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A 25-year old patient with a history of recent respiratory tract infection complains of severe chest pain at rest. The ECG of the patient is given. The most probable diagnosis of the patient is?
|
The history points to a recent viral infection that could contribute to the development of pericarditis. Acute Pericarditis -Most common cause of pericarditis is idiopathic or viral. -ECG findings: Hea rate= 75 bpm Axis= normal PR interval= 0.16 sec QRS= 0.08 sec QT= 400 msec Uniform ST segment elevation - Concave upwards (RED) in all the leads ST segment depression (BLUE) in aVR seals the diagnosis of pericarditis.
| 4 |
Acute MI
|
Prinzmetal angina
|
Takotsubo cardiomyopathy
|
Acute pericarditis
|
Medicine
|
Acute coronary syndrome
|
e78357f9-2c9a-4264-b7f8-553a446fe9b7
|
single
|
Which vein is preferable for coronary by pass grafting-
|
Ans. is 'a' i.e., Saphenous vein o Most common conduits used is greater saphenous vein. Ideal characteristics of a saphenous vein conduit are that it should be atleast having diameter of 3.5 mm and free from any varicosity or areas of structure,o If the saphenous vein is inadequate or unavailable^ short saphenous vein can be used,o Other conduits for CABG :* Internal mammary artery- (Left or right) - Preferred arterial conduits for LAD - Patency rate > 90% at 10 years* Radial artery * Gastroepiploic artery * Inferior epigastric arteries
| 1 |
Saphenous vein
|
Short saphenous vein
|
Epigastric vessels
|
Radial artery
|
Surgery
|
Thorax
|
f93516e5-a707-4dfe-9086-62b143d046e5
|
single
|
Hyperplastic arteriolitis with necrotizing arteriolitis is seen in?
|
Hyperplastic arteriolosclerosis is more typical of severe hypertension. Vessels exhibit "onion skin" ."concentric, laminated thickening of arteriolar walls and luminal narrowing . The lamination consists of smooth muscle cells and thickened , re duplicated basement membrane . In malignant hypertension these changes are accompnied by fibrinoid deposits and vessels wall necrosis .
| 2 |
Wegner’s granulomatosis
|
Malignant hypertension
|
Buerger’s disease
|
Benign hypertension
|
Pathology
| null |
b5b1a839-9b0c-4f59-9364-efd0d4c6845d
|
single
|
All of the following, statements ubout Digoxin induced arrhythmias are true, Except -
|
Digoxin remains one of the most frequently prescribed drugs in the management of atrial fibrillation. The main indications for digoxin in atrial fibrillation are restoration of sinus rhythm, prevention of recurrence and slowing of the ventricular rate Other common dysrhythmias associated with digoxin toxicity include: Frequent PVCs (the most common abnormality), including ventricular bigeminy and trigeminy. Regularised AF = AF with complete hea block and a junctional or ventricular escape rhythm. Ventricular tachycardia, including polymorphic and bidirectional VT Adenosine can, at times, terminate the rhythm, but not always. Ablation of atrial tachycardia is also an option, especially when medical therapy fails. Special Situations: Atrial tachycardia with 2:1 block; when atrial tachycardia occurs with a 2:1 conduction block digoxin is best and toxicity should be considered Ref Davidson 23rd edition pg 460
| 1 |
Biventricular Tachycardia
|
Paroxysmal Atrial Tachycardia with variable AV Book
|
Ventricular Bigeminy
|
May be used to Atrial Fibrillation
|
Medicine
|
C.V.S
|
0bf248f5-9706-4b4f-8d06-5b70a89a95e3
|
multi
|
Which of the following is the most useful investigation for thyroid function: September 2011
|
Ans. C: TSH TSH is usually regarded as the most useful investigation of thyroid function Thyroid pathology: Primary hypehyroidism: - Decreased TSH - Raised T4 Secondary hypehyroidism: Raised TSH Hypothyroidism: Raised TSH
| 3 |
T3
|
T4
|
TSH
|
TRH
|
Surgery
| null |
3b5cfa66-9f1c-478f-bbcc-d819035744c8
|
single
|
What is the indication of using systemic steroids in a case of rheumatoid arthritis -
| null | 3 |
Carpal tunnel syndrome
|
Presence of deformities
|
Mononeuritis multiplex
|
Involvement of articular cartilage
|
Medicine
| null |
513e714f-6132-48a6-ac78-5bf3eb9d1fac
|
multi
|
LMW heparin is preferred over unfractionated heparin because:
|
LMW heparin inhibit factor Xa only and have a weak effect on thrombin , aPTT, or CT are not prolonged. Heparin acts by activation of antithrombin III. LMW heparin is given subcutaneosly due to better bioavalability.LMW heparin have subcutaneous bioavalability of 70 - 90%. From medical pharmacology padmaja 4th edition Page no 337
| 4 |
LMW heparin directly inhibit thrombin whereas unfractionated heparin acts activation of anti thrombin
|
LMW heparins have higher risk of causing bleeding
|
LMW heparin can be given subcutaneously as well as orally
|
LMW heparin has consistent bioavailability.
|
Pharmacology
|
Hematology
|
6840b7b5-f280-4252-87b2-2592cffd7e16
|
multi
|
In TCA cycle of tricarboxylic acid, which is first formed
|
B i.e. Citrate
| 2 |
Isocitrate
|
Citrate
|
Succinate
|
Fumarate
|
Biochemistry
| null |
33113d21-1576-4289-be05-3fe2c9f5e224
|
single
|
Salt loosing nephritis is due to
|
Salt-losing nephritis is one of many clinical situations involving electrolyte disturbance in renal disease. This type of nephropathy is characterized by hyponatremia and hypochloremia, lassitude, thirst, polyuria, azotemia, and circulatory collapse. Interstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become swollen (inflamed). This can cause problems with the way your kidneys work. Refer robbins 9/e p930
| 3 |
Lupus nephritis
|
Streptococcal infection
|
Interstitial nephritis
|
Goodpasteures syndrome
|
Pathology
|
Urinary tract
|
c0180a23-75b0-40f5-9e26-a6cd13a380df
|
single
|
Adrenaline, noradrenaline and dopamine act through?
|
Ans is 'c' i.e. Seven pass receptor o Adrenergic receptors (Adrenaline, noradrenaline) and dopamine receptors are G-protein coupled receptors which are heptahelical receptors, i.e., have seven transmembrane spanning segments (Seven pass receptors)
| 3 |
Two pass receptor
|
Ligand gated channel
|
Seven pass receptor
|
One pass receptor
|
Pharmacology
| null |
51f6ee67-b6e2-4709-8b38-20e6f34ab16a
|
single
|
In random sampling, the chance of being picked up is -
| null | 1 |
Same and known
|
Not same and not known
|
Same and not known
|
Not same but known
|
Social & Preventive Medicine
| null |
de4448f4-2e41-4529-bb50-fa09c5101898
|
single
|
Renauld Braud phenomenon is seen in
|
Candida albicans has the ability to form germ tubes within 2hours when incubated in human serum at 37C - Reynolds-Braude phenomenon. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition
| 1 |
Candida albicans
|
Candida psittaci
|
Histoplasma
|
Cryptococcus
|
Microbiology
|
mycology
|
11a944e7-f256-4d11-8ec3-5819b417685d
|
single
|
Pseudolymphoma occurs because of long term use of :
|
Side effects of phenytoin Gingival hyperplasia Lymphadenopathy Hirsutism Osteomalacia Facial coarsening Skin rash
| 3 |
Carbamazepine
|
Phenobarbital
|
Phenytoin
|
Primidone
|
Pharmacology
|
Epilepsy
|
d922e5c1-038e-4607-a2ee-1d8f525e921d
|
single
|
Dimension of HDI which is measured to check good standard of living ?
|
Ans. is 'a' i.e., Income HDI is a composite index combining indicators representing three dimensions ? Longevity (life expectancy at bih) Knowledge (Adult literacy rate and mean years of schooling, i.e. Gross enrolement ratio) Income (real GDP per capita in purchasing power parity in US dollars) Among these three, income is included in standard of living. Standard of living It refers to the usual scale of our expenditure, goods we consume and services we enjoy. It includes :? Income & occupation Standards of housing, sanitation & nutrition Level of provision of health, educational, recreational and other services. Standard of living depends on per capita GNP
| 1 |
Income
|
Knowledge
|
Lingevity
|
Housing
|
Social & Preventive Medicine
| null |
1fa33af6-b952-47a5-aab8-d9d92590681a
|
single
|
Nerve supply of trapezius is by
|
the and sternocleidomastoid are supplied by spinal accessory nerve. Both of them develop from brachial arch mesoderm. The principal action of trapezius is to rotate scapula during abduction of arm beyond 90deg. Clinically the muscle is tested by asking the patient to shrug his shoulder against resistance. REF: BD Chaurasia 7th edition Page no: 64.
| 4 |
Axillary
|
Musculocutaneous
|
Median
|
Spinal accessory nerve
|
Anatomy
|
Upper limb
|
1537d19c-47b3-4a9a-a28e-a5b70a2f29f9
|
single
|
Which of the following structure is not a primary suppo of uterus?
|
Broad ligament is a secondary suppo of uterus. Structures forming primary suppo to the uterus are pelvic diaphragm, perineal body, urogenital diaphragm, uterine axis, pubocervical ligament, transverse cervical ligament, uterosacral ligament and round ligament of uterus.
| 4 |
Pelvic diaphragm
|
Uterosacral ligament
|
Transverse cervical ligament
|
Broad ligament
|
Anatomy
| null |
4ca78873-3cd6-4197-bfa2-32bce74538c5
|
single
|
Which of the following drug used in treating leprosy acts as a bactericidal agent?
|
Dapsone, rifampicin and clofazimine are WHO recommended drugs used in the treatment of leprosy. Among these only rifampicin is bactericidal. Rifampin binds to the beta subunit of bacterial DNA-dependent RNA polymerase and thereby inhibits RNA synthesis. It is bactericidal, it penetrates most tissues and into phagocytic cells. Indications: Treatment of tuberculosis along with other antimycobacterial drugs. Used to eliminate meningococcal carriage Leprosy Prophylaxis in contacts of children with Haemophilus influenzae type b disease In combination with a second agent is used to eradicate staphylococcal carriage In serious staphylococcal infections such as osteomyelitis and prosthetic valve endocarditis Ref: Gelber R.H. (2012). Chapter 166. Leprosy. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
| 3 |
Clofazimine
|
Dapsone
|
Rifampicin
|
Ethionamide
|
Pharmacology
| null |
a01afbde-879d-4cee-9de8-8305c8c1397e
|
single
|
Epley's maneuver is used in the treatment of
|
Epley`s maneuver is used in the treatment of Positional Veigo (BPPV)Dix Hallpike`s test is the diagnostic testOther exercises are: Semont`s maneuver, Brandt Darrof exercisesSurgeries: Singular neurectomy, Posterior canal occlusion, Labyrinthectomy, Vestibular nerve sectionRef: Hazarika; 3rd edition; Page no: 108
| 1 |
Positional veigo
|
Otosclerosis
|
ASOM
|
CSOM
|
ENT
|
Ear
|
43cfb3cb-6fb9-41da-8ccf-e3b23f828394
|
single
|
Bacitracin acts on :
|
Bacitracin acts by inhibiting the synthesis of the cell wall.
Other polypeptide antibiotics like polymyxin B, colistin and tyrothricin act by an affecting membrane.
| 1 |
Cell wall
|
Cell membrane
|
Nucleic acid
|
Ribosome
|
Pharmacology
| null |
972d4acd-cc5d-4baf-baf1-d7e60531d009
|
multi
|
Which of the following is false about starvation ketoacidosis?
| null | 3 |
Metabolic acidosis
|
Smell of acetone in breath
|
Benedict's test +ve
|
Rothera's test +ve
|
Biochemistry
| null |
be7b76fd-89d8-479e-9ba5-8b1d862534fe
|
multi
|
Spinal epidural space is the largest at the level of the
|
Spinal epidural space is largest at 3rd lumbar veebrae .Spinal epidural space is a closed anatomic space between the dura mater and the bony spinal canal. It extends from the foramen magnum to the sacrum. Unlike its intracranial counterpa, spinal epidural space is real. The presence of anchoring plicae and meningoveebral ligaments divide the space into anterior, lateral and posterior compaments. Ref - pubmed.com
| 4 |
12th thoracic veebra
|
1st lumbar veebra
|
2nd lumbar veebra
|
3rd lumbar veebra
|
Anatomy
|
Thorax
|
158a3ed4-8496-4ab2-aad6-2f115d37680c
|
single
|
Cyclosporine enlargement of gingiva can be classified as:
| null | 1 |
Non inflammatory
|
Inflammatory
|
Developmental
|
Malignant
|
Dental
| null |
258cec82-51fe-4888-a33d-5c08c7587e78
|
single
|
Which cell does not NOT differentiate in bone marrow?
|
Bone marrow provides the environment for development of precursor cells into erythrocytes, platelets, granulocytes, monocytes, and B lymphocytes. Although it is likely that T lymphocytes progenitor cells also arise in bone marrow, differentiation and programming of new T lymphocytes occurs in the thymus. Ref: Levinson W. (2012). Chapter 58. Cellular Basis of the Immune Response. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.
| 2 |
B lymphocyte
|
T lymphocyte
|
Neutrophil
|
Basophil
|
Microbiology
| null |
5dea3bcb-3e4f-4d6d-81ae-52cd81542e35
|
single
|
Which of the following is not true about medullary thyroid carcinoma?
|
Ans. is 'c' i.e., Form about 25% of the thyroid malignancies Medullary carcinoma of thyroid* Medullary carcinomas of the thyroid are neuroendocrine neoplasms derived from the parafollicular cells, or C cells, of the thyroid, and account for approximately 5% of thyroid neoplasms.* Medullary carcinomas, similar to normal C cells, secrete calcitoniny the measurement of which plays an important role in the diagnosis and postoperative follow-up of patients.* In some instances the tumor cells elaborate other polypeptide hormones, such as serotonin, ACTH, and vasoactive intestinal peptide (VIP).* About 70% of tumors arise sporadically. The remainder occurs in the setting of MEN syndrome 2A or 2B or as familial tumors without an associated MEN syndrome.* Activating point mutations in the RET proto-oncogene play an important role in the development of both familial and sporadic medullary carcinomas.
| 3 |
Are a type of neuroendocrine tumors
|
Associated with MEN 2A and 2B syndrome
|
Form about 25% of the thyroid malignancies
|
Tumor cells may secrete serotonin, ACTH and VIP
|
Surgery
|
Thyroid Gland
|
2f9356ad-4194-40b2-92b1-e181e1e249b5
|
multi
|
Which drug has inverse agonist activity at benzodiazepine receptors?
|
Benzodiazepine Binding Site Ligands: The components of the GABA A receptor-chloride ion channel macromolecule that function as benzodiazepine binding sites exhibit heterogeneity. Three types of ligand-benzodiazepine receptor interactions have been repoed: Agonists: facilitate GABA actions, and this occurs at multiple BZ binding sites in the case of the benzodiazepines. Antagonists are typified: by the synthetic benzodiazepine derivative flumazenil. Inverse agonists act as negative allosteric modulators of GABA-receptor function. Their interaction with BZ sites on the GABA A receptor can produce anxiety and seizures, an action that has been demonstrated for several compounds especially the b carbolines Naltrexone: Opioid receptor antagonist. Zopiclone: In contrast to benzodiazepines, zolpidem, zaleplon, and eszopiclone bind more selectively because these drugs interact only with GABA A -receptor isoforms that contain a1 subunits.
| 2 |
Flumazenil
|
Beta carboline
|
Naltrexone
|
Zopiclone
|
Pharmacology
|
JIPMER 2017
|
c6a5b265-7cbc-47eb-b938-26c7c3dc3ff6
|
single
|
Most common lesion in diabetic nephropathy
|
m/c - Diffuse glomerulosclerosis
Pathognomonic - Kimmelstiel Wilson nodule
| 3 |
fibrin caps
|
Capsular drops
|
Diffuse glomerulosclerosis
|
Kimmelstiel Wilson nodule
|
Medicine
| null |
8e32a34c-1f6e-447a-a2e0-502aa55d49e6
|
single
|
A thirty one year old male with neprhrotic syndrome complains of pain in right hip joint of 2 months duration. The movements at the hip are free but painful terminally. The most likely diagnosis is -
|
This patient has : -
Nephrotic syndrome (must be taking steroids)
Pain in hip
Terminal restriction of movements (in AVN, initially movements are restricted terminally only).
The diagnosis is AVN of Hip.
In all other three options movements of hip are grossly restricted (not terminally).
| 2 |
Tuberculosis of hip
|
Avascular necrosis of femoral head
|
Chondrolysis of hip
|
Pathological fracture of femoral neck
|
Orthopaedics
| null |
0d1b9517-c7bf-40df-97a6-2888a9aa4ec5
|
multi
|
A 35-year-old woman presents with infertility and palpable pelvic mass. Her CA-125 level is 90 rnIU/mL diagnosis is:
|
In this question we have insufficient information to make any definite diagnosis. At the best we can try to make the most probable diagnosis.
CA-125
• This is a non-specific tumor marker
• CA-125 is a glycoprotein which is normally not produced by ovarian epithelium but may be produced by both
malignant and benign epithelial ovarian tumors.
• Cut off level of CA-125 is < 35 U/mL.
• Levels of CA 125 can be raised in
| 2 |
Ovarian Ca
|
Endometrioma
|
Tuberculosis
|
Borderline ovarian tumor
|
Gynaecology & Obstetrics
| null |
dc0dd74f-7dde-4d16-9383-5fb31407b8bc
|
single
|
True regarding surface anatomy of internal jugularvein -
|
Ans 'b' i.e., Line passing from ear lobule to medial end of clavicle SURFACE MARKINGS OF IMPORL4N VESSELS OF NECKSurface anatomy of internal jugular vein:o Internal jugular vein is marked by a line joining a point on the neck, medial to the ear lobule to a point at the medial end of the clavicle.Surface anatomy of the external jugular vein:o Marked by a line joining a point a little below and behind the angle of the mandible to a point on the clavicle just lateral to the posterior border of the stemocleidonastoid.Subclavian vein:o Marked by a line joining the medial end of the bone to its midpoint.Common carotid artery:o Marked by a line joining a point on the stemovlavicular joint to a point on the anterior border of the sternocleidomastoid at the level of upper border of the thyrroid cartilage.Internal carotid artery :o Marked by a line joining a point on the anterior border of the stemocleidommastoid at the level of upper border of thyroid cartilage to a point on the posterior border of the condyle of the mandible.External carotid artery:o Marked by a line joining a point on the anterior border of the stemocleidommastoid at the level of upper border of thyroid cartilage to a point on the posterior border of the neck of the mandible.
| 2 |
Line passing from ear lobule to mid pt of clavicle
|
Line passing from ear lobule to medial end of clavicle
|
Line joining ear lobule to lateral end of clavicle
|
Line joining mastoid process to mid pt of clavicle
|
Anatomy
|
Triangles of Neck
|
fb222ec0-6af8-4c23-91b6-aded4a48981b
|
multi
|
Pyruvate dehydrogenase contains all except -
|
A i.e. BiotinPyruvate, the end product of aerobic glycolysis is transpoed into mitochondria by specific pyruvate transpoer, where it is conveed to acetyl CoA by pyruvate dehydrogenase (PDH) complexQ.
| 1 |
Biotin
|
NAD
|
FAD
|
CoA
|
Biochemistry
| null |
0d417fac-84a6-4f45-8a56-d4cb3e8e79ac
|
multi
|
Pleomorphism is most commonly seen in:
|
H. influenzae
| 2 |
Anaerobic staphylococci
|
H. influenzae
|
Corynebacterium diphtheria
|
Brucella abous
|
Microbiology
| null |
b8348fed-8422-4b00-99e0-99031111e7be
|
single
|
Drugs causing macular toxicity when given intiavitreally-
|
Ref:comprehensive ophthalmology AK Khurana 4th edition page no :152 Gentamycin is 4 times more retinotoxic (causes macular infarction) than amikacin. Preferably the aminoglycosides should be avoided.
| 1 |
Gentamycin
|
Vancomycin
|
Dexamethasone
|
Ceftazidime
|
Ophthalmology
|
Vitreous and retina
|
73edbb6d-6f04-4110-be92-df8368997dcd
|
multi
|
Shortest acting benzodiazepine is :
| null | 1 |
Midazolam
|
Alprazolam
|
Lorazepam
|
Diazepam
|
Pharmacology
| null |
94d4df55-9bcb-49ae-9d8c-13881bb52f8f
|
single
|
The recently approved antiepileptic drug lacosamide acts by:
|
(Ref: Katzung, 14th ed. pg. 417)* CRMP is Collapsing Response Mediator Protein, which causes neuronal excitotoxicity by releasing BDNF (Brain Derived Neurotropic Factor).* The drug Lacosamide acts by inhibiting CRMP protein, thereby causing protective action against neuronal excitotoxicity.
| 2 |
Inhibiting synaptic vesicular protein
|
Inhibing CRMP protine
|
Inhibing GABA metabolism
|
Inhibing glutamate release
|
Pharmacology
|
C.N.S
|
82abafc3-ceca-41a9-84b9-4fdb2c2ec29e
|
single
|
Radioisotopes used in Myocardial perfusion imaging: Thallium 201 18 FDG PET Tc-99m Sestamibi Tc-99m Pyrophosphate Tetrafosmin N-13 Ammonium
|
- Thallium-201, Sestamibi, Tetrofosmin scan are used for Myocardial Perfusion Imaging. - Pyrophosphate scan for Myocardial Infarction. - 18 FDG PET is used to detect Myocardial Viability - N-13ammoniaPETmyocardial perfusion imaging(MPI) yields larger stressperfusiondefects than dipyridamole stress and might reflect the truemyocardialischemic burden.
| 2 |
1,3,4,5
|
1,2,3,4,5,6
|
1,3,5,6
|
1,3,4,5,6
|
Radiology
|
Nuclear medicine
|
443372cc-b626-4bbe-bd13-7ab9d8830ae0
|
multi
|
Sensitivity of chemoreceptors in COPD
|
The main chemoreceptors involved in respiratory feedback are: Central chemoreceptors: These are located on the ventrolateral surface of medulla oblongata and detect changes in the pH of spinal fluid. They can be desensitized over time from chronic hypoxia (oxygen deficiency) and increased carbon dioxide Ref: guyton and hall textbook of medical physiology 12 edition page number:365,366,367
| 3 |
Decreased to H+
|
Increased to H+
|
Increased to PCO2
|
Increased to PO2
|
Physiology
|
Respiratory system
|
42f1c17a-65ee-4b24-b0f4-83786c2c1052
|
single
|
Which of the following is the most impoant neurotransmitter deficient in the coex of patients with Alzheimer's Disease
|
Answer is A (Acetylcholine):The most impoant biochemical abnormality in Alzheimer's disease is the decrease in coical levels of AcetylcholineBiochemically Alzheimer's disease is associated with a decrease in the coical levels of several proteins and neurotransmitters especially acetylcholine, its synthetic enzyme choline-acetyl-transferase, and nicotinic cholinergic receptors. Reduction of acetylcholine is related in pa to degeneration of cholinergic neurons in the nucleus basalis of Meyne (NBM) that projects through the coex. There is also noradrenergic and serotonergic depletion due to degeneration of brainstem nuclei such as the locus ceruleus and dorsal raphe' - Harrison's
| 1 |
Acetylcholine
|
Serotonin
|
Dopamine
|
Noradrenaline
|
Psychiatry
| null |
bf82c509-b54f-40bb-83f3-bdb14fd3e630
|
single
|
The most useful incision in the operating room for patients with penetrating pericardium injury is
|
The subxiphoid incision is useful for determining if there is blood in the pericardium and if there is an intracardiac injury; however, exposure is extremely limited, and definitive repair can rarely be performed through the incision. Left (or right) anterior thoracotomy is easily performed, especially in the emergency room, and gives adequate exposure to ceain areas of the hea. However, each has significant limitations in exposure. Either may be extended across the thoracotomy into the other side of the chest, thus producing a bilateral anterior thoracotomy. Exposure is excellent through this incision, and most injuries can be satisfactorily repaired through this approach. Most cardiac operations today are performed through median sternotomy incisions. If the patient is in the operating room, this incision is easily performed and always provides excellent exposure for all areas of the hea.
| 4 |
Left anterior thoracotomy
|
Right anterior thoracotomy
|
Subxyphoid
|
Median sternotomy
|
Surgery
|
Cardio thoracic surgery
|
f9dfa1fb-b5ae-4cdf-92ae-fe36e623bf19
|
single
|
Which of the following organisms is visualized by gram staining:
|
Ans: b (Borrelia)Ref: Ananthanarayan and Paniker's Textbook of Microbiology, 8th ed.* Treponema - do not stain by ordinary method. Prolonged Giemsa, Fontana or Levaditis method is used* Mycoplasma - has no cell wall. So they are gram negative but are better stained by Giemsa* Mycobacterium-resist decolonisation by alcohol even without mordant effect of iodine. Can be called gram positive even though it is not used for diagnosis* Borrelia - readily stain by ordinary methods and are gram negative
| 2 |
Treponema
|
Borrelia
|
Mycoplasma
|
Mycobacterium
|
Microbiology
|
Spirochetes
|
7c74aa83-8596-47c8-8fbe-552532f10f07
|
single
|
Deficiency of the following vitamin is most commonly seen in sho bowel syndrome ileal resection
|
If the distal 2/3rd of the ileum is including the ileocecal valve is resected, significant abnormalities of absorption of bike salts and Vitamin B12 may occur resulting in diarrhoea and anaemia. These abnormalities occur even though only 25% of total length of the small bowel is removed Proximal bowel resection is better tolerated than distal resection because the ileum can adapt and increase its absorptive capacity more efficiently than jejunum Ref: Sabiston 20th edition Pgno : 1171
| 1 |
Vitamin B12
|
Vitamin B1
|
Folic Acid
|
Vitamin K
|
Anatomy
|
G.I.T
|
79fb77c8-9330-4e98-b1ce-27ee744ac4d8
|
single
|
The water powder ratio of alginate is:
| null | 3 |
100 ml of water to 60 gms of powder
|
40 ml of water to 40 gms of powder
|
40 ml of water to 15 gms of powder
|
15 ml of water to 40 gms of powder
|
Dental
| null |
d20086f4-98f6-4a50-a89b-5a304f13a313
|
single
|
Shawl sign is seen in -
|
Shawl signConfluent macular violaceous erythema on the posterior neck and shoulders in patients of dermatomyositis is called Shawl sign. IADVL textbook of dermatology page 1246
| 4 |
Neonatal lupus
|
Cutaneous scleroderma
|
SLE
|
dermatomyositis
|
Dental
|
Autoimmune skin disorders
|
3efc5dca-3d40-4c35-b1f9-0ec1eaf7c9b7
|
single
|
Live vaccines are
|
BCG consists of living bacteria derived from an attenuated bovine strain of tubercle bacilli. The bacilli used for vaccine production are descendants of the original Calmette strain of BCG (refer pgno:196 park 23rd edition)
| 2 |
TT
|
BCG
|
DPT
|
OPV
|
Social & Preventive Medicine
|
Epidemiology
|
a38a721f-0ca6-4a5b-95ac-98dfc230ff30
|
single
|
Prolonged QT interval is not seen in
|
Hypercalcemia: The most common ECG findings of hypercalcemia are a sho QT interval secondary to a shoened ST segment. There may also be a widened or flattened T wave; however, significant hypercalcemia can cause ECG changes that mimic an acute myocardial infarction cuases of prolonged QT Bradycardia Central Nervous System diseases (intracranial trauma, subarachnoid hemorrhage, stroke) Congenital long QT syndrome Dysautonomy (Diabetes mellitus, amyloidosis, others) Elderly Electrolyte disturbances (hypomagnesemia, hypokalemia) Hea Failure Hypoglycaemia Hypothermia Hypothyroidism Ion channel polymorphism Ischemic myocardiopathy Obesity Reduced repolarization reserve Ref : Harrison 20th edition pg 1534
| 4 |
Hypokalemia
|
Hypocalcemia
|
Hypomagnesemia
|
Hypercalcemia
|
Medicine
|
C.V.S
|
47b6d301-78a9-4fec-ad89-44786e43aa10
|
single
|
Which of the following is diagnostic of GDM by 75 g GTT as per NICE 2015 criteria?
|
Ans. is c, i.e. Fasting blood glucose 5.6 mmol/LNICE 2015 guidelines for diagnosing Gestational diabetesGestational DiabetesDiagnose gestational diabetes if the woman has either:-A fasting plasma glucose level of 5.6 mmol/litre or above or-A 2-hour plasma glucose level of 7.8 mmol/litre or above. Also know - Metabolic goals as per NICE 2015Advise pregnant women with any form of diabetes to maintain their capillary plasma glucose below the following target levels, if these are achievable without causing problematic hypoglycaemia:Fasting: 5.3 mmol/litre and1 hour after meals: 7.8 mmol/litre or2 hours after meals: 6.4 mmol/litre.
| 3 |
FBG > 5.1 mmol/L
|
FBG > 7.0 mmol/L
|
Fasting blood glucose 5.6 mmol/L
|
2 hr PP OGTT more than 5.8 mmol/L
|
Gynaecology & Obstetrics
|
Antenatal Care & Assessment of Fetal Well Being
|
7c49d50e-1e4e-4f98-a56d-312fa0e0a41c
|
single
|
In facial nerve injury, loss of lacrimation is due to involvement of-
|
Ans. is 'c' i.e., Greater superficial petrosal nerve o In facial nerve injuryLoss of lacrimation Due to involvment of greater superficial petrosal nerve.Loss of stapedial reflex Due to involvement of nerve to stapedius.Lack of salivation Due to chordatympani.Loss of taste sensation from Anterior 2/3 of tongue: - due to chordatympani.Paralysis of muscle offacial expression Due to terminal (peripheral) branches.Hyperacusis (intolerance to loud noice) Due to involvement of nerve to stapedius (causing parolysis of stapedius).
| 3 |
Chorda tympani nerve
|
Buccal nerve
|
Greater superficial petrosal nerve
|
Deep petrosal nerve
|
ENT
|
Facial Nerve And Its Disorders
|
6a95b06c-9914-4886-8ef3-3adcdfc9ec01
|
single
|
Polypeptide chain termination is enhanced by
|
Termination requires stop codon (UAA, UAG, UGA) and releasing factors .
Peptidyl transferase is also required which along with releasing factor hydrolyses peptide bond between tRNA at 'P' site and promotes the release of a newly synthesized polypeptide chain from ‘P’ site.
| 4 |
Stop codon
|
Peptidyl transferase
|
UAA
|
All of these
|
Biochemistry
| null |
e5b43b26-bb09-471c-aeb2-eab735ded1ef
|
multi
|
Trauma from occlusion causes all except:
|
Clinical features of TFO
Mobility (progressive)
Pain on chewing or percussion
Fremitus
Occlusal prematurities/discrepancies
Wear facets in the presence of other clinical indicators
Tooth migration
Chipped or fractured tooth (teeth)
Thermal sensitivity
Key notes :
TFO hardly affects the gingival soft tissues.
| 1 |
Leads to marginal gingivitis
|
Reversible in nature
|
Does not cause pocket formation
|
Alveolar crest height might be reduced
|
Dental
| null |
b2fd244b-73e5-4811-9586-4c4dc8b2bfdf
|
multi
|
Which of the following is essential for tumor metastasis
|
Ref Harrison 17/e p 509; Robbins 9/e p305_306 Metastasis is a complex series of steps in which cancer cells leave the original tumor site and migrate to other pas of the body ,the bloodstream or the lympatic system ,to do so malignant cells break away from the primary tumor and degrade protein of the extacellular matrix .one of the critical events required for metastasis is the growth of a new network of blood vessels called tumor angiogenesis Vacularisation is promoted by VEGF and bFGF and inhibited by angiostatin ,endostatin and tumstatin it has been found that angiogenesis inhibitors would therefore prevent growth of metastasis
| 1 |
Angiogenesis
|
Tumorogenesis
|
Apoptosis
|
Inhibition of tyrosine kinase activity
|
Anatomy
|
General anatomy
|
96ea09f9-3ee2-4ca2-9a24-e27007cb422a
|
single
|
Poor accessibility is the main disadvantage of _______ flap
| null | 3 |
Trapezoid
|
Envelope
|
Semilunar
|
Any of the above
|
Surgery
| null |
e97cbd34-ef06-4211-bf7b-c84b1f71b8f3
|
multi
|
Fatal dose of methanol :
|
C i.e. 60-250 ml
| 3 |
15 ml
|
30-60 ml
|
60-250 ml
|
500 ml
|
Forensic Medicine
| null |
7ed5182c-45bd-48e6-bc26-1d59c398fcab
|
single
|
Shape of the interdental papilla in midline diastema cases is
| null | 4 |
Pyramidal
|
Round
|
Triangular
|
No specific shape
|
Dental
| null |
e74d9fd8-2fba-4fb0-8f5e-d3119a51d4d4
|
single
|
All of the following immunohistochemical markers are positive in the neoplotic cells of granulocytic sarcoma, EXCEPT:
|
A variety of markers for myeloid precursors in granulocytic sarcoma are identified. CD43, lysozyme, myeloperoxidase and CD 15 are the most sensitive markers staining a large propoion of the cells of the majority of well-differentiated tumors. CD 45 RO is not mentioned as a immunohistochemical marker of granulocytic sarcoma. Ref: Manual of Diagnostic Antibodies For Immunohistology By Anthony Siew-Yin Leong, Kumarasen Cooper, F. Joel W.-M. Leong, 2002, Page 339.
| 1 |
CD 45 RO
|
CD 43
|
Myeloperoxidase
|
Lysozome
|
Pathology
| null |
c10d7131-8dad-4ac2-b09c-6af1c032e9d2
|
multi
|
Response to iron in iron deficiency anemia is denoted by?
|
Ans. is 'b' i.e., Reticulocytosis Response to iron therapy When specific iron therapy is given, patients often show rapid subjective improvement, with disappearance or marked diminution of fatigue, lassitude, and other non-specific symptoms. This response may occur before any improvment in anemia is observed. The earliest hematological evidence of recovery is increase reticulocytes and their hemoglobin content. The reticulocytes attain a maximal value on the 5th to 10th day after institution of therapy and thereafter gradually return to nonnal. The reticulocyte response may not be detectable in mild iron deficiency anemia. The blood hemoglobin level is the most accurate measure of the degree of anemia in iron deficiency anemia. During the response to therapy, the red cell count may increase temporarily to values above normal, but the hemoglobin value lags behind. The red cell indices may remain abnormal for some time after the normal hemoglobin level is restored. As recovery occurs, a normocytic cell population gradually replaces the microcytic population; and one of the early signs of response to therapy is an increase in RBW from pretreatment level. When treatment is fully effective, hemoglobin reaches normal levels by 2 months after therapy is initiated, regardless of staing values. Of the epithelial lesions in iron deficiency, those affecting the tongue and nails are the most responsive to treatment.
| 2 |
Restoration of enzymes
|
Reticulocytosis
|
Increase in iron binding capacity
|
Increase in hemoglobin
|
Pathology
| null |
2bf56d57-44f9-4b74-a4b0-725b647c5bb2
|
single
|
Which organism causes toxin shock syndrome ?
|
Ans. is 'c' i.e., Staphylococcus aureus Toxic shock syndrome TSS is a potentially fatal multisystem disease characterized by sudden high fever, fainting, watery diarrhea, headache and muscle ache. There are two types of TSS :? 1. Staphylococcal TSS Staphylococcal TSS results from the elaboration of toxic shock syndrome toxin type-1 (TSST-1) also known as enterotoxin type F or pyrogenic exotoxin C. Enterotoxin B or C may also produce TSS. 2. Streptococcal TSS Streptococcal TSS results from the elaboration ofpyrogenic exotoxin A.
| 3 |
Pneumococcus
|
E. coli
|
Staphylococcus aureus
|
Enterococcus
|
Microbiology
| null |
117c4aa3-5da8-47c5-b490-9455ba0788a2
|
single
|
Busacca and Koeppe&;s nodules are characteristically seen in
|
Non-granulomatous uveitisGranulomatous uveitisBehcet disease HLA - B27 associated ankylosing spondylitis Reiter syndrome Inflammatory bowel disease Idiopathic Infections - Lyme disease, Kawasaki disease, rickettsia, mumps, measles, Chlamydia, influenza, adenovirusPsoriatic ahritis Secondary syphilis Trauma UGH syndrome Glaucomatocyclitic crisis Lens-induced uveitis Corneal graft rejection Sarcoidosis Sympathetic ophthalmitis Phacoanaphylaxis Vogt - Koyanagi - Harada syndrome Infections - Tuberculosis, Leprosy, Syphilis, Leptospirosis, Brucellosis, Herpes simplex, herpes zoster, varicella, systemic mycosisKoeppe' s nodules- situated at papillary border -posterior synechiae smaller in sizeBusacca' s nodules- situated at the collarette; larger in size(Refer: AH Khurana, Comprehensive Textbook of Ophthalmology,5thedition, pg no: 149)
| 3 |
Residual uveitis
|
Recurrent uveitis
|
Granulomatous uveitis
|
Non-granulomatous uveitis
|
Anatomy
|
All India exam
|
f9c7622e-cfdc-4d84-b35c-e498be027f08
|
multi
|
Which of the following centers are involved in maintaining the circadian rhythm?
|
The entrainment process in most cases is dependent on the suprachiasmatic nuclei (SCN) located bilaterally above the optic chiasma. Efferents from the SCN initiate neural and hormonal signals that enteain a wide variety of well known circadian rhythms including the sleep wake cycle and the secretion of the pineal hormone melatonin.
| 4 |
Supraoptic nuclei
|
Posterolateral nuclei
|
Ventrolateral nuclei
|
Suprachiasmatic nuclei
|
Physiology
| null |
9e30d956-4b20-4558-9663-a80209688115
|
single
|
P-value is the probability of -
|
• P-value:
– Is the ‘Probability of Type I error’ (Null hypothesis is true but rejected)
– Significance (a) level: is the maximum tolerable probability of Type I error
– P- value is calculated (on basis of data while Alpha is fixed in advance: by the choice of level of significance employed in the test
– P – value calculated can be less than, equal to or greater than alpha (a)
– Keep Type I error to be minimum (P < a): Then results are declared statistically significant.
| 2 |
Not rejecting a null hypothesis when true
|
Rejecting a null hypothesis when true
|
Not rejecting a null hypothesis when false
|
Rejecting a null hypothesis when false
|
Social & Preventive Medicine
| null |
6703721c-b8bf-411a-9763-c8c2a7986a03
|
multi
|
Which of the following is not a prefabricated pontic:
|
Example of prefabricated pontics are:
Trupontic, Long pin facing,
Flatback, Sanitary facings, Reverse pin facing, Pontips.
| 3 |
Long pin facing.
|
Pontip.
|
Perel pontic.
|
Sanitary facing.
|
Dental
| null |
1e001024-d434-4639-aa41-d506d6a9199b
|
single
|
Pneumatocele is caused by?
|
Ans. A. Staphylococcus aureus* S. aureus is a cause of serious respiratory tract infections in newborns and infants; these infections present as shortness of breath, fever, and respiratory failure.* Chest X-ray may reveal pneumatocele (shaggy, thin- walled cavities). Pneumothorax and empyema are recognized complications of this infection.
| 1 |
Staphylococcus aureus
|
Streptococcus pyogenes
|
Hemophilus parainfluenzae
|
Mycoplasma pneumoniae
|
Medicine
|
Infection
|
2422bca1-e571-463d-a199-e6548ae6b8b1
|
single
|
Psychosurgery is used in ?
|
Ans. is 'c' i.e., OCD
| 3 |
Phobia
|
Generalized anxiety
|
OCD
|
Depression
|
Psychiatry
| null |
9ea4b27b-90ca-428a-b5ae-df9ae6e8b29b
|
single
|
Odynophagia means:
|
Ans. a (Pain during swallowing). (Ref. Diseases of ENT by PL Dhingra /3rd 402, 444)TermDefinationOdynophagiapainful deglutition.Dysphagiadifficulty in deglutition.Dysphagia lusoriaesophageal compression due to aberrant vessel, leading to dysphagia.Globus hystericusa psychiatric condition characterized by dysphagia.Halitosisbad odour from mouth.
| 1 |
Pain during swallowing
|
Difficulty in swallowing
|
Bad odour from mouth
|
Psychiatric disease
|
ENT
|
Oesophagus
|
4eb3ad07-de18-411c-8c57-27739d0379a9
|
multi
|
In oral poisoning with carbamate insecticides, .............................. may be hazardous:
|
Oximes are ineffective in carbamate poisoning. Rather, these can worsen the poisoning due to weak anticholinesterase activity of its own.
| 1 |
Pralidoxime
|
Atropine
|
Magnesium sulfate purgative
|
Gastric lavage with activated charcoal
|
Pharmacology
| null |
56fc6e36-0abf-4870-a5ac-093081e1f7b4
|
single
|
Which of the following muscle is not supplied by Recurrent Laryngeal nerve: (PGI Dec 2008)
|
Ans: D (Cricothyroid) Nerve Supply of LarynxMotorAll the muscle which move the vocal cords (Abductor0- posterior cricoarytenoid; adductorQ-Lateral cricoarytenoid, Interarytenoid & thyroarytenoid: tensorQ-Cricothyroid, vocalis) are supplied by Recurrent Laryngeal nerve1'except the cricothyroid muscle. The latter receive its innervation from External Laryngeal nerveQ - a branch of superior Laryngeal nerveSensoryAbove vocal cords - Internal Laryngeal nerve, a branch of Superior Laryngeal nerve'3Below vocal cords - Recurrent Laryngeal nerveQRT Recurrent Lary ngeal Nerve - It arise from the vagusQ at level of subclavian artery, hooks around it & then ascends b/w the trachea & oesophagus.LT Recurrent Laryngeal Nerve - It arises from the vagusQ in the mediastinum at the level of arch of aorta, loops around it & then ascends into the neck in the tracheo-oesophageal groove. Thus, LTRLN has a much longer courseQ which makes it more prone to paralysis as compared to the right one.
| 4 |
Posterior cricoarytenoid
|
Thyroarytenoid
|
Lateral cricoarytenoid
|
Cricothyroid
|
ENT
|
Anatomy of Larynx
|
f599714b-89fe-4b9c-b997-688ffc087c9b
|
single
|
All of the following clinicopathologic features are seen more often in seminomas as compared to nonseminomatous germ cell tumors of the testis except
|
While hCG concentration may be inceased in patients with either nonseminoma or seminoma histology, the AFP concentration is increased only in patietns with nonseminoma." - Harrison Seminomas represent about 50% of all Germ cell tumors of testis. Median age is 4th decade (Nonseminomas are most frequent in the 3rd decade). Seminomas follow a more indolent course. Most seminomas (70%) present with stage I disease (disease limited to testis), about 20% with stage II disease (with retroperitoneal metastases), and 10% with stage III disease (spread beyond retroperitoneum) Seminomas as well as non-seminomas typically metastasize through lymphatics (except Choriocarcinoma which demonstrates early hematogenous spread) Seminomas are one of the most radiosensitive tumors (Non seminomas are insensitive to radiation). ref : Bailey & Love 25/e p1384
| 4 |
Tumors remain localized to testis for a long time
|
Thety are radiosensitive
|
They metastasize predominantly by lymphatics
|
They are often associated with raised levels of serum AFP and HCG
|
Surgery
|
Urology
|
83e6466d-f26e-4871-a34e-950e9b4e90fd
|
multi
|
Chances of adverse outcome in a hea disease patient are increased in all of the following periods except
|
Period of pregnancy during which a hea disease patient has high chance of adverse outcome 12 to 16 wks of pregnancy 28 to 32 wks of pregnancy During Labor Immediately after delivery-Maximum deaths 4 to 5 days after delivery Reference: William's Obstetrics; 24th edition; Chapter 49
| 4 |
28-32 weeks of pregnancy
|
At the time of labor
|
4-5 days after delivery
|
First 4weeks of Pregnancy
|
Gynaecology & Obstetrics
|
Medical, surgical and gynaecological illness complicating pregnancy
|
12163f1a-b885-4830-b527-2b8863b0bf3e
|
multi
|
Structures preserved in modified radical neck dissection are all except:
| null | 3 |
Accessory nerve
|
Sternocleidomastoid muscle
|
Submandibular gland
|
Internal jugular vein
|
Surgery
| null |
51a13c26-8e46-46cf-9057-70d7f3c98877
|
multi
|
Which ofthe following drugs is used for Irritable Bowel Syndrome of the constipating type-
|
Management of IBS The most impoant steps are to make a positive diagnosis and reassure the patient. Many people are concerned that they have developed cancer. A cycle of anxiety leading to colonic symptoms, which fuher heighten anxiety, can be broken by explaining that symptoms are not due to a serious underlying disease but instead are the result of behavioural, psychosocial, physiological and luminal factors. In individuals who fail to respond to reassurance, treatment is traditionally tailored to the predominant symptoms. Dietary management is effective for many patients. Up to 20% may benefit from a wheat-free diet, some may respond to lactose exclusion, and excess intake of caffeine or aificial sweeteners, such as sorbitol, should be addressed. A more restrictive, 'low-FODMAP' diet, supervised by a dietitian, with gradual re-introduction of different food groups, may help some patients, as may a trial of a gluten-free diet. Probiotics, in capsule form, can be effective if taken for several months, although the optimum combination of bacterial strains and dose have yet to be clarified. Patients with intractable symptoms sometimes benefit from several months of therapy with a tricyclic antidepressant, such as amitriptyline or imipramine (10-25 mg orally at night). Side-effects include dry mouth and drowsiness but these are usually mild and the drug is generally well tolerated, although patients with features of somatisation tolerate the drug poorly and lower doses should be used. It may act by reducing visceral sensation and by altering gastrointestinal motility. Anxiety and affective disorders may also require specific treatment . The 5-HT4 agonist prucalopride, the guanylate cyclase-C receptor agonist linaclotide, and chloride channel activators, such as lubiprostone, can be effective in constipation- predominant IBS. Trials of anti-inflammatory agents, such as ketotifen or mesalazine, and the antibiotic rifaximin may be considered in some patients with difficult symptoms but are best prescribed only after specialist referral. Psychological interventions, such as cognitive behavioural therapy, relaxation and gut-directed hypnotherapy, should be reserved for the most difficult cases. A range of complementary and alternative therapies exist; most lack a good evidence base but are popular and help some patients . Most patients have a relapsing and remitting course. Exac- erbations often follow stressful life events, occupational dissatisfaction and difficulties with interpersonal relationships. Ref Davidson edition23rd pg 826
| 1 |
Lubiprostone
|
Cholestyramine
|
Alosetron
|
Rifaximin
|
Medicine
|
G.I.T
|
764e207c-5756-4e11-ad62-55b2fc1ac023
|
single
|
Treatment of AIDS include
|
(2 Reverse transcriptase inhibitors + 1 Protease inhibitors) (1124-H) (1197-1201-300-CMDT-09) (1190- H17th)Currently licenced drugs for the treatment of HIV infections fall into three categories: those that inhibit the viral reverse transcriptase enzyme: those that inhibit the viral protease enzymes, and those that interfere with viral entry (1124-H)Reverse transcriptase inhibitors include(i) Nucleoside analogues - Zidovudine, Zalcitabine, Didanosine, Zalcitabine, Stavudine, Lamivudine, abacavir, and emtricibine(ii) Nucleotide analogues - tenofovirNon-nucleoside reverse transcriptase inhibitors - nevirapine, delavirdine and efavirenzProtease inhibitors (PIs) Saquinavir, Ritonavir, Indinavir, Nelfinavir, Amprenavir, Fosamprenavir, Lopinavir, AtazanavirEntry inhibitors (Fusion inhibitors) - Enfuvirtide* The combination of Zidovudine, Lamivudine and indinavir was the first "triple combination" shown to have a profound effect on HIV replication (1134-H)Symptomatic HIV disease or asymptomatic disease and CD4 < 200/pL or asymptomatic disease and special circumstances | Best first line treatment{CombivirEfavirenz Common altemativeregimens once a day regimens |||||* Tenofovir +Lamivudine +Efavirenz Tenofovir +Efavirenz +Afazanavir +Ritonavir + | | Intolerance to regimen Progression of disease or viral load does not decrease by > 0.5 log with initiation of treatment or increase of viral load by > 0.5 log while on treatmentLow pill burden regimens Combivir +Neviripine Trizivir | Change to alternative first line regimens High potency regimens| | Perform resistance testing and change to a regimen with three drugs to which the patient is not resistant. If possible Combivir +Lopinavir withRitonavir Approach to antiretroviral therapy
| 2 |
3 Reverse transcriptase inhibitors
|
2 Reverse transcriptase inhibitors + 1 Protease inhibitors
|
2 Reverse transcriptase inhibitors + 2 Protease inhibitors
|
3 Reverse transcriptase inhibitors + 1 Protease inhibitors
|
Medicine
|
Infection
|
6e47c395-02bd-4822-95e9-94efb2447db8
|
single
|
Eye signs can be seen in :
|
Toxic goitres are broadly of two distinct types: Primary & Secondary.
| 1 |
Primary toxic goitre.
|
Secondary toxic goitre.
|
Thyrotoxicosis.
|
All of the above.
|
Surgery
| null |
87fedd7e-aad8-4037-a6ee-d6864f34488c
|
multi
|
Child belongs toBihar Shows hypopigmented patches over his face. What is the right diagnosis?
|
As the child belongs to an endemic area, So our answer is inclined for Leprosy. The disease is clinically characterized by one or more of the three cardinal signs: hypopigmented or erythematous skin patches with definite loss of sensation, thickened peripheral nerves, and acid-fast bacilli detected on skin smears or biopsy material. Ref Robbins 9/e pg 234
| 2 |
P. alba
|
Leprosy
|
Vitilgo
|
None
|
Pathology
|
All India exam
|
59d5aa67-9fd0-46ad-852c-8438c28e847b
|
multi
|
Fetal middle cerebral artery Doppler is most useful in the evaluation of -
|
Ans-CMCA - PSA for fetal anemia in Rh- pregnancy.
| 3 |
intrauterine growth restriction
|
Preeclampsia
|
Fetal anemia
|
Fetal metabolic disorders
|
Unknown
| null |
d3657f58-206c-4321-8aae-d735d66a4ade
|
single
|
A durck granuloma is seen in -
|
Durck granuloma → Ring hemorrhages and small focal inflammatory reaction seen in Brain in cerebral malaria
| 1 |
Brain
|
Spleen
|
Liver
|
Lymphnode
|
Pathology
| null |
eed5d1e3-5f54-4dcc-9299-4ad963210f2e
|
single
|
Most common cause of HUS in children is
|
Ans. is 'a' i.e., E coli 0157/H7 The majority of HUS in children (90%) is related to prototypic diarrhea associated form, predominately in previously healthy children 6 months to 4 years of age with a peak between 1 and 2 years. Shiga toxin producing E coli (STEC) is the major cause of diarrhea associated HUS. Specifically, E coli with serotype 0157:H7 is the bacteria most commonly associated with HUS (90%) and is the most virulent. Other common bacteria implicated in causation of HUS are : Shigella dysenteriae Salmonella typhae Camphylobacter jejuni Yersinia species Pseudomonas species Clostridium difficle
| 1 |
E coli 0157/H7
|
S typhi
|
Shigella
|
None
|
Microbiology
| null |
d4fdd0ba-a753-4357-8a71-f94ca405c9b5
|
multi
|
What is first sign noticed in the eye after death of a person?
|
Fragmentation of blood columns in a retinal vessel is called Kevorkian sign. It is the first sign in eye after death of a person.
| 3 |
Corneal haziness
|
Tache noire sclerotica
|
Kevorkian sign
|
None of the above
|
Forensic Medicine
| null |
2e49c5e0-9f1e-489e-95e6-2744183e62ed
|
multi
|
Carotene is not found in high amounts in -
|
The cheapest source is green leafy vegetable such as spinach and amaranth. Vitamin A also occur in most green and yellow fruits and vegetables. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 21ST EDITION. PAGE NO - 615
| 3 |
Tomato
|
Cabbage
|
Potato
|
Spinach
|
Social & Preventive Medicine
|
Nutrition and health
|
7988937b-4e25-477b-88c9-eba531c78a71
|
single
|
A foy year old female visit the hospital with complaint of pain in her right hypochondriac region radiating towards the right shoulder tip. The pain begins after eating food and increases steadily over the period of 10-30 minutes then gradually decreases. She might have:-
|
Most probable diagnosis of this case is cholelithiasis. Cholelithiasis is commonly seen in fat foy feile females. In the given case the patient is experiencing pain after the meals and it increases for the period of 10 mins means during the time of gall bladder contraction to release bile. Gall bladder is supplied by the sympathetic nerves celiac and hepatic plexus. A few twigs from the right phrenic nerve carrying post ganglionic sympathetic fibers reach the gall bladder through the right phrenic and hepatic plexuses. This explains the referred pain of gall bladder inflammation at right shoulder tip.
| 1 |
Cholelithiaisis
|
Peptic ulcer
|
Acute pancreatitis
|
None of the above
|
Anatomy
|
Liver
|
1ad099d8-81c7-4b1f-b0b9-c2f1793ad8a5
|
multi
|
Which of the following is the most common etiological agent in parNasal sinus mycoses:
|
Most common type of fungal infection of nose and paranasal sinuses are due to aspergillus. A.fumigatus>A.niger>A.flavus are the most frequent offenders. Ref Maqbool 11/e,p 255.
| 1 |
Aspergillus
|
Histoplasma
|
Conidiobolus coronatus
|
Candida albicans
|
ENT
|
Nose and paranasal sinuses
|
8e34ea96-e83d-460e-be1b-bbaf299eb4a8
|
single
|
Salmonella osteomyelitis is common in
|
ANSWER: (A) Sickle cell diseaseREF: Textbook of orthopedics and trauma, By GS Kulkarni, page 289Salmonella osteomyelitis is more common in children with sickle cell disease, hemoglobinopathies and thalassemia. The reason for this higher incidence is as follows:Local thrombosis of intestinal mucosa causes disruption of mucosal integrity causing invasion of intra luminal bacteriaHyposplenmic state leads to prolongation of bacteremia to establish infectionHypoxia and aseptic necrosis causes multiple infarction of bone, leading to the point of low resistance favoring localization and spread of salmonella.
| 1 |
Sickle cell disease
|
HIV
|
IV drug abusers
|
Pregnancy
|
Orthopaedics
|
Infection of Bones & Joints
|
65b5a04a-c7b9-4e40-b538-3c3a0edc9392
|
single
|
Structure passing through foramen Rotundum:
|
Maxillary nerve
| 2 |
Maxillary aery
|
Maxillary nerve
|
Middle meningeal aery
|
Spinal accessory nerve
|
Anatomy
| null |
13628d53-22e9-4b43-921b-d28a6e7133bf
|
single
|
Sensitivity is
|
Repeated question
| 1 |
True positive\/ true positive + false negative
|
True negative\/ false positive + true negative
|
True negative\/ true negative + false positive
|
True negative\/ false negative + true positive
|
Social & Preventive Medicine
|
Screening
|
ec4b9ec2-2950-4733-b9c7-9443967c15f8
|
multi
|
Which of the following is labile cell ?
|
Ans. is 'd' i.e., Surface epitheliumWhen a cell proliferates, it pass through a cell cycle. o Cell cycle has a series of phases : -G iphase --> Rest phase (Presynthetic phase) S phase --> Synthetic phase in which synthesis of DNA takes place.a G2phase --> Resting phase (Postsynthetic or postmitotic phase). Mphase --> Mitotic phase in which mitosis takes place.Go phase When cell is not proliferating, it remains in quiescent phase (Go).Based on their proliferative capacity, cells are divided into.1. Labile cells (Continously dividing cells) or interinitotic cells. o Have capacity to proliferate and regenerate.o Have very sho Go and almost always remain in cell cycle. Example are : -u Surface epithelium (stratified squamous) of skin, oral cavity, vagina and cervix. Lining mucosa of all excretory ducts of glands (Salivary gland, pancreas, biliary duct). Columinar epithelium of GIT and uterus. Transitional epithelium of the urinary tract. Bone marrow cells and hematopoietic cells. Basal cells of epithelia.2. Stable or quiescent or reversible postimitotic cells. o Have limited capacity to proliferate and regenerate.o Ramain in Go phase of cell cycle but can enter in G1 phase when stimulated i.e., they usually remain quiescent, but proliferate in response to stimuli. Example are -Parenchymal cells of liver, kidney and pancreas. Mesenchymal cells, e.g., fibroblast and smooth muscles. Vascular endothelium Osteoblast, chondroblast Resting lymphocytes and other leukocytes.3.Permanent or nondividing or irreversible postmitotic cells. o Cannot divide and regenerate.o These cells are nondividing and have left the cell cycle, i.e., they do not belong to any phase of cell cycle. Example are -u Neurons Cardiac muscle Skeletal muscle
| 4 |
Cardiac cell
|
Liver parenchymal cell
|
Vascular endothelial cells
|
Surface epithelium
|
Pathology
| null |
045febbe-3c38-470f-aa66-ca6bee5ab50e
|
single
|
Spinal accessory nerve leave the cranium via
| null | 3 |
Foramen magnum
|
Foramen spinosum
|
Foramen jugulare
|
None
|
Anatomy
| null |
41652eec-6997-4258-9119-d06bc5497af9
|
multi
|
Animal waste such as placenta is disposed by-
|
- animal wastes comes under category no 2 of biomedical wastes. - it should be disposed by incineration. Reference: Park's textbook of preventive and social medicine, 23rd edition, pg no:793 <\p>
| 1 |
Incineration
|
Autoclave
|
Microwave
|
None
|
Social & Preventive Medicine
|
Hospital waste and disaster management, Occupational health
|
082ccf05-a5d2-4d9b-9ed9-e62fd49d2763
|
multi
|
Acute fluoride toxicity is seen at
|
- 5.0 grams – in AIPG
- 2.2 grams – in PGI
| 2 |
5 mg
|
5 grams
|
5.5 mg
|
55 grams
|
Dental
| null |
fecd2219-0338-4015-a2ac-e1847a2dafc5
|
single
|
All of the following are pa of the ASEPSIS wound grading except ?
|
REF : BAILEY AND LOVE 27TH ED.
| 3 |
serous discharge
|
purulent exudate
|
Induration
|
Erythema
|
Surgery
|
All India exam
|
0a9f1898-d816-499b-9320-ab8513dd80d7
|
multi
|
How is under-nutrition defined?
|
Ans. b. Weight for height < -2 SD (Ref: Ghai 8/e p96)Under nutrition is defined in terms of Height for Height, i. e. < -2 SD. Height for Height < -3 SD is severe under nutrition.Indicators of MalnutritionIndicatorParameterInterpretationStuntingLow height for ageChronic malnutritionQWastingLow weight for heightAcute malnutritionQUnder weightLow weight for ageBoth acute & chrome malnutritionQ WHO Classification of Malnutrition Moderate malnutritionSevere malnutrition (type)Symmetrical edemaNoYes (edematous malnutrition)Weight-for-heightSD score from -2 to -3SD score < -3 (severe wasting)Height-for-ageSD score from -2 to -3SD score < -3 (severe stunting)
| 2 |
Weight for age < -2 SD
|
Weight for height < -2 SD
|
Weight for age < -3 SD
|
Weight for height < - 3 SD
|
Pediatrics
|
Nutrition, Food Security, and Health
|
ac2e1827-f5e1-43d2-9d87-f1a25c32396c
|
single
|
Which of the following is higher at the apex of the lung than at the base when a person is standing?
|
Ans. A. V/Q ratioa. The alveoli at the apex of the lung are larger than those at the base so their compliance is less. Because the compliance is reduced, less inspired gas goes to the apex than to the base.b. Also, because the apex is above the heart, less blood flows through the apex than through the base.c. However, the reduction in airflow is less than the reduction in blood flow, so that the V/Q ratio at the top of the lung is greater than it is at the bottom.d. The increased V/Q ratio at the apex makes PA CO2 lower and PA O2 higher at the apex than they are at the base.
| 1 |
V/Q ratio
|
Blood flow
|
Ventilation
|
PaCO2
|
Physiology
|
Respiratory System
|
3452d565-b7c5-4c28-a92f-06e12f5d76ea
|
single
|
Growth factor oncogene is -
|
Sis oncogene is a growth factor.
Myc, jun and fos oncogenes are nuclear regulatory proteins
Following information have been added in 8th/ e of Robbin's
miRNA and cancer
It has already been explained in genetics that miRNA is a gene-silencing RNA, i.e. it inhibits gene expression at post-transcription level.
So, miRNA can be involved in tumorigenesis in two ways :
Reduced activity of miRNA that inhibits translation of an oncogene will result in excess of oncoprotein and tumorigenesis. For example, mRNA inhibits expression of anti-apoptotic gene Bcl 2. Reduced activity of this miRNA results in over-expression of Bcl-2 which inhibits apoptosis and results in leukaemia and lymphoma. Similarly, miRNA mediated upregulation of Ras and Myc oncogenes has been detected in lung tumor and B-cell leukemia, respectively.
On the other hand, overactivity of miRNA that targets a tumor suppression gene will result in inhibition of expression of tumor suppressor gene and tumorigenesis.
| 3 |
myc
|
fos
|
sis
|
jun
|
Pathology
| null |
9fe3701c-5fcb-4e53-922b-1340035a240a
|
single
|
WHO theme for 2019:
| null | 1 |
Universal coverage: Everyone, Everywhere.
|
Depression, lets talk.
|
Good health adds life to years.
|
Working together for health.
|
Dental
| null |
d700565e-b3a7-4ca8-8317-debd2f6c616a
|
single
|
A young lady is present with history of repeated episodes of overeating followed by purging using laxatives, she is probably suffering from
|
Bulimia Nervosa Bulimia nervosa is an eating disorder charac terised by the following clinical features: 1. Bulimia nervosa usually has an onset in early teens or adolescence. 2. There is an intense fear of becoming obese. There may be an earlier history of anorexia nervosa. 3. There is usually body-image disturbance and the person is unable to perceive own body size accurately. 4. There is a persistent preoccupation with eating, and an irresistible craving for food. There are episodes of overeating in which large amounts of food are consumed within sho periods of time (eating binges). 5. There are attempts to 'counteract' the effects of overeating by one or more of the following: selfinduced vomiting, purgative abuse, periods of starvation, and/or use of drugs such as appetite suppressants. 6. No known medical illness is present which can account for the disorder. 7. Absence of any other primary psychiatric disorder. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no.144
| 1 |
Bulimia nervosa
|
Schizophrenia
|
Anorexia nervosa
|
Benign eating disorders
|
Psychiatry
|
Sleep disorders and eating disorders
|
1ad5c5d6-7e55-4732-b2d3-bce2e7fc7eeb
|
single
|
A neonate delivered at 32 weeks, is put on a ventilator, X–ray shows 'white out lung' and ABG reveals PO2 of 75. Ventilator settings are an, FiO2 of 70, and rate of 50/minute. Next step to be taken should be ?
|
Lets see the individual findings.
The neonate is premature.
X - Ray shows 'White - Out' : is a sign of Hyaline Membrane disease in the Newborn i.e. RDS.
ABG reveals p0, of 75 : which is acceptable.
FiO, : Fractional Inspiratory 0„ here in the ventilator settings, is 75% well above the normal.
Respiratory Rate settings in the ventilator is 50/min : Normal for that age.
Now, we have the complete picture here :
The premature baby is having HMD, and so has been put on Artificial respiration.
The FiO2 being given is in the higher normal range, and also the partial pressure of 0, in the neonates blood is acceptable . So we will avoid increasing the Fi0„ as this carries a risk of blindness by ROP (Retinopathy of Prematurity). As a rule, we avoid tampering with the ventilator rate settings, because it causes changes in the CO, levels of the blood, and consequent disturbances in the acid - base balance. This is also one of the reasons for keeping this rate of 50/min. in this neonate.
Weaning from ventilator will start once the baby shows hyper - oxygenation with the currect settings, i.e. the p0, in the range of 120 .
The answer here would be to continue the current settings till such time when the baby shows hyper-oxygenation, and then slowly wean him off the ventilator
| 3 |
Increase rate to 60 per minute
|
Increase FiO2 to 80
|
Continue ventilation with the same settings
|
Weaning ventilator
|
Pediatrics
| null |
e86b9a60-feb3-4e39-86e9-30e98402c1d8
|
multi
|
True pseudo rosettes are seen in all except
|
Thecoma *Neuroblastoma: Homer-Wright pseudo rosettes can be found in which the tumor cells are concentrically arranged around the central space filled with neutrophil. *Medulloblastoma: The tumor has the potential to express neural cells or Homer Wright rosettes as occur in neuroblastoma. *Retinoblastoma: In well differentiated tumors there are Flexner-Winter-Steiner rosettes and fleurettes reflecting photoreceptor differentiation. *Thecoma: They are composed of well differentiated fibroblasts with more or less scant collagenous connective tissue interspace between the cells.
| 4 |
Neuroblastoma
|
Retinoblastoma
|
Medulloblastoma
|
Thecoma
|
Surgery
| null |
8fa3aab1-eb2c-4d4e-a197-b415a2d6c1c0
|
multi
|
Burkits Lymphoma is caused by:
|
EBV
| 4 |
HTLV1
|
HTLV2
|
HiPV
|
EBV
|
Microbiology
| null |
884150c4-9f48-4c96-b794-dd6ab025aa5a
|
single
|
Thymus glands are derived from:
| null | 3 |
I pharyngeal pouch
|
II pharyngeal pouch
|
III pharyngeal pouch
|
IV pharyngeal pouch
|
Anatomy
| null |
86c8a07c-feca-47f4-a272-6e1de455c28e
|
single
|
Quantitative assessment of liver function can be done by:
|
Answer is D (Estimation of Galactose Elimination capacity): Estimation of Galactose Elimination capacity (GEC) is an example of quantitative liver tests Liver Function tests Non quantitative Tests for Liver Function Although generally termed as Liver function tests, these are either not related to function or only reflect given aspects of liver function and are not over all parameters of latter These Include Serum Bilinthin Serum Alkaline phosphatase Serum Transminases Serum Bile Acids Serum Albumin Serum prothrombin time, etc Quantitative tests for Liver Function Quantitative tests for Liver function measure the true functional reserve of the liver These Include Galactose Elimination capacity Urea synthesis capacity Inducyanine clearance Sorbitol clearance caffeine clearance Aminopvrine Breath test Ketoisocaproic acid breath test
| 4 |
Degree of | Transaminases
|
Degree of |Alkaline phosphatase
|
Degree of | GGT
|
Estimation of Galactose Elimination capacity
|
Medicine
| null |
3df95836-75e3-4362-b47a-6bcbb524a92e
|
single
|
Which of the following rod is not used with the surveyor?
| null | 1 |
Incisal guide pin
|
Analyzing rod
|
Carbon marker
|
Wax trimmer
|
Dental
| null |
5a5f3372-b7a1-4785-a039-77b14d830aa5
|
single
|
Which of the following is true of botulinum toxin?
|
It acts on the postsynaptic membrane of peripheral nerves to block acetylcholine receptors Botulinum toxin is the most potent bacterial toxin known. One microgram of purified toxin is able to kill 200,000 mice. The toxin is released only upon the death and autolysis of the organism, and is thus classified as an exotoxin. Its activity is limited to the peripheral nervous system, where it is internalized into the presynaptic membrane at the neuromuscular junction and blocks the release of acetylcholine. Antibiotics have no direct effect on the toxin. The currently used antitoxin is of equine origin and is usually given as polyvalent. Injection of botulinum toxin is used in medical settings to treat strabismus and blepharospasm and has gained popularity recently as a cosmetic approach to lessen wrinkles (Botox).
| 2 |
It is an endotoxin
|
It acts on the postsynaptic membrane of peripheral nerves to block acetylcholine receptors
|
It is a neurotoxin, which primary affects the central nervous system
|
It is a relatively weak neurotoxin
|
Surgery
| null |
ec6fca24-29ff-4cf7-95c4-a74936bad74d
|
multi
|
Risk of kernicterus is increased in all except –
| null | 4 |
Low level of serum albumin
|
Prematurity
|
Acidosis
|
High levels of serum albumin
|
Pediatrics
| null |
71978105-71d8-4532-80d0-3d4b5069ce0e
|
multi
|
All are disorders of Phagocytosis except
|
Nezelof Syndrome is autosomal recessive condition characterised by cellular immunodeficiency.
| 4 |
Chronic granulomatous disease
|
Myeloperoxidase deficiency
|
Chediak-Higashi Syndrome
|
Nezelof Syndrome
|
Microbiology
| null |
e6a778aa-8efb-435b-be78-82329d4dc5ff
|
multi
|
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