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Chauffers fracture involves what ?
Chauffeur&;s fracture, also known as Hutchinson fracture, is a type offracture of the forearm, specifically the radial styloid process. The injury is typically caused by compression of the scaphoid bone of the hand against the styloid process of the distal radius. Ref : essential ohopaedics maheshwari and mhaskar 9th ed p 103<img alt="" src=" />
2
Radial head
Radial styloid process
Ulnar styloid process
Base of 1st metacarpal
Orthopaedics
Elbow injuries
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"French paradox" is -
The French paradox is a catchphrase first used in the late 1980s, that summarizes the apparently paradoxical epidemiological observation that French people have a relatively low incidence of coronary hea disease (CHD), while having a diet relatively rich in saturated fats,in apparent contradiction to the widely held belief that the high consumption of such fats is a risk factor for CHD. The paradox is that if the thesis linking saturated fats to CHD is valid, the French ought to have a higher rate of CHD than comparable countries where the per capita consumption of such fats is lower. The French paradox implies two impoant possibilities. The first is that the hypothesis linking saturated fats to CHD is not completely valid (or, at the extreme, is entirely invalid). The second possibility is that the link between saturated fats and CHD is valid, but that some additional factor in the French diet or lifestyle mitigates this risk--presumably with the implication that if this factor can be identified, it can be incorporated into the diet and lifestyle of other countries, with the same lifesaving implications observed in France. Both possibilities have generated considerable media interest, as well as some scientific research. It has also been suggested that the French paradox is an illusion, created in pa by differences in the way that French authorities collect health statistics, as compared to other countries, and in pa by the long-term effects, in the coronary health of French citizens, of changes in dietary patterns which were adopted years earlier. In 1991, Renaud extended his studies in panership with then junior researchers, cardiologist Michel de Lorgeril and dietician Patricia Salen. The three enhanced Renaud's study, with their paper concluding that: a diet based on southwestern Mediterranean cuisine; which is high in omega-3 oils, antioxidants and includes "moderate consumption" of red wine; created lower cases of cancer, myocardial infarction and cardiovascular disease; paly through increasing HDL cholesterol whilst reducing LDL cholesterol Ref Davidson 23rd edition pg 529
1
a) A wine and food-loving French population with a low incidence of obesity and cardiovascular disease
b) In spite of heavy smoking lower incidence bronchogenic carcinoma in France
c) A physical fitness conscious french population still having higher incidence of cardiovascular disease
d) In-spite of high sugar intake in diet a lower incidence of obesity and type 2 DM
Medicine
Miscellaneous
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A 64-year-old man with heart failure is recently started on 80 mg/day of furosemide. He now feels weak and tired, but notes that his heart failure symptoms have improved. There is no change in his urine output and he gets a good diuretic response every time he takes his furosemide.Select the characteristic ECG findings.
Hypokalemia results in prolongation of the QU interval. The delayed repolarization in hypokalemia is best expressed at QU rather than QT prolongation since it can be difficult to separate the T wave from the U wave. In severe cases, the ST segments become depressed. Quinidine, even in therapeutic doses, can cause similar ECG findings. This is felt to be a risk factor for ventricular arrhythmias, including Torsades des pointes.
3
shortened PR interval
lengthened PR interval
lengthened QU interval
shortening of the QT interval
Medicine
C.V.S.
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Diagnostic criteria for Bulimia nervosa are all EXCEPT
(B) Presence of other psychiatric disorders # BULIMIA NERVOSA (BN) is an eating disorder characterized by eating binges typically followed by efforts to purge calories through self-induced vomiting, laxative and/or diuretic abuse, prolonged fasting, or excessive exercise. Fear of weight gain leads to the characteristic purging behavior, but BN is centered around the practice of binge eating.> The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), describes diagnostic criteria for BN and includes the following:> Recurrent episodes of binge eating, characterized by the following:> Eating an amount of food, in a discrete period of time, that is larger than most people would eat during a similar period of time under similar circumstances.> A perceived lack of control over eating during the episode of binge eating> Recurrent inappropriate compensatory behavior used to prevent weight gain> Occurrence of binge eating and inappropriate compensatory behaviors, on average, at least twice a week for 3 months> Self-evaluation unduly influenced by body shape and weight> Does not occur exclusively during episodes of anorexia nervosa.
2
Binge Eating
Presence of other psychiatric disorders
Lack Of Control Over Eating Behaviour
Self Induced Vomiting
Psychiatry
Miscellaneous
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multi
Prolonged exposure to noise levels greater than the following can impair hearing permanently -
Repeated or continuous exposure to the noise around 100 decibels may result in a permanent hearing loss; inner ear damage may vary from minor changes in the hair cells to complete destruction of the organ of Coi. Park's Textbook of Preventive and Social Medicine, 22nd edition, Page No. 689
3
40 decibels
85 decibels
100 decibels
140 decibels
Social & Preventive Medicine
Environment and health
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single
Defect in type II hyperlipidemia
Familial hypercholesterolemia (type Ha) is due to deficiency of functional LDL receptors as a result of different types of mutations.
3
Apo-E
Lipoprotein lipase
LDL receptor
None
Biochemistry
null
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multi
Which of the following non collagenous protein of dentin prevents premature mineralization
null
1
Decorin and Biglycans
Dentin Phosphoprotein
Dentin Sialoprotein
All of the above
Dental
null
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What is meant by suppositious child -
Ans. is 'c' i.e., Child rear up by a woman & She claims the child Suppositious child Suppositious child means a factitious child. o Women may pretend pregnancy as well as delivery & later produces a child as if it is her own. She may substitute a living male child for a dead child or for a living female child born of her.
3
Second born of a twin pregnancy
Child born out of wedlock
Child rear up by a woman & She claims the child
Heterozygous mother & father
Pediatrics
null
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single
Corneal endothelial cell count is done by -
Ans. is 'a' i.e., Specular microscopy o Specular microcopy is used for corneal endothelial density.Important corneal examinationsCsed foro Keratometry. Comeal topographyCurvature of corneao Specular microscopyCorneal endothelial densityo Slit lampCorneal opacityo PachymeterThickness of corneao Placido's discCorneal sheeno Fluorescein, Alacian blue & Bengal rose stainComeal stainingo Window reflex, slit lamp biomicroscopy, Placidos' discComeal surface
1
Specular microscopy
Keratometry
Gonioscopy
Slit lamp
Ophthalmology
Techniques of Ocular Examination and Diagnostic Tests
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All are true about Amoebic liver abscess except: March 2007
Ans. B: Alcoholics are susceptible to develop amoebic liver abscess Amebic liver abscess is the most frequent extraintestinal manifestation of Entamoeba histolytica infection. This infection is caused by the protozoa Ehistolytica, which ascends the poal venous system. The right lobe (posterior superior quadrant) of the liver is more commonly affected than the left lobe. This has been attributed to the fact that the right lobe is supplied predominantly by the superior mesenteric vein, whereas the left lobe is supplied by the splenic vein. Histologic Findings of abscess The abscess contains acellular proteinaceous debris and is surrounded by a rim of amebic trophozoites invading tissue. The abscess contains a chocolate-colored fluid that resembles anchovy paste and consists predominantly of necrotic hepatocytes. Complications Pleuropulmonary infection is the most common complication. Cardiac involvement results following the rupture of an abscess involving the left lobe of the liver. It usually is associated with very high moality. Intraperitoneal rupture occurs in 2-7% of patients. Left lobe abscesses are more likely to progress to rupture because of their later clinical presentation. Bacterial superinfection can occur.
2
Common site is right posterosuperior pa of liver
Alcoholics are susceptible to develop amoebic liver abscess
Anchovy sauce pus
Fever is the most common sign
Medicine
null
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multi
All of the following conditions are associated with primary amenorrhea except:
Ans. is b, i.e. Stein-Leventhal syndromeRef: Shaw 15th/ed, p284-285The Stein-Leventhal Syndrome also known as Polycystic Ovarian Disease (PCOD) is an important cause of Secondary Amenorrhea in young women.Testicular Feminizing syndrome, Turners syndrome and Mayer Rokitansky Kuster Hauser syndrome are causes of Primary amenorrhea.
2
Testicular feminization syndrome
Stein-Leventhal syndrome
Turner's syndrome
Mayer Rockitansky Kuster Hauser Syndrome
Gynaecology & Obstetrics
Disorders in Menstruation
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Toxic megacolon is most commonly associated with-
null
1
Ulcerative colitis
Crohn's disease
Whipple's disease
Reiter's disease
Pathology
null
b4736868-8e5e-47d5-8cc2-7171be42f001
single
What is the drug of choice for Obsessive Compulsive Disorder?
Ans. (B) Fluoxetine(Ref: Harrison 17/e p2715; CMDT 2010/943; KDT 8/e p492)SSRIs are drug of choice for most of the neurotic disorders including OCD.
2
Imipramine
Fluoxetine
Benzodiazepines
Alprazolam
Pharmacology
C.N.S
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The cells most frequently found in a granuloma are
null
3
Mast cells
Giant cells
Lymphocytes
Neutrophilis
Pathology
null
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single
The drug causing curare like effects are all except
Refer KDT 6/e p 346 Drugs causing curare like effect are Aminoglycosides Polypeptide antibiotics Tetracycline Clindamycin, lincomycin
1
Chloramphenicol
Polymyxin
Tetracycline
Streptomycin
Pharmacology
Anesthesia
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multi
Investigation of choice on Meckel's Diveicula in pediatric age group is
In case of children 99mTc-peechnetate is preferentially taken up by the mucus secreting cells of gastric mucosa and ectopic gastric tissue in Meckel's Diveicula. In adults less ectopic gastric tissue is seen so the test is not much accurate in adults Ref: Sabiston 20th edition Pgno :1285
4
USG
CT
Barium meal
Na 99m Tc- peechnetate
Anatomy
G.I.T
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single
Os trigonum is which type of epiphysis ?
C i.e. Atavistic
3
Aberrant
Pressure
Atavistic
Traction
Anatomy
null
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single
Wolff-chaikoff effect is -
Ans. is 'c' i.e., Reduced thyroxine synthesis by iodides Iodine and Iodideso Iodine is the fastest acting thyroid inhibitor.o Most important action is inhibition of hormone release (thyroid constipation)\ but all facets of thyroid synthesis may be affected.o Excess iodide inhibits its own transport in thyroid cells and may alter the redox potential of cells, thus interfering iodination - reduced T4/T3 synthesis (Wolff-chaikoff effect).
3
Reduced thyroxine synthesis by radiotherapy
Reduced thyroxine synthesis by propylthiouracil
Reduced thyroxine synthesis by iodides
None of the above
Pharmacology
Endocrinology
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multi
Growth of virus in embryonated egg, eggs are incubated for -
Ans. is 'c' i.e., 5-12 days "For virus isolation, feile chicken eggs are incubated for 5-12 days, and a viral Suspension or suspected virus - containing" tissue is injected into the fluid of the egg.
3
4-8 hours
1-2 days
5-12 days
20-25 days
Microbiology
null
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single
Which of the following is primarily a bactericidal drug?
Aminoglycosides: Streptomycin, Gentamicin, Amikacin, Neomycin, etc. are considered as bactericidal drugs.
2
Chloramphenicol
Gentamicin
Sulphadiazine
Tetracycline
Pharmacology
null
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single
Crown completion of Mandibular Canine occur
null
2
At birth
6-7 years
11-12 years
8-9 years
Dental
null
2e04b9c6-9a90-4773-8849-6560535c7e9d
single
N K cell shows presence of -
Ans. is 'b' i.e., CD 16 o NK cells have CD-56 and CD-16 on their surface.
2
CD 44
CD 16
CD 54
CD 32
Pathology
Cells and Tissues of Immune System
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single
A radiologist notes the presence of fine, radiographically dense crystals in the tissues of a knee joint. This patient most likely has which of the following types of ahropathy?
Radiographically dense calcium pyrophosphate dihydrate (CPPD) crystals are deposited in cailage and joint soft tissues in pseudogout, which can involve the knees, wrists, elbows, shoulders, or ankles. If the patient is asymptomatic because the deposition is primarily within cailage, the condition is sometimes called chondrocalcinosis. In its more severe form, the joint involvement can clinically resemble rheumatoid ahritis. Neither gonococcal ahritis, osteoahritis, nor rheumatoid ahritis are associated with crystal formation. The monosodium urate crystals deposited in joints in gouty ahritis are not radio-opaque. Ref: Wyatt C., Kemp W.L., Moos P.J., Burns D.K., Brown T.G. (2008). Chapter 19. Pathology of the Bones and Joints. In C. Wyatt, W.L. Kemp, P.J. Moos, D.K. Burns, T.G. Brown (Eds), Pathology: The Big Picture.
4
Gonococcal ahritis
Gouty ahritis
Osteoahritis
Pseudogout
Medicine
null
bb86ecf4-fb4a-4b2c-b907-3b6a85932a9c
multi
All are seen with Pneumocystis carini in AIDS except:
In addition to pneumonia, a number of other clinical problems have been repoed in HIV-infected patients as a result of infection with P. jiroveci as:- Otic involvement may be seen as a primary infection, presenting as a polypoid mass involving the external auditory canal. In patients receiving aerosolized pentamidine for prophylaxis against PCP, one may see a variety of extrapulmonary manifestations of P. jiroveci. These include ophthalmic lesions of the choroid, a necrotizing vasculitis that resembles Buerger's disease, bone marrow hypoplasia, and intestinal obstruction. Other organs that have been involved include lymph nodes, spleen, liver, kidney, pancreas, pericardium, hea, thyroid, and adrenals.
4
Pneumonia
Otic polypoid mass
Ophthalmic choroid lesion
Meningitis
Medicine
viral infection
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multi
All of the following aeries are common sites of occlusion by a except:
Answer is D (Marginal aery)
4
Left anterior descending
Right coronary aery
Circumflex coronary aery
Marginal aery
Medicine
null
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von Willebrand disease is a defect of
Primary hemostasis: the formation of the platelet plug.Disruption of the endothelium exposes subendothelial von Willebrand factor (vWF) and collagen, which promote platelet adherence and activation. Activation of platelets results in a dramatic shape change as well as the release of secretory granules. Within minutes the secreted products recruit additional platelets, which undergo aggregation to form a primary hemostatic plug.Defects of primary hemostasis (platelet defects or von Willebrand disease) often present with small bleeds in the skin or mucosal membranes. These bleeds typically take the form of petechiae, minute 1 to 2 mm hemorrhages, or purpura, which are slightly larger (>=3 mm) than petechiae. Mucosal bleeding associated with defects in primary hemostasis may take the form of epistaxis (nosebleeds), gastrointestinal bleeding, or excessive menstruation (menorrhagia).Ref: Robbins and Cotran Pathologic; 9th edition; Chapter 4; Hemodynamic Disorders, Thromboembolic Disease, and Shock; Page no: 122
1
Primary hemostasis
Secondary hemostasis
Clot stabilization and resorption
Generalized defects involving small vessels
Pathology
General pathology
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multi
All true about sodium Thiopentone except -
Thiopentone is ultrasho acting barbiturate. Thiopentone does not produce analgesia and may even produce antianalgesia by reducing the pain threshold. Thiopentone has rapid onset of action (within 30 s) due to high lipid solubility and high non ionized fraction (60%). And ultra-sho duration of action (within 20 mins) due to rapid redistribution. Thiopentone does not completely suppress airway responses to laryngoscopy and intubation and may lead to bronchospasm in asthmatics. Thiopentone is cerebro protective: It reduces CSF volume by facilitating its absorption. It decreases CBF and cerebral blood volume, thus lowering intracranial pressure. It also has anticonvulsant propey which is advantageous in neurosurgical patients who are at increased risk of seizures.
1
It is intermediate acting barbiturates
It is cerebroprotective
It is agent of choice for narcoanalysis
It is contraindicated in acute intermittent porphyria
Anaesthesia
Intravenous Anesthetic Agents
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Which of the following antihypeensive inhibits vesicular uptake of NA -
Ans. is 'c' i.e., Reserpine o Reserpine inhibits vesicular uptake of NA, 5-HT & DA --) monoamines are gradually depleted and degraded by MAO.
3
Propranolol
Prazosin
Reserpine
Guanithidine
Pharmacology
null
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single
Gastric emptying is decreased by all of the following EXCEPT:
Acidity of the chyme, hyper- or hypo-osmolarity of the duodenal contents, irritation of the duodenal mucosa, protein or fat breakdown products in duodenum are the factors sensed by the duodenal receptors. Gastric emptying will then be decreased, by a combination of neural and hormonal signals. Neural signals would be enterogastric reflexes in the ENS; they are triggered by the acidic chyme in the duodenum. Hormonal signals would be in the form of CCK, Secretin, G.I.P. released from duodenal mucosa. Fat in the duodenum is very potent inhibitor of gastric emptying; it causes CCK release. Hormonal factors decrease the gastric motility and cause constriction of pyloric sphincter. Other effects include: fundic relaxation, inhibition of antral motor activity. Gastrin, in physiological amounts, is known to increase gastric motility.
4
Protein breakdown products
CCK
Enterogastric reflexes
Gastrin
Physiology
Gastrointestinal System
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multi
Cystic supratentorial tumor is?
Ans. is 'a' i.e. Craniopharyngioma * Craniopharyngioma is supratentorial slow growing cystic tumor.Other options* Ependymoma can both supra and infratentorial.* Medulloblastoma is an infratentorial tumor.
1
Craniopharyngioma
Ependymoma
Medulloblastoma
None of the above
Pathology
Central Nervous System
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multi
Microbiologic studies on a gram-positive coccus isolated from a skin abscess demonstrate a positive catalase test and a positive coagulase test. This is most consistent with which of the following organisms?
All of the organisms listed are gram-positive cocci. The positive catalase test excludes the Streptococci, S. pyogenes, and S. pneumoniae. Of the Staphylococci, only S. aureus has a positive coagulase test. S. epidermidis and S. saprophyticus are coagulase-negative Staphylococci. Ref: Ray C.G., Ryan K.J. (2010). Chapter 24. Staphylococci. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e.
1
S. aureus
S. epidermidis
S. pneumoniae
S. pyogenes
Microbiology
null
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True about incest is: Karnataka 11
Ans. Not punishable in India
4
Punishable under Sec. 294 IPC
Punishable under Sec. 377 IPC
Punishable under Sec. 304-A IPC
Not punishable in India
Forensic Medicine
null
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multi
Pneumocytes are cells found in epithelial lining of:
PneumocytesTwo types of pneumocytes contribute to the maintenance of the alveoli of the lungsType I pneumocytes and Type II pneumocytes.These cells function to aid in gas exchange, secretion of pulmonary surfactant, and self-regeneration
1
Alveoli
Bronchus
Trachea
Bronchioles
Anatomy
null
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Which one of the following is not a feature of liver histology in Non cirrhotic poal fibrosis (NCPF) ?
Ans. is 'd' i.e., Bridging fibrosisFibrosis bridging one poal tract to another (bridging fibrosis) is not seen.Pathology : o Non cirrhotic poal fibrosis is primarily a vascular disorder of the liver characterized by fibrous intimal thichening of the poal vein or its branches in patients with non cirrhotic protal hypeension.Vascular changesHallmark of the disease is thrombosis/sclerosis of the poal vein branches.The poal vein is dilated with sclerosis of the walls and in autopsy thrombin in medium or small poal vein branches with accompanying areas of ischaemic necrosis have been repoed.Aberrant Intrahepatic vessels may be present in the peripoal area, which correspond to dilated terminal poal vein branches or venules. These are often termed as "megasinusuoids" or peripoal angiomatosis. FibrosisVascular changes are accompanied by poal and peripoal fibrosis of varying extent.
4
Fibrosis in and around the poal tracts
Thrombosis of the medium and small poal vein branches
Non specific inflammatory cell infiltrates in the poal tracts
Bridging fibrosis
Pathology
null
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Which of the following is a harmful: March 2009
Ans. A: Alpha Paicle The radiation one typically encounters is one of four types: alpha radiation, beta radiation, gamma radiation, and X-radiation. Neutron radiation is also encountered in nuclear power plants and high-altitude flight and emitted from some industrial radioactive sources. A Alpha radiation is a heavy, very sho-range paicle and is actually an ejected helium nucleus. Some characteristics of alpha radiation are: Most alpha radiation is not able to penetrate human skin. Alpha-emitting materials can be harmful to humans if the materials are inhaled, swallowed, or absorbed through open wounds. A thin-window Geiger-Mueller (GM) probe can detect the presence of alpha radiation. Instruments cannot detect alpha radiation through even a thin layer of water, dust, paper, or other material, because alpha radiation is not penetrating. Alpha radiation travels only a sho distance (a few inches) in air, but is not an external hazard. Alpha radiation is not able to penetrate clothing. Examples of some alpha emitters: radium, radon, uranium, thorium. Alpha paicle has poor penetration but maximum ionizing power and is most damaging. B. Beta radiation is a light, sho-range paicle and is actually an ejected electron. Some characteristics of beta radiation are: Beta radiation may travel several feet in air and is moderately penetrating. Beta radiation can penetrate human skin to the "germinal layer," where new skin cells are produced. If high levels of beta-emitting contaminants are allowed to remain on the skin for a prolonged period of time, they may cause skin injury. Beta-emitting contaminants may be harmful if deposited internally. Most beta emitters can be detected with a survey instrument and a thin-window GM probe (e.g., "pancake" type). Examples of these difficult-to-detect beta emitters are hydrogen-3 (tritium), carbon-14, and sulfur-35. Clothing provides some protection against beta radiation. Examples of some pure beta emitters: strontium-90, carbon-14, tritium, and sulfur-35. Beta paicle has moderate penetration, moderate ionizing power and is moderate damaging. C. Gamma radiation and X-rays are highly penetrating electromagnetic radiation. Some characteristics of these radiations are: Gamma radiation or X-rays are able to travel many feet in air and many inches in human tissue. They readily penetrate most materials and are sometimes called "penetrating" radiation. X-rays are like gamma rays. X-rays, too, are penetrating radiation. Sealed radioactive sources and machines that emit gamma radiation and X-rays respectively constitute mainly an external hazard to humans. Gamma radiation and X-rays are electromagnetic radiation like visible light, radiowaves, and ultraviolet light. Dense materials are needed for shielding from gamma radiation. Clothing provides little shielding from penetrating radiation, but will prevent contamination of the skin by gamma-emitting radioactive materials. Gamma radiation is easily detected by survey meters with a sodium iodide detector probe. Gamma radiation and/or characteristic x rays frequently accompany the emission of alpha and beta radiation during radioactive decay. Examples of some gamma emitters: iodine-131, cesium-137, cobalt-60, radium-226, and technetium-99m. Gamma paicle are most penetrating, minimum ionizing power and is least damaging
1
Alpha paicle
Gamma paicle
Neutron
Electron
Radiology
null
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single
Drug of choice for treatment of leptospirosis is:
Penicillin is the drug of choice for treatment of leptospirosis. Other drugs used are tetracycline and doxycycline. Ref: Park 21st edition, page 267.
1
Penicillin
Ampicillin
Tetracycline
Doxycycline
Social & Preventive Medicine
null
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single
A 42 year old paraplegic woman has a neurogenic bladder and requires an indwelling urinary catheter. She develops a urinary tract infection and is seen by a urologist, who orders abdominal x-rays and an intravenous pyelogram. The radiographic studies demonstrate a very large stone that fills and follows the contours of the renal pelvis. The stone is most likely composed of which of the following?
Staghorn calculi, such as described in the question, are associated with infection by urea-splitting bacteria (notably Proteus species) and are composed of magnesium ammonium phosphate (struvite). They are more common in women than men, and are far more common in patients requiring chronic bladder catheterisation. Calcium-containing stones are typically seen in patients with hypercalciuria without hypercalcemia; one-fifth of patients with this type of stone have hyperuricosuria. Cholesterol is found in gallstones, not kidney stones. Cystine stones are rare; they may be seen in patients with cystinuria, an autosomal recessive disorder of amino acid metabolism. Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 16. Pathology of the Kidney and Bladder. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds), Pathology: The Big Picture.
4
Calcium salts
Cholesterol
Cystine
Magnesium ammonium phosphate
Pathology
null
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single
A depot contraceptive DMPA is to be given every
null
2
1 month
3 months
2 months
6 months
Social & Preventive Medicine
null
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single
Temporary and permanent removed by –
Permutit method (Base exchange process) can remove both permanent and temporary hardness.
3
Boiling
Addition of lime
Permutit method
All
Social & Preventive Medicine
null
035263a1-d47e-43b6-a32a-0e98c5373cac
multi
Fluoride ion acts as inhibitor of:
null
1
Enolase
Hexokinase
Cyt oxidase
Carbonic anhydrase
Biochemistry
null
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single
Puerperal pyrexia is defined as a temperature of more than:
A temperature of 38.0degC (100.4degF) or higher--in the puerperium. Causes Genital tract infection Breast engorgement Urinary infections Wound infection Perineal lacerations infection Respiratory complications Predisposing factors Home bih in unhygienic conditions, low socioeconomic status poor nutrition primiparity anemia prolonged rupture of membranes prolonged labor multiple vaginal examinations in labor cesarean section obstetrical maneuvers retained bits of placental membranes, tissues within the uterus Maternal complications septicemia endotoxic shock peritonitis or abscess formation
3
98.4 degree F
99 degree F
100.4 degree F
104 degree F
Gynaecology & Obstetrics
Puerperium
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single
CB 1 antagonist used in smoking cessation is ?
Ans. is 'b' i.e., Rimonabant Rimonabant A selective cannabinoid receptor-1 (CB-1) antagonist which is being tried as antismoking and antiobesity drug.
2
Naloxona
Rimonabant
Vareniloline
Bupripion
Pharmacology
null
fdbd7b3b-f26f-4d43-9680-6938763fea7e
single
Which of the following is not true about the difference between congenital cataract surgery and senile cataract surgery?
The energy used in phacoemulsification is lesser as compared to the senile cataract. Congenital Cataract Surgery Treatment of choice: Lens aspiration by manual SICS technique or by phaco-emucification technique. Lensectomy can be done in total cataract with retinal detachment or ROP or any congenital retinal condition where lens aspiration can't be done. IOL should be put in every child above 2 yrs of age and even in less than 2 year of age, less than 6 month avoid putting IOL. A unilateral cataract has to be operated asap.(within days) Note- Bilateral dense cataracts-removed early that is within 6 weeks of bih to prevent stimulus deprivation amblyopia. Extra edge: - In congenital cataract surgeries, Ziegler knife is used to open lens capsule & aspirate lens material. ZIEGLER KNIEF
3
Incidence of Posterior capsular opacification is higher
Incidence of glaucoma is higher
The energy used in phacoemulsification is higher.
The chances of refractive surprise is higher.
Ophthalmology
Cataract
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What is the ideal treatment for a 55-years-female with Simple hyperplasia of the endometrium with Atypia?
Management of Atypical Endometrial Hyperplasia: "Hysterectomy is the best treatment for women at any age with atypical endometrial hyperplasia because the risk of concurrent subclinical invasive disease is high." Williams Gynae 1st ed p 691 "In presence of atypia, response to progesterone therapy is poor and the relapse rate is high. Nearly one-third of them will progress to cancer and one-fourth may already have associated undiagnosed cancer. In women approaching or post menopause, hysterectomy is a safer choice in those with complex or atypical hyperplasia."   Jeffcoate 7th/ ed p 425 So Remember: Best management of atypical hyperplasia is hysterectomy. Also, Know Management of Endometrial Hyperplasia: Management depends on the patient's age and the presence or absence of cytological atypia. Non-atypical hyperplasia: Premenopausal women: Progesterone therapy- options: - Medroxyprogesterone acetate for 21 days a month daily for 3 months. Progesterone-containing IUCD. Postmenopausal women Simple hyperplasia without atypia - Generally followed without therapy. Complex hyperplasia without atypia - Cyclical/continuous progesterone therapy. These patients should be followed annually by endometrial biopsy. Atypical hyperplasia: The ideal treatment is a hysterectomy Premenopausal women willing to preserve fertility - High dose progesterone therapy after full information of risk of undiagnosed cancer or progression to cancer. In these cases periodic TVS and endometrial biopsy is necessary.
1
Simple hysterectomy
Medroxy progesterone acetate (MPA)
Levonorgesterol (LNG)
IUCD
Gynaecology & Obstetrics
null
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single
Ehrlich phenomenon is seen in
The difference between the amount of diphtheria toxin that will exactly neutralize one unit of antitoxin and that which, added to one unit of antitoxin, will leave one lethal dose free is greater than one lethal dose of toxin; i.e., it is necessary to add more than one lethal dose of toxin to a neutral mixture of toxin and antitoxin to make the mixture lethal (the basis of the L+ dose). Reference: Textbook of Microbiology; Anathanarayan and panicker's; 9th edition
4
Myobacterium Tuberculosis
Proteus
Staphylococcus
Corynebacterium
Microbiology
Bacteriology
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"Boiler's notch" is suggestive of ?
Boiler notch/Acoustic dip is seen in Noise induced hearing loss NIHL Boiler notch at 4000Hz Notch is seen in BC curve AC curve notch are insignificant Maximum seen at 3000-6000Hz Sound causing maximum NIHL 2000-3000Hz Stereocilia of Outer hair cells are first to be affected
2
Conductive Hearing Loss
Noise Induced Hearing Loss (NIHL)
Both 1 and 2
Normal Finding
ENT
Otosclerosis
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A 40 year old woman presents with a three day history of irritation, pain, and watery discharge of her left ear. She has just returned from holiday, where she admits to using her towel, aificial nails, and ear buds to try to allete itching in her ear. What is the likely diagnosis?
Inflammation of the ear canal with or without infection is the charecteristic of acute otitis externa. If symptoms are recurrent or if they last longer than three months, the condition is classed as chronic otitis externa. Acute otitis externa can also be classified according to its cause. These are split into three main groups: Infective (bacterial, fungal, and viral), Non-infective dermatitis (allergic, eczematous, and irritant), and Mixed infective and non-infective Exacerbating factors include: Warm humid climates, swimming, frequent hair washing (especially if in the bath), and inseion of foreign bodies can introduce bacterial infection and cause local trauma to the ear canal, making infection more likely. Prolonged use of hearing aids may also predispose to infection.
2
Mastoiditis
Otitis Externa
ASOM
Trigeminal Neuralgia
ENT
null
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Following anterior dislocation of the shoulder, apt develops weakness of flexion at the elbow and lack of sensation over the lateral aspect forearm; nerve injured is -
The most common complication of anterior dislocation of the shoulder is axillary (circumflex) nerve injury. There is consequent paralysis of the deltoid muscle, with a small area of anaesthesia at the lateral aspect of the upper arm. However, in this question, the sensation is lost on the lateral aspect of the forearm (not arm). The lateral side of the forearm has sensory supply from the lateral cutaneous nerve of foreign, a branch of musculocutaneous nerve. The musculocutaneous nerve also supplies the biceps brachii (a flexor of elbow joint). Therefore, musculocutaneous nerve injury will cause sensory loss over the lateral aspect of the forearm with the weakness of flexion at the elbow. As occasionally other branches of brachial plexus (other than axillary nerve) can also be injured, the answer to this question is a musculocutaneous nerve.
2
Radial nerve
Musculocutanous nerve
Axillary nerve
Ulnar nerve
Orthopaedics
null
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Heavy smoker for elective hernia repair, smoking should be stopped before how much period?
Ans. is 'd' i.e., 6-8 weeksRef: Postgraduate anaesthesia p. 786'Limited prospective data suggest that cessation for at least 6-8 weeks preoperative is necessary to decrease the incidence of pulmonary complication."
4
4 days
10 days
3-4 weeks
6-8 weeks
Anaesthesia
null
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single
A nerve injured in radical neck dissection leads to loss of sensation in medial side of the arm, nerve injured is:-
Nerve injured in radical neck dissection leads to loss of sensation in medial side of the arm, nerve injured is medial cutaneous nerve of arm. The medial cutaneous nerve of arm supplies the skin of the medial aspect of the arm. It is the smallest branch of the brachial plexus, and arises from the medial cord and contains fibres from the eighth cervical and first thoracic ventral rami.
4
Long thoracic nerve
Thoracodorsal nerve
Dorsal scapular nerve
Medial cutaneous nerve of arm
Surgery
Neck
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Inward flow of Na+ in hea leads to
Entry of Na ions into cardiac cell leads to depolarisation. (REF TEXTBOOK OF MEDICAL PHYSIOLOGY GEETHA N 2 EDITION, PAGE NO 52)
2
Plateu phase
Action potential
Repolarization
No change
Physiology
General physiology
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Apoplexy is: DNB 08
Ans. Sudden onset of bleeding in the brain
3
Learning disability
Insanity leading to commitment of a crime
Sudden onset of bleeding in the brain
Injury to the brain due to trauma
Forensic Medicine
null
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A 17-year old male complains of recurrent episodes of cough, wheezing and shoness of breath paicularly at night for the last 3 days. His sibling has a history of similar symptoms. A Skin test with pollen produces immediate wheal and flare. The laboratory finding most consistent with his clinical findings would be
Atopy is the major risk factor for asthma.Patients with asthma commonly suffer from other atopic diseases,paicularly allergic rhinitis and atopic dermatitis.Eosinophilic infiltration of airways along with peripheral eosinophilia is a characteristic feature seen in asthmatic patients.There will also be elevated total serum IgE and specific IgE to inhaled allergens(radioallergosorbent test) in atopic asthma. Ref:Harrison's medicine-18th edition,page no:2109.
4
Neutrophilia
Cold agglutinins
Positive direct antiglobulin test
Eosinophilia
Medicine
Respiratory system
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HLA complex in humans is located on?
Ans. b (Short arm of chromosome 6). (Ref Harrison's medicine 16th ed. 1930)MAJOR HISTOCOMPATIBILITY COMPLEX (MHC)# MHC is a gene cluster of various loci grouped together on a single locus.# The MHC of humans, or the HLA complex, is located on the short arm of chromosome 6 approximately 32 CM from the centromere.# The loci of the HLA complex may be divided into three classes: Class I, Class II, and Class III.# The products of Class I and Class II genes play an important role in the communication between cells. These MHC molecules are surface proteins which present antigenic peptides to T lymphocytes.
2
Long arm of chromosome 6
Short arm of chromosome 6
Short arm of chromosome 8
Long arm of chromosome 8
Pathology
Immunity
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With which of the following receptors theophylline has an antagonist interaction?
theophylline is an eg of methylxanthine the action of this identified as a) release of ca from sarcoplasmic reticulum b) inhibition of phosphodiesterase c)blockade of adenosine receptor ESSENTIALS OF MEDICAL PHARMACOLOGY SEVENTH EDITION KD TRIPATHI PG NO.226
3
Histamine receptor
Bradykinin receptor
Adenoside receptor
Inidazoline receptor
Pharmacology
Respiratory system
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Prodrug of cetrizine is
Ans. is 'c' i.e., Hydroxyzine Cetrizine is a metabolite of Hydroxyzine with marked affinity for peripheral HI receptors; penetrates brain poorly. It inhibits release of histamine and of cytotoxic mediators from platelets as well as eosinophil chemotaxis during secondary phase of allergic response. It is indicated in upper respiratory allergies, pollinosis, uicaria and atopic dermatitis; also used as adjuvant in seasonal asthama.
3
Foxefenadone
Terfenadine
Hydroxyzine
Azelastine
Pharmacology
null
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All the following are true of Craniopharyngioma except
Answer is C (Present in sella or infrasellar location): Some of these lesions arise from the sella, but most are suprasellar Q (Not infra-sellar). They arise from near the pituitary stalk and commonly extend into the supra sellar cistern. Craniopharyngiomas arise from Rathke's pouch and constitute 3-5% of all intracranial neoplasms. Some of these lesions arise from the sella, but most are suprasellar Q (Not infra-sellar). They arise from near the pituitary stalk and commonly extend into the supra sellar cistern. Consists of nests of cords of stratified squamous or columnar epithelium embedded in a spongy reticulum -- Robbins 61h/1129 Visual complaints are the presenting feature in about 80% of adults and 60% of children.
3
Derived from Rathke's pouch
Contains epithelial cells
Present in sella or infra-sellar location
Causes visual disturbances
Medicine
null
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multi
Par boiling of paddy helps in retaining – a) Vitamin Cb) Vitamin Ac) Niacind) Thiamine
null
2
ab
cd
bd
ac
Social & Preventive Medicine
null
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single
Characteristic feature of early congenital syphilis is:
D i.e. Vesicular rash with bulla over palms & soles
4
Microcephaly
Saddle nose
Interstitial keratitis with saber skin
Vesicular rash with bulla over palms and soles
Skin
null
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All of the following are true of pulmonary embolism except:
Classic Findings in Pulmonary Embolism:- Right Hea strain and Acute Cor Pulmonale - sudden onset of pleuritic chest pain, hemoptysis and hypotension - Tall, peaked P waves in lead II (P pulmonale) - Right axis detion - Right bundle-branch block - S1Q3T3 pattern. On Xray :- Hampton's hump, Westermark sign (areas of relative oligemia secondary to decreased caliber of regional pulmonary aeries) and Palla's sign (Enlarged right descending pulmonary aery )are seen. - CTPA is imaging modality of choice - It shows Rt. ventricular stress instead of left ventricular stress.
2
Sudden onset of pleuritic pain and hemoptysis and hypotension.
ECG shows evidence of acute left ventricular stress.
Pulmonary angiography is gold standard
CTPA is imaging modality of choice
Medicine
Thromboembolism and Fat Embolism Syndrome
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A patient presented with pain in left eye associated with visual distrubance, also a history of blunt trauma to eye 4 month back, first investingation of choice is
A i.e. Intraocular tension This is a case of angle recession glaucoma
1
Introcular tension
Ophthalmoscopy
Perimetry
Ultrasound
Ophthalmology
null
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72 year old patient it comes with esophageal carcinoma in lower oesophagus. There are no distant metastasis and lymph node involvement. What is the preferred surgery
null
1
Transhiatal esophagectomy
Ivor Lewis esophagectomy
Endoscopic resection
McKeown esophagectomy
Surgery
null
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Not seen in the peripheral smear in plasmodium falciparum infection -
Schuffner&;s dot in the Rbc can be seen in P. vivax and P. Ovale infection Maurer&;s dot -falciparum Ziemman&;s dot- malariae (refer pgno:61 baveja 3 rd edition)
3
Accole
Maurer'sdot
Shuffners dots
Schizonts
Microbiology
parasitology
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single
Carina is situated at which level
Carina is located at the bifurcation of trachea at lower border of T4.carina is the lower margin of lowest cailaginous ring that is a keel-shaped process curving downwards and backwards between the bronchi.The mucous membrane lining the area is highly sensitive and is origin of the protective cough reflex. It is visible during bronchoscopy and hence is an impoant landmark.If lymph nodes here enlarge due to spread of bronchogenic cancer, the carina becomes flattened and distoed.Reference: Clinical Anatomy for students, a problem-solving approach, Neeta v Kulkarni, 2nd edition, page no.211,212
2
T3
T4
T6
T9
Anatomy
Head and neck
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single
Bromocriptine can be used in following conditions except
Refer KDT 7th/e Pg 239. Bromocripine is approved in diabetes mellitus not diabetes insipudus Bromocriptine is an ergoline derivative and dopamine agonist that is used in the treatment of pituitary tumors, Parkinson's disease, hyperprolactinaemia, neuroleptic malignant syndrome, and type 2 diabetes.
4
Hyperprolactinoma
Acromegaly
Parkinsonism
Diabetes insipudus
Pharmacology
Kidney
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Calcification of soft tissues without any distrubances of calcium metabolism is called
Ref,Robbins 9/e p65
3
Inotrohic calcification
Monotrophic calcification
Dystrophic calcification
Calcium induced calcification
Anatomy
General anatomy
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multi
. Treatment of choice in cold nodule of thyroid
null
4
Subtotal thyroidectomy
Wait and watch
I-131
Hemithyriodectomy
Surgery
null
278dfca5-6193-4e47-9e2e-d58941f7e272
single
Wavelength of Nd:Yag laser
A i.e. 1040 nm
1
1040 nm
1040 mm
1040 cm
1040 pm
Ophthalmology
null
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single
Least common organ affected in blast injury is -
Ans. is 'c' ie., Muscles * An explosion is a phenomenon resulting from sudden release of energy which is then dissipated by a blast wave, by translocation of objects, or by the generation of heat.* Injuries in explosion occur due to four factors:-1) Blast or shock wave# When an explosion occurs, the explosive material produces a large volume of gas and releases a large amount of energy. It produces a 'shock wave' which spread concentrically from the site of explosion.# The injuries depend on the enviornment in which blast occurs:-i) Air blast (most common):* Explosion occurs in air. There is barotrauma to airfilled hollow organs. Tympanic membrane (ear drum) is most sensitive and most commonly injured. Lung is the second organ to be injured and is the most commonly injured hollow organ and most common cause of life threatening injury.* Other parts injured are middle ear, cochlea, eyes, bowels, mesentery, omentum and brain. Homogenous solid organs like liver and muscles are usually not affected.ii) Under water blast (explosion under water):* Gastrointestinal tract is injured most commonly. Lungs are also injured.iii) Solid blast:* Explosive is detonated near a rigid/solid structure and wave of energy spreads through it. If people are in contact with that rigid structure, injuries take place.* The injuries are mostly skeletal; fracture of legs and vertebral column are more common. GIT damage is more common than lung.2) Flame or hot gases# Burns or burning of body may occur.3) Flying missiles (debris)# Flying pieces of explosive debris may be driven through air against the skin causing bruises, abrasions, lacerations, and ragged perforations.4) Anoxia# Various gases liberated during explosion may cause anoxia, e.g. carbon monoxide, nitrous oxide, nitric oxide, HCN and SO2
3
Lung
Eardrum
Muscles
GIT damage
Forensic Medicine
Injuries
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A 58-year-old postmenopausal woman on estrogen replacement complains of recent onset of spotting. A bimanual pelvic examination is unremarkable. Most likely diagnosis?
Any postmenopausal woman who has been on unopposed estrogen and who is now experiencing vaginal bleeding is suspect for either endometrial hyperplasia or endometrial cancer. Endometrial hyperplasia is the end result of prolonged estrogenic stimulation of the endometrial mucosa. Morphologic forms of hyperplasia include cystic, adenomatous, and atypical hyperplasia. In cystic hyperplasia (simple hyperplasia), there are large, dilated glands lined by actively mitosing epithelial cells. Adenomatous hyperplasia refers to branching of the glands with papillary infolding or outpouchings (sometimes referred to as complex hyperplasia). Atypical hyperplasia has more glandular crowding and nuclear atypia than the latter condition and has the highest risk for progressing into carcinoma in situ and endometrial carcinoma. Endometrial carcinoma is the most common invasive cancer of the female genital tract. As with endometrial hyperplasia, the risk factors for endometrial cancer primarily relate to hyperestrinism and include obesity, nulliparity, diabetes, hypeension, infeility, breast cancer, low fiber/high fat diet, early menarche or late menopause, and tamoxifen. The most common clinical presentation is vaginal bleeding (90%) in a postmenopausal woman.
4
Cervical carcinoma
Cervical polyp
Dysfunctional uterine bleeding
Endometrial hyperplasia
Gynaecology & Obstetrics
Menopause and HRT
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single
Methods of introducing gene in target cells are all except
Fluorescence in situ hybridization(FISH) is a cytogenetic technique that uses fluorescent probes that bind to only those pas of the chromosome with a high degree of sequence complementarity.
4
Electroporation
Transfection
Site directed recombination
FISH
Biochemistry
Metabolism of nucleic acids
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multi
Treatment of pleomorphic adenoma without facial nerve infiltration and limited to superficial lobe:
Pleomorphic adenoma: * Most common salivary gland tumor * Benign, painless tumor with no facial nerve involvement * Most common site - Parotid, Submandibular, Sublingual, minor salivary gland * Location: Infront, below and behind ear lobule * Pathology: Mixed tumor has both epithelial and mesenchymal component * Tumor has finger like projections (pseudopodia)- so, Enucleation is C/I * Diagnosis: FNAC * Treatment: Superficial Parotidectomy
1
Superficial parotidectomy
Total parotidectomy
Parotidectomy followed by radiotherapy
Observation
Surgery
Salivary Glands
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single
Post is not required in all of the following conditions except:
Conditions where post should not be given: Any sign of endodontic failures are evident, i.e. tooth exhibits: Poor apical seal and poor quality obturation Active inflammation Presence of fistula or sinus Tender on percussion If adequate retention of core can be achieved by natural undercuts of crown. If there are horizontal cracks in the coronal portion of the teeth. When tooth is subjected to excursive occlusal stresses, that is, when there is presence of lateral stresses of bruxism or heavy incisal guidance.
4
If adequate retention of core can be achieved by natural undercuts of crown
If there are horizontal cracks in the coronal portion of the teeth
When tooth is subjected to excursive occlusal stresses, that is, when there is presence of lateral stresses of bruxism or heavy incisal guidance
None
Dental
null
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Pearson's Coefficient of skewness is defined as:
The coefficient used for checking the skewness of data, is called as the Karl Pearson coefficient, and is calculated as (Mean - Mode) S.D. Ref: Instant Medical Biostatistics, By Ranjan Das, Papri N. Das, 2009 Ane's Instant Medical Series, Page 41, 42.
1
(Mean-Mode) / SD
(Median-Mode) / SD
SD / (Mean - Mode)
SD / (Median -Mode)
Social & Preventive Medicine
null
2bdf8544-f059-4218-a0fe-abd58dec820c
single
Stocker's line is seen a –
Stocker's line is a line of iron deposition in the corneal epithelium seen adjacent to the head of the pterygium.
2
Pinguecula
Pterygium
Congenital Ocular Melanosis
Conjunctival epithelial melanosis
Ophthalmology
null
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single
Ovarian artery is a branch of-
Ans. is 'a' i.e., Abdominal aorta * 'Ovarian artery is a branch of abdominal aorta'
1
Abdominal aorta
Renal artery
Superior mesenteric artery
Celiac trunk
Anatomy
Abdomen & Pelvis
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single
Which of the following anti-angina drugs act by inhibition of long-chain 3-ketoacyl coenzyme A thiolase?
Trimetazidine Antianginal drug that act by inhibiting mitochondrial long-chain 3-ketoacyl coenzyme A thiolase enzyme. Reduced fatty acid metabolism and increased glucose metabolism in myocardium leading to a paial shift from FFA to glucose oxidation in the hea, which provides less ATP but requires less O2 and may therefore be beneficial in ischemia. Efficient in reducing angina and increase exercise tolerance, paicularly in patients with diabetes and hea failure.
1
Trimetazidine
Ivabradine
Ranolazine
Nicorandil
Pharmacology
CHF, Angina Pectoris and Myocardial Infarction
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single
A previously healthy 58 years old man is admitted to the hospital because of an acute inferior myocardial infarction. Within several hours, he becomes oliguric and hypotensive (blood pressure is 90/60 mmHg). Insertion of a pulmonary artery (Swan-Ganz) catheter reveals the following pressures: pulmonary capillary wedge- 4 mmHg; pulmonary artery- 22/4 mmHg: and mean right atrial- 11 mmHg. This man would best be treated With -
null
1
Fluids
Digoxin
Dopamine
Intraaortic balloon counterpulsation
Medicine
null
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multi
Post treatment HCG levels, during the follow up of molar pregnancy evacuation, comes back to normal in:
HCG follow up of vesicular mole: - weekly HCG estimation till negative (vesicular mole takes 9 weeks and paial mole takes 7 weeks) - weekly HCG till 3 more weeks - Once in a month for 6 months . Avoid pregnancy during this time. Use contraception, best being COCPs
3
3 weeks
6 weeks
9 weeks
12 weeks
Gynaecology & Obstetrics
Obstetrics
cc2e4e9b-7c5e-4fa9-b86a-207105cfb251
single
which of the following antidepressent can be safely used in elderly depresion
NaSSA * IMPOANCE Nor adrenergic and specific serotonergic antidepressant * MECHANISM * Alpha 2 adrenergic receptor antagonism=== increase serotonin and NA * 5HT2,3 antagonist============increase sleep and appetite * DRUGS miazapine * USE Elderly with depression * SIDE EFFECTS hyperlipidemia Ref. kaplon and aock, synopsis of psychiatry, 11 th edition, 955
2
trazadone
miazapine
fluoxetine
phenelezine
Psychiatry
Pharmacotherapy in psychiatry
7e099b78-be54-4447-874c-232efa04763c
single
Most common psychiatric disorder in community is
(A) Depression # DEPRESSION is the most common psychiatric illness in India.> Neurotic depression is far common than psychotic depression.> Neurotic depression is followed by anxiety neurosis is prevalence.> This is in contrast to West, where anxiety neurosis is the commonest.
1
Depression
Schizophrenia
Paranoid disorders
Obsessive compulsive neurosis
Psychiatry
Miscellaneous
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single
McBurney's point corresponds to which pa of appendix:
Base
2
Tip
Base
Orifice
Mid poion
Anatomy
null
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single
Muscle not supplied by median nerve REPEATED
Opponens pollicis, abductor pollicis brevis and first lumbrical is supplied by the recurrent branch of median nerve in palm.Extensor pollicis brevis is supplied by the deep division of radial nerve in the forearm.B D Chaurasia 7th edition Page no: 182
1
Opponens pollicis
Abductor pollicis brevis
Extensor pollicis brevis
First lumbrical
Anatomy
Upper limb
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single
Thyroid malignancies appear on USG as
On sonography, thyroid tumors are solid,hypoechoic masses.
1
Hypoechoic
Anechoic
Hyperechoic
Isoechoic
Radiology
ULTRASOUND
59c0554b-a859-4a76-83b9-307ae14499cb
single
Which micronutrient deficiency causes anemia?
Ans. is 'a' i.e., CopperCopper containing protein ceruloplasmin is necessary for transpo of iron in the Ferric form across membranesCopper is an integral component of ALA synthase, which is necessary for heme synthesisCopper helps in the uptake of iron across normoblasts
1
Copper
Molybdenum
Selenium
Flurine
Biochemistry
null
c1607548-8101-45f0-9d23-fc3ec936c485
single
A 45-year-old female has a solitary gall stone 1.5 cm in size which was incidentally diagnosed by ultrasound. She has no symptom. What should be the best line of management?
Cholecystectomy only if she develops biliary colic * Symptomatic gallstones are the main indication for cholecystectomy. * Absolute contraindications for the procedure are uncontrolled coagulopathy and end-stage liver disease.
1
Cholecystectomy only, if she develops biliary colic
Lap cholecystectomy immediately
Lap cholecystectomy even if she is asymptomatic after 2 months
Open cholecystectomy even if she is asymptomatic after 2 months
Surgery
null
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multi
Which of the following causes pseudotumour cerebrii -
null
3
Chronic subdural hematoma
Cerebellar tumours
Hypervitaminosis A
Cerebral hemangiomas
Medicine
null
cb5482dd-a27f-417c-b996-e1e07be1a911
single
Which one of the following is not seen in pheochromocytoma
Refer Robbins page no 1135 The dominant clinical manifestation of pheochromocytoma is hypeension observed in 90 percnt of patients.Approximately two thirds of patients with hypeension demonstrate paroxysmal episodes which are described as an abrupt precipitation elevation in blood pressure
4
Hypeension
Episodic palpitations
Weight loss
Diarrhea
Anatomy
Endocrinology
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single
Most common site of venous thrombosis: March 2013
Ans. B i.e. Veins of lower extremity Commoner sites of venous thrombosis includes deep vein in the lower extremity below the knee and superficial saphenous, hepatic and renal veins; dural sinuses.
2
Veins of upper extremity
Veins of lower extremity
Dural sinus
Poal vein
Pathology
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Duffy antigen is present in:
Ans. (c) P. VivaxRef: Microbiology by Ananthanarayan and Paniker 8th ed. 1694* Duffy antigen/chemokine receptor (DARC) also known as CD234, is a protein that in humans is encoded by DARC gene.* The Duffy antigen is located on the surface of red blood cells.* The Duffy antigen protein is also the receptor for the human malarial parasites Plasmodium vivax.* Polymorphisms in this gene are the basis of the Duffy blood group system.Clinical Significance of Duffy Antigen* Asthma: There appears to be a correlation with both total IgE levels and asthma and mutations in the Dufly antigen.* Malaria: On erythrocytes the Duffy antigen acts as a receptor for invasion by the human malarial parasites P. vivax and P. knowles.* Duffy negative individuals whose erythrocytes do not express the receptor are believed to be resistant to merozoite invasion.* HIV infection: The absence of the DARC receptor appears to increase the susceptibility to infection by HIV. HIV-1 appears to be able to attach to erythrocytes via DARC* Lung transplantation: The Duffy antigen has been implicated in lung transplantation rejection.* Multiple myeloma: An increased incidence of Duffy antigen has been reported in patients with multiple myeloma compared with healthy controls* Pneumonia: The Duffy antigen is present in the normal pulmonary vascular bed. Its expression is increased in the vascular beds and alveolar septa of the lung parenchyma during suppurative pneumonia.* Prostate cancer: Experimental work has suggested that DARC expression inhibits prostate tumor growth. The reasons for this increased risk are not known.* Sickle cell anemia: Duffy antigen-negative individuals with sickle cell anaemia tend to suffer from more severe organ damage than do those with the Duffy antigen.
3
P. Falciparum
P. Ovale
P. Vivax
P. Malariae
Microbiology
Virology
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Hea failure cells are?
Breakdown of red cells and hemoglobin leads to the appearance of hemosiderin-laden alveolar macrophages-- so-called hea failure cells--that reflect previous episodes of pulmonary edema. (Robbins Basic Pathology,9th edition,pg no.367)
3
polymorphonuclear cells
Steam cells
Macrophages
Fibroblasts
Pathology
Cardiovascular system
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Prolactinoma in pregnancy, all are true except:
Prolactinoma pituitary adenoma Prlactin level is >100ng/dl most are microadenoma<1cm diameter macroadenoma has bad prognosis visual field examination is essential to detect any compression effect on the optic nerves D.C.DUTTA&;S TEXTBOOK OF GYNECOLOGY,Pg no:464,6th edition
2
Most common pituitary tumor but rarely symptomatic
Increase in prolactin levels worse prognosis
Macroadenoma> 1 cm is associated with bad prognosis
Regular visual checkup
Gynaecology & Obstetrics
Medical, surgical and gynaecological illness complicating pregnancy
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Not true about red degeneration of myomas is :
Ans. is b i.e. Immediate Surgical intervention is required Lets see each option one by one. Red Degeneration of fibroid commonly occurs during pregnancy. (Option "a" is thus correct) The pathogenesis of fibroid is obscure but the initial change appears to be one of sub acute necrosis which is presembly due to an interference with its blood supply. Some say that aerial or venous thrombosis is the basis of this and the lesion is the result of infarction. (Option "c" is thus correct). Red degeneration should be managed conservatively with bed rest and analgesics to relieve the pain. (option "d" is thus correct) There is no need for surgical intervention. For more details on Red Degeneration, refer answer 6
2
It occurs commonly during pregnancy
Immediate surgical intervention is needed
Due to interference with blood supply
Treated with analgesics
Gynaecology & Obstetrics
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Stuart's medium is a transport media for
Stuart's and Amies medium are transport media for Neisseria.
2
Streptococcus
Neisseria
Vibrio
Shigella
Microbiology
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Which of following is not seen in nephritic syndrome:
d. Hypocholesterolemia(Ref: Nelson's 20/e p 2521-2528, Ghai 8/e p 477-482)Features of nephritic syndrome are: Hematuria and RBC casts, Nephritic range Proteinuria (<3.5g/day), hence edema is present, Hypertension, Uremia and Oliguria.
4
Edema
Hematuria
Hypertension
Hypocholesterolemia
Pediatrics
Kidney
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Fulminant hepatic failure can be caused by
The first modern halogenated volatile anesthetic, halothane, was introduced in 1955. Clinical exposure to halothane is associated with two distinct types of hepatic injury. Subclinical hepatotoxicity occurs in 20% of adults who receive halothane. It is characterized by mild postoperative elevations in alanine aminotransferase and aspaate aminotransferase, but is reversible and innocuous. Anaerobic halothane reduction by CYP2A6 to a 2-chloro-1,1,1-trifluoroethyl radical is thought to mediate this mild hepatic injury. The fulminant form of hepatotoxicity, commonly known as halothane hepatitis, is characterized by elevated alanine aminotransferase, aspaate aminotransferase, bilirubin, and alkaline phosphatase levels, massive hepatic necrosis following the administration of halothane. Halothane hepatitis is rare (1 in 5000 to 35,000 administrations in adults), but is fatal in 50% to 75% of these cases. Because of the potential for fatal hepatitis, halothane is no longer used in adult patients in many countries. Halothane hepatitis is caused by a hypersensitivity reaction associated with the oxidative metabolism of halothane. The highly reactive trifluoroacetyl chloride metabolite of halothane oxidation can react with nearby liver proteins. In most patients who developed hepatic necrosis after halothane anesthesia, antibodies against TFA-modified proteins were detected, suggesting that the hepatic damage is linked to an immune response against the modified protein, which acts as a neoantigen. Accordingly, patients who develop halothane hepatitis often have a history of prior exposures to halothane or other volatile anesthetics, together with symptoms suggestive of immune reactivity, such as fever, rash, ahralgia, and eosinophilia. A current hypothesis is that TFA-protein adducts induce a cytotoxic T cell reaction in sensitized individuals, which leads to liver damage. However, the immune responses observed in halothane hepatitis might not mediate liver injury. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e
1
Halothane
Isoflurane
Nitrous oxide
Phenobarbitone
Anaesthesia
Fundamental concepts
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Hartnup disease can present with:
Ans. (a) Pellagra like symptomsRef: Harrisons 20th ed. P 3021Hartnup Disease* It is an AR condition, mainly seen due to defect in the transport of tryptophan and other neutral amino acids from the renal tubules and intestine* Molecular defect: SLC6A19 gene (encode transporter protein of these amino acid)Clinical Features:* MC: Cutaneous photosensitivity* Constant neutral aminoaciduria* Intermittent pellagra like symptoms* Intermittent ataxia (unsteady wide based gait)Diagnosis: Obermeyer test (urinary test for indole compound)Treatment: High protein diet and Nicotinic acid Extra Mile* Drummond syndrome/Blue diaper syndrome: Tryptophan transport defect lies only in intestine, NOT in kidneyClass of substance and disorderIndividual substratesTissues manifesting transport defectMolecular defectMajor clinical manifestationsInheritanceAmino acids CystinuriaCystine, lysine, arginine, ornithineProximal renal tubule, jejunal mucosaShared dibasic-cystine transporter SLC3A1, SLC7A9Cystine nephrolithiasisARLysinuric protein intoleranceLysine arginine, ornithineProximal renal tubule, jejunal mucosaDibasic transporter SLC7A7Protein intolerance, hyperammonemia, intellectual disabilityARHartnup diseaseNeutral amino acidsProximal renal tubule, jejunal mucosaNeutral amino acid transporter SLC6A19Constant neutral aminoaciduria, intermittent symptoms of pellagraARBrain branched- chain amino acid deficiencyLeucine, isoleucine, valinePlasma membrane of blood brain barrierBranched-chain amino acid transporter SLC7A5Microcephaly, intellectual disability, seizuresARCitrullinemia type 2Aspartate, glutamate, malateInner mitochondrial membraneMitochondrial aspartate/glutamate carrier 2 SLC25413Sudden behavioral changes with stupor, coma, hyperammonemiaAR
1
Pellagra like symptoms
Nephrolithiasis
Protein intolerance
Microcephaly
Biochemistry
Proteins and Amino Acids
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A 8-year-old boy presents with petechiae, azotemic oliguria and altered sensorium, in casualty. There is a history of diarrhoea for the past 5 days. The clinical diagnosis is –
Hemolytic uremic syndrome HUS is characterized by the triad of - Anaemia (microangiopathic hemolytic anaemia) Renal failure (microangiopathy of kidney involving glomerular capillaries and arterioles). Thrombocytopenia (due to platelet destruction) HUS is common in children under 2 years of age. (But may also occur in older children). It usually follows an episode of acute gastroenteritis. The prodrome is usually of abdominal pain, diarrhoea and vomiting. Shortly thereafter, signs and symptoms of acute hemolytic anaemia, thrombocytopenia and acute renal failure ensue. Sometimes neurological findings also occur (But usually absent and differentiates HUS from TTP).
4
Acute prophyria
Idiopathic thrombocytopenic purpura
H.S. purpura
H.U.S.
Pediatrics
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True about Hb dissociation curve:
Oxygen-hemoglobin dissociation curve is shifted to right in the following conditions:  Decrease in partial pressure of oxygen.  Increase in partial pressure of carbon dioxide (Bohr effect). Increase in hydrogen ion concentration and decrease in pH (acidity).  Increased body temperature.  Excess of 2,3-diphosphoglycerate (DPG) in RBC. It is also called 2,3-biphosphoglycerate (BPG). DPG is a byproduct in Embden-Meyer-hof pathway of carbohydrate metabolism. It combines with β-chains of hemoglobin. In conditions like muscular exercise and in high attitude, the DPG increases in RBC. So, the oxygen-hemoglobin dissociation curve shifts to right to a great extent.
1
Acidosis shifts O2 dissociation curve to right
Increased CO2 shifts the curve to left
Hypoxia shifts curve to left
2,3 DPG has no effect on curve
Physiology
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Regarding the antibacterial action of gentamicin, which of the following statements is most accurate?
(Ref:Katzung 10/e p756, 757) Aminoglycosides show concentration dependenbt killing and prolonged post antibiotic effect. For details, refer to text.
3
Efficacy is directly propoionate to the time that the plasma level of the drug is greater than the minimal inhibitory concentration
Gentamicin continues to exe antibacterial effects even after plasma levels decrease below detectable range
Antibacterial activity is often reduced by the presence of an inhibitor of cell wall synthesis
The antibacterial action of gentamicin is time dependent
Pharmacology
Other topics and Adverse effects
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