lighteval/med_mcqa · Datasets at Hugging Face

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Extrahepatic cholestasis is associated with:	null	1	T bilirubin in urine	T urobilirubin in urine	T bilirubin and T urobilirubin in serum	T bilirubin in serum	Medicine	null	126ef47b-0f7d-4543-8148-e713e36f5fb5	single
Gene responsible for pathogenesis of H pylori	Cytotoxic: products of two genes namely cytotoxin- associated gene A(cagA) and vacuolating agent(vacA) gene cause gastritis, peptic ulceration and cancer GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK FIRST EDITION PAGE 379	1	Cag A	Cag B	Tax A	Hbx	Pathology	G.I.T	6813bebd-8421-4f0d-b71a-2b8162ef85e8	single
Rotator interval is between	Refer Essentials of Ohopedic surgery Rotator interval is a triangular poion of shoulder capsule which lies between supraspinatus and subsacapularis tendon	3	Supraspinatus and trees minor	Teres major and teres minor	Supraspinatus and subsacapularis	Subsapalris and infraspinatus	Anatomy	General anatomy	e7712da9-f9d4-4c8d-b6cd-c2b6913e2df2	single
Baon's fracture is injury to ?	Baon&;s fracture is an intra aicular fracture of distal radius. Here fracture extends from aicular surface of the radius to either its anterior or posterior coices. The small distal fragments get displaced and carries with it the carpals.(carpal bone subluxation) 2 types of volar Baons fracture and dorsal Baons fracture. Treatment: closed manipulation and plaster cast. when closed reduction fails, internal fixation with plate may be required. Ref: Essential Ohopaedics, Maheswari & Mhaskar, 9th ed, Page no: 114	4	Fracture distal end humerus	Extra-aicular fracture distal end radius	Intra-aicular fracture distal end radius	Intra-aicular fracture distal end radius with carpal bone subluxation	Orthopaedics	Forearm wrist and hand injuries	ea0ee668-fa8a-474e-9655-5ddfc2434bd0	single
In a seriously ill patient, addition of amino acids in the diet results in a positive nitrogen balance. The mechanism for this is	Glucose, mannose, aminoacids (such as leucine, arginine, others) and β ketoacids such as acetoacetate (derived from fat catabolism) stimulate insulin secretin and have protein sparing effect. Insulin has anabolic effect on metabolism. It decreases protein catabolism and fat catabolism for energy production and increases aminoacid uptake and protein synthesis (positive nitrogen balance).	3	Increased absorption of amino acids from the intestine	Enhanced rates of gluconeogenesis	Increased secretion of insulin	Increased Growth hormone secretion	Biochemistry	null	54b36f85-58b3-425e-9dc4-3149dc1e4a86	single
Nipple inversion occurs due to involvement of:	Ans. (b) Subareolar duct(Ref: Bailey 25/e p834)* Peau- de orange - Subdermal Lymphatic infiltration (T4b)* Dimpling/Puckering/tethering of skin - Due to Coopers ligament of breast involvement (It is not skin involvement is T staging)* Nipple retraction - Fibrosis in and around the Subareolar duct	2	Cooper's ligament	Subareolarm duct	Parenchyma of breast	Subdermal lymphatics	Surgery	Breast	bf09756a-031f-4562-a77c-327b2b6d8ee5	single
Which muscle does not decussate in modiolus	null	1	Levator labli superious	Orbiculesis Oris	Zygomaticus major	Buccinator	Dental	null	fbc9482a-38fe-465d-944b-c5340948a3dc	single
A 25 year old male presented with pigmentation of nose and pinna. After voiding, his urine becomes dark. His spine is most likely to show -	null	4	Atlantoaxial subluxation	Spondyloptosis	Basilar invagination	Calcification of disc	Medicine	null	4c0a19f7-4ad9-452e-b568-497b428c1cda	single
Hairy leukoplakia is characterized by?	Ans. is 'b' i.e. EBV infection Hairy leukoplakia (Oral hairy leukoplakia, OHL)* It is a condition caused by Epstein-Barr virus (EBV) and occurs usually in persons who are immunocompromised, especially those with HIV/AIDS.* It presents an asymptomatic white patch, which almost exclusively occurs on the lateral surfaces of the tongue. The lesion may grow to involve the dorsal surface of the tongue.* The texture is vertically corrugated ("hairy") or thickly furrowed and shaggy in appearance* The white appearance is created by hyperkeratosis (overproduction of keratin) and epithelial hyperplasia* Treatment is not necessary since the lesion is benign & self-limiting.	2	Pain	EBV infection	No association with HIV	Pre-cancerous	Pathology	Blood	d66af908-7c18-431c-9345-32ba450e68fc	single
Aery which does not supply Medulla is	Medulla supplied byAnterior spinalPosterior spinalPosterior inferior cerebellar Direct medullary branches of veebral and basilar	3	Anterior spinal	Posterior spinal	Superior cerebellar	Posterior inferior cerebellar	Anatomy	All India exam	7f084076-d7c8-4a93-8b87-128e3128e2bc	single
Silver impregnation technique is used in the identification of ?	Silver impregnation: cells and structure too thin to be seen under the ordinary microscope may be rendered visible if they are thickened by impregnation of silver on the surface. Such a method is used for the demonstration of spirochetes and bacterial flagella REF:Ananthanarayan & Panicker's Textbook of Microbiology 9th edition pg no:13	4	Spirochaetes	Leptospira	Borrelia	All of the above	Microbiology	general microbiology	684436ce-1d6f-4f0e-be65-2b71957b74d0	multi
Broad Granular casts are seen in	Broad granular casts - Chronic renal failure. RBC casts - Glomerular injury.	1	Chronic renal failure	Glomerular injury	Thrombotic Microangiopathy	Pyelonephritis	Medicine	null	2e7f82c7-75d9-4540-96eb-3860f7fbd9c1	single
Psoriasis associated with p – hemolytic streptococcal infection –	Guttate psoriasis is precipitated by upper respiratory tract infection, e.g. streptococcal tonsilitis.	4	Psoriasis vulgaris	Erythrodermic psoriasis	Pustular psoriasis	Guttate psoriasis	Dental	null	3210c88d-35f0-4b01-9ffb-60c5bacbc904	single
The deciduous canine emerges:	null	3	Before lateral incisor	Before first molar	After first molar	After second molar	Dental	null	4174d051-5f20-467a-a20c-ed8fb492b910	single
Longest acting local anaesthetic is: March 2013 (e, h)	Ans. C i.e. Bupivacaine Bupivacaine Amide with duration of action more than 2 hours, C/I for: Bier's block/Intravenous regional anaesthesia/IVRA It is highly cardiotoxic Cardiotoxicity is not easily reversible, Levo-bupivacaine is used by epidural/intrathecal route	3	Procaine	Lignocaine	Bupivacaine	All of the above	Anaesthesia	null	83253443-395f-40a1-b5a3-dafc6a994d52	multi
Population covered by Anganwadi in tribal area is	null	1	700	100	400	1000	Social & Preventive Medicine	null	6542d0f3-1aa3-4683-a2d1-9acd3f44439a	single
Partogram in pregnancy includes all of the following except -	Ans: D	4	Uterine contraction	Cervical dilatation in time scale	Descent of foetal head in time scale	Non-stress Test	Unknown	null	093720c7-9545-4cb9-b4cc-2a5be7c78eaa	multi
Otoconia is related to	Otoconia are bio-crystals which couple mechanic forces to the sensory hair cells in the utricle and saccule, a process essential for us to sense linear acceleration and gravity for the purpose of maintaining bodily balance. In fish, structurally similar bio-crystals called otoliths mediate balance Ref : Internet sources.	2	Hearing	Balance	Smell	Taste	ENT	Ear	6a97b712-564d-45cb-8ac6-556f97abb63f	single
True about Rheumatic fever	Answer is A (Chorea is aggrevated during pregnancy) Sydenham's chorea may be aggravated by pregnancy. 'Patient's with sydenham's chorea may have chorea during pregnancy (chorea gravidarum) and are at higher risk of chorea induced by phenytoin or oral contraceptives' - The 5- Minute Neurology consult (2003) /399 Sydenhom's chorea usually occurs in isolation and is not associated with ahritis usually. Subcutaneous nodules are typically non tender. Rheumatic fever is associated with Erythema marginatum and not Erythema multiforme Featues of Sydenham's chorea in Rheumatic Fever (10-15% of patients) It usually occurs after a prolonged latent period after group A streptococcus It usually occurs in the absence of other manifestation (usually not associated with ahritis or carditis) It usually occurs in females Presents as rapid, jerkey, involuntary movements (choreiform movements) affecting predominantly the Head /Face and Upper limbs May be generalized or restricted to one side / asymmetrical Typical signs include Milk maid Grip Spooning of extended hands Daing of the protruded tongue Pronator signs Typically associated with excessive emotional lability and personality changes It is a self limiting condition and eventually resolves completely, usually within 6 weeks. Recurrence of chorea may be seen late after complete resolution Factors inducing Recurrence Pregnancy (Chorea gravidorum) Re infection with streptocossus / non specific infections Use of oral contraceptives	1	Chorea is aggravated during pregnancy	Chorea & ahritis co-existing	Subcutaneous nodules are tender	Erythema multiforme seen	Medicine	null	2d025ca7-f64b-4159-b531-0a9382879426	multi
Treatment of multiple carboxylase deficiency	Treatment of multiple carboxylase or biotinidase deficiency is biotin.Oral dose is 10-40 mg/kg/day Reference:Essential pediatrics-Ghai,8th edition,page no:650	1	Biotin	Pyridoxine	Thiamine	Folic acid	Pediatrics	Metabolic disorders	048df25c-98b5-41a1-9c6d-3e714ce4ef73	single
HILL’S criteria of causal association are all except:	Bradford Hill & others pointed out that the likelihood of a causal relationship is increased by the presence of the following criteria : Temporal Association Strength of Association Specificity of Association Consistency of Association Biological Plausibility Coherence of Association	2	Specificity of association	Sensitivity	Consistency	Coherence	Unknown	null	1c4eabf1-9357-4d8a-8fce-6b38c826c6d3	multi
Aerial supply of latismus dorsi is:	A. i.e. Subscapular aerySubscapular aery is largest branch of axillary aeryQ arise from its 3i-cl pa & supplies lattismus dorsi and serratus anterior musclesQ.	1	Subscapular aery	Circumflex humeral aery	Thoracodorsal aery	Lateral aery	Anatomy	null	56c22e83-af00-4acf-a821-16d423d98cd8	single
The major lipids that make up the cell membrane are:	null	2	Triglycerides	Phospholipids	Sphingomyelins	Fatty acids	Biochemistry	null	a39ec856-51d2-4747-b07c-d3b734c0d558	single
A patient presents with B/L proptosis, heat intolerance and palpitations; most unlikely diagnosis here would be	Answer is D (Reidel's thyroiditis) : Reidel's thyroiditis is usually a consistently hypothyroid condition. The patient in the given question is presenting with symptoms of Hypehyroidism. The condition, most unlikely to produce the picture is the one where hypehyroidism is not a feature, not even transient. Reidel's thyroiditis is one such consistently hypothyroid condition. Thyrotoxicosis is usual with thyroid adenoma and diffuse thyroid goitre and Hashimoto's thyroiditis can present with transient hypehyroidism. Hashimoto's Thyroiditis (Auto immune): In this variant, mild hypehyroidism may be present initially, although hypothyroidism is inevitable. Hypothyroidism may develop rapidly or extremely slowly. The initial phase of hypehyroidism may account for the symptoms in the given patient. Thyroid adenoma, diffuse toxic goitre or Grave's disease, toxic nodular goitre, toxic nodule: All are causes of thyrotoxicosis & explain the symptoms of thyrotoxicosis in the above patient. 733/L&B Riedle's thyroiditis is a very rare disease wherein , the thyroid tissue is replaced by cellular fibrous tissue. The goitre may be unilateral or bilateral & is very hard and fixed. This condition presents with features of hypothyroidism. Hypehyroidism is not manifested, not even transiently. The differential diagnosis is from an anaplastic carcinoma & can be made with ceainity only by biopsy. Diffuse thyroid goitre :Most commonly presents with a euthyroid status however patients may present with hypehyroidism.	4	Hoshimoto's thyroiditis	Thyroid adenoma	Diffuse thyroid goitre	Reidel's thyroiditis	Medicine	null	cfba4c31-ce27-4d39-82c6-f87153bc3efb	single
At what age upper segment : lower segment ratio becomes 1 : 1 ?	Age US : LS Ratio Birth 1.7 : 1 3 years 1.3 : 1 7 - 10 years 1 : 1 > 10 years 0.3 : 1	3	3 - 6 years	5 - 8 years	7 - 10 years	10 - 12 years	Pediatrics	null	b8411ab8-d7c7-4012-b693-06800d743491	single
Which of these is not an ultrasound finding consistent with diagnosis of adenomyosis?	USG findings in adenomyosis Uterine enlargement not explained by leiomyoma Subendometrial echogenic linear striations Heterogenous echotexture Cystic anechoic spaces or hypoechoic areas: lakes of endometrial blood Junctional zone between endometrium and myometrium>12 mm (normal 5-8 mm) Obscured endo-myometrial interface	4	Uterine enlargement	Subendometrial echogenic linear striations	Thickening of transitional zone	Encapsulated hypoechoic lesion	Gynaecology & Obstetrics	Endometriosis, Adenomyosis	4a7da0f8-b3b4-4496-8ea8-6eb049ad9217	single
A person suffered an injury in the right eye with a tennis ball. Following which he developed pain and on examination of fundus a red spot is seen at the macula. What is the most probable diagnosis?	This patient has developed Berlins edema following injury to the eye. This is caused by a pressure wave which pass into the posterior pole of the eye following blunt eye trauma. In this condition retina develops a grey white colour seen mainly in the outer retina which may extend to the macula. If it involves the macula, it results in cherry red spot seen at the fovea. This is because fovea is very thin and it reflects the red colour of underlying normal choroid. Other causes of cherry red spot: Tay-Sachs disease, Niemann- Pick disease, generalized GM1, gangliosidosis, Farber's lipogranulomatosis, infantile Gaucher's disease, metachromatic leukodystrophy and sialidosis types 1 and 2.	1	Berlin's edema	Macular bleed	Macular hole	Macular tear	Ophthalmology	null	00b91470-bf87-4357-b706-7fb0bf1fc5f3	multi
The term "Dementia praecox" was coined by	Although earlier descriptions of schizophrenia-like illness are recorded in the literature (such as in Ayurveda; Kahlbaum's description of catatonia; Hecker's description of hebephrenia), the scientific study of the disorder began with the description of dementia praecox by Emil Kraepelin. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 54	3	Freud	Bleuler	Kraepelin	Schneider	Psychiatry	Schizophrenia and other psychotic disorders	428d8d0b-8de5-4a13-8ddc-c19579cd1930	single
A female presents with primary amenorrhea and absent vagina, the next investigation to be done is :	Laparoscopy	4	LH / FSH assay	Chromosomal analysis	Urianalysis	Laparoscopy	Gynaecology & Obstetrics	null	7b059419-4754-463a-a4ca-43d9a4db597f	single
what is the cell junction marked as circle ?	image shows : zona occludens : tight junctions in intestine and renal tubular cells ell Junctions Types Tight Junctions (Occluding Junctions) Seal adjacent epithelial cells together prevent passage of molecules, membrane-bound lipids and proteins Gap Junctions (Communicating Junctions)= Allow adjacent cell communication; pass ions & small molecules between cytoplasms Focal Adhesions & Hemidesmosomes (Anchoring Junctions, Actin & Intermediate Filament Attachment Sites)= Form around integrin-mediated cell--ECM contacts Focal adhesions connect integrins to actin filaments Hemidesmosomes connect integrins to intermediate filaments Adherens Junctions & Desmosomes (Anchoring Junctions, Actin & Intermediate Filament Attachment Sites) Form around cadherin-mediated cell--cell contacts Adherens junctions connect cadherins to actin filaments Desmosomes connect cadherins to intermediate filaments ref : bd chaurasia/guyton and hall	1	zona adherens	fascia adherens	macula adherens	zonna occludens	Anatomy	All India exam	2e137e8f-be8c-4d81-8ad0-fa41f8607fdc	single
Which of the following is true about colon carcinomaa) Rt. sided colon carcinoma associated with young individualsb) Most common site is sigmoid colonc) Rt. sided colon carcinoma present as chronic anemiad) Not resectable in case of metastasise) Rt. sided colon has better prognosis than Lt. sided colon.	• Left sided colon cancers are more infiltrative at the time of diagnosis than right lesions, associated with poor prognosis	1	bce	bc	acd	ace	Surgery	null	d46c8216-3b7e-4689-9222-14e3ed8ff060	multi
First reflex to reappear after spinal shock?	Ans. B Withdrawal reflexRef: Ganong, 25th ed. pg. 235* In days following development of spinal shock patient will have low threshold for elicitation of withdrawal reflex* Minimal noxious stimulus to arm will lead to withdrawal of one extremity and marked flexion-extension pattern of other 3 limbs.* Later the Deep tendon reflexes become brisk* Application of minor noxious stimulus will lead to evacuation of bladder and rectum called mass reflex.	2	Myotactic reflex	Withdrawal reflex	Stretch reflex	Inverse stretch reflex	Physiology	Nervous System	df6d683c-09c9-41ca-a67f-ff7ac4d16f91	single
The part of urinary bladder that shows non-keratinizing squamous metaplasia in adult females?	Ans. c (Trigone) (Ref. Smith's urology, p. 266)Nonkeratinizing squamous metaplasia (Trigonitis) is the squamous metaplastic changes that occur in the trigone of the bladder, almost exclusively in women of childbearing age (almost nonexistent in children).Trigonal nonkeratinizing squamous metaplasia# The trigone of the bladder (as well as the ureters) are embryologically derived from the mesonephric duct primordial.# Mucosal lining, with the exception of trigone, is rugose in undistended organ but smoothens as filling proceeds.# Normally, trigone is covered in relatively impermeable transitional epithelium. In young females, there may be an overgrowth of squamous vaginal-type epithelium, often referred to as trigonitis. Trigonitis is incorrect terminology because no associated inflammatory reaction exists, and this condition is referred to more properly as trigonal nonkeratinizing squamous metaplasia.# The keratinizing variant frequently is associated with chronic irritation secondary to indwelling instrumentation, calculi, or, in endemic areas, Schistosoma haematobium infection.	3	Anterior wall	Urethral orifice	Trigone	Ureteral orifice	Anatomy	KUB & Adrenal Gland	3824fd7a-1037-4750-bdc7-23ac1aceb92f	multi
Which of the following anaesthetic agent also has anti-emetic propey: September 2006	Ans. C: Propofol Anaesthetics with anti-emetic propey: Midazolam given at the onset of anaesthesia has been shown in to be as effective as ondansetron Propofol is versatile; the drug can be given for sho or prolonged sedation as well as for general anaesthesia. It is an anti-emetic.	3	Ketamine	Thiopentone	Propofol	Nitrous oxide	Anaesthesia	null	fb740464-9766-41b6-96c8-30ef960ff66d	single
Following injury to blood vessels , immediate haemostasis is achieved by which of the following	ref Robbins 8/e p115 Vascular spasm (Vasoconstriction) -Vasoconstriction is produced by vascular smooth muscle cells, and is the blood vessel's first response to injury. ... When a blood vessel is damaged, there is an immediate reflex, initiated by local sympathetic pain receptors, which helps promote vasoconstriction	2	Fibrin deposition	Vasoconstriction	Platelets adhesion	Thrombosis	Anatomy	General anatomy	0f6a7e1a-82b5-45a0-be16-483eb5336b8c	single
All of the following are true for Korsakoff's psychosis except: March 2010	Ans. C: Deficiency of cyanocobalamin Korsakoff's psychosis/amnesic-confabulatory syndrome is a neurological disorder caused by the lack of thiamine (vitamin B1) in the brain. There are six major symptoms of Korsakoff's syndrome: Anterograde amnesia and Retrograde amnesia, severe memory loss Confabulation, that is, invented memories which are then taken as true due to gaps in memory sometimes associated with blackouts Meager content in conversation Lack of insight Apathy - the patients lose interest in things quickly and generally appear indifferent to change. These symptoms are caused by a deficiency of thiamine, which is thought to cause damage to the medial thalamus and possibly to the mammillary bodies of the hypothalamus as well as generalized cerebral atrophy. When Wernicke's encephalopathy accompanies Korsakoff's syndrome, the combination is called the Wernicke-Korsakoff syndrome. Korsakoff's is a continuum of Wernicke's encephalopathy, though a recognised episode of Wernicke's is not always obvious. Korsakoff's involves damage to neurons; gliosis which is a result of damage to suppoing cells of the central nervous system; and hemorrhage or bleeding in mammillary bodies.	3	Organic amnestic syndrome	Loss of insight	Deficiency of cyanocobalamin	It may follow Wernicke's encephalopathy	Psychiatry	null	b45ddbd1-cfe6-477c-ae04-fa98c52dde7f	multi
A 17-year-old girl with keratitis and severe pain in the eye came to the hospital and acanthamoeba keratitis was suspected. The patient gave the history of the following 4 points. Out of these which is not a risk factor for acanthamoeba keratitis –	Corneal infection with acanthamoeba result from direct corneal contact with any material or water contaminated with the organism. The risk factors are : (i) Contact lens use, (ii) Trauma, (iii) Opportunistic infections.	4	Extended wear contact lens	Exposure to dirty water	Corneal trauma	Squamous blepharitis	Ophthalmology	null	26079d00-f4ac-4f51-b7f8-cfb3894b5b74	single
The primary defet which leads to sickle cell anemia is -	Ans. is 'b' i.e., Replacement of glutamate by valine in b chain of HBA Sickle cell anemia Sickle cell anemia is a hereditary hemoglobinopathy, i.e. the type of disease characterized by production of defective hemoglobin. Normal hemoglobin o The hemoglobin molecule is an assembly of four globular protein. o Each subunit is composed of a protein pa, i.e. globin and a nonprotein pa, i.e. heme, i.e. Each hemoglobin molecule contains four heme units and two pairs of similar protein, globin. o The heme pa of globular protein is same in all types of hemoglobin. o The protein pa vary in different hemoglobin ? 1. Adult hemoglobin (Hemoglobin A) consist of two identical alpha-chains and two identical alpha-chains. 2. Fetal hemoglobin (HbF) consists of two identical a-chains and two identical y chains. 3. Minor hemoglobin (HbA,) consist of two identical a-chains and two identical S chains. o Normally adult blood contains about 96% of HbA (a,(32)3-3.5% HbA2 (a2O2), and small amount of fetal hemoglobin HbF (.272). Defect in sickle cell anemia Sickle cell anemia results from mutation in fI-globin gene. o It is caused by a point mutation at the sixth position of the beta-globin chain leading to substution of a valine residue for a glutamic acid residue. resulting in sickle hemoglobin (HbS). Sickle cell anemia is an autosomal recessive disorder. o If an individual is homozygous for the sickle cell mutation, almost all the hemoglobin in the red cell is HbS. o In heterozyogotes, only about 40% of the hemoglobin is HbS, the remainder being normal hemoglobins.	2	An abnormality in porphyrin pa of hemoglobin	Replacement of glutamate by valine in b-chain of HbA	Replacement of glutamate by valine in b-chain of HbA	Substitution of valine by glutamate in the a-chain of HbA	Pediatrics	null	2ba68b18-3c86-4849-84ec-f912da9dcea9	single
A patient who has undergone partial gastrectomy presents with neurological symptoms. Most probable diagnosis:	Ans. (c) Vitamin B12 deficiencyRef: Sabsiton 20th Edition, Page 1212* Following partial gastrectomy there is decreased production of Intrinsic factor which leads to vitamin B12 deficiency.	3	Folic acid deficiency	Thiamine deficiency	Vitamin B12 deficiency	Iron deficiency	Surgery	Stomach & Duodenum	c4840878-99d8-4c26-b801-779d5e1da7f0	single
Essential for tumor metastasis is:	Angiogenesis	1	Angiogenesis	Tumorogenesis	Apoptosis	Inhibition of Tyrosine kinase activity	Pathology	null	fefd4680-c433-44c7-9dad-da11b78252f3	single
Ixekizumab is novel drug approved by the FDA for treatment of psoriasis, MOA of this drug is :	Ixekizumab, approved for treatment of plaque psoriasis. It is a humanized IL-17A antagonist that works when IgG4 monoclonal antibodies selectively bind with IL-17A cytokines and inhibit their interaction with the IL-17 receptor. Secukinumab, similar to Ixekizumab, this injectable is an IgG1 monoclonal antibody that selectively binds to the IL-17A cytokine and inhibits its interaction with the IL-17 receptor. It is approved for the treatment of plaque psoriasis and psoriatic ahritis. Ustekinumab : Anti IL-12/23 Apremilast: PDE-4 inhibitor	2	IL-17A agonist	IL-17A antagonist	IL-12/23 antagonist	PDE 4 inhibitor	Dental	Psoriasis	7bc96073-08a8-4c10-a97a-f5088ea393ff	single
For a survey a village is divided into 5 lanes then each lane is sampled randomly is an example is:	Stratified random sampling Random/probability sample : sample in which researcher can specify the population known factor of any one element (same)in the population being included.(being picking link). So every person has an equal chance of selection in random sampling. - Probability samples used in inferential statistics - Non probabilities samples used in only descriptive statistics Type of probability sample (Random sample) 1. Simple random sample - All person have equal right to be selected. Simplest type of random probability. 2. Stratified random sample - in it the population is 1st divided into relatively internally homogenous group of strata from which random sampling are drawn. Example:Village Population 3. Systematic sample - it involve selecting element in a systematic way. Example: Every 10th baby born in area. Every 3rd person admitted to hospital.	2	Simple random sampling	Stratified random sampling	Systematic random sampling	All if the above	Surgery	null	90e0bfce-9498-463c-8b3b-f4a32342ce8b	multi
13.All the following are true of antrochonal polyp,except:	Ref.Dhingra 6/e p 174,175	3	Common in children	Single and unilateral	Bleeds on touch	Treatment involves avulsion	Anatomy	General anatomy	4b1ae084-ba6e-453a-9d69-d8d195ca11ea	multi
Contents of Deep perineal pouch include all of the following, EXCEPT:	Root of penis is present in the superficial perineal pouch and not in the deep perineal pouch. Contents of the deep perineal pouch are: Sphincter urethraBubourethral glandsDorsal nerve of penisMembranous pa of urethraDeep transverse perineal muscleInternal pudendal vessel and its branches Ref: Clinical Anatomy for Medical Students By Richard S Snell, 6th Edition, Page 369	1	Root of penis	Sphincter urethrae	Bulbourethral gland	Dorsal Nerve of penis	Anatomy	null	d56adaf9-bd1d-4923-8804-6c9531addad2	multi
Not seen in hyponatremia: March 2009	Ans. B: Delusion	2	Nausea	Delusion	Vomiting	Anorexia	Medicine	null	6c5fb15c-0bd8-4e23-9f82-062bb1bc5a64	single
Which one of the following are most improtant antigen presenting cells in human-	Robbins and Cotran pathologic basis of disease South Asia edition. *immature dendritic cells within the epidermis are called langerhans cells .dendritic cells are the most impoant antigen presenting cells for initiating T cell responses against protein antigen.	3	Macrophages	Plasma cells	Langerhan's cells\/histiocytes	Lymphocytes	Pathology	General pathology	4de22e29-0e86-427d-b36e-c88b9e71ee42	single
Purulent inflammation and infection of terminal pulp space of distal phalanges is known as: September 2009	Ans. B: Whitlow Whitlow/Felons are closed-space infections of the fingeip pulp. This is the commonest hand infection . Fingeip pulp is divided into numerous small compaments by veical septa that stabilize the pad. Infection occurring within these compaments can lead to abscess formation, edema, and rapid development of increased pressure in a closed space. This increased pressure may compromise blood flow and lead to necrosis of the skin and pulp.There is little room for swelling, so that infection causes a throbbing pain early. Staphylococcus aureus is the most common cause Complications Osteomyelitis involving the diaphysis of distal phalanx is a common complication. The most serious complication is acute tenosynovitis, which may result from contiguous spread of infection. Other complications include skin necrosis, deformity of the fingeip, septic ahritis, and instability of the finger pad. It is managed by incision & drainage.	2	Acute paronychium	Whitlow	Acute suppurative tenosynovitis	Apical subungual infection	Surgery	null	10de49e2-bd48-4044-9b6c-e5025f7f4075	single
A 32-year-old female, asymptomatic, not requiring blood transfusion, presents with Hb 13.0 gm/dl. Her HbF levels are 95%, HbA2, 1.5%. Which of the following is the most likely diagnosis -	<p>In contrast to alpha thalassemia ,gene deletion rarely ever causes beta thalassemia & is only seen in an entity called hereditary persistence of foetal hemoglobin (HPFH).</p><p>In the given case scenario ,HbA2 is within normal limit (1.5-3.5%) in contrast to thalassemia where the HbA2 will be increased .</p><p>Reference :Harsh mohan textbook of pathology sixth edition pg no 322.</p>	1	Hereditary persistence of fetal hemoglobin	Beta homozygous thalassemia	Thalassemia intermedia	Beta heterozygous thalasiemia	Medicine	Haematology	cc56baeb-18b6-4eca-9674-1eb3ffe24b58	single
Y descent in jugular venous pulsation is due to	Y descent is due to passive movement of blood from atria to ventricles i.e. early diastolic filling	4	Ventricular systole	Atrial systole	Atrial filling	Ventricular filling	Medicine	null	a13e4404-e52c-4c6f-9b84-85b79de388de	single
Damage to which Brodmann area is responsible for motor aphasia	Motor aphasia is due to lesion in Broca's area which belong to Brodmann's area 44, (inferior frontal gyrus).	4	22	39	40	44	Anatomy	Neuroanatomy 1	2d27aa47-bc65-44fc-97bc-ada7550a0927	single
Superior cerebellar peduncle contains mainly which tract ?	Ans. is 'a' i.e., TectocerebellarSuperior cerebellar peduncle This is the major output of the brain and connects to the midbrain, the cerebellothalamic tract (to the thalamus), and the cerebellorubral tract (to the red nucleus). It receives afferents from the locus coeruleus, and ventral spinocerebellar tract.Middle cerebellar peduncle This is the largest peduncle and connects the cerebellum to the pons. It connects the contralateral pontine nucleus to the cerebellar coex and also carries the input from the contralateral cerebral coex. It is composed of three fasciculi including the superior, inferior and deep.Inferior cerebellar peduncleThis connects the spinal cord and medulla to the cerebellum. The posterior spinocerebellar tract receives proprioceptive information from the body. The cuneocerebellar tract receives proprioceptive input from the upper limb and neck. The trigeminocerebellar tract sends proprioceptive input from the face. The juxtarestiform is an efferent system here.	1	Tectocerebellar	Olivocerebellar	Vestibulo cerebellar	Reticulo cerebellar	Anatomy	null	36adbf3a-0324-4d51-8db6-5e06e68f8bde	single
WHO was established in?	WORLD HEALTH ORGANIZATION (WHO):- WHO is a specialized, non-political health agency of United Nations established in 1945. Constituition Came into force on 7th April, 1948. April -7th - World health day. Objective of WHO: is attainment by all people of the highest level of health First constitutional function of WHO: to act as the directing and co-coordinating authority on all international health work. Headquaers of WHO: Geneva, Switzerland. Structure of WHO: The world health assembly (WHA) The executive board The secretariat	1	1945	1948	1950	1956	Social & Preventive Medicine	International health agencies	97a42b0e-075a-4ef5-a3ca-a51937d7999a	single
After suffering a streptococcal throat infection, a 12-year-old immigrant boy develops cardiac symptoms that are attributed to rheumatic fever. Years later, at the age of 34 he is admitted to the hospital with pulmonary edema. Further examination reveals a diastolic murmur at the apex and mitral stenosis is diagnosed. Before surgical evaluation, which of the following findings can be attributed to mitral stenosis?	Dilation of the left atrium is the obvious complication following long-standing mitral stenosis. Echocardiography is the simplest and most precise method of showing enlargement of the left atrium. Frequently, there is a latency period of 15-20 years before symptoms become evident. Important complications of mitral stenosis include exertional dyspnea caused by an increase in left atrial pressure and backup of blood with possible pulmonary edema, decreased cardiac output, atrial fibrillation, emboli (15%), and pressure in the intermediate third of the esophagus as seen on an esophogram after barium swallow. The pulse in mitral or aortic stenosis is reduced.	2	Large left ventricle	Indentation of the middle third of the esophagus by an enlarged left atrium	Notching of the ribs	Bounding, full pulse	Surgery	Heart & Pericardium	a8d96feb-36a3-4016-90f5-a59fd8915626	single
A female child of a mother is diagnosed to have Duchenne's muscular dystrophy. What risk does the mother have for her next male child to suffer from similar illness?	(B) 50% # Duchenne muscular dystrophy is inherited in an X-linked recessive pattern.> Male children, who have an XY chromosome pair, receive one of their mother's two X chromosomes and their father's Y chromo- some. Women DMD carriers who have an abnormal X chromosome have a one-in-two chance of passing that abnormality on to their male children.> Unlike most female children, a male child with an inherited defective Xp21 gene does not have a second X chromosome to provide correct genetic instructions, and the disease manifests.> Sons of carrier females each have a 50% chance of having the disease, and the daughters each have a 50% chance of being carriers.> Daughters of men with Duchenne will always be carriers, since they will inherit an affected X chromosome from their father (note that the diagram only shows the results from an unaffected father).> Some females will also have very mild degrees of muscular dystrophy, and this is known as being a manifesting carrier. In one-third of the cases, the disease is a result of an unspontaneous or new mutation.	2	25%	50%	100%	0%	Pediatrics	Miscellaneous	332ae0b5-7f8e-437d-a2ea-c446f96c7f7d	single
On 7th postoperative day after laparoscopic cholecystectomy, patient developed right upper abdominal pain and 10 cm*8cm collection. Treatment consists of	Goals of therapy in Iatrogenic bile duct injury Control of infection limiting inflammation: Parenteral antibiotics Percutaneous drainage of peripoal fluid collection Clear and thorough delineation of entire biliary anatomy MRCP/PTC ERCP (especially if cystic duct stump leak suspected) Re-establishment of biliary enteric continuity Tension free, mucosa - to-mucosa anastomosis Longterm transanastomotic stents if involving bifurcation of higher Roux-en-Y hepaticojejunostomy Ref: Sabiston 20th edition Pgno :1503	2	Immediate laparotomy	Percutaneous drainage	Laparotomy and surgical exploration of bile duct and T-tube inseion	Roux-en-Y hepaticojejunostomy	Anatomy	G.I.T	6a17d2ef-fcb5-4e36-b429-b782654e648f	single
The function common to neutrophils, monocyte & macrophages is	Neutrophils, monocyte & macrophages are the pa of phagocytosis not the pa of immunty. Cellular Components and Phagocytosis Therefore, phagocytes, present in the blood, lymphoid tissue, liver, spleen, lung, and other tissues, are the cells responsible for the uptake and removal of foreign antigen. Phagocytes include (1) monocytes and macrophages; (2) granulocytes, including neutrophils, eosinophils, and basophils; and (3) dendritic cells. Histamine is released by mast cells . Destruction of old erythrocytes is by splenic tissue.	2	Immune response	Phagocytosis	Liberation of histamine	Destruction of old erythrocytes	Microbiology	Immunology Pa 2 ( Hybridoma Technology, Complement Pathways, Interferon, Structure and Functions of Immune Cells )	e2edeee6-b6f9-4568-984f-37e8408d3e1c	single
Propranolol, a non–selective beta blocker can be prescribed to decrease anxiety associated with:	null	3	Chronic neurotic disorder	Schizophrenia	Short term stressful situations	Endogenous depression	Pharmacology	null	b6571012-43e9-4f02-89be-278afe6adaef	single
All are true about poliovirus, except:	Ans. is 'c' i.e., Type 1 is responsible for vaccine paralytic poliomyelitis PandcVDPVFactSheet-Feb2015.pdfReference:Sabin strain type 1,2,3 are associated with Vaccine - associated paralytic polio (VAPP) and Vaccine derived poliovirus (VDPV).	3	Type 1 is responsible for most epidemics	Very difficult to eliminate type 1	Type 1 is responsible for vaccine paralytic poliomyelitis	Type 1 most commonly responsible with paralysis	Microbiology	Virology	74d65b25-9cae-4bfb-bf85-fbbcbad1967c	multi
Who gave the concept of "Clean tooth never Decays"?	null	2	Pierre fauchard	Leon Williams	Rihanna	Dean	Dental	null	e0807c95-9afa-4ade-8db5-fa73bdb0db5e	single
The patient with the following show the maximum deposits of lipofuscin in -	Ans. is 'd' i.e., Severe malnutrition	4	Gaucher's disease	Tay sach's disease	Acute Enteric fever	Severe malnutrition	Pathology	null	00e19edb-fa46-4601-a017-c1bd905e1faf	single
One criteria for prudent diet?	Ans. is 'd' i.e., Saturated fats < 10% of total energy Dietary goals prescribed by WHO expe committee prudent diet 3 Dietary modification is the principal preventive strategy in the prevention of CHD. The WHO Expe Committee (1) considered the following dietary changes to be appropriate for high incidence populations. Reduction of fat intake to 20-30 percent of total energy intake Consumption of saturated fats must be limited to less than 10 percent of total energy intake, some of the reduction in saturated fat may be made up by mono and poly-unsaturated fats. A reduction of dietary cholesterol to below 100 mg per 1000 kcal per day. An increase in complex carbohydrate consumption (i.e. vegetables, fruits, whole grains and legumes) Avoidance of alcohol consumption, reduction of salt intake to 5 g daily or less. Other specific interventions as pa of primordial prevention of coronary hea disease To achieve a smoke free society Reduction of Blood pressure through prudent diet. Regular exercise, weight control & cessation of smoking. Regular Physical Activity.	4	Fat intake 35-40% of total energy	Dietary cholesterole < 300 mg/1000Kcal per day	Salt intake <10 g/day	Saturated futs < 10% of total energy	Social & Preventive Medicine	null	aed7832e-a84a-40c4-b84c-3663e28c145c	single
Neurotransmitter playing major part in the pathogenesis of Alzheimer's disease -	Ans. is 'c' i.e., Acetylcholine Neurotransmitters in Alzheimer's diseaseo Acetylcholine has a major role in memory functions and deficiency in cholinergic functioning is associated with memory disturbances particularly short term memory. In Alzheimer's disease there loss of cells in the nucleus basalis of meyernet results in marked reduction in choline acetyltransferase (CHAT), an enzyme involved in the synthesis of acetylcholine - Decreased Acetylcholine.o The other important neurotransmitter involved is norepinephrine - There is decrease in nor-epinephrine containing neurons in the locus ceruleus.o Two other neuroactive peptides have been implicated in AD - Somatostatin and corticotropin, both of which have decreased concentration.	3	Serotonine	Norepinephrine	Acetylcholine	Dopamine	Psychiatry	Degenerative Disorders	1b061c59-19fe-4745-911f-fa4fcfde1237	single
Which of the following affects the wound healing most:	null	1	Cortisol	Growth hormone	Thyroxin	Adrenaline	Surgery	null	904964fe-42ca-4bc6-ac1f-7f1cbaf9e3ae	single
Rapid examination of Tubercle bacilli is possible with?	Ans. is 'c' i.e., Auramine Rhodamine stain	3	Ziehl-Neelsen stain	Kin young stain	Auramine-Rhodamine stain	Giemsa stain	Microbiology	null	2edb6d1a-e929-463c-a316-ae603b1efdf6	single
Negri bodies are characteristic of	Negri bodies are the inclusion bodies of the rabies virus formed in brain cells most commonly found in cerebellum (purkinje cells). Inclusion bodies are nuclear or cytoplasmic aggregates of stable substances, usually proteins. They typically represent sites of viral multiplication in a bacterium or a eukaryotic cell and usually consist of viral capsid proteins. Microscopic features of few disease:- Disease Microscopic feature Measles Wahin Finkeldy cells Rabies Negri bodies Trachoma Halbester Prowazek bodies Tetanus is a bacterial disease- caused by Cl. tetani, no inclusion bodies are seen.	4	Measles	Tetanus	HIV/AIDS	Rabies	Microbiology	Virology Pa-2 (RNA Virus Pa-1,2 & Miscellaneous Viruses)	885074dd-0459-4972-b8ed-87526d51c825	single
A 27 years old patient with 20 weeks sized uterus presented with vesicular mole. Treatment is:	Suction evacuation is the treatment of choice for hydatidiform mole, regardless of uterine size. Follow this, with a gentle curettage. b-HCG estimation weekly till negative: Values come to negative bya) 9 Weeks in a Complete moleb) 7 Weeks in an incomplete mole	4	Induction of labor	Methotrexate	Hysterotomy	Suction evacuation	Gynaecology & Obstetrics	Twin Pregnancy, Molar Pregnancy, Gestational Trophoblastic disease and contraception in special situations (Sour Grapes!)	3485549a-627d-430e-9a78-9bb5ff2c4d5b	single
Which of the following organism is identified by interferon	Interferon-gamma release assay: This test uses Mycobacterium tuberculosis antigen CFP10 which reacts with T-lymphocytes of the patient to release gamma interferon. This test is not very specific for pulmonary tuberculosis, hence is not recommended any longer. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg: 360	4	Staphylococcus	Leptospira	Campylobacter	Tuberculosis	Microbiology	Bacteriology	0a82c1de-63f8-4cb0-9b59-dd94992b5ffc	single
Triple sugar iron agar showing gas production with red slant and yellow butt. The organism cultured is ?	Ans. is 'b' i.e., Shigella flexneri	2	E coli	Shigella flexneri	Pseudomonas	None	Microbiology	null	8fd7ad59-c313-4d09-bb0a-fa8bb76bb4a4	multi
Drug of choice for pregnant female suspected of having a baby with congenital adrenal hyperplasia is	Dexamethasone is very potent and highly selective glucocoicoid to be staed before 10 weeks of gestation to suppress fetal androgen production effectively It has a long duration of action and cause marked pituitary-adrenal suppression. DOC for CAH is hydrocoisone but DOC for pregnant women having baby with CAH - dexamethasone REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 283	1	Dexamethasone	Betamethasone	Hydrocoisone	Predinsolone	Pharmacology	Endocrinology	2cc8c4ee-0c00-4835-8157-34efb1927cf9	single
Which is false about Penicillium marneffi?	Penicillium Marneffei: It is the only dimorphic fungus in the genus Penicillium. Causes oppounistic infection (fulminant) in immunocompromised hosts, such as patients with HIV. Lab Diagnosis: - Direct Microscopy: Shows oval or elliptical yeast cells with central septation, which indicates that these cells divide by transverse fission rather than budding - Culture: P. marneffei produces yeast like colonies at 37degC and mould form at 25degC. The mould form has a characteristic diffusible brick red pigment. Treatment: AIDS patients with severe penicillinosis are treated with amphotericin B till the condition improves followed by maintenance therapy with itraconazole for 12 weeks. In mild penicilliosis, itraconazole is recommended for 12 weeks.	1	Black colonies	Dimorphic fungi	Amphotericin B used for treatment	Causes fulminant infections in immunocompromised patients	Microbiology	Mycology	146361cf-500a-4f19-8410-96e1c6032ff8	multi
Which of the following can be viewed on a conventional radiograph?	Calcification of canals. Buccal curvature cannot be seen from the conventional radiographs. Gingival fibers and the periodontal ligament, being connective tissues, are radiolucent radiographically.	3	Buccal curvature of roots	Gingival fibers	Calcification of canals	Periodontal ligament	Dental	null	4d1b0038-0178-40ef-ae57-5d4bc4aabe00	single
All are steroids except ?	Ans. is 'd' i.e., Thyroxine Steroids Steroids are complex molecules consisting of four fused carbon rings. There is a phenanthrene nucleus made of three six-membered rings (A,B,C, rings), and a cyclopentane which forms D ring. The fully saturated parent compound (steroid) is known as cyclopentanoperhydrophenathrene. The alcohol derivatives of steroids, in which one or more OH groups are present in the steroids nucleus, are termed sterols, i.e. sterols are a class of steroids containing hydroxy (OH) group. Cholesterol, ergosterol, coprosterol and sitosterol are some impoant sterols.In animal tissues, Cholesterol is the major sterol. Functionally, cholesterol is a very impoant molecule being precursor of a variety of steroids -Steroid hormones :- Progesterone, estrogen, androgens (Testosterone), glucocoicoids, mineralocoicoids.Bile acids:- Cholic acid, Chenodeoxycholic acid.Vitamin DSo, all above mentioned compounds have cyclopentanoperhydrophenanthrene nucleus.	4	Testosterone	Vitamin D	Cholesterol	Thyroxine	Biochemistry	null	21c59e2e-aa57-4aaa-8a46-3e7d36b919c0	multi
Age was found to be a factor affecting the relation of diabetes mellitus and periodontics	null	3	Sampling Bias	Selection Bias	Confounding Bias	Information Bias	Dental	null	cba582e8-b343-4363-a06c-fd9f9fd0a4ff	single
In marfan syndrome, the defect is in -	Ans. is 'a' i.e., Fibrillin I Marfan syndromeo Marfan syndrome results from inherited defect in an extracellular glycoprotein fibrillin - 1 on chromosome -15.o It has autosomal dominant inheritance,o Pathogenesiso Defect in fibrillin affects the elastic recoil of extracellular connective tissue.Elastic fibres consist of a central core made up of elastin, surronded by a peripheral network of microfibrils that consists largely fibrillin.Defect in fibrillin causes defective function of elastic fibres.Microfibrils (containing fibrillin) are mainly distributed to Aorta, ligaments of joint and ciliary zolules of lens - So, in marfan syndrome these tissues are primarily affected.	1	Fibrillin I	Fibrillin II	Collegen	Elastin	Pathology	Mendelian Disorders: Single-Gene Defects	69661983-d45c-48b2-ad66-0c43975ebdf6	single
Which of the following is a compound condylar joint?	Knee joint has more than two bones paicipating (hence Compound joint). It is formed by lateral and medial femorotibial and the femoropatellar joints It is Compound synol joint incorporating two condylar joints between the condyles of the femur and tibia and one saddle joint between the femur and the patella TM joint is a condylar joint but it involves only 2 bones( not a compound joint) Wrist joint is an ellipsoid synol joint and elbow is a hinge synol joint Ref: Gray's39e/p185-210	1	Knee	TM joint	Wrist	Elbow	Anatomy	General anatomy	f4d0d369-f03b-4113-8c0b-d5c9aa51c540	single
False about medullary cancer thyroid	Ans. (d) These cancers take up Radio iodineRef: Bailey and Love 27th Edition Page 820* Medullary thyroid cancers are not hormone dependent (Not TSH dependent)* They don't take up RAI* Differentiated thyroid Cancers - Papillary and follicular take up Radio active iodine and used in cases of treatment of high risk cases.	4	Secrete Calcitonin	20-25% are familial	Diarrhea are seen in 30%	These cancers take up Radioactive Iodine	Surgery	Thyroid Gland	2ea30c38-1bb4-4161-9a7d-88b4f9128d25	multi
A 15 year old female presents with primary amenorrhoea. Her breasts are Tanner 4 but she has no axillary or pubic hair. The most likely diagnosis is :	Answer is C (Testicular feminization syndrome): Presence of well developed breast (tanner stage 4) with scanty axillary or pubic hair in a phenotypic 'female' with primary amenorrhea (? no uterus) suggests the diagnosis of Testicular feminization syndrome.	3	Turner's syndrome	Mullerian agensis	Testicular feminization syndrome	Premature ovarian failure	Medicine	null	2f0c0a03-629e-44a4-abf4-1b0613b0f2f3	single
Patient underwent inguinal lymph node dissection and drain was placed. On 10th day severe bleeding occurs. What type of bleeding is this?	Ans. (b) Secondary* Secondary hemorrhage is due to sloughing of wall of vessel. It usually occurs 7-14 days after injury and is precipitated by factors such as infection,pressure necrosis or malignancy.	2	Reactionary hemorrhage	Secondary	Primary	Tertiary	Surgery	Miscellaneous	39f9abd4-000c-4783-9277-1457f5521eac	single
Major aim of phase 1 clinical trials is to know the	Phase I trial is designed as a dose-escalation study to determine the maximum tolerable dosage (MTD), that is, the maximum dose associated with an acceptable level of dose-limiting toxicity. Phase 1 Clinical Trials: The drug is tested in healthy human volunteers (extremes of ages ; elderly and children are excluded). As the drug is not tested in the patients, so we cannot determine efficacy in this phase. This is mainly for finding the maximum tolerable dose of the drug. This is first in human study. Because anti-cancer drugs can produce unacceptable toxicity and we cannot expose healthy humans to such a toxicity, the phase-1 trials for anticancer drugs are done in the patients	3	Safety	Efficacy	Maximum Tolerable Dose	Pharmacokinetics	Pharmacology	CLINICAL TRIALS, DRUG LABEL	5c985d2c-e69f-455a-b449-1b841b442372	single
In which of the following step of TCA cycle, carbon dioxide is removed?	Ans: a)Alpha-ketoglutarate dehydrogenase The two oxidative decarboxylation reactions of the TCA cycle are: 1. Isocitrate dehydrogenase 2. a-ketoglutarate dehydrogenase	1	Alpha-ketoglutarate dehydrogenase	Malate dehydrogenase	Succinate dehydrogenase	Fumarase	Biochemistry	TCA Cycle	e8b85665-5c1c-45f7-883d-852d36c93c0d	multi
Precursor for the synthesis of testosterone is:	Pregnenolone or Progesterone are the precursors for the synthesis of testosterone, aldosterone, estradiol and cortisol.	3	Aldosterone	Cholesterol	Pregnenolone	Cortisol	Biochemistry	null	e6edf7ee-a6d0-407c-beea-99a945bef44c	single
Blastocyte comes out on which day after feilization ?	Ans. is 'a' i.e., 4-7 days Free floating unimplanted blastocyst is seen on 4-5 days.	1	4-7 days	10-12 days	12-15 days	15-20 days	Gynaecology & Obstetrics	null	e7632bb3-3f7c-4a64-9873-8bdf1949195e	single
Which one of the following gram positive organism is most common cause of UTI among sexually active women-	Ans. is 'c' i.e., Staphylococcus saprophyticus Staph saprophyticus . Staph saprophyticus may be present on normal human skin and the periurethral area and can cause urinary tract infection, paicularly in sexually active young women. . Staph saprophyticus strains causing UTI are usually sensitive to most antibiotics, except nalidixic acid. . Staph saprophyticus is novobiocin resistant.	3	Staphylococcus epidermidis	Staphylococcus aureus	Staphylococcus saprophyticus	Enterococcus	Microbiology	null	eabfa17f-80c3-4977-9de1-9aaa3a7b730a	multi
The axillary sheath is an extension of this fascia around the subclan aery and brachial plexus. Fascia around nerve bundle of brachial plexus is derived from?	The brachial plexus and the subclan aery course between the anterior and middle scalene muscles, and as the nerve plexus and aery emerge from those muscles, they carry an extension of the preveebral fascia along to form the axillary sheath.	1	Preveebral fascia	Pretracheal fascia	Investing layer	Superficial cervical fascia	Anatomy	null	0941bc5b-cae6-49aa-9f02-90867e6e21a5	single
Confounding factor is associated with:-	Confounding factor Any factor associated with both exposure, outcome and has an independent effect in causation of outcome is a confounder. BEST METHOD TO REMOVE CONFOUNDING:- MATCHING - Removes confounding bias by distributing known confounding factors equally in two groups RANDOMISATION(2ND BEST) RESTRICTION STRATIFICATION STATISTICAL MODELLING/ MULTIVARIATE ANALYSIS STRATIFIED RANDOMISATION (BEST METHOD)	3	Exposure only	Outcome only	Both exposure and outcome	Neither exposure nor outcome	Social & Preventive Medicine	Confounding and Bias	47e17e2a-5799-4c01-a9ab-b45560b99867	multi
% of offsprings affected by colour blindness, of a healthy male and heterozygous female:	b. 25%(Ref: Nelson's 20/e p 642; Ghai 8/e p 641)Color blindness is an X-linked recessive disorder.In X-linked disorders, if father is normal and mother is a carrier, 50% of children will inherit defective X chromosome.Out of these, the daughters (having 1 normal and 1 defective X chromosome) will act as carriersWhile, all sons, inheriting the defective X chromosome will be affected by colour blindness. Hence, 25% of children will be affected.	2	None	25%	50%	100%	Pediatrics	Genetics And Genetic Disorders	8c3f3cbb-0fbd-485b-b07d-6165ac33bffa	multi
Drug used for treatment of scorpian sting is -	Ans. is 'd' i.e., Prazosin Treatment of scorpian sting o Treatment after scorpian sting has two components :? A. Local o It includes; negative pressure extractor, compression wrap proximal to site of sting, local anaesthetic, local antiseptic, tetanus prophylaxis. B. Systemic o It includes: Maintenance of airway and circulation --> oxygen, intubation, strict hemodynamic monitoring Muscle relaxant (Phenobarbitone) If there is hyperdynamic cardiac changes --> P-blocker + a-blocker (Prazosin), nitrates If there is hypodynamic cardiac changes --> After load reduction by a-blocker (Prazosin), nifedipine, nitroprusside, hydralazine or ACE inhibitors. Dobutamine or norepinephrine can be used as last reso to correct hypotension refractory to fluid therapy. Diuretics for pulmonary edema. Insulin administration helps the vital organs to use metabolic substrate more efficiently. Atropine to counteract parasympathetic effects induced by venom. Antivenom is the treatment of choice after suppoive care is established.	4	Adrenaline	Morphine	Captopril	Prazosin	Pharmacology	null	4373eb89-7128-437d-80ea-33aa976185bc	single
In the right middle ear pathology, Weber&;s test will be	Weber test: In this test, a vibrating tuning fork is placed in the middle of the forehead or the veex and the patient is asked in which ear the sound is heard. Normally, it is heard equally in both ears. It is lateralized to the worse ear in conductive deafness and to the better ear in sensorineural deafness. In weber test, sound travels directly to the cochlea bone. Lateralization of sound in weber test with a tuning fork of 512 Hz implies a conductive loss of 15-25 dB in ipsilateral ear or a sensorineural loss in the contralateral ear. Ref:- Dhingra; pg num:-22	3	Centralized	Normal	Lateralized to right side	Lateralized to left side	ENT	Ear	816055af-7780-4536-a99b-2461d0e40282	single
Lee Jones test is used for -	Ans. is 'c' i.e., Cyanide Lee Jones testo Few crystals of ferrous sulfate is added to 5 ml of the gastric content,o To it, 5 drops of sodium hydroxide is added,o The mixture is boiled and cooled,o To it, 10 drops of 10% hydrochloric acid is added.o Greenish blue colour indicates cyanide and purplish colour indicates salicylate.	3	Carbolic acid	Arsenic	Cyanide	Lead	Forensic Medicine	Biological Materials & Stains	f370a9da-dca8-46c9-8a3e-7bb7fb39deb0	single
Type 1 glomus cell secrete neurotransmitter because of oxygen sensitive	Type I glomus cells have O2 sensitive K+ channels, whose conductance is reduced in propoion to the degree of hypoxia to which they are exposed. This reduces the K+ efflux, depolarizing the cell and causing Ca2+ influx, primarily L-type Ca2+ channels. The Ca2+ influx triggers action potentials and transmitter release, with consequent excitation. of the afferent nerve endings. The smooth muscle of pulmonary aeries contains similar O2-sensitive K+ channels, which mediate the vasoconstriction caused by hypoxia. This is in contrast to systemic aeries, which contain adenosine triphosphate (ATP) dependent K+ channels that permit more K+ efflux with hypoxia and consequently cause vasodilation instead of vasoconstriction. Ref: Ganong's Review of Medical Physiology, 23rd edition, page no: 628, 629 Ref image:	4	Na+ channel	Cl channel	Ca+2 channel	K+ channel	Physiology	Renal physiology	761f0813-bd10-4063-bcf8-c45f1c662c0d	single
Most common complication of meningitis in children is –	Complications of meningitis in children Seizure is the commonest complication of meningitis in children. It occurs in about 30% of patients. Other common complications of meningitis. Subdural empyema or effusions — It is commonly seen after meningitis with H. Influenza. rain Abscesses Neurological impairment → Hemiplegia, Aphasia, Mental retardation, blindness. Auditory impairment (sensor neural deafness) Hydrocephalus Ventriculitis, Arachnoidits Cranial nerve palsies Thrombosis of ducal venous sinuses Transverse myelitis Systemic complication - Shock, Myocarditis, Status epilepticus, Syndrome of inappropriate ADH secretion	2	Hearing loss	Seizures	Hydrocephalus	Mitral regurgitation	Pediatrics	null	934efe88-de8f-4fae-bdc4-434428f11dd7	single
A 66-year-old woman has a 5.5-cm infrarenal abdominal aortic aneurysm. What is the most common manifestation of such an aneurysm?	Most patients are unaware of their abdominal aneurysm until it is incidentally discovered by their physician. The importance of careful deep palpation of the abdomen cannot be overemphasized. On occasion, these aneurysms may expand, causing abdominal or back pain, and may even leak or rupture, mimicking other acute intra-abdominal conditions. Signs and symptoms of acute ischemia in the lower extremities are rare and usually follow thrombosis or embolization from an abdominal aneurysm.	3	Abdominal or back pain	Acute leak or rupture	Incidental finding on abdominal examination	Atheroembolism	Surgery	Arterial Disorders	1078a551-e298-4efb-8c44-80bf6dd24e57	single
Amniotic fluid is maximum at what gestational age-	Ans-C i.e., 36 weeks o Amniotic fluid volume is related to gestational age. It measures 50 ml at 12 weeks, 400 ml at 20 weeks and reaches its peak of 1 litre at 36 - 38 weeks of gestation. Thereafter the amount diminishes, till at term it measures about 600 - 800 ml. As the pregnancy continues post-term, further reduction occurs to the extent of about 200 ml at 43 weeks.	3	12 weeks	20 weeks	36 weeks	40 weeks	Unknown	null	4ce96b5a-23fd-44a9-9859-fae668cab9df	single
The main apolipoprotein of LDL is	The major apolipoproteins of HDL (a-lipoprotein) are apoAs. The main apolipoprotein of LDL (b-lipoprotein) is apo B (B-100), which is found also in VLDL. Chylomicrons contain a truncated form of apo B (B-48) that is synthesized in the intestine, while B-100 is synthesized in the liver. Apo E, found in VLDL, HDL, chylomicrons, and chylomicron remnants, is also freely transferable. Reference: Harper; 30th edition; Page no: 255	3	A-II	B-48	B-100	E	Biochemistry	Metabolism of lipid	bb25601a-c81f-46af-bf91-8ccea09f55ee	single
Wolff-chaikoff effect is ?	Ans. is 'c' i.e., Reduced thyroxine synthesis by iodides Iodine and Iodides Iodine is the fastest acting thyroid inhibitor. Most impoant action is inhibition of hormone release (thyroid constipation); but all facets of thyroid synthesis may be affected. Excess iodide inhibits its own transpo in thyroid cells and may alter the redox potential of cells, thus interfering iodination -reduced TIT3 synthesis ( Wolffichaikoff effect).	3	Reduced thyroxine synthesis by radiotherapy	Reduced thyroxine synthesis by propylthiouracil	Reduced thyroxine synthesis by iodides	None of the above	Pharmacology	null	c29c1c60-7aad-4eca-a9b1-4ef8394b30cd	multi
Cause of odema	Ref.robbins 8/e 112; 7/e 120- 121;9/e p114 Capillary blood contains a decreased quantity of colloids (protein-white circles) due to either decreased hepatic synthesis of these proteins or increased protein loss through the kidney or gastrointestinal tract. ... With decreased production of albumin the plasma colloidal osmotic pressure decreases and edema occurs.	1	Decreased plasma protein concentration	Increased lymph flow	Increased ECF	Increased plasma proteins concentration	Anatomy	General anatomy	087c9231-57a9-4c92-99ae-849364aa6024	single
Elemental iron and folic acid in adult IFA table is -	Ans. is 'd' i.e., 100 pg iron & 500 jag FA o Iron and Folic Acid content per I FA tablet# Adult tablet: 100 mg elemental iron and 500 meg folic acid.# Pediatric tablet: 20 mg elemental iron and 100 meg folic acid.	4	100 mg iron & 200 mg FA	200 mg iron & 100 mg FA	20 mg iron & 100 mg FA	100 mg iron & 500 mg FA	Social & Preventive Medicine	Obstetrics	fcf48980-4c07-468b-880b-6c4823637969	single
Esotrotropia is most commonly associated with	Near vision impaired they try to compensate by increasing their accomodation Infants are hyperopic by 2.5 D they are esotropic at bih ref : ak khurana 7th ed	1	Hyperopia	Myopia	presbyopia	Astigmatism	Ophthalmology	All India exam	705f1427-0db6-44e5-850d-7da1f8ca3d77	single
A young man with pulmonary tuberculosis presents with massive recurrent hemoptysis. For angiographic treatment, which vascular structure should be evaluated first -	Massive Hemoptysis Hemoptysis of >200-600cc in 24 hours. Massive Hemoptysis should be considered as a medical emergency Treatment Large-volume, life threatening Hemoptysis generally require immediate intervention regardless of the cause The first step is to establish a patent airway usually by endotracheal intubation and subsequent mechanical ventilation As most large - volume Hemoptysis Arises from an airway lesion, it is ideal if the site of the bleeding can be identified either by chest imaging or bronchoscopy (more commonly rigid than flexible) If bleeding doesnot stop with therapies of the underlying cause and passage of time, severe Hemoptysis from bronchial aeries can be treated with angiogrophic embolization of the culprit bronchial aery Bronchial aery are the major source of Hemoptysis Ref: Grainger Radiology 4th edition Pgno : 609	3	Pulmonary vein	Pulmonary aery	Bronchial aery	Superior vena cava	Anatomy	Cardio thoracic surgery	b890fd5f-d0b5-4b94-b50e-107303af62b2	single
Characteristic problem in females taking Norethisterone is :	Ans. is a i.e. Irregular bleeding Nor-ethisterone acetate is commonly used as an injectable steroid - 'NET-EN' It is a progesterone based contraceptive like DMPA and its side effect are similar to those of DMPA. The most frequent side effect is irregular bleeding. NET-EN is given in doses of 200 mg at 2 monthly interval. Composition Features Lunelle/cyclofem 25mg DMPA + 5mg estradiol cypionate Mesigyna 4g 50 mg NET-EN + 5mg estradiol valerate ed - menstrual irregularities Rapidly reversible Monthly injection Inhibits lactation Rapid return of feility Monthly injection same as lunelle Extra Edge : Combined injectable contraceptive.	1	Irregular bleeding	Thromboembolism	Hirsutism	Weight gain	Gynaecology & Obstetrics	null	a80dab2d-2045-4256-b723-6c797a71e53a	single

Extrahepatic cholestasis is associated with:

null

1

T bilirubin in urine

T urobilirubin in urine

T bilirubin and T urobilirubin in serum

T bilirubin in serum

Medicine

null

126ef47b-0f7d-4543-8148-e713e36f5fb5

single

Gene responsible for pathogenesis of H pylori

Cytotoxic: products of two genes namely cytotoxin- associated gene A(cagA) and vacuolating agent(vacA) gene cause gastritis, peptic ulceration and cancer GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK FIRST EDITION PAGE 379

1

Cag A

Cag B

Tax A

Hbx

Pathology

G.I.T

6813bebd-8421-4f0d-b71a-2b8162ef85e8

single

Rotator interval is between

Refer Essentials of Ohopedic surgery Rotator interval is a triangular poion of shoulder capsule which lies between supraspinatus and subsacapularis tendon

3

Supraspinatus and trees minor

Teres major and teres minor

Supraspinatus and subsacapularis

Subsapalris and infraspinatus

Anatomy

General anatomy

e7712da9-f9d4-4c8d-b6cd-c2b6913e2df2

single

Baon's fracture is injury to ?

Baon&;s fracture is an intra aicular fracture of distal radius. Here fracture extends from aicular surface of the radius to either its anterior or posterior coices. The small distal fragments get displaced and carries with it the carpals.(carpal bone subluxation) 2 types of volar Baons fracture and dorsal Baons fracture. Treatment: closed manipulation and plaster cast. when closed reduction fails, internal fixation with plate may be required. Ref: Essential Ohopaedics, Maheswari & Mhaskar, 9th ed, Page no: 114

4

Fracture distal end humerus

Extra-aicular fracture distal end radius

Intra-aicular fracture distal end radius

Intra-aicular fracture distal end radius with carpal bone subluxation

Orthopaedics

Forearm wrist and hand injuries

ea0ee668-fa8a-474e-9655-5ddfc2434bd0

single

In a seriously ill patient, addition of amino acids in the diet results in a positive nitrogen balance. The mechanism for this is

Glucose, mannose, aminoacids (such as leucine, arginine, others) and β ketoacids such as acetoacetate (derived from fat catabolism) stimulate insulin secretin and have protein sparing effect. Insulin has anabolic effect on metabolism. It decreases protein catabolism and fat catabolism for energy production and increases aminoacid uptake and protein synthesis (positive nitrogen balance).

3

Increased absorption of amino acids from the intestine

Enhanced rates of gluconeogenesis

Increased secretion of insulin

Increased Growth hormone secretion

Biochemistry

null

54b36f85-58b3-425e-9dc4-3149dc1e4a86

single

Nipple inversion occurs due to involvement of:

Ans. (b) Subareolar duct(Ref: Bailey 25/e p834)* Peau- de orange - Subdermal Lymphatic infiltration (T4b)* Dimpling/Puckering/tethering of skin - Due to Coopers ligament of breast involvement (It is not skin involvement is T staging)* Nipple retraction - Fibrosis in and around the Subareolar duct

2

Cooper's ligament

Subareolarm duct

Parenchyma of breast

Subdermal lymphatics

Surgery

Breast

bf09756a-031f-4562-a77c-327b2b6d8ee5

single

Which muscle does not decussate in modiolus

null

1

Levator labli superious

Orbiculesis Oris

Zygomaticus major

Buccinator

Dental

null

fbc9482a-38fe-465d-944b-c5340948a3dc

single

A 25 year old male presented with pigmentation of nose and pinna. After voiding, his urine becomes dark. His spine is most likely to show -

null

4

Atlantoaxial subluxation

Spondyloptosis

Basilar invagination

Calcification of disc

Medicine

null

4c0a19f7-4ad9-452e-b568-497b428c1cda

single

Hairy leukoplakia is characterized by?

Ans. is 'b' i.e. EBV infection Hairy leukoplakia (Oral hairy leukoplakia, OHL)* It is a condition caused by Epstein-Barr virus (EBV) and occurs usually in persons who are immunocompromised, especially those with HIV/AIDS.* It presents an asymptomatic white patch, which almost exclusively occurs on the lateral surfaces of the tongue. The lesion may grow to involve the dorsal surface of the tongue.* The texture is vertically corrugated ("hairy") or thickly furrowed and shaggy in appearance* The white appearance is created by hyperkeratosis (overproduction of keratin) and epithelial hyperplasia* Treatment is not necessary since the lesion is benign & self-limiting.

2

Pain

EBV infection

No association with HIV

Pre-cancerous

Pathology

Blood

d66af908-7c18-431c-9345-32ba450e68fc

single

Aery which does not supply Medulla is

Medulla supplied byAnterior spinalPosterior spinalPosterior inferior cerebellar Direct medullary branches of veebral and basilar

3

Anterior spinal

Posterior spinal

Superior cerebellar

Posterior inferior cerebellar

Anatomy

All India exam

7f084076-d7c8-4a93-8b87-128e3128e2bc

single

Silver impregnation technique is used in the identification of ?

Silver impregnation: cells and structure too thin to be seen under the ordinary microscope may be rendered visible if they are thickened by impregnation of silver on the surface. Such a method is used for the demonstration of spirochetes and bacterial flagella REF:Ananthanarayan & Panicker's Textbook of Microbiology 9th edition pg no:13

4

Spirochaetes

Leptospira

Borrelia

All of the above

Microbiology

general microbiology

684436ce-1d6f-4f0e-be65-2b71957b74d0

multi

Broad Granular casts are seen in

Broad granular casts - Chronic renal failure. RBC casts - Glomerular injury.

1

Chronic renal failure

Glomerular injury

Thrombotic Microangiopathy

Pyelonephritis

Medicine

null

2e7f82c7-75d9-4540-96eb-3860f7fbd9c1

single

Psoriasis associated with p – hemolytic streptococcal infection –

Guttate psoriasis is precipitated by upper respiratory tract infection, e.g. streptococcal tonsilitis.

4

Psoriasis vulgaris

Erythrodermic psoriasis

Pustular psoriasis

Guttate psoriasis

Dental

null

3210c88d-35f0-4b01-9ffb-60c5bacbc904

single

The deciduous canine emerges:

null

3

Before lateral incisor

Before first molar

After first molar

After second molar

Dental

null

4174d051-5f20-467a-a20c-ed8fb492b910

single

Longest acting local anaesthetic is: March 2013 (e, h)

Ans. C i.e. Bupivacaine Bupivacaine Amide with duration of action more than 2 hours, C/I for: Bier's block/Intravenous regional anaesthesia/IVRA It is highly cardiotoxic Cardiotoxicity is not easily reversible, Levo-bupivacaine is used by epidural/intrathecal route

3

Procaine

Lignocaine

Bupivacaine

All of the above

Anaesthesia

null

83253443-395f-40a1-b5a3-dafc6a994d52

multi

Population covered by Anganwadi in tribal area is

null

1

700

100

400

1000

Social & Preventive Medicine

null

6542d0f3-1aa3-4683-a2d1-9acd3f44439a

single

Partogram in pregnancy includes all of the following except -

Ans: D

4

Uterine contraction

Cervical dilatation in time scale

Descent of foetal head in time scale

Non-stress Test

Unknown

null

093720c7-9545-4cb9-b4cc-2a5be7c78eaa

multi

Otoconia is related to

Otoconia are bio-crystals which couple mechanic forces to the sensory hair cells in the utricle and saccule, a process essential for us to sense linear acceleration and gravity for the purpose of maintaining bodily balance. In fish, structurally similar bio-crystals called otoliths mediate balance Ref : Internet sources.

2

Hearing

Balance

Smell

Taste

ENT

Ear

6a97b712-564d-45cb-8ac6-556f97abb63f

single

True about Rheumatic fever

Answer is A (Chorea is aggrevated during pregnancy) Sydenham's chorea may be aggravated by pregnancy. 'Patient's with sydenham's chorea may have chorea during pregnancy (chorea gravidarum) and are at higher risk of chorea induced by phenytoin or oral contraceptives' - The 5- Minute Neurology consult (2003) /399 Sydenhom's chorea usually occurs in isolation and is not associated with ahritis usually. Subcutaneous nodules are typically non tender. Rheumatic fever is associated with Erythema marginatum and not Erythema multiforme Featues of Sydenham's chorea in Rheumatic Fever (10-15% of patients) It usually occurs after a prolonged latent period after group A streptococcus It usually occurs in the absence of other manifestation (usually not associated with ahritis or carditis) It usually occurs in females Presents as rapid, jerkey, involuntary movements (choreiform movements) affecting predominantly the Head /Face and Upper limbs May be generalized or restricted to one side / asymmetrical Typical signs include Milk maid Grip Spooning of extended hands Daing of the protruded tongue Pronator signs Typically associated with excessive emotional lability and personality changes It is a self limiting condition and eventually resolves completely, usually within 6 weeks. Recurrence of chorea may be seen late after complete resolution Factors inducing Recurrence Pregnancy (Chorea gravidorum) Re infection with streptocossus / non specific infections Use of oral contraceptives

1

Chorea is aggravated during pregnancy

Chorea & ahritis co-existing

Subcutaneous nodules are tender

Erythema multiforme seen

Medicine

null

2d025ca7-f64b-4159-b531-0a9382879426

multi

Treatment of multiple carboxylase deficiency

Treatment of multiple carboxylase or biotinidase deficiency is biotin.Oral dose is 10-40 mg/kg/day Reference:Essential pediatrics-Ghai,8th edition,page no:650

1

Biotin

Pyridoxine

Thiamine

Folic acid

Pediatrics

Metabolic disorders

048df25c-98b5-41a1-9c6d-3e714ce4ef73

single

HILL’S criteria of causal association are all except:

Bradford Hill & others pointed out that the likelihood of a causal relationship is increased by the presence of the following criteria : Temporal Association Strength of Association Specificity of Association Consistency of Association Biological Plausibility Coherence of Association

2

Specificity of association

Sensitivity

Consistency

Coherence

Unknown

null

1c4eabf1-9357-4d8a-8fce-6b38c826c6d3

multi

Aerial supply of latismus dorsi is:

A. i.e. Subscapular aerySubscapular aery is largest branch of axillary aeryQ arise from its 3i-cl pa & supplies lattismus dorsi and serratus anterior musclesQ.

1

Subscapular aery

Circumflex humeral aery

Thoracodorsal aery

Lateral aery

Anatomy

null

56c22e83-af00-4acf-a821-16d423d98cd8

single

The major lipids that make up the cell membrane are:

null

2

Triglycerides

Phospholipids

Sphingomyelins

Fatty acids

Biochemistry

null

a39ec856-51d2-4747-b07c-d3b734c0d558

single

A patient presents with B/L proptosis, heat intolerance and palpitations; most unlikely diagnosis here would be

Answer is D (Reidel's thyroiditis) : Reidel's thyroiditis is usually a consistently hypothyroid condition. The patient in the given question is presenting with symptoms of Hypehyroidism. The condition, most unlikely to produce the picture is the one where hypehyroidism is not a feature, not even transient. Reidel's thyroiditis is one such consistently hypothyroid condition. Thyrotoxicosis is usual with thyroid adenoma and diffuse thyroid goitre and Hashimoto's thyroiditis can present with transient hypehyroidism. Hashimoto's Thyroiditis (Auto immune): In this variant, mild hypehyroidism may be present initially, although hypothyroidism is inevitable. Hypothyroidism may develop rapidly or extremely slowly. The initial phase of hypehyroidism may account for the symptoms in the given patient. Thyroid adenoma, diffuse toxic goitre or Grave's disease, toxic nodular goitre, toxic nodule: All are causes of thyrotoxicosis & explain the symptoms of thyrotoxicosis in the above patient. 733/L&B Riedle's thyroiditis is a very rare disease wherein , the thyroid tissue is replaced by cellular fibrous tissue. The goitre may be unilateral or bilateral & is very hard and fixed. This condition presents with features of hypothyroidism. Hypehyroidism is not manifested, not even transiently. The differential diagnosis is from an anaplastic carcinoma & can be made with ceainity only by biopsy. Diffuse thyroid goitre :Most commonly presents with a euthyroid status however patients may present with hypehyroidism.

4

Hoshimoto's thyroiditis

Thyroid adenoma

Diffuse thyroid goitre

Reidel's thyroiditis

Medicine

null

cfba4c31-ce27-4d39-82c6-f87153bc3efb

single

At what age upper segment : lower segment ratio becomes 1 : 1 ?

Age US : LS Ratio Birth 1.7 : 1 3 years 1.3 : 1 7 - 10 years 1 : 1 > 10 years 0.3 : 1

3

3 - 6 years

5 - 8 years

7 - 10 years

10 - 12 years

Pediatrics

null

b8411ab8-d7c7-4012-b693-06800d743491

single

Which of these is not an ultrasound finding consistent with diagnosis of adenomyosis?

USG findings in adenomyosis Uterine enlargement not explained by leiomyoma Subendometrial echogenic linear striations Heterogenous echotexture Cystic anechoic spaces or hypoechoic areas: lakes of endometrial blood Junctional zone between endometrium and myometrium>12 mm (normal 5-8 mm) Obscured endo-myometrial interface

4

Uterine enlargement

Subendometrial echogenic linear striations

Thickening of transitional zone

Encapsulated hypoechoic lesion

Gynaecology & Obstetrics

Endometriosis, Adenomyosis

4a7da0f8-b3b4-4496-8ea8-6eb049ad9217

single

A person suffered an injury in the right eye with a tennis ball. Following which he developed pain and on examination of fundus a red spot is seen at the macula. What is the most probable diagnosis?

This patient has developed Berlins edema following injury to the eye. This is caused by a pressure wave which pass into the posterior pole of the eye following blunt eye trauma. In this condition retina develops a grey white colour seen mainly in the outer retina which may extend to the macula. If it involves the macula, it results in cherry red spot seen at the fovea. This is because fovea is very thin and it reflects the red colour of underlying normal choroid. Other causes of cherry red spot: Tay-Sachs disease, Niemann- Pick disease, generalized GM1, gangliosidosis, Farber's lipogranulomatosis, infantile Gaucher's disease, metachromatic leukodystrophy and sialidosis types 1 and 2.

1

Berlin's edema

Macular bleed

Macular hole

Macular tear

Ophthalmology

null

00b91470-bf87-4357-b706-7fb0bf1fc5f3

multi

The term "Dementia praecox" was coined by

Although earlier descriptions of schizophrenia-like illness are recorded in the literature (such as in Ayurveda; Kahlbaum's description of catatonia; Hecker's description of hebephrenia), the scientific study of the disorder began with the description of dementia praecox by Emil Kraepelin. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 54

3

Freud

Bleuler

Kraepelin

Schneider

Psychiatry

Schizophrenia and other psychotic disorders

428d8d0b-8de5-4a13-8ddc-c19579cd1930

single

A female presents with primary amenorrhea and absent vagina, the next investigation to be done is :

Laparoscopy

4

LH / FSH assay

Chromosomal analysis

Urianalysis

Laparoscopy

Gynaecology & Obstetrics

null

7b059419-4754-463a-a4ca-43d9a4db597f

single

what is the cell junction marked as circle ?

image shows : zona occludens : tight junctions in intestine and renal tubular cells ell Junctions Types Tight Junctions (Occluding Junctions) Seal adjacent epithelial cells together prevent passage of molecules, membrane-bound lipids and proteins Gap Junctions (Communicating Junctions)= Allow adjacent cell communication; pass ions & small molecules between cytoplasms Focal Adhesions & Hemidesmosomes (Anchoring Junctions, Actin & Intermediate Filament Attachment Sites)= Form around integrin-mediated cell--ECM contacts Focal adhesions connect integrins to actin filaments Hemidesmosomes connect integrins to intermediate filaments Adherens Junctions & Desmosomes (Anchoring Junctions, Actin & Intermediate Filament Attachment Sites) Form around cadherin-mediated cell--cell contacts Adherens junctions connect cadherins to actin filaments Desmosomes connect cadherins to intermediate filaments ref : bd chaurasia/guyton and hall

1

zona adherens

fascia adherens

macula adherens

zonna occludens

Anatomy

All India exam

2e137e8f-be8c-4d81-8ad0-fa41f8607fdc

single

Which of the following is true about colon carcinomaa) Rt. sided colon carcinoma associated with young individualsb) Most common site is sigmoid colonc) Rt. sided colon carcinoma present as chronic anemiad) Not resectable in case of metastasise) Rt. sided colon has better prognosis than Lt. sided colon.

• Left sided colon cancers are more infiltrative at the time of diagnosis than right lesions, associated with poor prognosis

1

bce

bc

acd

ace

Surgery

null

d46c8216-3b7e-4689-9222-14e3ed8ff060

multi

First reflex to reappear after spinal shock?

Ans. B Withdrawal reflexRef: Ganong, 25th ed. pg. 235* In days following development of spinal shock patient will have low threshold for elicitation of withdrawal reflex* Minimal noxious stimulus to arm will lead to withdrawal of one extremity and marked flexion-extension pattern of other 3 limbs.* Later the Deep tendon reflexes become brisk* Application of minor noxious stimulus will lead to evacuation of bladder and rectum called mass reflex.

2

Myotactic reflex

Withdrawal reflex

Stretch reflex

Inverse stretch reflex

Physiology

Nervous System

df6d683c-09c9-41ca-a67f-ff7ac4d16f91

single

The part of urinary bladder that shows non-keratinizing squamous metaplasia in adult females?

Ans. c (Trigone) (Ref. Smith's urology, p. 266)Nonkeratinizing squamous metaplasia (Trigonitis) is the squamous metaplastic changes that occur in the trigone of the bladder, almost exclusively in women of childbearing age (almost nonexistent in children).Trigonal nonkeratinizing squamous metaplasia# The trigone of the bladder (as well as the ureters) are embryologically derived from the mesonephric duct primordial.# Mucosal lining, with the exception of trigone, is rugose in undistended organ but smoothens as filling proceeds.# Normally, trigone is covered in relatively impermeable transitional epithelium. In young females, there may be an overgrowth of squamous vaginal-type epithelium, often referred to as trigonitis. Trigonitis is incorrect terminology because no associated inflammatory reaction exists, and this condition is referred to more properly as trigonal nonkeratinizing squamous metaplasia.# The keratinizing variant frequently is associated with chronic irritation secondary to indwelling instrumentation, calculi, or, in endemic areas, Schistosoma haematobium infection.

3

Anterior wall

Urethral orifice

Trigone

Ureteral orifice

Anatomy

KUB & Adrenal Gland

3824fd7a-1037-4750-bdc7-23ac1aceb92f

multi

Which of the following anaesthetic agent also has anti-emetic propey: September 2006

Ans. C: Propofol Anaesthetics with anti-emetic propey: Midazolam given at the onset of anaesthesia has been shown in to be as effective as ondansetron Propofol is versatile; the drug can be given for sho or prolonged sedation as well as for general anaesthesia. It is an anti-emetic.

3

Ketamine

Thiopentone

Propofol

Nitrous oxide

Anaesthesia

null

fb740464-9766-41b6-96c8-30ef960ff66d

single

Following injury to blood vessels , immediate haemostasis is achieved by which of the following

ref Robbins 8/e p115 Vascular spasm (Vasoconstriction) -Vasoconstriction is produced by vascular smooth muscle cells, and is the blood vessel's first response to injury. ... When a blood vessel is damaged, there is an immediate reflex, initiated by local sympathetic pain receptors, which helps promote vasoconstriction

2

Fibrin deposition

Vasoconstriction

Platelets adhesion

Thrombosis

Anatomy

General anatomy

0f6a7e1a-82b5-45a0-be16-483eb5336b8c

single

All of the following are true for Korsakoff's psychosis except: March 2010

Ans. C: Deficiency of cyanocobalamin Korsakoff's psychosis/amnesic-confabulatory syndrome is a neurological disorder caused by the lack of thiamine (vitamin B1) in the brain. There are six major symptoms of Korsakoff's syndrome: Anterograde amnesia and Retrograde amnesia, severe memory loss Confabulation, that is, invented memories which are then taken as true due to gaps in memory sometimes associated with blackouts Meager content in conversation Lack of insight Apathy - the patients lose interest in things quickly and generally appear indifferent to change. These symptoms are caused by a deficiency of thiamine, which is thought to cause damage to the medial thalamus and possibly to the mammillary bodies of the hypothalamus as well as generalized cerebral atrophy. When Wernicke's encephalopathy accompanies Korsakoff's syndrome, the combination is called the Wernicke-Korsakoff syndrome. Korsakoff's is a continuum of Wernicke's encephalopathy, though a recognised episode of Wernicke's is not always obvious. Korsakoff's involves damage to neurons; gliosis which is a result of damage to suppoing cells of the central nervous system; and hemorrhage or bleeding in mammillary bodies.

3

Organic amnestic syndrome

Loss of insight

Deficiency of cyanocobalamin

It may follow Wernicke's encephalopathy

Psychiatry

null

b45ddbd1-cfe6-477c-ae04-fa98c52dde7f

multi

A 17-year-old girl with keratitis and severe pain in the eye came to the hospital and acanthamoeba keratitis was suspected. The patient gave the history of the following 4 points. Out of these which is not a risk factor for acanthamoeba keratitis –

Corneal infection with acanthamoeba result from direct corneal contact with any material or water contaminated with the organism. The risk factors are : (i) Contact lens use, (ii) Trauma, (iii) Opportunistic infections.

4

Extended wear contact lens

Exposure to dirty water

Corneal trauma

Squamous blepharitis

Ophthalmology

null

26079d00-f4ac-4f51-b7f8-cfb3894b5b74

single

The primary defet which leads to sickle cell anemia is -

Ans. is 'b' i.e., Replacement of glutamate by valine in b chain of HBA Sickle cell anemia Sickle cell anemia is a hereditary hemoglobinopathy, i.e. the type of disease characterized by production of defective hemoglobin. Normal hemoglobin o The hemoglobin molecule is an assembly of four globular protein. o Each subunit is composed of a protein pa, i.e. globin and a nonprotein pa, i.e. heme, i.e. Each hemoglobin molecule contains four heme units and two pairs of similar protein, globin. o The heme pa of globular protein is same in all types of hemoglobin. o The protein pa vary in different hemoglobin ? 1. Adult hemoglobin (Hemoglobin A) consist of two identical alpha-chains and two identical alpha-chains. 2. Fetal hemoglobin (HbF) consists of two identical a-chains and two identical y chains. 3. Minor hemoglobin (HbA,) consist of two identical a-chains and two identical S chains. o Normally adult blood contains about 96% of HbA (a,(32)3-3.5% HbA2 (a2O2), and small amount of fetal hemoglobin HbF (.272). Defect in sickle cell anemia Sickle cell anemia results from mutation in fI-globin gene. o It is caused by a point mutation at the sixth position of the beta-globin chain leading to substution of a valine residue for a glutamic acid residue. resulting in sickle hemoglobin (HbS). Sickle cell anemia is an autosomal recessive disorder. o If an individual is homozygous for the sickle cell mutation, almost all the hemoglobin in the red cell is HbS. o In heterozyogotes, only about 40% of the hemoglobin is HbS, the remainder being normal hemoglobins.

2

An abnormality in porphyrin pa of hemoglobin

Replacement of glutamate by valine in b-chain of HbA

Substitution of valine by glutamate in the a-chain of HbA

Pediatrics

null

2ba68b18-3c86-4849-84ec-f912da9dcea9

single

A patient who has undergone partial gastrectomy presents with neurological symptoms. Most probable diagnosis:

Ans. (c) Vitamin B12 deficiencyRef: Sabsiton 20th Edition, Page 1212* Following partial gastrectomy there is decreased production of Intrinsic factor which leads to vitamin B12 deficiency.

3

Folic acid deficiency

Thiamine deficiency

Vitamin B12 deficiency

Iron deficiency

Surgery

Stomach & Duodenum

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single

Essential for tumor metastasis is:

Angiogenesis

1

Angiogenesis

Tumorogenesis

Apoptosis

Inhibition of Tyrosine kinase activity

Pathology

null

fefd4680-c433-44c7-9dad-da11b78252f3

single

Ixekizumab is novel drug approved by the FDA for treatment of psoriasis, MOA of this drug is :

Ixekizumab, approved for treatment of plaque psoriasis. It is a humanized IL-17A antagonist that works when IgG4 monoclonal antibodies selectively bind with IL-17A cytokines and inhibit their interaction with the IL-17 receptor. Secukinumab, similar to Ixekizumab, this injectable is an IgG1 monoclonal antibody that selectively binds to the IL-17A cytokine and inhibits its interaction with the IL-17 receptor. It is approved for the treatment of plaque psoriasis and psoriatic ahritis. Ustekinumab : Anti IL-12/23 Apremilast: PDE-4 inhibitor

2

IL-17A agonist

IL-17A antagonist

IL-12/23 antagonist

PDE 4 inhibitor

Dental

Psoriasis

7bc96073-08a8-4c10-a97a-f5088ea393ff

single

For a survey a village is divided into 5 lanes then each lane is sampled randomly is an example is:

Stratified random sampling Random/probability sample : sample in which researcher can specify the population known factor of any one element (same)in the population being included.(being picking link). So every person has an equal chance of selection in random sampling. - Probability samples used in inferential statistics - Non probabilities samples used in only descriptive statistics Type of probability sample (Random sample) 1. Simple random sample - All person have equal right to be selected. Simplest type of random probability. 2. Stratified random sample - in it the population is 1st divided into relatively internally homogenous group of strata from which random sampling are drawn. Example:Village Population 3. Systematic sample - it involve selecting element in a systematic way. Example: Every 10th baby born in area. Every 3rd person admitted to hospital.

2

Simple random sampling

Stratified random sampling

Systematic random sampling

All if the above

Surgery

null

90e0bfce-9498-463c-8b3b-f4a32342ce8b

multi

13.All the following are true of antrochonal polyp,except:

Ref.Dhingra 6/e p 174,175

3

Common in children

Single and unilateral

Bleeds on touch

Treatment involves avulsion

Anatomy

General anatomy

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multi

Contents of Deep perineal pouch include all of the following, EXCEPT:

Root of penis is present in the superficial perineal pouch and not in the deep perineal pouch. Contents of the deep perineal pouch are: Sphincter urethraBubourethral glandsDorsal nerve of penisMembranous pa of urethraDeep transverse perineal muscleInternal pudendal vessel and its branches Ref: Clinical Anatomy for Medical Students By Richard S Snell, 6th Edition, Page 369

1

Root of penis

Sphincter urethrae

Bulbourethral gland

Dorsal Nerve of penis

Anatomy

null

d56adaf9-bd1d-4923-8804-6c9531addad2

multi

Not seen in hyponatremia: March 2009

Ans. B: Delusion

2

Nausea

Delusion

Vomiting

Anorexia

Medicine

null

6c5fb15c-0bd8-4e23-9f82-062bb1bc5a64

single

Which one of the following are most improtant antigen presenting cells in human-

Robbins and Cotran pathologic basis of disease South Asia edition. *immature dendritic cells within the epidermis are called langerhans cells .dendritic cells are the most impoant antigen presenting cells for initiating T cell responses against protein antigen.

3

Macrophages

Plasma cells

Langerhan's cells\/histiocytes

Lymphocytes

Pathology

General pathology

4de22e29-0e86-427d-b36e-c88b9e71ee42

single

Purulent inflammation and infection of terminal pulp space of distal phalanges is known as: September 2009

Ans. B: Whitlow Whitlow/Felons are closed-space infections of the fingeip pulp. This is the commonest hand infection . Fingeip pulp is divided into numerous small compaments by veical septa that stabilize the pad. Infection occurring within these compaments can lead to abscess formation, edema, and rapid development of increased pressure in a closed space. This increased pressure may compromise blood flow and lead to necrosis of the skin and pulp.There is little room for swelling, so that infection causes a throbbing pain early. Staphylococcus aureus is the most common cause Complications Osteomyelitis involving the diaphysis of distal phalanx is a common complication. The most serious complication is acute tenosynovitis, which may result from contiguous spread of infection. Other complications include skin necrosis, deformity of the fingeip, septic ahritis, and instability of the finger pad. It is managed by incision & drainage.

2

Acute paronychium

Whitlow

Acute suppurative tenosynovitis

Apical subungual infection

Surgery

null

10de49e2-bd48-4044-9b6c-e5025f7f4075

single

A 32-year-old female, asymptomatic, not requiring blood transfusion, presents with Hb 13.0 gm/dl. Her HbF levels are 95%, HbA2, 1.5%. Which of the following is the most likely diagnosis -

In contrast to alpha thalassemia ,gene deletion rarely ever causes beta thalassemia & is only seen in an entity called hereditary persistence of foetal hemoglobin (HPFH).In the given case scenario ,HbA2 is within normal limit (1.5-3.5%) in contrast to thalassemia where the HbA2 will be increased .Reference :Harsh mohan textbook of pathology sixth edition pg no 322.

1

Hereditary persistence of fetal hemoglobin

Beta homozygous thalassemia

Thalassemia intermedia

Beta heterozygous thalasiemia

Medicine

Haematology

cc56baeb-18b6-4eca-9674-1eb3ffe24b58

single

Y descent in jugular venous pulsation is due to

Y descent is due to passive movement of blood from atria to ventricles i.e. early diastolic filling

4

Ventricular systole

Atrial systole

Atrial filling

Ventricular filling

Medicine

null

a13e4404-e52c-4c6f-9b84-85b79de388de

single

Damage to which Brodmann area is responsible for motor aphasia

Motor aphasia is due to lesion in Broca's area which belong to Brodmann's area 44, (inferior frontal gyrus).

4

22

39

40

44

Anatomy

Neuroanatomy 1

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single

Superior cerebellar peduncle contains mainly which tract ?

Ans. is 'a' i.e., TectocerebellarSuperior cerebellar peduncle This is the major output of the brain and connects to the midbrain, the cerebellothalamic tract (to the thalamus), and the cerebellorubral tract (to the red nucleus). It receives afferents from the locus coeruleus, and ventral spinocerebellar tract.Middle cerebellar peduncle This is the largest peduncle and connects the cerebellum to the pons. It connects the contralateral pontine nucleus to the cerebellar coex and also carries the input from the contralateral cerebral coex. It is composed of three fasciculi including the superior, inferior and deep.Inferior cerebellar peduncleThis connects the spinal cord and medulla to the cerebellum. The posterior spinocerebellar tract receives proprioceptive information from the body. The cuneocerebellar tract receives proprioceptive input from the upper limb and neck. The trigeminocerebellar tract sends proprioceptive input from the face. The juxtarestiform is an efferent system here.

1

Tectocerebellar

Olivocerebellar

Vestibulo cerebellar

Reticulo cerebellar

Anatomy

null

36adbf3a-0324-4d51-8db6-5e06e68f8bde

single

WHO was established in?

WORLD HEALTH ORGANIZATION (WHO):- WHO is a specialized, non-political health agency of United Nations established in 1945. Constituition Came into force on 7th April, 1948. April -7th - World health day. Objective of WHO: is attainment by all people of the highest level of health First constitutional function of WHO: to act as the directing and co-coordinating authority on all international health work. Headquaers of WHO: Geneva, Switzerland. Structure of WHO: The world health assembly (WHA) The executive board The secretariat

1

1945

1948

1950

1956

Social & Preventive Medicine

International health agencies

97a42b0e-075a-4ef5-a3ca-a51937d7999a

single

After suffering a streptococcal throat infection, a 12-year-old immigrant boy develops cardiac symptoms that are attributed to rheumatic fever. Years later, at the age of 34 he is admitted to the hospital with pulmonary edema. Further examination reveals a diastolic murmur at the apex and mitral stenosis is diagnosed. Before surgical evaluation, which of the following findings can be attributed to mitral stenosis?

Dilation of the left atrium is the obvious complication following long-standing mitral stenosis. Echocardiography is the simplest and most precise method of showing enlargement of the left atrium. Frequently, there is a latency period of 15-20 years before symptoms become evident. Important complications of mitral stenosis include exertional dyspnea caused by an increase in left atrial pressure and backup of blood with possible pulmonary edema, decreased cardiac output, atrial fibrillation, emboli (15%), and pressure in the intermediate third of the esophagus as seen on an esophogram after barium swallow. The pulse in mitral or aortic stenosis is reduced.

2

Large left ventricle

Indentation of the middle third of the esophagus by an enlarged left atrium

Notching of the ribs

Bounding, full pulse

Surgery

Heart & Pericardium

a8d96feb-36a3-4016-90f5-a59fd8915626

single

A female child of a mother is diagnosed to have Duchenne's muscular dystrophy. What risk does the mother have for her next male child to suffer from similar illness?

(B) 50% # Duchenne muscular dystrophy is inherited in an X-linked recessive pattern.> Male children, who have an XY chromosome pair, receive one of their mother's two X chromosomes and their father's Y chromo- some. Women DMD carriers who have an abnormal X chromosome have a one-in-two chance of passing that abnormality on to their male children.> Unlike most female children, a male child with an inherited defective Xp21 gene does not have a second X chromosome to provide correct genetic instructions, and the disease manifests.> Sons of carrier females each have a 50% chance of having the disease, and the daughters each have a 50% chance of being carriers.> Daughters of men with Duchenne will always be carriers, since they will inherit an affected X chromosome from their father (note that the diagram only shows the results from an unaffected father).> Some females will also have very mild degrees of muscular dystrophy, and this is known as being a manifesting carrier. In one-third of the cases, the disease is a result of an unspontaneous or new mutation.

2

25%

50%

100%

0%

Pediatrics

Miscellaneous

332ae0b5-7f8e-437d-a2ea-c446f96c7f7d

single

On 7th postoperative day after laparoscopic cholecystectomy, patient developed right upper abdominal pain and 10 cm*8cm collection. Treatment consists of

Goals of therapy in Iatrogenic bile duct injury Control of infection limiting inflammation: Parenteral antibiotics Percutaneous drainage of peripoal fluid collection Clear and thorough delineation of entire biliary anatomy MRCP/PTC ERCP (especially if cystic duct stump leak suspected) Re-establishment of biliary enteric continuity Tension free, mucosa - to-mucosa anastomosis Longterm transanastomotic stents if involving bifurcation of higher Roux-en-Y hepaticojejunostomy Ref: Sabiston 20th edition Pgno :1503

2

Immediate laparotomy

Percutaneous drainage

Laparotomy and surgical exploration of bile duct and T-tube inseion

Roux-en-Y hepaticojejunostomy

Anatomy

G.I.T

6a17d2ef-fcb5-4e36-b429-b782654e648f

single

The function common to neutrophils, monocyte & macrophages is

Neutrophils, monocyte & macrophages are the pa of phagocytosis not the pa of immunty. Cellular Components and Phagocytosis Therefore, phagocytes, present in the blood, lymphoid tissue, liver, spleen, lung, and other tissues, are the cells responsible for the uptake and removal of foreign antigen. Phagocytes include (1) monocytes and macrophages; (2) granulocytes, including neutrophils, eosinophils, and basophils; and (3) dendritic cells. Histamine is released by mast cells . Destruction of old erythrocytes is by splenic tissue.

2

Immune response

Phagocytosis

Liberation of histamine

Destruction of old erythrocytes

Microbiology

Immunology Pa 2 ( Hybridoma Technology, Complement Pathways, Interferon, Structure and Functions of Immune Cells )

e2edeee6-b6f9-4568-984f-37e8408d3e1c

single

Propranolol, a non–selective beta blocker can be prescribed to decrease anxiety associated with:

null

3

Chronic neurotic disorder

Schizophrenia

Short term stressful situations

Endogenous depression

Pharmacology

null

b6571012-43e9-4f02-89be-278afe6adaef

single

All are true about poliovirus, except:

Ans. is 'c' i.e., Type 1 is responsible for vaccine paralytic poliomyelitis PandcVDPVFactSheet-Feb2015.pdfReference:Sabin strain type 1,2,3 are associated with Vaccine - associated paralytic polio (VAPP) and Vaccine derived poliovirus (VDPV).

3

Type 1 is responsible for most epidemics

Very difficult to eliminate type 1

Type 1 is responsible for vaccine paralytic poliomyelitis

Type 1 most commonly responsible with paralysis

Microbiology

Virology

74d65b25-9cae-4bfb-bf85-fbbcbad1967c

multi

Who gave the concept of "Clean tooth never Decays"?

null

2

Pierre fauchard

Leon Williams

Rihanna

Dean

Dental

null

e0807c95-9afa-4ade-8db5-fa73bdb0db5e

single

The patient with the following show the maximum deposits of lipofuscin in -

Ans. is 'd' i.e., Severe malnutrition

4

Gaucher's disease

Tay sach's disease

Acute Enteric fever

Severe malnutrition

Pathology

null

00e19edb-fa46-4601-a017-c1bd905e1faf

single

One criteria for prudent diet?

Ans. is 'd' i.e., Saturated fats < 10% of total energy Dietary goals prescribed by WHO expe committee prudent diet 3 Dietary modification is the principal preventive strategy in the prevention of CHD. The WHO Expe Committee (1) considered the following dietary changes to be appropriate for high incidence populations. Reduction of fat intake to 20-30 percent of total energy intake Consumption of saturated fats must be limited to less than 10 percent of total energy intake, some of the reduction in saturated fat may be made up by mono and poly-unsaturated fats. A reduction of dietary cholesterol to below 100 mg per 1000 kcal per day. An increase in complex carbohydrate consumption (i.e. vegetables, fruits, whole grains and legumes) Avoidance of alcohol consumption, reduction of salt intake to 5 g daily or less. Other specific interventions as pa of primordial prevention of coronary hea disease To achieve a smoke free society Reduction of Blood pressure through prudent diet. Regular exercise, weight control & cessation of smoking. Regular Physical Activity.

4

Fat intake 35-40% of total energy

Dietary cholesterole < 300 mg/1000Kcal per day

Salt intake <10 g/day

Saturated futs < 10% of total energy

Social & Preventive Medicine

null

aed7832e-a84a-40c4-b84c-3663e28c145c

single

Neurotransmitter playing major part in the pathogenesis of Alzheimer's disease -

Ans. is 'c' i.e., Acetylcholine Neurotransmitters in Alzheimer's diseaseo Acetylcholine has a major role in memory functions and deficiency in cholinergic functioning is associated with memory disturbances particularly short term memory. In Alzheimer's disease there loss of cells in the nucleus basalis of meyernet results in marked reduction in choline acetyltransferase (CHAT), an enzyme involved in the synthesis of acetylcholine - Decreased Acetylcholine.o The other important neurotransmitter involved is norepinephrine - There is decrease in nor-epinephrine containing neurons in the locus ceruleus.o Two other neuroactive peptides have been implicated in AD - Somatostatin and corticotropin, both of which have decreased concentration.

3

Serotonine

Norepinephrine

Acetylcholine

Dopamine

Psychiatry

Degenerative Disorders

1b061c59-19fe-4745-911f-fa4fcfde1237

single

Which of the following affects the wound healing most:

null

1

Cortisol

Growth hormone

Thyroxin

Adrenaline

Surgery

null

904964fe-42ca-4bc6-ac1f-7f1cbaf9e3ae

single

Rapid examination of Tubercle bacilli is possible with?

Ans. is 'c' i.e., Auramine Rhodamine stain

3

Ziehl-Neelsen stain

Kin young stain

Auramine-Rhodamine stain

Giemsa stain

Microbiology

null

2edb6d1a-e929-463c-a316-ae603b1efdf6

single

Negri bodies are characteristic of

Negri bodies are the inclusion bodies of the rabies virus formed in brain cells most commonly found in cerebellum (purkinje cells). Inclusion bodies are nuclear or cytoplasmic aggregates of stable substances, usually proteins. They typically represent sites of viral multiplication in a bacterium or a eukaryotic cell and usually consist of viral capsid proteins. Microscopic features of few disease:- Disease Microscopic feature Measles Wahin Finkeldy cells Rabies Negri bodies Trachoma Halbester Prowazek bodies Tetanus is a bacterial disease- caused by Cl. tetani, no inclusion bodies are seen.

4

Measles

Tetanus

HIV/AIDS

Rabies

Microbiology

Virology Pa-2 (RNA Virus Pa-1,2 & Miscellaneous Viruses)

885074dd-0459-4972-b8ed-87526d51c825

single

A 27 years old patient with 20 weeks sized uterus presented with vesicular mole. Treatment is:

Suction evacuation is the treatment of choice for hydatidiform mole, regardless of uterine size. Follow this, with a gentle curettage. b-HCG estimation weekly till negative: Values come to negative bya) 9 Weeks in a Complete moleb) 7 Weeks in an incomplete mole

4

Induction of labor

Methotrexate

Hysterotomy

Suction evacuation

Gynaecology & Obstetrics

Twin Pregnancy, Molar Pregnancy, Gestational Trophoblastic disease and contraception in special situations (Sour Grapes!)

3485549a-627d-430e-9a78-9bb5ff2c4d5b

single

Which of the following organism is identified by interferon

Interferon-gamma release assay: This test uses Mycobacterium tuberculosis antigen CFP10 which reacts with T-lymphocytes of the patient to release gamma interferon. This test is not very specific for pulmonary tuberculosis, hence is not recommended any longer. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg: 360

4

Staphylococcus

Leptospira

Campylobacter

Tuberculosis

Microbiology

Bacteriology

0a82c1de-63f8-4cb0-9b59-dd94992b5ffc

single

Triple sugar iron agar showing gas production with red slant and yellow butt. The organism cultured is ?

Ans. is 'b' i.e., Shigella flexneri

2

E coli

Shigella flexneri

Pseudomonas

None

Microbiology

null

8fd7ad59-c313-4d09-bb0a-fa8bb76bb4a4

multi

Drug of choice for pregnant female suspected of having a baby with congenital adrenal hyperplasia is

Dexamethasone is very potent and highly selective glucocoicoid to be staed before 10 weeks of gestation to suppress fetal androgen production effectively It has a long duration of action and cause marked pituitary-adrenal suppression. DOC for CAH is hydrocoisone but DOC for pregnant women having baby with CAH - dexamethasone REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 283

1

Dexamethasone

Betamethasone

Hydrocoisone

Predinsolone

Pharmacology

Endocrinology

2cc8c4ee-0c00-4835-8157-34efb1927cf9

single

Which is false about Penicillium marneffi?

Penicillium Marneffei: It is the only dimorphic fungus in the genus Penicillium. Causes oppounistic infection (fulminant) in immunocompromised hosts, such as patients with HIV. Lab Diagnosis: - Direct Microscopy: Shows oval or elliptical yeast cells with central septation, which indicates that these cells divide by transverse fission rather than budding - Culture: P. marneffei produces yeast like colonies at 37degC and mould form at 25degC. The mould form has a characteristic diffusible brick red pigment. Treatment: AIDS patients with severe penicillinosis are treated with amphotericin B till the condition improves followed by maintenance therapy with itraconazole for 12 weeks. In mild penicilliosis, itraconazole is recommended for 12 weeks.

1

Black colonies

Dimorphic fungi

Amphotericin B used for treatment

Causes fulminant infections in immunocompromised patients

Microbiology

Mycology

146361cf-500a-4f19-8410-96e1c6032ff8

multi

Which of the following can be viewed on a conventional radiograph?

Calcification of canals. Buccal curvature cannot be seen from the conventional radiographs. Gingival fibers and the periodontal ligament, being connective tissues, are radiolucent radiographically.

3

Buccal curvature of roots

Gingival fibers

Calcification of canals

Periodontal ligament

Dental

null

4d1b0038-0178-40ef-ae57-5d4bc4aabe00

single

All are steroids except ?

Ans. is 'd' i.e., Thyroxine Steroids Steroids are complex molecules consisting of four fused carbon rings. There is a phenanthrene nucleus made of three six-membered rings (A,B,C, rings), and a cyclopentane which forms D ring. The fully saturated parent compound (steroid) is known as cyclopentanoperhydrophenathrene. The alcohol derivatives of steroids, in which one or more OH groups are present in the steroids nucleus, are termed sterols, i.e. sterols are a class of steroids containing hydroxy (OH) group. Cholesterol, ergosterol, coprosterol and sitosterol are some impoant sterols.In animal tissues, Cholesterol is the major sterol. Functionally, cholesterol is a very impoant molecule being precursor of a variety of steroids -Steroid hormones :- Progesterone, estrogen, androgens (Testosterone), glucocoicoids, mineralocoicoids.Bile acids:- Cholic acid, Chenodeoxycholic acid.Vitamin DSo, all above mentioned compounds have cyclopentanoperhydrophenanthrene nucleus.

4

Testosterone

Vitamin D

Cholesterol

Thyroxine

Biochemistry

null

21c59e2e-aa57-4aaa-8a46-3e7d36b919c0

multi

Age was found to be a factor affecting the relation of diabetes mellitus and periodontics

null

3

Sampling Bias

Selection Bias

Confounding Bias

Information Bias

Dental

null

cba582e8-b343-4363-a06c-fd9f9fd0a4ff

single

In marfan syndrome, the defect is in -

Ans. is 'a' i.e., Fibrillin I Marfan syndromeo Marfan syndrome results from inherited defect in an extracellular glycoprotein fibrillin - 1 on chromosome -15.o It has autosomal dominant inheritance,o Pathogenesiso Defect in fibrillin affects the elastic recoil of extracellular connective tissue.Elastic fibres consist of a central core made up of elastin, surronded by a peripheral network of microfibrils that consists largely fibrillin.Defect in fibrillin causes defective function of elastic fibres.Microfibrils (containing fibrillin) are mainly distributed to Aorta, ligaments of joint and ciliary zolules of lens - So, in marfan syndrome these tissues are primarily affected.

1

Fibrillin I

Fibrillin II

Collegen

Elastin

Pathology

Mendelian Disorders: Single-Gene Defects

69661983-d45c-48b2-ad66-0c43975ebdf6

single

Which of the following is a compound condylar joint?

Knee joint has more than two bones paicipating (hence Compound joint). It is formed by lateral and medial femorotibial and the femoropatellar joints It is Compound synol joint incorporating two condylar joints between the condyles of the femur and tibia and one saddle joint between the femur and the patella TM joint is a condylar joint but it involves only 2 bones( not a compound joint) Wrist joint is an ellipsoid synol joint and elbow is a hinge synol joint Ref: Gray's39e/p185-210

1

Knee

TM joint

Wrist

Elbow

Anatomy

General anatomy

f4d0d369-f03b-4113-8c0b-d5c9aa51c540

single

False about medullary cancer thyroid

Ans. (d) These cancers take up Radio iodineRef: Bailey and Love 27th Edition Page 820* Medullary thyroid cancers are not hormone dependent (Not TSH dependent)* They don't take up RAI* Differentiated thyroid Cancers - Papillary and follicular take up Radio active iodine and used in cases of treatment of high risk cases.

4

Secrete Calcitonin

20-25% are familial

Diarrhea are seen in 30%

These cancers take up Radioactive Iodine

Surgery

Thyroid Gland

2ea30c38-1bb4-4161-9a7d-88b4f9128d25

multi

A 15 year old female presents with primary amenorrhoea. Her breasts are Tanner 4 but she has no axillary or pubic hair. The most likely diagnosis is :

Answer is C (Testicular feminization syndrome): Presence of well developed breast (tanner stage 4) with scanty axillary or pubic hair in a phenotypic 'female' with primary amenorrhea (? no uterus) suggests the diagnosis of Testicular feminization syndrome.

3

Turner's syndrome

Mullerian agensis

Testicular feminization syndrome

Premature ovarian failure

Medicine

null

2f0c0a03-629e-44a4-abf4-1b0613b0f2f3

single

Patient underwent inguinal lymph node dissection and drain was placed. On 10th day severe bleeding occurs. What type of bleeding is this?

Ans. (b) Secondary* Secondary hemorrhage is due to sloughing of wall of vessel. It usually occurs 7-14 days after injury and is precipitated by factors such as infection,pressure necrosis or malignancy.

2

Reactionary hemorrhage

Secondary

Primary

Tertiary

Surgery

Miscellaneous

39f9abd4-000c-4783-9277-1457f5521eac

single

Major aim of phase 1 clinical trials is to know the

Phase I trial is designed as a dose-escalation study to determine the maximum tolerable dosage (MTD), that is, the maximum dose associated with an acceptable level of dose-limiting toxicity. Phase 1 Clinical Trials: The drug is tested in healthy human volunteers (extremes of ages ; elderly and children are excluded). As the drug is not tested in the patients, so we cannot determine efficacy in this phase. This is mainly for finding the maximum tolerable dose of the drug. This is first in human study. Because anti-cancer drugs can produce unacceptable toxicity and we cannot expose healthy humans to such a toxicity, the phase-1 trials for anticancer drugs are done in the patients

3

Safety

Efficacy

Maximum Tolerable Dose

Pharmacokinetics

Pharmacology

CLINICAL TRIALS, DRUG LABEL

5c985d2c-e69f-455a-b449-1b841b442372

single

In which of the following step of TCA cycle, carbon dioxide is removed?

Ans: a)Alpha-ketoglutarate dehydrogenase The two oxidative decarboxylation reactions of the TCA cycle are: 1. Isocitrate dehydrogenase 2. a-ketoglutarate dehydrogenase

1

Alpha-ketoglutarate dehydrogenase

Malate dehydrogenase

Succinate dehydrogenase

Fumarase

Biochemistry

TCA Cycle

e8b85665-5c1c-45f7-883d-852d36c93c0d

multi

Precursor for the synthesis of testosterone is:

Pregnenolone or Progesterone are the precursors for the synthesis of testosterone, aldosterone, estradiol and cortisol.

3

Aldosterone

Cholesterol

Pregnenolone

Cortisol

Biochemistry

null

e6edf7ee-a6d0-407c-beea-99a945bef44c

single

Blastocyte comes out on which day after feilization ?

Ans. is 'a' i.e., 4-7 days Free floating unimplanted blastocyst is seen on 4-5 days.

1

4-7 days

10-12 days

12-15 days

15-20 days

Gynaecology & Obstetrics

null

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single

Which one of the following gram positive organism is most common cause of UTI among sexually active women-

Ans. is 'c' i.e., Staphylococcus saprophyticus Staph saprophyticus . Staph saprophyticus may be present on normal human skin and the periurethral area and can cause urinary tract infection, paicularly in sexually active young women. . Staph saprophyticus strains causing UTI are usually sensitive to most antibiotics, except nalidixic acid. . Staph saprophyticus is novobiocin resistant.

3

Staphylococcus epidermidis

Staphylococcus aureus

Staphylococcus saprophyticus

Enterococcus

Microbiology

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The axillary sheath is an extension of this fascia around the subclan aery and brachial plexus. Fascia around nerve bundle of brachial plexus is derived from?

The brachial plexus and the subclan aery course between the anterior and middle scalene muscles, and as the nerve plexus and aery emerge from those muscles, they carry an extension of the preveebral fascia along to form the axillary sheath.

1

Preveebral fascia

Pretracheal fascia

Investing layer

Superficial cervical fascia

Anatomy

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Confounding factor is associated with:-

Confounding factor Any factor associated with both exposure, outcome and has an independent effect in causation of outcome is a confounder. BEST METHOD TO REMOVE CONFOUNDING:- MATCHING - Removes confounding bias by distributing known confounding factors equally in two groups RANDOMISATION(2ND BEST) RESTRICTION STRATIFICATION STATISTICAL MODELLING/ MULTIVARIATE ANALYSIS STRATIFIED RANDOMISATION (BEST METHOD)

3

Exposure only

Outcome only

Both exposure and outcome

Neither exposure nor outcome

Social & Preventive Medicine

Confounding and Bias

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% of offsprings affected by colour blindness, of a healthy male and heterozygous female:

b. 25%(Ref: Nelson's 20/e p 642; Ghai 8/e p 641)Color blindness is an X-linked recessive disorder.In X-linked disorders, if father is normal and mother is a carrier, 50% of children will inherit defective X chromosome.Out of these, the daughters (having 1 normal and 1 defective X chromosome) will act as carriersWhile, all sons, inheriting the defective X chromosome will be affected by colour blindness. Hence, 25% of children will be affected.

2

None

25%

50%

100%

Pediatrics

Genetics And Genetic Disorders

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Drug used for treatment of scorpian sting is -

Ans. is 'd' i.e., Prazosin Treatment of scorpian sting o Treatment after scorpian sting has two components :? A. Local o It includes; negative pressure extractor, compression wrap proximal to site of sting, local anaesthetic, local antiseptic, tetanus prophylaxis. B. Systemic o It includes: Maintenance of airway and circulation --> oxygen, intubation, strict hemodynamic monitoring Muscle relaxant (Phenobarbitone) If there is hyperdynamic cardiac changes --> P-blocker + a-blocker (Prazosin), nitrates If there is hypodynamic cardiac changes --> After load reduction by a-blocker (Prazosin), nifedipine, nitroprusside, hydralazine or ACE inhibitors. Dobutamine or norepinephrine can be used as last reso to correct hypotension refractory to fluid therapy. Diuretics for pulmonary edema. Insulin administration helps the vital organs to use metabolic substrate more efficiently. Atropine to counteract parasympathetic effects induced by venom. Antivenom is the treatment of choice after suppoive care is established.

4

Adrenaline

Morphine

Captopril

Prazosin

Pharmacology

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In the right middle ear pathology, Weber&;s test will be

Weber test: In this test, a vibrating tuning fork is placed in the middle of the forehead or the veex and the patient is asked in which ear the sound is heard. Normally, it is heard equally in both ears. It is lateralized to the worse ear in conductive deafness and to the better ear in sensorineural deafness. In weber test, sound travels directly to the cochlea bone. Lateralization of sound in weber test with a tuning fork of 512 Hz implies a conductive loss of 15-25 dB in ipsilateral ear or a sensorineural loss in the contralateral ear. Ref:- Dhingra; pg num:-22

3

Centralized

Normal

Lateralized to right side

Lateralized to left side

ENT

Ear

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Lee Jones test is used for -

Ans. is 'c' i.e., Cyanide Lee Jones testo Few crystals of ferrous sulfate is added to 5 ml of the gastric content,o To it, 5 drops of sodium hydroxide is added,o The mixture is boiled and cooled,o To it, 10 drops of 10% hydrochloric acid is added.o Greenish blue colour indicates cyanide and purplish colour indicates salicylate.

3

Carbolic acid

Arsenic

Cyanide

Lead

Forensic Medicine

Biological Materials & Stains

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Type 1 glomus cell secrete neurotransmitter because of oxygen sensitive

Type I glomus cells have O2 sensitive K+ channels, whose conductance is reduced in propoion to the degree of hypoxia to which they are exposed. This reduces the K+ efflux, depolarizing the cell and causing Ca2+ influx, primarily L-type Ca2+ channels. The Ca2+ influx triggers action potentials and transmitter release, with consequent excitation. of the afferent nerve endings. The smooth muscle of pulmonary aeries contains similar O2-sensitive K+ channels, which mediate the vasoconstriction caused by hypoxia. This is in contrast to systemic aeries, which contain adenosine triphosphate (ATP) dependent K+ channels that permit more K+ efflux with hypoxia and consequently cause vasodilation instead of vasoconstriction. Ref: Ganong's Review of Medical Physiology, 23rd edition, page no: 628, 629 Ref image:

4

Na+ channel

Cl channel

Ca+2 channel

K+ channel

Physiology

Renal physiology

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Most common complication of meningitis in children is –

Complications of meningitis in children Seizure is the commonest complication of meningitis in children. It occurs in about 30% of patients. Other common complications of meningitis. Subdural empyema or effusions — It is commonly seen after meningitis with H. Influenza. rain Abscesses Neurological impairment → Hemiplegia, Aphasia, Mental retardation, blindness. Auditory impairment (sensor neural deafness) Hydrocephalus Ventriculitis, Arachnoidits Cranial nerve palsies Thrombosis of ducal venous sinuses Transverse myelitis Systemic complication - Shock, Myocarditis, Status epilepticus, Syndrome of inappropriate ADH secretion

2

Hearing loss

Seizures

Hydrocephalus

Mitral regurgitation

Pediatrics

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single

A 66-year-old woman has a 5.5-cm infrarenal abdominal aortic aneurysm. What is the most common manifestation of such an aneurysm?

Most patients are unaware of their abdominal aneurysm until it is incidentally discovered by their physician. The importance of careful deep palpation of the abdomen cannot be overemphasized. On occasion, these aneurysms may expand, causing abdominal or back pain, and may even leak or rupture, mimicking other acute intra-abdominal conditions. Signs and symptoms of acute ischemia in the lower extremities are rare and usually follow thrombosis or embolization from an abdominal aneurysm.

3

Abdominal or back pain

Acute leak or rupture

Incidental finding on abdominal examination

Atheroembolism

Surgery

Arterial Disorders

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Amniotic fluid is maximum at what gestational age-

Ans-C i.e., 36 weeks o Amniotic fluid volume is related to gestational age. It measures 50 ml at 12 weeks, 400 ml at 20 weeks and reaches its peak of 1 litre at 36 - 38 weeks of gestation. Thereafter the amount diminishes, till at term it measures about 600 - 800 ml. As the pregnancy continues post-term, further reduction occurs to the extent of about 200 ml at 43 weeks.

3

12 weeks

20 weeks

36 weeks

40 weeks

Unknown

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The main apolipoprotein of LDL is

The major apolipoproteins of HDL (a-lipoprotein) are apoAs. The main apolipoprotein of LDL (b-lipoprotein) is apo B (B-100), which is found also in VLDL. Chylomicrons contain a truncated form of apo B (B-48) that is synthesized in the intestine, while B-100 is synthesized in the liver. Apo E, found in VLDL, HDL, chylomicrons, and chylomicron remnants, is also freely transferable. Reference: Harper; 30th edition; Page no: 255

3

A-II

B-48

B-100

E

Biochemistry

Metabolism of lipid

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single

Wolff-chaikoff effect is ?

Ans. is 'c' i.e., Reduced thyroxine synthesis by iodides Iodine and Iodides Iodine is the fastest acting thyroid inhibitor. Most impoant action is inhibition of hormone release (thyroid constipation); but all facets of thyroid synthesis may be affected. Excess iodide inhibits its own transpo in thyroid cells and may alter the redox potential of cells, thus interfering iodination -reduced TIT3 synthesis ( Wolffichaikoff effect).

3

Reduced thyroxine synthesis by radiotherapy

Reduced thyroxine synthesis by propylthiouracil

Reduced thyroxine synthesis by iodides

None of the above

Pharmacology

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Cause of odema

Ref.robbins 8/e 112; 7/e 120- 121;9/e p114 Capillary blood contains a decreased quantity of colloids (protein-white circles) due to either decreased hepatic synthesis of these proteins or increased protein loss through the kidney or gastrointestinal tract. ... With decreased production of albumin the plasma colloidal osmotic pressure decreases and edema occurs.

1

Decreased plasma protein concentration

Increased lymph flow

Increased ECF

Increased plasma proteins concentration

Anatomy

General anatomy

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single

Elemental iron and folic acid in adult IFA table is -

Ans. is 'd' i.e., 100 pg iron & 500 jag FA o Iron and Folic Acid content per I FA tablet# Adult tablet: 100 mg elemental iron and 500 meg folic acid.# Pediatric tablet: 20 mg elemental iron and 100 meg folic acid.

4

100 mg iron & 200 mg FA

200 mg iron & 100 mg FA

20 mg iron & 100 mg FA

100 mg iron & 500 mg FA

Social & Preventive Medicine

Obstetrics

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Esotrotropia is most commonly associated with

Near vision impaired they try to compensate by increasing their accomodation Infants are hyperopic by 2.5 D they are esotropic at bih ref : ak khurana 7th ed

1

Hyperopia

Myopia

presbyopia

Astigmatism

Ophthalmology

All India exam

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single

A young man with pulmonary tuberculosis presents with massive recurrent hemoptysis. For angiographic treatment, which vascular structure should be evaluated first -

Massive Hemoptysis Hemoptysis of >200-600cc in 24 hours. Massive Hemoptysis should be considered as a medical emergency Treatment Large-volume, life threatening Hemoptysis generally require immediate intervention regardless of the cause The first step is to establish a patent airway usually by endotracheal intubation and subsequent mechanical ventilation As most large - volume Hemoptysis Arises from an airway lesion, it is ideal if the site of the bleeding can be identified either by chest imaging or bronchoscopy (more commonly rigid than flexible) If bleeding doesnot stop with therapies of the underlying cause and passage of time, severe Hemoptysis from bronchial aeries can be treated with angiogrophic embolization of the culprit bronchial aery Bronchial aery are the major source of Hemoptysis Ref: Grainger Radiology 4th edition Pgno : 609

3

Pulmonary vein

Pulmonary aery

Bronchial aery

Superior vena cava

Anatomy

Cardio thoracic surgery

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single

Characteristic problem in females taking Norethisterone is :

Ans. is a i.e. Irregular bleeding Nor-ethisterone acetate is commonly used as an injectable steroid - 'NET-EN' It is a progesterone based contraceptive like DMPA and its side effect are similar to those of DMPA. The most frequent side effect is irregular bleeding. NET-EN is given in doses of 200 mg at 2 monthly interval. Composition Features Lunelle/cyclofem 25mg DMPA + 5mg estradiol cypionate Mesigyna 4g 50 mg NET-EN + 5mg estradiol valerate ed - menstrual irregularities Rapidly reversible Monthly injection Inhibits lactation Rapid return of feility Monthly injection same as lunelle Extra Edge : Combined injectable contraceptive.

1

Irregular bleeding

Thromboembolism

Hirsutism

Weight gain

Gynaecology & Obstetrics

null

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single