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Millard repair is used for treatment of: A. Cleft lip B. Cleft palate C. Meningocele D. Saddle nose
The rotation advancement cleft lip repair, also referred to as a Millard repair, is probably the most commonly performed repair today. Almost no tissue is discarded; the medial lip element is rotated downward, even with a back cut, if necessary, and the lateral lip element is advanced into the defect under the nasal sill. Mucosal flaps are used to line the nose and the vestibule of the lip So the answer to this question is A
During water analysis in a hostel, amoebic cysts were seen. The best step to manage it is – A. Iodine B. Boiling C. U.V Rays D. Chlorination
"Amoebic infection is spread by ingestion of food or water contaminated with cysts. since an asymptomatic carrier may excrete upto 15 million cysts/day. Prevention of infection requires adequate sanitation and eradication of cyst carriage. In high risk areas infection can be minimized by avoidance of unpeeled fruits and the use of Bottled water. Because cysts are resistant to readily attainable levels of chlorine, disinfection by iodination (Tetraglycine hyperiodide) is recommended." - Harrison So the answer to this question is A
Lillys antidote does not contain A. Sodium Nitrite B. Amyl Nitrite C. Sodium Thiosulfate D. Dicobalt EDTA
Lillys antidote Used for cyanide poisoning. Composition Sodium nitrite Amyl nitrite Sodium Thiosulfate So the answer to this question is D
CD marker specific for myeloid series is: A. CD34 B. CD45 C. CD99 D. CD117
. CD117 So the answer to this question is D
Fine reticular pigmentation with palmar pits are seen in - A. Dowling - Degos disease B. Rothmund thornpson syndrome C. Cockyane syndrome D. Bloom's syndrome
Fine reticular pigmentation with palmar pits is characteristic of downing Degos disease Dowling-Degos disease (DDD) is a type of reticulate pigmentary disorder in which hyperpigmented macules are found in the flexures. Iadvl text book of dermatology, page 737 So the answer to this question is A
Imaging tool of choice for GD? A. DWI MRI with ADC maps B. HMPAO SPECT C. MR Spectroscopy D. PET
Ans ACreutzfeldt-Jacob disease is a spongiform encephalopathy caused by prions. On MRI T2 hyperintensity in basal ganglia, thalamus (Hockey stick sign), cortex and white matter with persistent diffusion restriction in considered most sensitive sign. On PET scan there can be hypometabolsim in affected area however it is less sensitive So the answer to this question is A
A 16 years old girl presented with history of nasal obstruction for last 2 months. A CT Scan was done and following findings are seen. What is the most likely diagnosis? A. Juvenile Nasopharyngeal Angiofibroma B. Antrochoanal polyp C. Nasopharyngeal carcinoma D. Adenoid Hyperophy
CT Scan picture shows Crescent sign or Dodd's Sign seen in Antrochoanal Polyp Adenoid hyperophy: Dodd's Sign is negative JNAF- Epistaxis in adolescent males NPC- Old age, presents generally with Neck node metastasis So the answer to this question is B
A 2-year-old child comes with ear discharge, seborrheic dermatitis, polyuria and hepatosplenomegaly. Which of the following is the most likely diagnosis? A. Leukemia B. Lymphoma C. Langerhan's cell histiocytosis D. Germ cell tumor
c. Langerhan's cell histiocytosis(Ref: Nelson's 20/e p 2484-2489], Ghai 8/e p 620-623)Seborrheic dermatitis, polyuria, hepatosplenomegaly and ear discharge suggests diagnosis of LCH. So the answer to this question is C
Which of this following pas of veebral canal will show secondary curves with concavity towards back? A. Cervical Veibral Canal B. Thoracic Veibral Canal C. Sacral Veibral Canal D. Coccyx Veibral Canal
In adults, the cervical curve and lumbar curve is concave backwards. The thoracic and sacral curve is convex backwards.Ref: Clinical Anatomy by Systems, Richard S. Snell, Edition 2007, Chapter 12, Page 860; Anatomy at a Glance, Omar Faiz, 3rd Edition, Chapter 77, Page 175. So the answer to this question is A
KSY is A. Empowerment of females under maternity benefit scheme B. Adolescent girls scheme under ICDS C. Free and compulsory education for girl child D. Child care home scheme female juvenile delinquents
At present, there are two schemes for adolescent girls &;Kishore shakti yojana&; and &;Nutrition programme for adolescent girls&;Kishore shakti yojana is being implemented using the infrastructure of ICDS. The scheme targets adolescent girls in the age group of 11 to 18 years and address their needs of self-development, nutrition and health status, literacy and numerical and vocational skills.Nutrition programme for adolescent girls also being implemented using the infrastructure of ICDS. Undernourished adolescent girls in the age group 11 to 19 years (<30 in 11-15 ages and <35 in 15 to 19) are covered under the scheme.Park 23e pg: 592 So the answer to this question is B
Which is not an intracanal medicament : A. Calcium hydroxide. B. Chlorhexidine digluconate. C. MTAD. D. None.
The two antimicrobial intracanal medicaments recommended in contemporary endodontic practice are as follows: Calcium hydroxide Chlorhexidine digluconate So the answer to this question is C
If annual growth rate of a population is 1.5-2%, what number of years will be required to double the population A. 70-47 years B. 35-47 years C. 35-28 years D. 28-23 years
When crude death rate is substracted from crude bih rate , the net residual is current annual grow rate , exclusive of migration. When the annual growth rate of a population is 1.5% to 2.0%, it takes 35-47 years to double the size of population. Reference : Park&;s textbook of preventive and social medicine, 23rd edition, pg no: 481, table 5 So the answer to this question is B
HIV virus contains: A. Single stranded DNA B. Single stranded RNA C. Double stranded DNA D. Double stranded RNA
Ans. is 'b' i.e., Single stranded RNA(Ref: Ananthanarayan, 9th/e, p. 571 and 8th/e, p. 570)* The genome in HIV is diploid, composed of two identical single stranded positive sense RNA copies. So the answer to this question is B
A young man with tuberculosis presents with massive recurrent hemoptysis. Most probable cause would be. A. Pulmonary aery B. Bronchial aery C. Pulomary vein D. Superior vena cava
B i.e. Broncheal aery In great majority of patients hemoptysis originates from systemic rather than pulmonary aeries and the bronchial vessels are almost universally involved. (Grainger) Massive hemoptysis in a patient of T.B. is usually d/ t erosion of bronchial aery which bleeds at systemic pressure. So the answer to this question is B
25 years old male presented with diarrhea for 6 months. On examination the causative agent was found to be acid fast with 12 micro meter diameter. The most likely agent is - A. Cryptosporidium B. Isospora C. Cyclospora D. Giardia
Ans. is 'c' i.e., Cyclospora All the parasites mentioned in the question cause chronic diarrhoea {mostly in immunocompromised patients).All of them reveal oocyst on stool examination. In Giardiasis, parasite is also seen along with oocyst stool examination.Oocyst of all the organisms except giardia are acid fast. The diagnosis rests on the size of the oocyst.DIAGNOSIS OF INTESTINAL PROTOZOAL INFECTIONParasiteStoolFecal acid fast stainSize of the oocystGiardiaOocyst + Parasite 4 nuclei 8-12 x 7 x 10 pmCryptospo- ridiumOocyst+Small, 4-5 pm in diameterIsosporaOocyst+Large 25 pm in diameterCyclosporaOocyst+Medium 8-10 pm diameterMicrosporidiaSpores Special fecal stains, tissue biopsiesMore on this topicParasites causing chronic diarrhoeaGiardiaCryptosporidiosisIsosporaCyclosporaHookwormAmoebiasisStrongyloidesAcid fast organisms are -MycobacteriumLepra bacilliNocardiaIsosporaBacterial sporesRhodococcusSmegma bacilliSpermatic headCryptosporidiumCyclospora So the answer to this question is C
Skin surface elevation caused by hyperplasia and projections of the epidermis form an undulating surface under microscopic examination. What is this known as? A. Saw toothing B. Papillomatosis C. Villi D. Parakeratosis
Papillomatosis of skin Skin surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae. Papillary projections of the epidermis form an undulating surface under microscopic examination. So the answer to this question is B
Hyoid bone fracture does not occur in - A. Hanging B. Strangulation C. Throttling D. Choking
Ans. is 'd' i.e., Choking Features Hanging Strangulation Cause (mostly) Sigus of struggle Ligature mark Suicidal No * Above thyroid cartilageQ * Incomplete and directed obliquely upward * No skin damage under knot *Abrasion and bruise around ligature mark are * Dissection reveals a dry glistening white band of subcutaneous tissueQ Homicidal Present * Below thyroid cartilageQ * Completely encircelsQ neck horizontalQ * May be more than one turns * Abrasion and bruises are common *Dissection reveals ecchymosed subcutaneous tissueQ * Stretching of neck * Fracture-dislocation of vertebrae Present Absent * Fracture of hyoid, laryngeal cartilage, tracheal rings * Injury to neck muscles * Injury to carotid artery Rare Common Note - Throttling is m.c. cause of hyoid fracture Saliva Running out of angle of mouth vertically down Usually saliva not espaced but if so usually blood tinged and may not be vertically down * External signs of asphyxia *Face * Bleeding from nose and mouth Not well marked Pale Rare Well marked Congested, Cynosed with petechiaeQ Common So the answer to this question is D
Cell shape and motility are provided by A. Microfilaments B. Microtubules C. Golgi apparatus D. Mitochondria
Microtubules are polymers of tubulin that form pa of the cytoskeleton and provide structure and shape to cells So the answer to this question is B
Mean weight of 100 children was 12 kg. The standard detion was 3. Calculate the percent Coefficient of variation: A. 25% B. 35% C. 45% D. 55%
Coefficient of variation: - Is a measure used to compare relative variability - Is a unit-free measure to compare dispersion of one variable with another - Is SD expressed as percentage of mean CV = In the given question, Mean weight (u) = 12 kg, n = 100, Standard detion (s) = 3 Thus, coefficient of variance =s/ux 100 = 3/12 x100 = 25% So the answer to this question is A
About inverse agonism, true is: A. Action on the target receptors is similar to that of agonist B. Binds to the same receptor binding-site as an agonist for that receptor but exerts the opposite pharmacological effect C. Effective against receptors having intrinsic activity without acting of a ligand upon them D. None
Ans. b (Binds to the same receptor binding-site as an agonist for that receptor but exerts the opposite pharmacological effect). (Ref. KDT, Pharmacology, 6th ed., p 41)# Receptor agonists, antagonists and inverse agonists bind to the same receptor types:DefinitionAgonistsincrease the inhibitory transmitter GABA potencyInverse agonistsdecrease GABA potencyAntagonistsblock action of agonists and antagonists# An inverse agonist is an agent which binds to the same receptor binding-site as an agonist for that receptor but exerts the opposite pharmacological effect. Inverse agonists are effective against certain types of receptors (e.g. certain histamine receptors/GABA receptors) which have intrinsic activity without the acting of a ligand upon them (also referred to as 'constitutive activity'.)# One particular example is R015-4513 which the inverse agonist of the benzodiazepine class of drugs.# Gabapentin acts by facilitation of GABA mediated CT channel opening. It does not block GABA receptors. Substances called Beta carboline which also bend this receptor cause stimulation anxiety, increased muscle tone and convulsions. They are inverse agonists of benzodiazepine receptors. So the answer to this question is B
A 30 year old male was brought for evaluation. The history revealed that the patients 3 year old son died, 5 months back after being hit by a car. At the time of accident, patient was standing nearby and witnessed the accident. For last 5 months, he has been having symptoms of sadness of mood, crying spells, feelings of wohlessness, poor sleep and poor appetite. He has twice thought of killing himself but stopped at the end moment. He has not been attending the office of last 5 months. What is the likely diagnosis: A. Post traumatic stress disorder B. Normal grief C. Major depression D. Adjustment disorder
Depression: A major depressive disorder occurs without a history of a manic, mixed, or hypomanic episode. A major depressive episode must last at least 2 weeks DIAGNOSIS: Major Depressive Disorder The DSM-5 diagnostic criteria for major depression Sadness of mood Diminished interest in pleasure Significant weight loss or gain more than 5% in a month Crying spells Feeling of wohlessness Poor sleep (Insomnia or hypersomnia) Suicidal thoughts Psychomotor retardation Fatigue or loss of energy. Five or more of these symptoms present for 2 weeks or more or either depressed mood or loss of interest or pleasure. So the answer to this question is C
Most common type of skin carcinoma on face, in light skinned, is: March 2013 A. Squamous cell carcinoma B. Basal cell carcinoma C. Bowen's disease D. Erythroplasia of Queyrat
Ans. B i.e. Basal cell carcinoma In darkly pigmented racial groups, squamous cell carcinoma is the MC skin malignancy Skin tumours Basal cell carcinoma does not show lymphatic spread Conditions predisposing to Squamous cell carcinoma: - Actinic keratosis, - DLE Basal cell carcinoma MC site of BCC: Face MC type of BCC: Nodulo-ulcerative type Mode of spread: Direct Excision procedure done: Moh's micrographic excision So the answer to this question is B
Typhoid revaccination is recommended every ... years in endemic area- A. 1 B. 3 C. 5 D. 10
Ans. is 'b' i.e., 3 o To maintain protection, revaccination is recommended every 3 years. So the answer to this question is B
Length of esophagus in adults is: A. 25 cm B. 10 cm C. 15 cm D. 20 cm
The esophagus is a muscular, collapsible tube about 10 in. (25 cm) long that joins the pharynx to the stomach. The esophagus enters the abdomen through an opening in the right crus of the diaphragm.After a course of about 0.5 in. (1.25 cm), it enters the stomach on its right side. So the answer to this question is A
All are true for normal saline except A. normal saline 0.9% is most suitable to treat acute severe hyponatremia B. fluid of choice for head injury patient C. fluid of choice for hypovolemic shock D. lead to hyperchloremic metabolic acidosis
NaCl Is preferred in conditions in which increased plasma sodium is beneficial e.g traumatic brain injury Not suitable for treatment of acute severe hyponatremia as it has little effect on plasma sodium levels When infused > 30ml/kg/hr may lead to hyperchloremic acidosis So the answer to this question is A
All are true about Abnormal uterine bleeding except : A. Blood loss of less than 50 ml B. Cycle duration is more than 35 days or less than 21 days C. Bleeding period lasting 7 days or more D. Irregular bleeding during a regular cycle
Normal Menstrual Loss The upper limit of blood loss in a normal menstruation is considered as 80ml. Any bleeding above the specified normal limit is termed as abnormal uterine bleeding. Normal Menustration: Cycle interval-28days(21-35 days) Menustral flow- 4 to 5 days Menustral blood loss-35ml (20- 80ml) Common causes of AUB: 1.DUB 2.Infections 3.Endocrine Dysfunction 4.Pregnancy Complications 5.Hematological disorders 6.Neoplastic growth. Reference: Textbook of Gynaecology; Sheila balakrishnan; 2nd edition; Page 48 DC Dutta's Textbook of Gynecology; 7th edition ,page 152 So the answer to this question is A
Which influenza strain was isolated in 1989 spreading to many other countries? A. H2N2 B. H1N1 C. H3N2 D. H5N1
In 1989, epidemic - the reappearance of swine HINI virus Influenza can occur sporadically, as epidemics or pandemics In 2009, H1N1 Epidemic occurred in Mexico-recent Ref: Baveja 5th ed Pg: 468 So the answer to this question is B
All statements are true about the eye of a newborn except – A. Optic nerve is myelinated only upto lamina cribrosa B. Orbit is more divergent than adult C. Apart from macular area the retina is fully differentiated D. New born is usually myopic by –2 to –3D
Newborn is usually hypermetropic by +2 to +3D (not myopic). So the answer to this question is D
Which of the following is the national system that provides annual national as well as state reliable estimates of feility and Moality A. Civil registration system B. Census C. Ad-hoc survey D. Sample registration system
Sample registration system (SRS) : Was initiated in 1964-65 (on a pilot basis ; Full scale from 1969-70) to provide national as well as state level reliable estimates of feility and Moality SRS is a dual record system Field investigation : Continuous enumeration of bihs and deaths by an enumerator Independent retrospective survey : Every 6 months by an investigator-supervisor Findings of SRS survey Crude bih rate (CBR) : 20.4 per 1000 mid year population Crude Death rate (CDR) : 6. 4 per 1000 mid year population Natural growth rate : 14% Infant Moality rate (IMR) : 34 per 1000 live bihs Ref: Park 23rd edition 904 So the answer to this question is D
Homocystein is not associated with A. Coronary aery disease B. Fracture C. Hearing loss D. Neuropsychiatric manifestations
Ans. is 'c' i.e., Hearing lossElevated level of homocysteine (hyperhomocysteinemia) is associated with -i) Thrombosis, coronary aery disease & stroke.ii) Osteoporosis & fracture.iii) Neuropsychiatric manifestations.iv) Developmental delay.v) Visual disturbances.vi) Microalbuminuria. So the answer to this question is C
All are complications of chronic staphylo-coccal blepharoconjunctivitis except: A. Chalazion B. Marginal conjunctivitis C. Follicular conjunctivitis D. Phylectenular conjunctivitis
Ans. Chalazion So the answer to this question is A
Last organ to be affected in putrefaction-a) Prostateb) Uterusc) Kidneyd) Thyroid A. ab B. ac C. bd D. cd
Last soft tissue affected in male → Prostate Last soft tissue affected in female → Uterus Overall, last tissue affected (both in male & female) →3 Bone So the answer to this question is A
All are true about 'Molluscum contagiosum' , EXCEPT ? A. Caused by pox virus. B. Commonly seen in HIV and immune compromised subject. C. Treated by cryotherapy. D. Treated with metronidazole and doxyxycline.
Molluscum Contagiosum Benign viral infection caused by the poxvirus. Spread by close sexual or nonsexual contact and by autoinoculation Clinical features Presents with a crop of small domed vesicles with central umbilication measuring 1-5 mm in size. Diagnosis Giemsa staining of the discharge (white waxy material) reveals intracytoplasmic molluscum bodies Rx It consists of evacuation of the white material, excision of the nodule with a dermal curet and Rx of the base with Monsel's solution (ferric subsulphate) or 85% trichloracetic acid. Cryotherapy and electrocoagulation may be considered as an alternative therapy. So the answer to this question is D
Intramuscular injections are given which quadrant of the buttock A. Inferomedial B. Superomedial C. Superolateral D. Superomedial
The buttocks are the preferred site for administration of the intramuscular injection.  The muscles (gluteal) of this area are thick and are utilized frequently in daily activities, thus causing complete absorption of drugs.  To give the injection at the proper site, the gluteal region can be divided into four quadrant - i) Superomedial (upper inner quadrant) ii) Superolateral (upper outer quadrant) iii) Inferomedial (lower inner quadrant) iv) Inferolateral (lower outer quadrant)  The proper location for an injection is the upper outer quadrant (superolateral) because this is the location where there is least possibility of hitting bone, large blood vessels or the sciatic nerve. So the answer to this question is C
A 63-year-old man becomes febrile and begins expectorating large amounts of mucopurulent sputum. Sputum cultures are positive for Gram-positive diplococci. Which of the following mediators of inflammation provides potent chemotactic factors for the directed migration of inflammatory cells into the alveolar air spaces of this patient? A. Bradykinin B. Histamine C. Myeloperoxidase D. N-formylated peptides
Chemotactic factors are substance that stimulalte cellular migration The most potent chemotactic factors for leukocytes at the site of injury are:- Complement proteins (e.g., C5a) Bacterial and mitochondrial products, paicularly low molecular weight N-formylated peptides Products of arachidonic acid metabolism (especially LTB4) -Plasmin is a fibrinolytic enzyme generated by activated Hageman factor (clotting factor XII). So the answer to this question is D
An 8-year-old child is evaluated by the pediatrician, who notes small cafe-au-lait spots on the child's torso. In addition, on close inspection of the eyes, the presence of Lisch nodules is noted. The patient is eventually diagnosed with neurofibromatosis type 1. The protein that is mutated in this disorder normally does which of the following functions? A. Activates the GTPase activity of Ras B. Cleaves cellular proteins during apoptosis C. Functions as a cell cycle checkpoint regulator D. Promotes angiogenesis
The normal function of NF1 is to promote the intrinsic GTPase function of the RAS oncogene. Mechanism:- RAS has an intrinsic GTPase activity that is accelerated by GTPase-activating proteins (GAPs), which bind to active RAS and augment its GTPase activity by more than 1000-fold, thereby terminating signal transduction. Thus, GAPs prevent uncontrolled RAS activity. When the Ras protein is bound to GTP, the growth-promoting function of the molecule is "ON". On hydrolysis of the GTP to GDP, Ras is conveed to an inactive state. GAPs (GTPase Activating Proteins), such as NF-1, suppress cell growth by stimulating GTP hydrolysis. Disabling mutations of neurofibromin 1, a GAP (GTPase-activating protein) encoded by the NF1 gene, are associated with the inherited cancer syndrome familial neurofibromatosis type 1. NF1 is therefore an example of a tumor suppressor gene that acts through negative regulation of RAS signaling (inhibitor of RAS/MAPK signaling). Other Options:- Caspases function to cleave cellular proteins once apoptosis is triggered Vascular endothelial growth factor promotes tumor angiogenesis RB and TP53 function as cell cycle checkpoint regulators So the answer to this question is A
False about estrogen action ? A. Stimulates secondery sex characters in female B. Stimulates osteoclasts C. Decreases LDL D. Increases blood coagulability
Ans. is 'b' i.e., Stimulates osteoclastsMajor action of estrogen on bone is to inhibit osteoclastic bone resorption. Estrogen blocks the action of IL-6, a potent stimulator of osteoclasts.Estrogen also induces apoptosis of osteoclasts.Other three options are correct.Actions of estrogen have been explained in previous sessions. So the answer to this question is B
Glaucoma drug which is b-1 selectve p-blocker is ? A. Timolol B. Laevobuno I ol C. Caeolol D. Betaxolol
Ans. is 'd' i.e., Betaxolol o Among the given options, only betaxolol is 0-1 selective. So the answer to this question is D
A 6-month-old male baby comes with vomiting, lethargy and severe jaundice when weaning was staed with fruit juice. Which of the following enzymes is defective? A. Fructokinase B. Aldolase A C. Aldolase B D. Sucrase
The above clinical features on the initiation of fruit juice suggests a disorder of fructose metabolism. Hereditary fructose intolerance (HFI) is due to deficiency of the enzyme Aldolase B. Individuals affected with HFI are asymptomatic until they ingest fructose or sucrose (usually in the form of fruit, fruit juice or sweetened cereal). Symptoms include : Hepatomegaly Jaundice Vomiting Lethargy Convulsions Hypoglycemia Urine reducing sugar (Benedict's test) and tests for ketoses (Rapid Furfural and Seliwanoff's test) are positive. Treatment is removal of fructose and sucrose from the diet. Reference: Lippincott's Illustrated biochemisty 6th Edition Pg 138 So the answer to this question is C
In which of the following uveitic conditions is it contraindicated to put intraocular lens after cataract extraction A. Fuchs heterochromic cyclitis B. Juvenile rheumatoid ahritis C. Psoriatic ahritis D. Reiters syndrome
Inflammatory reaction in children is always serious and if the child is already suffering from uveitis IOL implantations can detoriate the condition Bewafa. REF:Khurana 6th edition page number 205 So the answer to this question is B
A 23-year-old female maid was making a bed in a hotel bedroom. As she straightened the sheet by running her right hand over the surface with her fingers extended, she caught the end of the index finger in a fold. She experienced a sudden, severe pain over the base of the terminal phalanx. Several hours later when the pain had diminished, she noted that the end of her right index finger was swollen and she could not completely extend the terminal interphalangeal joint. Which one of the following structures within the digit was most likely injured? A. The proper palmar digital branch of the median nerve B. The vinculum longa C. The insertion of the tendon of the extensor digitorum onto the base of the distal phalanx D. The insertion of the flexor digitorum profundus tendon
The contraction of the extensor mechanism produces extension of the distal interphalangeal joint. When it is torn from the distal phalanx, the digit is pulled into flexion by the flexor digitorum profundus. The proper palmar digital branches of the median nerve supply lumbrical muscles and carry sensation from their respective digits. Vincula longa are slender, bandlike connections from the deep flexor tendons to the phalanx that can carry blood supply to the tendons. The insertions of the flexor digitorum superficialis and profundus are on the flexor surface of the middle and distal phalanges, respectively, and act to flex the interphalangeal joints. So the answer to this question is C
After 28 weeks of gestation true is/are : A. Viable B. > 1000 gm C. Type II pneumocytes present D. All
Ans. is a, b and d i.e. Viable: >1000 gm: and Type II pneumocytes present So the answer to this question is D
The drug used for leishmaniasis treatment A. Pyrimethamine B. Albendazole C. Sodium stibogluconate D. Tinidazole
Sodium stibogluconate, is drug of choice in leishmaniasis. Meglumine antimoniate, Pentamidine, Amphotericin B, Miltefosine, Paromomycin are alternative drugs Basic and clinical pharmacology Katzung 13th edition pg 902 So the answer to this question is C
Fencing attitude of the dead bodies is caused by A. Coagulation of proteins B. Emulsification of fat C. Exposure to excess cold D. Electric shock
PUGILISTIC ATTITUDE OR BOXING OR FENCING OR DEFENCE ATTITUDE: The posture of the body which has been exposed to great heat is often characteristic. POSITION: the legs are flexed at hips and knees the arms are flexed at the elbow and held in front of the body head slightly extended all fingers are hooked like claws contraction of paraspinal muscles often causes a marked OPISTHOTONOS in an attitude commonly adopted by boxers CAUSE: Coagulation of proteins occurs whether the person was alive or dead at the time of burning The flexor muscles being bulkier than extensors contract more due to which joints of all limbs are flexed. REFERENCE: The Synopsis of Forensic Medicine and Toxicology 29th edition page no: 161. So the answer to this question is A
All of the following statements are true regarding retinoblastoma, except: A. Rb genes play major role in cell cycle regulation B. Require deletion of both the Rb genes C. Familial variant is autosomal dominant in inheritance D. Rb gene is on chromosome 14p13
Rb gene Governor of the cell cycle Negative regulator of the G1/S cell cycle transition. Located on 13q14 chromosome. To explain the two patterns of occurrence of retinoblastoma, Knudson proposed "two hit" hypothesis of oncogenesis. Two mutations (hits), involving both alleles of RB at chromosome locus 13q14, are required to produce retinoblastoma. Familial variant is autosomal dominant in inheritance. So the answer to this question is D
Organs first to be injured in blast - A. Ear, lung B. Kidney, spleen C. Pancreas, duodenum D. Liver, muscle
The synopsis of forensic medicine & toxicology ; Dr k.s narayan reddy ;28th edition ; pg.no. 138 Tympanic membrane rupture most commonly with hemorrhage in the ear . Blast lung is the other most common injury . So the answer to this question is A
Immunoprophylaxis of leprosy is best done by which of the following given choices? A. MMR B. Killed ICRC bacillus C. Plague bacillus D. Anthrax bacillus
Maximum work has been done with BCG+ heat killed M. leprae (will be the best answer). In the choices given Cat 2 killed ICRC bacillus is used for Immunoprophylaxis of leprosy. Ref: Park, 20th Edition, Page 286. So the answer to this question is B
A highly ionized drug A. Is excreted mainly by kidney B. Can carry placental barrier easily C. Is well absorbed from intestine D. Accumulates in cellular lipids
Ionized molecules cannot cross the biological membranes .therfore they are less likely to be absorbed . Entry of the molecules through blood brain barrier and blood placental barrier is also restricted .these drugs cannot be reabsorbed in the nephron,thus are excreted by the kidney . Refer kDT 7/e p29 So the answer to this question is A
'Bull-neck' is seen in severe cases of which of the following? A. Diphtheria B. Tubercular lymphadenitis C. Mumps D. Goitre
Ans. a. Diphtheria (Ref: Harrison 19/e p978, 18/e p1189-1190)Bull-neck is seen in severe cases of diphtheria.Respiratory DiphtheriaClinical Features:The clinical diagnosis of diphtheria is based on:Constellation of sore throatQAdherent tonsillar, pharyngeal, or nasal pseudomembranous lesionsQLow-grade feverQOccasionally, weakness, dysphagia, headache, and voice change are the initial manifestationsQ.Neck edema and difficulty breathing are seen in more advanced cases and carry a poor prognosisQ.The systemic manifestations of diphtheria stem from the effects of diphtheria toxin and include weakness as a result of neurotoxicity and cardiac arrhythmias or congestive heart failure due to myocarditisQ.The pseudomembranous lesion is most often located in the tonsiilopharyngeal regionQ.The diphtheritic pseudomembrane is gray or whitish and sharply demarcatedQ.Pseudomembrane in diphtheria is tightly adherent to the underlying tissuesQ.Less commonly, the lesions are detected in the larynx, nares. and trachea or bronchial passages.Large pseudomembranes are associated with severe disease and a poor prognosisQ.A few patients develop swelling of the tonsils and present with "bull-neck" diphtheria, which results from massive edema of the submandibular and paratracheal region and is further characterized by foul breath, thick speech, and stridorous breathingQ.Unlike the exudative lesion associated with streptococcal pharyngitis, the pseudomembrane in diphtheria is tightly adherent to the underlying tissuesQ.Diagnosis:Attempts to dislodge the membrane may cause bleeding.Hoarsensess suggests laryngeal diphtheria, in which laryngoscopy may be diagnostically helpful.In addition, diagnosis requires the isolation of C. diphtheria or the histopathologic isolation of compatible grampositive organismsQ. So the answer to this question is A
Danazol is not used in : A. Precocious pubey B. Endometrial Ca C. Endometriosis D. DUB
Endometrial Ca So the answer to this question is B
All are transmitted by Soft Tick, except- A. KFD B. Tularemia C. Qfever D. Relapsing fever
Ans. is 'b' i.e., Tularemia So the answer to this question is B
The given below instrument is used for: A. For cutting ribs in spinal surgery B. For smoothening of the edges in amputation surgery C. Used as nibbler and remove fibrous tissue from non-union site D. To hold the hard tissues
Ans. (c) Used as nibbler and remove fibrous tissue from non-union siteRef: Textbook of Orthopedics 4th Ed by John Ebnezar; Page No- 861* It is a Double-action bone nibbler (Rounger). The double- action nibblers are mechanically superior.* Bone nibbler is available in various sizes and with different angle of the nose.# Curved nibbler - use for spinal surgery# Straight nibbler -general use# Double action nibbler - straight or curved. So the answer to this question is C
Deep peroneal nerve supplies? A. First web space of foot B. Anterolateral aspect of leg C. Fourth web space of foot D. Lateral aspect of foot
First web space of foot is supplied by deep peroneal nerve while the rest three web spaces are supplied by superficial peroneal nerve. So the answer to this question is A
YAG laser is used in the treatment of: A. Retinal detachment B. Diabetic retinopathy C. Open-angle glaucoma D. After cataract
Ans. After cataract So the answer to this question is D
Virus that has increased association with anal was: A. HPV B. HIV C. LMV D. EBV
Anal Was Or Condylomata Accumulata HPV forms the etiological basis of: Anal and perianal was, AIN and SCC of the anus Subtypes (16,18,31,33) are associated with a greater risk of progression to dysplasia and malignancy Condylomata accuminata is the MC STD encountered by colorectal surgeons Most frequently observed inn homosexual men Clinical Presentation: Many are asymptomatic but pruritus, discharge, bleeding and pain are usual presenting complaints Rarely, relentless growth results in gaint condylomata (Buschke-Lowenstein tumour) which may obliterate the anal orifice Diagnosis is confirmed by biopsy Treatment: Application of 25% podophyllin Surgical excision Recurrence is common Ref: Sabiston 20th edition Pgno: 1412 So the answer to this question is A
Main LDL receptors is: A. APO-A B. APO-B-100 C. APOc-100 D. APO-100 & APO-E
Ans. (b) APO B 100Ref: Harper's Biochemistry, 30th ed. pg. 254* The low-density-lipoprotein (LDL) receptor is a cell- surface protein that plays an important part in the metabolism of cholesterol by mediating the uptake of LDL from plasma into cells.* Although LDL particles bind to the LDL receptor through their apolipoprotein B (apo B) and apolipoprotein E (apo E) moieties, other apo E-containing particles, like chylomicron remnants, are not dependent on the LDL receptor for uptake into cells.* ApoB100 levels are associated with coronary heart disease, and are even a better predictor of it than is LDL level. A simple way of explaining this observation is to use the idea that ApoB-100 reflects lipoprotein particle number (independent of their cholesterol content). In this way, one can infer that the number of ApoB100- containing lipoprotein particles is a determinant of atherosclerosis and heart disease.* Most important apoprotein in HDL: Apo A-I* Most important apoprotein in chylomicrons: Apo B-48, E* Most important apoprotein in LDL, IDL, VLDL: Apo B-100* Apo protein for IDL - Apo B 100 and E So the answer to this question is B
HLA B 27 is not seen in which of the following A. Ankylosing spondylitis B. Reiter's syndrome C. Rheumatoid ahritis D. Psoriatic ahritis
Ref Robbins 9/e p215 HLA and diseases, the association of B27 with ankylosing spondylitis (AS) is the strongest. The B27 antigen is present in over 90% of patients with AS as com- pared with the B27 prevalence of 8% in Caucasians in general. A strong but slightly minor association has also been found between B27 and Reiter's syndrome (RS), reactive ahritis (ReA), and acute anterior uveitis (AAU). It is negative in rheumatoid ahritis So the answer to this question is C
Typical clinical features of Homer's syndrome include all except: A. Dilated pupil B. Ptosis C. Enophthalmos D. Nasal stuffiness
Homer's syndrome is due to interruption of sympathetic fibres and therefore causes meiosis (constriction of pupil). Nasal stuffiness is due to dilatation of blood vessels. So the answer to this question is A
Which one of the following is not a treatment of gastroesophageal variceal haemorrhage ? A. Sclerotherapy B. Sengstaken tube C. Transjugular intrahepatic poacaval shunt D. Gastric freezing
Ans. is 'd' i.e., Gastric freezing So the answer to this question is D
Absolute contraindication for MRI: A. Pacemaker B. Claustrophobia C. Penile prosthesis D. Joint replacement
Ans. (a) PacemakerRef: Harrison 19th ed. /440e-tContraindications of MRIAbsolute contraindicationRelative contraindication* Pacemaker* Metallic foreign body in the eye* Deep brain stimulator* Swan-Ganz catheter* Bullets or gunshot pellets* Cerebral aneurysm clips* Cochlear implant* Magnetic dental implants* AAA stent* stapes implant* Implanted drug infusion device* Neuro or bone growth stimulator* Surgical clips, wire sutures, screws or mesh* Ocular prosthesis* Penile prosthesis* Joint replacement or prosthesis* Other implants, in particular mechanical devices So the answer to this question is A
Which of the following enzyme is inhibited by Aminophylline ? A. Monoamine oxidase B. Alcohol dehydrogenase C. Cytochrome P-450 D. Phosphodiesterase
Theophylline is a non selective phosphodiesterase inhibitor. Inhibition of this enzyme cause elevation of cellular cAMP and cGMP and cause bronchodilation. Other mechanism of action of Aminophylline includes: Antagonises adenosine receptor Increase release of IL 10 which has anti inflammatory effect It prevents the translocation of the pro-inflammatory transcription factor NF-kB into the nucleus, potentially reducing the expression of inflammatory genes in asthma and COPD. Side effects: Headache Nausea Vomiting Abdominal discomfo Restlessness Increased acid secretion Diuresis At high concentration it cause cardiac arrhythmias Very high concentration causes seizures Ref: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e chapter 36. So the answer to this question is D
A patient presented to ENT OPD with complaints of headache and nasal stuffiness. On CT scan Heterogeneous opacification involving multiple sinuses along with Bone erosion (as shown below) was noticed. What would be the most likely diagnosis? A. Acute bacterial rhinosinusitis B. Chronic Bacterial rhinosinusitis C. Allergic Fungal rhinosinusitis D. Invasive Fungal Rhinosinusitis
Heterogeneous opacification in multiple sinuses with areas of central hypoattenuation is characteristic of AFRS. Erosion of medial wall of right orbit can be clearly seen without any invasion into the orbit as Medial Rectus Muscle can be clearly seen with out distoion. ( compare with Left Side) Areas of increased signal intensity are thought to be due to the accumulation of heavy metals such as iron, manganese, and calcium within the inspissated allergic mucin. So the answer to this question is C
Most characteristic of megaloblastic anemia ? A. Target cell B. Macrocyte C. Microovalocyte D. Macroovalocyte
Ans. is 'd' i.e., Macroovalocyte So the answer to this question is D
Protein synthesis occurs in A. Ribosome B. Golgi apparatus C. Lysosomes D. Endosomes
Synthesis of proteins are based on the grnic information present on the DNA which is transcribef into the mRNA nucleotide sequence and then translated to the amino acid sequence of the polypeptide chain. The mRNA encodes the information,tge tRNA transposthe aminoacids and ribosomes provide the platform for the protein synthesizing machinery .Transfer RNA and ribosomal RBA are transcribed from specific genes on DNA by RNA polymerases Reference:FM.VASUDEVAN Textbook SEVENTH EDITION ,Page no: 597 So the answer to this question is A
Psychosurgery is used in A. Phobia B. Generalized anxiety C. OCD D. Depression
Psychosurgery can be used in the treatment of OCD that has become intractable and is not responding to other methods of treatment. The best responders are usually those who have significantly associated depression, although pure obsessives also respond. The main benefit is the marked reduction in associated distress and severe anxiety. (Ref: a sho textbook of psychiatry, Niraj Ahuja, 7th edition, pg no.98) So the answer to this question is C
Gluteus maximus is inserted on - A. Lesser trochanter B. Greater trochanter C. Spiral line D. iliotibial tract
Gluteus maximus -        Origin    Iliac crest    Posterior gluteal line of ileum and area behind and above it    Sacrum    Coccyx    Sacrotuberous ligament -        Insertion    Gluteal tuberosity    Iliotibial tract So the answer to this question is D
Amniocentesis is done at what intrauterine age? A. 12-Oct B. 20-Dec C. 20-25 D. 25-30
ANSWER: (B) 12-20REF: Current OB./GYN 10th edition chapter 13.Repeat from December 2011 & June 2008Amniocentesis is often performed between 15 and 20 weeks' gestation. Chorionic villus sampling (CVS) is an alternative to amniocentesis. It is performed between 10 and 12 weeks' gestation and can be performed either transcervically or transabdominally. So the answer to this question is B
'Whip-lash' injury is caused due to: AIIMS 06; Karnataka 07; BHU 12; NEET 15 A. Fall from a height B. Acute hyperextension of the spine C. Blow on top to head D. Acute hyperflexion of the spine
Ans. Acute hyperextension of the spine So the answer to this question is B
Splicing is a process of A. Activation of protein B. Removal of introns C. Synthesis of protein D. Replication of DNA
Removal of Introns : The primary transcripts are very long ;they have molecular weights more than 10 power of 7.Molecular weight of mature mRNA is about 1-2 x 10 power of 6.This means large poion of hnRNA are cleaved off. The primary transcript contains coding regions (exons)interspersed with non-coding regions (introns). These intron sequences are cleaved and the exons are spliced (combined together ) to orm the mature mRNA molecule.This processing is done in the nucleus.Splicing is an energy requiring process. REF :DM VASUDEVAN TEXTBOOK ;7th EDITION ; Page no :591. So the answer to this question is B
Supernumerary teeth common location - A. Upper incisor B. Canine C. Molar D. Lower incisor
Supernumerary teeth are those which are additional or in excess of the normal number. The most common site is upper incisor. Ref: K.S.Narayan Reddy's synopsis of Forensic Medicine and Toxicology 29 th edition Chapter 4,page- 59. So the answer to this question is A
Which one of the following tumors involving the female genital tract has the WORST prognosis? A. Dysgerminoma in a 35-year-old B. Uterine choriocarcinoma in a 25-year-old with a recent history of molar pregnancy C. Granulosa cell tumor in a 40-year-old D. Serous cystadenocarcinoma of the ovary in a 45-year- old
Ans. D. Serous cystadenocarcinoma of the ovary in' a 45-year-oldAround 75% of serous cystadenocarcinoma of the ovary are in an advanced stage at the time of diagnosis.These tumors have a worse prognosis than any of the other tumors listed. So the answer to this question is D
Most common site of disc prolapse in lumbar spine is A. L2-3 B. L3-4 C. L4-5 D. L5-S1
Ans. is 'c' i.e., L4-5 Prolapsed intervertebral disc:* Herniation of intervertebral disc is a common cause of combined back pain and sciatica (Pain in back with radiation to lower limb). Prolapsed intervertebral disc is often precipitated by injury, but it may also occur in the absence of any remembered injury.* The site of exit of the nucleus is usually posterolateralon one or the other side.Occasionally, it can be central (posterior-midline)disc prolapse.* The type of nuclear protrusion maybe: a protrusion, an extrusion or a sequestration.* A dissecting extrusion, (an extrusion with discmaterial between the body of the vertebra andposterior longitudinal ligament, stripping the latteroff the body), may occur.* The commonest level of discprolapse is between L4-L5 in the lumbar spine and C5-C6 in the cervical spine. So the answer to this question is C
Painless Breast lump in a young female A. Fibroadenoma B. Fibroadenosis C. Cancer D. Mastalgia
Ans. (a) Fibroadenoma(Ref. Bailey and Love 27th edition Page 870)* Fibroadenoma (Breast mouse) is mc in young females, painless and freely mobile with Firm Indian rubbery consistency So the answer to this question is A
Keratomalacia A. Occurs due to Vitamin A deficiency B. Relative Benign condition C. First feature of Vitamin A deficiency D. Also seen in retinitis pigmentosa
Night blindness is a first feature of Vitamin A deficiency and is also a feature of retinitis pigmentosa Refer: Khurana 6th edition page number 468 So the answer to this question is A
Anticipation is seen in? A. Translocation B. Chromosome breaking C. Trinucleotide - repeat expansion D. Mitochondrial mutation
Ans- (c) Trinucleotide - repeat expansionRef: Robbin's pathology 9th ed. /168* Anticipation is a phenomenon where by the symptoms of a genetic disorder become apparent at an earlier age as it is passed to next generation. In most cases, an increased severity of symptoms is also noted.* In triplet nucleotide repeat mutation, the DNA fragment is unstable and tends to expand further during cell division.So, in successive generations the expanded repeat increases and the manifestations of disease may worsen or may be observed at an earlier age; this phenomenon is referred to as anticipation. So the answer to this question is C
Hearing loss of 65dB, what is the grade of deafness- A. Mild B. Moderate C. Severe D. Moderately severe
Ans. is 'd' i.e., Moderately severe o WHO recommended the following classification on the basis of pure tone audiogram.Hearing threshold in better ear (average of 500,1000,2000Hz)Degree of impairment (WHO classification)Ability to understand speech0-25Not significantNo significant difficulty with faint speech2640MildDifficulty with faint speech.41-55ModerateFrequent difficulty with normal speech.56-70Moderately severeFrequent difficulty even with loud speech71-91SevereCan understand only shouted or amplified speechAbove 91ProfoundUsually cannot understand even amplified speech So the answer to this question is D
False about Varicocele is? A. Dilated pampiniform plexus veins B. More common on right side C. Doppler USG is best investigation D. Abnormality increases on Valsalva
Ans BVaricocele - The left testicle is affected much more commonly ([?]85%) than the right. This may be due to the shorter course of the right testicular vein and its oblique insertion into the IVC which creates less backpressure. Isolated right varicoceles are rare and should prompt evaluation for a secondary varicocele. So the answer to this question is B
All of the following are true about incidence of retinoblastoma except: A. Is the most common intraocular tumour of childhood B. Occurs in 1 in 14000-34000 live bihs C. No sex predisposition D. More common in negroes than whites
Ans. More common in negroes than whites So the answer to this question is D
The structural proteins are involved in maintaining the shape of a cell or in the formation of matrices in the body. The shape of these protein is: A. Globular B. Fibrous C. Stretch of beads D. Planar
Ans. B. FibrousBased on the shape of protein are classified into:Fibrous Protein#Elongated or Needle shaped or long cylindrical or rodlike a Minimum Solubility in water#Regular Secondary Structure#Axial Ratio >10#They are Structural Proteins, e.g. Collagen, Elastin, KeratinGlobular Proteins#Spherical or oval or Spheroidal in shape#Easily Soluble#Axial Ratio <3#They perform dynamic functions, e.g. Albumin, Globulin, most enzymes So the answer to this question is B
A sewage worker presnets to the Emergency depament with fever and jaundice. Laboratory findings reveal an elevated BUN and serum craetinine suggestive of renal failure. Which of the following antibiotics is recommended? A. Coctrimaxozole B. Erythromycin C. Ciprofloxacin D. Penicillin G
<p> It is a case of leptospirosis and the drug of choice is penicillin. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:292. <\p> So the answer to this question is D
Which of the following is seen in iridodialysis: September 2009 A. Biocular diplopia B. Degenerative condition C. Iris is torn away from its ciliary attachment D. Normal pupil
Ans. C: Iris is torn away from its ciliary attachment In iridodialysis there is rupture of the iris at its iris root and it frequently occurs following blunt trauma or penetrating injuries to the globe. Clinical features: A. Symptoms: Minimal with small iridodialyses With larger iridodyalises, patients may experience double pupil effect, monocular diplopia, glare and phophobia B. Signs: Commonly associated with hyphema and an irregular pupil (D-shaped pupil) May be single or multiple, small or extensive radially Damage of the trabecular meshwork and peripheral anterior synechiae may cause 10P elevation C. Management: Bed rest and observation. Sunglasses, tinted contact lenses or those with aificial pupil may help reduce the symptoms. Surgical repair may be considered in cases of large dialyses or persistent monocular diplopia So the answer to this question is C
Hernia not related to abdominal wall:- A. Amyand's hernia B. Richter's hernia C. Little's hernia D. Peterson hernia
Amyand's hernia - content is appendix Little's hernia - content is Meckel's diveiculum Richter's hernia - Herniation of pa of circumference of bowel - Mimics acute gastro enteritis Peterson hernia - Type of internal hernia - Hernia behind Roux - LIMB, After Roux-en-y gastrojejunostomy So the answer to this question is D
Which among the following causes staining of burnt area A. Sulfamylon B. Povidone iodine C. Silver nitrate D. Mafenide
Silver nitrate causes staining of burnt area. So the answer to this question is C
Most common type of emphysema is- A. Centriacinar B. Obstructed C. Distalacinar D. Panacinar
Ans. is A Centriacinar Types of emphysema 1) Centriacinar (centrilobular) emphysema o Centriacinar emphysema is the most common type of emphysema seen clinically. It is chracterized by involvement of respiratory bronchioles, i.e. central (proximal) part of the acinus. Occurs predominantly in heavy smokers and usually coexists with chronic bronchitis. 2) Panacinar (Panlobular) emphysema o The acini are uniformly enlarged from the level of the respiratory bronchiole to the terminal blind alveoli. This type of emphysema is associated with al-antitrypsin deficiency. 3) Distal acinar (Paraseptal) emphysema o This type of emphysema involves distal part of the acinus, while proximal part is normal.This type of emphysema is a common cause of spontaneous pneumothorax in young adults 4) Irregular emphysema (Para-cicatricial emphysema) o The acinus is involved irregularly and is almost invariably associated with scarring. It is the most common type of emphysema histologically Remember o Most common type of emphysema is irregular emphysema, but it is not clinically significant as most patients are asymptomatic and it is only an autopsy finding. Most common type of emphysema seen clinically is centracinar emphysema. So the answer to this question is A
Egg yields about ________K cal of energy - A. 50 B. 60 C. 70 D. 80
<p> EGG Contain all the nutrients except carbohydrates and vitamin C. An egg weighing 60g contains 6g of protein, 6g of fat , 30 mg of calcium and 1.5 mg of iron, and supplies about 70 kcal of energy. Egg proteins have all the nine essential aminoacids needed by body in right propoions. Egg protein is the standard against which the quality of other proteins is compared. Except for vitamin C, egg contains all the fat soluble and water soluble vitamins in appreciable amounts. Impoant minerals such as calcium, phosphorous, iron, zinc, and other trace elements. NPU (Net protein Utilization) is 100 for egg . Boiling destroys avidin , a substance which prevents the body from obtaining biotin . {Reference: Park&;s textbook of community medicine 23 rd edition} So the answer to this question is C
In ca ovary inguinal lymph nodes are involved in stage A. Stage II B. Stage III a C. Stage IIIc D. Stage IVb
FIGO revised the staging of carcinoma ovary in January 2014 and according to the new staging inguinal LN involvement is stage IV b. So the answer to this question is D
Which of the following is calcivirus? A. HEV B. HBV C. HCV D. HAV
Ans. (a) HEV According to Ananthanarayan 9/e, p 550 "HEV has been classified in genus hepesvirus under family calciviridae." But according to Harrison 18/e 2543 "HEV although resembling calicivirus is sufficiently distinct from any known agent to merit a new classification of its own as a unique genus; Hepevirus with in the family Hepeviridae." So the answer to this question is A
A 54-year-old man is brought to the emergency after experiencing several syncopal episodes. The patient states that he is currently taking erythromycin for treatment of bronchitis and another medication for treatment of gastroesophageal reflux disease (GERD). If an electrocardiogram reveals torsades de pointes, the patient is most likely taking which of the following medications for treatment of his reflux disease? A. Cisapride B. Famotidine C. Lansoprazole D. Metoclopramide
This question is about an impoant drug interaction occurring between erythromycin and cisapride (used for gastroesophageal reflux disease- GERD). Serious cardiac arrhythmias, including torsades de pointes, QT interval prolongation, ventricular tachycardia, and ventricular fibrillation, have been repoed in patients taking cisapride with medications that inhibit cytochrome P450 3A4. Examples of medications other than cisapride that have a similar interaction with erythromycin include ketoconazole, fluconazole, clarithromycin, nefazodone, and indinavir. It is impoant to note that QT prolongation, torsades de pointes, cardiac arrest, and sudden death have occurred in patients taking only cisapride. None of the other agents listed interact with erythromycin to produce these proarrhythmic effects. Famotidine is an H2 receptor antagonist used in the treatment of GERD and gastric ulcers; this agent is generally well tolerated with very little incidence of drug interactions. Lansoprazole is a proton pump inhibitor indicated for the treatment of gastric ulcerations and GERD. When this agent is administered with phenytoin, the clearance of phenytoin is decreased by 15%, leading to an extension of the therapeutic effect. Metoclopramide is a prokinetic agent indicated for the treatment of GERD and diabetic gastroparesis. When given with cyclosporine, the toxic effects of cyclosporine are more pronounced. Fuhermore, when metoclopramide is administered with levodopa, it decreases the effectiveness of levodopa. So the answer to this question is A
Critical temperature of oxygen is? A. 20 B. 118 C. 36.5 D. 400C
Ans. is 'b' i.e., -118 So the answer to this question is B
Cause of U/L secretory otitis media in an adult is - A. CSOM B. Nasopharyngeal carcinoma C. Mastoiditis D. Foreign body of external ear
Unilateral serous otitis media in an adult should always raise the suspicion of a benign / malignant tumor of nasopharynx “In adults presenting with a unilateral middle ear effusion the possibility of a nasopharyngeal carcinoma should be considered”. Ref. Dhingra 5/e, p 72, 6/e, p 251; Current Laryngology 2/e, p 659 So the answer to this question is B
A 26 year old third_gravida mother delivered a male baby weighing 4-2 kg at 37 weeks of gestation through an emergency caesarean section, for obstructed labour. The child developed respiratory distress one hour after bih. He was kept nil per orally (NPO) and given intravenous fluids. He maintained oxygen saturation on room air. No antibiotics were given. Chest radiograph revealed fluid in interlobar fissure. Respiratory distress settled by 24 hours of life. What is the most likely diagnosis ? A. Transient tachypnea of the newborn B. Meconium aspiration syndrome C. Persistent fetal circulation D. Hyaline membrane disease
Ans. is 'a' i.e., Transient tachypnea of newborn o Respiratory distress, which resolves within 24 hours without any respiratory suppo and fluid in interlobar fissure on chest X-ray suggest the diagnosis of TTN. So the answer to this question is A
Vagal stimulation of hea causes? (irrelevant to pharmacology) A. Increased hea rate B. Increased RR interval in ECG C. Increased cardiac output D. Increased force of contraction
Increased RR interval is seen in ECG on vagal stimulation. Normal values for waves and intervals are as follows: RR interval: 0.6-1.2 seconds. P wave: 80 milliseconds. ... QT interval: 420 milliseconds or less if the hea rate is 60 beats per minute (bpm) Ref: KD Tripathi 8th ed. So the answer to this question is B
A patient of CSOM has choleastatoma and presents with vertigo. Treatment of choice would be - A. Antibiotics and labyrinthine sedative B. Myringoplasty C. Immediate mastoid exploration D. Labyrinthectomy
The patient is presenting with CSOM and vertigo which means cholesteatoma has led to fistula formation involving semicircular canals which in turn has caused vertigo. So the management is immediate mastoid exploration to remove the cholesteatoma. So the answer to this question is C
Metabolically most active layer of cornea is: A. Endothelium B. Stroma C. Descemet's membrane D. Epithelium
Ans. Epithelium So the answer to this question is D
Octreotide is used in all except: A. Insulinoma B. Glucagonoma C. Glioma D. Carcinoids
Ans. c. GliomaOctreotide is a synthetic analogue of somatostatin and its pharmacological actions are similar to somatostatin, used in insulinoma, glucagonoma and carcinoid tumors but not in glioma."Somatostatin is a hypothalamic peptide that regulates the function of several endocrine and exocrine glands.Somatostatin acts primarily as a negative regulator of a variety of different types of cells blocking processes such as cell secretion, cell growth and smooth muscle contraction. It is secreted from the hypothalamus into the portal circulation and travels to the anterior pituitary gland where it inhibits the production and release of both growth hormone and thyroid stimulating hormone: Somatostatin is present in many tissues other than hypothalamus. It is also secreted by the cells in the pancreas and in the intestine where it inhibits the secretin of variety of hormones. " Action of Somatostatin BrainGITPancreasInhibits the release of:* Growth hormone* Thyroid stimulating hormoneInhibits the release of:* Gastrin* Chofecystokinin* Secretin* Motilin* Vasoactive intestinal polypeptide* Gastric inhibitory polypeptideInhibits the release of:* Insulin* Glucagon"By virtue of its pharmacological actions. Octreotide has been used to treat the symptoms associated with metastatic carcinoid tumors (flushing and diarrhea) and vasoactive intestinal peptide (VIP) secreting adenomas."Octreotide* Most widely used somatostatin analogue* Preferentially binds to SSTR-2 and SSTR-5 receptors* Administered subcutaneously; Peak effects within 30 minutes* Half life: 90 minutes; Duration of action: 12 hours* Adverse reactions: Nausea, abdominal pain and gall stones0Indications* Decreases GH secretion (indicated in acromegaly)* Decreases TSH secretion (indicated in thyrotrope adenomas)* Decreases insulin (indicated in insulinoma)* Decreases glucagon (indicated in glucagonoma)* Secretory diarrhea* Variceal bleeding* Pancreatitis* Intestinal dysmotilityBy virtue of its pharmacological actions, Octreotide has been used to treat the symptoms associated with metastatic carcinoid tumors (flushing and diarrhea) and vasoactive intestinal peptide (VIP) secreting adenomas. So the answer to this question is C
Sensitivity means the ability to detect - A. True negative B. True positive C. False negative D. False positive
For easy to remember : Sensitivity → "I know my patient has the disease. What is the chance that the test will show that my patient has it". Specificity → "I know my patient doesn't have the disease. What is the chance that the test will show that my patient doesn't have it". So the answer to this question is B
The following deformity is seen characteristically in A. Osteoahiritis B. Rheumatoid ahiritis C. Ankylosing spondylitis D. Psoriatric ahiritis
Deformities of Rheumatoid ahritis Swan-neck deformity: flexion posture of the DIP and hyperextension posture of the PIP joints. Buttonhole or Boutonniere Deformity: PIP in flexion, DIP in hyperextension. Wind sweep deformity: hallux valgus on one side & hallux varus on another side- produce deformity which is parallel to each other. Intrinsic plus deformity: caused by tightness and contracture of the intrinsic muscles, seen in RA, Cerebral palsy etc. Here the IP joints are in extension & MCP joints are in flexion. Z deformity: Radial detion of the wrist joint with ulnar detion of MCP joints. Pannus may form in RA, with underlying cailage destruction. With time, synol fibrosis occurs, resulting in joint stiffness Ref : Maheshwari 6e pg 282. So the answer to this question is B
Alpha feto protein is elevated in what percentage of children with hepatoblastoma: A. 10% B. 50% C. 90% D. 100%
Most liver function test results are normal. Alpha-fetoprotein levels are increased in 90% of children with hepatoblastomas but are elevated much less commonly in children with other liver malignancies. Ref: Schwaz's principle of surgery 9th edition, chapter 39. So the answer to this question is C
All of the following statements about Phenytoin are true, Except: A. Follows saturation kinetics B. Is teratogenic C. Is highly protein bound D. Stimulates Insulin secretion
Phenytoin inhibits the release of insulin and cause hyperglycemia. Ref: Essentials of Medical Pharmacology By KD Tripathi, 5th Edition, Page 372, 373. So the answer to this question is D
A 72-year-old man is newly diagnosed with bullous pemphigoid. Which of the following is the most appropriate next step in the management? A. plasmapheresis B. low-dose prednisone (10-20 mg/day) C. high-dose prednisone (50-100 mg/day) D. azathioprine (150 mg/day)
Severe cases require systemic steroids, often with the addition of azathioprine. Dapsone is useful in mild cases, and occasionally in very mild cases (or for local recurrences) topical glucocorticoid therapy will suffice. So the answer to this question is C