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Which of the following play most impoant role in memory:
Ans: a. Synaptic Net.Synaptic network s single best answer "Long-term memory involves changes in the structure of neurons including growth of new processes and synapses.So, to the extent that you remember anything about this material on memory tomorrow, or next week, or next year, it will be because structural changes in synapses are beginning in your brains.
1
Synaptic network
Electric conduction network
Conductivity circuit
Conductivity network
Physiology
null
1d24a24b-2e14-4f01-be23-23f87a9e8d74
single
Which of the following is false regarding transfusion associated anaphylactic reactions?
Ref: Aled scape/ Transfusion reactionsExplanation:Allergic transfusion reactions occur on a continuum of severity ranging from mild (urticarial) to moderate (anaphylactoid) to severe (anaphylactic). Anaphylactic transfusion reactions are severe allergic reactions characterized by profound hypotension and shock.Causes of anaphylaxis include:Recipient IgE or IgG antibodies to IgA in patients who have complete or partial (i.e., lack an isotopic or allotypic) IgA determinantRecipient IgE or IgG antibodies to polymorphic forms of other serum proteins (IgG. haptoglobin. C4, etc.) in transfused donor bloodRecipient sensitization to various compounds, including drugs in donor blood, chemicals used to produce or sterilize IV tubing and plastic bags, and foodstuffsCoincidental reaction to drugs or food taken prior to transfusionIg A deficiencyIn patients with IgA deficiency --Anti-IgA antibodies may develop after exposure to IgA in transfusions: anaphylactic reactions to IV immune globulin (IVIG) and other blood products that contain IgA may occur.Washed blood product can reduce the incidence of Anaphylaxis
2
Different from allergy
Seen in IgG deficient individuals
Washed blood products prevents it
Epinephrine is the drug of choice
Medicine
Transfusion
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Hepatitis E usually affects ?
Ans. is `b' i.e., Adults
2
Children
Adults
Old age
Toddlers
Microbiology
null
cebc80b5-6018-4478-951f-a4cfa2a8fe19
multi
Subdural empyema is most commonly caused by:
Answer is C (Streptococcus pneumoniae): Aerobic and Anaerobic streptococci are the most common aetiological agents for subdural ernphyema. influenzae is the most common causative organism in Children, and not in Adults. Subdural Empyema is a collection of pus in the space between he dura and arachnoid. In most cases a single organism is responsible, but many cultures are sterile because patients are often receiving antimicrobial therapy. The major pathogens include Aerobic and anaerobic Streptococci (about 50%) Staph (about 12-16%) Aerobic gram -ye bacilli (3-10%) Other anaerobes (5%)
3
H influenza
Staphylococcus aureus
Streptococcus pneumoniae
E. Coli
Medicine
null
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single
What is Cock's Peculiar tumour -
Ans. is 'a' i.e., Ulceration of sebaceous cyst on the scalp o Cocks peculiar tumour is actually a complication of sebaceous cyst -# When the sebaceous cyst of the scalp ulcerates excessive granulation tissue forms resembling fungating epithelioma. This is called cock's peculiar tumour.Also know these terms -o Cylindroma -# A malignant epithelial tumour also k/a Turban tumor# Known as cylindroma because of histological appearanceo Pilomatrixoma (Calcifying epithelioma of Malherbe)# It is a benign hair follicle derived tumouro Pott's puffy tumour# It is osteomyelitis of the skull associated with subperiosteal swelling and edema.
1
Ulceration of sebaceous cyst on the scalp
Calcifying epithelioma
Mesothelioma of pleura
Osteomylitis of skull
Surgery
Plastic & Reconstructive Surgery
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single
Which of the following is not found in commercially available tooth paste?
null
4
Humectants
sweetening agents
detergents
astringent
Dental
null
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multi
A bactericidal drug would be preferred over a bacteriostatic drug in a patient with
Bactericidal drugs kill the bacteria whereas bacteriostatic drugs only inhibits bacterial growth. Bacteriostatic activity is adequate for the treatment of most infections ,bactericidal activity nay be necessary for cure in patients with altered immune system like neutropenia ,HIV and other immunosuppressive conditions Refer KDT 6/e p686
1
Neutropenia
Cirrhosis
Pneumonia
Hea disease
Pharmacology
Chemotherapy
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single
Mechanism which is responsible for gentamicin ototoxicity is:
Ototoxicity involves progressive and irreversible damage to, and eventually destruction of, the sensory cells in the cochlea and vestibular organ of the ear.
2
Accumulation of drug metabolites.
Direct hair cell toxicity.
Inhibition of Na-K ATPase channels.
All of the above.
Pharmacology
null
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multi
Non-dominant hemisphere does all of the following function, except
(A) Parallel thinking # Hemispheres Versus "Cerebral Dominance":> Hemisphere is concerned with categorization and symbolization and has often been called the dominant hemisphere.> However, it is dear that the other hemisphere is not simply less developed or "non dominant"; instead, it is specialized in the area of spatiotemporal relations.> It is this hemisphere that is concerned, for example, with the identification of objects by their form and the recognition of musical themes. It also plays a primary role in the recognition of faces.> Consequently, the concept of "cerebral dominance" and a dominant and non-dominant hemisphere has been replaced by a concept of complementary specialization of the hemispheres, one for sequential-analytic process (Categorical hemisphere) and one for visuospatial relations (the representational hemisphere).> Categorical hemisphere is concerned with language functions, but hemispheric specialization is also present in monkeys, so it antedates the evolution of languages
1
Parallel thinking
Identification of objects by their form
Recognition of musical themes
Recognition of faces
Physiology
Nervous System
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What about durham pin is true ?
Ans. is 'd' i.e., All the above Denham pin It is a type of pin used to give skeletal traction. Threaded poion of the pin engages the bony coices and reduces the chances of pin sliding. This type of pin is used commonly to give skeletal traction through the cancellous bone i.e. calcaneum. It can also be used to give traction through osteoporotic bones.
4
It is used to give skeletal traction
It has threads in the center of pin
It is used to give skeletal traction through calcaneum
All the above
Surgery
null
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Nerve roots involved in klumpke's paralysis is:
Klumpke's Paralysis is due to injury of the lower trunk of branchial plexus. It involves mainly the T1 nerve root and paly C8 nerve root. All the small muscles of the hand are paralysed. Claw hand, horner syndrome and loss of sensation on the medial aspect of the arm are the common disabilities. Ref: B D Chaurasia's Human Anatomy: Volume 1, Page 52.
3
C6, C7
C7, C8
C8, T1
T1, T2
Anatomy
null
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single
A 2-year-old child develops acute respiratory distress. 0/E breath sounds are decreased with wheeze on right side. Chest X-ray shows diffuse opacity on right side--Most probable diagnosis:
Foreign body aspiration is a very common problem in pediatric age group (< 4 years). In the question, child is presenting with sudden onset respiratory distress and there is U/L decreased breath sounds + U/L wheezing and on chest X-ray a diffuse opacity is seen on right side i.e. there is clinical and radiological evidence of bronchospasm and collapse suggestive of a foreign body in bronchus
2
Pneumothorax
Foreign body aspiration
Pleural effusion
U/L emphysema
ENT
null
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single
Minimal reabsorption in kidney occurs for
Minimal reabsorption for ureaRef: Ganong&;s review of medical physiology; 24th edition; page no; 682, 681
1
Urea
Glucose
Na
HCO3
Physiology
Renal physiology
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single
Pathology in Marfan syndrome ?
Ans. is 'a' i.e., Fibrillin I o Marfan syndrome is an autosomal dominant disorder due to mutation in fibrillin-1 gene on chromosomal 15.Fibrillin-1 is a part of elastic fibres, thus defect in fibrillin-1 affects following systems:-1) Skeletal abnormalities: Tall with thin built; arachnodactyly (long and slender fingers and hand, spider like); decrease in upper segment: Lower segment body ratio (i.e. lower limbs are proportionately more lengthened); scoliosis and kyphosis; pectus excavatum and pectus craniatum; Hypermobility (laxity) of joint with hyperextensibly; high arched palate and dolicocephalic skull.2) CVS abnormalities : Mitral valve prolapse causing mitral regurgitation; aortic aneurysm begning at base of aorta and involving ascending aorta; cystic medial necrosis causing dissection of aorta (most common cause of death).3) Ocular abnormalities: Ectopia lends (with bilateral superolateral lens dislocation), elongated eyeball.4) Others: Spontaneous pneumothorax ; inguinal and incisional hernias.
1
Fibrillin I
Fibrillin II
Collegen
Elastin
Pathology
Cytogenetic Disorders
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Atropine causes:
Ans: b (Tachycardia) Ref: KDT, 6th ed, p. 107The most prominent action of atropine on heart is tachycardia due to the blockade of M receptors on the S A node through which vagal tone decreases heart rate.Other effects of atropine are:CNS: Overall stimulant action,rise in body temperature due to action on hypothalamusCVS: Tachycardia, no marked effect on BPGIT: Decreases intestinal motility by GI smooth muscle relaxationRESP: Bronchodilatation and reduced airway resistanceURINARY: Relaxes bladder and causes urinary retentionEYE: Local anesthetic action on cornea. Mydriasis, Cycloplegia, Abolition of light refelexGLANDS: Decreases lacrimation, Sweating, Salivation by M blockade
2
Bradycardia
Tachycardia
Aggravation of heart block
Decreased vasomotor tone
Pharmacology
A.N.S.
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A biopsy of the antrum of the stomach of an adult who presents with epigastric pain reveals numerous lymphocytes and plasma cells within the lamina propria, which is of normal thickness. There are also scattered neutrophils within the glandular epithelial cells. A Steiner silver stain from this specimen is positive for a small, curved organism, which is consistent with
Chronic gastritis is histologically characterized by the presence of lymphocytes and plasma cells. It is impoant to realize that the presence of neutrophils within the glandular epithelium indicates active inflammation and may be the main type of inflammation present (acute gastritis), or may be combined with more numerous chronic inflammations (active chronic gastritis). Chronic gastritis is divided into subgroups based either on etiology (immunologic or infectious), location (antrum or body), histopathology, or clinical features. H. pylori gastritis is associated with infection by H. pylori, a small, curved, gram-negative rod that is found in approximately 20% of the general population. The organisms are found in the mucus overlying the surface/foveolar epithelium. These changes tend to affect primarily the antral or antral-body-fundic mucosa. This is the type of gastritis normally associated with active chronic gastritis. The therapy for Helicobacter is either triple therapy (metronidazole, bismuth salicylate, and either amoxicillin or tetracycline) or double therapy (omeprazole and clarithromycin). In contrast, autoimmune gastritis, also known as diffuse corporal atrophic gastritis or type A atrophic gastritis, is characterized by the presence of autoimmune antibodies including parietal cell antibodies and intrinsic factor antibodies. This type of gastritis is associated with pernicious anemia and achlorhydria. Pernicious anemia is the result of decreased intrinsic factor, which in turn produces a vitamin B12 deficiency. This vitamin deficiency causes megaloblastic anemia and subacute combined disease of the spinal cord. Histologically there is diffuse atrophy (reduced mucosal thickness), gland loss, widespread intestinal metaplasia, and variable chronic and acute inflammation. These changes are found predominately in the body-fundus mucosa (usually absent in the antrum). There is an increased risk for gastric cancer, but these patients do not develop peptic ulcers. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition
3
Enteroinvasive Escherichia coli
Enterotoxigenic E. coli
Helicobacter pylori
Salmonella typhi
Pathology
miscellaneous
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multi
During moderately intense isotonic exercise all of the following increase except:
In mild-to-moderate exercise: There is increase in sympathetic drive. This results in an increase in stroke volume and hea rate, resulting in an increase in cardiac output; increased respiratory drive; dilation of vessels in the active muscles. This is due to a "muscle chemoreflex" because of metabolites from muscles e.g. K+, adenosine, NO. Diastolic BP (indicator of total peripheral resistance) either remains unchanged or decreases to some extent. The mean aerial pressure increases. Increase in ventilatory ratethat matches the increase in O2consumption and CO2production by the body. The stimulus for increased ventilation rate is due toactivation of joint proprioceptors at the beginning of the exercise.
4
Mean aerial pressure
Hea rate
Respiratory rate
Total Peripheral resistance
Physiology
Circulation
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multi
A 62-year-old woman eats a high carbohydrate meal. Her plasma glucose concentration rises, and this results in increased insulin secretion from the pancreatic islet cells. The insulin response is an example of
Negative feedback mechanisms ensure a proper level of hormone activity at the target tissue. After a stimulus (plasma glucose) causes a release of the hormone (insulin), conditions or products resulting from the action of the hormone (decrease sugar) tend to suppress its fuher release. In other words, the hormone (or one of its products) has a negative feedback effect to prevent oversecretion of the hormone or overactivity at thetarget tissueThe increase in plasma insulin lowers the plasma glucose concentration which in turn results in decreased insulin secretion
4
Chemical equilibrium
End-product inhibition
Feed forward control
Negative feedback
Physiology
General physiology
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single
Killing of a 6 months old child by parents is known as ?
Ans. is 'b' i.e., Infanticide Infanticide refers to killing a child after delivery, to till 1 year after bih. Infanticide in India is considered equivalent tomurder and is tried under section 302 IPC. Law considers every child as born dead and therefore in a case of infanticide,it has to be proved that the child was born alive and was then killed. Thus the first question in the investigation of a case of infanticide is, whether the child was still born or dead born or whether it was born live.
2
Genocide
Infanticide
Neonatal homicide
Aboion
Forensic Medicine
null
1fae64c1-c1e1-4783-9fc2-34297d2587c6
single
Painful arc syndrome which movement is painful:-
* Painful arc syndrome is subacute tendinitis of the rotator cuff tendons due to vascular congestion.* Treatment is usually rest +physiotherapy + NSAIDS. If not treated, local steroids and surgery can be done.* Pain is aggravated as arm transverses an arc between 60 and 120 degrees.
3
Initial abduction
Terminal abduction
Mid abduction
Full range of abduction
Orthopaedics
NEET 2019
5ce673aa-29fb-4861-9c38-23f6e54c8d77
single
Most common cause of stridor in children is:
(Laryngomalacia) (272-D)Laryngomalacia - (congenital laryngeal stridor)* It is the most common condition causing an inspiratory stridor at or shortly after birth.* It may persist throughout infancy & disappears by 2 years of age* Stridor increased on crying but subsides on placing the child in prone position, cry is normal.* Foreign bodies in the larynx are uncommon because they are either coughed out or causes fatal obstruction within a few minutes. If helps is not to hand.
1
Laryngomalacia
Congenital laryngeal paralysis
Foreign body in larynx
Congenital laryngeal tumours
ENT
Larynx
1c3d51e1-abbf-41dc-85a9-dac0a0e13991
single
Retinoblastoma can occur bilaterally in how many percentage of the cases?
25-30% bilateral involvement . Seen in childrens between 1-2 yrs of age. Ref : ak khurana 6th edition
4
10-15%
15-20%
20-25%
25-30%
Ophthalmology
Tumors
75070acb-b1e2-4723-9d91-1c35c12d772e
multi
Education criteria for mental retardation is ?
Ans. is 'a' i.e., Mild
1
Mild
Moderate
Severe
Profound
Social & Preventive Medicine
null
96e335fe-892b-4924-ade2-db03cd5cc8fd
single
Which of the following is naturally occurring tertiary amine and lipid-soluble reversible anticholinesterases:
All other reversible anticholinesterases are synthetic quaternary compounds and are lipid insoluble.
1
Physostigmine.
Neostigmine.
Pyridostigmine.
All of the above.
Pharmacology
null
3ea29a45-1884-483a-a8f7-633e5f201f19
multi
Funicular hernia is type of:
Types of Indirect Inguinal Hernia - 1. Bubonocele - Hernia is limited to the inguinal canal 2. Funicular - Processus vaginalis is closed just above epididymis. Contents of the sac can be felt separately from testis, which lies below the hernia. 3. Complete or scrotal - Testis appears to lie within the lower pa of hernia.
2
Direct inguinal hernia
Indirect inguinal hernia
Femoral hernia
Umbilical hernia
Surgery
Hernia and abdominal wall
4595de0c-957a-4593-9775-3571f3e7d72a
single
Not true about amoebic liver abscess
Larval forms of E.histolytica are not seen in the abscess
3
Adult forms are seen
Conservative treatment is generally seen
Larvae are seen
USG can diagnose it
Anatomy
G.I.T
50b5e6fa-607a-40f6-8da5-6c0b6b1b3b72
multi
Translocation seen in Follicular lymphoma
MalignancyTranslocationAcute myeloid leukemia (AML)(8;21)(q22;q22)(15;17)(q22;q21)Chronic myelogenous leukemia (CML)(9;22)(q34;q11)Burkitt lymphoma(8;14)(q24;q32)Mantle cell lymphoma(11;14)(q13;q32)Follicular lymphoma(14;18)(q32;q21)Ewing sarcoma(11;22)(q24;q12)Prostatic adenocarcinoma(7:21)(p22;q22)(17:21)(p21;q22)Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 7; Neoplasia; Page no:317; Table: 7-8
4
8;21
8;14
11;14
14;18
Pathology
General pathology
e0caa601-ce98-44ee-9980-b6fa5698ac71
single
Most common cause of Bronchiolitis is ?
<a href=" syncytial virus (RSV)</a> is the most common cause of bronchiolitis. Sometimes, the common also can cause it. Bronchiolitis is one of the common serious acute lower respiratory tract infection in infants. Affected infants are between ages of 1 and 6 months but the disease can affect children upto 2 years old.Disease usually occur in winter and spring .Respiratory syncytial virus is implicated in most cases.other causative agents include parainfluenza virus,influenza virus,adeno virus,Mycoplasma. protection against RSV is mediated by antibodies of IgG3 subclass. Ref : ESSENTIAL PEDIATRICS,O.P.GHAI,PG NO:356,7th edition
1
RSV
Adenovirus
Parainfluenza
Mycoplasma
Pediatrics
Respiratory system
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single
Cholinomimetics are useful in all of the following conditions EXCEPT
cholinomimetics use- 1.as miotic- in glaucoma/to reverse the effect of mydriatics after refraction testing/to prevent adhesions between lens and iris or cornea 2.in myasthenia gravis 3.in postoperative paralytic ileus 4.post operative decurarization 5.in cobra bite 6.in belladonna poisoning 8.in Alzheimer's disease REF: ESSENTIALS OF MEDICAL PHARMACOLOGY: KD TRIPATHI:7TH EDITION; PAGE NO 109
4
Glaucoma
Mysthenia gravis
Post operative atony of bladder
Paial hea block
Pharmacology
Autacoids
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multi
Gene mutations in Cystic fibrosis occurs at -
In cystic fibrosis, CFTR gene mutation occurs on the long arm of chromosome 7 Reference: Ghai essential pediatrics, 9 th edition, page 392
3
Sho arm of chromosome 7
Long arm os chromosome 5
Long arm of chromosome 7
Sho arm of chromosome .3
Medicine
Genetics
18c5a928-9ac1-4cca-9972-88423d388fff
single
Paget's disease of the breast, true is
Pagets disease of nipple is a superficial manifestation of intraductal carcinoma.It mimics eczema of nipple and areola. There is a hard lump just beneath the areola which later ulcerates and cause destruction of nipple.. Its unilateral condition ,seen in menopausal women not associated with itching.
2
Mastectomy needed
Intraductal carcinoma
Malignant
Bilateral
Surgery
null
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Ketamine is useful as an anesthetic agent in-
(Refer: Morgan and Mikhail’s Clinical Anaesthesiology, 5th edition, pg no. 182 – 184) Ketamine is a potent bronchodilator and relieves bronchospasm →Intravenous anaesthetic agent of choice in asthmatic Ketamine increases ICT, IOP and cardiac oxygen demand, therefore contraindicated in other three conditions Note-Inhalation anaesthetic agent of choice in asthmatics is halothane.
2
Ischemic heart disease
Intracranial hemorrhage
Hyperactive airways
Glaucoma
Unknown
null
6630dcc7-c8d6-4e86-8f83-4173ba853db3
single
What is true about Meniere&;s disease
Electrocochleography shows changes diagnostic of Meniere's disease. Normally the ratio of summating potential to action potential is 30%. In Meniere's disease, this ratio is greater than 30%. Ref: Diseases of EAR, NOSE and THROAT by PL Dhingra; 7th Edition; page no.113
2
Semont's manoeuvre is used for treatment
Electrocochleography is the gold standard for diagnosis
Surgery is the mainstay of treatment
V shaped audiogram is seen
ENT
Ear
67d6363d-ec72-4997-8f95-6dcd27dc2d93
multi
Which of the following is antitubercular drugs bus assoasiated with hypothyroidism
Refer KDT 7th/771 Ethionamide PAS They are two antitubercular drugs assoasiated with hypothyroidism and goitre
3
Rifamipicini
Pyrazinamide
Ethionamide
Streptomycin
Pharmacology
Chemotherapy
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single
Commonest presentation of primary biliary cirrhosis?
Ans is 'a' i.e., Pruritus Harrison writes "Most patients with Primary biliary cirrhosis are asymptomatic, and the disease is initially detected on the basis of elevated serum alkaline phosphatase levels during routine screening. Often the earliest symptom is pruritus, which may be either generalized or limited initially to the palms and soles. In addition fatigue is commonly a prominent early symptom. After several months or years, jaundice and gradual darkening of the exposed areas of the skin (melanosis) may ensue."
1
Pruritis
Pain
Jaundice
Fever
Surgery
null
ad8cda45-ccfe-4409-b9c1-5d4feafff36d
single
What is the recommended isolation period of Hepatitis A from the initial onset of symptoms?
Isolation period of Hepatitis A is first 14 days of illness and for at least 7 days after jaundice show up. Incubation period of Hepatitis A is 10-50 days, commonly about 30-35 days.
2
1 week
2 weeks
3 weeks
4 weeks
Social & Preventive Medicine
null
24eef242-f927-4c88-832a-c78a476d9934
single
Which of the following contraceptives provides complete protection against sexually transmitted disease: March 2013 (b, g)
Ans. B i.e. Barrier method Barrier methods They block sperm from entering the uterus. The following are barrier methods of contraception: - Condom - Female condom - Cervical cap (including Lea's Shield) - Diaphragm The male (and female) condom provides excellent protection against sexually transmitted infections.
2
IUCD
Barrier method
OCP
Minipill
Social & Preventive Medicine
null
8cab8900-9913-4677-9144-108c7ce2ba08
multi
True about conn&;s syndrome-
Ans is option 2 and 3 Decrease K+ and proximal myopathy In Conn&;s disease Proximal myopathy occurs due to hypokalemia. Hypokalemia causes alteration of electrical excitability of nerve and muscle fibre membranes, which prevents transmission of normal action potential, leading to severe muscle weakness. Ref Harrison 17/e p 2260,2261,2253
2
Increased K+
Decreased K+
Proximal myopathy
Ted plasma renin activity
Medicine
Endocrinology
86299b59-4e7c-40da-82fe-870eef1112d7
multi
Culture mediam for corynebacterium diphtheria?
Ans. is 'a' i.e., Loefflers serum slope
1
Loefflers serum slope
McConkey
Saburauds agar
Lowenstein Jensen medium
Microbiology
null
d85f6a61-5525-4726-87f5-ecda96bba8a9
single
Fetal growth restriction is defined as estimated fetal weight is below the ------ for their Gestational age
IUGR is replaced by fetal growth restriction, which was designed to identify fetuses with estimated weight below the 10th percentile for their gestational ages.Reference: Practical guide to High-risk pregnancy and delivery; Chapter 4; Fetal growth restriction
3
3rd percentile
5th percentile
10th percentile
15th percentile
Gynaecology & Obstetrics
General obstetrics
eaeef886-38fb-4dd0-9766-fb0ad2a061f1
single
Sporulation is seen in which phase of bacterial growth phase?
Ref: Ananthanarayan, 8thed. pg. 24Features of Stationary Phase1. Viable count of cells remain stationary as an equilibrium exists between dying cells and newly formed cells2. Cells are viable and show irregular staining due to intracellular storage granules3. Sporulation occurs at this stage4. Production of antibiotics and exotoxins is also seen at this stage.
3
Lag phase
Log phase
Stationary phase
Decline phase
Microbiology
General
590b8d4f-b239-4f51-8967-bf8654239813
single
One of the following is the most specific cardiac anomaly of a newborn to a diabetic mother:
Congenital malformation in fetus of a diabetic mother : * M/C system involved in congenital malformation CVS > CNS * Most specific structural anomaly seen - caudal regression syndrome ( sacral agenesis ) * Most specific cardiac anomaly seen in babes of diabetic mother - TGV
2
VSD
Transposition of great vessels
PDA
Pulmonic stenoisis
Gynaecology & Obstetrics
Gestational Diabetes Mellitus
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single
Neuronal degeneration is seen in all of the following except
Neurapraxia is a disorder of the peripheral nervous system in which there is a temporary loss of motor and sensory function due to blockage of nerve conduction, usually lasting an average of six to eight weeks before full recovery. This condition is typically caused by a blunt neural injury due to external blows or shock-like injuries to muscle fibers and skeletal nerve fibers, which leads to repeated or prolonged pressure buildup on the nerve. Ref: guyton and hall textbook of medical physiology 12 edition page number:74,75
4
Crush nerve injury
Fetal development
Senescence
Neuropraxia
Physiology
Nervous system
b9860043-d96a-4a25-8294-c97ac9dac23b
multi
Which among the following is the best diagnostic method for finding out ovulation?
The finding of secretory endometrium confirms ovulation. The use of an endometrial biopsy (EMB) near the end of the luteal phase can provide reassurance of an adequate maturational effect on the endometrial lining. Within 48 hours of ovulation, the cervical mucus changes under the influence of progesterone to become thick, tacky, and cellular, with loss of the crystalline fernlike pattern on drying. Ref: Ghadir S., Ambasumyan G., DeCherney A.H. (2013). Chapter 53. Infeility. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e.
3
Ultrasound
Laparoscopy
Endometrial biopsy
Chromotubation
Gynaecology & Obstetrics
null
b327730a-05c8-4db4-b2af-47c741d8df6f
single
1st urge at micturition comes at -
Ans. is 'c' i.e., 150 ml "First urge to void is felt at a bladder volume of about 150 ml, and a marked seme offullness at about 400 ml".- Ganong
3
50 ml
250 ml
150 ml
350 ml
Physiology
Bladder and Micturition Physiology
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single
During physical examination of a patient with history of TIA, it is found that the ankle jerk reflex is absent. Which of the following nerves is responsible for the reflex arc?,
The ankle jerk reflex, elicited by tapping the tendo Achilles with the reflex hammer, is mediated by Tibial nerve. The superficial fibular (peroneal) nerve supplies the foot eveor muscles of the lateral compament of the leg and provides sensory supply for the dorsum of the foot. The deep fibular (peroneal) nerve innervates the foot extensor and inveor muscles in the anterior compament of the leg and supplies skin between the first and second toes. The common fibular (peroneal) nerve combines the functions of the superficial and deep branches.
4
Common fibular (peroneal)
Superficial fibular (peroneal)
Deep fibular (peroneal)
Tibial
Anatomy
Nerve supply of Lower Limb
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single
Which of the following is the predominant immunoglobulin isotype secreted in the human MALT?
Ans. (d)The vast majority of the antibody generated in the human MALT (Mucosal Associated Lymphoid Tissues) is of the IgA isotype. IgE, IgG and IgM are present, but at far lower levels, and IgD is essentially absent.
4
IgA
IgD
IgG
IgE
Microbiology
Immunology
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single
Abdominal Aorta Bifurcates at the level of
Abdominal Aorta Bifurcates at the Lower border of L4
3
Body of L3
Lower border of L3
Lower border of L4
Body of L4
Anatomy
null
892a0708-fa8a-437f-b080-e8484a558aae
single
For post-exposure prophylaxis, dose of human rabies immunoglobulin is:
Human rabies immune globulin (HRIG): 20 IU/kg, maximum injected locally, rest IM in gluteal region. It is indicated in only in category III bites. Equine rabies immunoglobulin (ERIG)- It is given at dose of 40 IU/kg . Being heterologous in origin (horse), it is associated with serum sickness; hence not in use.
2
10 IU/kg
20 IU/kg
30 IU/kg
40 IU/kg
Microbiology
Virology Pa-2 (RNA Virus Pa-1,2 & Miscellaneous Viruses)
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single
PARULIS is an inflammatory enlargement seen in
null
1
End of sinus tract
Extraction socket
Due to irritation from calculus / over hanging restoration
None of the above
Pathology
null
c4010d2e-8732-46ea-ab8a-b14dedef0cb6
multi
Prader willi syndrome and Angel man syndrome are examples of
Genomic imprinting is a proces of epigenetic modification of nucleotides in which only one allele of specific gene is functioning, while the other allele is silenced based on the parent of origin.
2
RNA interferance
Genomic Imprinting
Gene Knockout
Impaired DNA repair
Biochemistry
null
6811e59d-14d7-4e29-a5e6-2e8aaad12b3a
single
Which pa of the ear has origin from all the three layers of germ layer:
The eardrum forms from the joining of the expanding first pharyngeal pouch and groove.Around day 30 of gestation, the endoderm-lined first expands to form the tympanic cavity, which subsequently envelops the inner ear ossicles.Simultaneously, the first pharyngeal groove, which is lined with ectoderm, expands to form the developing external auditory meatus.Separated by a thin layer of splanchnic mesoderm, the tympanic cavity and external auditory meatus join to form the tympanic membrane.As a result, the tympanic membrane is derived from all three germ layers.
2
Auricle
Tympanic membrane
Ossicles
Middle ear cavity
Anatomy
null
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multi
Consider the following 1* Malnutrition deficiency 2. Lithostatin (pancreatic stone protein 3. Cassava tuber Oxidant stress (heightened cytochrome P-450 activity) Which of the above produce tropical calcific pancreatitis (fibrocalculous pancreatic diabetes) ?
Calcification, which is another sign of chronic inflammation, can develop throughout the pancreas. These calcifications are like stones that are within the tissue itself, or within the pancreatic duct Ref Davidson 23rd edition pg 765
1
1, 2 and 3 only
2, 3 and 4 only
1 and 4 only
1, 2, 3 and 4
Medicine
Miscellaneous
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multi
A diagnosed case of psoriasis, taking MTX since last 15 yrs presents with jaundice and abnormal LFT. So, what will be the course of management:
Methotrexate is hepatotoxic drug- Therefore, abnormal liver function test & jaundice (in history)- Next step- stop Mtx- Therefore, B is ruled out 3 systemic drugs used in psoriasis1. Mtx (Teratogenic, hepatotoxic)2. Cyclosporine (nephrotoxic)-3H( HTN, Hyperiglyceridemia , Hyperichosis)3. Acitretin- teratogenic, dyslipidemia. In psoriasis systemic steroids are C/I Dapsone have no role.
4
Stop Mtx, sta dapsone
Mtx + cyclosporine
Stop Mtx, sta steroids
Stop Mtx, sta cyclosporine
Dental
Psoriasis
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In human dioploid cells rabies vaccine the schedule of immunisation is -
null
3
0,3,4,14,30,0
0,5,14,30,900
0,3,7,14,30,90
0,37,14,30,70
Social & Preventive Medicine
null
a9e32879-c752-45c2-9e95-bff1a3bbf114
single
A 35 year old is given excessive intravenous Benzodiazepine.She suddenly becomes agitated, combative, and exhibits involuntary movements. The anesthesiologist determines that she is having a reaction to the drug which has been given in excess. Next step would be adminstration of:
Flumazenil
2
Protamine
Flumazenil
Buprenorphine
Morphine
Pharmacology
null
c828c8a9-57df-4b31-aebe-42b4b40c95ea
multi
Malignant pustule is seen in -
Ans. is 'a' i.e., Cutaneous anthrax [Ref: Anantnarayan 8/ep 245\Anthrax is primarily a disease of the domestic animals.Humans are usually accidental hosts when brought into contact with infected animalsThe most common form of anthrax is cutaneous anthrax which is usually occurred via injured skin or musous membraneCutaneous anthraxCutaneous anthrax usually begins 2-5 days after inoculation of spores into an exposed part of the body typically the forearm or the hand.The initial lesion is an erythematous papule which may be mistaken for insect bite. This papule usually progresses through vesicular and ulcerative stages in 7-10 days to form a black eschar surrounded by edema The lesion is known as "malignant pustule" although it is neither malignant nor pustule. Associated symptoms are usually mild and the lesion typically heals very slowly after the eschar separates.Cutaneous anthrax generally resolves spontaneously but 10-20% of untreated patients may develop septicemia.Cutaneous anthrax generally resolves spontaneously but 10-20% of untreated patients may develop fatal septicemia or meningitis.
1
Cutaneous anthrax
Carbuncle
Ulcerating melanoma
Infected rodent ulcer
Microbiology
Bacteria
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single
A 35 year old captain in the army has been plagued by a painful, erosive lesion near his ear lobe since his return from operation dese storm several years ago. Punch biopsy of the leading edge of the erosion reveals macrophages distended with oval amastigotes. How was this infection acquired?
This is the history of cutaneous leishmaniasis caused by the L. tropica or L. major. The vector is sandfly (Phlebotomus sergenti or P.papatasii). This disease is also called as Delhi boil, Baghdad boil and oriental sore. Most cases of cutaneous leishmaniasis are seen in Afghanistan, Brazil, Iran, Iraq, Peru, and Saudi Arabia.
4
Contact with contaminated drinking water
Bite of infected anopheles mosquito
Bite of infected reduviid bug
Bite of sandfly
Microbiology
Parasitology Pa 1 (Protozoology)
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Polysaccharide capsular resistance to phagocytosis is seen in
The virulence of Streptococcus pneumoniae depends on the capsular polysaccharide. The capsular polysaccharide because of its acidic and hydrophilic propeies, protects the cocci from phagocytosis. Capsulated streptococcus pneumoniae are not phagocytosed efficiently in fluid media or exudates, however, they are susceptible to surface phagocytosis, being engulfed against a firm surface, such as a fibrin clot or epithelium. The enhanced virulence of type 3 Streptococcus pneumoniae is due to an abundance of its capsular material. Non-capsulated strains are avirulent. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 226
3
Neisseria meningitidis
Klebsiella pneumoniae
Streptococcus pneumoniae
Yeast
Microbiology
Bacteriology
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All of the following causes death in coarctation of Aorta except –
The causes of mortality in co-arctation of aorta are : Hypertension                                       o Aortic dissection                              o Premature atherosclerosis Rupture of aorta                                  o Left ventricular failure                        o Infective endocarditis Cerebral haemorrhage (due to aneurysm rupture)
4
Infective endocarditis
CCF
Intra cranial hemorrhage
Anterior MI
Pediatrics
null
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multi
Tensors of vocal cord are
Intrinsic muscles acting on vocal cords: Abductors: Posterior cricoarytenoid Adductors: Lateral cricoarytenoid, lnterarytenoid (transverse arytenoid) Thyroarytenoid (external pa) Tensors: Cricothyroid, Vocalis (internal pa of thyroarytenoid) Intrinsic muscles acting on laryngeal inlet: Openers of laryngeal inlet: Thyroepiglottic (pa of thyroarytenoid) Closers of laryingeal inlet: Interarytenoid (oblique pa), Aryepiglottic (posterior oblique pa of interarytenoids)
4
Posterior cricothyroid, internal interarytenoid
Lateral cricothyroid, internal interarytenoid 1
Thyroarytenoid, internal interarytenoid
Cricothyroid and internal thyroarytenoid
ENT
null
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single
All of the following are useful in the intravenous therapy for hypertensive emergencies except
Ans. (D) Nifedipine(Ref: Katzung 10/e p145, 179: KDT 8th/e p618, 619)Nifedipine can be used rarely for the rapid control of blood pressure but the route of administration is sublingual. Fenoldopam is a D1 agonist used i.v. for hypertensive emergencies whereas urapidil is an a blocker. Enalaprilat (not enalparil) can also be used for the same indication.
4
Fenoldopam
Urapidil
Enalaprilat
Nifedipine
Pharmacology
C.V.S
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multi
An elderly multiparous woman with intrauterine foetal death was admitted with strong labour pains. The patient suddenly goes in shock with cyanosis respiratory disturbances and pulmonary oedema. The most likely clinical diagnosis is :
Amniotic fluid embolism
3
Rupture of uterus
Congestive hea failure
Amniotic fluid embolism
Concealed accidental hemorrhage
Gynaecology & Obstetrics
null
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Technique used for Aspiration of sperm directly from Testes for In-vitro feilization is:
Testicular sperm aspiration (TESA) is a procedure sample of sperm cells are removed from the testicle through a small needle attached to a syringe. Other methods used are PESA: Percutaneous Epididymal Sperm Aspiration both TESA and PESA can be done under LA. MESA: Microsurgical Epididymal Sperm Aspiration TESE: Testicular Sperm Extraction MESA is the best technique for getting useable sperms since the epididymal sperms are the 'Ready'sperms which are ejaculated with the sexual act MESA allows for diagnosis and possible reconstruction of ductal pathology and because it usually yields very large numbers of sperm, sperm cryopreservation and avoidance of repeat surgery may be possible ICSI: Intracytoplasmic sperm injection GIFT: Gamete intra fallopian tube transfer IVF: In vitro feilisation
3
IVF
ICSI
TESA
GIFT
Gynaecology & Obstetrics
Infeility (Eggs'plantation!)
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A 25 year old female patient history of 6 months, altered sensorium, involuntary rnovements,memory deficit, headache convulsions, abnormal movements, forgetfulness, 4 attack during day, 2 attack at night. CT normal :
Epilepsy It is a case of epilepsyTwo features our the diagnosis of epilepsy:-Presence of altered sensoriumOccurrence of epilep.sy during sleepDissociation disorders may resemble epilepsy, especially complex paial seizure.Dissociative disorders are a group of psychiatric syndromes characterized by disruptions of aspect of consciousness, identity, memory, motor behaviour or environmental awareness.They may resemble epilepsy in presentation but an impoant feature of these disorders is that the patient is always ale and oriented.Two impoant ways to rule out organic epilepsy from psychogenic epilepsy are:-i) Abnormality in E.E.G.- Generalized tonic clonic seizures always produce marked E.E.G. abnormalities during and after the seizure.ii) Increase in prolactin secretion- Measurement of serum prolactin levels may also help to distinguish between organic and psychogenic seizures, since most generalized seizures and many complex seizures are accompanied by rise in serum prolactin.Amnesia can occur in ceain epilepsies (complex paial seizures)Complex paial seizures are characterized by foal seizure activity accompanied by a transient impairment of the patient's ability to maintain normal contact with the environment (altered sensorium)The patient is unable to respond appropriately to visual or verbal commands during the seizure and has impaired recollection or awareness of the ictal phase.Examination immediately following the seizure may show an anterograde amnesia (memory deficits) or in cases involving the dominant hemisphere, a postictal aphasia.Other two options can be easily rule outSomatization disorderIn these cases patient will compain of number of symptoms involving multiple organ .system of the body.Hypochondriasis In lzypochondriasis patient complains that he has some serious ailment and he consults many dotors.
1
Epilepsy
Dissociative disorder
Hypochiondriasis
Somatization disorder
Psychiatry
null
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single
Common posterior cranial fossa tumours include all of following except -
Ans. is 'b' i.e., Oligodendroglioma o Oligodendrogliomas are uncommon tumours of childhood, occur predominently in the cerebral coex and originate in white matter (Supratentorial). Common childhood infratentorial post fossa tumors 1) Cerebellar astrocytoma (cystic astrocytoma) 3) Brainstem glioma 2) Medulloblastoma (Primitive neuroectodermal tumor) 4) Ependymoma
2
Medulloblastoma
Oligodendroglioma
Ependymoma
Cystic astrocytoma
Pediatrics
null
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multi
Which of the following is not a complication of Total Parenteral Nutrition
.catheter related complication infections hydrothorax,pneumothorax,hemothorax cardiac tamponade injuriesto aeries and veins thrombotic complication air embolism metabolic complication azotemia essential fatty acid def fluid overload metabolic bone disease liver dysfunction glucose imbalance electrolyte imbalance trace elements and vitamin def
3
Metabolic bone disease
Essential fatty acid deficiency
Congestive cardiac failure
Hypophosphatemia
Surgery
General surgery
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single
H1 antihistaminics afford benefit in a number of conditions. All of the following conditions are benefited by antagonism of histamine :
In common cold , excessive secretions (like rhinorrhoea) are due to cholinergic overactivity. First generation antihistaminics possess anticholinergic propey and therefore are effective for common cold. On the other hand, all other conditions are allergic and reare benefited by antagonism of H1 receptors.
3
Dermographism
Insect bite
Common cold
Seasonal hay fever
Pharmacology
Histamine, 5-HT and PGs
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multi
Cardiac output during pregnancy is maximal at :
32nd week
1
32nd week
36th week
24th week
12th week
Gynaecology & Obstetrics
null
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single
A 58-year-old woman had a mitral valve replacement, and was placed on anticoagulants and prophylactic antibiotics following her surgery. Five days after her surgery, she developed a sharply demarcated, erythematous rash on her left thigh. Two days after the rash appeared, large hemorrhagic bullae began to form in the area of the rash. Which of the following medications most likely caused the patient's rash?
Warfarin is a coumarin anticoagulant used for the prophylaxis and treatment of thromboembolic complications associated with cardiac valve replacement and atrial fibrillation, as well as the prophylaxis and treatment of venous thrombosis and pulmonary embolism. Warfarin may cause necrosis of the skin (typically on the breasts, thighs, and buttocks) generally between the third and tenth days of therapy. The lesions are initially sharply demarcated, erythematous, and purpuric. They may resolve or progress to large, irregular, hemorrhagic bullae that can eventually lead to necrosis. The mechanism for this reaction is related to warfarin's ability to deplete protein C, which can lead to a state of hypercoagulability and thrombosis in the cutaneous microvasculature. Aspirin is commonly used for its antiplatelet effect; however, it would not be indicated for anticoagulation of a patient with a recent cardiac valve replacement. Fuhermore, aspirin is not associated with the development of this type of skin necrosis. Cefazolin is a first-generation cephalosporin antibiotic commonly used as a perioperative prophylactic agent. If the patient was allergic to this antibiotic, an erythematous rash might have appeared. However, the rash would not lead to the appearance of large, hemorrhagic bullae. Heparin is an intravenous anticoagulant indicated for the prophylaxis and treatment of thromboembolic complications associated with cardiac valve replacement and atrial fibrillation. It is also indicated for the prophylaxis and treatment of venous thrombosis, pulmonary embolism, and for treatment of some coagulopathies. Although heparin is associated with the development of thrombocytopenia, it is not associated with skin necrosis.
4
Aspirin
Cefazolin
Heparin
Warfarin
Pharmacology
null
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single
Bias can be eliminated by all except:
Ans. d. Multivariate analysis (Ref: Park 23/e p73, 83, 21/e p68-70, 78-79, 84; en.wikipedia.org/wiki/Bias_(statistics); style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">Multivariate analysis refers to the analysis of two or more dependent variables at a time. It is done after the study has been conducted, to analyze the study. While matching, binding and randomization all are done when the study is being conducted. (AIIMS November 2010 Repeat)."Confounding factors are an important source of bias. This can be removed by matching in case-control studies.""The selection bias can be eliminated by randomization.""Interviewer's bias can be eliminated by double-blinding."Groups to be compared are differentially susceptible to the outcome of interest, even before the experimental maneuver is performed is known as selection bias. In the given question, researcher is concerned that the smokers might differ from non-smokers in their diet, exercise, etc. This concern is known as selection bias.Some important Types of Biases in Epidemiological StudiesInterviewer bias* Interviewer devotes more time of interview with cases as compared to controlsQMemory/ Recall bias* Cases are more likely to remember exposure more correctly than controlsQSelection bias (Susceptibility bias)* Groups to be compared are differentially susceptible to the outcome of interest, even before the experimental manoeuvre is performedQInformation bias (Observer or misclassification bias)* Connective type of bias in which proportion of subjects are misclassified on exposure or diseases* Occurs due to people's curiosity and confusion of goals when trying to choose a course of action* It includes reporting, recall, interviewer & attention biasQBiasBias is any 'systematic error' in an epidemiological study, occurring during data collection, compilation, analysis and interpretation0Predominantly Biases are of 3 TypesSubject biasInvestigator biasAnalyzer bias* Error introduced by study subjects.* Examples:- Hawthorne effect- Recall biasQ* Error introduced by investigator* Selection biasQ* Error introduced by analyzer Some Important Types of Biases in Epidemiological StudiesApprehension bias* Certain levels (pulse, blood pressure) may alter systematically from their usual levels when the subject is apprehensiveAttention bias (Hawthorne effect)* Study subjects may systematically alter their behaviour when they know they are being observedQBerkesonian bias (Admission rate bias)* Bias due to hospital cases and controls being systematically different from each otherQInterviewer bias* Interviewer devotes more time of interview with cases as compared to controlsQLead time bias (Zero time shift bias)* Bias of over-estimation of survival time, due to backward shift in starting point, as by screening proceduresQMemory/ Recall bias* Cases are more likely to remember exposure more correctly than controlsQNeymann Bias (Prevalence-incidence bias)* Bias due to missing of fatal cases, mild/ silent cases and cases of short duration of episodes from the studyQSelection bias (Susceptibility bias)* Groups to be compared are differentially susceptible to the outcome of interest, even before the experimental manoeuvre is performedQ Minimization of Biases in Epidemiological Studies by BlindingTypeMethodMinimizesSingle blindingStudy subjects are not aware of the treatment they are receivingSubject biasDouble blindingStudy subjects as well as investigator are not aware of thetreatment study subjects are receivingSubject bias + Investigator biasTriple blindingStudy subjects, investigator as well as analyzer are not awareof the treatment study subjects are receivingSubject bias + Investigator bias + Analyser bias
4
Matching
Blinding
Randomization
Multivariate analysis
Social & Preventive Medicine
Principles of Epidemiology
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multi
Which of the following is not a cause of oropharyngeal carcinoma?
Ans. is 'a' i.e., Occupational exposure to hydrochloric acid Etiology of oropharyngeal carcinoma Tobacco in any form - cigarette smoking or chewing Heavy alcohol abuse Beetle nut chewing Plummer vinson syndrome, cirrhosis Syphilis Trauma Dental irritation Poor oral hygiene Occupational exposure to isopropyl alcohol, sulphuric acid and nickel HPV infection
1
Occupational exposue to hydrochloric acid
Smoking
Human Papilloma Virus infection
Occupational exposure to isopropyl oil
ENT
null
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single
Larva of which of the following is seen in feces
Filariform larva is the infective form of strongyloides stercoralis The rhabditiform larva migrates into the lumen of the intestine and passes down the gut to be released in faeces Ref : panikers textbook of Medical parasitology 8th edition page 182
1
Strongyloides stercoralis
Taenia solium
Taenia saginatum
Hymenolepis nana
Microbiology
parasitology
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single
Antibiotic potentiating the effect of NM blocker?
Ans. is 'b' i.e., Aminoglycoside Impoant interactions of skeletal muscle relaxants General anaesthetics potentiate competitive blockers in the following order : Isoflurane (most), sevoflurane, desflurane, enflurane, Holothane and nitrous oxide (least). . Anticholinesterase (neostigmine, pyridostigmine & edrophonium) reverse the action of competitive blockers, they can enhance depolarizing neuromuscular blockers. Calcium channel blockers (verapamil) potentiate both competitive and depolarizing neuromuscular blockers. Diuretics produce hypokalemia which enhances competitive block. Diazepam, propranolol and quinidine intensify competitive block. Aminoglycosides, tetracycline, polypeptide antibiotics, clindamycin and lincomycin can potentiate competitive block. High doses of glucocoicoids reduce the effect of competitive blockers
2
Erythromycin
Amino glycos ide
Co-trimoxazole
Nitrofurantoin
Anaesthesia
null
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single
Dent disease is due to defect of?
Dent's disease (or Dent disease) is a rare X-linked recessive inherited condition that affects the proximal renal tubules of the kidney. It is one cause of Fanconi syndrome and is characterized by tubular proteinuria, excess calcium in the urine, the formation of calcium kidney stones, nephrocalcinosis, and chronic kidney failure. About 60% of patients have mutations in the CLCN5 gene (Dent 1), which encodes a kidney-specific chloride/proton antipoer, and 15% of patients have mutations in the OCRL1 gene (Dent 2). Dent's disease often produces the following signs and symptoms: Rickets Extreme thirst combined with dehydration Nephrolithiasis (kidney stones) Hypercalciuria (high urine calcium - >300 mg/d or >4 mg/kg per d) with normal levels blood/serum calcium) Aminoaciduria (amino acids in urine) Phosphaturia (phosphate in urine) Diagnosis is based on a genetic study of CNCL5 gene Ref: wikipedia
3
Sodium channel
Potassium channel
Chloride channel
Calcium channel
Pathology
Nervous system
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single
A patient presents with low serum calcium, high phosphorus and etevated PTH. Which of the following investigations is least contributory to establish a diagnosis -
Ans is option 1.. Vit D levels Vit d deficiency is associated with hypophosphatemia and not hyperphosphatemia Renal failure, pseudohypoparathyroidism and increased urinary myoglobin may all be associated with combination of hypocalcemia, hyperphosphatemia and elevated PTH levels Ref Harrison 19/e p2482
1
Vitamin D levels
Serum creatinine levels
Cyclic AMP response to PTH
Urine myoglobin
Medicine
Endocrinology
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single
Earliest phenotypic manifestation of Idiopathic hereditary hemochromatosis is-
Answer is D (Increased Transferrin Saturation) The Most Common Manifestation of Hemochromatosis is Hepatomegaly. Liver Enzymes may be normal or elevated depending on the extent of hepatocyte damage. A transferrin saturation of more than 45% is the earliest phenotypic abnormality in hereditary hematochromatosis' Transferrin saturation and measurement of unbound iron bindeng capacity are recommended fir initial scrceening of individuals Tests Recommended for screening for Hereditary Hematochromatosis Transferrin Saturation The transfrrin saturation f wore than 45% is the earliest phenotypic abnormality in hereditary hematochromatosis Transferrin saturation is considered the best initial screening test for hereditary hematochromotosis Transferrin saturation has a high sensitivity of >90% in diagnosing hereditary hematochromatosis Transferrin saturation is the ratio of serum iron to total iron binding capacity (SUTIBC) Iron binding capacity (Unbound /Unsaturated) Unbound Iron binding capacity is an alternative screening test. Unbound Iron binding capacity UIBC=TIBC-Serum Iron Unbound iron binding capacity is decreased in hematochromatosis
4
Post prandial increase in serum iron concentration
Elevated serum ferritin level
Slate grey pigmentation of skin
Increased transferrin saturation
Medicine
null
4a425283-e660-4a57-ad58-c680789f127a
single
Live vaccine is -
Ans. is 'c' i.e., Sabin polioLive attenuatedInactivated or killedImmunoglobulins Bacterial BOG Typhoid oral VTral Oral Polio (Sabin) Yellow fever Measles Rubella Mumps Chicken pox Influenza Rickettsial Epidemic TyphusBacterial Typhoid Cholera Pertussis Meningitis Plague Viral Rabies Injectable polio (Salk) Influenza Hepatitis AJE KFDHuman normal Hepatitis A,B Measles Rabies Tetanus Mumps Human Specific Varicella Diptheria Non-Human (antisera) Diphtheria Tetanus Gas Gangrene Botulism RabiesSubunit Vaccines Hepatitis B Typhoid Vi antigenToxoids Diphtheria TetanusBoth active & passive immunization can be given together Diphtheria Hepatitis B Tetanus Rabies
3
Salk polio
KFD
Sabin polio
Meningococci
Microbiology
Immunity
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single
Prolonged use of one of the following anticonvulsant can produce weight loss -
Ans. is 'c' i.e., Topiramate o Use of topiramate is limited by its unwanted side effects paicularly weight loss, sedation and naming difficulties. Note - Other drug causing weight loss is Felbamate.
3
Gabapentin
Oxcarbazepine
Topiramate
Valproic acid
Pharmacology
null
4f3a2fe0-0a8b-47d9-84b6-0177bd239f07
single
Which of the following anti TB drugs acts on extracellular organisms and is bactericidal drug?
Streptomycin is the only anti-TB drug which acts on extracellular organisms and is bactericidal. All first line antitubercular drugs are bactericidal except ethambutol which is bacteriostatic. Impoant points about first line ATT: Drug Action Hepatotoxic Bacteria Inhibited Isoniazid CIDAL Yes Both Rifampicin CIDAL Yes Both Pyrazinamide CIDAL Yes Intracellular Ethambutol STATIC No Both Streptomycin CIDAL No Extracellular
2
Isoniazid
Streptomycin
Rifampicin
Ethambutol
Pharmacology
Mycobacterial Diseases (TB, Leprosy and MAC)
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single
The exact pa of the antigen that reacts with the immune system is called as ?
Ans. is 'b' i.e., Epitope Epitope . Also known as "antigenic determinant". . It is antibody binding site of antigen. . It is the smallest unit of antigenicity. . Antigenic determinants is composed of structures on the surface of molecules and can be constructed in two ways: 1. Within a single segment of primary sequence 4. Sequential epitopes 2. Assembled from residues far apa in the primary 3. Conformational epitopes sequence but brought together on the surface by the folding of the molecule into its native conformation . The majority of antigenic structures recognized by antibodies depend on the teiary configuration of the antigen (conformational), while T cell epitopes are defined by the primary structure (sequential). Paratope . The pa of the antibody or T cell receptor that interact with the epitope. "The idiotype is defined as the specific region of the fab poion of the 1g molecules to which antigen binds".
2
Clone
Epitope
Idiotope
Effector
Microbiology
null
6373d2a9-8cbf-4e5b-8789-42099043155a
multi
Best treatment for remission of acute ulcerative colitis is ?
GLUCOCOICOIDS Effective for inducing remission in both UC & CD. No role in maintenance in either UC or CD. Once clinical remission is achieved , they should be tapered.
2
Sulphasalazine
Prednisolone
Aminosalicyclic acid
NSAIDS
Surgery
Inflammatory bowel disease
fc1b0009-49a8-442f-bb17-9835708d2c29
single
Which of the following is not a feature of MEN type
Ans: d (Adrenocortical adenoma)Ref: Harrison, 17 ed pg. 2359MEN I (Wermer's syndrome) is characterized by pituitary, parathyroid & pancreatic affection. Pheochromocytoma is seen in all three even though less common in MEN I MEN' I (wermer's)MEN IIA (sipple)MEN II BPi tut aryAdenomaHyperplasia ParathyroidHyperplasiaAdenomaCarcinomaHyperplasia PancreasIslet cell hyperplasia,AdenomaCarcinoma Adrenal Pheochromocy- tomaPheochrom- ocytomaThyroid Ccell hyperplasiaC-cell hyperplasia MedullarycarcinomaMedullary carcinomaMucocutan- eous ganglioneu- romaMarta noidHabitus Less commonPheochromo- cytomaForgut carcinoidSubcutaneous/ visceral lipomaDermal angiofibroma Mutant gene RETRET MEN Hirschsprung - loss of function in RET protooncogene MEN 2A - gain of function in RET protooncogene.Please don't confuse Wermer's syndrome (MEN 1) with Werner's syndrome which is adult progeria. It is a rare condition and predisposes to papillary cancer thyroid.
4
Pheochromocytoma
Parathyroid adenoma
Pituitary adenoma
Adrenocortical adenoma
Medicine
Endocrinology
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single
Samters triad is seen in patients with -
Ans. is 'a' i.e.. Asthma [Ref: Dhingra 5th/ep. /55jSamter's triado Samter's triad is a medical condition consisting of asthma, aspirin sensitivity, and nasal/ethmoidal polyposis. It occurs in middle age (twenties and thirties are the most common onset times) and may not include any allergies.o Most commonly, the first symptom is rhinitis.o The disorder typically progeses to asthma, then polyposis, writh aspirin sensitivity coming last,o The aspirin reaction can be severe, including an asthma attack, anaphylaxis, and urticaria in some cases. Patients typically react to other NSA1DS such as ibuprofen, although paracetamol is generally considered safe,o Anosmia (lack of smell) is also typical, as the inflammation reaches the olfactory receptors in the nose.
1
Asthma
Chronic pancreatitis
Crohn's disease
Liver cell carcinoma
ENT
Nose and PNS
884b61db-8f3a-4b9a-a4ef-67a72d589857
single
Besides zidovudine and lamivudine, which following drug is a reverse transcriptase inh v used in the treatment of HIV infection?
Anti-Retroviral drugs (a) Nucleoside reverse transcriptase inhibitors (Nis) : Zidovudine (AZT), Didanosine, Zalcitabine*, Stavudine, Lamivudine, Abacavir (b) Nonnucleoside reverse transcriptase inhibitors (NNis) : Nevirapine, Eirenz, Delavirdine* (c) Protease inhibitors : Ritonavir, Indinavir, Nelfinavir, Saquinavir, Amprenavir*, Lopinavir Ref Harrison 20th edition pg 789
3
Saquinavir
Indinavir
Abacavir
Ritonavir
Medicine
Infection
f97d4d03-5145-4b8b-a607-d8113072d8c8
single
Chloride responsive alkalosis, causes are-
Repeat
1
Severe vomiting
Bater's syndrome
Milk alkali syndrome
Frusemide therapy
Medicine
Fluid and electrolytes
1048f5ce-adaf-4ba1-8e30-8b3e29d84f40
single
The bone matrix has the following crystals ?
Ans. is 'a' i.e., Calcium hydroxyapatite Structure of bone Bone is a specialized connective tissue. o Bone components are :? Inorganic elements (65%) Organic matrix (35%) 1. Inorganic elements It is the mineral phase, principally composed of calcium and phosphate, mostly in the form of hydroxyapatite.
1
Calcium hydroxyapatite
Calcium pyrophosphate
Calcium phosphate
Calcium sulphate
Surgery
null
cc667003-eef9-4719-95ef-df3c62899e84
single
Cabot&;s ring is seen in-
In the peripheral blood smear of megaloblastic anaemia . Cabot rings are thin, threadlike, red to violet rings or "figure 8" shaped inclusions in red blood cells. Cabot rings are remnants of the mitotic spindle, and can be seen in megaloblastic anemia, medication effect, myelodysplasia and other forms of dyserythropoiesis. reference :textbook of Pathology, 7th edition ,Author Harsha Mohan ,page number 283, figure 10.20
1
Megaloblastic anemia
Sickle cell disease
Iron deficiency anemia
Autoimmune anemia
Pathology
Haematology
7699ed2a-ae22-41a7-acac-d2f81d1a5a74
single
Not a surgical landmark for parotid surgery
surgical landmark of parotid surgery are : Tragal pointer Digastric posterior belly Styloid process tympansmastoid suture ref : hazarika 4th ed
1
Inferior belly of omohyoid
Tragal pointer
Digastric posterior belly
Dissecting from peripheral branches
ENT
All India exam
81c80479-6277-4219-86f2-af454124cadc
single
Comparison of efficacy of a new drug B with an existing drug A is done in which phase of clinical trials?
"The purpose of phase III trials is to obtain adequate data about the efficacy and safety of drugs in a larger number of patients of either sex in multiple centres usually in comparison with the standard drug." Phase I: Human Pharmacology (Non-therapeutic trials): Done in healthy persons Phase II: Therapeutic exploratory trials: conducted in patients to determine therapeutic effects, effective dose range and fuher evaluation of safety and pharmacokinetics in patients Phase III: Therapeutic confirmatory trials: Conducted to obtain adequate data about the efficacy and safety of drugs in a larger number of patients of either sex in multiple centres usually in comparison with the standard drug. Phase IV: Post marketing studies
3
Phase I
Phase II
Phase III
Phase IV
Pharmacology
CLINICAL TRIALS, DRUG LABEL
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single
Vogt Koyanagi–Harada (VKH) syndrome is –
VKH syndrome is a multisystem disorder characterized by chronic granulomatous uveitis with exudative retinal detachment that is often associated with neurological and cutaneous manifestations.
1
Chronic granulomatous uveitis
Chronic non-granulomatous uveitis
Acute purulent uveitis
None
Ophthalmology
null
d7f49e60-afce-4cc0-8069-0ea959d18ea7
multi
Features of hereditary spherocytosis include all of the following except :
Answer is C (MCV Ted) Mean corpuscular volume of RBC is decreased in patients with hereditary spherocytosis. Hereditary spherocytosis is characterised by defect in one of the proteins in the cytoskeleton of Red cell membrane, leading to loss of membrane, and hence decreased ratio of surface area to volume and consequently spherocytosis. Characteristic Laboratory abnormalities The mean corpuscular volume (MCV) : is decreasedQ The mean corpuscular Hb. concentration (MCHC) : is increasedQ Osmotic fragility is : increasedQ Remember the following also : * Most common membrane defect is that of Ankyrin Q * One characteristic clinical presentation is Striking splenomegaly Q * Treatment of choice is (anemia, splenomegaly, jaundice) Splenectomy Q
3
|Osmotic fragility
|MCHC
|mcv
Decrease surface area per unit volume .
Medicine
null
e7a8d54a-de75-48da-ac74-3598d892cc8f
multi
Which one of the following is NOT a component of the filtration slit diaphragm at the glomerulus?
The filtration barrier in the glomerulus is composed of the endothelial cells of glomerular capillaries, basement membrane that covers the endothelial cells, and foot processes of the epithelial cells surrounding the basement membrane Podocytes are separated by apparent gaps called filtration slits. Each filtration slit is bridged by a thin diaphragm. The filtration slit diaphragm is composed of several proteins, such as nephrin, podocin, a-actinin. Batin gene (also known as BSND) codes for the protein batin; this protein recruits the Cl- channel CLCNKB to the basolateral membrane in the TAL of loop of Henle.
4
Nephrin
Podocin
alpha-actinin 4
Batin
Physiology
Excretory System (Kidney, Bladder) Acid-Base Balance
b0d6a7a9-e686-4c08-a81f-55cce4eeccb9
single
By what age does a child achieve the following developmental milestone?
Age Milestones 4 months 6 months 9 months 10-12 months 12 months Bidextrous grasp Unidextrous / palmar grasp(Ulnar grasp) Immature Pincer grasp Palmar grasp (Radial grasp) Mature Pincer grasp
2
5 months
6 months
8 months
9 months
Pediatrics
null
6bbdb0a8-3ff1-4097-b9aa-a7c405f4a34c
single
Uses of PUVA – a) Pigmented purpuric lesionb) Herpes zosterc) Mycosis fungoidesd) Lupus panniculitise) Lichenoid dermatitis of Gougerot & Blum
Indications for PUVA and UVB Established major indications :- Psoriasis, atopic dermatitis, vitiligo, mycosis fungoides, Polymorphic light eruption, pompholyx. Less frequently treated (less evidence of effectiveness) :- Pityriasis rosea, morphea, chronic urticaria, Pityriasis lichenoid chronica, Alopecia totalis & Universalis, Lichen plaints, Pityriasis rubra pilaris, Granuloma annulare, Generalized pruritis, Nacrobiosis lipoidics. "Pignzented pruritic lichenoid dermatosis of Gougerot & Blum can be treated by PUVA".
4
acd
bde
cde
ace
Dental
null
cfcc9903-9888-48fd-82a8-f33e72647ca3
single
Drug of choice for Bupivacaine induced cardiac arrythmia
Bretylium is a class III Antiarrythmic used to treat Bupivacaine induced ventricular tachycardia.
3
Amiodarone
Procainamide
Bretylium
Flecainide
Pharmacology
null
3ad5b6f1-0144-4eb6-9a87-b6367e8b957b
single
Quod Hanc is-
Ans. is 'd' i.e., Psychologic impotence
4
Impotence to all women
Legally impotent
Medically impotent
Psychologic impontence
Forensic Medicine
null
309c3c51-a6c6-49c3-b01f-a9abd7fdc48b
multi
Area of skin supplied by single nerve supply
A dermatome is an area of skin that is mainly supplied by a single spinal nerve. There are eight cervical nerves (C1 being an exception with no dermatome), twelve thoracic nerves, five lumbar nerves and five sacral nerves. Each of these nerves relays sensation (including pain) from a particular region of skin to the brain. Spinal nerves not only play an important role in differentiation and motor innervation of the limb musculature, but also provide sensory innervations for the dermatomes.
1
Dermatome
Pedicle
Graft
Dermoid
Pathology
null
2b01133d-32b9-4ed5-a5db-7fdda3dc064d
single
Inactivated microorganisms are used in the manufacture of which of the following:
null
1
Salk vaccine
Tetanus toxoid
Sabin's oral vaccine
All of the above
Microbiology
null
23457e29-3545-43cd-82ae-76df8b90606a
multi
False statement about MODY is -
Maturity-onset diabetes of the young (MODY) is characterized by autosomal dominant inheritance, early onset of hyperglycemia (usually <25 years; sometimes in neonatal period), and impaired insulin secretion. It is non insulin requiring diabetes and can be managed by diet and sulfonylurea (paicularly HNF-1a and HNF-4a forms). Reference : page 806-7 Davidson's Principles and practice of Medicine 22nd edition
4
Age < 25 years
Impaired secretion of insulin
Responds to sulfonylureas
Insulin dependent
Medicine
Endocrinology
a8ea607b-d25d-49c7-9d7b-baaca64cd401
multi