Peussis toxin catalyzes the ADP ribosylation of the G proteins and activates them. . The activated G protein in turn activates adenylate cyclase, this results in an outpouring of cAMP which activates protein kinase and other intracellular messangers.
| 3 |
ADP ribosylation of proteins associated with receptors
|
Increase cyclic AMP
|
Increased calcium release from sarcoplasmic reticulum
|
Acts through G alpha subunit
|
Microbiology
| null |
7204f30c-60cc-4b04-bde9-cd979353bb75
|
multi
|
Drug producing dissociative anesthesia:
|
Ans: (c) KetamineRef: katzung 9th ed. 1604; KDT 6th ed./376* Ketamine is the only intravenous anesthetic that possesses analgesic properties and produces cardiovascular stimulation.* It causes "dissociative anesthesia" which is characterized by profound analgesia, immobility, amnesia and feeling of dissociation from ones own body and the surrounding.* In addition it also causes:# Hallucination# Delusion and illusion.# Profound analgesia* Ketamine increases all pressures like:# BP (hypertension)# Intracranial tension (ICT)# Intraocular pressure (IOP)* It is contraindicated in intracerebral mass/hemorrhage.About Ketamine: (Remembered as:)KKids: can be given to kidsEEmergence reaction: s/e occurring during recoveryTThalamo-cortical junction affected: Dissociative AnesthesiaAAnalgesia strongestMMeal: can be given with full stomachIIncrease: BP/IOP/ICTNNMDA receptor blockerEExcellent bronchodilator: inducing agent of choice in asthma patient.Also Kno* PROPOFOL causes myocardial depression and fall in BP.
| 3 |
Propofol
|
Enflurane
|
Ketamine
|
Sevoflurane
|
Anaesthesia
|
Miscellaneous General Anesthesia
|
d6cfb03f-ea60-48fc-923c-662ea2bb016e
|
single
|
All is true about pseudocyesis except:
|
Patient is not pregnant is pseudocyesis. Though she falsely believes that and there are also associated changes suggestive of pregnancy. Pseudocyesis False pregnancy There is development of classical symptoms of pregnancy like: Abdominal enlargement Amenorrhea Subjective sense of fetal movements Breast engorgement Labour pains at expected date of delivery Extra edge: Couvade Syndrome In this syndrome, the paner of the pregnant woman repos that he is experiencing some of the symptoms of pregnancy, complaining of nausea, morning sickness, and often of toothache. These complaints generally resolve after a fewweeks.
| 2 |
Abdominal enlargement
|
Patient is pregnant
|
Labor pains at expected date of delivery
|
Amenorrhea
|
Psychiatry
|
Neurotic, Stress Related and Somatoform Disorders
|
42b7fa27-244f-40eb-94e5-e6179788b0a4
|
multi
|
. A girl presents with; primary amenorrhea; grade V thelarche, grade II pubarche; no axillary hair; likely diagnosis is:
| null | 1 |
Testicular feminisation syndrome
|
Mullerian agenesis
|
Turners syndrome
|
Gonadal dysgenesis
|
Gynaecology & Obstetrics
| null |
9cfcfee0-0aa9-4af1-9175-24290fef7ab9
|
single
|
Injury that comes under sec 320 IPC
|
B i.e. Nasal bone fracture
| 2 |
Abrasion over face
|
'Nasal bone fracture
|
Epistaxis
|
Lacerated wound over scalp
|
Forensic Medicine
| null |
c48d21bd-988d-4ded-8aa8-2560aeaf5f69
|
single
|
Best results are obtained in oral submucous fibrosis is by:
| null | 1 |
Intralesional cortisone therapy, with hyaluronic acid
|
Oral cortisone with intralesional therapy (cortisone)
|
Vitamin E and oral cortisone
|
Intralesional placental extract
|
Pathology
| null |
3c2af126-3415-4323-9374-9ac1f5c546a4
|
single
|
Massive bleeding per rectum in a 70 yr old patient is due to :
|
Answer is A (Diveiculosis) Although anorectal disease is the most commonm cause of bleeding per rectum in the elderly, these lesions usually cause small amount of 'bright red' blood on the surface of stool and toilet tissue (small bleeds). Diveiculosis may give rise to massive colonic bleed. The usual presentation of diveicular hemorrhage is that of brisk painless passage of a maroon coloured stool. It is the most common cause of massive bleeding per rectum in those above 55 years of aze and hence the answer here. Angiodysplasias and diveiculosis were the most common reasons for LGIB Common causes of Acute Lower G.I. bleeding over 55 years of age are : Anorectal disease : Haemorrhoids and fissures Diveiculosis Angiodysplasia Polyps and Cancer Enterocolitis
| 1 |
Diveiculosis
|
Carcinoma colon
|
Colitis
|
Polyps
|
Medicine
| null |
edb00fdb-13b4-4365-a9ac-5b2c6f476888
|
single
|
Main recommendation of Jungalwalla committe?
|
Ans. is 'd' i.e., Integration of health services Health Planning in India The guide lines for national health planning were provided by a number of committees. These committees were appointed by the Government of India from time to time to review the existing health situation and recommend measures for fuher action.
| 4 |
Creation of multipurpose worker
|
Health survey and planning
|
1 PHC for 50000 population
|
Integration of health services
|
Social & Preventive Medicine
| null |
f4583027-b0c7-415a-829e-9f95e19dcae8
|
multi
|
Which of the following drugs is not used for the therapy of congenital adrenal hyperplasia?
|
Ans. C. AntibioticsPatients with congenital adrenal hyperplasia require lifelong treatment. Patients with salt wasting and virilizing forms should be treated with hydrocortisone and fludrocortisone. After completion of growth, synthetic glucocorticoid preparations (dexamethasone, prednisolone) can be used.
| 3 |
Hydrocortisone
|
Prednisolone
|
Antibiotics
|
Dexamethasone
|
Pediatrics
|
Endocrinology
|
5e31e3d1-c18d-4295-b3b6-68d3050a2b1d
|
single
|
The treatment of congenital glaucoma is-
|
Ans. is 'c' i.e. Trabeculectomy with trabeculectomy Treatment of congenital glaucoma:Treatment of congenital glaucoma is primarily surgical. However I.O.P. must be lowered by the following agents till surgery is doneHyper osmotic agentsAcetazolamideb Blockers Surgical procedures: -GoniotomyTrabeculectomyCombined trabeculectomy and trabeculectomy - It is now the preferred surgery with better resultsCongenital glaucoma has been discussed in detail in earlier papers.
| 3 |
Essentially topical medications
|
Trabeculoplasty
|
Trabeculotomy with trabeculectomy
|
Cyclocryotherapy.
|
Unknown
| null |
883f4802-624e-417e-8fc3-293a76a3c863
|
multi
|
The commonest site for extragonadal germ cell tumor
|
Reference Robbins page no 475 Extragonadal germ cell tumors form from developing sperm or egg cells that travel from the gonads to other pas of the body. ... These are more common than malignantextragonadal germ cell tumors and often are very large. Malignant extragonadal germ cell tumors are divided into two types, nonseminoma and seminoma In adults, the mediastinum is the most common extragonadal site for the development of germ cell tumors.229-233 The most common tumor in this site is mature teratoma.234 This diagnosis can be suggested by the presence of a large circumscribed anterior mediastinal mass with normal serum HCG and a-fetoprotein. Management of mature teratoma is surgical, and there is no role for chemotherapy or radiotherapy. Although these tumors histologically are benign, removal is often difficult. The tumors are commonly adherent to adjacent structures, such as the pericardium, lung, and great vessels.
| 2 |
Pineal gland
|
Mediastinum
|
Retroperitoneum
|
Sacrococcyygeal region
|
Pathology
|
Urinary tract
|
1ff34a90-f11e-4a55-b29c-59894a7724b2
|
single
|
Drug which is useful for the diagnosis of myasthenia gravis is?
|
The two types of weakness require opposite treatments. They can be differentiated by edrophonium test.
| 3 |
Neostigmine
|
Physostigmine
|
Edrophonium
|
Atropine
|
Pharmacology
| null |
9245790d-5757-48fc-9213-e5be0242a2e0
|
single
|
Surface area of tympanic membrance -
| null | 4 |
55 mm2
|
70 mm2
|
80 mm2
|
90 mm2
|
ENT
| null |
b4bd6114-d8ea-49eb-88ff-12a2f5ad4532
|
single
|
The transition from G2 to M phase is controlled by
|
The cell cycle is regulated by activators and inhibitors. Cell cycle progression is driven by proteins called cyclins. cyclin D-CDK4, cyclin D-CDK6, and cyclin E-CDK2 regulate the G1-to-S transition by phosphorylating the Rb protein (pRb). Cyclin A-CDK2 and cyclin A-CDK1 are active in the S phase. Cyclin B-CDK1 is essential for the G2-to-M transition.Reference: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 1; The Cell as a Unit of Health and Disease
| 4 |
Rb gene product
|
P53 protein
|
Cyclin E
|
Cyclin B
|
Pathology
|
General pathology
|
d95a4d9d-0255-4612-b59b-6bc698b7bf3b
|
single
|
Which feature is MOST helpful in distinguishing dementia from severe depression?
|
Somatic complaints such as anorexia, weight loss and headache are features of both conditions, though more prominent in patients with depression. The behavioural and cognitive functions are affected in both conditions. Poor concentration, poor attention span, poor memory and social withdrawal are encountered in both. Grasp reflex and other primitive reflexes indicate neuronal loss in the frontal lobe, which does not occur in depression. A positive response to antidepressant treatment is a reliable sign in our of depression
| 2 |
Weight loss
|
Grasp reflex
|
Persistent headache
|
Poor attention spans
|
Pathology
|
All India exam
|
cbb65396-bf33-4a01-9afa-a90dcec229d9
|
single
|
Middle ear effusion with intact eardrum gives rise to which type of tympanogram?
|
Type B tympanogram is flat in appearance, indicating lack of compliance. The volume measurement that is simultaneously performed with tympanometry helps to differentiate between a flat tympanogram suggesting an intact eardrum with middle ear effusion and a perforated eardrum or patent ventilating tube.
| 2 |
Type A
|
Type B
|
Type C
|
Type D
|
ENT
| null |
8608f531-0e03-496d-a52f-1d3535018db5
|
single
|
Modified Kastenbaum surgery is done for
|
Modified Kastenbaum Surgery *Recession resection of all four horizontal recti is done according to the type and amount of nystagmus
| 2 |
Esotropia
|
Nystagmus
|
Superior oblique palsy
|
Third nerve palsy
|
Ophthalmology
|
Squint
|
733e40bf-ed17-455e-8fbc-3b79af82209d
|
single
|
Direct standardization is used to compare the moality rates between two countries. This is done because of the differences in:
|
Age distributions !Ref. Park 20/e, p 55,56 (19/e, p 54, I8/e, p 53)] Repeat from May 06 & Nov 06 Because of the differences in age distribution of two populations, their moality experience could not be compared by using 'crude death rate', as it lead to wrong impression. A population (say population A) with more young people would have low crude death rate than a population (population B) with more old people, thus giving an impression that population A is healthier than B, which may not be so. This confounding effect of age is removed by means of 'standardization'.
| 3 |
Causes of death
|
Numerators
|
Age distributions
|
Denominators
|
Social & Preventive Medicine
| null |
063a843d-4eeb-45d2-b369-f8614e7b2936
|
single
|
A 2-day-old newborn male develops mild cyanosis. An ultrasound examination reveals a patent ductus arteriosus. Which of the following infections will most likely lead to this congenital anomaly?
|
Congenital heart defects are common problems that can be caused by teratogens, such as the rubella virus, or single-gene factors or chromosomal abnormalities.
| 2 |
Toxoplasmosis
|
Rubella
|
Cytomegalovirus
|
Varicella virus
|
Anatomy
|
Thorax
|
f478b40c-46a0-4f80-b00f-1105960d4b44
|
single
|
Separation of first polar body occurs at the time of: September 2007, March 2012
|
Ans. B: Ovulation Asymmetrical cell division (cytokinesis) leads to the production of polar bodies during oogenesis. To conserve nutrients, the majority of cytoplasm is segregated into either the secondary oocyte and, or ovum, during meiosis I or meiosis II, respectively. The remaining daughter cells generated from the meiotic events contain relatively little cytoplasm and are referred to as polar bodies. Eventually, the polar bodies degenerate. There may be one or two polar bodies in the ovum. The first polar body is one of the two products in the first stage of meiosis, just before ovulation and is considered diploid, with 23 duplicated chromosomes. The second polar body is haploid, with 23 unduplicated chromosomes and is produced only when a sperm penetrates the oocyte.
| 2 |
Feilization
|
Ovulation
|
Implantation
|
Menstruation
|
Physiology
| null |
5335216a-5eea-43a4-b172-d7007e335e89
|
single
|
According to ADA specification #1 for amalgam, what is the acceptable dimensional change?
|
According to ADA specification #1 for amalgam, the acceptable dimensional change is -20 to +20 micron/cm.
Reference: Marzouk Operative dentistry, pg-108
| 1 |
-20 to +20 micron/cm
|
-10 to +10 micron/cm
|
-20 to +10 micron/cm
|
-10 to +20 micron/cm
|
Dental
| null |
69e7b684-65d5-4db5-ae00-4a3b63f21361
|
single
|
Most common complication of intertrochanteric fracture femur is:(NEET 2013; WB 1999; AI 1998, 1988; DELHI 1997)
|
(a) Malunion- Most common complications of intracapsular fracture -AVN followed by non-union.- Most common complication of extracapsular fracture - Malunion.
| 1 |
Malunion
|
Non-union
|
Osteoarthritis
|
Nerve injury
|
Orthopaedics
|
Pelvis & Injuries
|
aed1e422-af1b-42ad-943c-73062ace4ef5
|
single
|
The parasympathetic secretomotor fibres to parotid traverse through all of the following, EXCEPT:
|
The parasympathetic secretomotor fibres to parotid arises from the glossopharyngeal nerve. The nerve reaches the gland tympanic branch, the lesser petrosal nerve, the otic ganglion and the auriculotemporal nerve. Course of the nerve: Preganglionic parasympathetic fibers originate from inferior salivary nucleus in the medulla oblongata and are carried in the glossopharyngeal nerve. These fibers leave the glossopharyngeal nerve in its tympanic branch, which enters the middle ear. Here it breaks into tympanic plexus which gives origin to lesser petrosal nerve. This nerve enters the middle cranial fossa from where it enters infratemporal fossa to terminate in otic ganglion. Postganglionic fibres join the auriculotemporal nerve which provide secretomotor fibers to parotid gland. Ref: Clinical Anatomy By Regions By Richard S. Snell, 7th Edition, Page 787; Neurological Differential Diagnosis By John Patten, 2nd Edition, Page 66; Clinical Anatomy (A Problem Solving Approach) By Kulkarni, 2nd Edition, Page 341
| 4 |
Otic ganglion
|
Tympanic plexus
|
Auriculo temporal nerve
|
Greater Petrosal nerve
|
Anatomy
| null |
4017c646-d359-4de7-80d9-9e9c320a24b8
|
multi
|
On thyroid function test, TSH value is raised and
t4 value is decreased. Referred diagnosis is
|
IF TSH raised ans T4 is decreased then its primary.
IF both are decreased then its secondary.
| 2 |
Hyperthyroidism
|
Primary hypothyroidism
|
Secondary hypothyroidism
|
Subclinical hypothyroidism
|
Surgery
| null |
2d2639c9-34f5-40bf-8447-6574dfcb8919
|
single
|
Which of the following interventions is NOT included in active management of IIIrd stage of labor: March 2013
|
Ans. B i.e. Immediate clamping, cutting and ligation of the cord
| 2 |
Administration of a uterotonic within 1 minute of delivery
|
Immediate clamping, cutting and ligation of the cord
|
Massage of uterus
|
Controlled cord traction
|
Gynaecology & Obstetrics
| null |
59ea0328-1036-47ff-a41a-2e022cffcd7e
|
single
|
The period of infancy usually refers to:
| null | 2 |
First 2 years after birth
|
First 1 year after birth
|
First 6 months after birth
|
First 3 years after birth
|
Dental
| null |
761d362f-85f9-4b3a-b299-9432a54aae5b
|
multi
|
The following are important in the maintenance of normal fecal continence except -
|
Normal fecal continence requires
adequate rectal wall compliance to accommodate the fecal bolus.
appropriate neurogenic control of the pelvic floor and sphincter mechanism, and
functional internal and external sphincter muscles
At rest the puborectalis muscle creates a 'sling' around the distal rectum, forming a relatively acute angle (Anorectal angle). Anorectal angle distributes intraabdominal forces onto the pelvic floor and play an important role in the continence mechanism. At the time of defecation, this angle straightens, allowing the downward force to be applied along the axis of the rectum and anal canal.
The internal & external sphincters are tonically active at rest.
the internal sphincter is responsible for most of the resting, involuntary sphincter force
the external sphincter is responsible for voluntary sphincter force.
Both the internal and external sphincters are innervated by pudendal nerve.
Finally, the hemorrhoidal cushions may contribute to continence by mechanically blocking the anal canal.
Thus impaired continence may result from :
poor rectal compliance
injury to internal and/or external sphincter or puborectalis, or
nerve damage or neuropathy
| 4 |
Anorectal angulation
|
Rectal innervation
|
Internal sphincter
|
Haustral valve
|
Surgery
| null |
8ad4b5e9-6832-467b-bc1a-288d03b8d30c
|
multi
|
Commonest benign tumour of the esophagus
|
Benign tumours of the oesophagus are unusual and constitute less than 1% of all oesophagal neoplasms. Approximately 60% of benign oesophagal lesions are leiomyomas, 20% are cysts, 5% are polyps, and the remaining 5% are other neoplasms.Ref: Sabiston 2oth edition pg:1047
| 1 |
Leiomyoma
|
Papilloma
|
Adenoma
|
Hemangioma
|
Surgery
|
G.I.T
|
c8ea3d08-b0b1-40ed-a375-c4316cb36c57
|
single
|
Main vascular supply of Little's area is all,except -
| null | 4 |
Septal branch of superior labial artery
|
Nasal branch of sphenopalatine artery
|
Anterior ethmoidal artery
|
Palatal branch of sphenopalatine
|
ENT
| null |
98362e6f-f174-4175-aa97-81358dd387b9
|
multi
|
Following surgery, a patient develops oliguria.. You believe the patient is hypovolemic, but you seek corroborative data before increasing intravenous fluids. The best data is?
|
When oliguria occurs postoperatively, it is impoant to differentiate between low output caused by the physiologic response to intravascular hypovolemia and that caus ed by acute tubular necrosis. The fractional excretion of sodium (FENa) is an especially useful test to aid in this differentiation. Values of FE < 1% in an oliquric setting indicate aggressive sodium reclamation in the tubules; values above this suggest tubular injury. Calculating the fractional excretion is simple: (urine Na x serum creatinine) + (serum sodium x urinary creatinine). In the setting of postoperative hypovolemia, all findings would reflect the kidney's effos to retain volume: the urine sodium would be below 20 meq/l, the urine chloride would not be helpful except in the metabolically alkalotic pent, the serum osmolality would be over 500 mOsm/kg, and the urine/serum creatinine ratio would be above 40.
| 3 |
Urine sodium of 28 meq/L
|
Urine chloride of 15 meq/L
|
Fractional excretion of sodium less than 1
|
Urinel Serum creatinine ratio of 20
|
Surgery
| null |
0f1b1da6-0b03-421e-845e-f80c7f7ae433
|
single
|
Most common cause of umbilicus does not separate at age of 2 years -
| null | 2 |
Raspbery tumour
|
Leukocyte adhesion deficiency
|
Patent urachus
|
Umblical granuloma
|
Surgery
| null |
f94a6ccf-d28f-4154-9dff-cacbb80d9328
|
single
|
A 50 year old female goes into shock and her blood pressure was 50 mmHg. Which of the following concerning her GFR is most likely?
|
Once blood pressure drops below about 60 mmHg, GFR will basically cease, although a very small amount of filtrate may continue to be produced. This is another reason why maintaining blood pressure is so impoant.
| 4 |
Myogenic autoregulation will keep GFR constant
|
Angiotensin II release will maintain normal GFR
|
The macula densa will cause constriction of the afferent aeriole to maintain GFR
|
GFR will viually cease
|
Physiology
| null |
9aeba4d4-7ca9-43af-ac68-951f16db0dc8
|
multi
|
Umbilicus is supplied by which spinal segment?
|
Ans. d (T10). (Ref. BD Chaurasia, Anatomy -2nd vol., 3rd/165; Bailey & love Surgery, 25th/982) # Skin around umbilicus is supplied by T10 segment of cord. # With reference to lymphatics and venous drainage it is water shed area. Educational point: # Dermatomes over: - The xiphoid process-T7 - The umbilicus-T10 - The pubis-L1 # Remnant of vitello-intestinal duct may form a tumor of umbilicus known as raspberry /cherry red tumor.
| 4 |
T4
|
T6
|
T8
|
T10
|
Anatomy
|
Abdominal Wall
|
9f5407ca-a07e-4c73-8f19-27b9def47e60
|
single
|
Iron requirement in pregnancy -
|
<p> iron The adult human body contains between 3-4 g of iron , of which about 60-70 % is present in blood as circulating iron and the rest as storage iron. Each gram of haemoglobin contain 3.34mg of iron. Functions: 1. Formation of haemoglobin 2. Brain development 3. Regulation of body temperature. 4. Catecholamine metabolism 5. Oxygen transpo. Sources: Foods rich in haem iron are liver , meat, poultry and fish. Foods rich in non haem iron are cereals, green leafy vegetables, legumes, nuts , oilseeds, jaggery and dried fruits. Among nuts cashew nut is rich in iron. Poor mans iron source is jaggery.It contain useful amounts of carotene and iron derived from cooking pans. Recommended Dietary Allowances for iron: 1. Healthy Indian male: 17mg 2. Healthy adult female: 21 mg 3. Pregnant women: 35 mg 4. Lactation: 21 mg 5. Infants:5mg {Reference: Park&;s textbook of community medicine 23 rd edition, pg no. 636}
| 2 |
100 mg
|
35 mg
|
500 mg
|
800 mg
|
Social & Preventive Medicine
|
Nutrition and health
|
75340e0e-0fdb-41a3-9706-7ed067fde323
|
single
|
Fixed-splitting of S2 is seen in
|
A fixed split S2 indicates an atrial septal defect (ASD). Spitting at both expiratory and inspiratory phases but does NOT lengthen with inspiration Compared to Wide splitting where there is splitting during expiration and even wider during inspiration, which is seen in conditions with delayed conduction down the right bundle ref - Harrisons internal medicine 20e pg 1671, 1672f
| 1 |
ASD
|
MS
|
PDA
|
PR
|
Medicine
|
C.V.S
|
60729b61-f97e-4444-9dab-55980c38af51
|
single
|
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