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Lymphatic filariasis is not caused by-
|
Lymphatic filariasis- infection with the filarial worms Wuchereria bancrofti & Brugia malayi is associated with clinical outcomes ranging from subclinical infection to hydrocele & elephantiasis. Loiasis is caused by Loa loa ,which is characterised by calabar swelling,an intense,tense,localised swelling that may be painful ,especially if it is near a joint. Reference Harrison20th edition pg 1123
| 3 |
Brugia malayi
|
Brugia timori
|
Loa loa
|
Wuchereria bancrofti
|
Medicine
|
Infection
|
3e51175c-f4a4-4273-b373-e87b8d09e58e
|
single
|
Recommended maximum dose of Lignocaine + adrenaline for peripheral nerve shock.
|
Local Anesthetic Maximum dose Over 24 hours Plain With Adrenaline Lidocaine 300mg 4.5mg/kg 500mg 7mg/kg Mepivacaine 300mg 4.5mg/kg 500mg 7mg/kg Prilocaine 600mg 8mg/kg 600mg 2-chloroprocaine 800mg 12mg/kg 1000mg Bupivacaine 175mg 3mg/kg 225mg 400mg Levobupivacaine 150mg 400mg Ropivacaine 225mg 3mg/kg 800mg maximum dose of plain lidocaine is mentioned differently in different anesthesia books - 3mg/kg BW ( Miller TEXT BOOK of Anesthesia) or 4.5 mg/kg BW (Morgan and Mikhail's Clinical Anesthesiology)
| 1 |
7 mg/kg bw
|
4.5 mg/kg bw
|
2 mg/ kg bw
|
3 mg/kg bw
|
Anaesthesia
|
Regional Anesthesia
|
5920aa93-772c-4582-bded-9eed0f6a33eb
|
single
|
Meckel's cartilage extends from:
| null | 1 |
Otic capsule
|
Styloid bone
|
Hyoid cartilage
|
None of the above
|
Anatomy
| null |
6c1a2feb-4cf0-4795-a9a8-633f74a6b12f
|
multi
|
Volume of lung after maximal forceful expiration -
|
Ans. is 'b' i.e., Residual volume Respiratory Volumes and Capacities for an Average Young Adult MaleMeasurementTypical valueDefinition Respiratory volumes1. Tidal volume (TV)500 mlAmount of air inhaled or exhaled in one breath during relaxed, quiet breathing2. Inspiratory reserve volume (IRV)3000 mlAmount of air in excess of tidal inspiration that can be inhaled with maximum effort3. Expiratory reserve volume (ERV)1200 mlAmount of air in excess of tidal expiration that can be exhaled with maximum effort4. Residual volume (RV)1200 mlAmount of air remaining in the lungs after maximum expiration, keeps alveoli inflated between breaths and mixes with fresh air on next inspiration Respiratory Capacities5. Vital capacity (VC)4700 mlAmount of air that can be exhaled with maximum effort after maximum inspiration (ERV-TV-IRV); used to assess strength of thoracic muscles as well as pulmonary function6. Inspiratory capacity (IC)3500 mlMaximum amount of air that can be inhaled after a normal tidal expiration (TV + IRV)7. Functional residual capacity (FRC)2400 mlAmount of air remaining in the lungs after a normal tidal expiration (RV - ERV )8. Total lung capacity (TLC)5900 mlMaximum amount of ai r the lungs can contain (RV + VC)
| 2 |
Tidal volume
|
Residual volume
|
Inspiratory reserve volume
|
Expiratory reserve volume
|
Physiology
|
Mechanics of Respiration
|
5a0a6b22-02a6-4164-bfa9-9f63bde5a5ff
|
single
|
Which of the following in not a cause of death due to suffocation
|
Suffocation is a general term used to indicate a form of asphyxia where entry of air to the lungs is prevented by any means other than pressure on the neck or drowning. Smothering is caused by closing the external respiratory orifices either by hand or by other means. Gagging is closing of mouth & nose by cloth or soft object & Chocking is caused by obstruction within airway. But throttling is an asphyxia produced by compression of the neck by human hands so it is by means of pressure on the neck. Ref: The synopsis of forensic medicine & Toxicology 28th edition pg: 185,188&189
| 4 |
Choking
|
Gagging
|
Smothering
|
Throttling
|
Forensic Medicine
|
Asphyxia
|
023fea31-e560-4303-8c07-81b4165e52ac
|
single
|
All of the following statement are true regarding silicosis, except:
|
Silica occurs in both crystalline and amorphous forms, but crystalline forms (including quaz, cristobalite, and tridymite) are much more fibrogenic. After inhalation, the paicles are phagocytosed by macrophages. The phagocytosed silica crystals activate the inflammasome, leading to the release of inflammatory mediators, paicularly IL-1 and IL-18. As the disease progresses, these nodules coalesce into hard, collagenous scars. Histologic examination reveals the hallmark lesion characterized by a central area of whorled collagen fibers with a more peripheral zone of dust-laden macrophages.
| 2 |
Crystalline forms are much more fibrogenic
|
Phagocytosed silica crystals activate the inflammasome, leading to the release of inflammatory mediators, paicularly IL-2 and TNF
|
As the disease progresses, nodules coalesce into hard, collagenous scars
|
Histologic examination reveals the hallmark lesion characterized by a central area of whorled collagen fibers with a more peripheral zone of dust-laden macrophages.
|
Pathology
|
Interstitial lung diseases
|
3f57fdf4-f854-4f4f-9fba-8111e6c5c343
|
multi
|
The initial investigation of choice for a post cholecystectomy biliary stricture is:
|
Ans. is ' d' i.e. ie Magnetic resonance cholangiography The initial investigation of choice for a post cholecystectomy stricture would be an MRCP. It is a non-invasive modality and provides high resolution images of the entire biliary tree. "PTC is the imaging method of choice for most postoperative biliary strictures, but expeise with this is not available at all centers. ERCP may be easier to obtain in a patient with a biliary stricture and cholangitis who requires urgent cholangiography and biliary decompression. However, ERCP is only useful in patients with bile duct continuity."- An ultrasound or a CT can also be used as initial study but an MRCP would be better, as it would provide better anatomic information about the location and the degree of stricture. Management of biliary strictures Schwaz 9/e p11.58 writes- "Percutaneous or endoscopic dilatation and/or stent placement give good results in more than one half of patients. Surgery with Roux-en-Y choledochojejunostomy or hepaticojejunostomy is the standard of care with good or excellent results in 80 to90% of patients."
| 4 |
Ultrasound scan of the abdomen
|
Endoscopic cholangiography
|
Computed tomography
|
Magnetic resonance cholangiography
|
Surgery
| null |
4d3efdc6-3775-47c5-9be2-35481794131b
|
single
|
A 66-year-old woman collapses while shopping and expires suddenly of cardiac arrest. Her past medical history is significant for long-standing type 2 diabetes mellitus. Her relatives note that she had complained of chest heaviness and shoness of breath for the past 2 weeks. Sterile fibrinous pericarditis and pericardial effusion are observed at autopsy. What additional finding would be expected during autopsy of this patient?
|
Fibrinous pericarditis may develop 2 to 10 weeks after a transmural myocardial infarction. Patients with long-standing diabetes mellitus are paicularly susceptible to coronary atherosclerosis and myocardial infarction. One fouh to one half of all nonfatal myocardial infarctions are asymptomatic. In such patients, sudden death usually reflects a cardiac arrhythmia.
| 4 |
Endocardial fibroelastosis
|
Marantic endocarditis
|
Mitral valve prolapse
|
Myocardial infarct
|
Pathology
|
Myocardial Infarction
|
994a102f-d194-4b49-8865-a4eaab7d3807
|
single
|
Patient wants to scratch for itching in his amputated limb is an example of ?
|
Ans. C. Phantom limb hallucinationPhantom limb hallucination - The person feels his body pas intact in their respective places even after they are lost through amputation or injury.In the question given patient feels itching in the amputated limb and tries to scratch the limb. Thus it is an example of phantom limb hallucination.
| 3 |
Illusion
|
Pseudohallucination
|
Phantom limb hallucination
|
Autoscopy hallucination
|
Psychiatry
| null |
b7e5abd8-57e2-4d9d-ad86-d5a3b3804857
|
multi
|
Ehlers-Danlos syndrome is a disease affecting _____.
|
Ehlers-Danlos syndromes are characterized by defects in collagen (i.e., connective tissues).
| 2 |
Bone
|
Connective tissue
|
Muscle
|
Joints
|
Microbiology
| null |
953bb88d-fd24-4338-bb19-64f0b94b51d6
|
single
|
H1 antagonist has all the functions except :
| null | 3 |
Antipruritic
|
Sedation
|
Decrease gastric acid secretion
|
Antivertigo
|
Pharmacology
| null |
278fb6b6-3007-4c68-b878-1de2d10bb468
|
multi
|
A 52-year-old recent immigrant from Vietnam complains of abdominal swelling, weight loss, and upper abdominal pain of 3 weeks in duration. His past medical history includes malaria and infection with the liver fluke Clonorchis sinensis. The liver is hard on palpation. An abdominal CT scan shows a hypo-attenuated mass with lobulated margins in the liver. A biopsy discloses well-differentiated neoplastic glands embedded in a dense fibrous stroma. Which of the following is the most likely diagnosis?
|
Carcinoma originates anywhere in the biliary tree. Cholangiocarcinoma:- Arising within the liver Associated with substantial fibrosis Confused with metastatic carcinoma and reactive fibrosis. These tumors occur at an increased frequency in persons infected with the liver fluke C. sinensis The other choices are not associated with a history of C. sinensis infestation.
| 2 |
Carcinoma of the gallbladder
|
Cholangiocarcinoma
|
Hemangiosarcoma
|
Hepatocellular carcinoma
|
Pathology
|
Miscellaneous
|
2cb99ffe-fe25-45c7-a0d3-aaab2b3f995b
|
multi
|
Sensory nerve supply above the level of vocal cords is:
|
Sensory nerve supply to larynx above the level of vocal cords is superior laryngeal nerve, while below the cords it is recurrent laryngeal nerve. Superior laryngeal nerve is a branch of vagus. It divides into two branches - external laryngeal supplying motor fibres to cricothyroid muscle and an internal laryngeal nerve which runs submucosally in pyriform fossa and supplies the larynx.
| 2 |
Glossopharyngeal
|
Superior laryngeal
|
Recurrent laryngeal
|
Pharyngeal branch of vagus
|
ENT
|
Larynx
|
c3fd2686-471a-4295-a5e7-20aaa765f4c6
|
multi
|
Action of truncal vagotomy is equal to that of
|
(C) Proton pump inhibitors> In addition to Truncal vagotomy, the antrum of stomach was removed, thus eradicating the source of gastrin, and the gastric remnant was joint to the duodenum.> Proton pump inhibitors can effectively render a patient achlorhydric and all benign ulcers will heal using these drugs.
| 3 |
Antacids
|
H2 blockers
|
Proton pump inhibitors
|
All of the above
|
Surgery
|
Miscellaneous
|
6a1491bb-c31e-4bed-9bf9-ee6d55e39f01
|
multi
|
Patey's modification of mastectomy is
|
Ans. (b) Total mastectomy with Level 1 through 3 axillary LN with pectoralis minor resection(Ref. Operative Surgery Fischer 55)* Patey procedure - Pectoralis muscle is removed from coracoid process* Auchincloss - Pectoralis muscle is retracted* Scanlon - Pectoralis muscle is divided
| 2 |
Total Mastectomy with level 1 nodes
|
Total mastectomy with Level 1 through 3 axillary LN with pectoralis minor resection
|
Total mastectomy with all nodes removed with Retraction of Pectoralis minor
|
Simple mastectomy
|
Surgery
|
Breast
|
a6294a30-0ed6-4cc3-8114-9790d57ffbe1
|
multi
|
Somatic innervation to the pelvic organs is
|
For most of its pelvic course, the femoral nerve (L2, L3, L4) travels within the substance of the psoas muscle and then exits its lateral side to pass under the inguinal ligament. It supplies sensation to the anterior thigh and motor innervation to the extensors of the knee.
| 3 |
Greater splanchnic nerve
|
Lesser splanchnic nerve
|
Pudendal nerve
|
Ilioinguinal nerve
|
Anatomy
|
Abdomen and pelvis
|
a2aeba83-437c-44bf-bb05-8081baa44e98
|
single
|
All the following are features of constrictive pericarditis except
|
Ref Harrison 19 th ed pg 1576 The patient often appears chron- ically ill, and in advanced cases, anasarca, skeletal muscle wasting, and cachexia may be present. Exeional dyspnea is common, and ohop- nea may occur, although it is usually not severe. Acute left ventricular failure (acute pulmonary edema) is very uncommon. The cervical veins are distended and may remain so even after intensive diuretic treatment, and venous pressure may fail to decline during inspiration (Kussmaul's sign). The latter is common in chronic pericarditis but may also occur in tricuspid.
| 4 |
Ascitis
|
Retractile apex
|
Pericardial knock
|
Acute pulmonary edema
|
Medicine
|
C.V.S
|
3d6fbdf0-5fd8-431d-b974-6870e412c7ec
|
multi
|
Chronic renal failure is associated with
| null | 1 |
Metabolic acidosis
|
Respiratory acidosis
|
Respiratory alkalosis
|
Hypoxia
|
Medicine
| null |
9eb9569c-000a-4d19-abef-3fe8899b1a85
|
single
|
Most important buffer system in human blood:
|
Ans. a (Bicarbonates); (Ref. Ganong, Physiology, 21st ed., 736; Satyanarayan, Biochemistry 2nd ed. - 525)PRINCIPAL BUFFERS IN BODY FLUIDSBlood1. H2CO3 K H+ +HCO-3 (Bicarbonate buffer) =>>most predominant buffer of ECF. especially blood plasma.2. HProt K H+ + Prot- & HHb K H++ Hb- (Protein buffer)3. H2PO4 - KH-+ HPO42- (Phosphate buffer)Interstitial fluid1. H2 CO3 K H+ + HCO-3Intracellular fluid1. HProt K H+ + HCO 32. H2PO4 - KH-+ HPO42-
| 1 |
Bicarbonates
|
Chlorides
|
Hb
|
Phosphates
|
Physiology
|
Kidneys and Body Fluids
|
dfb0d6fb-0d67-4924-b42e-44488835c946
|
single
|
The earliest sign of papilloedema -
|
Ans. is 'b' i.e., Blurring of disc margin Ophthalmoscopic signs of papilloedema o Blurring of disc margin o Venous :- Engorgment, congestion, loss of pulsation (first sign) o Hyperemia of the disc with capillary dilatation. o Filling of physiological cup with gradual obliteration of physiological cup. o Gradual elvetion of disc (mushroom or dome shaped) with sharp bending of vessels over its margins. o Cotton- wool spots (soft exudates) and both flame shaped (superficial) and punctate (deep) hemorrhages o Macular fan or macular star due to hard exudates. o Late findings in long standing (vintage) papilloedema :- Markedly elevated disc with champagne cork appearance, post neuritic optic atrophy,corpora amylacea deposits on disc margin, generalized retinal pigmentation.
| 2 |
Filling of the physiological cup
|
The blurring of the disc margin
|
Obliteration of cup
|
Cotton-wool spots
|
Unknown
| null |
3187fae9-566c-4afb-b920-dd27278bc58b
|
single
|
On 3 phase 99mTc-MDP bone scan, which of the following bone lesions will show least osteoblastic activity.
|
D i.e. Fibrous coical defect
| 4 |
Paget's disease
|
Osteoid Osteoma
|
Fibrous Dysplasia
|
Fibrous coical defect
|
Radiology
| null |
8ecd20e4-b661-4ff0-8d0d-c8d6d64466c9
|
single
|
What is not seen in Reiters syndrome?
|
A. i.e. Subcutaneous nodules
| 1 |
Subcutaneous nodules
|
Keratoderma blennorrhagicum
|
Circinate balanitis
|
Oral ulcers
|
Skin
| null |
0f7de35f-f4c1-47d1-af3e-61866469bb4f
|
single
|
Which is not given at the time of birth ?
| null | 4 |
OPV
|
BCC
|
Hepatitis B
|
HiB
|
Pediatrics
| null |
16a772d9-cfdb-48e2-aa0c-f0a27fe69ec6
|
single
|
The following primary tumours are common in the vulva except :
|
Invasive lesions of vulva : Squamous cell carcinoma--most common 90% Melanoma 1-5% Adenocarcinoma 1% Sarcoma 2% Rodent ulcer or basal cell carcinoma 1%. Reference: Shaw's Textbook of Gynaecology 16th edition page no 475
| 3 |
Adenocarcinoma
|
Basal cell carcinoma
|
Choriocarcinoma
|
Squamous cell carcinoma
|
Gynaecology & Obstetrics
|
Gynaecological oncology
|
5685f20d-8f82-4fce-a3e0-22253b60cf12
|
multi
|
A patient presented with clinical features of ataxia and in-coordination. It is most likely due to involvement of which aery among the following
|
Clinical features of ataxia and in-coordination belong to cerebellar pathology, which might arise if there was involvementof superior cerebellar aery. Cerebral aery involvement (anterior, middle or posterior) does not usually present with cerebellar sign and symptoms.
| 4 |
Anterior cerebral
|
Posterior cerebral
|
Middle cerebral
|
Superior cerebellar
|
Anatomy
|
Brainstem lesions and blood supply of CNS
|
a5464088-fba6-4107-a3fc-9de1056b6de8
|
single
|
A case of acute flaccid paralysis must be observed for how many days for residual weakness in poliomyelitis?
|
Poliomyelitis is an acute viral infection caused by a RNA virus which is primarily an infection of the gastro-intestinal tract affecting the central nervous system. Acute flaccid paralysis is a common presentation of poliomyelitis where the patient presents with paralysis of acute onset (less than 4 weeks) and affected limbs are flaccid with decreased tone and diminished or absent deep tendon reflexes. Surveillance is done for all cases of AFP, where patients less than 15 years of age are investigated and should be kept under observation for a minimum of 60 days to check if there is any residual paralysis. Ref: Park's Textbook of Preventive and Social Medicine, 19th Edition, Pages 166-172; Epidemiology and Demography in Public Health By Japhet Killewo, Kristian Heggenhougen, Stella R. Quah, Pages 98-99; Recent Advances in Paediatrics, Pages 91-97; Approach to Practical Pediatrics By Narang, Pages 262-268.
| 3 |
30 days
|
42 days
|
60 days
|
90 days
|
Social & Preventive Medicine
| null |
94e96099-0618-493f-abd7-fc174332695c
|
single
|
Atropine is used in all EXCEPT ?
|
Ans. is 'a' i.e., Glaucoma Atropine increases 'OP, therefore is contraindicated in glaucoma.
| 1 |
Glaucoma
|
Mydriatic
|
Cyclopegic
|
Preanaesthetic medication
|
Pharmacology
| null |
97807595-9e48-4bea-95c9-ad716d1c083d
|
multi
|
Which of the following is true about multiple sclerosis except
|
. *Multiple sclerosis is characterised by prominent nystagmus which is observed in the abducting eye,along with a small skew detion . *A bilateral internuclear ophthalmoplegia is paicularly suggestive of MS *Other common gaze disturbances in MS include (1) horizontalgaze palsy (2)a "one and half"syndrome (3)acquired pendular nystagmus . Ref Harrison20th edition pg 2567
| 2 |
Nystagmus on abducting eye
|
Nystagmus on adducting eye
|
One and half syndrome
|
Pendular nystagmus
|
Medicine
|
C.N.S
|
97e1b089-1f07-485b-9449-87a27616399a
|
multi
|
Memory T cell can be identified using the following marker
|
.
| 4 |
CD45RA
|
CD45RB
|
CD45RC
|
CD45RO
|
Anatomy
|
All India exam
|
38a71d46-d7fa-41e5-9c2e-58dec94e1538
|
single
|
False statement about duodenal atresia is
|
OPTION 1 : Correct Duodenum is M/C site of intestinal atresia . Duodenal atresia is M/C cause of neonatal intestinal obstruction . OPTION 2 : Incorrect Type 1 - Mucosal web (windsock deformity) Type 2 - Two ends are separated by fibrous cord . Type 3 - Complete separation of two ends . OPTION 3 : Correct Vomiting is bilious as obstruction is distal to ampulla of vater . OPTION 4 : Correct Double Bubble sign is seen in :- Annular Pancreas / Duodenal atresia
| 2 |
Most common cause of neonatal intestinal obstruction .
|
In Type 2 atresia , two ends are completely separated .
|
Bilious vomiting
|
X-ray shows double bubble sign .
|
Surgery
|
Pediatric Surgery
|
58e01fae-284f-46c6-b7b4-8dd2d0dc806f
|
multi
|
Correlation of 1.1 means?
| null | 1 |
Computational error
|
Positive strong association
|
Weak association
|
Mild association
|
Dental
| null |
4c2bf68a-1543-455b-acc8-b878a2d6374e
|
single
|
All are associated with endocarditis except:
|
Ans. D. ESKAPE groupESKAPE group (Enterococcus, Serratia, Klebsiella, Acinetobacter, Pseudomonas, Enterobacter) are associated with healthcare associated infections
| 4 |
Staph aureus
|
Enterococcus
|
HACEK group
|
ESKAPE group
|
Microbiology
|
Bacteria
|
be4c31a5-9019-4732-83c4-9f3d1f4717c4
|
multi
|
Inguinal ligament forms the boundries of -
|
Ans. is 'c' i.e., Both border of SartoriusMedial border of adductor longusInguinal ligamentPoint where medial and lateral boundaries meetInferior epigastric artery Lateral border of rectus abdominisInguinal legament
| 3 |
Femoral triangle
|
Hesselbach's triangle
|
Both
|
None
|
Anatomy
|
Abdominal Wall
|
5eff7568-0ef4-4774-b82b-388b69fdf31b
|
multi
|
Hasse's formula used in pregnancy to?
|
ANSWER: (A) Estimate fetal ageREF: Textbook of Forensic Medicine and Toxicology by Nagesh Kumar Rao - Page 321Hasse's formulaIf the crown heel length is known then the intrauterine age of fetus is calculated as:If CH length is up to 25 cm thenIU age = Square root of CH lengthIf the CH length is > 25 cm thenIU age = 1/5 of CH length
| 1 |
Estimate fetal age
|
Identify fetal blood group
|
Identify fetal sex
|
Identify fetal congenital malformations
|
Gynaecology & Obstetrics
|
Fetal Assessment
|
89692f81-88ae-4b7a-9fbe-5f077f0b11a6
|
single
|
A HIV mother delivers a baby. All are true,except -
| null | 1 |
Risk of HIV in the baby is upto 90%
|
HIV infection cannot be diagnosed in the baby with available methods.
|
AIDS can be transmitted from mother to child during delivery.
|
Breast feeding can transmit AIDS
|
Microbiology
| null |
7ddabf29-6e8d-4be7-8530-d2e97a3e3723
|
multi
|
Zoonotic diseases are -
|
Ans. is 'All
| 4 |
Salmonellosis
|
Plague
|
Anthrax
|
All
|
Social & Preventive Medicine
| null |
3ac35c2f-fe3e-49fb-8f0d-1e93d683f062
|
multi
|
The test likely to help in diagnosis of a patient who presents with an itchy annular plaque on the face is:
|
B i.e. KOH mount Trichophyton rubrum is most common cause of tinea corporis (body), t. cruris, t. pedis, t. manuum & t.unguiumQ. Diagnosis is made by KOH wet mount.
| 2 |
Gram's stain
|
Potassium hydroxide mount
|
Tissue smear
|
Wood's lamp examination
|
Skin
| null |
3fad6767-a9c1-4b57-bdd8-3d8c8bd3c446
|
single
|
A patient presents with sudden headache and vomiting and unconciousness. The diagnosis is
|
Sub Arachnoid Hemorrhage Most common cause : Trauma >Spontaneous rupture of Berry aneurysm Clinical features Sudden transient loss of consciousness (occurs in nearly half of the patients) Excruciating severe headache: presenting complaint in 45% of cases (worst headache of patients life) more common upon regaining consciousness when loss of consciousness is associated. Neck stiffness and vomiting are common associations Focal neurologicalal deficit : uncommon Sudden headache in the absence of Focal neurological deficit is the Hallmark of aneurysmal rupture Associated prodromal symptoms (suggest location of progressively enlarging unruptured aneurysm) Third nerve cranial nerve palsy :Aneurysm at junction of PCS and ICA Sixth nerve palsy :Aneurysm in cavernous sinus Occipital and posterior cervical pain: Inferior cerebellar aery aneurysm Pain in or behind the eye :MICA aneurysm Ref: Sabiston 20th edition Pgno :1918
| 1 |
Subarachnoid hemorrhage
|
Intracerebral hemorrhage
|
Sudural hemorrhage
|
Exbtradural hemorrhage
|
Surgery
|
Trauma
|
23a5d5e8-2681-4bdd-bf0d-df9f9e043391
|
single
|
Pseudoarthrosis of Tibia is classical feature of?
|
Pseudoarthrosis of Tibia and scoliosis are classicle feature of NF 1.
| 2 |
Sturge Weber syndrome
|
Neurofibromatosis type 1
|
Neurofibromatosis type 2
|
Tuberous sclerosis
|
Pathology
| null |
08c6c68c-1373-4f4a-ad26-dce49c036c4a
|
single
|
Costochondral joint is an example of
|
Primary Cailaginous joint The bones are united by a plate of hyaline cailage so that the joint is immovable and strong These joints are tempory in nature because after a ceain age the cailaginous plate is repalced by bone (synostosis) Ref :BD CHAURASIA S Handbook of General Anatomy Fouh edition Page no 63
| 2 |
Fibrous joint
|
Primary cailaginous joint
|
Secondary cailaginous joint
|
Synol joint
|
Anatomy
|
General anatomy
|
a9f1cc9a-f8e5-4179-ab2c-df18533c0c35
|
single
|
Japanese encephalitis is transmitted by?
|
ANSWER: (A) CulexREF: Park 20th ed p. 676Also asked in June 2011See APPENDIX-43 below for list of medically important "Mosquitos" APPENDIX - 43Mosquito AnophelesCulexAedesMansoniaA.K.A Nuisance mosquitoTiger mosquito Egg layingSingly on waterIn small dusters of 200-300 on waterSingly on damp soilIn star shaped clusters/Rafts on under surface of aquatic plantsEgg shapeBoat shaped2 Lateral floats +Trabeculated surface +Raft shape No lateral floatsCigar shapedNo lateral floatsStar shapedNo lateral floatsDesiccationCannot surviveCannot surviveCan surviveCannot surviveLarva (Wrigglers) 5-7 daysHorizontal floating Surface feeders.Mo siphon tubeHead down at an angle of 45deg parallel to the surface of 'water.Bottom feeders. Siphon tube 8th segment of abdomenHead down at an angle of 45deg parallel to the surface of water.Bottom feeders. Siphon tube 8th segment of abdomenHead down at an angle of 45'' parallel to the surface of water. Bottom feeders. Siphon tube 8th segment of abdomenPupa/T umblers 1-2 daysTrumpet/siphon tube broad & shortTrumpet/ siphon tube long & narrowTrumpet/ siphon tube long & narrowTrumpet/ siphon tube long & narrowAdult (2 weeks)Body inclined with surface at rest. Wings spotted Long palpi in both sexes.Body parallel to surface at rest. Wings not spotted. Short palpi in females.Body parallel to surface at rest. Wings not spotted. Short palpi in females.Body parallel to surface at rest.Wings not spotted. Short palpi in females.Feeding habitNight bitersNight biters Biting peak at MidnightDay time bitersNight bitersBreeding habitClean waterDirty and polluted waterArtificial collection of waterAquatic vegetationVector ofMalariaFilaria (not in India)Bancroftianfllariasis, Japanese encephalitis, west Nile feverYellow fever (not in India), Dengue, Chikungunya, Rift valley fever, Filaria (not in India)Malayan (Brugianfllariasis),ChikungunyaEggs hatch in 48 hoursPupa is resting stage, moves actively but do not feed Eggs to adult = 7-10 daysDuring growth, the larva molts (sheds its skin) four times. The stages between molts are called instars Life span of mosquito varies from 8-34 days (2 weeks average), males are short lived.Males never bite (feed on nectar). Females need blood meals every 2-3 days for development of eggs
| 1 |
Culex
|
Aedes
|
Anopheles
|
Hard tick
|
Social & Preventive Medicine
|
Japanese Encephalitis
|
41170104-a9b3-47d6-949d-e9023d9d1eac
|
single
|
A 48-year-old man with mitral regurgitation (MR) comes to the physician for a routine examination. The best position to auscultate for MR is usually at the apex.
Which of the following options most accurately corresponds to the location to auscultate?
| null | 3 |
Left 2nd intercostal space
|
Left 4th intercostal space
|
Left 5th intercostal space
|
Right 2nd intercostal space
|
Pediatrics
| null |
06d8d591-23a8-4f2a-9f4a-a854e19efda7
|
multi
|
Most sensitive test for detection of argemone oil –
|
Paper chromatography is the most sensitive test.
| 2 |
Nitric acid test
|
Paper chromatography
|
Phosphatase test
|
Methylene blue test
|
Social & Preventive Medicine
| null |
b787c034-1503-499d-902d-fffae072f114
|
single
|
Which of the following structure does not pass through the parotid gland ?
|
Facial aery does not pass within the parotid gland. Structures passing through parotid gland are: External carotid aery Retro-mandibular vein Sympathetic plexus Facial nerve Passes in the middle of gland Do not supply parotid gland Creates a surgical plane - Deep : Lymph node are less - Superficial : Lymph node are more
| 1 |
Facial aery
|
Facial nerve
|
Retromandibular vein
|
External carotid aery
|
Anatomy
|
Neck Triangles and parotid gland
|
418da9e1-128d-4843-9c45-78955236a074
|
single
|
All are steroids except
|
Ref: Textbook of Medical Biochemistry, 8th Edition, Dr (Brig) MN Chatterjea, Rana Shinde, page no: 589,590
| 4 |
Testosterone
|
Vitamin D
|
Cholesterol
|
Thyroxine
|
Biochemistry
|
Metabolism of lipid
|
a017cdbc-d9e3-4003-b158-2bfca3207aaa
|
multi
|
Tic douloureux is facial pain traveling through the _____ nerve?
|
Harrison's principles of internal medicine 17th edition. * Trigeminal neuralgia(Tic douloureux) is characterised by excruciating paroxysms of pain in lips , gums, cheek or chin and very rarely in distribution of ophthalmic division of 5th nerve.
| 3 |
Facial
|
Hypoglossal
|
Trigeminal
|
Vestibulocochlear
|
Medicine
|
C.N.S
|
5a876d27-bb9f-41e7-84e3-bca5d5f17bed
|
single
|
HHH syndrome is due to a defect of which pathway?
|
Ans. is 'd' i.e., Urea cycle* In urea cycle, as the enzyme ornithine transcarbamylase is present in mitochondria, ornithine should be taken into mitochondria. Ornithine then reacts with carbamyl phosphate to form citrulline within mitochondria. After citrulline is formed, it should leave the mitochondria to reach cytoplasm.* Hence ornithine should get into mitochondria and citrulline should leave the mitochondria. This is by ornithine citrulline transporter.* Defect of ornithine citrulline transporter results in HHH syndrome characterised by# Hyperammonemia (as ornithine can not get into mitochondria, urea cycle is inhibited and hence ammonia accumulates)# Hyperornithinemia (as ornithine is not being utilised for urea cycle)# Hyperhomocitrullinemia (when carbamyl phosphate of urea cycle does not find ornithine within mitochondria, it reacts with lysine to form homocitrulline and hence homocitrullinemia)* Thus HHH syndrome or Hyperammoniemia Hyperornithinemia Hyperhomocitrullinemia is caused by Ornithine Citrulline transporter present in mitochondrial membrane.
| 4 |
HMP shunt
|
Citric acid cycle
|
Bile acid synthesis
|
Urea cycle
|
Biochemistry
|
Proteins and Amino Acids
|
557d9021-d0ac-49f0-8a9b-a7df32ccb85f
|
single
|
Which of the following is/are not the features of Henoch-Schonlein purpura (HSP)?
|
c. Thrombocytopenia(Ref: Nelson's 20/e p 1612, Ghai 8/e p 632)HSP is characterized by a tetrad of palpable purpura, arthritis, glomerulonephritis and abdominal painLess common skin lesions are macules, vesicles, bullous lesions, splinter hemorrhage and ulcerations; Rarely, epistaxis may occur.
| 3 |
Abdominal pain
|
Splinter hemorrhage
|
Thrombocytopenia
|
Epistaxis
|
Pediatrics
|
Kidney
|
bc993334-7e2d-480f-a161-7fb585e5846a
|
single
|
Lateral surface of cerebral hemisphere is supplied mainly by?
|
The lateral surface of the hemisphere is mainly supplied by the middle cerebral aery. This includes the territories of the motor and somatosensory coices which represent the whole of the body, apa from the lower limb, and also the auditory coex and language areas.Ref: Gray's anatomy 40th edition, Chapter 17.
| 2 |
Anterior cerebral aery
|
Middle cerebral aery
|
Posterior cerebral aery
|
None of the above
|
Anatomy
| null |
0a742c77-ce47-40fb-895c-2fcf1c5491ad
|
multi
|
Critical temperature for liquid nitrogen is ?
|
Ans. is 'c' i.e., -147deg C Critical temperature (Tc) of a substance is the temperature at and above which vapour of that substance can not be liquified, no matter how much pressure is applied (Note : Below critical temprature a substance can exist as a liquid or gas depending on pressure). Critical temperature of N2 is -146.9deg C; that means N2 can be liquified below -146.9deg C --> So, liquid nitrogen must be stored below -146.9deg C.
| 3 |
36.5degC
|
-20degC
|
-147degC
|
-242degC
|
Anaesthesia
| null |
6dd386d1-f46c-45ae-aaa6-c7efa703c13b
|
single
|
True about Peutz jegher syndrome
|
Ans. is 'a' i.e., Most common site is small intestine; 'b' i.e., Polypectomy on colonoscopy is treatment of choice; 'c' i.e., Hamaomatous polyp Peutz -Jeghers syndrome o It is an autosomal dominant condition characterized by :? 1. Hamaomatous polyps in Small intestine -4 100% Colon --> 30% Stomach --> 25% 2. Extraintestinal carcinomas of pancreas, breast, ovary, lung and uterus. 3. Mucocutaneous pigmentation o Approximately 3% of patients develop intestinal adenocarcinoma. o The condition is caused by a mutation in the LKB1/STK11 gene which codes for a serine - threonine kinase that is thought to play a role in apoptosis. Clinical features o Most common age of involvement is between 20-30 years. o The major symptoms depend on the intestinal location of the polyps (i.e. small intestine, colon, stomach) :- (i) Intestinal obstruction & intussusception (43%) (ii) Abdominal pain (23%) (iii) Hematochezia (14%) (iv) Prolapse of colonic polyps (7%) o There may be mucocutaneous pigmentation :- (i) Cutaneous pigmentation :- Perioral & perinasal region, finger, toes (ii) Mucous membrane pigmentation :- Buccal mucosa o Other manifestations include precocious pubey, rectal mass (rectal polyp), testicular mass, gynecomastia and growth acceleration (due to seoli cell tumor). Treatment o Treatment consists of identification of the syndrome and careful monitoring of the tissues that are at risk for cancer development. o Intestinal polyps are usually removed (polypectomy) when discovered during colonoscopy.
| 4 |
Most common site is small intestine
|
Polypectomy on colonoscopy is treatment of choice
|
Hamaomatous polyp
|
All
|
Pathology
| null |
33484ce7-4704-4553-86ee-1e4552f8f514
|
multi
|
A 8 year old male had non blanching rashes over the shin and swelling of knee joint with haematuria+++ and protein +. Microscopic analysis of his renal biopsy specimen is most likely to show
|
Probable diagnosis is Henoch-Schonlein purpura . Henoch-Schonlein purpura is a small-vessel vasculitis caused by immune complex deposition following an infectious trigger. It is predominantly a disease of children and young adults. The usual presentation is with purpura over the buttocks and lower legs, accompanied by abdominal pain, gastrointestinal bleeding and ahralgia. Nephritis can also occur and may present up to 4 weeks after the onset of other symptoms. Biopsy of affected tissue shows a vasculitis with IgA deposits in the vessel wall. Henoch-Schonlein purpura is usually a self-limiting disorder that settles spontaneously without specific treatment. Glucocoicoids and immunosuppressive therapy may be required in patients with more severe disease, paicularly in the presence of nephritis. Ref - davidsons 23e p1043
| 3 |
Tubular necrosis
|
Visceral podocyte fusion
|
Mesangial deposits of IgA
|
Basement membrane thickening
|
Medicine
|
Immune system
|
179d2679-9dea-433c-af42-5921cc2321bc
|
single
|
Which of the following specimens should never be refrigerated
|
H.influenzae ishighly sensitive to low temperature.
| 1 |
H.influenzae
|
P.aeruginosa
|
Moraxella catarrhalis
|
Escherichia coli
|
Anatomy
|
Bacteriology
|
b073a677-5df1-4208-94d0-536ef7244562
|
single
|
Which one is not associated with peptic ulcer -
|
Conditions also. with peptic ulcer have already been described. Plummer Vinson Paterson Kelly syndrome consists of :- Iron deficiency anemia Dysphasia atrophic oral mucosa, glossitis brittle spoon-shaped fingernails. Typically pts are Woman over 40 yrs of age. Its a Pre-malignant condition* for both oral cavity & esophagus. Ref : S Das textbook, 3/e, p818
| 3 |
Smoking cigarrete
|
Zollinger Ellison's syndrome
|
Plummer vinsons syndrome
|
Cirrhosis
|
Anatomy
|
G.I.T
|
bdd0b9dc-0ef8-4044-9aac-59ceed63f784
|
single
|
In Japanese Encephalitis, pigs acts as -
|
Pigs acts as an amplifier host REF:<\p> ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.521(epidemiology)
| 1 |
Amplifier
|
Definitive host
|
Intermediate host
|
Any of the above
|
Microbiology
|
Virology
|
11ac6d5c-b733-4542-aff0-93c2b759c9b7
|
multi
|
A 17-year-old girl was evaluated for complaints of weight gain, hair loss, constipation and weakness. Her free T4 level was low and TSH was increased. Which of the following is the most likely diagnosis?
|
The patient is having symptoms of hypothyroidism and thryoid profile reveals primary hypothyroidism. Analyzing all options, Graves' disease and McCune-Albright syndrome are associated with hypehyroidism. (excludes 'a' & 'b') In pituitary adenoma/TSH-secreting pituitary tumor - increased TSH with increased T3/T4 would be seen. (option 'c' excluded) Primary hypothyroidism is d/t defect in thyroid gland itself; associated with high TSH & low free T4 levels. Hashimoto's thyroiditis is a cause of primary hypothroidism.
| 4 |
Graves' disease
|
McCune-Albright syndrome
|
TSH-secreting pituitary adenoma
|
Hashimoto's thyroiditis
|
Pathology
|
Hypehyroidism and Goitre
|
f1607ab3-42ad-43c3-99b0-098f3a4a892d
|
single
|
Recommended vaccines for rabies -
|
HDCV, PCEC, PVC vaccines are currently used for immunization REF:<\p> ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.535
| 4 |
Semple
|
Duck embryo vaccine
|
Suckling mouse brain vaccine
|
HDCV
|
Microbiology
|
Virology
|
f9dc057b-48d9-4c6a-a3a6-61db92a7a529
|
single
|
Which of the following is not a content of plane LA
| null | 2 |
Methyl paraben
|
Epinephrine
|
Nacl
|
Lignocaine
|
Surgery
| null |
1c9b39ee-09b3-4d33-b690-6e68ddeaf396
|
single
|
C-peptide occurs in
|
C-peptideA biologically inactive residue of insulin formation in the beta cells of the pancreas. When proinsulin is conveed to insulin, an equal amount of C peptide, a chain of amino acids, is also secreted into the bloodstream. Beta cell secretory function can be determined by measuring the C peptide in a blood sample.Proinsulin is a precursor of insulin, having low biologic activity.Glucagon is a polypeptide hormone secreted by the alpha cells of the islets of Langerhans in response to hypoglycemia or to stimulation by growth hormone.Thyroxine is a thyroid hormone that contains iodine and is a derivative of the amino acid tyrosine, occurring naturally as l-thyroxine; its chemical name is tetraiodothyronine.Ref: Ganong&;s review of medical physiology; 24th edition; page no-433
| 1 |
Proinsulin
|
Glucagon
|
Paratharmone
|
Thyroxine
|
Physiology
|
Endocrinology
|
735865c9-10eb-444b-bbba-c4d599662fa4
|
single
|
The finding in nerve conduction study to suggest axonal neuropathy among the following is:
|
To classify neuropathy into axonal degeneration or segmental demyelination the most helpful test is: NCS-Nerve conduction study. MUST KNOW: Findings to suggest axonal neuropathy in NCS: Relatively preserved distal latencies, conduction velocities, and late potentials. Fibrillations on needle EMG Findings to suggest demyelination in NCS: Slow conduction velocities, Prolonged distal latencies Late potentials Relatively preserved amplitudes Absence of fibrillations on needle EMG Ref: Harrison, Edition-18, Page- 3448
| 4 |
Slow conduction velocities
|
Prolonged distal latency
|
Relatively preserved amplitude
|
Late potentials
|
Medicine
| null |
b7857c79-153f-4298-8410-cc9f9925fa48
|
single
|
All are true regarding gynaecomastia, EXCEPT -a) May be seen in Addison' s diseaseb) Usually unilateral in young malesc) Acini are not involvedd) Bilaterality is due to endocrinopathy
| null | 2 |
ac
|
ab
|
ad
|
bc
|
Surgery
| null |
7cc2b8de-21ba-4f38-8e8d-89762a69e95b
|
multi
|
Incidence can be calculated by -
|
Ans. is 'a' i.e., Prospective study
| 1 |
Prospective study
|
Retrospective study
|
Case control study
|
Cross-sectional study
|
Social & Preventive Medicine
| null |
9cd267f8-1d69-4813-ab6c-8a85e779c127
|
single
|
Approximate distance of diphragmatic constriction from nostril & incisor are
|
C i.e. 17" & 16"
| 3 |
7" & 6"
|
11' & 10"
|
17" & 16"
|
23" & 22"
|
Anatomy
| null |
7d53a9d8-e6a4-4143-9b0e-2a50505efb2a
|
single
|
Which of the following is true about P. falciparum ?
|
Ans. is 'b' i.e., Accole forms are seen The parasite often attaches itself to the margin or the edge of the host cell, the nucleus and a small pa of the cytoplasm remaining almost outside. This is known as form applique or accole.
| 2 |
James dots are seen
|
Accole forms are seen
|
Relapses are frequent
|
Longest incubation period
|
Microbiology
| null |
c38cd13b-226f-4ad2-9daf-fb36374babd8
|
multi
|
All of the following are true about anopheles type of mosquito Except -
|
Anopheles mosquito: Causes malaria and filaria Breeding habitat: Clean water Eggs laid singly with boat-shaped lateral floats Larvae have no Siphon tube; rest parallel to the undersurface of water Pupae have a broad and sho siphon tube Adults are inclined at an angle to the surface and with spotted wings Can fly 3-5 km Sophisticated mosquitoes Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 831
| 3 |
Eggs are boat shaped and provided with lateral floats
|
Larvae rest parallel to water surface
|
Larvae have siphon tube
|
Pupae have broad and sho siphon
|
Social & Preventive Medicine
|
Environment and health
|
36f56172-bfc1-4bd4-ab22-fcf475853e66
|
multi
|
The following are true for Bordetella pertussis except-
| null | 4 |
It is a strict human pathogen
|
It can be cultured from the patient during catarrhal stage
|
It leads to invasion of the respiratory mucosa
|
Infection can be prevented by a acellular vaccine
|
Microbiology
| null |
0c8aa8de-1697-449d-84c8-fbf58aa0f2a1
|
multi
|
Virus infected cells killed by?
|
Natural killer cells: Natural killer (NK) cells are morphologically described as large granular lymphocytes. These cells are called natural killer cells due to their ability to kill ceain virally infected cells and tumor cells without prior sensitization. Functions of natural killer cells: Kill virus-infected cells and tumor cells by secreting cytotoxins, such as perforins and granzymes similar to those of cytotoxic T lymphocytes and also by FasL-mediated apoptosisby a mechanism called ADCC (antibody-dependent cellular cytotoxicity) Both IL-12 and gamma interferons are potent activators of NK cells. Nonspecific killing of virus-infected cells and tumor cells. Killing is independent of antigen presentation by MHC proteins. Mechanism of killing is by perforins and granzymes, which cause apoptosis of target cell. Plasma cells- involved in antibody formation B-cells- humoral immunity
| 1 |
Natural killer cells
|
Plasma cells
|
B-cells
|
None
|
Microbiology
|
Immunology Pa 2 ( Hybridoma Technology, Complement Pathways, Interferon, Structure and Functions of Immune Cells )
|
abae4f6b-6b7d-4655-9f0c-a3d784a34b88
|
multi
|
18 year old girl with circumscribed bald patch with no organic disease & no behavioural disorder has ?
|
Ans. is 'b' i.e., Trichotillomania As there is no organic or behavioral disorders, this girl is suffering with impulse control disorder of compulsive hair pulling, known as Trichotillomania. Impulse control disorder These disorders are characterized by failure to resist an impulsive behavior that may be harmful to self or others. There may be a feeling of release of tension by doing the act and a feeling of guilt after the act is over. Impoant impulse control disorder are : - Pyromania (Pathological fire setting) Kleptomania (Pathological stealing) Trichotillomania (Compulsive hair pulling) Pathological gambling Intermittent explosive disorder Impulse control disorder not otherwise specified Oniomania (Compulsion to shop/buying) Internet compulsion (Internet addiction) Cellular or Mobile phone compulsion Compulsive sexual behavior (sexual addiction).
| 2 |
Depression
|
Trichotillomania
|
OCD
|
Phobia
|
Psychiatry
| null |
7cdafd10-0852-4045-9676-939b9ac70a85
|
single
|
Pseuddogia Fantastica is seen in
|
Patients with "Factitious disorder or Munchausen syndrome" distart the history and there will be discrepancy between history, examination and reports which is termed as "Pseudologia Fantastica".
| 2 |
Malingering
|
Factitious disorder
|
Somatization syndrome
|
Dissociative fugue
|
Psychiatry
| null |
940a4255-7b65-4a61-a1c5-967e5e1c1e15
|
single
|
Gluten sensitive enteropathy is most strongly associated with -
|
Ans. is 'a' i.e., HLA - DQ2o Almost all individuals with celiac disease share the major histocompatibility complex II HLA-DQ 2 or HLA - DQ8. o Gliadin is deamidated by the enzyme transglutaminase and deamidated gliadin peptides bind to DQ2 and DQ8. o Recognition of these peptides by CD4+T cells leads to secretion of IFN-y, which damages the intestinal wall. Pathophvsiologv o Celiac disease is caused by action of acidic peptides containing the gliadin fraction of wheat.The basic abnormality is thought to be an increased rate of loss of epithelial cells. Crypt cells show increased activity. This causes hyperophy of crypt. But even this increased activity cannot keep pace with loss of cells, resulting in progressive decrease in height of villi causing villous atrophyThe epithelial cells show decreased cytoplasm and mucusThe intestinal biopsy shows a decreases in the villus: crypt ratio. Normally the villi are 3-4 times the height of the crypts (ratio of 3-4 : 1); in celiac disease, the ratio decreases progressively (paial, subtotal and total villous atrophy). Total villous atrophy is seen in severe celiac ds and is quite characteristic of celiac ds (paial villous atrophy may be seen in many other conditions).
| 1 |
HLA-DQ2
|
HLA-DR4
|
HLA-DQ3
|
Blood group 'B'
|
Pathology
| null |
8d57ab97-7990-46e7-8f07-34a0c36e32c0
|
single
|
Which among the following is the main content of lipid bilayer of cell membrane in animal cells?
|
The most common sterol in the membranes of animal cells is cholesterol, which resides mainly in their plasma membranes, but can also be found in lesser quantities in mitochondria, Golgi complexes, and nuclear membranes. Cholesterol intercalates among the phospholipids of the membrane, with its hydroxyl group at the aqueous interface and the remainder of the molecule within the leaflet. Ref: Murray R.K., Granner D.K. (2011). Chapter 40. Membranes: Structure & Function. 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.
| 2 |
Glycerol
|
Cholesterol
|
Cholesteryl ester
|
Triacylglycerol
|
Microbiology
| null |
299b9b29-c17c-43e4-bbd7-d3ed0ca487bb
|
single
|
With regards to G6PD deficiency, which of the following in false
|
Ans. is 'd' i.e., X-linked recessive disorder that does not affect heterozygous famales Glucose 6-phosphate dehydrogenase (G6PD) deficiency, an X-linked disorder, is the most common enzymatic disorder of red blood cells in humans, affecting 400 million people worldwide. Clinical spectrum The clinical expression of G6PD variants encompasses a spectrum of hemolytic syndromes The four forms of symptomatic G6PD deficiency : Acute hemolytic anemia Favism Congenital nonspherocytic hemolytic anemia Neonatal hyperbilirubinemia G6PD deficiency is expressed in males carrying a variant gene that results in sufficient enzyme deficiency to lead to symptoms. Acute hemolytic anemia Almost all individuals with the most prevalent G6PD variants, G6PD A- and G6PD Mediterranean, are asymptomatic in the steady state. They have neither anemia, evidence of increased red cell destruction, nor an alteration in blood morphology,. o However sudden destruction of enzyme deficient erythrocytes can be triggered by ceain drugs or chemicals, by selected infections, and rarely by metabolic abnormalities (eg, diabetic ketoacidosis). Clinical course At two to four days after drug ingestion, there is the sudden onset of jaundice, pallor, and dark urine, with or without abdominal and back pain. This is associated with an abrupt fall in the hemoglobin concentration of 3 to 4 g/dL, during which time the peripheral blood smear reveals red cell fragments, microspherocytes, and eccentrocytes or "bite" cells. The anemia induces an appropriate stimulation of erythropoiesis, characterized by an increase in reticulocytes that is apparent within five days and is maximal at 7 to 10 days after the onset of hemolysis. Even with continued drug exposure, the acute hemolytic process ends after about one week, with ultimate reversal of the anemia. Inciting events Patients with class II or III variants develop intermittent hemolysis only after one or more of the following inciting events. Infection Oxidant drugs Chemical agents (eg, moth balls, aniline dyes, henna compounds) Diabetic ketoacidosis Ingestion of a beans Drugs and chemicals Primaquine, dapsone, and a number of other drugs can precipitate hemolysis in G6PD deficient subjects. Foods: a beans and bitter melon G6PD deficiency can also be precipitated by the the ingestion of fresh a beans (ism). Manifestation ofism begins 5-24 hrs after a bean ingestion and include headache, nausea, back pain. Congenital nonspherocytic hemolytic anemia Patients with class I G6PD variants have such severe G6PD deficiency that lifelong hemolysis occurs in the absence of infection or drug exposure. Such patients fall under the category of having congenital nonspherocytic hemolytic anemia. These G6PD variants have low in vitro activity and/or marked instability of the molecule, and most have DNA mutations at the glucose-6-phosphate or NADP binding sites. These sites are central to the function of G6PD, which oxidizes glucose-6-phosphate and reduces NADP to NADPH. It is presumed that the functional defect is so severe that the red cells cannot withstand even the normal oxidative stresses encountered in the circulation. Anemia and jaundice are often first noted in the newborn period, and the degree of hyperbilirubinemia is frequently of sufficient severity to require exchange transfusion. After infancy, hemolytic manifestations are subtle and inconstant. Most individuals have mild to moderate anemia (hemoglobin 8 to 10 g/dL) with a reticulocyte count of 10 to 15 percent. Pallor is uncommon, scleral icterus is intermittent, splenomegaly is rare, and splenectomy generally is of little benefit. Hemolysis can be exaggerated by exposure to drugs or chemicals with oxidant potential or exposure to a beans. Some drugs with relatively mild oxidant potential that are safe in patients with class II or class III G6PD variants may increase hemolysis in patients with class I variants. Neonatal hyperbilirubineinia The clinical picture of neonatal jaundice due to G6PD deficiency differs from neonatal jaundice seen in hemolytic disease of the fetus and newborn (HDFN) associated with Rh(D) incompatibility in two main respects. G6PD deficiency-related neonatal jaundice is rarely present at bih; the peak incidence of clinical onset is between days two and three. a There is more jaundice than anemia, and the anemia is rarely severe. The severity ofjaundice varies widely, from being subclinical to imposing the threat of kernicterus if not treated
| 4 |
Affects the pentose phosphate pathway
|
Associated with neonatal jaundice
|
Acute haemolysis can be precipitated by broad beans
|
X-linked recessive disorder that does not affect heterozygous famales
|
Medicine
| null |
21617ff5-1791-46b5-8258-93388cac7dd0
|
multi
|
Surgical management of a case of undescended testis is indicated at which age?
|
Optimum age for surgical correction of undescended test is between 9-15 months. The surgical procedure done is called Orchidopexy. Ref: Nelson Text Book of Pediatrics, 17th Edition, Page 1817; Nursing Care of The Pediatric Surgical Patient By Nacy TKacz Browne, Page 147-8.
| 3 |
2 months of age
|
6 months of age
|
12 months of age
|
24 months of age
|
Surgery
| null |
084d187d-5659-4757-bd2f-7b937a0fff44
|
single
|
Marsh's test is used for detection of
|
A i.e. Arsenic
| 1 |
Arsenic
|
Lead
|
Strychnine
|
Mercury
|
Forensic Medicine
| null |
960a83d9-15af-4060-bed5-046a11057196
|
single
|
True about acute pancreatitis
|
Gall stones are the most common cause, alcohol being IInd most common. Ultrasound is often the first imaging investigation but CT is the best imaging investigation. Serum amylase is the most widely used laboratory test because of its simplicity. It lacks the specificity to pancreas and may be raised in a multitude of condition causing high false positive reactions. Moreover there can be cases of acute pancreatitis with normal serum amylase levels. Serum amylase level usually return to normal after 48 to 72 hrs of acute episode, fuher limiting its usefulness. Serum Lipase is now the single best enzyme to measure for the diagnosis of acute pancreatitis. Its level remains elevated for much longer duration of time (7 to 14 days) Other specific serum markers for acute pancreatitis are: - pancreatic isoamylase - trypsinogen One more fact about serum amylase is woh mentioning There is no significant correlation between the magnitude of serum amylase elevation and severity of pancreatitis, in fact, a milder form of acute pancreatitis is often associated with higher levels of serum amylase as compared with that in a more severe fonn of the disease. Surgical treatment is needed rarely in acute pancreatitis. The disease is self-limited in --85% to 90% of patients and subsides within 3-7 days. Surgical management is needed in cases of necrotic pancreatitis, pancreatic abscess and intervention in gall stone pancreatitis. Grey Turners sign is bluish discolouration seen at the flanks Bluish discolouration around the umbilicus is known as Cullen's sign. Mnemonic: GF Grey Turner's sign - Flanks Cullen's sign - Umbilicus Both of these signs indicate severe necrotizing pancreatitis. Ref : Harrison 17/e p2002 , Schwaz 9/e p1181
| 2 |
Serum Amylase is diagnostic
|
CECT is preferred over USG in diagnosis
|
Grey Turner sign seen around the umbilicus
|
Alcohol is the MC cause
|
Anatomy
|
G.I.T
|
372a94c6-7f03-43b1-868c-865b8a9595b5
|
multi
|
All of the following about PDA are true except ?
|
Ans. is 'a' i.e., It is more common in males than females PDA is more common in females than males - Nelson Lesions more common in girls Lesions more common in boys ASD PDA TGA VSD Pulmonic stenosis Left sided obstructive lesions
| 1 |
More common in males
|
Common hea lesion in rubella
|
Treatment is closure of defect by ligation and division of ductus
|
Hypo xi a and immaturity are impoant in maintaining the patency
|
Pediatrics
| null |
6418673c-e93b-47fb-a801-19c7fc369d73
|
multi
|
For maturity estimation, amniotic fluid cells are stained with :
|
Nile blue sulphate
| 1 |
Nile blue sulphate
|
Methylene blue
|
Mucicarmine
|
Sudan black
|
Gynaecology & Obstetrics
| null |
aaf96869-9073-4b48-9f1c-026b7748655c
|
single
|
Select the true statements :
|
A i.e. Imipramine is used in endogenous depression - PimozideQ & Loxapine are hetrocyclic antipsychotics. Fluoxitine (SSRI), Amitryptyline (TCA) & Trazadone (atypical) are antidepressants. - Imipramine is TCA & used in endogenous depression. Increased appetite & weight is seen in TCAs but not with SSRI (eg. fluoxetine). Fluoxetine lit weight lossQ Thioridazine is potent central anticholinergicQ drug with S/E of male sexual dysfunction (impaired ejaculation)Q - BZ's have lower abuse liability than barbiturates.
| 1 |
Imipramine is used In treatment of endogenous depression
|
Fluoxetine causes weight gain
|
Thioridazine cause less anticholinergic effects
|
BZD's have same abuse potential as barbiturates
|
Psychiatry
| null |
50c7d40b-b81b-4f08-8429-4cafba5730a9
|
multi
|
Drug that do not increase QT interval:
|
Ans is 'c' i.e. Digitalis o Digitals causes shoening of QT intervalo Other drugs (given in options) cause prolongation of QT interval.
| 3 |
Amiodarone
|
Quinidine
|
Digitalis
|
Amitryptyline
|
Pharmacology
| null |
41bb6887-462d-4ecf-9a9a-83ea5d179ab7
|
single
|
FSH and LH concentrations at birth
|
FSH and LH concentrations rise abruptly in response to fall in placental oestrogen levels, and are highest in first 3 months of life.
| 1 |
Rise abruptly
|
Fall abruptly
|
No change
|
Rise after 3 months of age
|
Gynaecology & Obstetrics
| null |
7b9e365c-3b31-48f0-9cd0-8488e1ac3c00
|
multi
|
Acitomycin D interferes with enzyme induction by combining with -
|
B i.e. DNA
| 2 |
TRNA
|
DNA
|
R-RNA
|
Repressor protein
|
Biochemistry
| null |
30d17f2d-4c63-4f27-abae-786f4ed6fae4
|
single
|
Antiglaucoma drug contraindicated in acute uveitis
|
Answer- A. PilocarpineCholinomimletic (Pilocarpine) :- Uveitis
| 1 |
Pilocarpine
|
Timolol
|
Brimonidine
|
Latanoprast
|
Ophthalmology
| null |
f0b0697f-6cda-49a1-8a0d-52e49a4e7a6d
|
single
|
Concurrent flexion of both wrists in response to electrical stimulation is characteristic of which area of the nervous system
|
A few of the fibers of pyramidal tract do not cross to the opposite side in the medulla but pass ipsilaterally down the cord in the ventral coicospinal tracts. Many, if not most, of these fibers, eventually cross to the opposite side of the cord either in the neck or in the upper thoracic region. These fibers may be concerned with control of bilateral postural movements by the supplementary motor coex.The supplementary motor area tends to produce bilateral motor responses when stimulated. The other areas would tend to produce unilateral responses.Ref: Guyton; 13th edition; Chapter 56; Coical and Brain Stem Control of Motor Function
| 4 |
Postcentral gyrus
|
Vestibulospinal tract
|
Dentate nucleus
|
Supplementary motor coex
|
Physiology
|
General physiology
|
ada06bb5-c79f-4ab3-a674-c2316894b291
|
multi
|
Which is not true regarding Insulinoma -
|
Hypoglycemic attacks are part of Whipple's triad
Insulinoma is usually solitary (~90%)
Only 5 to 15% are malignant
| 2 |
Hypoglycemic attacks
|
Weight loss
|
Usually Solitary tumour
|
Mostly benign tumour
|
Surgery
| null |
efd13cfc-37cc-401a-9802-ef562f3734d3
|
multi
|
True about autism -
|
Ans. is 'c' i.e., Stas before 2-3 years of age Autism o Autism is a neurologic disroder characterized by ? Qualitative impairment in social interaction Qualitative impairment in communication. Restricted repetitive and streotyped patterns of behaviour, interests, and activities. Onset of symptoms is usually before 3 years of age. 3-5 times more common in boys, but more severe when occurs in girls. o More common among low socio-economic groups. Clinical features Impairment in communication Impairment in social interaction Inability to concentrate Restricted repetitive and streotypes patterns of behaviour, interests and activities. Failure to acquire speech. Approximately 75% of children with autism are mentally retarded. Epilepsy develops in approximately one-fifth to one-third individuals. Half of autistic patients have abnormalties on EEG.
| 3 |
Occurs in high economic striata
|
Normal communication
|
Stas before 2-3 years of age
|
More common in girls
|
Pediatrics
| null |
672d3b9f-8a57-4f30-a5db-8116670fa3a7
|
multi
|
The operation that precipitates portosystemic encephalopathy is
|
Portosystemic encephalopathy is a neuropsychiatric syndrome, It most often results from high gut protein or acute metabolic stress
(eg, GI bleeding, infection, electrolyte abnormality) in a patient with portosystemic shunting.
In portosystemic shunting, absorbed products that would otherwise be detoxified by the liver enter the systemic circulation and reach the brain, causing toxicity, particularly to the cerebral cortex.
| 4 |
Splenorenul shunt
|
Siguira operation
|
Talma - Marison Operation
|
Portacaval anastomosis
|
Surgery
| null |
c75d05af-8d8d-487c-a3c8-838c4bbd0b73
|
single
|
A pt. presented with renal cell carcinoma invadvin IVC and the renal vein. False statement is:
|
Answer is B (IVC involvement indicates inoperability): Extension of tumor into IVC does not indicate inoperability. 'Extension into renal vein or inferior vena cava does not preclude resection even if cardiopulmonary bypass is required. Half of these patients have prolonged survival' - Harrison
| 2 |
Preop biopsy is not necessary
|
IVC involvement indicates inoperability
|
Pre op radiotherapy is not essential
|
Chest x-ray should be done to rule out pulmonary metastasis.
|
Medicine
| null |
deeca405-7d86-45a4-8215-23eab750b8bd
|
multi
|
Typical silvery scales of psoriasis are absent in –
|
Scaling is absent or minimal
Flexures (Groins, axillae, infra - mammary folds, vulva, gluteal cleft)
Glans in uncircumcised patients (in circumcised patients scales are present on glans
Guttate psoriasis
| 3 |
Scalp
|
Kee
|
Groin
|
Elbow
|
Dental
| null |
b50f21a4-6858-4b26-8fb1-d108489f341e
|
single
|
Population growth is said to be less than adequate requirement when NRR is
|
Net reproductive rate is defined as the number of daughters a newborn girl will bear during her life time assuming fixed age specific feility and moality rates It is a demographic indicator NRR of 1 is equivalent to attaining approximately the 2 child norm If NRR is less than 1, then the reproductive performance of the population is said to below replacement level Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 489
| 1 |
< 1
|
1
|
> 1
|
0
|
Social & Preventive Medicine
|
Demography and family planning
|
2a29dcd5-497b-427b-b616-a92f3c0fab4c
|
single
|
Aschoff's nodules are seen in -
|
• Aschoff’s bodies are characteristic focal inflammatory lesion of acute rheumatic fever found in any of the three layers of the heart.
| 3 |
Subacute bacterial endocarditis.
|
Libman - Sacks endocarditis
|
Rheumatic carditis
|
Non - bacterial Thrombotic endocarditis
|
Pathology
| null |
0ce36abf-f59b-4bef-b437-3e7d5ff77b07
|
single
|
Issuing false ceificate is punishable under Sec 197 IPC for imprisonment upto
|
Issuing false ceificate is punishable under Sec 197 IPC : imprisonment upto 7 years and fine and erasure of name from medical register. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 11
| 3 |
4 years
|
5 years
|
7 years
|
10 years
|
Anatomy
|
General anatomy
|
cfb6aad9-1417-4160-99cd-362facae5d45
|
multi
|
All of the following drugs can cause cholestatic jaundice EXCEPT:
|
The above drugs erythromycin, oc pills, chlorpromazine effects the liver and damage it leading to cholestasis. Mostly because all these drugs are metabolized and excreted bile and hence during bile formation, they damage the liver but isoniazid an antitubercular drug is extensively metabolized in liver but excreted in the urine. It mostly induces peripheral neuritis rather than cholestatic jaundice ESSENTIALS of medical PHARMACOLOGY SEVENTH EDITION -K D TRIPATHI Page:753,321,766.413
| 2 |
Erythromycin estolate
|
INH
|
OC pills
|
Chlorpromazine
|
Pharmacology
|
Other topics and Adverse effects
|
7e6c775d-15ac-443b-a846-9bc5573db1df
|
multi
|
Karyotyping under light microscopy is done by
|
G-banding, G banding, or Giemsa banding is a technique used in cytogenetics to produce a visible karyotype by staining condensed chromosomes.It is useful for identifying genetic diseases through the photographic representation of the entire chromosome complement.
| 3 |
R banding
|
Q banding
|
G banding
|
C banding
|
Biochemistry
|
Metabolism of nucleic acids
|
9b45c908-246e-4828-bd88-863d9752e81a
|
single
|
In Neurogenic shock true is:
|
Ans. A. Hypotension with bradycardiaIn neurogenic shock, main pathology is stretching of neural pathways in spinal cord. In this type of shock, low blood pressure & slowed heart rate occurs due to disruption of autonomic pathways in spinal cord.
| 1 |
Hypotension with bradycardia
|
Hypertension with bradycardia
|
Hypotension with tachycardia
|
Hypertension with tachycardia
|
Medicine
|
C.V.S.
|
09e46b8f-dbe6-4e3f-95c9-3a038f56f30a
|
multi
|
All are complication of Typhoid ulcer EXCEPT -
|
complications include: Intestinal:perforation,hemorrhage ExtraIntestinal:encephalopathy,meningitis,seizures,endocarditis,myocarditis,pneumonia etc GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK PAGE NO:394
| 2 |
Perforation
|
Stricture
|
Haemorrhage
|
Endocarditis
|
Pathology
|
G.I.T
|
ca8da046-b91b-41b7-a6d4-20ce185fe748
|
multi
|
Anti Ul-RNP antibody is seen in?
|
Ans. is 'c' i.e., MCTDo Mixed connective tissue disease (MCTD) is characterized serologically by high titers of antibodies to ribonucleoprotein paicle-containing Ul ribonucleoprotein (Anti-Ul RNP)
| 3 |
SLE
|
Scleroderma
|
MCTD
|
Derniatomyositis
|
Pathology
| null |
8f677a94-c177-43d9-bd19-c4730df5bc84
|
single
|
In a patient with multiple bilateral nasal polyps with X-ray showing opacity in the paranasal sinuses. The treatment consists of all of the following, except:
|
Bilateral ethmoidal polypi are either the result of long-standing nasal allergy or fungal sinusitis. Opaque paranasal sinuses can result in both. Treatment therefore can include antihistamines, steroids and. if fungal, amphotericin-B. Epinephrine (adrenaline) has no role.
| 1 |
Epinephrine
|
Corticosteroids
|
Amphotericin-B
|
Antihistamines
|
ENT
|
Nose and PNS
|
b96591b3-0a21-4fe4-ab96-904eb193e1a1
|
multi
|
Which hormone act on intracellular receptors-
|
Ans. is 'a' i.e., Thyroxine Hormones with intracellular receptors (Group I hormones)* Cytoplasmic Glucocorticoids (cortisol/cortisone), mineralocorticoids, androgens, progestins.* Nucleus Estrogen, Thyroid hormones (T3 T4), retinoic acid, Vitamin D (Calcitriol or 1,25 (OH)2 D3).
| 1 |
Thyroxine
|
Glucagon
|
Insulin
|
PDGF
|
Physiology
|
Endocrinology and Reproduction
|
97d4cfd7-c1bb-4a72-88b9-bc26910d6f80
|
single
|
Changes in middle ear after bih are observed in?
|
Ans. is 'a' i.e., Werdin's test Werdin's test: Before bih middle ear contains gelatinous embryonic tissue which is replaced by air after respiration.
| 1 |
Werdin's test
|
Ploucquet's test
|
Fodere's test
|
Breslau's test
|
Forensic Medicine
| null |
5250bfec-2d5b-47fb-a481-875858c59362
|
single
|
True about rotavirus vaccine:
|
Ans. c. Pentavalent vaccine
| 3 |
Killed vaccine
|
Given subcutaneous
|
Pentavalent vaccine
|
Should be given before 5 years
|
Microbiology
| null |
f677c0ae-7e76-41c3-b8f6-c65b4bb06b85
|
multi
|
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