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Characteristic feature of the urine in diabetes insipidus include the following EXCEPT
|
Ans. c (Specific gravity > 1.020). (Ref. Harrison, Medicine, 18th. Ch. 340 and 44)Fluid deprivation test: If fluid deprivation does not result in urine concentration (osmolarity >300 mosmol/L, specific gravity >1.010) before body weight decreases by 5% or plasma osmolarity/sodium rise above the upper limit of normal, the patient has severe pituitary or severe nephrogenic DI. These disorders usually can be distinguished by administering desmopressin (0.03 g/kg SC or IV) and repeating the measurement of urine osmolarity 1-2 hours later. An increase of >50% indicates severe pituitary DI, whereas a smaller or absent response is strongly suggestive of nephrogenic DI.Criteria for Dl (Diabetes insipidus)# Polyuria of > 3 L/d# Urine osmolality < 3000 mOsm/kg# Urine specific gravity < 1.00.Criteria for central Dl# Inappropriately dilute urine even with strong stimuli for AVP secretion.# Absence of intrinsic renal disease.# Rise in urine osmolality with ADH.Criteria for nephrogenic Dl# Normal rates of renal filtration and solute excretion.# Persistent hypotonic urine.# Failure of exogenous ADH to raise urine osmolality or to reduce urine volume. Source: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J: Harrison's principles of Internal Medicine, 18th Edition: www. accessmedicine. ComCopyrightr (S) The McGraw-Hill Companies, Inc. All rights reserved.
| 3 |
Has no proteins
|
Has no sugar
|
Specific gravity > 1.020
|
No casts
|
Medicine
|
Endocrinology
|
3342a49a-b0c3-4296-8cdc-a64d8f18d5a8
|
multi
|
The structures passing posterior to diaphragm are all except ?
|
The aoa passess posterior to the diaphragm.Accompanying the aoa through the aoic hiatus is the thoracic duct and the azygous vein.The greater and lesser splanchinic nerves passess through the crura on either side.
| 4 |
Aoa
|
Azygous vein
|
Thoracic duct
|
Greater splanchnic nerve
|
Anatomy
| null |
e4908255-aaed-4abb-a411-d064ade90893
|
multi
|
In cryptorchidism, hallmark histological changes appear in testis at:
|
Histopathology- Abnormal germ cell histology- 1-2 Years:* Earliest change - Hypoplasia of Leydig cells (1 month of age)- Degeneration of Seoli Cells- Delayed disappearance of gonocytes- Delayed appearance of adult dark spermatogonia
| 4 |
4 months
|
6 months
|
8 months
|
1 year
|
Surgery
|
Testis and scrotum
|
9b3918b0-8dcb-4429-8cb3-4e2adef4b1b1
|
multi
|
All are features of iridocyclitis except
|
Ans) b (Mucopuntlent discharge) Ref: Kansk, 6th ed p447-448Mucopurulent discharge is seen in conjunctivitis Symptoms of iridocyclitis-Sudden onset painPhotophobiaRednessLacrimationSignsVisual acuity decreased,Circumcomeal congestionMiosisKeratic precipitatesAqueous cells and flare, hypopyon occAnterior vitreous cellsPosterior synechiaLow IOP
| 2 |
Pain
|
Mucopurulent discharge
|
Constricted pupil
|
Circum corneal congestion
|
Ophthalmology
|
Uveal Tract
|
e5d2d45d-5d09-4109-a001-1482c349897d
|
multi
|
Thymoma is associated with -
| null | 1 |
Myasthenia gravis
|
Scleroderma
|
Oesophageal atresia
|
Hypergammaglobulinemia
|
Medicine
| null |
b80734e0-a8d1-41f9-8214-0456f5b6d1a5
|
single
|
Which enzyme is inhibited by fomepizole
| null | 1 |
Alcohol dehydrogenase
|
Acetaldehyde dehydrogenase
|
Catalase
|
Peroxidase
|
Biochemistry
| null |
437c9d67-e2a3-473c-9192-3d7396752adc
|
single
|
The local anaesthetic with the longest duration of action is :
|
* Longest acting, most potent and most toxic LA is dibucaine. * Chlorprocaine is the shoest acting LA.
| 4 |
Procaine
|
Chlorprocaine
|
Lignocaine
|
Dibucaine
|
Pharmacology
|
Anaesthesia
|
d5df13a4-6bcb-40d0-8a54-f568364df593
|
single
|
Among all the layers of the scalp which layer is highly vascular?
|
Scalp consists of the overlying soft tissues as well as underlying calvarium. The soft tissues composing the scalp are skin, connective tissue (subcutaneous), aponeurosis (galea aponeurotica), loose areolar connective tissue, and pericranium. The connective tissue layer (subcutaneous) contains the vast majority of the vasculature and nerve supply of the scalp. This layer is laced with strong fibrous reticula that hold the vessels open when the scalp is cut, causing profuse bleeding. The external carotid aery and internal carotid aery provides vessels to the scalp, with extensive anastomoses.
| 2 |
Skin
|
Subcutaneous tissue
|
Aponeurosis
|
Loose connective tissue
|
Anatomy
| null |
892a3177-6689-4f33-9404-9a894605f8d7
|
multi
|
Multifactorial causation of disease theory was proposed by
|
Traits and conditions that are caused by more than one gene occurring together are multifactorial, and diseases that are caused by more than one factor interacting (for example, heredity and diet in diabetes) are multifactorial. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 40
| 2 |
Louis Pasteur
|
Pettenkofer
|
Robe Koch
|
Aristotle
|
Social & Preventive Medicine
|
Concept of health and disease
|
6b342cec-65ae-41ac-9d3f-6a6f651bcf02
|
single
|
Predisposing factors for skin cancer are-a) Smokingb) U-V-light c) Chronic ulcerd) Infrared light
|
Exposure to Sun (UV rays) Major predisposing factors. o Old burn scars
Industrial carcinogens (Tars and oils) o Ingestion of arsenicals
Chronic ulcers and draining osteomyelitis. o Ionizing radiation
Note : Cigarette smoking and tobacco & betel nut chewing are predisposing factors for squamous cell carcinoma of lips and oral cavity.
| 1 |
bc
|
c
|
ac
|
ad
|
Pathology
| null |
dcbdfa33-8de2-4fb2-9377-306c3a26e9d3
|
single
|
A 58-year-old man with cirrhosis complains of worsening fatigue and confusion over the past 5 days. He also repos that over the past 48 hours he has had a declining urinary output. On examination, he is gaunt and jaundiced. He has tense ascites and a liver span of 7 cm in the midclavicular line. Lab result reveals a WBC 4600/mm3, Hb 9.4 g/dL, and PCB 29%. BUN of 34 mg/dL and a creatinine of 3.1 mg/dL. A urinary Na <10 mEq/L. Most appropriate treatment for his elevated BUN and creatinine?
|
This patient with well-advanced cirrhosis and poal hypeension has developed the onset of renal insufficiency consistent with hepatorenal syndrome. This occurs during the end stages of cirrhosis and is characterized by diminished urine output and low urinary sodium. In the setting of end-stage liver disease, renal vasoconstriction occurs, and the distal convoluted tubule responds by conserving sodium. Unless the renal function is allowed to deteriorate fuher, liver transplantation will reverse this vasoconstriction and kidney function will return to normal.A large volume paracentesis may relieve the ascites but will have no significant benefit on the impaired renal function. There are no indications in this question to suggest that the patient requires acute hemodialysis. A mesocaval shunt is a surgical procedure that may decompress the poal pressure but will not have any benefit on renal function. Renal transplantation is of no value in this patient since the underlying lesion is in the liver; the kidneys will return to normal function if there is the improvement in hepatic function. Ref - Harrison's internal medicine 20e pg 2401,2422
| 4 |
Large volume paracentesis
|
Hemodialysis
|
Mesocaval shunt
|
Liver transplantation
|
Medicine
|
G.I.T
|
4cb37de5-785c-4841-863e-ec734ff97e1e
|
single
|
False about eukaryotic protein synthesis is:
|
A i.e. N formyl Met is the first - RNA to come into action
| 1 |
N formyl Met is the first-RNA to come into action
|
mRNA read from 5' to 3'
|
Eft shift between GDP to GTP
|
Capping helps in attachment of mRNA to 40 S ribosome
|
Biochemistry
| null |
fd229d6b-b5f1-44b1-93c7-399c6249847a
|
multi
|
Loosening of association is an example of -
|
Ans. is 'a' i.e., Formal thought disorder Thought disordersFormal thought disorders (Disorders of thought process)Disorders of thought contenti) Racing thoughts :- Anxiety, Schizophreniaii) Retarded thoughts :- Depressioniii) Circumstantiality :- Mania, Schizophreniaiv) Thought blocking :- Schizophrenia, Severe anxietyv) Perseveration :- Organic brain disease, Schizophrenia ( occasionally)vi) Loosening of association :- Schizophreniavii) Flight of ideas:- Maniaviii) Tangentialityix) Clunging & punning :-Mania & schizophreniax) Neologism, word salad, Echolalia :-Schizophreniai) Delusion :- Psychosis (Schizophrenia, mania, depression & othersii) Obsessioniii) Compulsioniv) Preoccupationsv) Phobiasvi) Depersonalization & Derealizationo In schizophrenia and mood disorders (depression, mania) all parts of the thought (thought process as well as content) are involved.o However, schizophrenia is conventionally referred as formal thought disorder.
| 1 |
Formal thought disorder
|
Schneider's first symptoms
|
Perseveration
|
Concrete thinking
|
Psychiatry
|
Cognitive Development
|
064894d5-3208-4cff-bb7f-1d82b31a4293
|
single
|
Epstein-Barr virus (EBV) VCA-IgG 1 :80 and EBV antibody to early antigen EA1 :320 suggest which one of the following diseases?
|
Infectious mononucleosis (IM) may be suspected clinically but it is confirmed serologically. The heterophil antibody test, however, may be negative in up to 15% of adults and 35 to 40% of children. Because IM is caused by Epstein-Barr virus (EBV), a specific test for viral capsid antigen (VCA) of EBV is indicated when heterophil tests are negative. Acute IM is characterized by a VCA-IgM titer, and no VCA-IgG antibody or EBNA. Chronic EBV disease causes elevated VCA-IgG titers as well as high EA antibody titers.
| 1 |
Chronic infectious mononucleosis
|
Primary syphilis
|
Scarlet fever
|
Primary atypical pneumonia
|
Microbiology
|
Immunology
|
717ab440-fea6-4bb9-917f-e144173cd782
|
single
|
Chyluria is caused by all except: March 2007
|
Ans. D: Bile duct stones Chyluria/chylous urine is a condition involving the presence of chyle in the urine stream, which results in urine appearing milky white. Chyluria is often caused by filariasis due to the parasite Wuchereria bancrofti, a thready nematode which lodges the lymph channels. Another cause is pregnancy or childbih. It may also be seen in ascariasis, malaria, tumour and tuberculosis. Once the lymph channels are blocked, one may open into the kidney hilum or ureter or sometimes into the bladder and chyle can leak into the urinary tract resulting in milky white urine.It may also result in renal colic and hypoproteinemia. Blood sometimes mixes with the urine resulting in haemato-chyluria. Usually the condition is self limiting. If left untreated, chronic chyluria can lead to malnutrition and vitamin deficiency.
| 4 |
Pregnancy
|
Childbih
|
Filariasis
|
Bile duct stones
|
Surgery
| null |
06d0f069-0ccd-4b32-8fa4-1205ee2c7a81
|
multi
|
Most common organ affected in polyarteritis nodosa?
|
Ans. b (Kidneys). (Ref. Harrisons Medicine, 18th/ Chapter 326. The Vasculitis Syndromes)PAN is necrotising vasculitis of small and medium sized arteries.Descending order of frequency of involvement of organs in PAN is# Kidney# Heart# Liver# GIT# Muscle# Pancreas# Testis# CNS# Skin
| 2 |
Lungs
|
Kidneys
|
Pancreas
|
Spleen
|
Pathology
|
Blood Vessels
|
ec2bb273-11fe-4327-8769-3483ce37affc
|
single
|
A patient with blunt trauma of abdomen at 48 hours, USG shows normal, but patient had tenderness in left lumbar region. Best appropriate diagnosis is by:
|
Suspect - injury of kidney in left abdomen. MCU is IOC for Vesicourethral Reflux IVP is IOC for Ureterocele
| 3 |
MCU
|
IVP
|
CECT abdomen
|
Repeat USG
|
Surgery
|
DNB 2018
|
a82ee225-fa3b-4fa6-afa3-51bc69aaec26
|
single
|
An addict presents with increased sweating, lacrimation, diarrhea, yawning and rhinorrhea. These symptoms may occur due to withdrawal of ?
| null | 1 |
Heroin
|
Cocaine
|
Cannabis
|
Alcohol
|
Pharmacology
| null |
4dc014a1-9646-4cc5-974a-51d881eba0f4
|
single
|
Insulin acts on glucose metabolism by
|
Insulin signals the cells of insulin-sensitive peripheral tissues, primarily skeletal muscle, to increase their uptake of glucose.Secondly, insulin acts on the liver to promote glycogenesis.Finally, insulin simultaneously inhibits glucagon secretion from pancreatic a-cells, thus signalling the liver to stop producing glucose glycogenolysis and gluconeogenesis Ref: DM Vasudevan, 7th edition, page no: 165, 318, 323
| 2 |
| permeability of glucose across cell membrane
|
| permeability of glucose across cell membrane against glucose gradient
|
| permeability of renal cells
|
| glucose transpo to brain
|
Biochemistry
|
Endocrinology
|
56d5d8d7-3ea1-445e-bb19-bf8c7757dac2
|
single
|
Medullary cystic disease of the kidney is best diagnosed by -
| null | 4 |
Ultrasound
|
Nuclear scan
|
Urography
|
Biopsy
|
Medicine
| null |
b7cb0a91-a1e6-408e-95b4-2e770de7ed09
|
single
|
Which is wrong about the treatment of condition shown?
|
CXR - Ellis S shaped curve CP angle blunting Pleural effusion Thoracocentesis: Done with patient sitting in scapular line If patient cannot sit, he should be at edge of bed, arm raised above level of head, head end elevated by 30deg Severe Hiccoughs is a contraindication to thoracentesis Max fluid can be removed safely per sitting is about < 1500 ml/day. We don't remove fluid >1500 ml due to risk of development of re-expansion pulmonary edema.
| 1 |
Maximum fluid than be removed safely per sitting is 500ml
|
Severe Hiccoughs is a contraindication to thoracentesis
|
Done with patient sitting in scapular line
|
If patient cannot sit, he should be at edge of bed, arm raised above level of head, head end elevated by 30o
|
Medicine
|
Pleural effusion & Pulmonary alveolar proteinosis
|
e6fbfea4-9d36-4767-8c0f-bcde9bca2d37
|
multi
|
Bifurcations and trifurcations are most commonly observed in
| null | 3 |
Maxillary 1st premolar
|
Maxillary 2nd premolar
|
Mandibular 1st premolar
|
Mandibular 2nd premolar
|
Dental
| null |
d988b2da-11db-4562-8a5d-d55976f95ee1
|
single
|
HLA typing is useful in: September 2004
|
Ans. D i.e. Parental dispute
| 4 |
Blood grouping
|
Assessing prognosis of disease
|
Cancer therapy
|
Cases of parental dispute
|
Microbiology
| null |
0b53f759-330d-4d16-885d-a80bfd2f96fc
|
single
|
Chronic constipation in children is seen in all A/E?
|
Ans. is 'b' i.e., Jejunal polyp
| 2 |
Hirschspring disease
|
Jejunal polyp
|
Hypothyroidism
|
Stricture
|
Pediatrics
| null |
c416bff6-4f14-4b11-b3fe-f3f3c9066962
|
multi
|
Cardiac lesion in SLE cause -
| null | 4 |
Verrucous endocarditis
|
Valvular incompetence
|
Myocardial fibrosis
|
All of the above
|
Medicine
| null |
5267b489-ab65-4e47-97e9-b84f59d39fb2
|
multi
|
Autoantibody specific for SLE -
|
Ans. is 'a' i.e., ds DNA Antinuclear antibodies in SLEo Systemic lupus erythematosus is characterized by bewildering array of autoantibodies, particularly antinuclear antibodies.o The antibodies are directed against an array of nuclear and cytoplasmic components of the cell, in addition a third group of antibodies is directed against cell surface antigen of group cells,o The existence of seemingly limitless number of antibodies in patients against self-constituents indicate that the fundamental defect in SLE is a failure of the mechanism that maintain self-tolerance.o ANA is positive in virtually every patient of SLE, hence this test is sensitive but is not specific because patients with other autoimmune diseases are also positive.o Of the numerous antinuclear antibodies, antibodies to double stranded DNA and the antibodies, to (Smith) antigen are virtually diagnosis of SLEQ.o Presence of abtibodies to antismith and anti double stran ded DNA is virtually diagnostic of SLE.o The best serening test for SLE is demonstration of antinuclear antibodies.o Most sensitive antibody test for SLE - Antinuclear antibody test for SLE.o Afost specific antibody test for SLE - Anti ds DNA and Anti Sm antibodyo Antibody associated with drug induced SLE - Antihistone antibodyAutoantibodies in Systemic Lupus Ery thematosus (SLE! Prevalence Antibody%Antigen RecognizedClinical Utilityo Antinuclear antibodies98Multiple nuclearBest screening test; repeated negative tests make SLE unlikelyo Anti-ds DNA70DNA (double-stranded)High titers are SLE-specific and in some patients correlate with disease activity, nephritis, vasculitiso Anti-Sm25Protein complexed to 6 species of nuclear U1 RNASpecific for SLE; no definite clinical correlations; most patients also have anti-RNP; more common in blacks and Asians than whiteso Anti-RNP40Protein complexed to U1 RNAyNot specific for SLE; high titers associated with syndromes that have overlap features of several rheumatic syndromes including SLE; more common in blacks than whiteso Anti-Ro (SS-A)30Protein complexed to hY RNA, primarily 60 kDa and 52 kDaNot specific for SLE; associated with sicca syndrome, predisposes to subacute cutaneous lupus, and to neonatal lupus with congenital heart block; associated with decreased risk for nephritis -o Anti-La (S3-B)1047-kDa protein com- plexed to hY RNAUsually associated with anti-Ro; associated with decreased risk for nephritiso Antihistone70Histones associated with DNA (in nucleo-some, chromatin)More frequent in durg-induced lupus than in SLEo Antiphospholipid50Phospholipids, b2 glycoprotein 1 cofac- tor prothrombinThree tests available - ELISAs for cardiolipin and b2G1, sensitive prothrombin time (DRVVT); predisposes to clotting, fetal loss, thrombocytopeniao Antierythrocyte60Erythrocyte membraneMeasured as direct Coombs' test; a small proportion develops overt hemolysiso Antiplatelet30Surface and altered cytoplasmic antigens on plateletsAssociated with thrombocytopenia but sensitivity and specificity are not good; this is not a useful clinical testo Anti neuronal (includes anti-glutamate receptor!60Neuronal and IvmphoIn some series a positive test in CSF correlates with cyte surface antigens active CNS lupuso Antiribosomal P20Protein in ribosomesIn some series a positive test in serum correlates with depression or psychosis due to CNS lupus
| 1 |
ds DNA
|
Anti RO
|
Anticentromere
|
Anti topoisomerse
|
Pathology
|
Autoimmune Diseases
|
42b5d9e5-56e9-4fdb-b2e8-4d122f40c71f
|
single
|
Which of the following drugs should not be administered concomitantly with warfarin as it decreases the effect of oral anticoagulants ?
| null | 4 |
Broad spectrum antibiotic
|
Cimetidine
|
Aspirin
|
Oral contraceptive
|
Pharmacology
| null |
b3248dd9-19e2-4131-9b37-5bd29c48fc4b
|
single
|
Which of the following accessory ligaments of the TMJ is likely to have significance upon mandibular movements?
|
The stylomandibular ligament is formed due to thickening of the investing layer of deep cervical fascia, which separates the parotid and submandibular glands. This ligament also becomes taut when the mandible is protruded.
The accessory ligaments of temporomandibular joints control range of motion (ROM) of TMJs and with mandible form a ‘swing’.
The ligaments are the fibrous capsule, temporomandibular, sphenomandibular, and stylomandibular ligaments. The latter two are accessory ligaments.
| 2 |
Sphenomandibular
|
Stylomandibular
|
Pterygomandibular
|
All of the above
|
Anatomy
| null |
07efdae6-6a17-4319-a33e-4a0d5f7374c3
|
multi
|
The commonest true benign tumour of the bone is
|
OSTEOID OSTEOMA It is the commonest true benign tumour of the bone. Pathologically, it consists of a nidus of tangled arrays of paially mineralised osteoid trabeculae surrounded by dense sclerotic bone. Clinical presentation: The tumour is seen commonly between the ages of 5-25 years. The bones of the lower extremity are more commonly affected; tibia being the commonest. The tumour is generally located in the diaphysis of long bones. The presenting complaint is a nagging pain, worst at night, and is relieved by salicylates. There are minimal or no clinical signs, except for mild tenderness at the site of the lesion, and a palpable swelling if it is a superficial lesion. Diagnosis: It is generally confirmed on X-ray. The tumour is visible as a zone of sclerosis surrounding a radiolucent nidus, usually less than 1 cm in size. In some cases, the nidus may not be seen on a plain X-ray because of extensive surrounding sclerosis, and may be detected on a CT scan. Treatment: Complete excision of the nidus along with the sclerotic bone is done. Prognosis is good. It is not a pre-malignant condition. Reference: Maheshwari; Essential Ohopaedics 9th ed; Page no:235
| 2 |
Osteoma
|
Osteoid osteoma
|
Osteoblastoma
|
Osteochondroma
|
Orthopaedics
|
Tumors
|
e233d65b-4427-49be-93c2-8015ab8a0e87
|
multi
|
As deglutition involved voluntary and involuntary stages, so among the following, which structure limits the size of bolus swallowed:
| null | 2 |
Soft palate
|
Posterior pharyngeal pillars
|
Upper esophageal sphincter
|
Larynx
|
Physiology
| null |
81a5d44e-8bde-4784-9af4-a83ffefc6def
|
multi
|
Type of inheritance in Tuberous sclerosis -
|
Ans. is 'a' i.e., Autosomal dominant
| 1 |
Autosomal dominant
|
Autosomal recessive
|
X-linked dominant
|
X-linked recessive
|
Pathology
|
Central Nervous System
|
d6ed5699-a8c0-40a1-b5d7-f53cb379b408
|
single
|
In normal adult wave V of ABR is generated from
|
Wave I - Distal pa of CN VIII Wave II - Proximal pa of CN VIII near the brainstem Wave III - Cochlear nucleus Wave IV - Superior olivary complex Wave V - Lateral lemniscus Waves VI and VII - Inferior colliculus Note: Auditory brainstem response (ABR): Also called BAER or BAEP (brainstem auditory evoked response or potential) or BERA (brainstem evoked response audiometry) is to elicit brainstem responses to auditory stimulation by clicks or tone bursts. Ref: Dhingra; 6th Edition; pg no 27
| 3 |
Cochlear nucleus
|
Superior olivary complex
|
Lateral leminiscus
|
Inferior colliculus
|
ENT
|
Ear
|
1c41ffba-2830-4590-956b-c4a714a4b50c
|
single
|
Umblicated nodules are produced by?
|
Ans. is 'a' i.e., Poxvirus Nodules with central umblication is produced in molluscum contagiosum, caused by a Poxvirus.
| 1 |
Poxvirus
|
Enterovirus
|
Rhinovirus
|
Myxovirus
|
Microbiology
| null |
19053972-322c-4bd7-a0bb-a930cfe7fce7
|
single
|
All of the following are essential amino acids include all, EXCEPT:
|
The essential amino acids are leucine, isoleucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine, and histidine. Protein is required for growth and for maintenance of body structure and function. The true requirement is for nine essential amino acids plus additional nitrogen for protein synthesis. Adequate protein must be consumed each day to replace essential amino acids lost through protein turnover. Allowing for differences in protein quality and utilization and for individual variability, the RDA (USA) for protein is 56 g/d for men and 45 g/d for women. Ref: Baron R.B. (2013). Chapter 29. Nutritional Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds), CURRENT Medical Diagnosis & Treatment 2013.
| 4 |
Valine
|
Methionine
|
Lysine
|
Alanine
|
Biochemistry
| null |
6315e2a2-94a5-4226-832f-bfa3b89b17fc
|
multi
|
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) causes
|
The syndrome of inappropriate antidiuresis (SIAD) is the most frequent cause of euvolemic hyponatremia. Glucocoicoid deficiency, Hypothyroidism, Stress, Drugs are other causes of euvolemic hyponatremia. Common causes of SIAD include pulmonary disease (e.g., pneumonia, tuberculosis, pleural effusion) and central nervous system (CNS) diseases (e.g., tumour, subarachnoid haemorrhage, meningitis). SIAD also occurs with malignancies, most commonly with small-cell lung carcinoma (75% of malignancy-associated SIAD) SIAD is also a frequent complication of ceain drugs, most commonly the selective serotonin reuptake inhibitors (SSRIs). Ref: Harrison 19e pg: 300
| 1 |
Euvolemic hyponatremia
|
Hypovolemic hyponatremia
|
Hypervolemic hyponatremia
|
Hypernatremia
|
Medicine
|
Fluid and electrolytes
|
ff16f2de-f713-4018-845b-5c94e78089a2
|
single
|
All of the following are true about case control study except -
|
Ans. is 'd' i.e., Less prone to bias Case control studyo Case control study is a common first approach to test causal hypothesis.o Caseo Control--Case is an individual who has developed the disease.Is an individual who has not developed the disease but is otherwise comparable to case (e.2. age, sex, occupation, social status etc).o The case - control study has three distinct features - Both exposure (risk factor) and outcome (disease) have occurred before the start of study - so, there is no further risk for subjects. Study proceeds backn'ards from effect to cause - retrospective study.It uses a control or comparison group to support or refute an inference.o The focus is on a disease that has already developed.o Association between risk factor and disease can be tested - risk factor can be identified,o For example, if it is our intention to test the hypothesis that cigarette smoking causes lung cancer, the investigation begins by assembling a group of lung cancer cases (a + b) and a group of suitable matched control (not having lung cancer). Then past history for the presence or absence of smoking is explored in both groups.Suspected risk factorCases(disease present)Control(disease absent)PresentAbsentacbda + cb + do If the frequency of smoking, a / (a + c) is higher in cases than in control b / (b + d), an association is said to exist between smoking and lung cancer,o Case - control study is rapid and inexpensive,o Problem of bias is common.
| 4 |
Rapid and inexpensive
|
No risk to subjects
|
Risk factor can be identified
|
Less prone to bias
|
Social & Preventive Medicine
|
Analytical Epidemiology
|
fd52cc53-873e-4f95-8b58-149fe1da8a3d
|
multi
|
True statements about congenital megacolon include all of the following except:
|
S. Das writes - "The symptoms appear within 3 days of birth and the presenting features are as follows:
Constipation
Abdominal distention"
Nelson writes - "The clinical symptoms of Hirschprung disease usually begin at birth with the delayed passage of meconium."
Loud borborygmi are heard due to intestinal obstruction.
About stool, Nelson writes -
"The stools when passed may consist of small pellets, maybe ribbon-like or may have fluid consistency; the large stools and faecal soiling of patients with functional constipation are absent."
Also, know
a large faecal mass may be palpable in the left lower abdomen, but on rectal examination, the rectum is usually empty of faeces (faeces in rectum are found in functional constipation).
| 4 |
Dilatation & hyper trophy of pelvic colon
|
Loud borborygmi
|
Symptoms appear with in 3 days following birth
|
Large stool
|
Surgery
| null |
b5478ba5-7e3b-4397-bc0c-82e3411c164e
|
multi
|
Which of the following remnant of wolffian duct is present on medial part of broad ligament
|
All remnants of wolffian duct are present in lateral part of broad ligament except paroophoron.
| 3 |
Epoophoran
|
Kobelt tubercle
|
Paroophoran
|
Gartner's duct
|
Gynaecology & Obstetrics
| null |
9bf2e6d8-5a0f-4629-bce4-643a95dc2548
|
single
|
WHO stage IV HIV includes all, except -
|
<p> Oral thrush is not included in the clinical stage 4 for HIV. Reference:Park's textbook of preventive and social medicine,K.Park,23rd edition,page no:349.<\p>
| 4 |
Toxoplamosis
|
Pneumocystis carinii
|
HIV wasting syndrome
|
Oral thrush
|
Social & Preventive Medicine
|
Communicable diseases
|
24f12653-f46f-445f-9c3c-bfc5835a529b
|
multi
|
A 55-yrs-old woman complains of stiff, aching hands, especially in the morning. Radiographs of the hands reveal expansion at the base of the terminal phalanges & tapering of the proximal phalanges. This patient most likely has:
|
There are three main varieties of psoriatic arthritis (an inflammatory arthritis affecting 5 to 42% of patients with psoriasis): asymmetric inflammatory arthritis, symmetric arthritis , and psoriatic spondylitis. The pathology is similar to that seen in RA (early neutrophil and later monocytic synovial infiltration). There are no characteristic laboratory abnormalities in patients with psoriatic arthritis, but radiographs, if they reveal features unique to this disease relative to RA, may be diagnostically helpful. Such special features include the pencil-in-cup appearance of the distal terminal phalanx due to cuplike erosions. and bony proliferation with tapering of the proximal phalanx; proliferation of the bone near osseous erosions, terminal phalyngeal osteolyis, bone proliferation and periostitis, and telescoping of one bone into another (opera-glass deformity). Inflammation of the tendons and ligaments (ethesopathy) is also characteristic. Nonsteroidal anti-inflammatory agents are the therapeutic mainstays; sulfasalazine or methotrexate is often required in difficult cases.
| 3 |
SLE
|
Rheumatoid arthritis
|
Psoriatic arthritis
|
Gouty arthritis
|
Unknown
| null |
5f338d3a-66a1-4487-b2e0-12315c8e14b1
|
multi
|
Amide group containing amino acid is:
|
Amide (-CONH) group is present in:- Asparagine Glutamine Asparagine is the amide of Aspaate Glutamine is the amide of Glutamate
| 2 |
Asparate
|
Glutamine
|
Glutamate
|
Glutamic acid
|
Biochemistry
|
Classification and metabolism of amino acids
|
0b74cd43-53e5-4458-abf3-67da20c1ec34
|
single
|
All are true regarding superior laryngeal nerve block, except:
|
Superior laryngeal nerve supplies sensory supply to the mucosa of larynx upto the level but not including the vocal cords. Sensory supply of vocal cords and larynx below vocal cords is by recurrent laryngeal nerve. Thus in superior laryngeal nerve block, sensory supply below the level of vocal cords will be maintained.
| 2 |
Needle pierces through thyrohyoid membrane
|
Sensory loss below level of vocal cords occurs
|
Internal laryngeal nerve is anesthetized
|
Thyroid notch is used as a landmark
|
Surgery
| null |
3baf86ce-6bdc-43e2-828a-546943241a45
|
multi
|
About ureter true is
|
Abdominal ureter. The ureter is roughly 25-30 cm long in adults and courses down the retroperitoneum in an S curve. At the proximal end of the ureter is the renal pelvis; at the distal end is the bladder. The ureter begins at the level of the renal aery and vein posterior to these structures . Ref - BDC 6e vol2 pg 318
| 2 |
5 cm long
|
25 cm long
|
35 cm long
|
Totally retroperitoneal
|
Anatomy
|
Abdomen and pelvis
|
e0be218a-000a-422e-a954-cf26db367e68
|
multi
|
A patient is taking ketoconazole for fungal infection develops cold for which he is prescribed terfenadine. Possible interaction between terfenadine and ketoconazole is
|
(A) Ketoconazole decreases metabolism of terfenadine# Large amounts of Terfenadine reach systemic circulation if erythromycin, ketoconazole, clarithromycin are concurrently administered, as these drugs are P450 enzyme inhibitors.> Azithromycin, fluconazole have no effect & found to be safe.
| 1 |
Ketoconazole decreases metabolism of terfenadine
|
Terfenadine increases levels of ketoconazole
|
Ketoconazole decreases levels of terfenadine
|
No interaction
|
Pharmacology
|
Miscellaneous (Pharmacology)
|
c57c2506-0c5d-4950-bbda-494d03eef2b9
|
single
|
Where is the Cave of Retzius present?
|
Space of Retzius
- Horseshoe shaped space
- Between the anterolateral pelvic wall and the sides of bladder and prostate.
| 3 |
Between urinary bladder and rectum
|
Between urinary bladder and cervix
|
In front of the bladder
|
Between the cervix and the rectum
|
Anatomy
| null |
f35fd423-9e89-4e83-a5b2-a3d45ea45ef6
|
single
|
Prolonged treatment with INH leads to deficiency of:
|
Ans. (A) Pyridoxine(Ref: Katzung 11th/e p825, KDT 8th/e p818)Isoniazid can cause peripheral neuropathy due to deficiency of pyridoxine.
| 1 |
Pyridoxine
|
Thiamine
|
Pantothenic acid
|
Niacin
|
Pharmacology
|
Chemotherapy: General Principles
|
6cb2d3f2-8e2c-4def-a726-30634ab1ad31
|
single
|
Klebsiella pneumonia is
|
Klebsiella pneumonia :
Air bronchogram sign positive.
Involves upper lobe.
Cavitations and pleural effusion is common.
| 3 |
Lobar pneumonia with absent air bronchogram sign
|
Involves lower lobe predominantly
|
Cavitation is common
|
Pleural effusion is not commonly seen
|
Medicine
| null |
d4658cbc-2293-4fe2-9f1d-861feda3ae1f
|
single
|
For calculation of incidence denominator is taken as -
|
ref: Park&;s 23rd edition pg 60 INCIDENCE= No. of new cases of specific disease during a given time period / population at risk during that period x 1000
| 2 |
Mid year population
|
Population at risk
|
Total number of cases
|
Total number of deaths
|
Social & Preventive Medicine
|
Epidemiology
|
f04b2771-384e-4f7b-86be-d673d1e1cf08
|
single
|
Which is NOT an oncogenic virus-
|
Ans. is 'None'
| 4 |
HTLV- 1
|
Herpes simplex
|
Papilloma virus
|
None
|
Microbiology
| null |
cb8097f1-0612-4ca8-9917-722104cbda1f
|
multi
|
Most impoant in establishing diagnosis of leprosy is: March 2010
|
Ans. C: Slit smear for AFB Tissue smear testing/slit-skin smears. An incision is made in the skin, and the scalpel blade is used to obtain fluid from a lesion. The fluid is placed on a glass slide and stained by using the Ziehl-Neelsen acid-fast method or the Fite method to look for organisms. The bacterial index (BI) is then determined as the number of organisms at 100X with oil immersion. Skin smears have high specificity but low sensitivity because 70% of all patients with leprosy have negative smear results. However, this test is useful because it detects the most infectious patients. Presence of AFB in suggestive skin lesions, even in the absence of sensory deficit, confirms the diagnosis of leprosy. Lepromin test is not of diagnostic impoance but is of prognostic impoance.
| 3 |
Evidence of neural involvement
|
Hypopigmented patches
|
Slit smear for AFB
|
Positive lepromin test
|
Skin
| null |
7994ea6c-aa3b-4d46-8d5c-021ca843fe94
|
single
|
The laser procedure, most often used for treating iris neovascularization is:
|
C i.e. Panretinal photocoagulation (PRP)
| 3 |
Goniophotocoagulation
|
Laser trabeculoplasty
|
Panretinal photocoagulation (PRP)
|
Laser iridoplasty
|
Ophthalmology
| null |
387767cf-6641-4758-961c-e78eacf4d166
|
single
|
Anterior compament of leg contains all except
|
ANTERIOR COMPAMENT:- Muscles:-1. Tibialis anterior 2. Extensor hallucis longus3. Extensor digitorum longus 4. Peroneus teius. Aery: anterior tibial aery. The blood supply of anterior compament is reinforced by the perforating branch of peroneal aery. Nerve:-Deep peroneal nerve. {Reference: BDC 6E vol2 pg 93}
| 1 |
Peroneus brevis
|
Tibialis anterior
|
External hallucis longus
|
External digitorum longus
|
Anatomy
|
Lower limb
|
487a9f93-70c6-4f51-8864-4b6b1a681e3e
|
multi
|
All of the following methods are antilarval measures except -
|
Antilarval measures of mosquito control are environmental control- source reduction and minor engineering measures like filling, levelling, intermittent irrigation. chemical control- mineral oils, Paris green, synthetic insecticides (Fenthion, Chlorpyrifos, and Abate). biological control -larvivorous fishes like Gambusia and Lebister are grown in burrow pits, ponds. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 833
| 4 |
Intermittent irrigation
|
Paris green
|
Gambusia affinis
|
Malathion
|
Social & Preventive Medicine
|
Environment and health
|
0d2e01e2-13cb-4dcf-b101-c16fd0664e70
|
multi
|
in case of unstable lie of fetus, the placenta is usually:
|
Unstable lie This is a condition where the presentation of the fetus is constantly changed beyond 36th week of pregnancy when it should have been stabiliseed The causes are those which prevent the presenting pa to remain fixed in the lower pole of the uterus that is grand multipara,hhydramnios,contracted pelvis,placenta prae,pelvic tumor At admission the investigation is directed to exclude placenta prae,contracted pelvis,or congenital malformation of the fetus with the help of sonography for the localisation of placenta D.C.DUTTA&;S TEXTBOOK OF OBSTETRICS,Pg no:397,7th edition
| 4 |
Cornual
|
Lateral wall
|
Fundus
|
Lower segment
|
Gynaecology & Obstetrics
|
Abnormal labor
|
c396fc9b-70af-4e21-a0b6-f9051923befe
|
multi
|
Capsicum seed can be confused with ?
|
Ans. is 'b' i.e., Dhatura
| 2 |
Strychnine
|
Dhatura
|
Risinus
|
Opiun
|
Forensic Medicine
| null |
6a9d6141-070f-4d55-8017-a18870ca1e0d
|
single
|
The ocular basement membrane is stained with
|
Not only ocular almost all basement membranes are stained with PAS (Periodic acid-Schiff) Because they have mucopolysaccharides.Periodic acid-Schiff reactive (PAS) method is principally used to demonstrate structures rich in polysaccharides (glycogen), mucopolysaccharides (e.g., ground substance of connective tissues, basement membrane, and mucus), glycoproteins (thyroglobulin), and glycolipids.
| 4 |
Alcaine blue
|
Giemsa stain
|
Methylene blue
|
Periodic acid-Schiff
|
Pathology
|
General pathology
|
9ea76fc8-ac95-4e35-bd7e-c1a5fca25edb
|
single
|
Kyasanur Forest Disease (KFD) is transmitted by
|
KFD is a tick-borne viral hemorrhagic fever endemic to South AsiaThe disease is caused by a virus belonging to family Flaviviridae, which also includes yellow fever and dengue feverThe vector for KFD is Haemophysalis spinigera, a forest tickHumans contract infection from the bite of nymphs of the tickReservoir hosts are porcupines, rats, squirrels, mice and shrewsRef: Harrison's 18/e p1236, table 189-4
| 3 |
Fleas
|
Mosquitoes
|
Ticks
|
Mites
|
Medicine
|
All India exam
|
08d6cd19-c93f-407a-9d61-2fa8ff70d9f2
|
single
|
Hexosaminidase A deficiency causes:
|
Ans: b. Tay-Sachs disease [Refs Harper 30th/251; Lippincott 6th/212; Harrison 19th/432e,433eHexosaminidase A deficiency is an enzyme deficiency that causes brain and other nerve cells to die, which can lead to severe neurological and mental problems.Hexosaminidase A (HEX A) deficiency is caused by a deficiency in an enzyme called beta-hexosaminidase A. This enzyme helps break down a paicular fatty acid called GM2 ganglioside.Without adequate amounts of functional enzymes, GM2 ganglioside will build up in nerve cells and cause them to die.There are several forms of HEX A deficiency, including acute infantile (Tay-Sachs disease), juvenile, chronic, or adult-onset forms.
| 2 |
Niemann-pick
|
Tay-Sachs disease
|
Hurler syndrome
|
Gaucher's disease
|
Biochemistry
| null |
258cff73-e9ff-49fd-b590-f6d6c61b48bd
|
single
|
Monge's disease refers to:
|
Answer is B (High Altitude Erythrocytosis) lionge's disease (Chronic :Mountain Sickness) is also known as High Altitude Pathologic Erythrocytosis. Chronic Mountain Sickness; Monge's disease; (High Altitude Pathologic Erythrocytosis; High Altitude Excessive Polycythem a) * Excessive Erythrocytosis (Hb>19 /dL for females and 21/dL for males) Chronic Mountain Sickness is a clinical * Hypoxemia syndrome that occurs in natives or long? * Pulmonary hypeension (in some cases) life residents above 2500m. Headache, * Right hea failure or Cor-Pulmonale (in severe cases) dizziness and fatigue are typical initial * Recovery on descent to low altitude presenting symptoms
| 2 |
Primary Familial Polycythemia
|
High Altitude Erythrocytosis
|
Spurious Polycythemia
|
Polycythemia Vera
|
Medicine
| null |
112b0600-5175-4afe-bcee-f6f0fe8d99cd
|
single
|
All are true of police inquest, except:
|
Police inquest is held by a police officer (Investigation Officer--IO) not below the rank of senior head constable in all cases of unnatural deaths with the exceptions mentioned under Magistrate inquest. Police inquest (174 CrPC) : Most common type of inquest. Minimum cadre of police for conducting inquest is station officer( senior Head Constable) Panchanama - enquiry repo Can summon
| 4 |
Senior head constable can investigate
|
Most common inquest
|
Panchnama has to be signed by IO
|
IO cannot summon
|
Forensic Medicine
|
FMT Q Bank
|
f11e4916-a8f7-4d3c-865d-cf2d1d8cf673
|
multi
|
Following drugs act against HIV–2 Except :
| null | 3 |
Ritonavir
|
Tenofovir
|
Efavirenz
|
Zalcitabine
|
Pharmacology
| null |
9c1f703b-cdad-48ed-af7c-d2daab2a1fc7
|
multi
|
Vidian Neurectomy is indicated in
|
Vasomotor rhinitis: increased parasympathetic discharge Vidian neurectomy is done. Ref : SRB&;s 4thE
| 3 |
Glossophayngeal neuralgia
|
Trigeminal neuralgia
|
Vasomotor rhinits
|
Atrophic rhinits
|
Surgery
|
Trauma
|
a4668f83-200f-4fb8-aa4f-0b3b5e0aa7e3
|
single
|
Precocious puberty in girls is defined by the onset of secondary sexual characteristic before the age of
|
Precocious puberty :
Onset of secondary sexual characteristic before the age of 8 years in girls and 9 years in boys.
| 3 |
5 years
|
7 years
|
8 years
|
9 years
|
Pediatrics
| null |
8e3b5309-7b30-4083-816b-c20bc268fd57
|
single
|
Trismus in CA of temporal bone occurs due to involvement of-
|
Ans. is 'b' i.e., Temporo mandibular joint Clinical Assessment of Temporal bone Tumorso A long history of ear discharge suggests cancer associated with inflammatory ear disease (Maijolins ulcer)o Pulsatile tinnitus suggests tumor of vascular origin such as glomus tumor or a middle ear vascular anamoly; or a duralarteriovenous abnormality.o Deep headache raises the suspicion of dural involvement.o Facial weakness indicates invasion of the facial nerveo Onset of vertigo and sensineuronal hearing loss indicates involvement of the labyrinth and the development of speech and swallowing problems heralds involvement of the lower cranial nerves in the jugular foramen.o The onset of trismus due to the involvement of temporomandibular joint, pterygoid muscles or mandible suggests advanced disease that has spread anteriorly. Also the appearance of perauricular and parotid swelling is a grave sign.
| 2 |
Dura
|
Temporo mandibular joint
|
Mastoid
|
Eustachian tube
|
ENT
|
Oral Cavity
|
20c8c878-2096-49cb-ae7f-dc88dd9df786
|
single
|
Which is the wrong statement regarding hepatitis viruses?
|
Hepatitis A & E are non enveloped virus Hepatitis B is the only DNA virus Hepatitis B & D have a circular genome ref - davidsons medicine 23e pg872-875
| 1 |
Hepatitis A & E are enveloped viruses
|
Hepatitis D are circular RNA virus
|
Hepatitis C & E contains linear RNA virus
|
No vaccine is available for hepatitis C virus
|
Medicine
|
Nutrition
|
0c49c311-b16c-4e0a-a7b9-5706beb6295d
|
multi
|
The earliest morphological evidence of ovulation on endometrial biopsy is:
|
Endometrial biopsy was used in the past to find out whether the female has ovulated or not. Nowadays USG follicular monitoring is being done
Subnuclear basal vacuolation is characterized by glandular growth and presence of vacuoles due to secretion of glycogen between nuclei and basement membrane. It is due to the effect of progesterone.
Basal vacuolization is the earliest evidence of ovulation (36-48 hours after ovulation) and persists until the about 21st day of the cycle.
Pseudostratification of nuclei is characteristic of proliferation phase but persists until active progesterone secretion begins. Hence, it is noted until the 18th 19th day of the menstrual cycle.
| 2 |
Pseudostratification
|
Basal vacuolation
|
Decrease in glycogen content
|
Predecidual reaction
|
Gynaecology & Obstetrics
| null |
39c543dc-ce59-414b-9cd1-29bee8818dbc
|
single
|
What is the test being done & what sign is it used to demonstrate?
|
Auspitz sign is characterized by:- a) Micaceous silvery white scales b) Burkley membrane c) Pin point bleeding This is seen in psoriasis & demonstrated by grattage test. Auspitz sign is presence of pinpoint bleeding at the base of a plaque after scale is forcibly removed in patients with psoriasis. The successive removal of psoriatic scales usually reveals an underlying smooth, glossy, red membrane (membrane of Burkley) with small bleeding points where the thin suprapapillary epithelium is turn off. The red membrane is known as Burkley's membrane.
| 4 |
Scraping test, Auspitz sign
|
Grattage test, Koebner's phenomenon
|
Scrapping test, Koebner's phenomenon
|
Grattage test, Auspitz sign
|
Dental
|
Psoriasis
|
fd41c473-b47c-4045-bc53-a0212b779317
|
single
|
Transverse myelitis usually presents
|
Usual time of onset of symptoms of post-radiation transverse myelitis is 12-24 months but can occur as early as 6 months after radiation.
| 4 |
1 – 2 weeks
|
1 – 2 months
|
4 – 6 months
|
1 year
|
Radiology
| null |
84564aa0-85cf-41f5-92cb-26cfbdef6777
|
multi
|
Positive nitrogen balance is seen in-
|
Ans. is 'd' i.e., Recovery phase of protein deficiency Nitrogen Balance* Because nitrogen is excreted as proteins are recycled or used, we can use the nitrogen in body to evaluate whether the body is getting enough protein.* To estimate the balance of nitrogen, and therefore the protein in body, nitrogen intake is compared to the sum of all sources of nitrogen output.* Nitrogen Balance = Grams of Nitrogen intake - Grams of nitrogen output* If nitrogen intake equals nitrogen output the nitrogen balance is zero and the body is in nitrogen equilibrium.* If nitrogen intake exceeds nitrogen output the body is said to be in positive nitrogen balance. Positive nitrogen balance means that the body is adding protein; growing children, pregnant women, or people recovering from protein deficiency or illness should be in positive nitrogen balance.* If nitrogen output exceeds nitrogen intake the body is in negative nitrogen balance. This means that the body is losing proteins. People who are starving or who are in extreme weight loss diets, or who suffer from fever, severe illness, or infections are in a state of negative nitrogen balance.
| 4 |
Starvation
|
Extreme weight loss
|
During fever
|
Recovery phase of protein deficiency
|
Medicine
|
Nutrition
|
b8e3b2be-89ac-478d-a394-4e528b8def94
|
single
|
True regarding electrophoresis are all except
|
Electrophoresis depends on size as well as on shape
Electrophoresis is the process that uses an electric field to drive the movement of charged particles. Electrophoresis depends on the net charge of the particle, molecular weight, pH of the medium, the strength of the electric field and temperature.
About other options
Ampholyte is used in isoelectric focusing to create a pH gradient across the supporting media. Molecules stop migrating as soon as they reach their respective isoelectric point (pI).
Electrophoresis can adversely affect the structure and function of proteins.
Electrophoresis is the most common method for protein separation.
"Electrophoresis is the most common method of protein separation in the clinical laboratory".
"PAGE and SDS-PAGE are extensively used for characterization and purification of tissue proteins, enzyme, receptors, and surface antigens".
Electrophoresis uses an electric field
| 3 |
Isoelectric focusing use ampholytes & pI
|
Adversely affect structure & function
|
Depends on size not on shape
|
Commonest method of purifying protein
|
Biochemistry
| null |
ba165b83-fcc9-4933-b981-f8a6f29b874e
|
multi
|
Asthenospermia means:
|
Ans: A (Immotile sperms) Ref: Harrison's 18th edn.Explanation:Azoospermia - Absence of sperm in the ejaculate.Aspermia - Zero volume ejaculate.Oligospermia - Low numbers of sperm.Asthenospermia - Poor sperm motility.Teratospermia - Abnormal morphology (shape) of sperm.
| 1 |
Immotile sperms
|
Absent sperms
|
Dead sperms
|
Dysmorphic sperms
|
Medicine
|
Gynae & OBS
|
8ca2891a-ba0f-434a-b9f6-071529cb6885
|
single
|
Which of the following increases BMR?
|
Factors that influence basal metabolic rate are: Body size: Metabolic rate increases as weight, height, and surface area increase. Body composition: Fat tissue has a lower metabolic activity than muscle tissue. As lean muscle mass increases, metabolic rate increases. Gender: The basal metabolic rate (BMR) averages 5 to 10 percent lower in women than in men. This is largely because women generally possess more body fat and less muscle mass than men of similar size. Age: A decrease in lean muscle mass during adulthood results in a slow, steady decline of roughly 0 3 percent per year in BMR after the age of about 30. This can be largely avoided by strength training throughout adulthood. Climate and body temperature: The BMR of people in tropical climates is generally 5 to 20 percent higher than their counterpas living in more temperate areas because it takes energy to keep the body cool. Exercise performed in hot weather also imposes an additional metabolic load. Body fat content and effectiveness of clothing determine the magnitude of increase in energy metabolism in cold environments; it takes energy to keep the body warm if you work or exercise in very cold weather. Hormonal levels: Thyroxine (T4), the key hormone released by the thyroid glands has a significant effect upon metabolic rate. Hypothyroidism is relatively common, especially in women near or after menopause. Everyone with a weight problem should have their thyroid function checked by their doctor and treated appropriately if it turns out to be low. Health: Fever, illness, or injury may increase resting metabolic rate two-fold Ref: guyton and hall textbook of medical physiology 12 edition page number:564,565,566
| 3 |
Starvation
|
Obesity
|
Ingestion of food
|
Sleep
|
Physiology
|
Endocrinology
|
4f896369-a8ab-4770-8bd8-62a456719d4b
|
single
|
Which of the following is relatively difficult tooth
to extract
| null | 1 |
Maxillary canine
|
Maxillary central incisor
|
Mandibular premolar
|
Mandibular canine
|
Surgery
| null |
bc24d9f3-f9ce-4b86-aaad-7295d62c7082
|
single
|
Gold standard investigation for screening of breast carcinoma in patients with breast implant
|
MRI Indicated in scarred breast, implants and borderline lesions for breast conservation Investigation of choice for implant related complications Gold standard for imaging breast in females with implants Ref: Sabiston 20th edition pgno: 826-828
| 1 |
MRI
|
USG
|
Mammography
|
CT- Scan
|
Anatomy
|
Endocrinology and breast
|
a17e0a12-f553-4be2-bd2e-6873b37e98b8
|
single
|
Which of the following drug can produce Dramatic improvement in patients with type 2 Lepra reaction
|
Refer KDT 6/e Pg 756 Steroids are drug of choice for both type 1 as well as type 2 Lepra reaction Thalidomide us used in steroid resistant type 2 Lepra reaction
| 1 |
Thalidomide
|
Steroids
|
Dapsone
|
Clofazimine
|
Pharmacology
|
Chemotherapy
|
06c90691-ce04-42e4-a7da-ac5d629a6f4c
|
single
|
Which of the following colonic polyps has no risk far malignancy
|
.Juvenile Polyps * Commonest polyp of colorectum in infants and children. * Can cause intussusception, prolapse through rectum, bleeding.* Colonoscopic polypectomy is done. * Not a pre-malignant condition. PEUTZ-JEGHER'S POLYP is common in small intestine (jejunum) * Features are multiple, familial, hamaomatous intestinal polyps. * Asssociated with melaenosis of the oral mucosa, lips (lower lip) and occasionally digits (not in tongue). * Microscopically it contains tree like branching filaments of mucosa with smooth muscle wall. * It can occasionally turn into malignancy FAMILIAL ADENOMATOUS POLYP (FAP) * It is inherited as an autosomal dominant neoplastic condition (chromosome no. 5 * It is familial with a high potential for malignant transformation. ref:SRB&;s manual of surgery,ed 3,pg no 834
| 1 |
Juvenile polyps
|
Hamaomatous polyps associated with Peutzjegher's syndrome
|
Juvenile polyposis syndrome
|
Familial adenomatous polyposis syndrome
|
Surgery
|
G.I.T
|
d91e11aa-1b50-4a33-9bb5-73fe4271e190
|
single
|
Aldosterone is known to cause sodium retention. Its Na+ retaining action is exeed on which pa of the nephron?
|
* Aldosterone is the principal mineralocoicoid. It stimulates the reabsorption of Na+ and excretion of K+ and H+ by its action on late distal tubules and collecting ducts.
| 3 |
Proximal convoluted tubule
|
Ascending limb of loop of Henle
|
Collecting ducts
|
Early distal convoluted tubule
|
Pharmacology
|
Adrenal
|
401d7a95-fd66-44c9-a63d-807d9874751d
|
single
|
A woman of 45, a known cause of pemphigus vulgaris on a regular treatment with controlled primary disease presented with pain in the right hip and knee. Examination revealed no limb length discrepancy but the patient has tenderness in the scarpa's triangle and limitation of abduction and internal rotation of the right hip joints as compared to the other side. The most probable diagnosis is -
|
This patient has
Pemphigus vulgaris taking treatment (steroid is the DOC).
Pain in hip and knee (Pain of hip can refer to hip).
Limitation of abduction & internal rotation.
Diagnosis is AVN of hip.
| 2 |
Stress fracture of neck of femur
|
Avascular necrosis of femoral head
|
Perthe's disease
|
Transient synovitis of hip
|
Orthopaedics
| null |
aaad5cfd-46f8-4e33-b589-7c70c8f78958
|
single
|
Monro-Kellie doctrine is related to injury of
|
An increase in volume of any one of rhe three components brain,blood, CSF must be at the expense of other two Brain is least compressible among the three Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:813,814,815
| 1 |
Head
|
Abdomen
|
Chest
|
Leg
|
Physiology
|
General physiology
|
e7a856a0-e8a2-4dc1-8ca6-9343d491b034
|
single
|
Kveim Slitzbach test is useful in the diagnosis of
| null | 2 |
Tuberculosis
|
Sarcoidosis
|
Leprosy
|
Cat scratch disease
|
Pathology
| null |
c061ee25-c8e1-44d0-ad47-51cfef2f6e39
|
single
|
Diversion of urinary bladder is best done at :
|
Ileal segment is the best for urinary diversion after cystectomy. Still better method is "Continent cutaneous diversion" method. But the best method is "Orthotopic neobladders".
"Incontinent cutaneous urinary diversion" by ileal conduit: a segment of ileum is exteriorized in the form of a stoma through the abdominal wall, around which an appliance is secured and into which urine continuously drains.
"Continent cutaneous diversions" — All continent cutaneous reservoirs rely upon a low-pressure pouch constructed of various detubularized bowel segments and a functional mechanism that connects the reservoir to the skin, designed to prevent involuntary urine flow. The most obvious advantages of this type of diversion are the ability to avoid continuous urine drainage and the need for an external appliance.
These continent cutaneous diversions require intermittent clean self-catheterization through the stoma both to empty the reservoir and to irrigate mucous. No stomal appliance is usually required.
Although continent cutaneous diversions have been largely supplanted by the orthotopic neobladder, this procedure is used when the urethra or bladder neck is non-functional or involved by tumor, and avoidance of an external appliance is desired.
"Orthotropic neobladders"— Orthotropic neobladders are internal reservoirs that are connected to the native urethra and rely upon the external striated sphincter for continence. These reservoirs are constructed from a segment of detubularized intestine (usually ileum) anastomosed to the native urinary outflow tract.
Because this approach facilitates the restoration of normal self-image by approximating normal voiding, construction of an orthotropic neobladder has become the procedure of choice for most patients following cystectomy for bladder cancer in both men and women.
It is contraindicated if the urethra is nonfunctional or involved with tumor.
| 2 |
Jejunum
|
Ileum
|
Cecum
|
Colon
|
Surgery
| null |
72d90c63-5e0d-4735-a452-d6be4b5efce1
|
single
|
An 18-year-old woman presents with abdominal pain localized to the right lower quadrant, nausea and vomiting, mild fever, and an elevation of the peripheral leukocyte count to 17,000/uL. Examination of the surgically resected appendix is most likely to reveal
|
Acute appendicitis, a disease found predominantly in adolescents and young adults, is characterized histologically by acute inflammatory cells (neutrophils) within the mucosa and muscular wall. Clinically, acute appendicitis causes right lower quadrant pain, nausea, vomiting, a mild fever, and a leukocytosis in the peripheral blood. These symptoms may not occur in the very young or the elderly. The inflamed appendiceal wall may become gangrenous and perforate in 24 to 48 h. Even with classic symptoms, the appendix may be histologically unremarkable in up to 20% of the cases. False-positive diagnoses are to be preferred to the possible severe or fatal complications of a false-negative diagnosis of acute appendicitis that results in rupture. Lymphoid hyperplasia with multinucleated giant cells (Wahin-Finkeldey giant cells) is characteristic of measles (rubeola). These changes can be found in the appendix, but this is quite rare. Dilation of the lumen of the appendix, called a mucocele, may be caused by mucosal hyperplasia, a benign cystadenoma, or a malignant mucinous cystadenocarcinoma. If the latter tumor ruptures, it may seed the entire peritoneal cavity, causing the condition called pseudomyxoma peritonei. The most common tumor of the appendix is the carcinoid tumor. Grossly it is yellow in color and is typically located at the tip of the appendix. Histologically, carcinoids are composed of nests or islands of monotonous cells. Appendiceal carcinoids rarely metastasize Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition
| 2 |
An appendix with a normal appearance
|
Neutrophils within the muscular wall
|
Lymphoid hyperplasia and multinucleated giant cells within the muscular wall
|
A dilated lumen filled with mucus
|
Pathology
|
miscellaneous
|
b3f58f90-3133-4568-9211-34a42a741789
|
multi
|
A 40 year old woman is being evaluated. She is noted to have a decreased latency of REM. Which disorder is this woman most likely to be suffering from?
|
Ans. B. Major depressionA decreased latency of REM sleep is seen in major depression. Depression is the psychiatric disorder that has been most associated with disruptions in biological rhythms. Besides the decreased latency of REM sleep, one can find early morning awakening and other neuroendocrine perturbations.
| 2 |
Schizophrenia
|
Major depression
|
PTSD
|
Obsessive-compulsive disorder
|
Psychiatry
|
Mood Disorders
|
20b599b2-2dc7-4675-98f2-92174ed2aaa2
|
single
|
Hypersensitivity is seen with following medicament?
| null | 1 |
CHX
|
Povidone iodine
|
Oxygenated water
|
Peroxide (H2O2)
|
Dental
| null |
e22dea82-9f84-4355-bcc1-e44a1749c4ef
|
single
|
Reactivation tuberculosis and primary squamous cell carcinoma of the lung are similar in that they both are commonly associated with:
|
Both reactivation tuberculosis (TB) and primary squamous-cell carcinoma of the lung are associated with cavitation. Other pulmonary diseases associated with cavitation include systemic fungal infections, Klebsiella pneumonias, and silicosis. In silicosis, the large fibrotic nodules undergo central necrosis from ischemia. Furthermore, silicosis predisposes patients to the development of TB within the fibrotic nodules, thus producing cavitation.
Ectopic secretion of a parathormone-like peptide producing hypercalcemia is seen only in squamous cell carcinoma. Scar carcinomas are a possible sequela of old scar tissue in TB. Adenocarcinomas are more frequently associated with scar carcinomas than squamous carcinoma. The most common extrapulmonary site for TB is the kidneys, and the adrenal gland is the most common site for metastatic squamous cancer. Silicosis predisposes patients to TB, but not to primary lung cancer.
| 1 |
Cavitation
|
Scar carcinomas
|
Silicosis
|
Ectopic secretion of a parathormone-like peptide
|
Unknown
| null |
cb6fb480-a4a6-4627-b338-8d763f427505
|
multi
|
Giant hypertrophy of gastric mucosa similar to brain surface is seen in -
|
Menetrier disease
It is characterized by giant cerebriform (similar to brain surface) enlargement of rugal folds of gastric mucosa.
Enlargement of rugal folds is due to profound hyperplasia of surface mucous cells → gastric secretion & contain excessive mucus.
There is accompanying glandular atrophy → gastric disease is more common in males in the fourth to sixth decades.
The hypertrophic change may predominanty involve the body, fundus or antrum or may affect the entire stomach.
Patients develop protein-losing gastropathy accompanied hypoalbuminemia and edema.
Infrequently, the mucosal hyperplasia becomes metaplastic, providing a soil for the development of gastric carcinoma.
| 3 |
Peptic ulceration
|
Carcinoma stomach
|
Menetrier's disease
|
Liomyosarcoma
|
Pathology
| null |
2ba0b7dd-9892-4316-a7dc-5b7cb8a3f8c9
|
single
|
In PCOD which of the following drug is not used for infertility
|
Clomiphene citrate:
Used for induction of ovulation; can be 50 mg/day increased to 150mg/day; Starting from day 2 to day 6 of the cycle for 5 days
Tamoxifen 10 mg daily for 6 months has been effective in treating male infertility
Testosterone 25 -50 mg daily orally improves testicular functions
Spironolactone is an antiandrogen; used for treating Hirsutism
| 3 |
Clomiphene
|
Tamoxifen
|
Spironolactone
|
Testosterone
|
Gynaecology & Obstetrics
| null |
0bb6f41a-830b-4db7-82fa-54bf582d6d54
|
single
|
Major form of folic acid to transfer one carbon is -
|
Ans. is 'a' i.e.. Methylene THFFolic acido The active form of folic acid (pteroyl glutamate) is tetrahydrofolate (THF).o THF serves as a carrier of one-carbon (C1) unitQ during several biosynthetic reactions like nucleic acidQ and amino acid metabolism.o Two other cofactors are also known to be involved in the addition of one carbon (C1) unit to a metabolic precursor, biotin in carboxylation reaction and S-adenosylmethionine (SAM) as methylating agent.o However, folic acid is more versatile than either of these two because it can transfer the C1 units in several oxidation states.o THF acts as a carrier of one carbon unitQ.o The one carbon units can be : Methyl (CH3) methylene (CH2), methenyl (CH),formyl (CHO), or formimino (CH =NH)o One carbon unit binds to THF through A5 or N10 or both A5, N10position.o For example, if formyl unit is attached to N-5, it is called N5-formyl THF; if methylene unit is attached to both N5 and Nro, it is called N5, N10 methylene THF.o Carbon units attached to N5 are formyl, formimino, or methyl; attached to N10 is formyl; and attached to both N5-N10 are methylene or methenyl.o So, various possible THF are : - N5-Formyl THF, N5-formimino THF, N5-methyl THF, Nl0-formyl THF, N5-Nl0-methylene THF and N5-N10-methenyl THF.o THF receives the C, units from various donor molecules during catabolic reactions and can transfers them tospecific acceptors for the synthesis of various compounds.o The major point of entry for one-carbon unit into substituted folates is methylene THF, which is formed by the reaction of glycine, serine and choline. Serine is the most important source ofsubstitutedfolates for biosynthetic reactions, and activity' of serine hydroxymethyltransferase is regulated by the state offolate substitution and availability of folate
| 1 |
Methylene THF
|
Formyl THF
|
Methyl THF
|
All
|
Biochemistry
|
Vitamins
|
26f14f3e-6623-49c8-8525-7d285105dfd0
|
multi
|
Spinal epidural space contains
|
Epidural space This is the interval which seperates the periosteum in the veebral canal from the spinal duramater.The space is filled with loose areolar tissue,semiliquid fat,a network of veins,and the small aeries which supply the structures in the veebral canal. REF.CUNNINGHAM'S MANUAL OF PRACTICAL ANATOMY,Vol.3,PG.193
| 1 |
Areolar tissue and internal veebral venous plex uses
|
Only areolar tissue
|
Only cerebrospinal fluid
|
Veebral venous plexus and cerebrospinal fluid
|
Anatomy
|
Thorax
|
00e5f19a-b3e1-4d49-9468-d30ea7aba357
|
single
|
Brachytherapy is the internal radiation therapy procedure for treating tumors. All are used in brachytherapy, EXCEPT:
|
Clinically used isotopes in brachytherapy include iridium 192 (192 Ir), iodine 125 (125 I), cobalt 60 (60 Co), cesium 137 (137 Cs), gold 198 (198 Au), and palladium 103 (103 Pd). Iodine 131 is not used in brachytherapy. Ref: Nuclear Development Beneficial Uses and Production of Isotopes 2004 Update ... By OECD, Nuclear Energy Agency, 2005, Page 23; Brachytherapy: Applications and Techniques By Phillip M. Devlin, M.D., 2007, Page 52.
| 2 |
I 125
|
I 131
|
Cs 137
|
Iridium 192
|
Radiology
| null |
7e8c04d4-450b-4917-8d86-920ed217dd16
|
multi
|
Which one of the following is not a feature of liver histology in non-cirrhotic poal fibrosis (NCPF)?
|
Ans. is 'd' i.e., Bridging fibrosis
| 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 |
a09a5e23-152d-41c9-8a8d-f94509bf59ce
|
multi
|
Derelation & depersonalisation seen in which type of disorder ?
|
Ans. A. Dissociative disorder
| 1 |
Dissociative disorder
|
Personality disorders
|
Mania
|
None
|
Psychiatry
| null |
42632552-2564-447a-964b-803a592b6bb1
|
multi
|
Nerve involved in Arcade of Frohse ?
|
Ans. is 'c' i.e., PIN
| 3 |
Median
|
Ulnar
|
PIN
|
Radial
|
Surgery
| null |
03676389-e816-4895-bfc2-6408c588d1ed
|
single
|
The primary respiratory regulatory centre is located at
|
The respiratory centers are located in the medulla oblongata and pons, which are pas of the brainstem. The respiratory centers are divided into four major groups, two groups in the medulla and two in the pons. The two groups in the medulla are the dorsal respiratory group and the ventral respiratory group. The two groups in the pons are the pneumotaxic center also known as the pontine respiratory group, and the apneustic center. The Inspiratory center (Dorsal respiratory group) -Location: Dorsal poion of medulla -Nucleus: Nucleus tractus solitarius. Ref: guyton and hall textbook of medical physiology 12 edition page number:370,371,372
| 1 |
Dorsal medulla
|
Aponeurotic centre
|
Pneumotaxic center
|
Ventral medulla
|
Physiology
|
Nervous system
|
d1735984-db7a-4f1f-b196-357960ebd4ea
|
single
|
In cases of burn, which is the fluid of choice in first 24 hours?
|
Ans is 'a' i.e. Ringer lactate
| 1 |
Ringer Lactate
|
Normal saline
|
5% Dextrose
|
Blood
|
Surgery
| null |
2861342b-131c-4b4d-ab50-c69190c2bcc8
|
single
|
A surgeon was doing a laparoscopic hernia surgery and he visualised the triangle of doom. Which of the following is not the boundary of the same
|
The preperitoneal anatomy seen in laparoscopic hernia repair led to characterization of impoant anatomic areas of interest, known as the triangle of doom, the triangle of pain, and the circle of death. The triangle of doom is bordered medially by the vas deferens and laterally by the vessels of the spermatic cord. The contents of the space include the external iliac vessels, deep circumflex iliac vein, femoral nerve, and genital branch of the genitofemoral nerve Ref: Schwaz's principle of surgery 10th edition Pgno: 1499
| 4 |
Vas deferens
|
Gonadal vessels
|
Reflected peritoneum
|
Inguinal ligament
|
Anatomy
|
Urology
|
d3a8c27b-1380-478f-82c3-cb1c9acde99f
|
single
|
Which of the following are histopathological features of Extra hepatic Biliary Atresia -
|
(c) Marked Bile duct proliferation
| 3 |
Bile lakes
|
Hepatocyte ballooning degeneration
|
Marked bile duct proliferation
|
All
|
Surgery
| null |
c438c1e4-5cdc-49ce-8f29-dc1518639d3c
|
multi
|
Drug emerging as the agent of choice for initial treatment of tourette syndrome -
|
Ans. is 'd' i.e., ClonidineTounette syndromeo Mild and non disbling-Education and counselling without pharmacological tic suppression therapyo With bothersome Tics-Tetrabenzineo Only focal or vocal motor Tics-Botulinum toxin injection into the affected muscleso With ADHD-Guanafacine or clonidine
| 4 |
Haleperidol
|
Valproate
|
B complex
|
Clonidine
|
Medicine
|
Drugs (C.N.S.)
|
3c9d9f65-eecf-4d89-8883-fd1648e77026
|
single
|
What is NOT a feature of Sturge Weber syndrome :
|
Answer is D (Empty sella): The clinical hallmark in the form of convulsions, Rail road tract appearance on X-ray and unilateral coical atrophy (hemiatrophy) on CT scan are diagnosis of Sturge-Weber syndrome. Sturge weber syndrome It results from the anomalous development of primordial vascular bed during early stages of cerebral vascularization. The leptomeninges are richly vascularized and the brain beneath becomes atrophied and calcified, paicularly in molecular layer of coex
| 4 |
Rail track appearance
|
Herniatrophy of the brain
|
Convulsion
|
Empty sella
|
Medicine
| null |
53f1fa23-266f-4aaa-9177-e34e77f7bb6c
|
single
|
Dark field microscopy used in ?
|
Ans. is 'b' i.e., Syphilis Dark field microscopy is used for spirochetes (for example T pallidum which causes syphilis). Dark ground/ Dark field microscope Very slender organisms such as spirochetes and filamentous organs such as flagella are not visible under ordinary illumination. The contrast in dark field microscopy gives an illusion of increased resolution so that these structures can be seen under the dark field mcroscope. In dark field microscopy reflected light is used instead of the transmitted light used in the ordinary microscope.
| 2 |
Vibrio
|
Syphilis
|
TB
|
Brucellosis
|
Microbiology
| null |
a9a267a2-47b2-4ede-aa64-a703c8ffdff8
|
single
|
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