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0
|
db5fef4c-5673-4572-a1a0-e8ba1eb2a1b6
|
Which of the following is not a component of superficial perineal pouch?
|
[
"Duct of bulbourethral glands"
] |
[
"0"
] |
[
"Sphincter urethrae",
"Buibospongiosus",
"Posterior scrotal nerves",
"Duct of bulbourethral glands"
] |
. Sphincter urethrae (Ref: BDC 5/e vol-Il p361-64: Keith Moore 6/e p404-6; Gray's 40/e p1093-97)Sphincter urethrae is not a component of superficial perineal pouch."Root, crura and bulb of penis (corpus spongiosa and corpora cavernosa), bulbospongiosus muscle, ducts of bulbourethral gland, and posterior scrotal nerve/artervQ are contents of superficial perineal pouch.""Deep perineal pouch contains bulbourethral glands, membranous urethra, sphincter urethrae muscle (internal urethral sphincter) and dorsal nerve of penisQ."Urogenital Triangle (Region)Superficial Perineal PouchDeep Perineal Pouch* If lies between perineal fascia and perineal membrane, below perineal membrane (inferior fascia of urogenital diaphragm)* Limited superficially by deep perineal fascia.* It is superficial to the perineal membrane.* It is bounded superficially (inferiorly) by perineal membrane and deeply (superiorly) by endopelvic fascia of pelvic floor (diaphragm).Contents of Superficial Perineal PouchContents of Deep perineal pouchMalesFemalesMalesFemales* Ischiocavernosus* BulbospongiosusQ* Superficial trersus perinea* Ischiocavernosus* Bulbospongiosus* Superficial trersus perinei* Bulbar urethral glandQ* Membranous urethraQ* Urethra and vagina* Long perineal nerve from posterior cutaneous nerve of thigh* 3 branches of perineal nerve, i.e. posterior scrotal, branch to bulb and muscular br.* Long perineal nerve from posterior cutaneous nerve of thigh* 3 branch of perineal nerve, i.e. posterior labial nerve, branch to bulb and muscular br.* Sphincter urethrae muscleQ* Deep trerse perinea* Sphincter urethrae* Deep trerse perinei* Pudendal nerve* Dorsal nerve of penisQ* Perineal nerve* Pudendal nerve* Dorsal nerve of clitorisQ* Perineal nerve* Posterior scrotalQ and trerse perineal artery* 4 branches of artery of penis, i.e. deep and dorsal arteries of pens, urethral artery, and artery to bulb of penis* Posterior labial and trerse perineal artery* 4 branches of artery of clitoris, i.e. deep and dorsal artery of clitoris, urethral artery and artery to bulb of vestibule.* Internal pudendal vessels* Artery of penis* Stems of origin of 4 branches, i.e, deep and dorsal arteries of penis, urethral artery and artery to bulb of penis* Internal pudendal* Vessels* Artery of clitoris* Stems of origin of 4 branches, i.e, deep and dorsal arteries of clitoris, urethral artery and artery to bulb of vestibule* Ducts of bulbo urethral glandsQ* Root of penis including one corpus spongiosa and two corpora cavernosa* Greater vestibular glands and their ductsQ.* Body of clitoris including two in completely separated corpora cavernosa.
|
[
"Sphincter urethrae",
"Buibospongiosus",
"Posterior scrotal nerves"
] |
Buibospongiosus
|
1
|
fcdea38d-dcee-4c77-866c-136e55daf419
|
Newborn male baby presented with congestive heart failure. On examination enlarged fontanelles, a loud cranial bruit and following radiological finding was noted -the most likely diagnosis is:
|
[
"Sinus pericranii"
] |
[
"1"
] |
[
"Sinus pericranii",
"Vein of Galen malformation",
"Arachnoid cyst",
"Dandy walker malformation"
] |
Vein of Galen malformationCongenital malformation of median prosencephalic veinQ which shows dilated midline vascular channel in posterior part of cranium. Commonest cause of high output cardiac failure in paediatric age groupQ.
|
[
"Vein of Galen malformation",
"Arachnoid cyst",
"Dandy walker malformation"
] |
Vein of Galen malformation
|
2
|
158a3ed4-8496-4ab2-aad6-2f115d37680c
|
Spinal epidural space is the largest at the level of the
|
[
"2nd lumbar veebra"
] |
[
"3"
] |
[
"12th thoracic veebra",
"1st lumbar veebra",
"2nd lumbar veebra",
"3rd lumbar veebra"
] |
Spinal epidural space is largest at 3rd lumbar veebrae .Spinal epidural space is a closed anatomic space between the dura mater and the bony spinal canal. It extends from the foramen magnum to the sacrum. Unlike its intracranial counterpa, spinal epidural space is real. The presence of anchoring plicae and meningoveebral ligaments divide the space into anterior, lateral and posterior compaments. Ref - pubmed.com
|
[
"12th thoracic veebra",
"1st lumbar veebra",
"3rd lumbar veebra"
] |
1st lumbar veebra
|
3
|
0bc7da0f-5f4e-43c1-a02f-5a948bb74872
|
Which of the following stain is used to assess tear film integrity:-
|
[
"Alcian Blue"
] |
[
"2"
] |
[
"Congo red",
"Alcian Blue",
"Rose bengal",
"All of the above"
] |
Tests for Tear Film and Epithelial Integrity Stains used commonly : -Fluorescein -Rose Bengal -Lissamine green -Rhodhamine Blue Fluorescein Stains exposed basement membrane Stains cornea more than conjunctiva. For diagnosing Filamentary keratitis, measuring TBUT CORNEAL STAINING OF DRY EYE USING FLUORESCEIN STAINING CONJUNCTIVAL STAINING IN DRY EYE USING FLUORESCEIN STAINING. CONJUNCTIVAL VASCULAR TOUOUSITY IS ALSO EVIDENT Rose Bengal Stains dead and devitalised cells Healthy cells protected inadequately by a mucin coating Irritation on instillation Early or mild cases detected more easily with Rose Bengal Stain more visible on conjunctiva than cornea Interpalpebral staining of the nasal and/or inferior paracentral cornea is seen in KCS
|
[
"Congo red",
"Rose bengal",
"All of the above"
] |
All of the above
|
4
|
2ac2e646-5ad8-4e0f-986f-60614a655348
|
Which of the following is not true regarding infrabulge clasp
|
[
"Increased retention without tipping"
] |
[
"2"
] |
[
"It is esthetic",
"Increased retention without tipping",
"More chances of accidental distortion",
"Approaches abutment from gingival side"
] |
Some of the advantages attributed to the infrabulge clasp are, Its interproximal location, which may be used to esthetic advantage. Increased retention without tipping action on the abutment. Less chance of accidental distortion, resulting from its proximity to the denture border.
|
[
"It is esthetic",
"More chances of accidental distortion",
"Approaches abutment from gingival side"
] |
Approaches abutment from gingival side
|
5
|
eff94721-2af7-430b-b193-537ac18aff86
|
Which of the following is not an anesthetic that acts for more than 2hrs?
|
[
"Bupivacaine"
] |
[
"1"
] |
[
"Bupivacaine",
"Prilocaine",
"Etidocaine",
"Tetracaine"
] |
Prilocaine have only intermediate duration and potency (30-90 min). Tetracaine, Bupivacaine, Etidocaine have long duration and potency (>120 min). Ref: Miller Anaesthesia, 5th Edition, Page 586.
|
[
"Prilocaine",
"Etidocaine",
"Tetracaine"
] |
Prilocaine
|
6
|
4825e789-94e2-4dc7-9a07-5d58301fb2df
|
A patient develops hepatosplenomegaly, lymphadenopathy following sexual contact, 3 weeks back. The best test to rule out HIV infection is :
|
[
"Western blot"
] |
[
"2"
] |
[
"ELISA",
"Western blot",
"P24Ag",
"Lymph node biopsy"
] |
P24 Ag. "Antibodies to HIV usually appear within 6 weeks and almost invariably within 12 weeks of primary infection." - Harrison,15/eDetection of these Antibodies forms the basis of most diagnostic screening tests for HIV infection. Such as ELISA & Western blot test.In the question the patient is giving H/O sexual contact just 3 weeks back. So there is strong probability of that Antibodies might not have developed against HIV. Now the diagnosis of HIV in this patient depends upon the direct detection of HIV or one of its components.The simplest of the direct detection test is the p24 Antigen Capture Assay.
|
[
"ELISA",
"P24Ag",
"Lymph node biopsy"
] |
P24Ag
|
7
|
08408838-b901-4d4d-8fbe-18c5ce8790bd
|
Which glycosaminoglycan is present in cornea ?
|
[
"Hyaluronic acid"
] |
[
"3"
] |
[
"Dermatan sulfate",
"Chondroitin Sulfate",
"Hyaluronic acid",
"Keratan Sulfate"
] |
: Keratan sulafte Glycosaminoglycan in cornea: Keratan sulafte (KS) >>> Chondroitin sulfate (CS) & Dermatan sulfate (DS) All are present in cornea but KS is in maximum amount Immunohistochemistry revealed the presence of both high- and low-sulphated epitopes of KS, as well as DS, throughout the cornea CS only in the peripheral cornea before the limbus. Keratan sulfate is also responsible for corneal trarency. Keratan Sulfate-I is present in cornea while Keratan Sulfate-II is present in cailages.
|
[
"Dermatan sulfate",
"Chondroitin Sulfate",
"Keratan Sulfate"
] |
Chondroitin Sulfate
|
8
|
4b0b9b71-e9e2-4dd2-9ba3-33ebfa155bc5
|
An unidentified dead body is brought to you for autopsy. You notice a faded tattoo mark on the left arm of the body. Which of the following methods can you use to enhance the tattoo mark for identification?
|
[
"Application of isopropyl alcohol"
] |
[
"1"
] |
[
"Application of isopropyl alcohol",
"Infrared photography",
"Bright illumination",
"All of the above"
] |
Infrared photography makes old tattoos readily visible. A faded tattoo mark can by visualized by Ultraviolet light. Infrared photography. Rubbing the pa and examining with a magnifying lens. In decomposed bodies, the tattoo marks can be visualized by removing the epidermis by a moist cloth. The lymph nodes near a tattoo mark also show a deposit of the pigment. Reference The Synopsis of FORENSIC MEDICINE and Toxicology 29th Edition
|
[
"Infrared photography",
"Bright illumination",
"All of the above"
] |
All of the above
|
9
|
2b42ac45-27a8-4304-b28d-7554722e76ba
|
What is the most probable poal of entry of Aspergillus?
|
[
"Blood"
] |
[
"2"
] |
[
"Puncture wound",
"Blood",
"Lungs",
"Gastrointestinal tract"
] |
Aspergillus species are widely distributed on decaying plants, producing chains of conidia. Aspergillus species unlike Candida species do not form the pa of normal flora of hum They are ubiquitous in the environment; hence trission of infection is mostly exogenous. Aspergillus trission occurs by inhalation of airborne conidia. Risk Factors for invasive aspergillosis are: Glucocoicoid use (the most impoant risk factor) Profound neutropenia or Neutrophil dysfunction Underlying pneumonia or COPD, tuberculosis or sarcoidosis Antitumor necrosis factor therapy.
|
[
"Puncture wound",
"Lungs",
"Gastrointestinal tract"
] |
Gastrointestinal tract
|
10
|
8c56cb65-648f-465e-997e-4bc352da3ef7
|
Amount of coronary flow per minute is
|
[
"225 ml"
] |
[
"1"
] |
[
"225 ml",
"250 ml",
"50 ml",
"300 ml"
] |
Total blood flow through various org(whole organ) Liver - 1500ml/min - 27.8% of cardiac output Kidney - 1260ml/min - 23.3% of cardiac output Skeletal muscle - 840ml/min - 15.6% of cardiac output Brain - 750ml/min - 13.9% of cardiac output Skin - 462ml/min - 8.6% of cardiac output Heart - 250ml/min - 4.7% of cardiac output Blood flow per unit mass in decreasing order –ml/100gm/min (Highest to lowest) Kidney Heart Liver Brain Skin Skeletal muscle
|
[
"250 ml",
"50 ml",
"300 ml"
] |
250 ml
|
11
|
de4fce81-ce14-422b-8f68-b6c276f47f83
|
WHO prognostic score for a high-risk GTN is
|
[
">= 6"
] |
[
"1"
] |
[
">= 6",
">= 7",
">= 10",
">= 15"
] |
Modified World Health Organization Prognostic Scoring System, as Adapted by FIGO, by which women whose score is 0-6 are Considered Low Risk (Requiring Single-Agent Chemotherapy) and score of 7 or more, High Risk (Requiring Multiagent Combination Chemotherapy)Scores0123Age<40>= 40----Antecedent pregnancyMoleAboionTerm--Interval months from index pregnancy<44-67-13>= 13Pretreatment serum hCG<10001000-1000010,000-100,000>100,000Largest tumor size --3-5 cm>= 5 cm--Site of metastasesLungSpleen, liverGastrointestinalL brainNo. of metastases--1-45-8>8Previous failed chemotherapy----Single drug>= 2 DrugsReference: William's Obstetrics; 25th edition, chapter 20; Gestational trophoblastic diseases
|
[
">= 7",
">= 10",
">= 15"
] |
>= 10
|
12
|
782765bf-57d1-434a-82bb-ff5f74c0a2aa
|
Wind Swept deformity is seen in:
|
[
"Scurvy"
] |
[
"2"
] |
[
"Ankylosing spondylitis",
"Scurvy",
"Rheumatoid ahritis",
"Rickets"
] |
Rheumatoid ahritis Detion of all toes in one direction (usually laterally) is known as wind-swept deformityQ found in Rheumatoid ahritis.
|
[
"Ankylosing spondylitis",
"Rheumatoid ahritis",
"Rickets"
] |
Rickets
|
13
|
9e1ac2ed-b9d0-42d1-99dc-1fa01f6fcecf
|
Pisiform is which type of bone:
|
[
"Pneumatic bone"
] |
[
"1"
] |
[
"Pneumatic bone",
"Sesamoid bone",
"Accessory bone",
"Long bone"
] |
The pisiform is a sesamoid bone, with no covering membrane of periosteum. It is the last carpal bone to ossify. The pisiform bone is a small bone found in the proximal row of the wrist (carpus). It is situated where the ulna joins the wrist, within the tendon of the flexor carpi ulnaris muscle.
|
[
"Sesamoid bone",
"Accessory bone",
"Long bone"
] |
Sesamoid bone
|
14
|
701ae56e-89d5-484e-8859-33b9f54db72d
|
A patient with a peptic ulcer was admitted to the hospital and a gastric biopsy was performed. The tissue was cultured on chocolate agar incubated in a microaerophilic environment at 37degC for 5 to 7 days. At 5 days of incubation, colonies appeared on the plate and were curved, Gram-negative rods, oxidase-positive. The most likely identity of this organism is
|
[
"Haemophilus influenzae"
] |
[
"3"
] |
[
"Campylobacter jejuni",
"Vibrio parahaemolyticus",
"Haemophilus influenzae",
"Helicobacter pylori"
] |
Helicobacter pylori was first recognized as a possible cause of gastritis and peptic ulcer by Marshall and Warren in 1984. This organism is readily isolated from gastric biopsies but not from stomach contents. It is similar to Campylobacter species and grows on chocolate agar at 37degC in the same microaerophilic environment suitable for C. jejuni (Campy-Pak or anaerobic jar without the catalyst). H. pylori, however, grows more slowly than C. jejuni, requiring 5 to 7 days incubation. C. jejuni grows optimally at 42degC, not 37degC, as does H. pylori.
|
[
"Campylobacter jejuni",
"Vibrio parahaemolyticus",
"Helicobacter pylori"
] |
Campylobacter jejuni
|
15
|
0aa45c86-ab7c-4b9b-ba1a-9d15ffdc6d48
|
The recommended oral dose of vitamin A to be given in a 10-month child with deficiency on each of day 1, 2 and 28 is __________
|
[
"50,000 IU"
] |
[
"1"
] |
[
"50,000 IU",
"1,00,000 IU",
"2,00,000 IU",
"6,00,000 IU"
] |
Immediately on diagnosis, oral vitamin A is administered in a dose of 1 lakh IU in children aged 6-12 months.The same dose is repeated next day and 4 weeks later. Ref: Page 121, Ghai essential pediatrics; 6th edition
|
[
"1,00,000 IU",
"2,00,000 IU",
"6,00,000 IU"
] |
2,00,000 IU
|
16
|
addda9c2-a204-46fa-864f-2b48da876099
|
The majority of body sodium is present ?
|
[
"Plasma"
] |
[
"3"
] |
[
"Extra cellular fluid",
"Intra cellular fluid",
"Plasma",
"Bone"
] |
Bone- Typical western diet consumption provides approximately 150 mmol of sodium chloride (NaC1) dailyQ.- Normal level of serum sodium is 136 -145 mmol/L (SI unit) or 136- 145 meg/L (conventional unit)Q.Na' - I(' ATP pase pump actively tros Na+ out of cells. As a result, 85- 90% of all sodium is extracellularQ and ECF volume is a reflection of total body Na+ content(2. And in the same way total body Na+ content is a reflection of ECF volume.Sodium reserve is chiefly stored in stomach wallQ, which makes it alkaline to counter balance the acidic environment. 30-40% sodium is stored in skeletal muscles.- The normal plasma osmolality is 275 - 290 milliosmoles/kg. To maintain it, normally about 600 mosmols/day solute must be excreted. And since maximum urine osmolality is 1200 mosmols/kg a minimum urine out put of 500 mL/ d is required.- Osmoreceptor located in anterolateral hypothalmusQ is stimulated by hypeonicity. Ineffective osmols i.e. solutes that do not contribute to shift water across cell membrane, like urea and glucoseQ do not play a role in stimulating thirst. The average osmotic threshold for thirst is - 295 mosmol/kg. Osmotic adaptation is a defence mechanism of brain cells in chronic hypo & hyper natremia against large water shiftsQ. It is mediated by initialshifts of K' & Na* f/b synthesis, impo or expo of organic solutes (osmolytes) such as inositol, betaine & glutamineQ. In chronic hyponatremia brain cells lose & in chronic hypernatremia gain solutes. Sodium is the principal cation content of ECF. The total body sodium is - 5000 mmol, of which 44% is in extracellular fluid 9% is in intracellular fluid and remaining 47% is in boneQ.98% of potassium (K*) is intracellular & 2% in extracellular fluid. 3/4 of total boy IC+ (- 3500 minol) is found in skeletal muclesQ. Normal adult ingests - 1.0 rnmol/kg of IC+ in food. Fruit, milk & honey are rich in K+.
|
[
"Extra cellular fluid",
"Intra cellular fluid",
"Bone"
] |
Bone
|
17
|
9d5816ce-aaf1-49b4-ac72-7a2c8f75cf15
|
All are true about Digoxin except
|
[
"Acts by inhibiting Na+K+ATPase in myocardial fibres"
] |
[
"2"
] |
[
"Causes bradycardia due to increased vagal tone causes bradycardia due to increase the vagal tone",
"Acts by inhibiting Na+K+ATPase in myocardial fibres",
"It is 95% plasma protein bound",
"Primaryly excreted unchanged by glomerular filtration"
] |
Plasma protein binding of digitoxin is high(95%) whearas it is Low(70-80%) for Digoxin Refer kDT 6/e p497
|
[
"Causes bradycardia due to increased vagal tone causes bradycardia due to increase the vagal tone",
"It is 95% plasma protein bound",
"Primaryly excreted unchanged by glomerular filtration"
] |
Primaryly excreted unchanged by glomerular filtration
|
18
|
67c676f3-33ab-4f06-9266-84b6d58b2be4
|
The process of coating a microbe, to target it for phagocytosis is:
|
[
"Chemotaxis"
] |
[
"3"
] |
[
"Diapedesis",
"Margination",
"Chemotaxis",
"Opsonisation"
] |
Opsoniztion:- Refer to coating of microbes or self cell by antibodies, which facilitates the phagocytosis of the same cell or microbe. Chemotaxis:-It is movement or migration of cell from from one place to another, eg, Migration of Neutrophils during inflammation Diapedesis:-Passage of blood cells through the intact walls of capillaries, eg, WBC at inflammed site. PECAM-1 OR CD31 useful for diapedesis.
|
[
"Diapedesis",
"Margination",
"Opsonisation"
] |
Diapedesis
|
19
|
2b411ea0-4293-46d7-a00f-c7f3257f9bde
|
High risk pregnancy are all except
|
[
"Sho stature primi"
] |
[
"2"
] |
[
"Elderly primi",
"Sho stature primi",
"Veex presentation",
"Diabetes"
] |
High risk pregnancy cases include: 1. Elderly primi (30yrs and more) 2. Sho statured primi (140cm and less) 3.Malpresentations such as breech , trerse lie etc. 4. Antepaum haemorrhage , threatened aboion 5. Preeclampsia and eclampsia 6. Anaemia 7. Twins , hydraminos 8. Previous still bih, intrauterine death, manual removal of placenta 9. Elderly grandmultiparas 10. Prolonged pregnancy (14 days after expected date of delivery) 11. History of previous caesarean or instrumental delivery 12. Pregnancy associated with general diseases like cardiovascular diseases, kidney disease, diabetes, TB, liver disease, malaria, convulsions, asthma, HIV, I , STI ect. 13. Treatment for infeility 14. Three or more spontaneous consecutive aboions The only exception to the question is option 3 as veex presentation is not a case of high risk pregnancy. Reference: Park&;s textbook of preventive and social medicine 23rd edition pg 526
|
[
"Elderly primi",
"Veex presentation",
"Diabetes"
] |
Diabetes
|
20
|
7fc61507-d0c5-4956-96f7-efc872a37b38
|
A physician decides to discontinue or not to use extraordinary life sustaining measures to prolong his patients life. It is known as?
|
[
"Active euthanasia"
] |
[
"1"
] |
[
"Active euthanasia",
"Passive euthanasia",
"Positive euthanasia",
"Assisted Suicide"
] |
Active euthanasia or positive euthanasia is a positive merciful act, to end useless suffering or a meaningless existence. It is an act of commission. Example: By giving large doses of drugs to hasten death. Passive euthanasia meiscontinuing or not using extraordinary life sustaining measures to prolong life. This includes acts of omission. Example: Failure to resuscitate a terminally ill or hopelessly incapacitated patient. Assisted suicide: A person providing information to another with information, guidance and meto take his own life with the intention that it will be used for this purpose is assisted suicide. Ref: The Essentials of Forensic Medicine and Toxicology 29th Ed Page 42.
|
[
"Passive euthanasia",
"Positive euthanasia",
"Assisted Suicide"
] |
Assisted Suicide
|
21
|
d8cbeb55-23f2-4ed6-96bf-9d91141c2db7
|
Balthazar scoring system is used for?
|
[
"Cholangitis"
] |
[
"0"
] |
[
"Acute Pancreatitis",
"Acute Appendicitis",
"Acute Cholecystitis",
"Cholangitis"
] |
cute PancreatitisREF: REF: Schwartz 9th ed chapter 33, Sabiston 18th ed chapter 55, The Washington Manual of Critical Care by Marin Kollef page 418See "ASSESSMENT OF SEVERITY OF PANCREATITIS" in Surgery 2012 Session 2
|
[
"Acute Pancreatitis",
"Acute Appendicitis",
"Acute Cholecystitis"
] |
Acute Appendicitis
|
22
|
f9a1bf42-e1c1-47dc-8657-f46184b6b3bc
|
Wrong about dhatura seeds is?
|
[
"Yellow brown"
] |
[
"3"
] |
[
"Kidney shaped",
"Odourless",
"Yellow brown",
"Convex smooth surface"
] |
onvex smooth surfaceREF: Modern Medical Toxicology By Pillay 4th ed page 207, Review of Forensic Medicine and Toxicology By Gautam Biswras 2nd ed page 496See APPENDIX-42 ANTIDOTES & TOXICOLOGY See PLATE F-l PLATE F-1 APPENDIX - 42AntidotesAntidotePoison/drug/toxinN-AcetylcysteineAcetaminophenCarbon tetrachlorideOther hepatotoxinsAmyl nitrite, sodium nitrite and sodium thiosulfate (Cyanide antidote kit)NitrilesBromatesChloratesCyanide (e.g., HCN, KCX and NaCN)Mustard agentsNitroprussideSmoke inhalation (combustion of synthetic materials)Antivenin, Crotalidae Polyvalent (Equine Origin)Pit viper envenomation (e.g. rattlesnakes, cottonmouths, timber rattlers and copperheads)Antivenin, Crotalidae Polyvalent Immune Fab - Ovine (CroFab)Pit viper envenomation (e.g.. rattlesnakes, cottonmouths, timber rattlers and copperheads)Atropine sulfateAlpba2 agonists (e.g., clonidine)Alzheimer drugs (e.g., donepezil, galantamine, rivastigmine, tacrine)Antimyesthenk agents (e.g., pyridostigmine)Bradyarrhythmia-producing agents (e.g., beta blockers, calcium channel blockers and digitalis glycosides)Cholinergic agonists (e.g., bethanechol) .Muscarine-containing mushrooms Nerve agents (sarin, soman, tabun and VX)Organophosphate and carbamate insecticidesDigoxin immune FabCardiac glycoside-containing plants (foxglove and oleander)Digitoxin, DigoxinEthanolEthylene glycolMethanolFlumazenilBenzodiazepinesZaleplonZolpidemFolic acid and Folinic acid (Leucovorin)Formaldehyde/Formie AcidMethanolMethotrexate, trimetrexatePyrimethamineTrimethoprimFomepizoleEthylene glycolMethanolGlucagonBeta blockersCalcium channel blockersHypoglycemiaHypoglycemic agentsHydroxocobalaminNitrilesBromatesChloratesCyanide (e.g., HCN, KCN and NaCN)Mustard agents NitroprussideSmoke inhalation (combustion of synthetic materials)Hyperbaric oxygen (HBO)Carbon monoxideCarbon tetrachlorideCyanideHydrogen sulfideMethemoglobinemiaMethylene blueMethemoglobin-inducing agents including;Aniline dyesDapsoneLocal anesthetics (e.g., benzocaine)MetoclopramideNaphthaleneNitrates and nitritesNitrobenzenePhenazopyridineNalmefene and NaloxoneACE inhibitorsAlpha2 agonists (e.g., clonidine)Imidazoline decongestants (e.g., oxymetazoline and tetrahydrozoline) LoperamideOpioids (e.g., codeine, fentanyl, heroin, meperidine, morphine)Physostigmine salicylateAntihistaminesAtropine and other anticholinergic agentsDhatura poisoningIntrathecal baclofenPhytonadione (Vitamin Kl)Long-acting anticoagulant rodenticides (e.g., brodifacoum and bromadiolone) WarfarinPralidoxime chloride (2-PAM)Antimyesthenic agents (e.g., pyridostigmine)Nerve agents (sarin, soman, tabun and VX)Organophosphate insecticidesTacrineProtamine sulfateEnoxaparinHeparinPyridoxine hydrochloride (Vitamin B6)Acrylamide Ethylene glycol Hydrazine Isoniazid (INH)Sodium bicarbonateChlorine gasHyperkalemiaSerum Alkalinization:Agents producing a quinidine-like effect as noted by widened QRS complex on EKG (e.g., amantadine, carbamazepine, chloroquine,cocaine, diphenhydramine, flecainide,tricyclic antidepressants, quinidine)Urine Alkalinization:Weakly acidic agents (chlorpropamide, methotrexate, phenobarbital and salicylates)Deferoxamine and DeferasiroxAcute iron poisoningDimercaprol (BAL in oil)Hydrofluoric acid (HF)Hyperkalemia (not digoxin-induced)HypermagnesemiaCalcium disodium EDTA (Versenate)Acute arsenic poisoning,Acute mercury poisoning,Lead poisoning (in addition to EDTA)Dicobalt EDTACyanide poisoningSucdmer/ Dimercaptosuccinic acid (DMSA)Lead poisoning,Arsenic poisoning,Mercury poisoningDimercapto-propane sulfonate (DMPS)Severe acute arsenic poisoning,Severe acute mercury poisoningD-Penicillamine (Cuprimine)Mainly in: copper toxicityOccasionally adjunctive therapy in: Gold toxicity, Arsenic poisoning, Lead poisoning, Rheumatoid arthritisBotulinum antitoxin * Bivalent (types AB)<< Trivalent (types ABE)Food-borne botulismWound botulismBotulism as a biological weaponNote: Not currently recommended for infant botulismL-CarnitineValproic acidCyproheptadine HCLMedications causing serotonin symdromeDantrolene sodiumMedications causing neuroleptic malignant symdrome (NMS)Medications causing malignant hyperthermiaInsulin and dextroseBeta blockersCalcium channel blockers (diltiazem, nifedipine, verapamil)Octreotide acetateSulfonylurea hypoglycemic agents (e.g., glipizide, glyburide)Sodium thiosulfateBromatesChloratesMustard agentsNitroprussideThiamineEthanolEthylene glycolPrussian blue, ferric hexacyan ofer rateRadioactive cesium (Cs-137), radioactive thallium (Tl-201), and nonradioactive thallium
|
[
"Kidney shaped",
"Odourless",
"Convex smooth surface"
] |
Kidney shaped
|
23
|
02750dd8-e8bc-41e9-85c0-3dece223c01b
|
All of the following conditions are more commonly associated with LBBB pattern than RBBB Pattern on ECG, Except:
|
[
"Lev Disease"
] |
[
"3"
] |
[
"Acute MI",
"Aoic valve disease",
"Lev Disease",
"Ashman Phenomenon"
] |
(Ashman Phenomenon) Ashman Phenomenon is more commonly associated with an RBBB aberration than LBBB. Ashman's phenomenon should be suspected in atrial fibrillation when there is a long cycle followed by a sho cycle, with the subsequent QRS complex manifesting a right bundle branch block pattern. Ashman Phenomenon is more commonly associated with an RBBB aberration than LBBB Ashman's phenomenon is a trent functional bundle brunch block resulting from an aberrant intraventricular conduction abnormality that occurs in response to a change in QRS cycle length (When a sho cycle follows a long one). RBBB aberration is typically more common than LBBB. Ashman's phenomenon should be suspected in atrial fibrillation when there is a long cycle followed by a sho cycle, with the subsequent QRS complex manifesting a right bundle branch block pattern. Acute Myocardial Infarction, Aoic Valve disease and Lev Disease are all associated with LBBB Selected Causes of Left Bundle Branch Block Coronary Hea Disease/ Acute MI (frequently with impaired left ventricular function) Hypeensive Hea Disease Aoic Valve Disease Cardiomyopathy Idiopathic fibrosis of the bundle branch fibres (Lev disease and Lenegre Disease
|
[
"Acute MI",
"Aoic valve disease",
"Ashman Phenomenon"
] |
Aoic valve disease
|
24
|
22d8f1ef-33b7-4891-8fc6-c340279202b3
|
Not a feature of CBD stone
|
[
"Fever"
] |
[
"3"
] |
[
"Pain",
"Jaundice",
"Fever",
"Septic shock"
] |
Clinical features of CBD stone CBD stone may be silent and are often discovered incidentally. In these patients, biliary colic, jaundice, clay coloured stools and darkening of the urine Fever and chills may be present in patients with choledocholithiasis and cholangitis Serum bilirubin, aminotrerases, and ALP are commonly elevated in patients with biliary obstruction but are neither sensitive nor specific for the presence of common duct stones Among these, serum bilirubin has the highest positive predictive value for the presence of choledocholithiasis Laboratory values may be normal in one third of Patients with choledocholithiasis Ref: Sabiston 20th edition Pgno:1494
|
[
"Pain",
"Jaundice",
"Septic shock"
] |
Pain
|
25
|
7fca4e73-c0d6-4059-ae8c-80dd95c9098a
|
Sodium Thiopentone is ultra sho acting d/t
|
[
"Rapid metabolism"
] |
[
"2"
] |
[
"Rapid absorption",
"Rapid metabolism",
"Rapid redistribution",
"Rapid excretion"
] |
Barbiturate pharmacokinetics has been described in physiologic and compament models. Both these pharmacokinetic models describe rapid redistribution as the primary mechanism that terminates the action of a single induction dose. Physiologic models of barbiturates describe a rapid mixing of the drug within the central blood volume followed by a quick distribution of the drug to highly perfused, low-volume tissues ( brain), with a slower redistribution of the drug to lean tissue (muscle), which terminates the effect of the initial (induction of anesthesia) dose. In these models, adipose tissue uptake and metabolic clearance (elimination) play only minor roles in the termination of the effects of the induction dose. The reasons are the minimal perfusion ratio of adipose tissue compared with other tissues and the slow rate of removal. Ref: Miller's anesthesia 8th edition
|
[
"Rapid absorption",
"Rapid redistribution",
"Rapid excretion"
] |
Rapid excretion
|
26
|
3bd16bdf-b7ea-460e-ae85-f8bf61e816c1
|
Which of the following NSAID does not having antiinflammatory activity?
|
[
"Mefenamic acid"
] |
[
"3"
] |
[
"Ketorolac",
"Diclofenac",
"Mefenamic acid",
"Acetaminophen"
] |
All NSAIDs, including selective COX-2 inhibitors, are antipyretic, analgesic, and anti-inflammatory, with the exception of acetaminophen, which is antipyretic and analgesic but is largely devoid of anti-inflammatory activity. Ref: Grosser T., Smyth E. (2011). Chapter 34. Anti-inflammatory, Antipyretic, and Analgesic Agents; Pharmacotherapy of Gout. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.
|
[
"Ketorolac",
"Diclofenac",
"Acetaminophen"
] |
Ketorolac
|
27
|
c3ca2ec8-36c4-47d0-b1b5-c89172443acc
|
Anastomotic leaks are most commonly seen in
|
[
"Antral gastrectomy"
] |
[
"0"
] |
[
"Billroth 1",
"Roux en y gastrojejunostomy",
"Polya gastrectomy",
"Antral gastrectomy"
] |
Since there is end to end gastroduodenal anastomosis in billroth 1 there are more chances of anastomotic leak
|
[
"Billroth 1",
"Roux en y gastrojejunostomy",
"Polya gastrectomy"
] |
Polya gastrectomy
|
28
|
2c2474cc-80d4-4903-813f-1244b4f8ee13
|
The commonest cause of intestinal obstruction and abdominal pain in children between 3 months to 6 years of age:
|
[
"Nonspecific cause"
] |
[
"0"
] |
[
"Intussusception",
"Meckel's diverticulum",
"Intestinal polyp",
"Nonspecific cause"
] |
. IntussusceptionIntussusception occurs when a portion of the alimentary tract is telescoped into an adjacent segment. It is the most common cause of intestinal obstruction between 3 month and 6 yr. of age.
|
[
"Intussusception",
"Meckel's diverticulum",
"Intestinal polyp"
] |
Intestinal polyp
|
29
|
a199b04b-ebb0-44eb-b585-c1dd930ab3e3
|
Antibody mediated enhancement is a feature of
|
[
"Yellow fever"
] |
[
"1"
] |
[
"Yellow fever",
"Dengue heomorrhagic fever",
"Omsk heomorrhagic fever",
"Japanese encephalitis"
] |
Antibody mediated enhancement is non-neutralizing antibody produced against the first serotype will combine, cover and protect the second serotype from host immune responce.seen in dengue hemorrhagic fever.
|
[
"Dengue heomorrhagic fever",
"Omsk heomorrhagic fever",
"Japanese encephalitis"
] |
Japanese encephalitis
|
30
|
ea0f0bb4-92de-4965-973b-5f01ab3ddd38
|
Which of the following is associated with the development of Chalcosis?
|
[
"Iron"
] |
[
"1"
] |
[
"Iron",
"Copper",
"Lead",
"Mercury"
] |
Chalcosis refers to the specific changes produced by the alloy of copper in the eye. Copper from the alloy are dissociated electrolytically and are deposited under the membranous structure of the eye. Clinical manifestations of chalcosis includes: Kayser Fleischer rings: due to deposition of copper under peripheral pas of Descement's membrane. Sunflower cataract: due to deposition of copper under the posterior capsule of the lens. Deposition of golden plaques at the posterior pole of retina which reflects the light with a metallic sheen. Ref: Comprehensive Ophthalmology By AK Khurana, 4th edn, page 410
|
[
"Copper",
"Lead",
"Mercury"
] |
Mercury
|
31
|
658932cf-5880-4766-a73f-63492cddda37
|
A person breaks someone's mandible in alleged fight. Police can -
|
[
"Arrest with warrant"
] |
[
"1"
] |
[
"Arrest with warrant",
"Arrest without warrant",
"Declares him hostile and out him in jail",
"Put him in mental asylum"
] |
The synopsis of forensic medicine & toxicology;Dr k.s narayan reddy; 28th edition; pg.no. 155; Breaking of mandible comes under grievous hu,so the police can arrest the the person who caused the hu without a warrant.
|
[
"Arrest without warrant",
"Declares him hostile and out him in jail",
"Put him in mental asylum"
] |
Put him in mental asylum
|
32
|
2612ad6b-f50b-40a2-99be-24ff47be7963
|
Calcium homeostasis is maintained by all except
|
[
"Kidney"
] |
[
"1"
] |
[
"Kidney",
"Lung",
"Liver",
"Skin"
] |
(lung)Ref: Ganong, 22nd ed. Pg. 392Kidney, liver and skin is related to the production of vitamin D in the body, so these are involved in calcium haemostasis. Hormones related to calcium metabolism and their effectParathormone (PTH)-Increase in PTH causes increase bone resorptionIncrease renal reabsorption of calcium, "!reabsorption of phosphatesIncrease Intestinal absorption of calcium through vitamin DOverall effect -- increased S. calcium, decreased S. phosphate.Calcitonin-increase in calcitonin causes- Increase bone mineralization Increase renal excretion-proximal tubule Decrease bone resorptionVitamin D-increased in vitamin D causes:Increase Intestinal reabsorption of calcium through Calbindin D 28K.Increase bone resorption by osteoclastic activity Increase renal reabsorption in proximal tubule of both calcium and phosphates Overall effects-Increase in S. calcium, and increase in S. phosphatesEffects of Hormones on bonePTH - Increase osteoclast, Increase osteoblast Vitamin D - Increase osteoclast, Increase osteoblastCalcitonin - Decrease osteoclast, osteoblast no changeRememberPTH has no direct action on Intestine, but acts through vitamin D Vitamin D augments the action of PTH in kidneyRANKL is seen on the osteoblast and RANK on osteoclastOPG (osteoprotegerin) - inhibitor of RANKL Osteoblastic trucing signal - cbfal
|
[
"Lung",
"Liver",
"Skin"
] |
Skin
|
33
|
b7f970e0-d8ab-4705-b2e8-0b9c18938be9
|
Which of the following is not a pyrimidine base ?
|
[
"Uracil"
] |
[
"2"
] |
[
"Cytosine",
"Uracil",
"Guanine",
"Thymine"
] |
Guanine Purines Pyrimidines Adenine Cytosine Guanine Uraci I Thymine Both purines (adenine and guanine) are found both in DNA & RNA. Among pyrimidines - Li Cytosine and uracil are found in RNA (thymine is not found in RNA). Cytosine and thymine are found in DNA (uracil is not found in DNA). In DNA, adenine is always paired with thymine by two hydrogen bonds; and guanine always paired with cytosine by three hydrogen bonds.
|
[
"Cytosine",
"Guanine",
"Thymine"
] |
Thymine
|
34
|
bf531196-1fd4-4a01-9e79-71b1825294b3
|
Indoor management of anorexia nervosa is done on priority patients with:-
|
[
"Binging episodes"
] |
[
"1"
] |
[
"Binging episodes",
"Weight for height less than 75% of normal",
"Amenorrhea",
"Depression"
] |
Treatment: Hospitalization (dehydration/electrolyte imbalance/ Significant weight loss, weight for height Less than 80% of normal) Behavioral therapy Cyproheptadine which stimulates appetite and SSRIS
|
[
"Weight for height less than 75% of normal",
"Amenorrhea",
"Depression"
] |
Amenorrhea
|
35
|
051a75e7-275c-470a-a275-6cd56a6b5b0d
|
Thyroid gland is situated at the level of:
|
[
"C4-T1"
] |
[
"2"
] |
[
"C4-C8",
"C4-T1",
"C5-T1",
"C6-T2"
] |
C5-T1* Thyroid gland is located in anterior triangle of the neck and weighs 20 grams. Gland lies against C5 to T1 vertebra.* Isthmus extends from 2-4th tracheal rings
|
[
"C4-C8",
"C5-T1",
"C6-T2"
] |
C5-T1
|
36
|
2fc16ed5-9269-4a8b-9a84-533b51a2d92b
|
Descending motor tract responsible for rapid skilled movements.
|
[
"Anterior corticospinal tract"
] |
[
"1"
] |
[
"Anterior corticospinal tract",
"Rubrospinal tract",
"Vestibulospinal tract",
"Reticulospinal tract"
] |
Rubrospinal tract o Pyramidal (corticospinal) tract and extrapyramidal tracts concerned with the muscles of the trunk and proximal portion of limbs (Le., the muscle mainly concerned with the postural control) occupy anterior white column of spinal cord and terminate in the medial ventral horn on the medial group of intemeurons. These tracts are collectively called medial pathways. Medial pathways include ventral (anterior) corticospinal tract, vestibulospinal tracts, reticulospinal tract and rubrospinal tract.o On the other hand, descending tracts concerned with distal muscles of the limb ( those muscles which mediate fine skilled movements(A1 13)) occupy lateral white column and are called lateral pathways. Lateral pathways include lateral corticospinal tract and rubrospinal tracts.
|
[
"Rubrospinal tract",
"Vestibulospinal tract",
"Reticulospinal tract"
] |
Reticulospinal tract
|
37
|
057effe2-fbbd-4031-be2d-29384189e278
|
TRUE/FALSE regarding blood supply of facial nerve is/are? 1. Ascending Pharyngeal aery 2. Greater palatine aery 3. Middle meningeal aery 4. Labyrinthine branch of ethmoidal aery 5. Stylomastoid branch of occipital aery
|
[
"1, 2 false & 3,4,5 true"
] |
[
"2"
] |
[
"1,2,3 true & 4,5 false",
"1, 2 false & 3,4,5 true",
"2,4 false & 1,3,5 true",
"All true"
] |
Blood supply of facial nerve: Aerial supply: In Canal: 1. Superficial petrosal (branch of middle meningeal aery) 2. Stylomastoid (branch of posterior auricular or occipital aery) Extracranially: 1. Stylomastoid (branch of posterior auricular or occipital aery) 2. Superficial temporal, trerse facial and tympanic (branch of ascending pharyngeal aery) Venous drainage: 1. Venae comitantes of superficial petrosal and stylomastoid aeries.
|
[
"1,2,3 true & 4,5 false",
"2,4 false & 1,3,5 true",
"All true"
] |
All true
|
38
|
1f6a2ed3-9c37-4937-8cb6-ad7ccb6af18e
|
Hepatitis B can be transmitted through all of the following, except
|
[
"Breast milk"
] |
[
"3"
] |
[
"Semen",
"Blood",
"Breast milk",
"Fecal-oral (stool)"
] |
(Fecal-oral route) Trission of Viral Hepatitis: Feature HAV HBV HCV HDV HEV Trission Fecal-oral +++ - - +++ Percutaneous Unusual +++ +++ +++ - Perinatal - +++ +- + ? Sexual +- ++ + ++ --
|
[
"Semen",
"Blood",
"Fecal-oral (stool)"
] |
Semen
|
39
|
44144759-dd0e-431c-9f81-45e5631061ab
|
KFD is transmitted by: March 2010
|
[
"Mite"
] |
[
"0"
] |
[
"Tick",
"Sandfly",
"Mosquito",
"Mite"
] |
: Tick Kyasanur forest disease is a tick-borne viral hemorrhagic fever endemic to South Asia. The disease is caused by a virus belonging to the family flaviviridae, which also includes yellow fever and dengue fever. There are a variety of animals thought to be reservoir hosts for the disease, including porcup rats, squirrels, mice and shrews. The vector for disease trission is Haemaphysalis spinigera, a forest tick. Humontract infection from the bite of nymphs of the tick. Estimated incubation period is between 3-8 days.
|
[
"Tick",
"Sandfly",
"Mosquito"
] |
Mosquito
|
40
|
36672a93-fda0-4188-9825-b7a86ebd9590
|
Arteriole is
|
[
"Conducting vessel"
] |
[
"1"
] |
[
"Conducting vessel",
"Resistance vessel",
"Exchange vessels",
"Capacitance vessel"
] |
Arterioles regulate the distribution of blood flow by altering their diameter to increase or decrease the peripheral resistance as required.
|
[
"Resistance vessel",
"Exchange vessels",
"Capacitance vessel"
] |
Capacitance vessel
|
41
|
426ed496-7aac-4813-acc4-0f3c09ff014d
|
Hypertrophy of the sebaceous glands in the nasal skin is called
|
[
"Rhinodporidiosis"
] |
[
"1"
] |
[
"Rhinodporidiosis",
"Rhinophyma",
"Rhinolith",
"Rhinorrhoea"
] |
o Rhinophyma is large, bulb-shaped, red-colored (ruddy) nose. It is a slow growing benign tumor due to hypertrophy of the sebaceous glands. o Has been explained in previous sessions
|
[
"Rhinophyma",
"Rhinolith",
"Rhinorrhoea"
] |
Rhinolith
|
42
|
837c69f7-3fba-45d2-83f4-b6a33bd74490
|
Salvage pathway of purine nucleotide synthesis are used by all except ?
|
[
"Brain"
] |
[
"1"
] |
[
"Brain",
"Liver",
"RBC",
"Leukocytes"
] |
Purine nucleotide synthesis occurs by two pathways :- 1.De novo synthesis 2.Salvage pathway Liver is the major site of purine nucleotide biosynthesis (de novo). Ceain tissues cannot synthesize purine nucleotides by de novo patyway, e g. brain, erythrocytes and polymorphonuclear leukocytes. These are dependent on salvage pathway for synthesis of purine nucleotides by using exogenous pur which are formed by degradation of purine nucleotides synthesized in liver.
|
[
"Liver",
"RBC",
"Leukocytes"
] |
Liver
|
43
|
c90ef7d9-66fc-4acc-a644-6e81449fe93a
|
Investigation of choice for pulmonary embolism –
|
[
"CT scan"
] |
[
"1"
] |
[
"CT scan",
"Contrast CT",
"Ventilation - Perfusion scan",
"MRI"
] |
No option is absolutely correct. The pulmonary angiography has traditionally been considered as the gold standard test for pulmonary embolism. But, now a days CT contrast (MDCTA) is the investigation of choice. Amongst the given options, lung V/Q scan is the best s it is the 2nd choice of the investigation after MDCTA.
|
[
"Contrast CT",
"Ventilation - Perfusion scan",
"MRI"
] |
Contrast CT
|
44
|
d9a4bfd2-ea44-4fdc-9517-bd11a2c73820
|
All are true regarding Klinefelter's syndrome except:
|
[
"Small Testes"
] |
[
"1"
] |
[
"Small Testes",
"Webbing of neck",
"Gynecomastia",
"Increased FSH levels"
] |
(Webbing of neck) Ref: Robbins Pathologic Basis of Disease, 8th edition.Explanation:Webbing of neck is characteristically seen in Turner's syndromeKlinefelter SyndromeMale hypogonadism that occurs when there are two or more X chromosomes and one or more Y chromosomes.MC genetic disease involving the sex chromosomesMost common cause of hypogonadism in the male.Incidence 1 in 660 live male birthsIt can rarely he diagnosed before puberty because the testicular abnormality develop late.Distinctive body habitus -Increase in length between the soles and the pubic bone ->> elongated bodyEunuchoid body habitusLong legsSmall atrophic testesSmall penisLack of secondary male characteristics as deep voice, beard & pubic hair.GynecomastiaThere is increased incidence ofType 2 diabetesThe metabolic syndromeMitral valve prolapse in 50%.Autoimmune diseases (SLE)Breast cancer (20 times more common than in normal males)Extragonadal germ cell tumors||Plasma gonadotropin concentrations (FSH) & || testosterone levelsT Plasma estradiol levels (Unknown mechanism)The ratio of estrogens and testosterone determines the degree of feminization in individual cases.Reduced spermatogenesis and male infertilityTesticular tubules are totally atrophied and replaced by pink, hyaline, collagenous ghosts.Somet apparently normal tubules are interspersed with atrophic tubules.In some patients all tuhules are primitive and appear embryonic, consisting of cords of cells that never developed a lumen or progressed to mature spermatogenesis.Leydig cells appear prominent, as a result of the atrophy and crowding of tubules and elevation of gonadotropin concentrations.The classic pattern of Klinefelter syndrome is associated with a 47, XXY karyotype (90% of cases).This complement of chromosomes results from nondisjunction during the meiotic divisions in one of the parents.15%' of patients w ith Klinefelter syndrome have been found to have a variety of mosaic patterns, most of them being 46, XY/47, XX\r (Other patterns are 47, XXY/48, XXXY )Turner SyndromeTurner syndrome results from complete or partial monosomy of the X chromosome and is characterized primarily by hypogonadism in phenotypic femalesIt is the most common sex chromosome abnormality in females.Three types of karyotypic abnormalities are seen in Turner syndrome.Entire X chromosome is absent (57%), resulting in a 45 XO karyotype.Structural abnormalities of the X chromosomes (14%)Mosaics (29%).Examples of karyotypes that mosaic Turner females may have are the following: (1) 45,X/ 46, XX; (2) 45. X/46. XY; (3) 45, X/47, XXX; or (4) 45, X/46. X. i(X)(ql0).The mosaics with a Y chromosome-containing population (e.g., 45. X/46, XY karyotype) may be at risk of developing GonadoblastomaClassical Features of Turners syndromePresent durings infancy with edema of the dorsum of the hand and foot due to lymph stasis. Swelling of the nape of the neck (due markedly distended lymphatic channels leading on to cystic hygroma)Bilateral neck webbingPersistent looseness of skin on the back of the neck.Congenitat heart disease (esp preductal coarctation of the aorta and bicuspid aortic valve)Failure to develop normal secondary sex characteristics.Turner syndrome is the single most important cause of primary amenorrheaApproximately 50% of patients develop autoantibodies to thyroid gland, and can develop hypothyroidism.Glucose intolerance, obesity, and insulin resistance in minority of patients
|
[
"Webbing of neck",
"Gynecomastia",
"Increased FSH levels"
] |
Increased FSH levels
|
45
|
84296a2f-99fd-4335-b56f-ba5543f98361
|
The organ of Coi normally contains:
|
[
"3-4 rows each of inner and outer hair cells"
] |
[
"2"
] |
[
"A single row of inner hair cells and a single row of outer hair cells",
"3-4 rows each of inner and outer hair cells",
"A single row of inner hair cells and 3-4 rows of outer hair cells",
"A single row of outer hair cells and 3-4 rows of inner hair cells"
] |
Organ of Coi organ for truction of sound. Hair cells are receptor cells in organ of Coi There is a single row of inner hair cells (toward the center of cochlea) and 3-4 rows of outer hair cells (on the outer side). Each row contains about 3000 hair cells.
|
[
"A single row of inner hair cells and a single row of outer hair cells",
"A single row of inner hair cells and 3-4 rows of outer hair cells",
"A single row of outer hair cells and 3-4 rows of inner hair cells"
] |
A single row of inner hair cells and a single row of outer hair cells
|
46
|
2f4ee4c9-9bbf-4520-988b-cd5ca6ec8774
|
How does acyclovir inhibit herpes virus replication?
|
[
"They inhibit reverse transcriptase activity"
] |
[
"2"
] |
[
"They block capping of viral mRNA",
"They inhibit reverse transcriptase activity",
"They inhibit viral polymerase activity",
"They block viral uncoating"
] |
Acyclovir and ganciclovir are variants of acycloguanosine and are used to treat herpes simplex virus and cytomegalovirus infections, respectively. Both agents are viricidal and act by interfering with viral polymerase activity. In the case of herpes simplex virus infection, the virally- coded thymidine kinase monophosphorylates the acyclovir. Cellular kinases then add two more phosphates, creating a nucleotide that is accepted by the virally-coded DNA polymerase. The structural analog is incorporated into the growing DNA chain and elongation is terminated. Ribavirin, used to treat paramyxovirus (respiratory syncytial virus) infection, works by interferring with viral messenger RNA (mRNA) capping. Amantadine, used to treat influenza A infections, blocks viral un coating. It is most effective when given before viral infection occurs. Reverse trriptase inhibitors (e.g., azidothymidine, didioxycytocine, didioxyinosine) directly interfere with normal enzyme activity. These agents are virostatic, and virus growth occurs when the agents are removed. Interferons are induced as a result of viral infection of a cell. Products of viral nucleic acid replication activate genes that code for interferons, which directly prevent virus growth by inducing an antiviral protein within virus- infected cells.
|
[
"They block capping of viral mRNA",
"They inhibit viral polymerase activity",
"They block viral uncoating"
] |
They block viral uncoating
|
47
|
03977c5b-733c-4544-8109-96c22348cdab
|
Tempering temperature for agar is:
|
[
"65 degrees Celsius"
] |
[
"2"
] |
[
"100 degrees Celsius",
"65 degrees Celsius",
"45 degrees Celsius",
"None of the above"
] |
Making the Agar Impression This process requires a three-compartment conditioning unit for the agar tray material that allows liquefaction, storage, and tempering, while the agar syringe material is used only in the liquefaction and storage compartments. The first step in impression making is to liquefy the hydrocolloid gel in the tube in boiling water at 100°C for a minimum of 10 minutes. The tube is then placed in a storage bath at 65°C to retain the sol condition until it is needed. For the immediate preparation step, the impression tray is filled with hydrocolloid sol from the tube taken from the storage bath, a gauze pad is placed over the top of the tray material, and the tray is placed in the water-filled tempering compartment (at about 45°C) of the conditioning unit. The tempering time is 3 to 10 min, just sufficient to ensure that all the material has reached a lower temperature (55°C or less). In any case, the loaded tray should never be left in this bath for more than 10 minutes as partial gelation can occur, thereby making the material unusable. Reference: PHILLIPS’ SCIENCE OF DENTAL MATERIALS, 12th ed page no 170
|
[
"100 degrees Celsius",
"45 degrees Celsius",
"None of the above"
] |
45 degrees Celsius
|
48
|
0af68ae0-bb6d-4640-957b-8a142a8cab5c
|
Only right sided cardiac sound which decreases in intensity with inspiration is:
|
[
"Systolic murmur of TR"
] |
[
"0"
] |
[
"Pulmonary ejection sound",
"Right ventricular S3",
"Systolic murmur of PS",
"Systolic murmur of TR"
] |
(Pulmonary ejection sound) Ref: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 10th edition, pg: 103Explanation:"The ejection systolic sound accompanying pulmonic valve disease decreases in intensity with inspiration, the only right sided cardiac event to behave in this manner. Ejection systolic sounds disappear as the culprit valve loses its pliability over time."Ref: Braunwald's Heart DiseaseHeartmurmursandsoundsChangewithinspirationChangewithexpirationMechanismExceptionRightsidedincreasesDecreases* In inspiration, there is increased blood return to right side of heartPulmonicstenosisejection systolic murmur decreases with inspirationLeft sidedDecreasesIncreases* The increased filling of the right ventricle pushes the septum toward the left ventricle compromising its filling* In inspiration, more blood stays behind in the lungs, leading to decreased venous return to the left ventricleThe click ofMVP moves closer to St and murmur may be tonger and accentuated with inspirationAlso Remember:Carvallo's sign: The pstolic murmur of tricuspid regurgitationbecomes louder during inspiration, differentiating this from the murmur of mitral regurgitation.
|
[
"Pulmonary ejection sound",
"Right ventricular S3",
"Systolic murmur of PS"
] |
Right ventricular S3
|
49
|
74e518ab-0ffe-4293-b808-b9e38187b9af
|
Eagle syndrome is also known as -
|
[
"Amourosis"
] |
[
"0"
] |
[
"Styalgia",
"Ludwig's Angina",
"Pharyngeal bursitis",
"Amourosis"
] |
Styalgia StyalgiaChronic throat pain along the anatomic course of thyrohyoid ligament.It is also called Eagle's syndromeIt is related to unrecognised elongation of styloid process, a clacified stylohoid ligament, or stylohyoid muscle tendinitis.Elongated styloid process protrudes into the tonsillar fossa and puts pressure on the trigeminal, glossopharyngeal,vagus or facial nerves.
|
[
"Styalgia",
"Ludwig's Angina",
"Pharyngeal bursitis"
] |
Ludwig's Angina
|
50
|
8cee1ac7-b184-4204-b460-9c35c65181a2
|
Fever with pulmonary disease leading to severe pneumonia if untreated caused by which of the following dimorphic fungi?
|
[
"Aspergillus"
] |
[
"0"
] |
[
"Coccidiodes immitis",
"C neoformis",
"C albicans",
"Aspergillus"
] |
Coccidiodes immitis-pulmonary system severely affected Fatal if untreated It is dimorphic fungus present in yeast and in mycelial form Ref: Baveja 5th ed pg: 555
|
[
"Coccidiodes immitis",
"C neoformis",
"C albicans"
] |
Coccidiodes immitis
|
51
|
c65a4f74-634b-4689-b082-b2966c98e231
|
which of the antidepressent is used in low dose as hypnotic
|
[
"bupropion"
] |
[
"0"
] |
[
"trazadone",
"fluoxetine",
"fluvoxamine",
"bupropion"
] |
SARI * IMPOANCE antidepressant with good sleep, no sexual problems and no GI side effects. It was thought this would replace SSRI but dint do well because of notorious side effects * MECHANISM Serotonin antagonist and reuptake inhibitor * DRUGS Trazodone Nefazodone * USE low dose trazodone is used as a hypnotic * SIDE EFFECTS Trazodone----------- priapism Nefazodone ---------hepatotoxicity Ref. kaplon and Sadock, synopsis of psychiatry, 11 th edition, pg no. 955
|
[
"trazadone",
"fluoxetine",
"fluvoxamine"
] |
fluvoxamine
|
52
|
1bfbb88b-7019-4a30-abdb-9127c9e177d8
|
Best indicator of protein quality:-
|
[
"Protein efficiency ratio"
] |
[
"0"
] |
[
"DIAAS",
"Amino acid score",
"PDCAAS",
"Protein efficiency ratio"
] |
Best indicator of protein quality: DIAAS (Digestible indispensable amino acid scores) > PDCAAS (Protein digestibility-corrected amino acid score) >NPU (Net protein utilization). DIAAS =100 x . NPU = 100 x (Nitrogen retained by the body) / (Nitrogen intake) Other indicators: Amino acid score, Biological value, Protein efficiency ratio. Amino acid score = 100x (mg of amino acid per gm of test protein)/(mg of same amino acid per gm of reference protein) Also remember, protein quantity is measured by protein energy ratio = 100 x energy from protein / total energy in diet.
|
[
"DIAAS",
"Amino acid score",
"PDCAAS"
] |
PDCAAS
|
53
|
b195b84c-f180-42e2-a35b-f4690c7c3c3f
|
Following an upper respiratory infection, a 7 year old child develops multiple petechial hemorrhages over her entire body. Her mother takes her to the physician, who does a complete blood count, revealing marked thrombocytopenia. Which of the following diagnoses is most appropriate for this individual?
|
[
"Bernard-Soulier syndrome"
] |
[
"1"
] |
[
"Bernard-Soulier syndrome",
"Idiopathic thrombocytopenic purpura",
"Thrombasthenia",
"Thrombotic thrombocytopenic purpura"
] |
The process described is commonly called acute idiopathic thrombocytopenic purpura (ITP), even though the autoimmune basis has been clearly established (some authors use "immune thrombocytopenic purpura," so that the initials still work). The thrombocytopenia in this disorder appears to be secondary to splenic destruction of opsonized platelets, and usually follows a viral upper respiratory tract infection or exanthem. The acute form of ITP is usually explosive, but self-limited; a chronic form in adults may respond to steroid therapy or splenectomy. In Bernard-Soulier syndrome, platelets are unable to adhere to collagen. Thrombasthenia is associated with a functional defect in platelets (they do not aggregate). In thrombotic thrombocytopenic purpura, platelets are consumed in intravascular platelet microthrombi. Ref: Alexandrescu D.T., Gallo R.L. (2010). Chapter 123. The Vascular Purpuras. In J.T. Prchal, K. Kaushy, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds),Williams Hematology, 8e.
|
[
"Idiopathic thrombocytopenic purpura",
"Thrombasthenia",
"Thrombotic thrombocytopenic purpura"
] |
Idiopathic thrombocytopenic purpura
|
54
|
71c5fb5d-dcff-43de-9842-d2976c7d3cee
|
Drug of choice for diphyllobothrium latum is
|
[
"Albendazole"
] |
[
"2"
] |
[
"Mebendazole",
"Albendazole",
"Praziquantel",
"Pyrantel pamoate"
] |
Praziquantel is the drug of choice for Diphyllobothrium latum. It is rapidly taken up by susceptible worms and act by causing leakage of intracellular calcium from the membranes producing contracture and paralysis of the worms.
|
[
"Mebendazole",
"Praziquantel",
"Pyrantel pamoate"
] |
Pyrantel pamoate
|
55
|
1df001aa-5271-46fd-ba6a-cc74fb87f224
|
Spinal part of accessory nerve supplies -
|
[
"Platysma"
] |
[
"1"
] |
[
"Platysma",
"Sternocleidomastoid",
"Stylohyoid",
"Diagastric"
] |
Sternocleidomastoid o Accessory nerve (eleventh cranial nerve) has two rootsy cranial and spinal.o Spinal accessory supplies :SternocleidomastoidTrapeziuso Follow ing are the 2 parts of the accessory nerve with their distribution:I Spinal part1 Sternocleidomastoid2. TrapeziusIICranial partMuscles of the pharynx except stvlopharyngeus which is supplied by the glossopharyngeal nerveMuscles of the palate except tensor veli palatini which is supplied by the mandibular division of the trigeminal nerve.o All muscles of the tongue are supplied by the hypoglossal nerve except palatoglossus which is supplied by the accessory nerve.
|
[
"Sternocleidomastoid",
"Stylohyoid",
"Diagastric"
] |
Stylohyoid
|
56
|
7538e508-8cb8-49c3-a76b-f4e22a21489a
|
Lack of Homogentisate oxidase enzyme causes
|
[
"Phenylketonuria"
] |
[
"1"
] |
[
"Phenylketonuria",
"Alkaptonuria",
"Maple syrup urine disease",
"Homocystinuria"
] |
Alkaptonuria # ALKAPTONURIA: The defective enzyme in alkaptonuria is homogentisate oxidase in tyrosine metabolism. Homogentisate accumulates in tissues & blood, gets oxidized to the corresponding quinones, which polymerize to give black or brown colour. For this reason, the urine of alkaptonuric patients resembles coke in colour.
|
[
"Alkaptonuria",
"Maple syrup urine disease",
"Homocystinuria"
] |
Homocystinuria
|
57
|
7f04024e-c732-45e2-9107-90d0a7226606
|
Which of the following is primarily bacteriostatic?
|
[
"Ciprofloxacin"
] |
[
"1"
] |
[
"Ciprofloxacin",
"Chloramphenicol",
"Vancomycin",
"Rifampicin"
] |
BASED ON TYPE OF ACTIVITY: Antimicrobial drugs is classified into: Primarily bacteriostatic: Sulfonam Erythromycin Tetracyclines ,Ethambutol Chloramphenicol ,Clindamycin Linezolid Primarily bactericidal: Penicillins, Cephalosporins Aminoglycosides ,Vancomycin Polypept Nalidixic acid Rifampinl Ciprofloxacin Isoniazid, Metronidazole PyrazinamCotrimoxazole ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:669
|
[
"Chloramphenicol",
"Vancomycin",
"Rifampicin"
] |
Chloramphenicol
|
58
|
59735783-ba5f-4bd4-9221-fc28d894158d
|
Most common type of malignancy of stomach is:September 2007
|
[
"Lymphoma"
] |
[
"0"
] |
[
"Adenocarcinoma",
"Squamous carcinoma",
"Anaplastic carcinoma",
"Lymphoma"
] |
: AdenocarcinomaGastric adenocarcinoma is a malignant epithelial tumor, originating from glandular epithelium of the gastric mucosa. Stomach cancers are commonly adenocarcinomas (90%).Histologically, there are two major types of gastric adenocarcinoma (Lauren classification): intestinal type or diffuse type. Adenocarcinomas tend to aggressively invade the gastric wall, infiltrating the muscularis mucosae, the submucosa, and thence the muscularis propria.Intestinal type adenocarcinoma tumor cells describe irregular tubular structures, harboring pluristratification, multiple lumens, reduced stroma ("back to back" aspect). Often, it associates intestinal metaplasia in neighboring mucosa. Depending on glandular architecture, cellular pleomorphism and mucosecretion, adenocarcinoma may present 3 degrees of differentiation: well, moderate and poorly differentiate.Diffuse type adenocarcinoma (mucinous, colloid, linitis plastica, leather-bottle stomach) Tumor cells are discohesive and secrete mucus which is delivered in the interstitium producing large pools of mucus/colloid (optically "empty" spaces). It is poorly differentiated. If the mucus remains inside the tumor cell, it pushes the nucleus at the purpley"signet-ring cell".Around 5% of gastric carcinomas are lymphomas (MALTomas, or MALT lymphoma).Carcinoid and stromal tumors may also occur.
|
[
"Adenocarcinoma",
"Squamous carcinoma",
"Anaplastic carcinoma"
] |
Adenocarcinoma
|
59
|
6eddecb5-3179-4b25-aa47-551191396114
|
PQLI dues not include: (Repeat)
|
[
"Infant Mortality rate"
] |
[
"1"
] |
[
"Infant Mortality rate",
"Gross national Product",
"Litreacy rate",
"Life expectancy at l year of age."
] |
(Gross national Product) Ref: Textbook of Preventive and Social Medicine. K Park, 22nd edition, Pg: 16Explanation:Physical Quality of life index (PQLI)Consolidates three indicators* Infant mortality* Life expectancy at age one* Literacy* Range - 0 to 100 Human developmental index (HDI)Consolidates three indicators* Life expectancy at birth (Longevity)* Adult literacy rate and mean year of schooling (Knowledge)* Real GDP per capita (Income)Notes:1. Extra indicator as compare to PQLI is income2. Infant mortality and life expectancy at age one is conceptually clubbed in HDI as life expectancy at birthRange - 0 to 1
|
[
"Gross national Product",
"Litreacy rate",
"Life expectancy at l year of age."
] |
Life expectancy at l year of age.
|
60
|
b55585ba-703b-4eeb-8df9-d0d3c67c452f
|
Negative symptoms of schizophrenia are all except:-
|
[
"Apathy"
] |
[
"0"
] |
[
"Over activity",
"Anhedonia",
"Alogia",
"Apathy"
] |
Negative symptoms of Schizophrenia Avolition: loss of drive for meaningful activities. -Apathy: lack of concern. -Anhedonia: lack of pleasure. Asociality: lack of social interaction. Affective flattening/Emotional blunting. Alogia: decreased verbal communication. *Do not respond well to medications. *Poor prognostic factor.
|
[
"Over activity",
"Anhedonia",
"Alogia"
] |
Over activity
|
61
|
f3b5a1d9-4c50-4dd2-a847-a5d88cd821ba
|
Membrane incised during hemilaryngectomy is
|
[
"Thyrohyoid"
] |
[
"1"
] |
[
"Thyrohyoid",
"Cricothyroid",
"Aryepiglottic",
"Infralaryngeal"
] |
Cricothyroid Steps in hemlaryngectomyIndications and containdications* Ideal for bulky lesions of the membranous true vocal cord* Normal or slightly impaired vocal cord mobility* No involvement of the supraglottis* Tumor may extend as far as the apex of the ventricle* Subglottic extension of no more than 5 mm posteriorly (10 mm anteriorly)* The body of the arytenoid is a contraindication, although the vocal process is not* No more than one third of the contralateral vocal cord involved (consider supracricoid partial laryngectomy)Technical points* Administer perioperative antibotics* Re-encloscope the patient* Perform a preliminary tracheostomy* Make a horizontal skin incision over the thyroid ala.* Raise the flaps superiorly and inferiorly while avoiding the tracheostomy incision* Incise the perichondrium from the thyroid notch down the midline over the ericothyroid membrane.* Elevate the perichonadrium with the attached overlying strap muscles.* Mark the cartilage incisions while retaining a 3 mm wide posterior strip.* Out with a saginal saw* Use a headlight* Incise the perichondrium along the superior border of the thyroid ala. Incise across the petiole of the spiglotis. This will provide panoramic view of the larynx.* Incise the cricothyroid membrane along the superior aspect of the circoid cartilage.* Using a no. 15 blade, cut down to the true vocal cord and examine and cut through the one vocal cord either in the midline or in lesions that cross the anterior commissure. 2 to 3 mm behind the visible tumor.* Using hooks, open the thyroid alae like a book.* STOP. Carefully evaluate the lesion and determine the ares to be excised.* Excise the tumor by incising along the apex of the aryepiglotic fold down around the arytenoid or through the vocal process of the arytenoid, depending on the posterior extent of the tumor.* Orient and examing the surgical specimen and select sites for frozen section examination of the margins* Obtain hemostasis* Suture the contralateral cord to the anterior end of the remaining cartilage or to the external perichondrium* An epiglotopex must be performed in cases of extended vertical partial laryngectomy.* Insert a nasogastric tube for feeding* Close the perichondrium with probable suture* Inferiorly based or pedicled muscle flaps may be used reconstrict the glottis but are probably not necessary* A cricopharyngeal myotomy is not required* Close the wound in layers over a chain* Apply a neck dressing
|
[
"Cricothyroid",
"Aryepiglottic",
"Infralaryngeal"
] |
Aryepiglottic
|
62
|
7b5c8f3a-9423-4a3c-9bcd-41bdf784ab8b
|
Restrictive and constrictive cardiomyopathy occurs together in
|
[
"Post cardiotomy"
] |
[
"3"
] |
[
"Radiation",
"Adriamycin",
"Post cardiotomy",
"Amyloidosis"
] |
The etiologies of RCM may be grouped into broad categories as follows: Primary/idiopathic: Endomyocardial fibrosis (EMF), loeffler eosinophilic endomyocardial disease Secondary: Infiltrative, amyloidosis (the most common cause of RCM in the United States), sarcoidosis , progressive systemic sclerosis (scleroderma) , hemochromatosis, , carcinoid hea disease, glycogen storage disease of the hea, radiation/treatment induced, metastatic malignancy, anthracycline toxicity Ref Davidson 23rd edition pg 467
|
[
"Radiation",
"Adriamycin",
"Amyloidosis"
] |
Adriamycin
|
63
|
20a57af8-5434-4b09-a362-9f3ffdaef4df
|
Most common benign tumor of liver
|
[
"Adenoma"
] |
[
"2"
] |
[
"Focal nodular hyperplasia",
"Adenoma",
"Hemangioma",
"Angiolipoma"
] |
BENIGN LIVER TUMORSThree common benign tumors occur and all are found predominantly in women. They are hemangiomas, adenomas, and focal nodular hyperplasia (FNH). FNH is typically benign, and usually, no treatment is needed.Hemangiomas are the most common and are entirely benign. Treatment is unnecessary unless their expon causes symptoms.Adenomas are associated with contraceptive hormone use. They can cause pain and can bleed or rupture, causing acute problems. Their main interest for the physician is a low potential for malignant change and a 30% risk of bleeding.Reference: Harrison&;s Principles of Internal Medicine; Chapter 111; Tumors of the Liver and Biliary Tree
|
[
"Focal nodular hyperplasia",
"Hemangioma",
"Angiolipoma"
] |
Focal nodular hyperplasia
|
64
|
568b8642-534c-4dbd-a9d0-4ed017a0e9f4
|
Cystic hygroma is known to occur in all except
|
[
"Mediastinum"
] |
[
"0"
] |
[
"Calf",
"Neck",
"Axilla",
"Mediastinum"
] |
(Calf). (Ref. LB, 25th/ 729)Cystic hygroma (Cavernous lymphangioma)# It is a benign cyst seen most commonly in neck; other sites include axilla, groin, cheek and mediastinum.# It is supposed to be congenital due to sequestration of lymphatics (of portion of jugular lymph sac).# It is brilliantly trucent swelling common in anterior triangle of neck.# It usually presents in neonates or early infancy, occasionally at birth and can be so large to obstruct labour or cause intrauterine hydrops fetalis and death.# Swelling may involve parotid, submandibular gland, tongue and floor of mouth.# It may be bilateral.# It may undergo spontaneous regression.# The cysts are filled with clear lymph and lined with a single layer of epithelium with mosaic appearance.# Excision of cyst with excision of all lymphatics bearing tissue is treatment of choice.# Sclerosants should be avoided. Recurrence is common with percutaneous picibanil & other sclerosants.
|
[
"Calf",
"Neck",
"Axilla"
] |
Calf
|
65
|
e61f40f1-1b3e-48a9-9404-8d8b28ed5020
|
Slapped cheek sign is seen in -
|
[
"Mumps"
] |
[
"0"
] |
[
"Parvovirus B19",
"JC virus",
"Rota virus",
"Mumps"
] |
parvo virus B19 causes erythema infectiosum it sta with erythema of cheeks called slapped cheek appearance REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.554
|
[
"Parvovirus B19",
"JC virus",
"Rota virus"
] |
JC virus
|
66
|
29a5b07b-8d6d-43dd-b4f9-3f60d0d55cc4
|
Which of the following is not permeable through the Blood Brain Barrier
|
[
"Gas"
] |
[
"3"
] |
[
"Water",
"Lipophilic drugs",
"Gas",
"Proteins"
] |
Proteins(Ref: Ganong, 25th ed/p. 607)Substances that crosses the Blood Brain Barrier easily are,#Water (using carrier protein Aquaporin -4)#Glucose (using glucose trorters GLUT 1 55K and GLUT 1 45K)#O2 #CO2 #Steroid hormonesSubstances that do not crosses the Blood Brain Barrier easily are,#Protein hormones#Dopamine#H+ ions#Bicarbonate ions
|
[
"Water",
"Lipophilic drugs",
"Proteins"
] |
Water
|
67
|
d1229a21-3c77-4386-a5b0-f11ffef59a42
|
In volume-cycled ventilation the inspiratory flow rate is
|
[
"110-130 L/min"
] |
[
"2"
] |
[
"140-160 L/min",
"110-130 L/min",
"60-100 L/min",
"30-50 L/min"
] |
60-1001/min The ventilators serve as energy source only during inspiration replacing the muscles of chest wall & diaphragm; expiration is passive driven by the recoil of the lung & chest wall In volume cycled ventilation inspiratory flow rate is usually maintained at 60I/minQ
|
[
"140-160 L/min",
"60-100 L/min",
"30-50 L/min"
] |
30-50 L/min
|
68
|
59b8655e-d7a1-449a-a2bf-4ba6bc6c502d
|
A 31 year old female patient complains of bilateral impairment of hearing for the past 5 years. On examination, tympanic membrane is normal and audiogram shows a bilateral conductive deafness. Acoustic reflexes are absent. All constitute pa of treatment EXCEPT:
|
[
"Sodium fluoride"
] |
[
"3"
] |
[
"Hearing aid",
"Stapectomy",
"Sodium fluoride",
"Gentamycin"
] |
There is no medical treatment that cures otosclerosis. Sodium fluoride has been tried to hasten the maturity of active focus and arrest fuher cochlear loss, but controversies exist and this treatment is NOT recommended generally
|
[
"Hearing aid",
"Stapectomy",
"Gentamycin"
] |
Gentamycin
|
69
|
e005d332-34ac-4ce0-a882-6036a06d422c
|
Which of the following does not contain b-alanine?
|
[
"Anserine"
] |
[
"2"
] |
[
"Carnosine",
"Anserine",
"Homocarnosine",
"Pantothenic acid"
] |
Carnosine, rine, Pantothenic acid contain b- alanine in their structure Homocarnosine does not contain b alanine..
|
[
"Carnosine",
"Homocarnosine",
"Pantothenic acid"
] |
Homocarnosine
|
70
|
b4f4f84c-26a8-443b-a3ef-909b1ed32d5c
|
A 70 kg old athlete was posted for surgery, Patient was administered succinylcholine due to unavailability of vecuronium. It was administered in intermittent dosing (total 640 mg). During recovery patient was not able to respire spontaneously & move limbs. What is the explanation ?
|
[
"Pseudocholinesterase deficiency increasing action of syccinylcholine"
] |
[
"1"
] |
[
"Pseudocholinesterase deficiency increasing action of syccinylcholine",
"Phase 2 blockade produced by succinylcholine",
"Undiagnosed muscular dystrophy and muscular weakness",
"Muscular weakness due to fasciculation produced by succinylcholine"
] |
Phase 2 blockade produced by succinylcholine - Sch is depolarizing/ non competitiveQ M.R. with shoest duration of actionQ (3-5 min) d/t rapid hydrolysis by pseudo cholinesteraseQ. It causes dual/ biphasic blockQ. It increases K. (ie hyperkalemiaQ 1/t diastolic cardiac arrest), intraocular & intragastric pressure and temperature (l/t) malignant Hypehermia)Q - Depolarizing block (phase I & II) caused by Succinyl cholineQ is also called Dual or Biphasic Block. In contrast to phase II depolarization block & Non depolarizing block, phase I depolarization block does not exhibit fade during tetanus or train-of-four, neither does it demonstrate post tetanic potentiation. Phase I block is potentiated by isoflurane, Mg, Li & Anticholine-esterase while phase II block is potentiated by enflurane. - The onset of paralysis by succinylcholine is signaled by visible motor unit contractions called fasciculation.Q Patients who have received suxamethonium have an increased incidence of postoperative myalgiaQ. This is more common in healthy female outpatients. Pregnancy & extremes of age seem to be protective. Succinylcholine releases a metabolite succinylmonocholine, causing excitation of the cholinergic receptors in the sinoatrial node resulting in bradycardia. Q Intravenous atropine is given prophylactically (paicularly in children, who are more susceptible) in children and always before a second dose of sch. - Prolonged apnea after suxamethonium is best managed by providing mechanical ventilation, maintaining anesthesia and continuous monitoring until muscle function returns to normal.Q Trusion of fresh frozen plasma is beneficial (as it provides pseudocholinesterase) its infectious risks outweigh its potential benefits -Morgan Administration of purified pseudocholinesterase, blood or plasma may antagonize the block. However because of the risk associated with their use, infusion of banked blood or fresh frozen plasma cannot be recommended - Churchill. - Succinylcholine & mivacurium are metabolized by pseudocholinesterase, while esmolol and remifentanyl are metabolized by RBC es terase.(2 - Pseudo cholinesterase deficiency causes prolonged residual paralysis at normal Sch dose (1-2 mg/kg)Q whereas, phase 2 non-depolarization blockade occurs after administration of higher doses >6 (7-10) mg/kgQ Despite large decrease in pseudo cholinesterase activity (level) there is only moderate increase in duration of action of Sch. In contrast to the doubling or tripling of blockade duration seen in patients with low pseudo cholinesterase enzyme levels or hetozygous atypical enzyme, patients with homozygous atypical enzyme will have a very blockade (4-8 hrs) following Sch administration.
|
[
"Phase 2 blockade produced by succinylcholine",
"Undiagnosed muscular dystrophy and muscular weakness",
"Muscular weakness due to fasciculation produced by succinylcholine"
] |
Phase 2 blockade produced by succinylcholine
|
71
|
b4da220b-f313-45fc-b101-d0cf7a33f96e
|
Drug of choice for prophylaxis of meningococcal meningitis in a pregnant female after contact with a case is: -
|
[
"Ciprofloxacin"
] |
[
"1"
] |
[
"Ciprofloxacin",
"Ceftriaxone",
"Cefalexin",
"Rifabutin"
] |
Impoant points to remember about Meningococcal Meningitis Doc for Empirical Treatment ceftriaxone Doc for Definitive Treatment Penicillin G Doc for Prophylaxis ciprofloxacin Doc for Prophylaxis in pregnancy ceftriaxone
|
[
"Ceftriaxone",
"Cefalexin",
"Rifabutin"
] |
Rifabutin
|
72
|
aeed08e6-da2f-402b-8d73-fca9691fce7b
|
Radical mastoidectomy includes all except
|
[
"Ossicles removed"
] |
[
"2"
] |
[
"Closure of auditory tube",
"Ossicles removed",
"Cochlea removed",
"Exteriorisation of mastoid"
] |
It is an operation to eradicate disease of the middle ear and mastoid in which mastoid, middle ear, attic and the antrum are exteriorized into the external ear by removal of posterior meatal wall. All remnants of tympanic membrane, malleus, incus (not the stapes), chorda tympani and the mucoperiosteal lining are removed, and the opening of eustachian tube closed by packing a piece of muscle or cailage into the eustachian tube. Ref: Dhingra 7e pg 459.
|
[
"Closure of auditory tube",
"Cochlea removed",
"Exteriorisation of mastoid"
] |
Cochlea removed
|
73
|
e6c0c257-40bd-48c6-ac8d-39ee5c1979d3
|
Which of the following is the only intrinisic muscle of larynx that lies outside the laryngeal framework?
|
[
"Lateral cricothyroid"
] |
[
"0"
] |
[
"Cricothyroid",
"Superior constrictor",
"Cricopharyngeus",
"Lateral cricothyroid"
] |
Cricothyroid muscle is the only intrinsic muscle which is supplied by external laryngeal nerve and lies outside the laryngeal framework
|
[
"Cricothyroid",
"Superior constrictor",
"Cricopharyngeus"
] |
Superior constrictor
|
74
|
0315a1c7-4bd2-466c-901a-dbf23087eb84
|
Ionophores have following action except:
|
[
"Inhibit ADP to ATP conversion"
] |
[
"2"
] |
[
"Abolish proton gradient",
"Inhibit ADP to ATP conversion",
"Hydrophilic in character",
"Abolish pH gradient"
] |
Hydrophilic in characterIonophoresaillCeain microbes synthesize small organic molecules called ionophores, that function as shuttle for the movement of ions across membrane.
|
[
"Abolish proton gradient",
"Hydrophilic in character",
"Abolish pH gradient"
] |
Abolish proton gradient
|
75
|
c40dca76-a001-4607-8e3d-2726191c582a
|
Complex I of ETC is inhibited by -
|
[
"H2S"
] |
[
"0"
] |
[
"Amobarbital",
"Cyanide",
"0",
"H2S"
] |
Amobarbital Inhibitors of Electron trort chain (Respiratory chain)o Complex I:- Barbiturates (amobarbital), piercidin A, rotenone, chlorpromazine, guanithidine.o Complex II:- Carboxin, TTFA, malonate.o Complex III :- Dimercaprol, BAL, actinomycin A, Naphthyloquinone.o Complex IV :-(cytochrome c oxidase) Carbon monoxide (CO), cyanide (CN-), H2S, azide (N3 )
|
[
"Amobarbital",
"Cyanide",
"0"
] |
0
|
76
|
bf2e22b9-8f57-49cd-a0b5-c09f6e23c1a1
|
Parkinsonism is associated with which metal?
|
[
"Se"
] |
[
"2"
] |
[
"Mg",
"Se",
"Mn",
"Mo"
] |
Harrison's principles of internal medicine 17th edition. *Exposure to manganese, CO,disulf cyanide and methanol can lead to parkinsonism
|
[
"Mg",
"Mn",
"Mo"
] |
Mo
|
77
|
7f71fe57-a008-40ab-a10c-35f5ed9506f8
|
The organism most commonly causing genital filariasis in most pa of Bihar and easteran U.P. is?
|
[
"Dirofilaria"
] |
[
"0"
] |
[
"Wuchereria bancrofti",
"Brugia malayi",
"Onchocerca volvulus",
"Dirofilaria"
] |
Wuchereria bancrofti . W. bancrafti is the most widely distributed human filarial parasite.
|
[
"Wuchereria bancrofti",
"Brugia malayi",
"Onchocerca volvulus"
] |
Wuchereria bancrofti
|
78
|
8d006fd4-5995-4ebf-bec6-0454d92d4abc
|
In intubation which drug is used instead of succinylcholine
|
[
"Dantrolene"
] |
[
"2"
] |
[
"Doxacurium",
"Dantrolene",
"Rocuronium",
"None"
] |
Muscle relaxants are used in intubation, which are of two types: Depolarizing muscle relaxant, Succinylcholine Non-depolarizing muscle relaxant, eg., Rocuronium, vecuronuim, Atracurium, etc
|
[
"Doxacurium",
"Rocuronium",
"None"
] |
Doxacurium
|
79
|
732c3be6-5873-420d-a099-7050cd14a3ea
|
Orchidopex is done in cases of undescended testes at the age of -
|
[
"Neonate"
] |
[
"1"
] |
[
"Neonate",
"1-2 yrs",
"5 yrs",
"Pubey"
] |
1-2 years "Congental undescended testis should be treated surgically no later than 9-15 months. Surgical correction at 6 months is appropriate". - Nelson Crvptorchidism o An undescended testis (cryptorchid) is the most common disorder of sexual differentiation in boys. o At bih approximately 4-5% of boys have an undescended testis. The majority of undescended testes descend spontaneously during the first 3 months of lift, and by 6 month the incidence decreases to 0.8%. o If the testis has not descended at 4 months, it will remain undescended. o Cryptorchidism is bilateral in 20% of cases. Consequences of cryptorchidism o Infeility o Torsion o Testicular maligancy ----> Most common seminoma o Associated hernia o Psychological effects of empty scrotum.
|
[
"1-2 yrs",
"5 yrs",
"Pubey"
] |
5 yrs
|
80
|
c1cd3816-2e6e-4f24-ac76-ffc0f1c54495
|
Which is not true about thoracic outlet syndrome ?
|
[
"Positive Adson's test"
] |
[
"0"
] |
[
"Radial Nerve is commonly affected",
"Neurological features are most common",
"Resection of Pt rib relieves symptom",
"Positive Adson's test"
] |
ie Radial Nerve is commonly affected Not the Radial nerve, but Ulnar nerve is most commonly affected in thoracic outlet syndrome.
|
[
"Radial Nerve is commonly affected",
"Neurological features are most common",
"Resection of Pt rib relieves symptom"
] |
Neurological features are most common
|
81
|
1161d849-cda0-4034-be05-81e50ca537fa
|
'Clue cells' are seen in:
|
[
"Trichomoniasis"
] |
[
"0"
] |
[
"Bacterial vaginosis",
"Vaginal Candidiasis",
"Chlamydial vaginosis",
"Trichomoniasis"
] |
Clue cells are epethelial cells covered with bacteria and are identified on microscopy. They are characteristic of Bacterial Vaginosis. Ref: Clinical Obstetrics and Gynaecology by Brian A. Magowan, Philip Owen, James Drife, Pages 125-134.
|
[
"Bacterial vaginosis",
"Vaginal Candidiasis",
"Chlamydial vaginosis"
] |
Bacterial vaginosis
|
82
|
064b5578-c0ce-4bff-bb4e-93df3062c35b
|
Cailaginous pa of external auditory canal is
|
[
"Medial 1/3"
] |
[
"1"
] |
[
"Medial 1/3",
"Lateral 1/3",
"Medial 2/3",
"Lateral 2/3"
] |
Lateral 1/3rd of the external auditory canal is cailaginous and medial 2/3rd is bony.Ref: Hazarika; 3rd ed; Pg 9
|
[
"Lateral 1/3",
"Medial 2/3",
"Lateral 2/3"
] |
Lateral 1/3
|
83
|
47883e79-2f27-4064-851a-45b557dd214a
|
Carcinoid of hea presents as?
|
[
"Aoic stenosis"
] |
[
"1"
] |
[
"Aoic stenosis",
"Tricuspid regurgitation",
"Mitral stenosis",
"Aoic regurgitation"
] |
Tricuspid valve disease (especially regurgitation) was most prevalent. Patients with carcinoid hea disease typically present with symptoms of right hea failure (hepatomegaly, edema, asc fatigue and low cardiac output). Ref Davidson 23rd edition pg 455
|
[
"Tricuspid regurgitation",
"Mitral stenosis",
"Aoic regurgitation"
] |
Mitral stenosis
|
84
|
9f4a1de7-2b4e-4fe5-99f3-06d5804fd0cc
|
NOT a feature of childhood asthma is ?
|
[
"History of atopic dermatitis"
] |
[
"1"
] |
[
"History of atopic dermatitis",
"Raised IgG level",
"Improves with age",
"Absence of wheezing after exercise"
] |
Raised IgG level Asthma Bronchial asthma is a disease characterized by an increased responsiveness of airways to a variety of stimulus and causes recurrent attacks of wheezing, breathlessness, chest tightness and cough. The symptoms are due to bronchoconstriction which is reversible in a large majority of the cases, either spontaneously or in response to treatment. o Asthma is the commonest chronic illness during childhood. o It is a type I hypersensitivity, which is mediated by IgE IgE is raised (not IgG) Risk factors o Family history of asthma o Family history of atopic disease (Atopic dermatitis, allergic rhinitis). Bronchiolitis during infancy. Sensitization to allergenes (dust mite, animal danders, cockroaches and alternaria) during childhood. Passive smoking Response of Asthmatic patients to exercise ? Mild exercise running for 1-2 minutes caused bronchodilation in asthmatic patients and can reduce wheezing (wheezing is produced due to obstruction in bronchi). Severe exercise will cause bronchoconstriction in viually all asthmatic patients and will aggravate wheezing. Prognosis of Asthma ? The prognosis of young asthmatic children is generally good. Longitudinal studies indicate that in patients who have mild asthma the remission rate is about 50% 50% of them will be asthma free in their adulthood. In severe asthma characterized by chronic steroid dependent disease, the remission rate is very less. About 95% of them will develop into asthmatic adults.
|
[
"Raised IgG level",
"Improves with age",
"Absence of wheezing after exercise"
] |
Absence of wheezing after exercise
|
85
|
04be7b8b-e555-4a3e-92ed-732c666afc50
|
A 65-year-old man develops the onset of severe right knee pain over 24 hours. The knee is red, swollen, and tender. The patient does not have fever or systemic symptoms; he has never had severe joint pain before. Plain film of the knee shows linear calcification of the articular cartilage without destructive change. Definitive diagnosis is best made by which of the following?
|
[
"Serum calcium"
] |
[
"2"
] |
[
"Serum uric acid",
"Serum calcium",
"Arthrocentesis and identification of positively birefringent rhomboid crystals",
"Rheumatoid factor"
] |
Acute monoarticular arthritis in association with linear calcification of the cartilage of the knee (chondrocalcinosis) suggests the diagnosis of pseudogout, a form of calcium pyrophosphate dihydrate deposition (CPPDD) disease. In its acute manifestation, the disease resembles gout. Positively birefringent crystals (looking blue when parallel to the axis of the red compensator on a polarizing microscope) can be demonstrated in joint fluid, although careful search is sometimes necessary. Serum uric acid and calcium levels are normal, as are rheumatoid factor and ANA. Pseudogout is about half as common as gout but becomes more common after the age of 65. CPPDD disease is diagnosed in symptomatic patients by characteristic x-ray findings and crystals in synovial fluid. Pseudogout is treated with NSAIDs, colchicine, or steroids. Arthrocentesis and drainage with intra-articular steroid administration is also an effective treatment. Linear calcifications or chondrocalcinosis are often found in the joints of elderly patients who do not have symptomatic joint problems; such patients do not require treatment.
|
[
"Serum uric acid",
"Arthrocentesis and identification of positively birefringent rhomboid crystals",
"Rheumatoid factor"
] |
Arthrocentesis and identification of positively birefringent rhomboid crystals
|
86
|
2949130e-edee-4fcb-98ef-315340ac86ba
|
Most common cause of neuropathic joint:
|
[
"Leprosy"
] |
[
"0"
] |
[
"Diabetes",
"Amyloidosis",
"Syphilis",
"Leprosy"
] |
(Diabetes) Ref: Harrison, 16th ed, p. 2060; 17th ed, p. 2180Most common cause of neuropathic joint is diabetesNeuropathic joint (Charcot joint)It is a progressive destructive arthritis associated with loss of pain sensation, proprioception or both.Clinical featuresIt begins as a single joint and then progresses to involve other joints. Swelling is present, loose bodies may be palpated.Joint becomes unstable and subluxation may occur. The amount of pain experienced by the patient is less than that would be anticipated based on the degree of joint involvement.Causes of Charcot jointDiabetes mellitusTabes dorsalisMeningomyelocoele or syringomyeliaAmyloidosisLeprosyPeroneal muscular atrophyCommonly involved joints in various diseasesDiabetes mellitus: Tarsal and metatarsal jointsTabes dorsalis: Knee, hips and anklesSyringomyelia: Glenohumeral joint, elbow and wrist
|
[
"Diabetes",
"Amyloidosis",
"Syphilis"
] |
Amyloidosis
|
87
|
54197c00-ac8a-4a13-a710-f0b433268427
|
Patent formen ovale is due to failure of fusion of?
|
[
"Ostium primum with Septum primum"
] |
[
"3"
] |
[
"Ostium primum with Endocardial cushion",
"Ostium primum with Ostium Secundum",
"Ostium primum with Septum primum",
"Septum primum with septum secundum"
] |
Septum primum with septum secundumUnequal division of conus Gordis resulting from anterior displacement of conotruncal septum gives rise to Fallot's tetralogyQ.- Ligamentum teres hepatis is remnant of umbilical vein (left)Q and ligamentum aeriosum in adult is remnant of ductus aeriosusQ.Patent foramen ovale is d/t failure of septum primum with septum secundumQ.
|
[
"Ostium primum with Endocardial cushion",
"Ostium primum with Ostium Secundum",
"Septum primum with septum secundum"
] |
Ostium primum with Endocardial cushion
|
88
|
63066b0a-b8db-47d7-b367-8263bdd4999d
|
Organism causing otitis externa includes all except
|
[
"Candida albicans"
] |
[
"2"
] |
[
"Escherichia coli",
"Candida albicans",
"Streptococcus pyogenes",
"Staphylococcus aureus"
] |
Some Causes of Otitis Externa a. Staphylococcus aureus b. Pseudomonas pyocyaneus c. B. proteus d. Escherichia coli e. Aspergillus niger f. Aspergillus fumigatus g. Candida albich. Herpes zoster
|
[
"Escherichia coli",
"Streptococcus pyogenes",
"Staphylococcus aureus"
] |
Staphylococcus aureus
|
89
|
6cd6781c-ac10-421c-b960-cfeb3baf8236
|
In which of the following conditions, the medical treatment of ectopic pregnancy is contraindicated:
|
[
"Blood in pelvis is 70 mL"
] |
[
"2"
] |
[
"Sac size is 3 cm",
"Blood in pelvis is 70 mL",
"Presence of fetal heart activity",
"Previous ectopic pregnancy"
] |
is c, i.e. Presence of fetal heart activityRef Dutta Obs. 7/e, p 186; Leon Speroff 7/e, p 1287, 1288; Novak 14/e, p 624; Williams Gynae 7/e, p 166Methotrexate: It is a folic acid analogue which inhibits dehydrofolate reductaseQ and prevents synthesis of DNA.QCandidates for methotrexate (Williams 24/e, p 384, Table 19.2): --Leon Speroff 7/e, p 1290Absolute requirementsHemodynamic stabilityQNo evidence of acute intra-abdominal bleedingQReliable commitment to comply with required follow-up careQNo contraindications to treatment viz woman should not be breast feeding/renal/hepatic dysfunction.Preferable requirementsAbsent or mild painSerum beta hCG level less than 5,000IU/L (best results seen with HCG<2000IU/L)Q It is the single best prognostic indicator of treatment success.Absent embryonic heart activityQEctopic gestational mass less than 4 cm in diameter without cardiac activity and < 3.5 cm with cardiac activityQFriends, there is no doubt on this issue that presence of cardiac activity is a relative contraindication according to books like Williams Obs 23/e, Williams Gynae 1/ed and Leon Speroff 7/ed."Fetal cardiac activity - Although this is a relative contraindication to medical therapy; the admention is based on limited evidence." --William Obs. 23/e, p 247"The presence of embryonic heart activity is not an absolute contraindication for medical management but the likelihood of failure and the risk of tubal rupture are substantially increased (therefore it is a relative contraindication)." --Leon Speroff 7/e, p 1287As far as fluid in cul-de-sac is concerned: Earlier, it was also considered a relative contraindication to medical treatment, but studies have shown that free peritoneal fluid can be seen in almost 40% of women with early unruptured ectopic pregnancy and so it's presence and absence does not accurately predict the success or failure of medical treatment.Contraindications to methotrexate treatment: (Williams 24/e, p 384, Table 19.2)Breast feedingQ Immunodeficiency statesQAlcoholism or evidence of chronic liver disease (elevated trminases) QRenal disease (elevated serum creatinine) QHematological abnormalities (severe anemia, leukopenia or thrombocytopenia) QKnown sensitivity to methotrexateQActive pulmonary diseaseQPeptic ulcer disease. QEvidence of tubal rupture
|
[
"Sac size is 3 cm",
"Presence of fetal heart activity",
"Previous ectopic pregnancy"
] |
Sac size is 3 cm
|
90
|
fe1623c0-dbc3-4cc4-a137-a0f8c57c7980
|
Vectors may transmit infection by all of the following methods, EXCEPT:
|
[
"Contamination with body fluids"
] |
[
"0"
] |
[
"Ingestion",
"Regurgitation",
"Rubbing of infected faeces",
"Contamination with body fluids"
] |
Methods by which vectors trit an infectious agents are: Biting Regurgitation Scratching in infected faeces Contamination of host by body fluids of vectors Ref: Preventive and Social Medicine, by K.Park, 19th edition, Page 92.
|
[
"Ingestion",
"Regurgitation",
"Rubbing of infected faeces"
] |
Regurgitation
|
91
|
8cfc536f-a96a-40a7-bf9a-e5e5386bda76
|
Nerve injured in Caldwell Lus operation is?
|
[
"Lingual nerve"
] |
[
"1"
] |
[
"Lingual nerve",
"Infra orbital nerve",
"Optic nerve",
"Facial nerve"
] |
is'b' Infra orbital nerve.Complications of Caldwell - Luc operationPost - operative bleeding. This can be controlled by nasal packAnaesthesia of the cheek due to stretching of infraorbital nerve. It may last for a few weeks or months.Anaesthesia TeethInjury to nasolacrimal ductSublabial fistula (oroantral fistula)Osteomyelitis of maxilla (rare)
|
[
"Infra orbital nerve",
"Optic nerve",
"Facial nerve"
] |
Optic nerve
|
92
|
a2212b25-0439-44b0-b20b-ce85898138b8
|
Congenital hea disease is most likely in the newborn of mothers suffering from all except
|
[
"Systemic lupus erythematosus"
] |
[
"1"
] |
[
"Systemic lupus erythematosus",
"Rheumatoid ahritis",
"Diabetes in pregnancy",
"Congenital hea disease of the mother"
] |
Effects of SLE on pregnancy : Risks of lupus rash,anemia, leukopenia, thromboctopenia and renal failure are increased. They are increased risks of First trimester miscarriage,lupus nephritis, reccurent DVT,PIH, Prematurity,IUGR and stillbihs. Neonatal lupus syndrome is due to crossing of maternal lupus antibodies(anti-RO or anti-La) to the fetus causing Hemolytic anemia,leukemia and thrombocytopenia. Isolated congenital hea block is pesent in about one-third of cases. Effect of Diabetes on pregnancy: Congenital Malformation (6-10%) is related to the severity of diabetes affeting organogenesis, in the firs trimester(both type 1 and tye 2) Effects of Congenital hea disease of mother on Pregnancy Likely to cause hea disease in newborn accounts for 3-13% Reference DC.Duttas textook of OBG ,9th edition
|
[
"Rheumatoid ahritis",
"Diabetes in pregnancy",
"Congenital hea disease of the mother"
] |
Congenital hea disease of the mother
|
93
|
5d063b74-9fa3-419e-a222-71d7d6e58743
|
Aerial branches which supply the head and neck of the femur is/are:
|
[
"Profunda femoris aery"
] |
[
"3"
] |
[
"Medial circumflex aery",
"Lateral circumflex aery",
"Profunda femoris aery",
"All"
] |
A. i.e. Medial circumflex a.; B. i.e. Lateral circumflex a.; C. i.e. Profunda femoris aProximal femur (head & neck) is supplied by aery of ligamentum teres (branch of obturator aery), medial (main) & lateral circumflex femoral aeryQ (both arise from profunda femoris aery, give rise to ascending cervical (+ metaphyseal) and retinacular (+ epiphyseal:lateral & inferior) aeries and form extracapsular & intracapsularsubsynol aerial rings)
|
[
"Medial circumflex aery",
"Lateral circumflex aery",
"All"
] |
Medial circumflex aery
|
94
|
c2a0b87d-c4e4-459d-973f-61e7281cd41d
|
Reverse smoking is common in:
|
[
"Gujarat"
] |
[
"2"
] |
[
"Maharashtra",
"Gujarat",
"Andhra Pradesh",
"Rajasthan"
] |
Reverse chutta (crude form of cigar) smoking, practised especially among females of Srikakulam district of Andhra Pradesh, recorded a prevalence of 8.8% of leukoplakia, 4.6% preleukoplakia and 17.9% leukokeratosis nicotina palati (Daftary et al, 1992). Palatal involvement was noted in 85% of the leukoplakia cases and in 57% of the preleukoplakias, and, of course, in all of the cases of Ieukokeratosis nicotina palati. Palatal changes associated with reverse smoking thus exhibited a spectrum of clinical changes, and it was not satisfactory to group them under leukoplakia, preleukoplakia or leukokeratosis nicotina palati. Reference: Shafer’s Textbook of ORAL PATHOLOGY Eighth Edition page no 145
|
[
"Maharashtra",
"Andhra Pradesh",
"Rajasthan"
] |
Maharashtra
|
95
|
decdf4d8-8556-4421-80e0-acd8c8c1baf5
|
Shoe polish like smell is seen in:
|
[
"Paraldehyde"
] |
[
"3"
] |
[
"Mercaptans",
"Lacquer",
"Paraldehyde",
"Nitrobenzene"
] |
. Nitrobenzene (Ref: Reddy 33/e p507; Industrial Hygiene and Toxicology. General Principles/p 174)Shoe polish like smell is seen in Nitrobenzene."Nitrobenzene is an oily yellow to yellow-brown liquid that smells like bitter almonds or shoe polish. Nitrobenzene dissolves only slightly in water and easily in other chemicals. It is man-made. The most common exposure is at workplaces that use nitrobenzene to produce dyes, drugs, pesticides or some types of rubber. "Characteristic Odours produced by ToxinsOdourToxinsAcrid (Pear smell)* ParaldehydeQ, Chloral hydrateQBitter almonds* CyanideQBurnt rope* Marijuana (Cannabis)QDisinfectant* Phenol (Carbolic acid), CreosoteGarlic* PhosphorusQ, Tellurium, Thallium* Dimethyl sulfoxide (DMSO)Fish or raw liver (Musty)* Zinc phosphideQ. Aluminum phosphideQKerosene like* OrganophosphateMint* Methylsalicylate (Oil of Wintergreen), MentholMothballs* Naphthalene, Camphor, p-dichlorobenzenePepper* o-chlorobenzylidene malonitrile (Tear gas)Rotten eggs* Hydrogen sulph Carbon disulphideQ* MercaptisulfiramQ, N -acetyIcysteineQShoe polish* NitrobenzeneVinegar* Acetic acidQ; Hydrofluoric acid
|
[
"Mercaptans",
"Lacquer",
"Nitrobenzene"
] |
Nitrobenzene
|
96
|
9b3cda10-913a-4b26-bd56-93f4d5cf5def
|
Iridium 192 half life
|
[
"8 days"
] |
[
"2"
] |
[
"2.7 days",
"8 days",
"74 days",
"16 hours"
] |
74 daysRef: Basic radiological physics 2nd ed. /180* Iridium-192, emits gamma rays. It has energy of 0.4MeV.* Tl/2 of iridium 192: 74 daysImportant Half Life of Radionuclides* Gold-198: 2.7 days* Iodine- 123: 13.3 hours* Iodine-131: 8 days* Phosphorus-32: 14.3 days* Yttrium 90: 64 hours* Cobalt-60: 5.26 years* Caesium-137: 30 years* Radium-226: 1620 years
|
[
"2.7 days",
"74 days",
"16 hours"
] |
2.7 days
|
97
|
b0fd6350-1f4c-470a-935b-02d4d9d5ea7f
|
Which one of the following is not a wound closure technique ?
|
[
"Composite graft"
] |
[
"2"
] |
[
"Paial thickness skin graft",
"Composite graft",
"Vascular graft",
"Musculo-cutaneous graft"
] |
vascular graft is used to redirect blood flow in a region of the body. It is commonly performed due to inadequate blood flow (ischemia) and as a pa of organ trlantation. In general, someone&;s own vein is the preferred graft material (or conduit) for a vascular bypass, but other materials such as ePTFE, dacron or a different person&;s vein (allograft) are also commonly used. Aeries can also be redirected and serve as vascular grafts. A surgeon sews the graft to the target vessel by hand using surgical suture, creating a surgical anastomosis. A composite graft is a small graft containing skin and underlying cailage or other tissue. Donor sites include, for example, ear skin and cailage to reconstruct nasal alar rim defects.
|
[
"Paial thickness skin graft",
"Vascular graft",
"Musculo-cutaneous graft"
] |
Musculo-cutaneous graft
|
98
|
679e4acf-36c2-458c-bb05-5f296a25219c
|
The number of ATPs produced by HMP shunt is
|
[
"Four"
] |
[
"0"
] |
[
"Zero",
"One",
"Two",
"Four"
] |
The number of ATPs produced by HMP shunt is zero HMP shunt/ Pentose Phosphate pathway Neither produces nor utilizes ATPs. 2 main products of HMP shunt: NADPH - in the irreversible oxidative phase Ribose-5-phosphate - In Reversible non-oxidative phase Rate limiting enzyme - Glucose-6-phosphate dehydrogenase. Extra Edge: The pathways producing Zero ATPs are: HMP (Hexose Monophosphate Pathway) Uronic Acid Pathway Alpha Oxidation Oxidation of Very Long Chain Fatty Acids (VLCFA) RL Shunt/cycle Synthesis of Ketone Bodies
|
[
"Zero",
"One",
"Two"
] |
Two
|
99
|
aef1c973-0b7c-4a46-88cb-a803f2120397
|
Which of the following tocopherol is the most active form of vitamin E?
|
[
"Delta"
] |
[
"0"
] |
[
"Alpha",
"Beta",
"Gamma",
"Delta"
] |
Vitamin E family contains tocopherols and tocotrienols. There are 4 vitamers a, b, g and d in each group. a-tocopherol is the most active form. Look at the isoprene side chain of tocopherol. All fat-soluble vitamins contain isoprene units. Structure of alpha tocopherol
|
[
"Alpha",
"Beta",
"Gamma"
] |
Gamma
|
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