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Retinoscopy in 5 year old is best done with:
null
1
Atropine
Homatropine
Cyclopentolate
Tropicamide
Pharmacology
null
46f8b899-d307-4ab0-8906-f26f8a5f5cfb
single
Which of the following is most characteristic of diabetic neuropathy?
Diabetic neuropathy usually presents as peripheral polyneuropathy, usually bilateral, including symptoms of numbness, paresthesia, severe hyperesthesia, and pain. Impairment of proprioceptive fibers can lead to gait abnormalities and Charcot's joints. Mononeuropathy is less common and is often spontaneously reversible. Common syndromes include wrist or foot drop and third, fourth, or sixth cranial nerve palsies. Autonomic neuropathy may cause gastroesophageal dysfunction, bladder dysfunction, and orthostatic hypotension.
1
it is usually bilateral
pain is not a feature
it most commonly affects the brain
it spares the autonomic system
Medicine
Endocrinology
71ed60b6-c4cc-4fad-9c58-1ae876a59842
multi
The Loop diuretic acts at
(C) Ascending loop # Loop diuretics: are diuretics that act on the ascending loop of Henle in the kidney.> They are primarily used in medicine to treat hypertension and edema often due to congestive heart failure or renal insufficiency.# Mechanism of action:> Loop diuretics act on the Na+-K+-2CI' symporter (cotransporter) in the thick ascending limb of the loop of Henle to inhibit sodium & chloride reabsorption. This is achieved by competing for the Cl' binding site.> Because magnesium and calcium reabsorption in the thick ascending limb is dependent on sodium and chloride concentrations, loop diuretics also inhibit their reabsorption> By disrupting the reabsorption of these ions, loop diuretics prevent the urine from becoming concentrated and disrupt the generation of a hypertonic renal medulla
3
PCT
DCT
Ascending loop
Descending loop
Pharmacology
Miscellaneous (Pharmacology)
2532d806-70f9-4268-b334-4f7fc8614702
single
Neointimal hyperplasia causes vascular graft failure as a result of hyperophy of
Vascular injury leading to endothelial cell loss or dysfunction stimulates smooth muscle cell growth and associated matrix synthesis. Healing of injured vessels involves the migration of smooth muscle cells or smooth muscle cell precursor cells into the intima. Here these cells proliferate, and synthesize ECM in much the same way that fibroblasts fill in a wound, forming a neointima that typically is covered by an intact endothelial cell layer. This neointimal response occurs with any form of vascular damage or dysfunction, including infection, inflammation, immune injury, physical trauma (e.g., from a balloon catheter or hypeension), or toxic exposure (e.g. oxidized lipids or cigarette smoke). Thus, intimal thickening is a stereotypical response of the vessel wall to any insult ( Robbins Basic Pathology, 9 th edition, page 334 )
3
Endothelial cells
Collagen fibers
Smooth muscle cells
Elastic fibers
Pathology
Cardiovascular system
9c01d5d9-32c0-47d5-930c-4a66cab39afc
single
Increased plasma concentration of calcium is associated with: March 2009
Ans. C: Primary hyperparathyroidism The most common cause of high calcium levels (hypercalcemia) is an overproduction of parathyroid hormone, or hyperparathyroidism. Hyperparathyroidism tends to be more common in women, and occurs in 25 out of every 100,000 individuals. Hyperparathyroidism can be the result of all four parathyroid glands producing an excessive amount of parathyroid hyperplasia (PTH), or the result of just one gland specifically producing an excessive amount of PTH (usually the result of a parathyroid adenoma or benign tumor). Other conditions associated with hypercalcemia include: Cancers, paicularly multiple myeloma, breast cancer and lung cancer; Excessive levels of vitamin D from vitamins, excessive dietary calcium, or from diseases that may result in excess vitamin D production; Immobilization over a long period of time; Kidney failure; Overactive thyroid (hypehyroidism) or excessive thyroid hormone intake; and Use of ceain medications such as thiazide diuretics. Endocrine disorders like adrenal insufficiency, pheochromocytoma Calcitonin is a hypocalcemic hormone.
3
Rickets
Osteomalacia
Primary hyperparathyroidism
Pseudohypoparathyroidism
Medicine
null
04fdda71-03fe-4220-a3c1-849ba4e2fd66
single
Most sensitive investigation for abdominal trauma in a hemodynamically stable patient is-
Ans. is 'a' i.e., CT Scan Investigations to rule out abdominal injury in trauma patient* Investigations are driven by the cardiovascular status of the patient.* Blood loss into the abdomen can be subtle and there may be no clinical signs (blood is not an irritant and may not initially cause any abdominal pain). If stable, the best and most sensitive modality is a CT scan with intravenous contrast; however, in the unstable patient, this is generally not possible.A) Hemodynamically stable patient - CT with contrastB) Hemodynamically unstable -# Provision for FAST available and reliable operator - FAST# Provision for FAST unavailable and/ or unreliable operator - Diagnostic peritoneal lavage
1
CT Scan
Ultrasonography
Diagnostic peritoneal lavage
MRI
Surgery
Trauma
9537c431-d912-47f2-bf40-bd02c345c611
multi
True about streptococcus:
null
3
Lancefield classification is based on M protein
Group ‘G’ not found in human
Group ‘B’ causes neonatal meningitis
Group ‘C’ can be isolated from vaginal flora
Microbiology
null
f9f29d54-e41a-42d6-85e7-4a89043dc92e
multi
Which of the following is a persistant biochemical marker of rickets -
Serum alkaline phosphatase is a consistent marker and is raised in all types of rickets.
2
S.Ca++
S Alkaline phosphatase
S. Acid phosphate
S. phosphate
Orthopaedics
null
4088c200-1f92-43aa-bd79-95be7bf011d6
single
All are toxicities seen with Amiodarone therapy except -
Ans. is 'd' i.e., Productive cough Amiodarone is a class III antiarrhythmic drug and thus blocks potassium channel. It acts by increasing the action potential duration and effective refractory period.In spite of its present classification as class 3 drug, amiodarone also significantly blocks inactivated sodium channels. It also has weak adrenergic and calcium channel blocking actions.Consequence of these actions include slowing of the heart rate and AV node conduction.Amiodarone is the most powerful antiarrhythmic drug available for the treatment and prevention of both atrial and ventricular arrhythmias.Adverse effect:-Even short term use of Amiodarone causes serious toxicity.Amiodarone accumulates in many tissues which includes heart, lung, liver and skin.Pulmonary toxicityIt is the most important adverse effect.It is dose related. Fatal pulmonary fibrosis may be observed even in low doses.Patient usually presents with cough, chest pain and shortness of breath. Symptoms usually start with dry cough and dyspnoea. Remember, that patients on amiodarone often have dyspnoea attributable to other problems such as heart failure, so amiodarone lung toxicity is difficult to diagnose.Liver toxicityAbnormal liver function and hepatitis develops during amiodarone therapy. (I have not got any documented evidence of liver cirrhosis).Skin depositsSkin deposits results in photodermatitis and gray blue skin discoloration in sun exposed areas e.g. the malar region.Corneal micro depositsCorneal micro deposits are seen in virtually all patients treated with Amiodarone after few weeks of treatment.Sometimes optic neuritis may develop and progress to blindness.Effect of Amiodarone on ThyroidAmiodarone is a potential source of large amount of inorganic iodine and it also blocks the peripheral conversion of thyroxine (T4) to triiodothyronine (T3).Thus Amiodarone may result in hypothyroidism or hyperthyroidism.Thyroid function should be evaluated prior to initiation of treatment and monitored periodically.Cardiac toxicityAmiodarone may produce symptomatic bradycardia and heart block in patients with preexisting sinus or A-V node disease.
4
Pulmonary fibrosis
Corneal micro-deposits
Cirrhosis of liver
Productive cough
Pharmacology
C.V.S
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multi
Which of the following statements regarding prezinamide is false
Ref-Katzung 10/e p775 Pyrazinamide is a first line antitubercular drug that can cause hyperuricemia and hepatotoxicity. Non gouty ahralgia is very common adverse etfect of this drug.Hyperuricemia per se is not the indication for discontinuation of pyrazinamide.
1
One should discontinue treatment if hyperuricemia occurs
There is minimal cross resistance with INH
Polyahralgia is a common side effect
It can cause hepatotoxicity
Anatomy
Other topics and Adverse effects
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multi
Opioid agonist are ALE aEUR'
Ketamine
3
Morphine
Codeine
Ketamine
Methadone
Pharmacology
null
d02d6a95-02d4-4597-900c-3181ae17980d
single
All of the following statements about dislocation of the shoulder are true, except
B i.e. The commonest position for the head of the humerus to move into is the subspinous
2
The injury is produced by a fall with the arm fully abducted
The commonest position for the head of the humerus to move into is the subspinous
The auxiliary (circumflex humeral) nerve is likely to be injured
The easiest way to reduce it is by simple pressure with the patient under general anesthesia with muscle relaxation
Surgery
null
3186ca0a-d18e-4581-9498-23f2e177b348
multi
Patient diagnosed to have malaria, smear shows all stages of schizonts 14-20 merozoites, yellowish - brown pigment. The type of malaria is -
null
3
Pl. falciparum
Pl. malariae
Pl. vivax
Pl. ovale
Microbiology
null
884413ca-e19b-4176-a1d3-5eecaf9933a7
multi
Exhumation can be ordered by
Ans. c (District magistrate) (Ref. Parikh FMT 6th ed., p 2.90)EXHUMATION# By exhumation is meant the lawful disinterment or digging out of buried body from the grave.# It is sometimes necessary for -- Identification- Determination of cause of death (foul play suspected)# As the Hindus who form majority cremate their dead bodies within a few hrs, exhumation in India is quite rare.# Only a magistrate or coroner can order it.# In India, there is no time limit for exhumation.
3
Doctor
Civil surgeon
District magistrate
Police commissioner
Forensic Medicine
Law & Medicine, Identification, Autopsy & Burn
6ba158c7-60fb-4434-978f-025b4dfe554b
single
Which of the following pa of the colon has maximum basic electrical rhythm (BER)?
Basic electrical rhythm (BER) is initiated by the interstitial cells of Cajal, stellate mesenchymal pacemaker cells. The rate of the BER is about 4/min in the stomach. It is about 12/min in the duodenum and falls to about 8/min in the distal ileum. In the colon, the BER rate rises from about 2/min at the cecum to about 6/min at the sigmoid. The function of the BER is to coordinate peristaltic and other motor activity, such as setting the rhythm of segmentation; contractions can occur only during the depolarizing pa of the waves. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 27. Gastrointestinal Motility. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e.
3
Ascending colon
Descending colon
Sigmoid colon
Transverse colon
Physiology
null
75fd3bd6-96ac-4988-9134-eb5fec5d6722
single
Major pa of the skin of pinna is supplied by:
D i.e. Great auricular
4
Aurculo temporal nerve
Auricular branch of the vagus
Posterior auricular nerve
Great auricular nerve
Anatomy
null
c49b77af-453b-4d15-95e6-4722f7e86e7f
single
Crude birth rate denominator is -
null
4
Total no of live births in that year
1000 live births
Total numbers of births
Mid year population
Social & Preventive Medicine
null
f0d53dbc-18d9-4bfa-9f92-d61450708934
single
As per the World Health Organisation guidelines, iodine deficiency disorders are endemic in a community if the prevalence of goiter in school age children in more than -
Epidemiological criteria for assessing severity of IDD. Total goitre Rate (TGR) : Grade I + Grade II Median urinary iodine excretion. Thyroid volume (Ultrasound). Salt iodine content Criteria for sustainable elimination of IDD. Median Urinary Iodine Excretion 100 mcg/L Level of iodization: 1) 30ppm at production level 2) 15 ppm at consumer level Total goitre Rate (TGR) :<5% Ref: Assessment of IDD and monitoring their elimination, WHO 3rd edition
3
1%
5%
10%
15%
Social & Preventive Medicine
Nutrition and health
9a189c08-0c4f-44a5-9493-42a3fe5f69dc
single
Organophosphate insecticides are all except -
Organochloride compounds: DDT Lindane Methoxychlor HCH Chlordane Dieldrin Aldrin Toxaphene Kepone Mirex Organophosphorous compounds: Chlohion Diazinon Dioxathion Dimethoate EPN Malathion (OMS-1) Fenthion (OMS-2) Methyl parathion Parathion Ronnel Trichlorfon Dichlorvos Abate (OMS-786) Naled Gardona Chlorpyrifos Fenitrothion (OMS-43) Dicapthon (OMS-214 Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 843
1
Dieldrin
Fenthion
Diazinon
Propoxur
Social & Preventive Medicine
Environment and health
325fa77f-4b1d-4b7c-80ba-e2c309b51661
multi
Medium used to isolate M. tuberculosis contains all except ?
Ans. is 'c' i.e., Bromothymol blue Lowenstein-Jensen Medium (LT medium)LJ medium consists of mineral salts, asparagine, glycerol, malachite green and hen's egg.The malachite green prevents the growth of other microorganism on medium.It is used as a primary isolation medium for mycobacteria.Mineral salts are monopotassium phosphate, magnesium or sodium citrate and magnesium sulphate
3
Malachite green
Hen's egg
Bromothymol blue
Glycerol
Microbiology
null
4844a5dd-40f6-4894-8d8e-75b1a2e41875
multi
Intrauterine exposure of diethylstilboestrol is associated with -
null
3
Squamous cell carcinoma of cervix
Adenocarcinoma of endometrium
Clear cell adenocarcinoma of vagina
Sarcoma of uterus
Pathology
null
def76173-b7b5-459b-babd-6ef86b0c9435
single
The biological indicator used in various autoclave machines for quality check is-
METHOD Sterlization control Hot air oven Autoclave Filtration Ionizing radiation (cold sterilization) Ethylene oxide Plasma sterilization Clostridium tetani non toxigenic strain, B.subtilis sub sp. niger B.Stearothermophillus Brivundimonas dimunata B. Pumilus B.Globigi B.Stearothermophillus
2
Clostridium tetani
Bacillus stereothermophilus
Bacillus pumilus
Bacillus subtilis
Microbiology
General Microbiology Pa-2 and Pa-3 (Sterilization and Bacterial Genetics)
837e0afb-c3ec-4aa4-93ad-25acf3acfcc8
single
Disease elimination is helped by-
Ans. is 'a' i.e., Herd immunity o If the herd immunity is sufficiently high, the occurrence of an epidemic is regarded as highly unlikely.o If that high level of immunity is maintained and stepped up, by an on-going immunization programme, to the point where the susceptible persons are reduced to a small proportion of the population, it may lead to elimination of the disease in due course.o This has been achieved in such diseases as diphtheria and polio.
1
Herd immunity
Isolation
Quarantine
null
Social & Preventive Medicine
Infectious Disease Epidemiology
15a6780f-24ae-494f-b810-305c3d0b6bc8
multi
In retinitis pigmentosa, following are true except –
ERG is markedly subnormal in retinitis pigmentosa. There is perivascular pigment deposition, pale- waxy disc and marked attenuation (narrowing) of retinal vessels
4
Pigments present
Pale waxy disc
Narrowing of vessels
ERG – normal
Ophthalmology
null
23fd3020-f63b-4347-9bf4-dbc7772dd411
multi
Aminoglycoside class of drugs causes hearing loss by damaging?
Ans. is 'b' i.e., Outer hair cells of basal turn o Aminoglycosides affect exclusively outer hair cells, paicularly of basal coil of cochlea.
2
Inner hair cells of basal turn
Outer hair cells of basal turn
Inner hair cells of apical turn
Outer hair cells of apical turn
Pharmacology
null
76da772d-b1fa-4e52-a37d-62988939b96f
single
A six month old infant fed totally on cow's milk has been brought with bleeding spots, anaemia, fever and generalised tenderness. On examination, there were swelling in both the lower extremities and the blood count was normal. The most likely diagnosis is?
Ans. is 'd' i.e., ScurvyExclusive feeding on Cow's milk in a 6 months infant with anemia, bleeding, fever and generalized tenderness suggest the diagnosis of scurvy.Cow's milk does not contain sufficient amount of Vitamin C. On the other hand breast milk contains sufficient Vitamin C.Clinical manifestations of scurvy o The usual age of manifestations of scurvy is 6-18 months.o The manifestions are ?1. General symptoms --> Low grade fever, irritability, tachypnea, digestive disturbances, loss of appetite.2. Bleeding --> Subperiosteal, gingival and conjuctival hemorrhage, purpura & ecchymoses, petechiae, perifollicular hemorrhage, epistaxis.3. Defective dentition --> Bluish purple, spongy swellings of mucous membrane (due to hemorrhage), especially over the upper incisors.4. Generalized tenderness and pseudoparalysis --> child is difficult to handle due to pain and generalized tenderness. The pain results in pseudoparalysis with the hips and knees in semi-flexed position and the feet rotated externally.5. Scorbutic rosary Due to epiphyseal sepration, costochondral junction is disrupted and sternum is displaced backward with attached costal cailages. The end of ribs becomes prominent ----> rosary.6. Anemia -+ Due to defect in utilization of iron & folic acid.7. Bones are brittle and easily fractured.8. Irritability and other psychologic symptoms.9. Others --> Ahralgia, muscle weakness, degenration of skeletal muscles, cardiac hyperophy, adrenal atrophy and bone marrow depletion.Differences between rachitic and scorbutic rosary Rachitic Rosary Scorbutic Rosaryo Due to metaphyseal widening o Due to epiphyseal separationo Non-tender o Tendero Rounded o AngularRememberVitamin Cis not stored in the body, but is taken up by all tissues, the highest levels are found in the pituitary and adrenal glands.
4
Ahritis
Poliomyelities
Osteomyelities
Scurvy
Pediatrics
null
31ecfe9a-45f3-46db-802c-6bf6a560b55e
multi
Which of the following is not true in obstructive lung disease?
Ans. (b) TLC |Ref: Harrison 19th ed. / 306e-2fParameterObstructiveRestrictiveFEV1REDUCEDREDUCEDTLCNORMAL/ INCREASEDREDUCEDFVCREDUCEDREDUCEDFEV1/FVC RATIOREDUCEDNORMAL/INCREASEDRESIDUAL VOLUMEINCREASEDDECREASED
2
FEV|
TLC|
FVC|
Reduced timed vital capacity
Medicine
Chronic Obstructive Pulmonary Disease
eefe4735-a79e-4cfd-8cae-84308296fa1d
multi
Which of the following Antiepileptic acts by opening Potassium channel?
null
1
Ezogabine
Felbamate
Lacosamide
Gabapentin
Pharmacology
null
e1727ef5-d204-4767-9e02-f090639fb286
single
Normal CD4:CD8 ratio is
Ans. b (2:1) (Ref. Harrison's Principles of Internal Medicine 16th ed., 2019)CD4/CD8 Ratio# The ratio of 2:1 found in normal tissues.# In HIV infection the CD4 count is often decreased and the CD8 count increased so the ratio might 'invert', that is become less than 1.AIDS Diagnosis:* < 200 CD4 count,* HIV Positive with Aids indicator conditions (E.g., PCP),or* CD4/CD8 ratio < 1.5.# Lymphopenia predominantly due to selective loss of the CD4+ helper-inducer T-cell subset; inversion of CD4:CD8 ratio.CD4 Cell# Also known as "T4" or "helper T cell," the CD4 cell is the primary target of HIV.# It performs critical functions such as signaling other parts of the immune system to respond to an infection.# There are two main types of T-cells.- T4 cells, also called CD4+, are "helper" cells.* They lead the attack against infections.- T8 cells (CD8+) are "suppressor" cells that end the immune response.* CD8+ cells can also be "killer" cells that kill cancer cells and cells infected with a virus.# Treatment decisions are often based on viral load and CD4 count.# Normal counts range from 500 to 1500.
2
3:01
2:01
1:02
1:03
Pathology
Immunity
7d435cfd-c3c1-47eb-9db5-6ea56f801628
single
Which group of streptococcus grow at > 60degC -
Option 1, 2, 3 Heat tolerance test (60oC) is negative for Group A, B, C Streptococci. Option 4 Enterococcus is heat resistant. Enterococcus grows in presence of 6.5% NaCl, pH 9.6 and temperature >55oC which differentiate it from Group D streptococci.
4
A
B
C
D
Microbiology
Systemic Bacteriology Pa 1 (Gram Positive Cocci, Gram Negative Cocci)
2a769350-8300-4499-ae2e-9dc723aa6715
single
Which of following are associated with external oblique muscle -a) Pouparts ligamentb) Lacunar ligamentc) Superficial inguinal ringd) Conjoint tendone) Cremaster muscle
Internal oblique forms cremasteric muscle. Internal oblique and transversus abdominis form the conjoint tendon. Poupart's ligament, lacunar ligament, pectineal ligament, superficial inguinal ring, and external spermatic fascia are all formed by external oblique muscle.
2
ab
abc
acd
bcd
Anatomy
null
81f1689f-eddf-4365-96fa-863bb23a1ae7
single
IgE is secreted by -
IgE is synthesised by plasma cells. Monomers of IgE consist of two heavy chains (e chain) and two light chains, with the e chain containing 4 Ig-like constant domains Reff: Ananthanarayanan & Panikers textbook of microbiology 9th edition pg:136
4
Mast cell
Basophils
Eosinophils
Plasma cells
Microbiology
Immunology
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single
A 25 year old married male presents with infeility. He had undergone retroperitoneal lymphnode disection at age of 15 years for embryonal carcinoma of right testis. Semen analysis shows-quantity-0.5 ml, no. sperm, no fructose. Biopsy of testis shows normal spermato genesis. Best treatment here would be ?
Ans. is 'c' i.e., Microtesticular Aspiration and intra-cytoplasmic injection Absence of sperms in presence of normal spermatogenesis along with absence of fructose is suggestive of an obstruction in the ejaculatory duct (as described in previous chapter - Prostate & seminal vesicles) "Sperm aspiration techniques are indicated in men in whom the transpo of sperm is not possible because the ductal system is absent or surgically unreconstructable. Aspiration procedures can involve microsurgery to collect sperm from the sperm reservoirs within the genital tract (vas deferens, epididymis or testicle)" - Smith's Urology 17/e, p 710 Microtesticular aspiration of sperm with In Vitro Feilization can help this couple to achieve pregnancy. (Intracytoplasmic injection is a form of IVF)
3
Aificial insemination of donor
Penile-prosthesis
Microtesticular aspiration and intracyto plasmic injection
None of the above
Surgery
null
3974ae54-1b34-40d7-95bc-05618d526915
multi
The lamina propria, a layer of dense connective tissue is:
The lamina propria may attach to the periosteum of the alveolar bone , or it may overlay the submucosa.
1
Thicker in anterior than posterior part of the palate.
Thicker in posterior than anterior part of the palate.
Not found in the posterior part of the palate.
Not found in the anterior part of the palate.
Dental
null
7f775dbd-b0e1-4901-b30b-3692df793fac
single
Drug which is used in lie detection (truth serum)
Hyoscine or scopolamine and thiopentone sodium are the drugs used in lie detection .they are considered as truth serum .under CNS depression it is implied that the patient usually tells the truth Ref: Goodman Gillman 11th ed pg 231-232
3
Glycopyrrolate
Solifenacin
Hyoscine
Acetylcholine
Pharmacology
Autonomic nervous system
60956c24-8b5c-4a54-82df-9fadf05a9573
single
Test for allergic rhinitis -
Ans. is 'c' i.e.. Nasal Smear o A nasal smear can sometimes be helpful for establishing the diagnosis of allergic rhinitis.o The presence of eosinophils is consistent with allergic rhinitis.
3
CT Scan
X-ray
Nasal Smear
MRI
ENT
Nose and PNS
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multi
TRUE about normal curve is all, EXCEPT:
Normal or Gaussian distribution has the following features: Bell shaped Symmetrical about the mean Mean, mode and median coincides Ref: Medical biostatistics, 1st edition pg: 126
4
Bell shaped
Symmetrical about the mean
Mean, mode and median coincides
Value of mean is 1
Social & Preventive Medicine
null
84c1acbb-2e66-49b4-b38b-b9f7359dedfa
multi
The Ducts of Bellini are typically seen in
Inderbir Singh's Human Histology Sixth edition Pg 304 The space between renal columns constitute ducts of bellini
3
Pancreas
Liver
Kidney
Submandibular salivary gland
Anatomy
General anatomy
84166851-7abd-4243-a850-61c41c361cf2
multi
In apoptosis which is/are involved
Cytochrome c is a component of the electron transpo chain in mitochondria. ... Cytochrome c is also involved in initiation of apoptosis. Upon release ofcytochrome c to the cytoplasm, the protein bindsapoptotic protease activating factor-1 (Apaf-1).which is very impoant for cellular apoptosis Ref guyton and hall textbook of medical physiology 12/e pg 40
1
Apaf-1
Bcl2
Caspases
Programeed cell death
Physiology
General physiology
dbb6a4db-35a1-42d7-85a5-cb8246dcb910
single
Maximum pressure in left ventricle is seen in which phase of cardiac cycle ?
Ans. is 'b' i.e., Ventricular ejection During ventricular ejection phase, when the steeply rising left ventricular pressure exceeds the aoic pressure (120 mm Hg), it is able to push open the aoic valve and eject the blad into the aoa, making the onset of ventricular ejection. PHASE OF CARDIAC CYCLE A cardiac cycle refers to the interval between onset of one heabeat to the onset of the next hea beat. It has two main phases : Ventricular systole and ventricular diastole. Ventricular systole (or simply systole) The systolic phase is divided into : - i) Isovolumetric contraction : As the ventricular contraction stas, the intraventricular pressure begins to rise, leading to an abrupt closure of AV valves (mitral and tricuspid valves). The closure of AV valves produces first hea sound (S1). the pressure is not enough to push open the semilunar valves (aoic and pulmonary) but causes the closed AV valve to bulge into the atrium, causing a small but sharp rise in atrial pressure called the 'C' wave on jugular venous pulse (JVP). Because both the valves (AV valves an semilunar valves) are closed, there is no change in volume, i.e., there is isovolumetric (isometric) contraction. Isovolumetric contraction ends with opening of semilunar (aoic and pulmonary) valves. ii) Ventricular ejection : When the steeply rising ventricular pressure exceeds the pressure in aoa and pulmonary aery, the semilunar valves open and ventricular ejection begins. The ejection of blood is rapid at first (rapid ejection phase), but slows down during later pa of systole (slow ejection phase). During rapid ejection phase, when the ventricles contract, the fibrous paition separating the ventricles from the atria (the AV ring) is pulled down. As a result, the atrial muscles get stretched and the atria dilate which causes a sharp fall in atrial pressure and the X-descent in JVP. iii) Protodiastole : In this very sho phase, ventricles sta relaxing and ventricular pressure begins to fall very sharply but the semilunar valves are still open. As a result, the column of blood in aoa (or pulmonary aery for right ventricle) tries to fall into the ventricle, hitting on its way the semilunar (aoic or pulmonary) valves. This causes closure of the aoic/pulmonary valves which produces 2" hea sound (S2). The venous blood flow continues to flow in the atria from great veins (SVC and ICC) and there is relaxation of fibrous AV ring due to ventricular relaxation; both of which cause a rise in atrial pressure and production of `V' wave in JVP. Ventricular diastole (or simply diastole) The diastole phase is divided into : - i) Isovolumetric relaxation : - This phase is the period between the closure of semilunar valve and opening of the AV valve. The ventricles continue relaxing and there pressure continues to fall. However, as both valves (AV valves and semilunar valves) are closed, there is no change in volume, i.e., isovolumetric relaxation. Relaxation phase ends with opening of AV valve. ii) Rapid ventricular filling : - When the ventricular pressure falls below atrial pressure, AV valves open and the accumulated blood in the atria rushes into the ventricle very rapidly. This passive filling contributes to 70% of ventricular filling, normally. This results in a sharp fall in atrial pressure which produces Y descent in JVP. iii) Diastasis : - After the initial rapid ventricular filling, blood flows slowly and smoothly from the SVC and IVC through the right atrium into the right ventricle without any turbulence anywhere along the path. Similarly, blood from the pulmonary veins flows into the left ventricle without any turbulence. This phase of nonturbulent ventricular filling is called diastasis. The atrial pressure remains slightly greater than the ventricular pressure because inflow to atrium exceeds the outflow the atrium. iv) Last rapid filling phase (atrial systole) : - The atria contract and pump blood rapidly into the ventricles.Atrial systole is associated with sharp rise in atrial pressure which produces a-wave in JVP.
2
Isovolumetric contraction
Ventricular ejection
Protodiastole
Rapid ventricular filling
Physiology
null
66c6c3eb-83bd-499a-952a-5528d96ca0c5
single
A 4-year-old female brought to the casualty department with multiple fractured ribs, and inconspicuous history from parents. On examination show multiple bruises and healed fractures. The probable diagnosis is -
child abuse have certain characteristic features : Inflicted fractures of the shaft are more likely to be spiral rather than transverse. A classic finding is a chip fracture in which a corner of the metaphysis of a long bone is torn off with damage to epiphysis and periosteum. Bruises, Petechiae and Ecchymosis... all provide further clues to the diagnosis of child abuse. In the given patient presence of spiral fracture femur, along with varying degrees of ecchymosis is highly suggestive of Battered baby syndrome.
4
Polytrauma for evaluation
Flail chest
Munchausen syndrome
Battered baby syndrome
Orthopaedics
null
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single
Which of the following statements is TRUEregarding spermicides found in vaginal foams, creams, and suppositories?
All spermicides contain an ingredient, usually nonoxynol-9, that immobilizes or kills sperm on contact. Spermicides provide a mechanical barrier and need to be placed into the vagina before each coital act. Their effectiveness increases with increasing age of the women who use them, probably due to increased motivation. The effectiveness of spermicides is similar to that of the diaphragm, and increases with the concomitant use of condoms.
1
The active agent in these spermicides is nonoxynol-9
The active agent in these spermicides is levonorgestrel
Effectiveness is higher in younger users
Effectiveness is higher than that of the diaphragm
Gynaecology & Obstetrics
Contraceptives
53b97e98-0641-415d-84d3-4f6ae2fb1017
multi
Sickness benefit under ESI is available for a period-
Ans. is 'd' i.e., 91 days Sickness benefit under ESI* The sickness benefit is payable for a maximum period of 91 days in any continuous period of 365 days.* The daily rate is 50% of the average daily wage.* Extended sickness benefit - In this, persons suffering from certain long term diseases are entitled to Extended sickness benefit in addition to 91 days.* The extended sickness benefit is payable for 309 days.* Diseases for which extended sickness benefit is payable. (In case where the insured person has been in continuous employment for 2 years).
4
30 days
46 days
57 days
91 days
Social & Preventive Medicine
Occupational Health
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single
Negative BMR is observed with:
null
2
Pituitary disturbance
Thyroid disturbance
Parathyroid
All of the above
Physiology
null
44e59998-01ac-49cb-ad34-ec1de4985672
multi
Black piedra is caused by ?
Ans. is 'a' i.e., Piedraia hoae Piedra is an asymptomatic superficial fungal infection of the hair shaft also known as trichomycosis nodu- laris. Black piedra is caused by Piedraia hoae, whereas white piedra is caused by pathogenic species of the Trichosporon genus, namely Trichosporon asahii, Trichosporon ovoides, Trichosporon inkin, Trichosporon mucoides, Trichosporon asteroides, and Trichosporon cutaneum.
1
Piedraia hoae
Trichosporon asahi
Trichosporon ovoides
Trichosporon inkin
Skin
null
1c3d5617-2e2d-4071-b693-6a2b1d7bb1c3
single
Asepsis means -
null
1
Absence of pathogenic microbes
Disinfection of the surface
Prevention of infection
Destroying all forms of micro organism
Microbiology
null
b886dd10-e154-48e8-834f-7e87cd0e5a5c
multi
Notching of ribs occurs in all, EXCEPT:
Hypothyroidism is not associated with rib notching. Inferior rib notching is much commoner than superior notching. Causes of inferior rib notching are coarctation of aoa, tetralogy of Fallot, superior venacava obstruction, Blalock-Taussig shunt, neurofibromatosis. Causes of superior rib notching include, hyperparathyroidism, collagen vascular disease, rheumatoid ahritis, systemic lupus erythemoatosus, poliomyelitis, Marfan's syndrome, osteogenesis imperfecta. Ref: Differential Diagnosis in Conventional Radiology By Francis A. Burgener, Mati Kormano, Tomi Pudas, 2007, Page 310 ; Fundamentals of Diagnostic Radiology By William E. Brant, 2012, Page 519.
3
Coarctation of aoa
Neurofibromatosis
Hypothyroidism
Osteogenesis imperfecta
Medicine
null
22f5299b-4c33-44bb-842f-fc63393776c4
multi
Sense organ which is having efferent supply
Ans. is 'b i.e., Organ of coiAfferent (sensory) neurons carry information form sense organs to CNS (brain & spinal cord).Hair cells (in organ of coi) are the sensory recepors which are also innervated by efferent neurons.
2
Golgi tendon organ
Organ of coi
Retina
Taste bud
Physiology
null
daf0b8f9-21e9-4a81-95be-0803c77e186d
single
Local anaesthetic with prolonged action -
Ans. is 'd' i.e., Dibucaineo Dibucaine is the longest acting local anaesthetico Chlorprocaine is the shortest acting local anaesthetico Decreasing order of duration : - Dibucaine > Bupivacine = Tetracaine = Ropivacaine =Etidocaine > Prilocaine = Lignocaine = Mepivacaine = Cocaine > Procaine > Chlorprocaine.
4
Procaine
Cocaine
Lidocaine
Dibucaine
Anaesthesia
Miscellaneous (Local and Regional Anesthesia)
bfc166ab-500e-43f6-99b1-509356d54f80
single
In . sided hemithorax on chest X-ray PA view what can be excluded:
A i.e. CCF Congestive cardiac failure is a condition which presents with B/L changes in chest X RayQ - so it can be excluded by seeing U/L hemithorax on chest X Ray, if it is normal.;
1
CCF
TB
Pulmonary infarct
None of the above
Radiology
null
fecc884c-e78b-4852-b0a6-e158601b8125
multi
The response to shock includes which of the following metabolic effects?
The biochemical changes associated with shock result from tissue hypoperfusion, endocrine response to stress, and specific organ system failure. During shock, the sympathetic nervous system and adrenal medulla are stimulated to release catecholamines. Renin, angiotensin, antidiuretic hormone, adrenocorticotropin, and cortisol levels increase. Resultant changes include sodium and water retention and an increase in potassium excretion, protein catabolism, and gluconeogenesis. Potassium levels rise as a result of increased tissue release, anaerobic metabolism, and decreased renal perfusion. If renal function is maintained, potassium excretion is high and normal plasma potassium levels are restored.
4
Increase in sodium and water excretion
Increase in renal perfusion
Decrease in cortisol levels
Hyperkalemia
Surgery
Trauma
c4d6fa3b-a648-4c82-9e87-3c2aa24ea876
single
Leukemoid reaction is seen in:
Acute infection Persistent neutrophilia of 30,000-50,000 cells/ul, or greater is known as leukemoid reaction. It is a term used to distinguish this degree of neutrophilia from leukemia. In a leukemoid reaction, the circulating neutrophils are mature and not cion ally derived. leukemoid reaction is seen in ACUTE INFECTIONS in children.
1
Acute infection
Erythroleukemia
Myelomatosis
Hemorrhage
Surgery
null
0a631a65-b2a8-417e-9fa8-25cbb3cea67f
single
Intracellular calcification begins in which of the following organelles?
Calcium may be deposited at sites of cell death, resulting in pathologic calcification. Initiation of intracellular calcification occurs in the mitochondria of dead or dying cells that accumulate calcium.
1
Mitochondria
Golgi body
Lysosomes
Nucleus
Pathology
Reversible Cell Injury
3dce9767-584e-490a-bcd7-1267ab5bed72
single
Popkorn cells are found in
null
1
Hodgkins Lymphoma
Non Hodgekins lymphoma
Multiple myeloma
Iron deficiency anaemia
Pathology
null
26fdaad3-3f6d-444e-aa1c-2e4f526f15e0
single
Vasodilators in Meniers disease are useful because they:
Ans: c (Increase endolymph reabsorption)Ref: Dhingra E.N.T. 3rd/e p. 129 & 2nd/e p. 103One of the etiological factors for menier's disease is poor vascularity & poor absorption. Vasodilators improve vascularity and therby absorption.
3
Dilate tympanic vessels
Decrease endolymph secretion
Increase endo lymph reabsorption
Area of no use
ENT
Menier's Disease
d5a9e83b-dc17-46a3-9383-a9ead8de1d6c
single
Froments test is used in
Froment's sign: the patient is asked to grip a card firmly between thumbs and index fingers; normally this is done using the thumb adductors while the interphalangeal joint is held extended. In patients with ulnar nerve injury or palsy, because the adductor pollicis is weak, the patient grips the card only by acutely flexing the interphalangeal joint of the thumb using flexor pollicis longus which is supplied by the median nerve.(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 519)
1
Ulnar nerve injury
Median nerve injury
Radial nerve injury
Axillary nerve injury
Orthopaedics
All India exam
33c88d4c-cc2e-4015-b07c-fb27af811f00
single
Which of the following is a primary skin lesion?
Ans. C. Purpura* Purpura is a primary skin lesion.* Purpura is a condition of red-or purple-discolored spots on the skin that do not blanch on applying pressure. The spots are caused by bleeding underneath the skin usually secondary to vasculitis or dietary deficiency of vitamin C.Other Options:Option a: Crusts (scabs): Crusts consist of dried serum and other exudates.Option b: Atrophy* Loss of tissue from one or more of the epidermis, dermis or subcutaneous tissues.* There may be fine wrinkling and increased translucency if the process is superficial.Option d: Induration: Dermal thickening that clinically presents as skin that feels thicker and firmer on palpation than normal.Primary Lesions of SkinPrimary lesions of the skin include:* Papule* Plaque* Wheal* Vesicle* Bulla* Nodule* Macule* Patch* Purpura* PustuleFor mnemonic lovers, the following mnemonic might help!"Predatory Poisonous Wasps Viciously Bit on the Nose of My Patient causing Purulent Pus"
3
Crust
Atrophy
Purpura
Induration
Skin
Miscellaneous
413ebe85-1aca-40c2-a89f-8e6d69b883b9
single
Germ cells appear in yolk sac at :
As early as the third week of gestation, primordial germ cells appear in the endoderm of yolk sac, and these migrate along the dorsal mesentry to the urogenital ridge by the eighth week Reference: Shaw's textbook of Gynaecology 15th edition page 27
1
3 weeks
6 weeks
9 weeks
5 weeks
Gynaecology & Obstetrics
General obstetrics
da681051-eee3-46a2-b7b3-b9bdae16e717
single
Which of the following inhalational anaesthetic agent can cause hepatitis on repeated use?
Halothane causes hepatitis .It can also cause arrhythmia by making adrenaline more adrenogenic, i.e , Adrenaline Shows more adrenogenic action when halothane is used. Hence it should not be used in conditions where adrenaline is high ,i.e, pheochromocytoma
1
Halothane
Isoflurane
Sevoflurane
Ether
Pharmacology
FMGE 2019
8615e8c6-d60b-4404-95b5-6cb18395796f
single
Which of the following organism is biggest -
largest protozoal parasite of human Lives in large intestine Two stages- trophozoite and cyst (refer pgno:82 baveja 3 rd edition )
1
Balantidium coli
Entamoeba coli
Escherichia coli
Entamoeba histolytica
Microbiology
parasitology
58e52b30-980e-4ffe-b626-52efb255ed4d
single
All of the following are seen in the Horner’s syndrome, except :
null
3
Drooping of upper eyelid
Enophthalmos
Dilated pupil
Loss of sweating of same sides of face
Unknown
null
dbaa874e-c58b-4801-94c9-4126a558ef90
multi
NOT of use in bipolar disorder: September 2012
B i.e. Phenytoin Phenytoin It acts to suppress the abnormal brain activity seen in seizure by reducing electrical conductance among brain cells by stabilizing the inactive state of voltage-gated sodium channels. Aside from seizures, it is an option in the treatment of trigeminal neuralgia in the event that carbamazepine or other first-line treatment seems inappropriate. It is sometimes considered a class lb antiarrhythmic.
2
Carbamazepine
Phenytoin
Sodium valproate
Lamotrigine
Pharmacology
null
00e8a051-7cc4-48f9-9e04-ea20af4ecb35
single
An unstable and emotional temporary social group with a leader is known as –
Crowd and mob are related terms. Crowd means a large number of persons gathered together. A crowd can be a crowd of random people doing different things or it may be people with one intent or purpose. Mob is highly emotional crowd whose members have with one intent or purpose and are engaged in or are ready to engage in, violence against specific target: a person, a category of people or physical property.
4
A band
A crowd
A herd
A mob
Social & Preventive Medicine
null
c7b3b5b4-75eb-466c-9dce-673365965955
single
Horse shoe kidney lies below the level of:
Inferior mesenteric aery
3
Coeliac trunk
Superior mesenteric aery
Inferior mesenteric aery
Median sacral aery
Anatomy
null
75d0000b-236f-41a9-aba3-8392f1a4448e
single
Berkesonian bias is a selection bias which occurs in?
Ans. is 'b' i.e., Hospital-based studies
2
Community-based studies
Hospital-based studies
Laboratory-based studies
Natural exposure studies
Social & Preventive Medicine
null
610fe6bb-5934-48c4-80c7-5cc59f011780
single
A case-control study is conducted to assess the relationship between poor diet and coronary artery disease. They enroll cases from cardiac floors in hospitals and controls from primary care physician offices in a single metropolitan area, Diet for the past 10 years was recorded using an in-person interview. On average, the dietary interview with cases lasted 30 minutes longer than the interview with controls. In addition, the information collected from cases was much more detailed. Which of the following type of bias most likely occurred?
null
3
Berkson’s bias
Loss to follow-up
Observer bias
Recall bias
Social & Preventive Medicine
null
e8a59d75-6f7a-4df1-ae1e-454f8df1a4b4
multi
How to avoid lipodystrophy in diabetics?
By changing the injection site every day, the incidence of lipodystrophy can be reduced significantly. Ref: KD Tripathi 8th ed.
2
Avoid insulin injection
Change injection sites
Give injection on same site
Give injection on alternate days
Pharmacology
Endocrinology
64566e03-e83f-48fd-adda-ada1cb56c288
single
Which one of the following is a distinguishing feature of Edward's syndrome-
Ans. is 'd' i.e., Rocker bottom feet
4
Hypotonia
Hypotelorism
Holoprosencephaly
Rocker bottom feet
Pediatrics
null
c0698704-f7cc-47ea-9e5d-223e1daef6f3
single
Which is not an antiviral drug:
dRef: KDT, 5th ed, p. 725, 783, 770 & 4th ed, p. 781
4
Vidarbine
Acyclovir
Zidovudine
Mitomycin
Pharmacology
Anti Microbial
e680ed3b-80ae-40d1-869e-6dd5bc6c7a1d
single
True about varicella vaccine is ?
Ans. is 'c' i.e., Avoid salicylates for 4-6 weeks A live attenuated varicella virus vaccine is safe and currently recommended between 12-18 months of age who have not had chicken pox.The vaccine is very immunogenic, sero-conversion occurs in 95% of children after a single dose.A duration of immunity is not known, but is probably 10 years.
3
Poorly immunogenic
Duration 4-6 months
Avoid salicylates for 4-6 weeks
Given to child< 12 months when they do not have chicken pox
Social & Preventive Medicine
null
57f326c2-5f05-427e-9153-8c2c7147fd55
multi
For every case of poliomyelitis the subclinical cases of poliomyelitis to be estimated
null
3
500 children and 50 adults
750 children and 75 adults
1000 children and 75 adults
1000 children and 50 adult
Social & Preventive Medicine
null
c3b948a2-a28d-4a91-a18f-724bb9519b66
single
A young lady presents to your office with complain of copious vaginal discharge, but there is no cervical discharge on per speculum examination. Which of the following should be given for the management
Ans.'a'Metronidazole and fluconazole
1
Metronidazole and fluconazole
Metronidazole and azithromycin
Metronidazole and doxycycline
Fluconazole only
Gynaecology & Obstetrics
null
9957b17f-6ab6-4b25-8309-cd9fb1c616c0
single
Development of hepatic central lobular necrosis secondary to acetaminophen overdose can be prevented effectively by which of the following if given within a few hours after ingestion :
null
1
N–acetylcysteine
Dimercaprol
Sodium nitrite
Amyl nitrite
Pharmacology
null
a66b563f-a396-49c9-b25b-fa97bffe2b50
single
A 50 year old male patient complains of reduced mouth opening. Patient gives h/o RTA 1 week back. Submentovertex view x-ray was taken which revealed zygomatic arch fracture. Which of the following is true regarding the central beam in this x-ray-
Submentovertex view- The central beam is perpendicular to the image receptor, directed from below the mandible toward the vertex of the skull (hence the name submentovertex), and centered about 2 cm anterior to a line  connecting the right and left condyles. White and Pharoah, Oral radiology, ed 7th, pg-161
3
It is parallel to the image receptor
It is directed from skull to the mandible
It is centered about 2 cm anterior to a line connecting the right and left condyles
It is posterior to a line connecting the right and left coronoid process
Radiology
null
a750d39a-844c-4fc6-9253-9e6d171a80c4
multi
A 3 week old boy is brought to pediatrics emergency depament with projectile vomiting which is non bilious. On physical examination, firm, olive like mass is noted in the epigastric region post breastfeed and USG revealed thickened pyloric muscle. What is the most likely pathological finding if the pylorus muscle is biopsied?
The clinical symptoms, examination with USG findings of thickened pyloric muscle (>3mm) and elongated pyloric canal (>15mm) reveal the diagnosis as CHPS- congenital hyperophic pyloric stenosis which has hyperophy of circular muscle as depicted in option A Hyperophy-Small spindle-shaped (uterine smooth muscle cells) from a normal uterus, compared with large plump cells (the gravid uterus), at the same magnification.A Normal kidney tubules with Early (reversible) ischemic injury showing surface blebs, increased eosinophilia of cytoplasm, and swelling of few cells. Atrophy-Normal brain parenchyma of a young adult compared with Atrophy of the brain. Note made is of loss of brain substance that narrows the gyri and widens the sulci. Apoptosis- The shown cell is reduced in size, contains brightly eosinophilic cytoplasm and a condensed nucleus.
1
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<img style="max-width: 100%" src=" />
<img style="max-width: 100%" src=" />
<img style="max-width: 100%" src=" />
Unknown
Integrated QBank
a28d8d30-2766-445e-8c51-672337d6e6f0
single
Which of the following is NOT a constituent of Virchow's triad?
null
4
Damage to endothelium due to injury or inflammation
Diminished rate of blood flow
Increased coagulability of blood
Increased venous blood pressure
Pathology
null
848a156f-a358-4028-a5a9-dc5e6ddf252f
single
When assessing tooth mobility the best indicator is
null
3
Condition of gingival periodontal fibers
Horizontal crown displacement
Root displacement within the remaining periodontal ligament
Amount of calculus and plaque present
Dental
null
7034b11d-1407-4c4d-a666-c137f06fadb3
single
Recall bias is most commonly associated with which study design-
.<p>1`when cases and controls are asked questions about their past history,it may be more likely for the cases to recall the existence of ceain events or factors,than the controls who are healthy individuals.cases may have a different recall of past events than controls.</p><p>ref;park&;s textbook of preventive and social medicine,22 nd edition,pg no 71</p>
1
Case control study
Coho study
Coho case control study
Cross sectional study
Social & Preventive Medicine
Epidemiology
3838d8e2-4653-45c6-a638-b5b4ab8286d7
multi
In aluminum phosphide poisoning, which is NOT true: AIIMS 10; Punjab 11
Ans. Accumulation of acetylcholine at NM junction
1
Accumulation of acetylcholine at NM junction
Cytochrome oxidase inhibition
Phosphene formation
Metabolic acidosis
Forensic Medicine
null
14867ac3-30ed-419e-8441-885184977594
multi
To prevent synechiae formation after nasal surgery, which one of the following packings is the most useful -
Now, Mitomycin is being increasingly used for this purpose and is proving more useful. Mitomycin is an anticancer agent that has shown to decrease scar formation after E.N.T. surgery. It is an anti fibroblastic agent and thus prevents the wound healing and subsequent synechiae formation. It is useful in preventing synechiae formation in following operations :- DCR Sinus surgery
1
Mitomycin
Ribbon gauze
Ribbon gauze with liquid paraffin
Ribbon gauze steroids
ENT
null
6ec5028e-43b6-4f77-975b-737123f541f0
single
A 75-year-old male patient is a known case of a pulmonary disease and is being treated with inhalational coicosteroids and daily theophylline.The patient was admitted to a hospital for urinary retention few days back and catheterization was done. However, the condition got complicated with urinary tract infection and the patient was put on an antibiotic for the same. Now the patient is presenting with symptoms such as nausea, vomiting, abdominal pain, headache and a fine hand tremor. The patient also appears to have tachycardia. According to the doctor, the symptoms may be due to increased serum levels of the drugs taken by the patient. Which of the following drug may be responsible for the patient's condition?
Theophylline is metabolized mainly by CYP1A2 hepatic microsomal enzyme. Inhibitors of CYP1A2: Cimetidine Ciprofloxacin Erythromycin Others are: - Aemisinin Atazanavir Enoxacin Ethinyl estradiol Fluvoxamine Furafylline Galangin Mexiletene Tacrine Thiabendazole Zileuton All these drugs inhibit the metabolism of theophylline and therefore may result in its toxicity. Nausea is a common side effect; tachycardia and tremors are also seen. Monitoring of blood theophylline levels is required to minimize toxicity.
4
Amoxicillin
Ceftriaxone
Nitrofurantoin
Ciprofloxacin
Unknown
Integrated QBank
bb2da234-b6f2-4782-9156-99c748cf4b6e
single
Safety muscle of tongue is
null
2
Hyoglossus
Genioglossus
Palatoglossus
Styloglossus
Anatomy
null
58769b68-42c5-4c1f-90a8-772411ea8c38
single
Most common cause of death in measles ?
Answer- D. PneumoniaMost commot cause of death in measles is pneumonia
4
Encephalitis
Meningitis
Dehydration
Pneumonia
Medicine
null
6d379f1c-8d18-4de6-b19b-867c27c4a9b6
single
Earliest symptom of Congenital Glaucoma
Earliest but nonspecific symptom of Congenital Glaucoma is photophobia
3
Lacrimation
Blepharospasm
photophobia
Diminision of vision
Ophthalmology
null
d241fa04-6033-4ffa-8aa0-999355e09d91
single
Pathognomic features of acute rheumatic fever is -
null
4
Pericarditis
Myocarditis
Mitral stenosis
Aschoffs nodules
Pathology
null
ba8ae3c4-e7ea-4c99-9e79-589c6040cb73
single
Etomidate causes all except ?
Ans. is 'a' i.e., Coronary insufficiency Etomidate produces little cardiovascular and respiratory depression --> Agent of choice for cardiovascular surgeries (bypass, aneurysms, valve surgery). Etomidate is the most cardiostable inducing agent. Etomidate has the highest incidence of nausea and vomiting amonst inducing agents 30%-40%. It can produce hiccups and myoclonus. Superficial thrombophlebitis and pain on injection may occur --> Pain can be reduced by using larger vein and injecting lidocaine just before etomidate.
1
Coronary insufficiency
Decreased steroid
Decreases Intracranial tension
Nausea and vomiting
Pharmacology
null
6ea2350a-1c7f-4b28-88a3-20f5e425ddd2
multi
Ranolazine is a?
ANSWER: (B) AntianginalREF: KDT 6th edition page 522, 536, Katzung 12th edition page 205CLASSIFICATION OF ANTIANGINAL DRUGSNitrates:Short acting: Glyceryl trinitrate (GTN, Nitroglycerine)Long acting: Isosorbide dinitrate (short acting by sublingual route), Isosorbide mononitrate, Erythrityl tetranitrate, Pentaerythritol tetranitrateBeta Blockers; Propranolol, Metoprolol, Atenolol and others.Calcium channel blockers:Phenyl alkylamine: verapamilBenzothiazepin: DiltiazemDihydropyridines: Nifedipine, Felodipine, Amlodipine, Nitrendipine, Nimoil, Lacidipine, Lercanidipine, BenidipinePotassium channel openers; Nicorandi-Others; Dipyridamole,'Tiimetazidine, Ranolazine, OxyphednneRANOLAZINE This recently developed trimetazidine congener LC3-KAT inhibitor is a metabolic modifier approved by US-FDA in 2006 for treatment of chronic angina pectoris in patients who fail to respond to standard antianginal therapy. Approved for chronic angina (KDT 6th edition), Prophylaxis of angina (Katzung) with combination therapyMechanism of action: Ranalozone act by shifting fatty acid oxidation to carbhohydarate oxidation. By reducing late sodium current in myocardium which facilitates Calcium entry. This reduced calcium entry during ischemia provides cardioprotective action.Pharmacokinetics: Orally absorbed, Bioavailablity 30-50%Side effects: Weakness, postural hypotension, Prolongation QT interval, torsades de pointes.
2
Vasodilator
Antianginal
Antihypertensive
Antiarrhythmia
Pharmacology
Anti-Anginal
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Which of the following hypothesis was initially given for etiology of schizophrenia?
Ans. B. Dopamine hypothesisThe dopamine hypothesis of schizophrenia or the dopamine hypothesis of psychosis is a model attributing symptoms of schizophrenia (like psychoses) to a disturbed and hyperactive dopaminergic signal transduction. The model draws evidence from the observation that a large number of antipsychotics have dopamine-receptor antagonistic effects. The theory, however, does not posit dopamine overabundance as a complete explanation for schizophrenia. Rather, the over activation of D2 receptors, specifically, is one effect of the global chemical synaptic dysregulation observed in this disorder.Some researchers have suggested that dopamine systems in the mesolimbic pathway may contribute to the 'positive symptoms' of schizophrenia (whereas problems with dopamine function in themes cortical pathway may be responsible for the 'negative symptoms', such as avolition and alogia.) Abnormal expression, thus distribution of the D2 receptor between these areas and the rest of the brain may also be implicated in schizophrenia, specifically in the acute phase. A relative excess of these receptors within the limbic system means Broca's area which can produce illogical language, has an abnormal connection to Wernicke's area, which comprehends language, but does not create it. Note that variation in distribution is observed within individuals, so abnormalities of this characteristic likely play a significant role in all psychological illnesses. Individual alterations are produced by differences within glutamatergic pathways within the limbic system, which are also implicated in other psychotic syndromes. Among the alterations of both synaptic and global structure, the most significant abnormalities are observed in the uncinate fasciculus and the cingulate cortex. The combination these creates a profound dissymmetry of prefrontal inhibitory signaling, shifted positively towards the dominant side. Eventually, the cingulate gyrus becomes atrophied towards the anterior, due to long-Term Depression (LTD) and Long-Term Potentiation (LTP) from the abnormally strong signals transversely across the brain. This, combined with a relative deficit in GABAergic input to Wernicke's area, shifts the balance of bilateral communication across the corpus callosum posteriorly.
2
Serotonin Hypothesis
Dopamine hypothesis
Learned helplessness
Cognitive theory
Psychiatry
Schizophrenia
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Following a motor vehicle accident, a truck driver complains of severe abdominal pain. Serum amylase level is markedly increased to 800 U. Grey Turner's sign is seen in the flanks. Pancreatic trauma is suspected. Which statement is true of pancreatic trauma?
Because of its protected retroperitoneal location, pancreatic injury occurs with deep penetrating wounds or with significant blunt trauma to upper abdomen. Blunt trauma accounts for less than 20-30% of all pancreatic injuries. The most common site of injury is at the neck of the pancreas where the pancreatic tissue is compressed against the spine. Associated visceral and vascular injuries occur commonly and together with the delay in diagnosis account for the high morbidity and mortality. Fistulae, pseudocyst, infection, and secondary (delayed) hemorrhage are common complications. Pancreatic injuries frequently are overlooked initially, and their detection requires a high index of suspicion. Elevation of amylase after trauma is nonspecific.
4
It is mainly caused by blunt injuries.
It is usually an isolated single-organ injury.
It often requires a total pancreatectomy.
It may easily be overlooked at operation.
Surgery
Pancreas
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Incisura is absent in ?
The occurrence and magnitude of the incisura of the central aoic pressure were shown in 66 patients to depend on the functional state of the aoic valve. In normal subjects and children with congenital aoic stenosis (with thin flexible leaflets), the incisura ranged between 6 and 14 mm Hg. With aoic regurgitation, the incisura diminished as the severity of regurgitation increased. With calcific aoic stenosis, the incisura was smaller or absent. These observations imply a valve mechanism productive of the incisura. In vitro studies of human aoic valves confirmed these observations. Additional in vitro studies with high speed cinematography (2,000 frames/sec) of a stented normal porcine valve also showed that early diastolic stretch and recoil of the leaflets occurs. These results indicate that in the presence of a normal or diseased aoic valve the aoic incisura is produced primarily by valve distension or recoil, respectively. Distension and rebound of the aoic walls do not appear to contribute significantly in the presence of a normal or a diseased valve. Because acquired aoic valve disease affects the magnitude of the central aoic incisura, inspection of the incisura may be of ancillary valve in evaluating the pathologic state of the aoic valve. Ref Davidson 23rd edition pg 431
2
Aoic valve replacement
Aoic stenosis
Cardiac tamponade
Hypovolumic shock
Medicine
C.V.S
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Concerning the gastrointestinal (GI) tract during pregnancy, which of the following is true?
Heaburn (pyrosis) is the feeling of substernal burning, often radiating to the neck. It is caused by the reflux of acidic (or, rarely, alkaline) material into the esophagus, it is highly specific for gastroesophageal reflux disease. Epulis: A pyogenic granuloma is a common, benign proliferation of connective tissue in response to local trauma or irritation. It occurs primarily on the gingiva. A specific pyogenic granuloma occurring in pregnancy is referred to as a pregnancy tumor. This tumor is benign and usually recurs if removed during pregnancy. If the tumor does not regress 2 to 3 months postpaum, definitive removal is indicated. Ref: Beaudreau R.W. (2011). Chapter 240. Oral and Dental Emergencies. In J.E. Tintinalli, J.S. Stapczynski, D.M. Cline, O.J. Ma, R.K. Cydulka, G.D. Meckler (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e.
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Gastric emptying time is increased in each trimester
Epulis is a systemic highly vascular swelling of mucosal membranes
Gastric emptying time is shoened during labor
Pyrosis is caused by reflux of acidic secretions into the lower esophagus
Gynaecology & Obstetrics
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Which of the following is positive in Follicular lymphoma?
Follicular lymphoma likely arises from germinal center B cells and is strongly associated with chromosomal translocations involving BCL2. Its hallmark is a (14;18) translocation that juxtaposes the IGH locus on chromosome 14 and the BCL2 locus on chromosome 18. The t(14;18) is seen in up to 90% of follicular lymphomas, and leads to overexpression of BCL2. BCL2 antagonizes apoptosis and promotes the survival of follicular lymphoma cells. Notably, while normal germinal centers contain numerous B cells undergoing apoptosis, follicular lymphoma is characteristically devoid of apoptotic cells. BCL 10 : associated with extra nodal marginal zone lymphoma The t(14;18)(q32;q21) and t(1;14) (p22;q32) translocations cause increased expression of intact MALT1 and BCL-10 protein respectively. This translocation is associated with gastric MALToma. Each of the three translocations has the same net effect, the constitutive activation of NF-kB, a transcription factor that promotes B-cell growth and survival. Antigen dependent activation of NF-kB in normal B and T cells. requires both BCL-10 and MLT, which work together in a pathway downstream of the B- and T-cell antigen receptors. Thus, H. pylori-induced inflammation may trigger NF-kB activation through the MLT/BCL-10 pathway in MALTomas that lack these translocations. Removal of this stimulus may explain why these tumors tend to respond to H. pylori eradication. In contrast, NF-kB is constitutively active in tumors bearing translocations involving MLT or BCL10, and H. pylori treatment is ineffective. BCL 6 : associated with diffuse large b cell lymphoma(DLBCL). DLBCL is most common subtype of non Hodgkin lymphoma globally. BCL 1 : also called cyclin D1 and is associated with Mantle Cell Lymphoma
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Bcl 2
Bcl 6
Bcl 1
Bcl 10
Pathology
NEET 2019
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Acute hemorrhagic conjunctivitis is seen with -
Hemorrhagic conjunctivitis is caused by picornaviruses (Enterovirus-70, coxsackievirus A24) and sometimes Adenovirus type11. Ref: Duker 2nd/e p.229
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Adenovirus
Staphylococcal
Pneumococcus
Hemophilus
Ophthalmology
Conjunctiva
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Risk of scar rupture in previous LSCS with lower segment scar is -
Ans. is 'a'i.e., 1% o The risk of lower segment scar - rupture is low (0[?]2-1[?]5%) and even if it does occur, maternal death is much less and the perinatal mortality is about 1 in 8.o Previous history of classical caesarean section or hysterotomy makes the woman vulnerable to unpredictable rupture of the uterus. This may occur either late during pregnancy or during labour and when it does, the maternal mortality is to the extent of 5% and the perinatal mortality to 75%.
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1%
5%
10%
50%
Gynaecology & Obstetrics
Caesarean Section
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A surgeon excises a portion of liver of the left of the attachment of the falciform ligament. The segments that have been resected are -
The portion of liver on the left side of falciform ligament is left (anatomical) lobe of liver. And in Couinaud's functional segmentation of liver, the segment number 2, 3, 4a and 4b form the left liver lobe.
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Segment la and 4
Segment 1 and 4b
Segment 2 and 3
Segment 1 and 3
Anatomy
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Urea is synthesized in all except
The ammonia from all over the body thus reaches liver.It is then detoxified to urea by liver cells, and then excreted thougth kidneys. Urea is the end product of protein metabolism. Since mammals including humanbeings excrete amino nitrogen mainly as urea , they are referred to as ureotolic.Although , ammonia is toxic and has to be immediately detoxified, in kidney cells, ammonia generated on purposefrom glutamine with the help of glutaminase. REF:DM VASUDEVAN TEXTBOOK ;7th EDITION ;Page no:203
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Liver
Kidney
Brain
Spleen
Biochemistry
Metabolism of nucleic acids
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Epsilon aminocaproic acid (EACA) can be used in the treatment of adverse effects caused by :
null
1
Streptokinase
Heparin
Warfarin
Any of the above
Pharmacology
null
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Which of the following is not a parameter for the WHO classification of malnutrition:
Weight-for-age is not a parameter for the WHO classification of malnutrition. It has limited clinical significance as it does not differentiate between wasting and stunting. WHO Classification Parameter Moderate malnutrition Severe malnutrition Symmetrical edema no yes Weight/height (wasting) <-2SD to >-3SD (70 to 79% of expected) <-3SD (<70%) Height/age (Stunting) <-2SD to > -3SD (85 ot 89%) < -3SD (<85%) Ref: Nelson textbook of pediatrics 21st edition Chapter 57
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Symmetrical edema
Weight for height
Weight for age
Height for age
Pediatrics
Nutrition
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Popliteal aneurysm-All are true except-
• Occur in conjunction with aortic aneurysm in 40% cases • Most isolated iliac aneurysm involve common iliac artery (70%) and internal iliac artery (20%) • Multiple iliac aneurysms occur in most patients and are bilateral in 33% cases Etiology • Occur in association with atherosclerosis • Can also occur in pregnancy in absence of atherosclerosis as well as in Marfan and Ehlers-Danlos syndromes, Kawasaki disease, Takayasu’s arteritis, cystic medial necrosis and arterial dissection Clinical Features • More common in males, right and left sides are equally involved • Symptoms are caused by compression of adjacent pelvic structures (bladder, colon, ureter, rectum, lumbosacral nerves and pelvic vein) • Most common iliac aneurysms can be palpated on abdominal exam whereas internal iliac artery aneurysm are more readily palpated on rectal examination Treatment • Operative mortality rate in patients with ruptured iliac aneurysm is 40%. • Iliac aneurysms >3.5 cm are repaired if possible. Minimum Size for Surgery (AIPF: All India Police Force) Abdominal Aortic Aneurysm (5.5 cm) = Iliac aneurysm (3.5 cm) + Popliteal/Femoral aneurysm (2.0 cm)
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Presents as a swelling behind the knee
Presents with symptoms due to complication
Surgery is indicated in case of complication
Uncommon among peripheral aneurysm
Surgery
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Metabolic Syndrome has following features except
The metabolic syndrome (syndrome X, insulin resistance syndrome) consists of a constellation of metabolic abnormalities that confer increased risk of cardiovascular disease (CVD) and diabetes mellitusThe major features of the metabolic syndrome include central obesity, hyperiglyceridemia, low levels of high-density lipoprotein (HDL) cholesterol, hyperglycemia, and hypeensionRef: Harrison; 19th ed; Pg 2449
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High triglycerides
High blood pressure
High blood sugar
High HDL levels
Social & Preventive Medicine
Non communicable diseases
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