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The most common tumour of cerebellopontine angle is
Acoustic neuroma comprises 80% of all cerebellopontine angle tumours. Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 125
2
Meningioma
Acoustic neuroma
Neurofiroma
None of the above
ENT
Ear
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multi
In community-acquired acute bacterial sialadenitis, the most common causative pathogen is:
In community-acquired acute bacterial sialadenitis, the most common causative pathogen is S. aureus, which can be eradicated using an antibiotic with Gram-positive coverage such as amoxicillin with clavulanate or clindamycin.
1
S. aureus
S. albus
S. salivarius
None of the above
Pathology
null
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multi
DOC for ventricular arrhythmias due to digitalis toxicity is:
Ventricular arrhythmias due to digitalis toxicity Lidocaine i.v. repeated as required is the drug of choice It suppresses the excessive automaticity but does not accentuate A-V block Quinidine, Procainamide, and propafenone are contraindicated Note: Lignocaine is DOC but 2nd alternative option is Phenytoin for digitalis-induced ventricular arrhythmias
1
Lignocaine
Quinidine
Amiodarone
Verapamil
Pharmacology
Hypeension, Arrhythmias, Dyslipidemia
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single
Power of a study can be increased by-
<p> Decreasing ss error. Reference:Simple Biostatistics by Indrayan & Indrayan,1stbedition,page no: <\p>
2
Increasing a error
Decreasing ss error
Decreasing a error
Increasing ss error
Social & Preventive Medicine
Biostatistics
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single
Note true about Japanese encephalitis
Ans. b. Caused by group A arbovirus
2
Transmitted by culex mosquito
Caused by group A arbovirus
Pig is amplifier host
Man is incidental host
Microbiology
null
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multi
All of the following statements are true about repair of groin hernias except:
Ans. (c) In shouldice repair, non absorbable mesh is usedRef: Sabiston 19/e p1120-1126* Lichtenstein uses Tension free prolene mesh (procedure of choice for Inguinal hernia)* TEP repair - Total Extra Peritoneal repair* Shouldice- Anatomical repair- Double breasting of Fascia transversalis done* Hernia Surgeries are done by Local Anesthesia Infiltration
3
Lichtenstein tension free repair has a low recurrence rate
TEP repair is an extraperitoneal approach to laparoscopic repair of groin hernia
In Shouldice repair, non-absorbable mesh is used
The surgery can be done under local anesthesia in selected cases
Surgery
Hernia
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multi
A 23 years old female patient presented with sever diffuse hair fall for last 1 month. She had a major accident with severe blood loss 5months back for which she had to be hospitalized for 1 month. She is very anxious that all her hair will fall. Most likely diagnosis is?
Ans. is 'b' i.e., Telogen effluvium Points in favor arei) Diffuse hair fallii) History of accident with blood loss (stress)iii) Hair loss after 5 months of accident
2
Alopecia aerate
Telogen effluvium
Anagen effluvium
Androgenetic alopecia
Skin
Alopecia
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Which of the following is not affected by a lesion in posterior column of spinal cord:
Answer is B (Temperature sense): Temperature sense is a feature of the spinothalamic tract and not the posterior column. Vibration & Joint position sense are transmitted the posterior column. Altered joint position sense may lead to Ataxia and a positive Romberg's sign.
2
Romberg's sign
Temperature sense
Vibration sense
Ataxia
Medicine
null
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single
. A 45 year male with a history of alcohol dependence presents with confusion, nystagmus and ataxia. Examination reveals 6th cranial nerve weakness. He is most likely to be suffering from:
B i.e. Wernicke encephalopathy
2
Korsakoff's psychosis
Wernicke encephalopathy.
De Clerambault syndrome
Delirium tremens
Psychiatry
null
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single
Post Kidney transplantation complication caused by CMV is?
The answer here is simple as the pyelonephritis is the only option related to kidney. The impoant point to revise here is that CMV in transplant patients is the a complication of immunosuppression SIDE EFFECTS OF NON SPECIFIC IMMUNOSUPPRESSION 1) INFECTION : bacterial and fungal infections are most common , risk greatest in first 6 months , chemoprohylaxis and vaccinations for high risk patients , viral infections are from reactivation of latent virus or a primary infection . CMV is a major problem . 2) MALIGNANCY : children are at high risk for lymphoproliferative disorders , sq cell ca very common ref ( Bailey 27th ed , chapter 82 , pg 1541
3
Parotitis
Cholecystitis
Pyelonephritis
GI Necrosis and stricture
Surgery
Urology
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Total Iron required per day for pregnancy period:-
Group Recommended intake (mg/day) Man 17 Woman (non-pregnant) & lactating women 21 Pregnancy 35
2
65 mg/day
35 mg/day
25 mg/day
70 mg/day
Social & Preventive Medicine
RDA, Nutritional Requirements
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Oral combined contraceptive pills contain which one of the following sets of hormones?
null
2
Ethinyl estradiol, progestogen, and estrone
Progestogen and ethinyl estradiol
Progestogen and estrone
Estrone and ethinyl estradiol
Unknown
null
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single
A study of peripheral blood smears shows that neutrophil nuclei of women have a Barr body, whereas those of men do not. The Barr body is an inactivated X chromosome. Which of the following forms of RNA is most likely to play a role in Barr body formation?
There are forms of noncoding RNA that play a role in gene expression. Long noncoding RNA (lncRNA) segments greater than 200 nucleotides in length can bind to chromatin to restrict access of RNA polymerase to coding segments. The X chromosome transcribes XIST, a lncRNA that binds to and represses X chromosome expression. However, not all genes on the "inactive" X chromosome are switched off. The RNA transcribed from nuclear DNA that directs protein synthesis through translation is mRNA. MicroRNAs (miRNAs) are noncoding RNA sequences that inhibit the translation of mRNAs. Gene-silencing RNAs (small interfering RNAs ) have the same function as miRNAs, but they are produced synthetically for experimental purposes. Transfer RNA (tRNA) participates in the translation of mRNA to proteins by linking to specific amino acids.
1
lncRNA
mRNA
miRNA
siRNA
Pathology
Cellular Pathology
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Anti topoisomerase 1 is marker of
Ref Robbins 9/e p228 B cell activation also occurs, as indicated by the pres- ence of hypergammaglobulinemia and ANAs. Although there is no evidence that humoral immunity plays a signifi- cant role in the pathogenesis of SS, two of the ANAs are viually unique to this disease and are therefore useful in diagnosis (Table 4-10). One of these, directed against DNA topoisomerase I (anti-Scl 70), is highly specific; it is present in as many as 70% of patients with diffuse scleroderma (and in less than 1% of patients with other connective tissue diseases) and is a marker for the devel- opment of more aggressive disease with pulmonary fibro- sis and peripheral vascular changes. The other ANA is an anticentromere antibody, found in as many as 90% of patients with limited scleroderma (i.e., the CREST syn- drome); it indicates a relatively benign course.
1
Systemic sclerosis
Classical polyaeritis nodosa
Nephrotic syndrome
Rheumatoid ahritis
Anatomy
General anatomy
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The patient gives history of putting tobacco in buccal vestibule and chewing betel quid, the lesion is:
Tobacco pouch keratosis: A white, wrinkled change of the mucosa in the mandibular buccal vestibule secondary to the use of chewing tobacco. This lesion consists of a thick brownish black encrustation on the buccal mucosa at the site of placement of the buccal quid. It is often seen among heavily addicted betel quid chewers. It could be scraped off with a piece of gauze; it regresses spontaneously; more frequently when the habit is discontinued.
4
Pan chewer’s lesion
Tobacco pouch keratosis
Leukoplakia
Both 1 and 2
Pathology
null
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multi
Marker for granulocytic Sarcoma-
Answer is option 3,CD117 kit, a proto-oncogene, encodes the transmembrane tyrosine kinase receptor CD117 and is detected by flow cytometry in the majority of cases of acute myeloid leukemia. The prognostic significance of the presence of c-Kit in acute myeloid leukemia is debated. Granulocytic sarcoma is a primary or secondary manifestation of acute myeloid leukemia. www.archivesofpathology.org
3
CD33
CD38
CD117
CD137
Pathology
Haematology
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Thoracic duct does NOT drain:
Right upper quadrant of the body drains the lymphatics into the right lymphatic duct and rest of the body drains into thoracic duct Thoracic duct is continuation of cysterna chyli as it pass through aoic hiatus begin at lower border of T12 . At T5(angle of louis) it crosses to left side and drains at left Jugulo-subclan venous angle at C7 .
1
Right upper pa of body
Left upper pa of body
Right lower pa of body
Left lower pa of body
Anatomy
Back and Thorax
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single
All the following are seen at Transpyloric Plane except
The transpyloric plane is an imaginary transverse plane often referred to in anatomical descriptions.The transpyloric plane of Addison passes midway between the suprasternal notch and the pubic symphysis. It lies roughly a hand&;s breadth below the xiphisternal joint. Anteriorly, it passes through the tips of the ninth costal cailage; and posteriorly through the body of veebra LI near its lower border.It passes through the Pyloric orfice of the stomach, the fundus of the gallbladder, the neck of the pancreas, hila of the kidneys, the origin of the superior mesenteric aery, and the splenic vein.Reference: Chaurasia Volume II; 7th edition; Page no: 414
3
Pylorus of Stomach
Hilum of Kidney
Body of Gall Bladder
Neck of Pancreas
Anatomy
Abdomen and pelvis
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multi
100% moality disease, incidence and prevalence relationship will be;
Prevalence = Incidence x Duration Duration= Prevalence/Incidence - longer the duration of the disease, the greater its prevalence. - if the disease is acute and of sho duration either because of rapid recovery or death, the prevalence rate will be relatively low compared with the incidence rate. (P < 1).
3
P = 1
P > 1
P < 1
No relationship
Social & Preventive Medicine
FMGE 2019
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Urinary anion gap is?
Urinary anion gap (Na+ + K+ ) - (Cl- ) = 0 Urine is electro neutral *Anion gap in Blood = (Na+) - (Cl- + HCO3-)
2
Plus 1
0
Minus 1
Cannot be calculated
Medicine
Fluids and Electrolyte Imbalance
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Esophagus enters through
C. i.e. Muscular pa of diaphragm
3
Central tendon of diaphragm
Along aoic opening
Muscular pa of diaphragm
All
Anatomy
null
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multi
Which of the following is true of lepromatous leprosy a) Bacterial index + to ++ b) Involvement of earlobes c) Symmetrical involvement d) Only a few bacilli are seen in the lesion e) Loss of eyebrows
null
2
abc
bce
ade
cde
Medicine
null
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multi
All can cause recurrent pulmonary infection except:
Answer is C (TOF) ASD, L VF and VSD are all associated with pulmonary congestion and hence predispose to pulmonary infections. TOF is associated with reduced pulmonary blood flow (oligenic lung fields) due to right ventricular outflow obstruction and hence does not predispose to recurrent pulmonary infections.
3
VSD
Recurrent LVF
TOF
ASD
Medicine
null
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All of the following structures are derived from mesonephric duct, EXCEPT:
The wolffian duct or mesonephric duct forms the epididymis, vas deferens and seminal vesicles. Testosterone directs the development of wolffian duct. Trigone of the bladder develop from the caudal end of the mesonephric duct. A pair of ureteric bud grow upwards from the distal mesonephric duct near its inseion into the cloaca to form the renal pelvis, calyces and collecting ducts. Most of the prostate gland develop from the same primordial area of urogenital sinus that forms the vaginal plate in females. The mullerian or paramesonephric duct forms the fallopian tubes, uterus and upper third of the vagina. Ref: The Reproductive System at a Glance By Linda J. Heffner 3rd edn page 22. Atlas of Urogynecological Endoscopy By Peter L. Dwyer page 38.
4
Vas deferens
Ureter
Trigone of urinary bladder
Prostatic utricle
Anatomy
null
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For each mol of substrate oxidized Complexes I, III, and IV in the respiratory chain NADH, --- mol of ATP are formed?
For each mol of substrate oxidized Complexes I, III, and IV in the respiratory chain (ie, NADH), 2.5 mol of ATP are formed per 0.5 mol of O2 consumed; ie, the P:O ratio = 2.5. On the other hand, when 1 mol of the substrate (eg, succinate or 3-phosphoglycerate) is oxidized Complexes II, III, and IV, only 1.5 mol of ATP are formed; that is, P:O = 1.5. These reactions are known as oxidative phosphorylation at the respiratory chain level. Reference: Harper; 30th edition; Page no: 131
4
1
1.5
2
2.5
Biochemistry
Respiratory chain
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All of the following are Eradicable disease except
Till date only one disease has been eradicated - SMALLPOX. Diseases that are amenable to eradication are measles, diphtheria, polio and guniea worm. Ref : Park&;s Textbook of Preventive and Social Medicine; 23rd edition; Page 94
1
Tuberculosis
Guinea worm
Polio
Measles
Social & Preventive Medicine
Concept of health and disease
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Power driven instrument is
null
1
Gates glidden drill
Reamers
Giromatic
Racer-Engine
Dental
null
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In pyogenic liver abscess commonest route of spread is
Routes of spread 1st most common - Biliary tract 2nd most common - poal vein
2
Hematogenous through poal vein
Ascending infection through biliary tract
Hepatic aery
Local spread
Anatomy
G.I.T
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Which of the following organs is not involved in hemochromatosis?
Hereditary hemochromatosis is an adult-onset disorder that represents an error of iron metabolism characterized by inappropriately high iron absorption resulting in progressive iron overload and accumulation of iron in parenchymal organs, leading to organ toxicity.This is the most common inherited liver disease in white persons and the most common autosomal recessive genetic disorder. This disease is the most common cause of severe iron overload. The organs involved are the liver, hea, pancreas, pituitary, joints, and skin. Phlebotomy is the treatment of choice. Chelating agents are also used.
3
Liver
Hea
Testis
Pancreas
Medicine
null
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single
Most impoant component of Bishop score
The most impoant component of bishop score is dilatation of cervix
2
Position
Dilatation
Station
Effacement
Anatomy
General obstetrics
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Most sensitive investigation for diagnosis of asymptomatic chlamydial infection:aEUR'
Nucleic acid amplification Chlamydial infections are frequently asymptomatic. - Confirmation of chlamydial infection usually depends on taking an appropriate clinical sample .from the patient ,followed by the direct detection of the organism using a suitable laboratory-based diagnostic test. The demonstration of chlamydial antibodies (serology) in an individual is rarely diagnostic. For many years, the optimum method of confirming the presence of chlamydial infection was the growth of the infecting organism in cell culture and the demonstration of characteristic chlamydial inclusions. - However, this method necessitated the availability of good transpo and cold-storage facilities in order to maintain the bility of the organism prior to inoculation. - Moreover growth and isolation of the organisms in cell culture was relatively tedious and difficult to quality control. - Chlamydial cell culture ,facilities were available to relatively few clinical centres. - It is now widely recognized that cell culture techniques were, at best, only 60 to 80% sensitive. A key advance in the laboratory diagnosis of chlamydial infections has been the development of non-bility dependent tests which place less demand on specimen transpo. The first of these tests were the chlamydial antigen detection tests, which relied, either on The direct detection of chlamydial elementary bodies in clinical material using fluorochrome-labelled, chlamydial specific, monoclonal antibodies. Direct immunofluorescence - Capture and detection of chlamydial antigen in an extract of clinical material using enzyme immunoassay based procedures. These methods are still appropriate in some settings and they remain in widespread use. However, they are gradually being superseded by newer, methods based on the detection of chlamydial nucleic acid, either by -- Direct hybridization or by - Nucleic acid amplification The latter use a variety of amplification reactions including the: ? - Polymerase chain reaction - Ligase chain reaction - Strand displacement amplification or transcription mediated amplification. Nucleic acid-based methods generally offer superior sensitivity and specificity to the antigen detection tests, but at greater cost and a greater requirement for trained staff. A second major advance has been the recognition that cervical or urethral specimens requiring invasive genital sampling are by no means essential for the laboratory diagnosis of chlamydial infection. Non invasive and or self collected samples which may be adequate include male and ,female urine, various vulval-introital samples or vaginal fluid expressed from a tampon. More on chlamydial diagnosis Chlamydia is an obligate intracellular parasite. It cannot survive outside its host i.e. it cannot grow on cell free media. - Up until the early 1980s, the main method of confirming a diagnosis of chlamydial infection, was the inoculation of clinical material into animals, embryonated hens eggs or (usually) tissue culture cells and the demonstration of characteristic chlamydial inclusions. Generally speaking inclusions were demonstrated in cell culture ? - Either by staining with iodine - By staining with Giemsa stain - Fluorochrome-labelled poly - or mono-clonal antibody - Enzyme immunohistochemistry The usual tissue culture cells were - - HeLa 229, - L434 mouse fibroblasts or C'. trachomatis and C. psittaci; - McCoy cells - Buffalo Green Monkey kidney cells (C. psittaci and - HL or Hep2 cells C. pneumoniae) Growth of the organisms was facilitated by the use of ? - Antimetabolites directed against the host cell (cyclohexitnide; emetine or ntitomycin C) or, - By the use of charged anionic polymers such as Poly - L - lysine or DEAR dextran for C trachomatis TRIO biovar. Compounds like polyethylene glycol or high energy glucose 6 phosphate also aided the growth of some chlamydiae.
2
Culture
Nucleic acid amplification
Serology
Direct microscopic examination of tissue scraping
Microbiology
null
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The histologic entity that has the worst prognosis in interstitial lung disease is:
Ans: c (Acute interstitial pneumonia)Ref: Rosai and Ackerman's Surgical Pathology 9th ed Pg. 377, Harrison 18th ed chp 261Acute Interstitial Pneumonia (Hamman-Rich Syndrome)* A fulminant form of lung injury characterized by idiopathic ARDS and organizing diffuse alveolar damage by lung biopsy.* The onset is usually abrupt following a prodromal illness.* CXR - Diffuse, bilateral, air-space opacification.* HRCT - bilateral, patchy, symmetric areas of ground-glass attenuation & areas of air-space consolidation. A predominantly subpleural distribution may be seen.* The mortality rate is high (>60%), most patients die within 6 months.* Treatment is supportive, glucocorticoid therapy role not clear.
3
Non-specific interstitial pneumonia
Desquamative interstitial pneumonia
Acute interstitial pneumonia
Usual interstitial pneumonia
Unknown
null
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JAK-2 mutation is strongly associated with?
Ans. is 'b' i.e., Polycythemia vera * Janus kinase 2 (JAK2), a member of the Janus kinase family, is a non-receptor tyrosine kinase.* JAK2 fusions with the TEL(ETV6) (TEL-JAK2) and PCM 1 have found to be associated with leukemia, particularly clonal eosinophilia forms of the disease.* JAK-2 mutations are associated withi) Polycythemia vera,ii) Essential thrombocythemiaiii) Myelofibrosis (and other myeloproliferative disorders)iv) Abnormal heart defects
2
Burkitt's lymphoma
Polycythemia vera
Multiple myeloma
Mantle cell lymphoma
Pathology
Blood
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A 32-year old adult male broke the jaw of another in an alleged fight. The investigating police officer:
Ans. b. Can arrest him without warrant Fracture or dislocation of mandible is a 'Grievous injury' for which punishment is defined under IPC 325. It is a 'cognizable offence' hence a police officer can arrest the accused without warrant. "Cognisable offence: An offence for which a police officer can arrest a person without warrant from magistratedeg e.g. rape, robbery, murder, dowry death, raggingdeg, death due to rash or negligent act." Grievous Injury (Sec 320 IPC)Q EmasculationQ Permanent privation of either eyeQ Permanent privation of either ear Privation of any member (pa, organ or limb) or joint Permanent disfiguration of head or faceQ Fracture or dislocation of a bone or a toothQ Destruction or permanent impairing of powers of any member or joint Any hu which endangers life, or which causes the sufferer to be, during the space of 20 days, in severe body pain, or unable to follow his daily routinevQ.
2
Can arrest him only after procuring warrant
Can arrest him without warrant
May declare him hostile and put him in jail
May declare him sociopath and send him to mental asylum
Forensic Medicine
null
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In an emphysematous patient with bullous lesions, which is the best investigation to measure lung volume:
Answer is A (Body Plethysmography): Body Plethysmography is the investigation of choice fir estimating lung volumes in the setting of COPD with bullous lesions (trapped air) Estimating Lung Volumes Gas Dil ion Technique (Helium / Nitrogen Dilution Method) Gas dilution methods are fairly accurate in measurement of lung volumes in restrictive lung diseases, but not so in obstructive lung diseases with trapped air in bullae. Gas dilution methods tend to under-estimate lung volumes in patients with emphysema with ballous lesions as they do not measure the volume of trapped gas or bullae. Body Plethysmography Body Plethysmography is fairly accurate in measurement of lung volumes in both restrictive lung diseases and obstructive lung diseases even with trapped air in bullae Body Plethysmography also measures the volume of any gas containing space in the thorax, including bullae. The difference between Lung volume measurements by Body Plethysmography and gas dilution technique reflects the amount of gas trapped, in bullae.
1
Body Plethysmography
Gas dilution
Transdiaphragmatic pressure
DLco
Medicine
null
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Bisphosphonates are not used in:
Vitamin D intoxication
4
Hypercalcemia
Osteoporosis
Cancer induced osteolysis
Vitamin D intoxication
Pharmacology
null
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single
A 20 yrs aged patient, presents in coma with pin point pupils and fasciculations but no fever. Most probable diagnosis is:
D i.e. Organophosphorus poisoning Pinpoint pupils (miosis) is seen in 'Bar Car OR Mor - Chlor' i.e. Barbiturates, Carbolic acid (Phenol), Organophosphorus, Morphine (Opioid), Choral hydrate.Q & Pontine haemorrhageQ So we are left with two options - Pontine haemorrhage & Organophosphorus. Not useful in Carbamate poisoning Useful in Organophosphorus poisoning - Physo / Pyrido / Riva/Neo - - ParathionQ & MalathionQ stigmineQ - Dyflos (DEP - D-iso fluro - Ambenonium & phosphateQ) EdrophoniumQ - Diazinon (TIK - 20) - Carabaryl (sevin) - EchothiophateQ - PropoxurQ (Baygon) - Tabun, Sarin, Soman - Demecarium - Donepezil
4
Head injury
Dhatura
Pontine haemorrhage
Organophosphorus poisoning
Forensic Medicine
null
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single
In family welfare programme, score of 1 is given to:
Ans. is 'b' i.e. Net reproductive rate NRR of 1 is equivalent to attaining approx., the 2 child norm*The Govt, of India in 1983 adopted the policy of attaining a NRR of 1 by the year 1996 (now to be achieved by 2006).
2
Birth rate
Net reproduction rate
Achievement of goal
Total implementation of programme
Social & Preventive Medicine
Demography
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single
Foamy macrophage is formed by -
Ans. is 'c' i.e., Oxidized LDLo Foam cells are lipid laden cells that derive predominantly from macrophages, but smooth muscle cells can also imbibe lipid to become foam cells.o Macrophages and endothelial cells generate oxygen free radicals that induce chemical change in LDL to yield oxidized (modified) LDL.o Oxidized LDL has following effects -Ingested by macrophages through the scavenger receptor, distinct from LDL receptors, thus forming foam cells.Increases monocyte accumulation in lesions.Stimulates release of growth factors and cytokines.Is cytotoxic to smooth muscle cells and endothelial cells,o Oxidized LDL form the core of the atheromatous plaque.
3
LDL
HDL
Oxidized LDL
Oxidized HDL
Pathology
Histo Pathology
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single
Dye for myelography is injected in?
Ans. c (Subarachnoid space). (Ref. Clark, Positioning in Radiography, 10th ed., 588)MYELOGRAPHY# Myelography is the radiographic investigation of the spinal canal for the diagnosis of space occupying & obstructive lesions & requires the contrast agent to be injected into the subarchnoid space (which lies between pia mater & the arachnoid mater) usually following a lumbar puncture.# Either a negative contrast agent like air or oxygen is used or more usually a positive non reactive water-soluble preferably non-ionic, organic iodine compound (Iohexol).# Nonionic iodinated compounds have replaced myodil (iophendylate) due to its advantages like freely miscible with CSF, flows along subarachnoid spaces around the nerve roots & is absorbed from subarachnoid space within 48 hours.# They are isotonic with CSF in concentration usually used for lumbar myelography, made upto a volume of 10 cc.# They also have low viscosity and thus a narrow bone needle can be used.# Reactions like headache, nausea seldom last for more than 24 hours.# Arachnoiditis is severe most complication, however with newer contrast, it is extremely uncommon.- Iohexol (omnipaque) is nonionic contrast commonly used today. Iohexol has more evenly distributed OH groups hence has less subarachnoid toxicity.# MRI has replaced myelography and CT myelography.
3
Subdural space
Epidural space
Subarachnoid space
Extradural space
Radiology
Nervous System
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Treatment for mild ptosis is-
*Fasanella-Servat operation. It is performed in cases having mild ptosis (1.5-2mm) and good levator function. In it, upper lid is eveed and the upper tarsal border along with its attached Muller's muscle and conjunctiva are resected. Ref: Khurana 7th/e p.395
1
Fasanella servat operation
Levator resection
Frontalis sling operation
Everbusch's Operation
Ophthalmology
Diseases of orbit, Lids and lacrimal apparatus
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single
Rash is not caused by ?
Ans. is 'b' i.e., Shigella Salmonella (typhoid) and meningococci cause morbiliform rash. Staphylococcus causes scarlentiform rash in TS S and SSSS. Infections causing Exanthems (acute generalized rash) Morbilliform Viral : Measles (rubeola), rubella, erythema infectiosum, EBV, CMV, adenovirus, echovirus, early HIV, coxasackie virus. Bacterial : Typhoid, Early secondary syphiis, Early rickettsia, Early meningoccemia. Scarlentiform Scarlet fever (streptococcus). Toxic shock syndrome. Staphylococcal scalded skin syndrome.
2
Salmonella
Shigella
Meningococci
Staphylococcus
Microbiology
null
523326bc-fe56-4c06-b19d-4a64feb3a3f0
single
Ligament preventing the displacement of humerus is
The area between the superior and middle glenohumeral ligament is a point of weakness in the capsule( foramen of Weitbrecht) which is a common site of anterior dislocation of humeral head. Reference : page no:147,BD chaurasia- upper limb& thorax, 7th edition.
4
Coracoclavicular
Coracohumeral
Coracoacromial
Glenohumeral
Anatomy
Upper limb
90120236-907a-4065-8657-34da37055af5
single
True about Dressler's syndrome is all, except :
Answer is A (Occurs with in hours after myocardial infarction) Dressler's syndrome develops after an interval of 1 to 4 weeks (or even month) following cardiac injury (MI) and not within hours. Dressler's syndrome / Post Cardiac Injury Syndrome Dressler's syndrome refers to an acute farm of pericarditis that develops after myocardial infarction The pericarditis typically develops I to 4 weeks following cardiac injury/MI but may appear after several months Recurrence may be seen sometimes upto 2 years or more after MI / Injury Pathological pericarditis may be of the fibrinous variety The mechanism is not ceain but they are believed to result from a hypersensitivity reaction in which the antigen originates from the injured myocardial tissue. Circulating antibodies to myocardium occur frequently. The principal symptom is 'chest pain' of acute pericarditis. Leukocvtosis, T ESR and ECG changes of acute Pericarditis may also occur. The pericarditis is usually resolves in I to 2 weeks and often no treatment is necessary apa from aspirin, NSAIDS or analgesics. Therepy with NSAIDS or coicosteroids is usually effective.
1
Occurs with in hours after myocardial infarction
Recurrence may be seen
Chest pain is common
Responds well to salicylates
Medicine
null
edbc33a9-9bb2-4c7d-ba77-d867412ffde6
multi
Wide and fixed 2nd heart sound seen in -
(A) (ASD) 632. Davidson 21st (1922 - 24 - H 19th)Atrial septal defect* Wide fixed splitting of the second heart sound wide because of delay in right ventricular ejection (increased stroke volume and right bundle branch block) and fixed because the septal defect equalizes left and right atrial pressures throughout the respiratory cycle.* A systolic flow murmur over the pulmonary valve.* ECG - incomplete RBBB (right bundle branch black)VENTRICULAR SEPTAL DEFECT:* Pansystolic murmur usually heard best at the left sternal edge but radiating all over the precardium.* A small defect often produces a loud murmur (maladie-de-Roger) in the absence of other haemodynamic disturbances.* Most congenital defects are "perimembranous" i.e. at the junction of the membranous and muscular portions.* ECG shows bilateral\ ventricular hypertrophy.TETRALOGY OF FALLOT:* Cyanosis with a loud ejection systolic murmur in the pulmonary area* ECG right ventricular hypertrophy* X-ray chest 'boot shaped heart'PATENT DUCTUS ARTERIOSUS:* A continuous ''machinery" murmur is heard with late systolic accentuation, maximal in the second left intercostals space below the clavicle.* It is frequently accompanied by a thrill, pulse are increased in volume.* ECG is usually normalAORTIC STENOSIS:A harsh ejection systolic murmur radiates to the neck with a soft second heart sound particularly in those with calcific valve, low pitched, rough and rasping in character.The murmur is often likened to a saw cutting wood and may (especially in older patients) have a musical quality like the 'new' of a seagull.* Slow rising carotid pulse, narrow pulse pressure.* Thrusting apex beat (LV pressure overload)* Sign of pulmonary venous congestion (e.g. crepitations),ECG - LV hypertrophy, ST - segment depression and T. wave inversion (LV - 'strain*)Lutembacher's syndrome consist of - ASD and MS
1
ASD
VSD
Aortic stenosis
PDA
Medicine
C.V.S.
6b637ee8-0476-44aa-99fa-2e2124c09de8
single
Ivacaftor was approved by FDA in 2018 for
Ivacaftor is used for treating cystic fibrosis
1
Cystic fibrosis
Migraine
Hypeension
Glycogen storage disorders
Pharmacology
All India exam
3d795a0e-7c30-4278-bb77-8f53fdf275d4
single
One of the most common side effects of inhaled beclomethasone dipropionate is:
(Ref: KDT 6/e p225) Most common adverse effect of inhaled coicosteroids is oropharyngal candidiasis. Pituitary adrenal suppression is less likey with inhalational route of coicosteroids than with oral route.
2
Pneumonia
Oropharyngeal candidiasis
Atrophic rhinitis
Pituitary adrenal suppression
Pharmacology
Other topics and Adverse effects
45fddbe1-5644-4dbb-9e11-eec420418754
single
All of the following are associated with proximal muscle weakness except –
The general rule in that : Myopathies have proximal muscle weakness. Neuropathies have distal muscle weakness. Myotonic dystrophy is an exception to this general rule and mainly involves the distal muscles. Also, know The difference between myopathy and muscular dystrophy. Myopathy Any skeletal muscle disorder that causes structural changes or functional impairment of muscle. It also includes muscular dystrophies. Muscular dystrophy The muscular dystrophy means an abnormal growth of muscle. It is characterized by - It is a primary myopathy  It has a genetic basis  Course is progressive    Degeneration & Death of muscle fibres occur at some stage of the disease       So, muscular dystrophy is a type of myopathy.
4
Spinomuscular atrophy
Duchenis muscular dystrophy
Polymyositis
Myotonic dystrophy
Pediatrics
null
f6c0a096-3608-415c-99d0-3a4958d6c586
multi
Insulin does not facilitate glucose uptake in the following except :
B i.e. Hea
2
Liver
Hea
RBC
Kidney
Physiology
null
fa180203-1346-4615-9aa1-d3f47340b046
multi
The electrical potential difference necessary for a single ion to be at equilibrium across a membrane is best described by the
At normal body temperature (37degC), the electrical difference that will balance a given concentration difference of univalent ions--such as Na+ ions--can be determined from the following formula, called the Nernst equation.Ref: Guyton; 13th edition; Chapter 4 Transpo of Substances Through Cell Membranes
4
Goldman equation
van't Hoff equation
Fick's law
Nernst equation
Physiology
General physiology
03596924-87f8-477d-8b0b-546a95950c39
single
Which one of the following ligaments contains splenic artery -
Linorenal (splenorenal) ligament contains tail of pancreas, splenic vessels, lymph nodes and lymphatics and sympathetic nerve.
3
Gastrosplenic ligament
Splenocolic ligament
Splenorenal ligament
Splenophrenic ligament
Anatomy
null
327bac05-518c-4c0c-b6df-87485609de7d
single
The non poisoning Salt of cyanide is :
D i.e. Potassium ferrocyanide
4
Potassium cyanide
Hydrocyanic acid
Sodium cyanide
Potassium ferroc yanide
Forensic Medicine
null
370f65fc-f5ae-4e4b-8bb2-fb5dbcd32f06
single
α - intercalated cells are present in _________ helps in __________
Intercalated cells are present in Collecting duct I cells are of 2 types. Alpha : acid secretion Beta : HCO3 secretion
3
Distal convoluted tubule, HCO3– secretion
Distal convoluted tubule, H+ secretion
Collecting duct, H+ secretion
Collecting duct, HCO3– secretion
Physiology
null
d6a35c91-5899-46de-9d71-60b6cd131157
single
M.C. retroperitoneal tumour is -
Ans is 'b' ie Liposarcoma The most common primary malignancy of the retroperitoneum is sarcoma.(Ref Sabiston) "In the retroperitoneal location, well-differentiated and dedifferentiated liposarcoma and leiomyosarcoma are the most common histiotypes, whereas in the visceral location, GISTs are found most commonly."- Devita's Oncology
2
Fibrosarcoma
Liposarcoma
Dermoid cyst
Rhabdosarcoma
Social & Preventive Medicine
null
4116a0c4-a0e4-48e6-acdb-189b25db75c4
single
Hydrolysis of which of the following compounds yield urea?
Arginine is an amino acid that is deaminated to form ornithine primarily in the liver as part of the urea cycle. Ornithine, argininosuccinate, aspartate and citrulline are generated in the urea cycle but do not provide free ammonia for urea synthesis.
4
Ornithine
Argininosuccinate
Aspartate
Arginine
Biochemistry
null
e6a9b479-6407-4acf-ab8e-90bf8c4b7c0b
single
Mild mental retardation is defined when IQ is-
Ans. is 'a' i.e., 50-70 CategoryIQMild50-70Moderate35-49Severe20-34Profound<20
1
50-70
35-49
20-34
<20
Social & Preventive Medicine
Social Science, Mental Health & Genetics
66e36868-979b-433b-9826-3c27eed88e01
single
Histology of acute rejection of renal transplant are-
Harshmohan textbook of pathology 7th edition. *in hyper acute rejection there are numerous neutrophils around dialated and obstructed capillaries which are blocked by fibrin and platelet thrombi. *in acute rejection there is extensive infilteration in interstitium of the transplant by lymphocytes and a few plasma cells monocytes and polymorphs. *in chronic rejection there is initial fibrosis .
4
Aeriolar hyalinosis
Eosinophilic infiltration
Glomerular vasodilation
Neutrophilic infiltration
Pathology
General pathology
69dca969-55d0-4574-a203-1740b3228daa
single
The hormone associated with cold adaption is:
B i.e. Thyroxine
2
Growth hormone.
Thyroxine.
Insulin.
Melanocyte Stimulating Hormone
Physiology
null
b3726d86-8727-4d6b-b33c-07de2d709c06
single
Which of the following does not cross a blood brain barrier
Ref-Katzung 11/e p121 Pralidoxime or 2-PAM, usually as the chloride or iodide salts, belongs to a family of compounds called oximes that bind to organophosphate-inactivated acetylcholinesterase. It is used to treat organophosphate poisoning in conjunction with atropine and diazepam
1
Pralidoxime
Obidoxime
Diacetylmonoxime
Physostigmine
Pharmacology
Autonomic nervous system
3ca29e32-90e5-40b5-adaf-9119fe864a41
single
Marker for Hairy cell Leukemia is:
CD 103
2
CD 30
CD 103
CD1
CD4
Pathology
null
b0f60cde-5ffa-4f74-b9e4-00cfc6a31bf8
single
All of the following drugs are used in Opioid dependence, except
(D) Nalorphine # Opioid dependence> Levomethadyl acetate> Levomethadyl acetate, also known as levo-a-acetylmethadol (LAAM) is a synthetic opioid similar in structure to methadone.> It has a long duration of action due to its active metabolites.> It was approved for use in the treatment of opioid dependence.> Indications> LAAM is indicated as a second-line treatment for the treatment and management of opioid dependence if patients fail to respond to drugs like methadone or buprenorphine.> Other forms of treatment include replacement drugs such as methadone or buprenorphine, used as a substitute for illicit opiate drugs.> Although these drugs are themselves addictive, opioid dependency is often so strong that a way to gradually reduce the levels of opioid needed are required.> In some countries, other opioid derivatives such as levomethadyl acetate, dihydrocodeine, dihydroetorphine and even heroin are used as substitute drugs for illegal street opiates, with different drugs being used depending on the needs of the individual patient
4
LAAM
Buprenorphin
Methadone
Nalorphine
Psychiatry
Miscellaneous
d8d50d0b-a7e8-4f93-81ea-24515f1c6833
multi
Platelet aggregation is caused by -
Robbins basic pathology 9th edition page no 46, Answer is option 2, thromboxaneA2 Thromboxane A2 is a potent platelet aggregating agent and a vasoconstrictor, is the major prostaglandin produced in these cells. Itvis an intrmediate produced in the cyclooxygenase pathway by the enzyme thromboxane synthase.
2
Nitrous oxide
Thromboxone A2
Aspirin
PGI2
Pathology
Haematology
e0d28304-c51e-4948-9c06-748934a723c9
single
Gold standard investigation for screening breast carcinoma in patients with breast implant -
Ans. is 'a' i.e., MRI o It can be useful to distinguish scar from recurrence in women who have had previous breast conservation therapy for cancer (although it is not accurate within 9 months of radiotherapy because of abnormal enhancement).o It is the best imaging modality for the breasts of women with implants,o It has proven to be useful as a screening tool in a high-risk women (because of family history).o It is less useful than ultrasound in the management of the axilla in both primary breast cancer and recurrent disease.
1
MRI
USG
Mammography
CT scan
Surgery
Breast Cancer - Prognosis and Follow-Up
f43e9739-0a1d-4c89-be3b-a84dc5e8269b
single
Murphy sign is seen in: March 2013 (g)
Ans. C i.e. Acute cholcystitis Murphy's sign It is useful for differentiating pain in the right upper quadrant. Typically, it is positive in cholecystitis, but negative in choledocholithiasis, pyelonephritis and ascending cholangitis.
3
Acute pancreatitis
Acute appendicitis
Acute cholecystitis
Acute esophagitis
Surgery
null
312af99f-ba2b-4ab3-9c04-0aec1663295c
single
All of the following structures forms the boundary of the Hesselbach's triangle, EXCEPT?
Hesselbach's triangle is a region in the anterior abdominal wall. It is bounded inferiorly by the inguinal ligament, medially by the lateral border of the rectus muscles, and laterally by the inferior epigastric vessels.Base of the triangle is formed by pubic pecten and pectineal ligament.
4
Rectus muscle
Inguinal ligament
Inferior epigastric vessel
Deep circumflex iliac vessel
Anatomy
null
ce41aef7-8aca-4b2f-a993-825aff799df0
multi
The recommended target HbA1C to minimise the risk of vascular complications in diabetic individual is
null
3
10% or more
8%
7% or less
9%
Medicine
null
3f3a0746-67b3-4be9-b894-ad7e5886c2e3
single
A young female patient came for routine examination. On examination a mid systolic click was found. There is no history of RHD. The histopathological examination is most likely to show
Ans. a. Myxomatous degeneration and prolapse of the mitral valve
1
Myxomatous degeneration and prolapse of the mitral valve
Fibrinous deposition on the tip of papillary muscle
Rupture of chordae tendinae
Aschoff nodule on the mitral valve
Pathology
null
6c42610f-f16f-46a4-a941-e5eaf133db2b
single
Most common testicular tumour
Seminoma is the most common germ cell tumor of the testis or, more rarely, the mediastinum or other extra- gonadal locations. It is a malignant neoplasm and is one of the most treatable and curable cancers, with a survival rate above 95% if discovered in early stages.
1
Seminoma
Teratoma
Seoli cell tumour
Chorio ca
Anatomy
Urology
f9ee5718-6ce5-4028-a9c2-1d4e61029d6e
single
All except one ­are absorbed in the DCT:
Although K+ is also absorbed in DCT, secretion of K+ may exceed K+ absorption in this segment. So, B should be the most appropriate answer.
2
Water
Potassium
Chloride
Sodium
Physiology
null
06230cf0-22a7-4e3c-8fec-944022f94eef
multi
Subarachnoid hemorrhage blood is collected mostly in which pa of the skull -
Answer- A. Basal cisterncausative factor-Exclude underlying aneurysmal ruptureTypical location-Basal cisternsClinical profileHeadache,meningismusdelayed manifestations,vasospasm
1
Basal cistern
Around Fah carebri
Near cerebellum
Tentorium
Surgery
null
aab097c4-282f-47b5-a1e6-24809e2c8319
single
Not a layer of retina:
Layers of the retina, from the outside inwards Retinal Pigment Epithelium Layer of rods and cones External (Outer) limiting membrane Outer nuclear layer Outer plexiform layer Inner nuclear layer Inner plexiform layer Ganglion cell layer Layer of optic nerve fibres Internal (Inner) limiting membrane The neural retina meets the optic nerve at the optic. disc (or optic papilla), which is devoid of photoreceptor cells, forming a blind spot in the visual field. The fovea, lateral to the optic disc, is the area of greatest visual acuity, and is surrounded by a yellow pigmented zone called the fovea lutea. Bowman's membrane is present in cornea
3
Outer limiting membrane
Retinal pigment epithelium
Bowman's membrane
Ganglion cell layer
Anatomy
null
a23d0f4d-6485-4fd2-b492-5ba9f9e19c0f
single
Which of the following statement regarding water reabsorption in the tubules?
Water reabsorption occurs along with sodium reabsorption.Ref: Ganong&;s review of medical physiology; 24th edition; page no: 685
1
The bulk of water reabsorption occurs secondary to Na+ reabsorption
Majority to facultative reabsorption occurs in proximal tubule
Obligatory reabsorption in ADH dependent.
20% of water is always reabsorbed irrespective of water balance
Physiology
Renal physiology
d92d357b-22b3-422b-8c73-799e412f01d0
multi
A man 25-yrs-old presents with renal failure. His uncle died of renal failure 3 yrs ago. On slit lamp examination, keratoconus is present. Diagnosis is -
null
3
ADPCKD
ARPCKD
Aloport's syndrome
Denysh-Drash syndrome
Medicine
null
d2c651fc-b16e-40b6-9b07-688bc8ac0614
single
In a fetus, testis lies at superficial inguinal ring at:
Ans. C 8 monthsRef: Netter's Clinical Anatomy, 3rd ed. pg. 325Descent of testis3rd monthIliac fossa7th monthDeep inguinal ring7th monthTransits through inguinal canal8th monthSuperficial inguinal ring9th monthEnters the scrotum
3
6th month
7th month
8th month
9th month
Anatomy
Embryology
8a612f97-7227-4fe2-bc4e-c920ca0674e4
single
Which of the following is not a sequelae of trachoma?
Proptosis REF: Khurana 4th ed p. 66 Sequelae of trachoma: Lids : entropion, tylosis, ptosis, madarosis , ankyloblepharon Conjuctiva: concretions, pseudocyst, xerosis, symblepharon. Cornea: opacity, ectasia, xerosis. Others: Dacrocystitis, chronic dacryoadenitis.
1
Proptosis
Tylosis
Pseudocyst
Dacrocystitis
Ophthalmology
null
92353c07-f3e0-4492-91d4-7121edb744f9
single
In open angle glaucoma investigation least done is :
Investigations to be done in open angle glaucoma are : Slit lamp examination Tonometry Gonioscopy Direct ophthalmoscopy Perimetry
1
Indirect ophthalmoscopy
Tonometry
Direct ophthalmoscopy
Perimetry
Unknown
null
232436fc-4236-42b2-847a-55feeba56ebc
single
A 50-year-old man with fasting blood glucose >140 mg/ dL on two occasions is put on a restricted caloric diet and started on a glucagon-like peptide-1 (GLP-1) receptor agonist. Which of the following laboratory studies is most likely to afford the best method of monitoring disease control in this man?
Nonenzymatic glycosylation refers to the chemical process whereby glucose attaches to proteins without the aid of enzymes. The degree of glycosylation is proportionate to the level of blood glucose. Many proteins, including hemoglobin, undergo nonenzymatic glycosylation. Because RBCs have a life span of about 120 days, the amount of glycosylated hemoglobin is a function of the blood glucose level over the previous 120-day period. The level of glycosylated hemoglobin is not appreciably affected by short-term changes in plasma glucose levels. Random glucose testing is an immediate way of monitoring short-term adjustments with diet and medications such as insulin and oral agents. Fasting glucose testing affords a better way to diagnose diabetes mellitus initially. Measurements of cholesterol and fructosamine have no value in managing diabetes mellitus. Microalbuminuria may presage the development of the diabetic renal disease. The "incretin effect" is diminished in patients with type 2 diabetes, and the use of GLP-1 receptor agonists can help to restore incretin function and lead to improved glycemic control and loss of weight via increased satiety.
3
Cholesterol, total
Fasting plasma glucose
Glycosylated hemoglobin
Microalbuminuria E Random plasma glucose
Pathology
Endocrine
0120662c-2bcb-4a25-b0a8-ee3c23603812
single
In case of xeropthalmia secondary to Vitamin A deficiency, what does X2 indicate according to WHO:
Ans.(c) Corneal xerosisRef: A.K. Khurana 6th ed. /468* Xeropthalmia: all the ocular manifestation of Vitamin A deficiency.* First clinical sign of Vitamin A deficiency: Conjunctival Xerosis* First clinical symptom of vitamin A deficiency: Night blindnessWHO Classification of XeropthalmiaCLASSSIGNSX1AConjunctival xerosisX1BConjunctival xerosis with bitot's spotX2Corneal xerosisX3ACorneal xerosis with ulcerationX3BKeratomalacia
3
Conjunctival xerosis
Bitot's spot
Corneal xerosis
Corneal ulcer
Ophthalmology
Symptomatic Conditions
46d67568-d256-4e48-a4e1-5d3fff23519a
single
All of the following can result in serotonin syndrome when combined with MAO inhibitors except
Tyramine containing foods along with MAO inhibitors produce cheese reaction that is develop severe hypeension. In serotonin syndrome hypehermia, sweating, restlessness, muscle rigidity, aggressive behavior, tremors, seizures and coma occur. Ref KD Tripati 8th ed.
4
Tricyclic antidepressants
Selective serotonin reuptake inhibitors
Carbamazepine
Tyramine containing foods
Pharmacology
Central Nervous system
3d5ecc1e-60c3-4b61-bb87-7824cc7a9af9
multi
In which type of nerve fibres is conduction blocked maximally by pressure
null
1
A alpha
A beta
A gamma
C
Physiology
null
82cef1e1-949c-4520-af74-83cfb755e82c
multi
According to PALS 2010, all are components of initial impression of child except:
Ans: C (Airway) Ref: Pediatric Advanced Life Support 2010 Guidelines. Pediatric Advanced Life Support Provider Manual (A Modification of the Pediatric Assessment Triangle in the 2006 edition of the PALS textbook)Explanation:Consciousness, breathing, colour are seen in initial evaluation. Then Pulse and airway are seen according to PALS.PALS Systematic Approach Algorithm of the 2010 EditionInitial ImpressionConsciousness, breathing, and color are assessed initially.Consciousness"The level of consciousness may be characterized as unresponsive, irritable, or alert.Decreased level of consciousness may result from inadequate 02 or substrate delivery or brain trauma,'dysfunction."Breathing"Abnormal breathing includes use of accessory muscles, extra sounds of breathing or abnormal breathing patterns.''Color"Pale, modeled, or bluisIVgray skin color suggests poor perfusion, poor oxygenation, or both.A flushed appearance suggests fever or the presence of a toxin."T1CLSConsciousness in the newborn and infant can be assessed using the TICLS mneumonic.T stands for tone. And the tone can be from vigorous to limp. Every child including newborns should have good muscle tone, that is, they should not be floppy.I stands for interactive. The infant normally should be interested in his or her surroundings.C stands for consolability. The normal infant should be able to be consoled.L stands for look meaning gaze. The normal infant should follow with his or her eyes interesting objects. A glassy eyed stare is abnormal.S stands for speech or cry. The normal infant should have a normal cry.PALS Systematic Approach Algorithm Initial Impression(conscliousness, breathing, color) |Is child unresponsive with no breathing or only gasping | Yes | NoShout for help/Activate Emergency Response(as appropriate for setting)|||Is there a pulse?Yes-Open airway and begin ventilation and oxygen as available | No ||YesIs the pulse <60/min with poor perhlsion despite oxygenation and ventilation?No----||------| |Start Cpr(C-A-B) If at any time youidentify cardiac arrest------------Evaluate* Primary assessment* Secondary assessment * Diagnostic tests| Go toPediatric Cardiac ArrestAlgerithmIntervene | IdentityAfter ROSC beginEvaluate-Identify-Intervene sequence (right column
3
Consciousness
Colour
Airway
Breathing
Pediatrics
Newborn Infant - Physical Examination
ff137df2-9c26-4944-a0d7-04688504eedb
multi
Dhobi's itch is:
B. i.e. Tinea cruris
2
Tinea corfioris
Tinea cruris
Tinea barbae
Tinea capitis
Skin
null
9e98f99d-288e-49c4-b1a4-1fb870f0d080
single
Endolymphatic sac decompression is done in?
Ans. is 'a' i.e., Menieres disease Treatment of Meniere's disease Most treatments are for symptoms believed to be caused by excess endolymphatic fluid. Treatment of Meniere's disease is of two types :? A) Medical management B) Surgical management Medical management: Treatment of Meniere's disease begins first with medical management. Medical treatment controls the condition in over two third of patients. Medical management includes :? 1. Antihistamine labyrinthine sedatives (vestibular sedatives) Many cases can be controlled by vestibular sedatives like prochlorperazine, promethazine, dimenhydramine, and cinnarzine. 2. Anxiolytic and tranquillizers Many patients are anxious, therefore they may be helped by anxiolytic and tranquillizers like diazepam. 3. Vasodilators Betahistine hydrochloride appears to be the most useful recent addition to the medical armamentarium and is routinely prescribed for most patients. It increases labyrinthine blood flow by releasing histamine. Other vasodilators employed include nicotinic acid, thymoxamine, inhaled carbogen (5% CO2 with 95% 02), and histamine drip. Vasodilators increase vascularity of endolymphatic sac and its duct and thereby increases reabsorption of endolymphatic fluid. 4. Diuretics (furosemide) Diuretics with fluid and salt restriction can help to control recurrent attacks if not controlled by vestibular sedatives or vasodilators. 5. Other drugs Propantheline bromide, phenobarbitone and hyoscine are effective alternatives. Surgical management Surgical therapy for meneire's disease is reserved for medical treatment failures and is otherwise controversial. Surgical procedures can be divided into two main categories Destructive surgical procedures Nondestructive surgical procedures Destructive surgical procedures : rationale is to control veigo. Endolymphatic hydrops causes fluid pressure accumulation within the inner ear, which causes temporary malfunction and misfiring of the vestibular nerve. These abnormal signals cause veigo. Destruction of the inner ear and / or the vestibular nerve prevents these abnormal signals. The procedures performed are : Labyrinthectomy Intermittent low pressure pulse therapy (Meniett device therapy) Conservative surgical procedures : are used in cases where veigo is disabling but hearing is still useful & needs to be preserved. They are : Decompression of endolymphatic sac Endolymphatic shunt operation Sacculotomy (Fick's operation & Cody's tack procedure) Vestibular neuronectomy Ultrasonic destruction of vestibular labyrinth to preserve cochlear function. Stellate ganglion block or cervical sympathectomy I ntratympanic gentamycin Vestibular nerve section
1
Menieres disease
Otosclerosis
Otitis media
Vestibular schwannoma
ENT
null
f6839e12-e7c6-45fa-81e5-a200d26c3589
single
CT Scan of head showing a 'Tram track5 appearance in
Ans. is 'd' i.e.,. Sturge Weber Syndrome. Sturge-Weber syndrome is characterized by -A large unilateral cutaneous angioma* (.Port wine stain*) of the faceA cerebral angioma involving the ipsilateral* cerebral hemisphere and meninges.Adrenal pheochromocytoma*.Cerebral angioma leads to cortical atrophy and epilepsy*.Characteristic tram track calcification* is seen on x-ray and CT head.
4
Neurofibroma
Tuberous sclerosis
Von Hippel Lindau disease
Sturge weber syndrome
Radiology
Brain Imaging: Anatomy, Trauma, and Tumors
0d4c0885-dac2-4fe9-8b85-eaccced048b0
single
Which of the following is not a typical feature of Meniere's disease?
null
2
Sensorineural deafness
Pulsatile tinnitus
Vertigo
Fluctuating deafness
ENT
null
aba2d09c-2e6c-4326-ac3c-dd922b0a31ca
single
Salivary gland tumor exclusively seen in parotid gland
Answer-A. Wahin's tumor"Wahin's tumor arises only in the parotid gland" - Textbook of surgery"Wahin's tumor arises almost exclusively in the parotid gland (the only tumor viually restricted to the parotid)"Salivary gland tumor seen only it parotid gland- Wahins'tumor.
1
Wahin's tumor
Pleomorphic adenoma
Mucoepidermoid Ca
Adenoid cystic Ca
Pathology
null
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single
A 60 year old male was diagnosed as carcinoma right lung. CECT of the chest shows a tumor of 5x5 cm in upper lobe and another 2x2 cm size tumor nodule in middle lobe. Which of the following is the treatment of choice?
Question does not indicate the type of lung cancer in the patient. Depending on the given size of the cancer (5cm) and absence of nodal involvement or metastasis, patient is in T2 N0 M0 or Stage I cancer. The current standard of treatment of stage I and II lung cancer is surgical resection, accomplished by lobectomy or pneumonectomy, depending on the tumor location. Ref: Schwaz's Principles of Surgery, 9th Edition, Chapter 19.
1
Surgery
Radiotherapy
Chemotherapy
Suppoive treatment
Surgery
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A most common cause of death due to burns in the early period is?
Srb's manual of surgery,4th edition Pathophysiology of burns: 1.Burns, 2.Loss of fluid, 3.Severe hypovolemia, 4.Reduced cardiac output, a.Decreased myocardial function. b.altered pulmonary resistance causing pulmonary edema, 5.Infection, 6.Systemic inflammatory response syndrome-SIRS, 7.Multiorgan dysfunction syndrome-MODS 8. Ultimately leading to death.
2
Sepsis
Hypovolemic shock
Both
None
Surgery
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A pregnant patient in second trimester falls into syncope during extraction of upper molars. She should be kept in
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4
Trendelenburg position
Head down towards her feet
Right Lateral position
Left lateral position
Surgery
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multi
What is the indication of using Indocyanine green angiography indication in eye?
ANSWER: (A) Occult choroidal neovascularizationREF: Vaughan & Asbury's General Ophthalmology 17th ed chapter 2, Kanski 5th Ed Ch 14, Khurana 4th EdPg275INDOCYANINE GREEN ANGIOGRAPHYThe principal use for fluorescein angiography in age-related macular degeneration is in locating subretinal choroidal neovascularization for possible laser photocoagulation. The angiogram may showr a well-demarcated neovascular membrane. Frequently, however, the area of choroidal neovascularization is poorly defined ("occult") because of surrounding or overlying blood, exudate, or serous fluid.Indocyanine green angiography is a separate technique that is superior for imaging the choroidal circulation. Fluorescein diffuses out of the choriocapillaris, creating a diffuse background fluorescence. As opposed to fluorescein, indocyanine green is a larger molecule that binds completely to plasma proteins, causing it to remain in the choroidal vessels. Thus, larger choroidal vessels can be imaged. Unique photochemical properties allow the dye to be transmitted better through melanin (eg, in the retinal pigment epithelium), blood, exudate, and serous fluid. This technique therefore serves as an important adjunct to fluorescein angiography for imaging occult choroidal neovascularization and other choroidal vascular abnormalities. Following dye injection, angiography is performed using special digital video cameras. The digital images can be further enhanced and analyzed by computer.
1
Occult choroidal neovasularisation
Conjunctivitis
Vitreous hemorrhage
Corneal ulcer
Ophthalmology
Anatomy
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single
Population coverage of primary health center
null
4
20,000 in plain area
10,000 in tribal area
30,000 in tribal area
30,000 in plain area
Social & Preventive Medicine
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single
Prokaryotes are characterized by -
Different between Prokaryotes and Eukaryotes PROKARYOTES EUKARYOTES Nuclear membrane absent Nuclear membrane well defined Cytoplasmic structures absent e.g. Mitochondria, Lysosomes, Golgi apparatus, and endoplasmic reticulum are absent. All these cell organelles are present In cell wall muramic acid & diaminopimelic acids (DAPA) present Both absent in cell wall No sterols in cell membrane Sterols present in cell membrane Eg-bacteria, blue-green algae Fungi, protozoa, slime moulds Site of respiration - Mesosomes Mitochondria Ribosomes--protein production site - 70S (50S + 30S), free in cytoplasm or bound to cell membrane Ribosomes--protein production site - 80S (60S + 40S), attached to rough endoplasmic reticulum
1
Absence of nuclear membrane
Presence of microvilli on its surface
Presence of smooth endoplasmic reticulum
All of the above
Microbiology
General Microbiology Pa 1 (History, Microscopy, Stains and Structure and Physiology of Bacteria)
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Fracture shaft of humerus can cause damage to which of the following nerves?
Radial nerve palsy associated with humeral shaft fractures is the most common nerve lesion complicating fractures of long bones. Radial nerve injury is commonly associated with: Fracture shaft of humerus Saturday night palsy Injection palsy
4
Median nerve
Ulnar nerve
Axillary nerve
Radial nerve
Surgery
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single
Reliability of screening test does not mean ?
Ans. is 'c' i.e., Validity Repeatability (reliability) Repeatability means, the test must give consistent results when it is repeated more than once on the same individual under same conditions. That means the results of test are precise (exact), So repeatability is some time called precision, reliability or reproducibility.
3
Reproducibility
Repeatability
Validity
Precision
Social & Preventive Medicine
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single
A newborn vomits after each feeding of milk-based formula, and does not gain weight. Biochemical testing reveals a severe deficiency of galactose-1-phosphate uridyltransferase, consistent with homozygosity. If this condition goes untreated, what is the likely outcome for this patient?
Galactosemia occurs in two very different clinical forms. Deficiency of galactokinase produces very mild disease with the only significant complication being cataract formation. In contrast, homozygous deficiency of galactose-1-phosphate uridyltransferase produces severe disease culminating in death in infancy. In addition to galactosemia and galactosuria, these patients have impaired renal tubular resorption leading to aminoaciduria, gastrointestinal symptoms, hepatosplenomegaly, cataracts, bleeding diathesis, hypoglycemia, and mental retardation. Pathologically, the CNS showed neuronal loss and gliosis and the liver shows fatty change progressing to cirrhosis. Benign disease with cataract formation is characteristic of galactokinase deficiency. Chronic emphysema is not associated with homozygous galactose-1-phosphate uridyltransferase deficiency, but rather with alpha 1-antitrypsin deficiency. Impaired tubular reabsorption (producing aminoaciduria) is seen within a few days or weeks of feeding milk to an infant with severe galactosemia, as opposed to chronic renal failure appearing in adolescence. Ref: Bender D.A., Mayes P.A. (2011). Chapter 21. The Pentose Phosphate Pathway & Other Pathways of Hexose Metabolism. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.
4
Benign disease except for cataract formation
Chronic emphysema appearing in early adulthood
Chronic renal failure appearing in adolescence
Death in infancy
Biochemistry
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multi
Structure passing through anterior pa of jugular foramen
Jugular foramen transmits Through anterior pa: 1. Inferior petrosal sinus 2. Meningeal branch of the ascending pharyngeal aery Notes: through the middle pa: 9th, 10th,11th cranial nerves Through the posterior pa: internal jugular vein and meningeal branch of the occipital aery. BDC 6th edition vol 3 page no:20
1
Inf petrosal sinus
Internal jugular vein
Internal jugular vein
X, XI nerve
Anatomy
Head and neck
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single
Role of Fluorine in dental health is the following EXCEPT
Ans. a. (To make enamel harder than usual) (Ref. Guyton physiology 11th/994, 879)Role of Fluorine in Preventing Caries. Teeth formed in children who drink water that contains small amounts of fluorine develop enamel that is more resistant to caries than the enamel in children who drink water that does not contain fluorine. Fluorine does not make the enamel harder than usual, but fluorine ions replace many of the hydroxyl ions in the hydroxyapatite crystals, which in turn makes the enamel several times less soluble. Fluorine may also be toxic to the bacteria. Finally, when small pits do develop in the enamel, fluorine is believed to promote deposition of calcium phosphate to "heal" the enamel surface. Regardless of the precise means by which fluorine protects the teeth, it is known that small amounts of fluorine deposited in enamel make teeth about three times as resistant to caries as teeth without fluorine.# Fluorine does not seem to be a necessary element for metabolism & it does not make the teeth themselves stronger but has a poorly understood effect in suppressing the cariogenic process.# Even though the mottled teeth are highly resistant to the development of caries, the structural strength of these teeth may be considerably lessened by the mottling process.
1
To make enamel harder than usual
To replace several hydroxyl ions in hydroxyapatite
To make enamel several times less soluble
To promote deposition of calcium phosphate to 'heal' pits in enamel surface
Physiology
Misc.
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multi
A 50-year-old family physician has veical diplopia; the man feels unsure when descending stairs. He can eliminate the double vision by tilting his head toward the opposite side. Which of the following extraocular muscles is responsible for the ocular malalignment?
The superior oblique depresses, abducts, and intos the eye. Paralysis of this muscle results in extorsion and weakness of downward gaze. Head tilting compensates for extorsion. Chin depression would be seen in Superior oblique palsy
4
Inferior rectus
Inferior oblique
Lateral rectus
Superior oblique
Ophthalmology
Squint
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Loss of heterozygosity associated with
Ref Robbins 9/e p292_293 familial case of retinoblastoma 1 defective and 1 normal gene at bih (heterozygous) second mutation causes both genes to be defective loss of heterozygosity Increased chances of cancer sporadic case of retinoblastoma both normal gene at bih _ homogeneous normal genes Both mutations occur somatic Ally within a single cell (homozygous abnormal genes ) increased chances of cancer
3
Acute myeloid leukemia
ALL
Retinoblastoma
Promyelocytic leukaemia
Anatomy
General anatomy
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multi
JE virus life cycle in nature run between?
-Japanese encephalitis virus infect several extra human host, animals and birds. - The basic cycles of transmission are from pig to mosquito. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:285 <\p>
1
Pigs-Mosquito
Cattle-Birds
Pigs-Human
Birds-Pigs
Social & Preventive Medicine
Communicable diseases
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