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Flourosis develops when water fluoride content is above 15mg/lit but it has been observed after different studies that this flourosis can also develop in people whose staple diet is
| null | 3
|
Wheat
|
Rice
|
Jowar
|
Bajra
|
Social & Preventive Medicine
| null |
65dcf10b-180b-48ea-b792-9c4f7527ae79
|
multi
|
Associated with surveillance are all of the following except: September 2007
|
Ans. B: Randomisation Disease surveillance is an epidemiological practice by which the spread of disease is monitored in order to establish patterns of progression. The main role of disease surveillance is to predict, observe, and minimize the harm caused by outbreak, epidemic, and pandemic situations, as well as increase our knowledge as to what factors might contribute to such circumstances. A key pa of modern disease surveillance is the practice of disease case repoing. The main objectives of surveillance are: To provide information about new and changing trends in the health status of population To provide feedback which may be expected to modify the policy Provide timely warning of the public health disasters so that timely interventions can be mobilized. Sentinel surveillance is a method for identifying all the missing cases and thereby supplementing the notified cases.
| 2
|
Sentinel search
|
Randomisation
|
Information regarding trends of health status of population
|
Providing timely warnings of public health disasters
|
Social & Preventive Medicine
| null |
72126bfa-c1ea-4c2b-9f58-448e87585ee1
|
multi
|
True about C.S.F. finding in pyogenic meningitis is -
| null | 1
|
Protein ↑ sugar ↓
|
Protein ↓ sugar ↑
|
Chloride ↑ protein↓
|
↓ Protein ↓ chloride
|
Medicine
| null |
395e3a21-0284-4a77-a23d-9d0157e17cd9
|
multi
|
Conditions associated with an increased risk of squamous cell carcinoma of the oesophagus include all of the following except -
|
Barret's esophagus predisposes to adenocarcinoma.
| 1
|
Barrett's Oesophagus
|
Achalasia cardia
|
Smoking
|
Tylosis
|
Pathology
| null |
03f90938-4314-4d45-a40c-b464a9aacb9e
|
multi
|
Osteoporosis is seen in -
|
Osteoporosis It refers to reduction ofbone mass per unit volume (loss of matrix and defective mineralisation) (Fig. 9.47). Aetiology 1.Involutional 2.Endocrinological 3.Gastrointestinal 4.Haematological 5.Rheumatological 6.Collagen vascular Normal bone Type I (postmenopausal) and Type II (senile) Hypehyroidism Hyperparathyroidism Diabetes mellitus Hypogonadism Cushing's syndrome Malnutrition Malabsorption Anorexia nervosa Multiple myeloma Mastocytosis Rheumatoid ahritis Marfan's syndrome Ehler-Danlos syndrome Osteogenesis imperfecta Osteoporosis Fig. 9.47 Anticonvulsants Steroids Vitamin A Alcohol Heparin Furosemide Thyroid hormone in excessive doses Lithium GnRH agonist Cyclosporin Cytotoxic drugs 8.Cigarette smoking 9.Glucocoicoid therapy 10.Hypogonadism 11.Alcoholism 12.Renal disease 13.GI/Hepatic disorders. Bone forming agents a.Fluoride--75 mg/day b.Anabolic steroids: Testosterone is used in the treatment of osteoporotic man with gonadal deficiency. R ALAGAPPAN MANUAL OF PRACTICAL MEDICINE FOUH EDITION PAGE NO-690
| 4
|
Thyrotoxicosis
|
Cushmg's disease
|
Menopause
|
All of the above
|
Medicine
|
Endocrinology
|
2cd8f58f-8c19-4ac1-93eb-9400d0d970d2
|
multi
|
The direct filling gold segments can be compacted:
|
The gold segments can be compacted by hand pressure alone, by hand pressure combined with a hand mallet, or by a mechanical device that is activated by a spring, pneumatic pressure, or electronically (using an electromallet).
The direction of force application, the amount of applied pressure, and the compaction pattern are critically important factors controlling the quality of the gold restoration.
Ref:Phillip’s Science of Dental Materials ed 12 pg 414
| 4
|
By hand pressure alone
|
By hand pressure combined with a hand mallet
|
By using electromallet
|
All of the above
|
Dental
| null |
7ab7cd04-bff6-4ce9-a2b2-8a9c5fbfa4b4
|
multi
|
Acceptable noise levels in bed room
|
Acceptable noise levels Expressed in dB (A), sound pressure levels conforming to weighting curve (A) Environment Place Acceptable noise level dB(A) Residential Bed room 25 Living room 40 Commercial Office 35-45 Conference 40-45 Restaurants 40-45 Industrial Work shop 40-60 Laboratory 40-50 Educational Class room 30-40 Library 35-40 Hospitals Wards 20-35 Ref: Park 25th edition Pgno : 779
| 4
|
40dB
|
35dB
|
20dB
|
25dB
|
Social & Preventive Medicine
|
Environment and health
|
5f0259bf-60fb-4e72-bcc5-c6ade1450ca2
|
single
|
All are causes of hypervolemic hyponatremia except
|
Causes of hypervolemic hyponatremia Urine sodium concentration >20 mmol/L Acute or chronic renal failure Urine sodium concentration <20 mmol/L Nephrotic syndrome Cirrhosis Cardiac failure Causes of Euvolemic hyponatremia Glucocoicoid deficiency Hypothyroidism Stress Drugs Syndrome of inappropriate antidiuretic hormone secretion Ref: Harrison 19e pg: 299
| 1
|
Hypothyroidism
|
Cirrhosis
|
Chronic renal failure
|
Nephrotic syndrome
|
Medicine
|
Fluid and electrolytes
|
60c6fbdf-5c20-4b26-84ff-20bd6a763c0d
|
multi
|
A diabetic patient developed cellulitis due to Staphylococcus aureus, which was found to be Methicillin resistant on the antibiotic sensitivity testing. All the following antibiotics will be appropriate except:
| null | 2
|
Vancomycin
|
Imipenem
|
Teicoplanin
|
Linezolid
|
Pharmacology
| null |
dd18aa21-d143-4473-9bf9-65f67be5534e
|
multi
|
Alcaftadine trial used this concentration of drug:
|
* ALCAFTADINE is a H1 receptor antagonist, and can be used for allergic conjunctivitis* The trial done for alcaftadine used 0.25% solution.* The trial states: "When Alcaftadine was tested against placebo and olopatadine, only Alcaftadine 0.25% was shown to have a clinically significant reduction in conjunctival redness scores 7 and 15 minutes after administration'
| 3
|
5%
|
1%
|
0.25%
|
2.50%
|
Pharmacology
|
Endocrinology
|
ffeaeb27-74d4-417b-9262-36f9602bccd9
|
single
|
Which chromosome is responsible for the production of MIF?
|
Ref. Robbins Pathology. 9th edition. Page. 148
Anti-Mullerian Hormone (AMH) / Mullerian Inhibiting Factor (MIF); Mullerian-inhibiting Hormone (MIH) / Mullerian-inhibiting Substance (MIS).
AMH - Downstream genes regulated by SRY pathway
SRY - Gene in “Sex determining region” - short arm of Y chromosome - Testis determining factor.
| 4
|
Chromosome 16
|
Chromosome 22
|
X Chromosome
|
Y Chromosome
|
Unknown
| null |
5ff22325-030e-4251-bb0c-37db2955f9e5
|
single
|
Which of the following does not form Waldeyer's ring?
|
Ans-CRef: Diseases of Ear, Nose & Thr oat. by Dhingra 5th edition. Chapter on diseases of pharynxExplanation:Waideyer's ringIt is formed by aggregated collections of lymphoid tissues distributed in the pharyngeal mucosa.It is formed by:AdenoidsPalatine tonsilsLingual tonsilsTubal tonsils in the fossa of RossenmullerLateral pharyngeal bandsNodules in the posterior pharyngeal wall
| 3
|
Palatine Tonsils
|
Adenoids
|
jugulodigastric node
|
Lateral pharyngeal bands
|
Unknown
| null |
546f2b32-9f5d-4d45-a06a-7197fe34e45f
|
single
|
Patient a known case off alcohol dependence after 12 to 18 hrs of last drink develops seizure for the first time in his life.possible diagnosis is rum fits. Treatment for the above mentioned patient after doing his LFT which was within normal limits
|
Detoxification implies removal of the toxic substance from the body, this can be done by using a drug similar to alcohol and thus benzodiazepine is chosen. This is the main drug used in treatment of alcohol withdrawal despite the problem being simple withdrawal, rum fits or delirium tremens IF LIVER FUNCTION IS WITHIN NORMAL LIMITS CHOOSE CHLORDIAZEPOXIDE, AS IT HAS A SIMILAR STRUCTURAL FORMULA LIKE ALCOHOL IF LIVER FUNCTION IS ABNORMAL CHOOSE LORAZEPAM, AS IT DOES NOT WORSEN LIVER DERANGEMENTS FRONT LOADING=====patient is loaded with benzodiazepines SYMPTOM TRIGGER=== benzodiazepines is offered only as and when the withdrawal symptom arises FIXED DOSAGE====== regular fixed dosage of benzodiazepine is given in divided doses and slowly tapered so that the patient is not on any drugs by the end of 2 weeks Reference. Kaplon and Sadock, synopsis of psychiatry, 11 th edition, pg no.625
| 4
|
phenytoin
|
Thiamine
|
.Lorazepam
|
chlordiazepoxide
|
Psychiatry
|
Symptoms and signs in psychiatry and classification
|
35119333-c26a-47ec-ab55-98a35570f5d3
|
multi
|
Smooth muscle relaxant nitric oxide is synthesized from:
|
Ans. (c) ArginineRef: Harper's Biochemistry 30th edn. 1314, 660-61
| 3
|
Methionine
|
Cyseine
|
Arginine
|
Ornithine
|
Biochemistry
|
Amino Acid Metabolism
|
9dd660ae-436a-45b0-bb9e-9bc9cc72ac80
|
single
|
A person presents with fever and altered consciousness. Investigations reveal anemia with fragmented red blood cells, platelet count of 20,000/mm', serum creatinine of 3.0 mg % and normal PT and aPTT. Which of the following is the most appropriate treatment for the patient:
|
Answer is A (Plasma Exchange Therapy): Plasma Exchange Therapy is the treatment of choice for TTP Pentad of Fever, Microangiopathic Hemolytic Anemia, Thrombocytopenia (platelets count = 20,000), Renal Failure (I'verum creatinine) and Neurological dysfunction (altered consciousness) together with normal tests of coagulation (normal PT and aPTT) confirms a diagnosis of Thrombotic Thrombocytopenic Purpura. Plasma Exchange .forms the mainstay of treatment of TTP. 'Plasma Exchange remains the mainstay of treatment of TTP'
| 1
|
Plasma Exchange Therapy
|
Coicosteroids and Intravenous
|
Immunoglobulins
|
Anticoagulation with Heparin
|
Medicine
| null |
7bebb540-b5ea-4b48-b037-cf6dab19b1c8
|
single
|
Mc Ardles diseaae is due to:
|
Muscle Phosphorylase deficiency
| 2
|
Liver Phosphorylase deficiency
|
Muscle Phosphorylase deficiency
|
Lysosomal alpha-1,4-glucosidase deficiency
|
G6PD Deficency
|
Biochemistry
| null |
8aebf433-743a-4d4f-a59d-a09b2b29dc49
|
single
|
In Tzank smear multinucleated cells are seen in:
|
A i.e. Chicken pox - In patients with vesico-bullous lesions and oral ulcer (mucosal involvement), the diagnosis is pemphigus vulgaris and the bed side diagnostic Tzank test from floor of bullae shows acantholysis with numerous acantholytic keratinocyte cellsQ. In Tzank smear diagnostic multinucleated giant cells with ballooning degeneration is seen in herpes simplex, herpes zoster and varicella zoster (chicken pox) virusQ.
| 1
|
Chicken pox
|
Psoriasis
|
Molluscum contagiosum
|
Pemphigus vulgaris
|
Skin
| null |
f0981937-0e4a-437c-8ed9-39b4d6d6569f
|
single
|
Drug of choice for the treatment of type 2 Brittle Asthma is?
|
Type 2 Brittle asthma, are symptom-free patients developing sudden onset acute attack of asthma requiring mechanical ventilation or even death. These patients should ideally keep an auto-injector of epinephrine. Type 1 Brittle asthma is characterized by >40% variation in P.E.F.R for >50% of the time. It is managed with L.A.B.A + high dose inhaled coicosteroids and oral steroids. Long-term continuous subcutaneous infusion of P2 agonists like terbutaline is also given.
| 4
|
b-adrenergic agonist
|
Inhaled coicosteroids
|
Antileukotrines DM
|
Subcutaneous epinephrine
|
Medicine
|
COPD and Asthma
|
b6d0045b-4033-4eac-840a-cd4470cf9a52
|
single
|
A 3 year old boy was admitted to the hospital for high fever and difficulty in breathing. He had been well until 4 days before admission, when he developed sneezing and a runny and stuffy nose followed by a non-productive cough on next day. This was followed by appearance of characteristic rash on face, trunk, extremities and back along with fever. O/E, Shotty anterior cervical and supraclavicular lymph nodes. Hyperaemic conjunctiva Ceain spots on buccal mucosa The white blood cell count was 3,100/ml, with a differential of 70 % polymorphonuclear leukocytes. All of the following are complications of the above disease EXCEPT?
|
This is a case of measles. The face is completely erythematous and there is an erythematous maculopapular rash on the trunk and extremities, with large confluent areas on the back. 3RD image shows the classical appearance of the Koplik spots, an exanthem (mucosal rash) that is felt to be pathognomonic (distinctly characteristic) of measles. Complications of measles: - Diarrhoea Otitis media Giant cell pneumonia Croup Malnutrition Mouth ulcers Retrobulbar neuritis SSPE Myocarditis Appendicitis Pneumothorax and Pneumomediastinum
| 3
|
Hecht Giant cell pneumonia
|
SSPE
|
Orchitis
|
Otitis media
|
Unknown
|
Integrated QBank
|
19585c4a-70e7-4b96-9518-db97780b16d2
|
multi
|
In which of the following, 'Zellballens' are seen?
|
Ans. C. Pheochromocytoma. (Ref. Robbin's 8th/pg. 1159)Robbins pathology 8th edition, page no.1159.......# Microscopically, pheochromocytomas are composed of polygonal to spindle-shaped chromaffin cells and their supporting cells, compartmentalized into small nests, or "Zellballen," by a rich vascular network.Histopathologv of Pheochromocytoma:# Microscopically, pheochromocytomas are composed of polygonal to spindle-shaped chromaffin cells and their supporting cells, compartmentalized into small nests, or "Zellballen," by a rich vascular network.# The cytoplasm of the neoplastic cells often has a finely granular appearance, highlighted by a variety of silver stains, because of the presence of granules containing catecholamines.# Electron microscopy reveals variable numbers of membrane-bound, electron-dense granules, representing catecholamines and sometimes other peptides. The nuclei of the neoplastic cells are often quite pleomorphic.# Both capsular and vascular invasion may be encountered in benign lesions, and the presence of mitotic figures per se does not imply malignancy.# Therefore, the definitive diagnosis of malignancy in pheochromocytomas is based exclusively on the presence of metastases. These may involve regional lymph nodes as well as more distant sites, including liver, lung, and bone.
| 3
|
Gastric carcinoma
|
Angiosarcoma
|
Pheochromocytoma
|
Colon carcinoma
|
Pathology
|
Endocrine
|
7f17385c-a314-46ec-9563-19a409ba6114
|
multi
|
The minimum level of TSH that can he detected by TSH assay of the third generation thyroid function tests is which of the following?
|
Functional sensitivities for three generations of TSH assays: First generation: Functional sensitivity is 1-2 IU/mL Second generation: Functional sensitivity is 0.1-0.2 IU/mL Third generation: Functional sensitivity is 0.01-0.02 IU/mL Among the options more appropriate is 0.04 IU/mL Ref: Aicle: Evolution of TSH Assays: A Third Generation Viewpoint
| 2
|
0.4 lU/ml
|
0.04 IU/ml
|
0.004 lU/ml
|
4 IU/ml
|
Biochemistry
| null |
b804d1e5-b8c5-455e-8f72-874cc56c25d2
|
single
|
A 70yr old male has a pathological fracture of femur. The lesion appears a lytic on X- rays film with a circumscribed punched out appearance .The curetting from fracture site is most likely to show which of the following?
|
Olf patients along with lytic circumscribed punched our X- rays appearance suggests multiple myeloma. Multiple myeloma most often presents as multifocal destructive bone tumours composed of plasma cells throughout the skeletal system.(ref Robbins 9/e p599,7/679)
| 2
|
Diminshed and thinned trabecular bone
|
Sheets of atypical plasma cells
|
Metaplastic prostatic adenocarcinoma
|
Malignant cells forming osteoid bone
|
Anatomy
|
Haematology
|
a47e16f8-68ab-4c56-89fd-a1c9dd7aad7b
|
single
|
The positioning of the needle is TRUE regarding thoracocentesis in which of the following statements?
|
The needle should be kept close to the upper border of the rib to avoid injuring the intercostal vessels and nerve in the subcostal groove. Ref: Snell's Clinical Anatomy, 7th Edition, Page 61
| 1
|
Upper border of the rib
|
Lower border of the rib
|
Center of the intercostal space
|
Anterior to the intercostal space
|
Anatomy
| null |
b74101fe-ae8c-4e05-9641-2981c447191b
|
multi
|
Which is not true about Fragile X syndrome
|
Fragile X syndrome is associated with the loci Xq27.3 on the distal long arm of the X chromosome. In affected males, it is mainly characterized by mental retardation, macroorchidism, autistic behaviour, facial features like long face, large ears, prominent square jaw Pigmented naevi are not seen associated with fragile X syndrome. Reference : Nelson paediatrics 19th edition pg 411
| 2
|
Large testis
|
Pigmented nevi
|
Large ear present
|
Long face
|
Pediatrics
|
Genetic and genetic disorders
|
feb1b947-995f-4a14-9b14-5cc1f1a50062
|
multi
|
A cervical Pap smear repo stating that "koilocytic atypia is present" indicates the:-
|
HPV infection of squamous cells Produces wrinkled nuclei surrounded by a clear halo. This is called koilocytosis. Whether it is indicative of a low or a high grade lesion in the cervix requires tissue documentation. This is usually obtained with a colposcopic biopsy.
| 3
|
Presence of high-grade cervical intraepithelial neoplasia
|
Cytologic effect of herpesvirus type 2
|
Cytologic effect of human papillomavirus
|
Presence of chlamydial infection
|
Gynaecology & Obstetrics
|
Cervical Carcinoma
|
0396fe06-5dce-4bc8-a248-41f78be325ec
|
single
|
All of the following statements are true except?
|
Kupffer cells are modified macrophages in Liver.
| 3
|
Microglial cells are modified macrophages in Brain
|
Hofbauer cells are modified macrophages in placenta
|
Stellate cells are modified macrophages in Liver
|
Osteoclasts are modified macrophages
|
Pathology
| null |
cabc9178-7f7c-4156-bbce-e0e922d6195b
|
multi
|
The term &;disease control&; employs all of the following except
|
Disease control - reducing the disease incidence to a level at which it is no longer a public health problem. Disease elimination - interruption of transmission of disease, reduction to zero of incidence and continued measures to prevent re-establishment. Disease eradication - permanent reduction to zero of the worldwide incidence of infection by a specific agent. Interventions are no longer needed once eradication has been achieved. Ref: Park&;s Textbook of Preventive and Social Medicine,24th edition, Page no. 99, 273
| 4
|
Reducing the complications
|
Reducing the risk of fuher transmission
|
Reducing the incidence of the disease
|
Reducing the prevalence of the disease
|
Social & Preventive Medicine
|
Concept of health and disease
|
1ce0f4fe-b29c-4d82-a5d0-e8a1b38614f3
|
multi
|
Erythema nodosum is seen in A/E
|
A i.e. Salicylate poisioning
| 1
|
Salicylate poisioning
|
Typhoid
|
Tuberculosis
|
Leprosy
|
Skin
| null |
00b9d19c-6824-48d9-a4ed-73bdb3070dfe
|
single
|
Oxytocin causes all except -
|
Ans. is 'a' i.e., Lactogenesis Impoant actions of oxvtocin are : Contraction of uterine smooth muscle (directly by acting on GPCR and indirectly by release of PG and LTs). Milk ejection by contraction of myepithelial cells surrounding mammary alveoli. At high concentration; anti-diuretic and vasopressor action can be seen. Note : Lactogenesis is the action of prolactin (not oxytocin).
| 1
|
Lactogenesis
|
Milk ejection
|
Contraction of uterine muscle
|
Myoepithelial cell contraction
|
Pharmacology
| null |
fd8bd231-ac6f-402c-9650-388364e6e6b5
|
multi
|
One of the following is a definite sign of death due tob drowning :
|
D i.e. Diatoms in bone marrow
| 4
|
Sand and mud in the mouth of nostrils
|
Fine lathery froth in the mouth of nostrils
|
Washerman's hands and feet
|
Diatoms in bone marrow
|
Forensic Medicine
| null |
d53e364f-59d0-4413-8642-6483bf9a41d5
|
single
|
Sweating is not present in:
|
Ans. c. Heat stroke (Ref: Reddy 33/e p319; Parikh 6/e p381)Sweating is not present in Heat stroke."Heat stroke (hyperpyrexia, sunstroke, systemic hyperthermia): This is attributed to an impaired functioning of the heat regulating mechanism caused by failure of cutaneous circulation and sweating. It is due to prolong exposure to he sun's infrared rays, and/or to hot atmosphere. "Heat stroke (Heat hyperpyrexia/Sun stroke/ Thermic Fever)Heat cramps (Miner's cramps/ Stoker's cramp/ Firemen's cramp)Heat exhaustion (Heat collapse/Heat syncope/Heat prostration)* It is due to failure of heat regulating mechanismQ* Caused by failure of cutaneous circulation & sweatingQ.* Occurs due to exposure to heat in open & humid environmentQ.* All signs of shock are present* There is sudden collapse with loss of consciousness.* Dry skin, hot flushes with absence of sweatingQ* These are painful spasm of voluntary muscles, which follow strenuous work in a hot atmosphere.* Caused by toss of water & salt in profuse sweatingQ.* Collapse without any elevation of body temperature.* Occurs due to exposure to high temperature in closed environment* Precipitated by muscular exercise & unsuitable clothing.* There is extreme exhaustion with peripheral vascular collapse with scanty sweatingQ
| 3
|
Heat syncope
|
Heat cramp
|
Heat stroke
|
Heat fatigue
|
Forensic Medicine
|
Injuries
|
2aef15be-1714-4a48-8a08-cf84e05bfdee
|
single
|
In Indoor air pollution, carbon monoxide is produced by
|
(All of the above) (593 - Park 19th) (642-Park 20th)Sources of Indoor air pollutantsPollutantSources* Respirable particle* Carbon monoxide* Nitrogen - dioxide* Sulphur dioxide* Formaldehyde* Ozone* Radon and daughters* Asbestos* Mineral fibresTobacco smoke, stove, Aerosol spraysCombustion equipment, stove, Gas heatersGas cookers, cigarettesCoal combustionParticle board, carpet adhesives insulationElectric arcing, UV light sourcesBuilding materialInsulation, fire proofingAppliances
| 4
|
Combustion equipment
|
Stove
|
Gas heaters
|
All of the above
|
Social & Preventive Medicine
|
Environment and Health
|
85ab3ebf-4d99-4725-9012-daa41f6a3139
|
multi
|
In the first step of Heme synthesis, what is required -
|
Two starting materials of heme synthesis are succinyl-CoA and glycine. Pyridoxal phosphate is also required.
| 3
|
Fe
|
Folate
|
Glycine
|
Histidine
|
Biochemistry
| null |
feb84fa1-9664-47f3-98ad-7411a4e33a18
|
multi
|
Nephrotic syndrome in children is caused by
|
NEPHROTIC SYNDROME:- Characterised by massive proteinuria, hypoalbuminemua and edema, hyperlipidemia is often associated. Some patients show hematuria and hypeension. Heavy proteinuria( more than 1g/metre square/day) is the underlying abnormality leading to hypoalbuminemia ( serum albumin below 2.5g/dl). The resultant fall in plasma oncotic pressure leads to interstitial edema and hypovolemia. This stimulates the renin angiotensin aldosterone axis and ADH secretion that enhances sodium and water retention. Hypoalbuminemia also induces hepatic synthesis of beta lipoproteins resulting in hypercholesterolemia. Main cause of nephrotic syndrome in children is associated with minimal change disease. Other causes include amyloidosis, vasculitis, SLE, postinfectious glomerulonephritis, and hepatitis B nephropathy. Steroid sensitive nephrotic syndrome:- MCNS accounts for 80% cases of nephrotic syndrome. Electron microscopy shows non specific obliteration of epithelial foot processes. Immunofluorescence studies shows deposits of occassional mesangial IgM. Lab findings- urine examination shows heavy proteinuria. Hyaline and granular casts are present. Serum albumin is low. Hypercholesterolemia impa a milky appearance to plasma. Blood urea and creatinine values within normal range. Blood levels if IgG low and IgM elevated. Low serum calcium level. Steroid resistant nephrotic stndrome:- Homozygous or complete heterozygous mutations in genes encoding podocyte proteins, including podocin(NPHS2), nephrin(NPHS1) and wilms tumor(WT1) genes. Reference: GHAI essential Paediatrics
| 1
|
Minimal change disease
|
RPGN
|
MPGN
|
FSGS
|
Pediatrics
|
Urinary tract
|
47228bcf-cf77-4a20-b1aa-7a491d26851d
|
single
|
Given three genera of mosquitoes (('ulex, Anopheles and Aedes) act as vectors for which of the following diseases world w ide -
|
Ans. is 'c' i.e., Filariasis o Filariasis is transmitted by all four genera of mosquitoes including Anopheles, Aedes, Culex and Mansonoides.
| 3
|
Malaria
|
Dengue
|
Filariasis
|
Yellow Fever
|
Social & Preventive Medicine
| null |
1102427c-62b4-4cc6-8059-24b664b2550e
|
single
|
Chromosomal translocation characteristic in acute promyelocytic leukemia is:
|
In AML with the t(15;17),acute promyelocytic leukemia (M3 stage) ,auer rods present (most common stage associated with DIC) t(8,21) AML With maturation stage (M2 stage) t(16,16) associated with best prognosis. Presence of "FAGGOT CELLS" is a characterstic feature of AML M3 (acute promyelocytic leukemia) Faggot cells are cluster of auer rods (shown in image below) All-trans retinoic acid (ATRA)- induce the neoplastic promyelocytes to differentiate into neutrophils rapidly.
| 1
|
t ( 15; 17)
|
t ( 22; 9)
|
t ( 21; 17)
|
t ( 8; 21)
|
Pathology
|
Acute Myelogenous Leukemia
|
895d8a6c-69c9-4ee1-8757-546226f971e5
|
single
|
All the following drugs are effective in t/t of ptyriasis versicolor except –
|
Griseofulvin is effective only against dermatophytes. It is ineffective against T. versicolor and candida.
| 3
|
Selenium sulphide
|
Ketoconazole
|
Grieseofulvin
|
Clotrimazole
|
Dental
| null |
3d498037-92d6-4170-82c5-74713006f449
|
multi
|
Euvolemic hyponatremia is seen in:
|
Ans. C. SIADHHypervolemic hyponatremia -- Both sodium & water content increase: Increase in sodium content leads to hypervolemia and water content to hyponatremia. Total body water and sodium are regulated independently* Cirrhosis of the liver* Congestive heart failure* Nephrotic syndrome in the kidneys* Massive edema of any causeEuvolemic hyponatremia -- there is no volume expansion in the body, no edema, but hyponatremia occurs* States of severe pain or nausea* In the setting of trauma or other damage to the brain* SIADH (and its many causes)* Hypothyroidism* Glucocorticoid (steroid) deficiencyHypovolemic hyponatremia -- THE hypovolemia (extracellular volume loss) is due to total body sodium loss. The hyponatremia is caused by a relatively smaller loss in total body water.* Any cause of hypovolemia such as prolonged vomiting, decreased oral intake, severe diarrhea* Diuretic use (due to the diuretic causing a volume depleted state and thence ADH release, and not a direct result of diuretic-induced urine sodium loss)* Addison's disease and congenital adrenal hyperplasia in which the adrenal glands do not produce sufficient steroid hormones (combined glucocorticoid and mineralocorticoid deficiency)
| 3
|
Adrenocortical failure
|
Burns
|
SIADH
|
Cirrhosis
|
Medicine
|
Endocrinology
|
6bd41a77-1b70-4dd4-80b0-be366aded9c3
|
single
|
Congenital larygeal stridor also know as
| null | 2
|
Laryngeal web
|
Laryngomalocia
|
Laryngeal atenosis
|
Vocal cord palsy
|
ENT
| null |
0a23a2b4-6d4c-4c8b-a3e3-2be96d49c72d
|
single
|
A patient came to casualty for acute bronchial asthma after treatment for glaucoma. The probable drug may be
|
Timolol is a non selective Beta blocker and can precipitate acute attacks of asthma in a susceptible individual blockade of Beta 2 receptors. Betaxolol is a cardioselective Beta blocker and is less likely to cause this adverse side effect Refer kDT 6/e p 139
| 1
|
Timolol
|
Betoxalol
|
Lantanoprost
|
Anticholinesterase
|
Pharmacology
|
Autonomic nervous system
|
d15f7cba-283c-4014-96b5-cdb6a4e53f55
|
single
|
Which of the following drug is not used in influenza?
|
Ans. D. AcyclovirOseltamivir is neuraminidase inhibitor which can be given for both influenzas A and B. Amantadine is drug which inhibit the uncoating of influenza A virus RNA. Ribavirin has a broad spectrum antiviral activity which inhibit the synthesis of viral RNA. Acyclovir mainly inhibit the viral DNA and its drug of choice for herpes simplex infection.
| 4
|
Oseltamivir
|
Amantadine
|
Ribavirin
|
Acyclovir
|
Pharmacology
|
Anti Microbial
|
6ee8cd57-fbd5-4120-b0af-9aa94fb4c832
|
single
|
Periphery of retina is best visualized with :
|
Indirect ophthalmoscopy can be used to examine the entire retina, even out to its extreme periphery, the ora serrata. This is possible for two reasons. Optical distoions caused by looking through the peripheral lens and cornea interfere very little with the indirect ophthalmoscopic examination compared with the direct ophthalmoscope. In addition, the adjunct technique of scleral depression can be used. Ref : Chang D.F. (2011). Chapter 2. Ophthalmologic Examination. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.
| 2
|
Direct ophthalmoscopy
|
Indirect ophthalmoscopy
|
Retinoscopy
|
USG
|
Ophthalmology
| null |
4710e7fb-fd64-45f7-8812-cc7a3b5f16e4
|
single
|
Acute Primary Amoebic meningoencephalitis true is-
|
Diagnosis of acute primary amoebic meningoencephalitis is established by microscopic examination of the cerebrospinal fluid which contains trophozoite and red cells but no bacteria.
About other options
Acanthamoeba causes chronic meningoencephalitis, while Naegleria fowleri is responsible for acute cases of meningoencephalitis.
The cases are seen in children who swim or dive in warm, soil contaminated pools (in temperate regions e.g. in Europe and N. America).
The amoebas enter via the nose and the cribriform plate of the ethmoid passing directly into the brain tissue where they form nests of amoebas that cause extensive hemorrhage and damage, chiefly in the basilar portion of the cerebrum and cerebellum.
| 2
|
Meningitis caused by acanthamoeba species is acute in nature
|
Diagnosis is by demonstration of trophozoite in CSF
|
Caused by faeco-oral transmission
|
More common in tropical climate
|
Microbiology
| null |
94db2c98-02a6-47df-8544-ce520e9d0133
|
multi
|
In a patient with Foville's syndrome all of the following cranial nerves are involved, EXCEPT:
|
In a patient with foville's syndrome there is involvement of the V, VI, VII and VIII cranial nerves. The lesion in this syndrome affects the dorsal pa of the brain stem thereby involving structures such as medial longitudinal fasciculus, pontine paramedian reticular formation, fifth nerve and sympathetic neruons. These patients presents with horizontal conjugate gaze palsy, ipsilateral V, VI, VII, and VIIIth nerve palsies with ipsilateral Horner's syndrome. Ref: Textbook of Ophthalmology edited by Sunita Agarwal,page 342.
| 2
|
Facial
|
Trochlear
|
Trigeminal
|
Abducens
|
Ophthalmology
| null |
1691ffc3-2b64-4287-870d-be82f9c288e9
|
multi
|
Cervical rib arises from:
|
It is a Fibrous band arising from C7, which inserts on 1st thoracic rib.
| 3
|
C6
|
C7
|
C8
|
T
|
Surgery
| null |
e0f9b9fd-db34-4c61-8f96-3714356d3158
|
single
|
Left-Right movement of skull occurs at
|
Left-Right movement of skull occurs at Atlanto - axial joint.
Up - down movement of skull occurs at Atlanto - occipital joint.
| 3
|
C2 - C3
|
Atlanto - occipital joint
|
Atlanto - axial joint
|
C4 - C5
|
Orthopaedics
| null |
47af1ea4-82c5-46fa-bc25-7c3ce2f14af8
|
single
|
Ophthalmoplegic migraine means
|
B i.e. When the headache is followed by paial paralysis of 3rd nerve without any scotoma Ophthalmoplegic migrane is characterized by recurrent episodes of migraine like headache accompanied mostly by recurrent, ipsilateral and transient paresis of 3rd (most common), 6th (rare) and/ or 4th (rarest) cranial nervesQ. It is more common in childhood & typically stas before the age of 10 years.
| 2
|
When headache is followed by complete paralysis of the IlIrd and VIth nerve on the same side as the hemicrania
|
When the headache is followed by paial paralysis of the IIIrd nerve on the same side as the hemicrania without any scotoma
|
Headache is associated with IIIrd, IVth and VIth nerve paralysis
|
Headache associated with optic neuritis
|
Ophthalmology
| null |
faf7f665-d0c5-48e9-a718-f4c1483e5d38
|
single
|
What causes mallet finger?
|
Mallet finger: A finger flexed at the DIP joint due to avulsion or rupture of extensor tendon at the base of the distal phalanx. Mallet finger occur due to forced flextion of the finger tip. Hyper- extension splint is the treatment for atleast 6-8 weeks.
| 4
|
Extensor tendon rupture
|
Bony avulsion of distal phalanx at the extensor tendon
|
Strain and subsequent stretching of the extensor tendon
|
All the above
|
Orthopaedics
|
Fracture Management
|
ec2ef1de-05e1-4bd6-bd26-de89cb411383
|
multi
|
All of the following diseases show abnormal folding of proteins except :
|
Multiple sclerosis[Ref: Harrison 171h/e p. 2647; Harper 27th/e p. 38; Lippincott p. 20j The process of protein folding is remarkably efficient, but sometimes it can go wrong. Incorrectly folded proteins are considered to be the cause of many diseases. Amvloidoses The common characteristic of all amyloidoses is the collection of plaques of insoluble protein in the extracellular tissue which cannot be broken down by enzymes. Their ordered structure gives them a crystal like propeies and they are are made up of long filaments (fibrils) that are formed from densely packed p pleated sheets. There are about 20 different proteins that can act as the building block of these fibrils each of which is associated with a different disease. In the so called systemic amyloidoses, the precursors of these plaques are transpoed through the blood stream from their point of origin to the point of deposition. Localized amyloidoses are of greater clinical significance as they mainly affect the central nervous system, the extracellular tissue of which is paicularly susceptible to damage. Alzheimer's disease One of the main characteristics of Alzhiemer's disease is the accumulation of plaques of insoluble p amyloid in the brain. The p amyloid plaques are formed by cleavage of amyloid precursor protein (APP) by two different enzymatic activities which release amyloid - p peptide fragments that are 40 or 42 amino acids long. These then form fibrils which aggregate into insoluble clumps of p amyloid plaques that surround neurons and cause damage. But this cleavage also occurs in healthy individuals and soluble p amyloid proteins are normal constituents of brain tissue. How, then do the plaques form in Alzhiemer's patients? It is thought that the, mis folding of the protein, dramatically alters its propeies. In the normal protein, hydrophobic amino acids bury themsleves inside the protein right from the sta of the folding. However, if the protein folds wrongly, these hydrophobic amino acids are exposed and they rapidly seek out and bind to hydrophobic groups on other protein molecules forming the insoluble aggregates or plaques that are found in Alzhiemers patients. Prion disease : Prion are fatal neurodegenerative disease caused by transmissible proteins and are characterized by spongiform changes, astrocytic gliomas and neuronal loss from the deposition of insoluble protein aggregates in neural cells. Prions are caused by human prion related protein (PrP) (a glycoprotein rich in a helix). PrP is endogenous to the host and in most people, the PrP protein folds normally leaving the person healthy. Rarely, a mutation in the PrP gene will allow the protein to be made incorrectly and it will fold incorrectly making a PrPsc prion. (Which is a glycoprotein rich in fi sheets). These PrPsc prions when exposed to PrP, which is in the process of folding will encourage that PrP to fold incorrectly too, thus creating another PrPsc. While PrP can be processed and cleaned out of a cell once it has been used, PrPsc is shaped differently enough so that it can't be cleaned out and it aggregates inside the cell. These PrPsc aggregates quickly builds up into plaques destroying the nervous tissue. Thus a pathological prion protein serves as the templates for the conformational transformation of normal PrP into PrPsc. Creutzfeldt Jabok disease is caused by prions. Other examples of disease caused by protein misfolding Huntingtons Parkinson's Amyotrophic lateral sclerosis
| 3
|
Creutzfeldt-jabok disease
|
Prion disease
|
Multiple sclerosis
|
Amylidosis
|
Surgery
| null |
9661c611-14d2-45e2-b72a-a11230c52409
|
multi
|
Enteric fever is caused by -
|
Ans. is 'd' i.e., AH of the above Enteric fevero The term enteric fever includes typhoid fever caused by S.typhi and paratyphoid fever caused by S. paratyphi A, B and C.o The ability to resist intracellular killing and to multiply with in these cells is a measure of virulence of salmonella.o The incubation period for S. typhi ranges from 3 to 2i days.o Most prominant symptom of this systemic infection is prolonged fever. (Step-ladder pyrexia).o Early physical findings are - Rash (rose spot), Relative bradycardia, Hepatosplenomegaly, Epistaxis.o Complications occur in 3rd and 4th weeks - Intestinal perforation and GI hemorrhage are the two most common complications.
| 4
|
S typhi
|
Sparatyphi A
|
S paratyphi C
|
All of the above
|
Microbiology
|
Enterobecteriaceae
|
75c3512b-39d8-42d7-a397-0106e6775458
|
multi
|
FNAC cannot detect which of the following?
|
Ans. a. Follicular carcinoma (Ref: Robbins 9/e p1097, 8/e p1123; Schwartz 9/e p1364, 1357; Sabiston 19/e p901-902; Bailey 26/e 765, 25/e p775)FBI AC cannot detect follicular carcinoma.'The hallmark of all follicular adenomas is the presence of an intact, well-formed capsule encircling the tumor. Careful evaluation of the integrity of the capsule is therefore critical in distinguishing follicular adenomas from follicular carcinomas, which demonstrate capsular and/or vascular invasion. This cannot be done by cytology of aspirate alone obtained by a fine needle. - Robbins 8/e p1123Limitations of FNAC in Thyroid DiseasesNot able to distinguish follicular adenoma from follicular carcinomaQNot able to distinguish Hurthle cell adenoma from Hurthle cell carcinomaQUseless in Reidel's thyroiditisQ (Biopsy is preferred)QFNAC is less reliable in patients who have history of head and neck irradiation or family history of thyroid cancer due to higher likelihood of multifocal lesions and occult cancerQFollicular carcinoma of ThyroidFTC account for 10% of thyroid cancersOccurs more commonly in iodine-deficient areasQ.More common in women with mean age of 50 yearsGenes implicated in FCT: p53Q, PTENQ, RasQ , PAX8/PPAR1Pathology:Usually solitary lesion surrounded by capsuleQ.Histologically, follicles are present, but the lumen may be devoid of colloidQ.Malignancy is defined by the presence of capsular and vascular invasionQ.Tumor infiltration and invasion, as well as tumor thrombus within the middle thyroid or jugular veins, may be apparent at operation.Clinical Features:Usually present as solitary thyroid nodules, occasionally with a history of rapid size increase, and long-standing goiterQ.Pain is uncommon, unless hemorrhage into the nodule has occurred.Cervical lymphadenopathy is uncommon at initial presentation (about 5%)Preoperative clinical diagnosis of cancer is difficult unless distant metastases are present.Large follicular tumors (> 4 cm) in older men are more likely to be malignantQ.MC site of metastasis is bone (Osteolytic metastasis with pulsating secondaries in flat bones)QDiagnosis:FNAC is unable to distinguish benign follicular lesions from follicular carcinomasQ.Intraoperative frozen-section examination usually is not helpful, but should be performed when there is evidence of capsular or vascular invasion, or when adjacent lymphadenopathy is present.Treatment:Follicular lesion: HemithyroidectomyQ (80% of these patients will have benign adenomas)Thyroid cancer: Total thyroidectomyQTotal thyroidectomy in older patients with follicular lesions > 4 cm because of the higher risk of cancer in this setting (50%)Q.Prophylactic nodal dissection is unwarrantedQ because nodal involvement is infrequentPrognosis:The cumulative mortality: 15% at 10 years and 30% at 20 years.Most important prognostic factor: Age and distant metastasis.Poor long-term prognosis* Age >50 yearsQ* Tumor size > 4 cmQ * Higher tumor gradeQ* Marked vascular invasionQ* Extrathyroidal invasionQ* Distant metastasesQ
| 1
|
Follicular carcinoma
|
Papillary carcinoma
|
Colloid goiter
|
Hashimoto's thyroiditis
|
Surgery
|
Thyroid Malignancies
|
66511959-4ba2-4dfb-a253-822c7ce684d2
|
single
|
Radio-frequency ablation is done for
|
Ablation bypass tract offers a permanent cure of supraventricular tachycardias. The advantage of radio-frequency catheter ablation has viually eliminated the need for surgery Ref Harrison 20th edition pg 1567
| 3
|
Ventricular tachycardia
|
PSVT
|
WPW
|
Atrial tachycardia
|
Anatomy
|
General anatomy
|
b006bb32-d600-4a03-86ec-474c2f4123e4
|
single
|
A person brings gifts for her wife next day after having fight with her. This is an example of
|
Undoing is a neurotic defense mechanism where an act is done to nullify a previous act.
| 3
|
Reaction formation
|
Aim inhibition
|
Undoing
|
Suppression
|
Psychiatry
| null |
afbb9828-ce13-467a-bdd6-768d5b4d8691
|
single
|
All of the following are true about excitation-contraction coupling except
|
Calcium binds to troponin to initiate exitation contraction coupling Troponin is present attached to tropomyosine Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:82,83,84
| 4
|
Acetylcholine is released at the nerve terminal
|
Calcium is pumped back into the sarcoplasmic reticulum during relaxation
|
Calcium is released from sarcoplasmic reticulum during contraction.
|
Calcium binds to tropomyosin to initiate muscle contraction.
|
Physiology
|
General physiology
|
5b61bf6e-4e68-4c2c-a84e-9b31ee94f9a8
|
multi
|
Lisch nodule seen in-
|
*Lisch nodules are the most common type of ocular involvement in NF-1. These nodules are melanocytic hamaomas, usually clear yellow to brown that appear as well- defined, dome-shaped elevations projecting from the surface of the iris. Ref: Harrison 18th/e p.2964
| 2
|
Sympathetic ophthalmitis
|
Neurofibromatosis
|
Chronic iridocyclitis
|
Trachoma
|
Ophthalmology
|
Miscellaneous
|
ba1e4de0-be97-4807-8760-753e3b0ca5f2
|
single
|
Needle biopsy of solitary thyroid nodule in a young woman with palpable cervical lymph nodes on the same sides demonstrates amyloid in the stroma of lesion. Likely diagnosis is
|
Presence of thyroid nodule along with palpable cervical lymph nodes and amyloid histologically is clearly indicative of Medullary Carcinoma Thyroid, as explained before. Ref : Bailey 25/e p797
| 1
|
Medullary carcinoma thyroid
|
Follicular carcinoma thyroid
|
Thyroid adenoma
|
Multinodular goitre
|
Anatomy
|
Endocrinology and breast
|
91b75df8-05c3-454a-9d60-6e892fc3f88d
|
single
|
All the following are the features of the Kuntscher (K) nail devised by a German surgeon for internal fixation of femoral fractures except
|
The K nail is a hollow tube with a slot on one side. It is clover shaped cross section. The fixation by K nailing based on the three point fixation i.e when a straight rod passes through a curved medullary cavity It fixes the bones at three points at either ends and at the isthmus. The clover leaf shape is designed to give rotational stability. The nail is provided with an eye at both ends that facilitates removal.
| 2
|
It is clover leaf in cross section
|
The nail has eye at one end
|
The nail is a hollow with a slot on one side
|
The fixation by k nailing is based on the three point fixation
|
Surgery
| null |
e4184f7b-e742-4833-a74c-37c40d58e1e4
|
multi
|
Slice of tissue X-rays is:
|
A i.e. Tomography Hounsfield units (CT number) represent average linear attenuation coefficientQ. The Hounsfield scale is an arbitray one with air at-1000 and water at 0 units as fixed pointsQ. Fat which is less dense than water also has a negative value (- 20 to - 100 range). CT has been designated a high dose procedure as it exposes 50-500 times higher radiation doses than a conventional radiograph. Lead shielding or coating (1/16 inch) is most common way of protectionQ. Other protective agents include concrete (4-6 inch standard density i.e. 147 pounds/cubic foot), brick blocks and barium plaster. Narrow beam collimation, high spatial reconstruction algorhythm like bone algorhythm and small field of view improve spatial resolution of HRCTQ.
| 1
|
Tomography
|
Mammography
|
Contrast studies
|
All of the above
|
Radiology
| null |
c13415ae-9119-46ee-a554-e9db0ecbaf7a
|
multi
|
Child knows his/her sex by age of-
|
Ans, is 'b' i.e., 3 year AgeMilestone2 MonthSocial smile3 MonthRecognise mother6 MonthStmger anxiety9 Monthwave bye - bye12 MonthComes when called15 MonthJargon18 MonthsCopies parents task2 yearAsk for food, drink, shows toys3 yearKnow full name & gender4 yearPlays in group.5 yearHelps in household task, decrease & undresses
| 2
|
2 year
|
3 year
|
4 year
|
5 year
|
Pediatrics
|
Developmental-Behavioral Screening and Surveillance
|
b1375587-d8f5-45c4-9846-c5aeefd46ab7
|
single
|
Treatment of choice for Intrahepatic Cholestasis in Pregnancy is:
|
Ursodeoxycholic acid (10-15 mg/kg/day) is the drug of choice in the treatment of intrahepatic cholestasis in pregnancy. It relieves pruritus, reduces bile salt levels in maternal serum and may reduce the frequency of fetal complications. It improves serum liver test and liver histology in cholestatic disease. Ref: Oxford Textbook of Medicine, 4th Edition, Pages 422 ; Textbook of Obstetrics By DC Dutta, 6th Edition, Page 291 ; Bile Acids and Pregnancy By U. Leuschner, P. A. Berg, J. Holtmeier, 2002, Page 36.
| 2
|
Cholestyramine
|
Ursodiol (Ursodeoxycholic acid)
|
Coicosteroids (Dexamethasone)
|
Antihistaminics
|
Gynaecology & Obstetrics
| null |
a772d32d-5bed-4959-a7ea-3b703fb06621
|
single
|
Skin over the angle of mandible and parotid area is supplied by -
| null | 1
|
Greater auricular nerve
|
Posterior auricular nerve
|
Auriculotemporal nerve
|
Facial nerve
|
Anatomy
| null |
d3af455d-1c68-46a1-8c41-958be61663ec
|
single
|
Ruptured tendon is most commonly seen in
|
C i.e. Overuse Most frequent cause of paial or complete rupture of a muscle or tendon is eccentric overloadQ of the muscle tendon unit. One factor contributing to muscle overload is fatigue (due to over use)Q, which makes the muscle unable to absorb as much as eccentric force before overload. Strains most commonly occur in muscles that cross two joints, muscles that have higher % of type II fast twitch muscle fibers, and weaker muscle of an agonist antagonist muscle group. eg hamstring, gastrocnemius & rectus femoris. Achiles tendon rupture commonly occurs to otherwise healthy men b/w the ages of 30 & 50 years who have no previous injury or problem repoed in affected leg; typically "weekened warrious" who are active intermittently. Most TA tears occurs in left leg in the substance of TA, - 2- 6 cm - the watershed zone - above the caleaned inseion of tendon (d/t right handed more commonly push off with left foot) The most common mechanism of injury include sudden forced plantar flexion of foot unexpected dorsiflesion of foot, & violent dorsiflexion of planter flexed foot. Other mechanism indude direct trauma & less commonly, attrition of the tendon as a result of long standing peritenositis with or without tendinosis that body is unable to repair.
| 3
|
Stab injury
|
Soft Tissue tumour
|
Overuse
|
Congenital defect
|
Surgery
| null |
51ba8067-6955-4dda-8913-a27c2eda6bdf
|
single
|
Which of the following doesn't elevate the larynx?
|
Elevators: Primary elevators act directly as they are attached to the thyroid cartilage and include stylopharyngeus, salpingopharyngeus, palatopharyngeus and thyrohyoid. Secondary elevators act indirectly as they are attached to the hyoid bone and include mylohyoid (main), digastric, stylohyoid, geniohyoid.
Depressors: They include sternohyoid, Sternohyoid and omohyoid.
| 1
|
Sternohyoid
|
Thyrohyoid
|
Mylohyoid
| null |
Anatomy
| null |
7320bf6f-8358-450e-82d6-3619eab761ae
|
multi
|
Acromegaly is due to excess of:
|
Ans. (b) Growth hormone(Ref: Ganong, 25th ed/p325.)Excess levels of growth hormone causes Gigantism (before the closure of epiphysis) and Acromegaly (After the closure of epiphysis)
| 2
|
Somatomedin
|
Growth hormone
|
Somatostation
|
Insulin
|
Physiology
|
Endocrinology and Reproduction
|
a6c7c209-64d7-4129-9160-0b52c65a1b58
|
single
|
Condition (s) associated with hypokalemia except -
|
Type IV A is the only type characterized by a hyperkalemic, hyperchloremic acidosis. CAUSES OF HYPOKALEMIA Inadequate potassium intake Eating disorders : Anorexia, bulimia, starvation, pica, and alcoholism Dental problems: Impaired ability to chew or swallow Povey: Inadequate quantity or quality of food (eg, "tea-and-toast" diet of elderly individuals) Hospitalization: Potassium-poor TPN Increased potassium excretion Mineralocoicoid excess (endogenous or exogenous) Hyperreninism from renal aery stenosis Osmotic diuresis: Mannitol and hyperglycemia can cause osmotic diuresis Increased gastrointestinal losses Drugs Genetic disorders Endogenous sources of excess mineralocoicoid include the following: <a href=" syndrome</a> Primary hyperaldosteronism, most commonly from an adrenal adenoma or bilateral adrenal hyperplasia Secondary hyperaldosteronism from volume depletion, congestive hea failure, cirrhosis, or vomiting Tumor that is producing adrenocoicotropic hormone Genetic disorders Exogenous causes of mineralocoicoid excess include the following: Steroid therapy for immunosuppression Glycyrrhizic acid - Inhibits 11-beta hydroxysteroid dehydrogenase; contained in licorice and Chinese herbal preparations Renal tubular disorders - Type I and type II renal tubular acidosis Hypomagnesemia Drugs that can cause hypokalemia include the following: Diuretics (carbonic anhydrase inhibitors, loop diuretics, thiazide diuretics): Increased collecting duct permeability or increased gradient for potassium secretion can result in losses Methylxanthines (theophylline, aminophylline, caffeine) Verapamil (with overdose) Quetiapine (paicularly in overdose) Ampicillin, carbenicillin, high-dose penicillins Bicarbonate Antifungal agents (amphotericin B, azoles, echinocandins) Gentamicin Cisplatin Ephedrine (from Ephedra; banned in the United States, but available over the Internet) Beta-agonist intoxication Genetic disorders Congenital adrenal hyperplasia (11-beta hydroxylase or 17-alpha hydroxylase deficiency) Glucocoicoid-remediable hypeension Bater syndrome Gitelman syndrome Liddle syndrome Gullner syndrome Glucocoicoid receptor deficiency Hypokalemic period paralysis Thyrotoxic periodic paralysis (TTPP) Seizures, sensorineural deafness, ataxia, mental retardation, and electrolyte imbalance (SeSAME syndrome) A shift of potassium to the intracellular space may result from any of the following: Alkalosis (metabolic or respiratory) Insulin administration or glucose administration (the latter stimulates insulin release) Intensive beta-adrenergic stimulation Hypokalemic periodic paralysis Thyrotoxic periodic paralysis Refeeding: This is observed in prolonged starvation, eating disorders, and alcoholism Hypothermia (ref : harrisons principles of internal medicine, 19E, page 305)
| 1
|
Typo I Renal Tubular Acidosis ( A)
|
Type II A
|
Type IV A
|
Pencillin therapy
|
Medicine
|
Fluid and electrolytes
|
6ff15e50-6c6e-419a-8945-4ff940027367
|
multi
|
If pneumocephalus created either by surgery or by performance of a pneumoencephalogram, it is suggested that nitrous oxide be avoided for how many days –
|
Once the pneumoencephalum has developed nitrous oxide should not be used for 1 week.
| 4
|
4 days
|
5 days
|
6 days
|
7 days
|
Anaesthesia
| null |
8d8b916d-e4fe-4b4d-8964-e641619ad6dd
|
single
|
False regarding Primary hyperparathyroidism is
|
PHPT results from the enlargement of a single gland or parathyroid adenoma in approximately 80% of cases, multiple adenomas or hyperplasia in 15% to 20% of patients, and parathyroid carcinoma in 1% of patients. Most cases of PHPT are sporadic. It also occurs within the spectrum of a number of inherited disorders such as MEN1, MEN2A, isolated familial HPT, and familial HPT with jaw-tumour syndrome. All of these syndromes are inherited in an autosomal dominant fashion. PHPT is the earliest and most common manifestation of MEN1 and develops in 80% to 100% of patients by age 40 years old.
| 3
|
Most cases are sporadic
|
It is the earliest and most common manifestation of MEN1 syndrome
|
Autosomal recessive inheritance seen in association with MEN syndrome
|
80% cases due to enlargement of a single gland or parathyroid adenoma
|
Anatomy
|
All India exam
|
ee52abb9-ad94-47b2-aeb1-b65cd4a3028a
|
multi
|
Lichenisation occurs in which layer of skin?
|
Ans. is 'a' i.e., Stratum malpighi
| 1
|
Stratum malpighi
|
Stratum corneum
|
Stratum lucidum
|
Stratum granulosum
|
Skin
| null |
792df70f-e703-41d9-8c35-b0a6b9c06729
|
single
|
TRUE/FALSE statements about carpal tunnel syndrome are: 1. Occurs in pregnancy 2. Affects medial three and half fingers 3. Associated with hypothyroidism 4. Froment sign positive 5. Median nerve involvement is present
|
Carpal tunnel syndrome is caused by the compression of the median nerve at wrist and is most common type of nerve entrapment syndrome. This is usually due to excessive use of the hands and occupational exposure to repeated trauma. Infiltration of the transverse carpal ligament with amyloid (as occur in multiple myeloma) or thickening of connective tissue in rheumatoid ahritis, acromegaly, amyloidosis, mucopolysaccharidosis and hypothyroidism are less common cause of the syndrome. It is not uncommon for the condition to make its appearance during pregnancy. The syndrome is essentially a sensory one; the loss or impairment of superficial sensations affect the palmar aspect of the thumb. Index and middle fingers (especially the index finger) and may or may not split the ring finger. So the lateral three and half fingers are involved (not medial 3 1/2 fingers). The paresthesia are characteristically worsen during night. Froment sign is seen in ulnar nerve injuries not in median nerve injuries. Ref: Apley's 8/e, Page 247-48; Harrison 17/e, Page 2153-54, 2231, 47; Maheshwari 3/e, Page 56.
| 2
|
1,2,3 true & 4,5 false
|
1,3,5 true & 2,4 false
|
1,2,3,4 true & 5 false
|
1,2,3,5 true & 4 false
|
Surgery
| null |
146d0f8e-4460-4909-8cbe-de3c287dc40f
|
multi
|
HLA testing aids in the diagnosis of which ocular affection: March 2010
|
Ans. B: Uveitis Conditions associated with uveitis in which HLA testing is employed: Ankylosing spondylitis is a type of ahritis that mainly affects the spine. This can cause recurrent ahritis. It is mostly associated with HLA B27 Reiter's syndrome is an inflammatory ahritis common in young men - often caused by chlamydia infection. It is mostly associated with HLA B27 Other diseases associated with specific HLA antigens: Vogt-Koyanagi-Harada syndrome is an inflammatory condition that involves the eyes and meninges (coverings of the brain). The condition is most common in Asians and American Indians. It often causes uveitis in both eyes and retinal detachments, and can result in serious vision loss and blindness. Behcet's disease is a rare, chronic inflammatory disease. The cause of Behcet's disease is unknown. If often begins when individuals are in their 20s or 30s, although it can happen at any age. Uveitis is very common with people suffering from Behcet's, which can cause acute uveitis that happens soon after onset of Behcet's disease.
| 2
|
Conjunctivitis
|
Uveitis
|
Retinitis
|
Viteous hemorrhage
|
Ophthalmology
| null |
a569f8de-a4b1-4e92-b057-159c070100fd
|
single
|
A newborn baby presented with profuse bleeding from the umbilical stump after birth. Rest of the examination and PT, APTT are within normal limits. Most probable diagnosis is -
|
Normal PT and APTT exclude option a and c because PT is raised in factor X deficiency and APTT is raised in Von Willebrand disease.
So we are left with Glanzmann's thrombasthenia and Bernard Soulier syndrome.
Both these disorder are platelet function disorders and can result in neonatal bleeding.
Disorders of platelet function produce defects in the formation of a hemostatic plug and thus results in bleeding.
Both are congenital disorders.
There is little to differentiate between these two disorders.
Between these two, Glanzmann's thrombasthenia can present as bleeding since birth.
Glanzmann's thrombasthenia
Glanzmann's thrombasthenia is a rare autosomal recessive disorder.
The disease is characterized by a deficiency of glycoprotein IIb/IIIa which acts as a receptor for fibrinogen.
The disease manifests at birth with increased bleeding from the umbilical cord stump.
a. There is a lifelong mucocutaneous bleeding tendency in the form of epistaxis, ecchymoses and bleeding from the gums.
b. Episodes of G.I. bleeding genitourinary bleeding or post surgery/trauma may occur. However, bleeding episodes decrease with increasing age.
Bernard Soulier syndrome
It is a rare autosomal disorder characterized by mild thrombocytopenia, giant platelets and defective adhesion.
The striking abnormality is giant platelet in peripheral smear.
The membrane abnormality is GPIb-IX-V complex in platelets and megakaryocytes.
Bleeding usually begins at an early age.
There is moderate bleeding in the form of purpuric rash, bruising epistaxis, gingival bleeding and men.
The main lab findings are increased in bleeding time without any coagulation abnormality.
| 2
|
Factor X deficiency
|
Glanzmann thrombasthenia
|
Von willebrand disease
|
Bernard soulier disease
|
Pathology
| null |
06d74933-95e3-4819-88a8-31564de07144
|
single
|
A 27-year-old male presents with a testicular mass, which is resected and diagnosed as being a yolk sac tumor. Which one of the listed substances is most likely to be increased in this patient's serum as a result of being secreted from the cells of this tumor?
|
Germ cell tumors of the testis often secrete enzymes or polypeptide hormones, examples of which include a fetoprotein (AFP) and human chorionic gonadotropin (hCG). AFP is synthesized by the fetal gut, liver, and yolk sac. It may be secreted by either yolk sac tumors (endodermal sinus tumors) or embryonal carcinomas. AFP may also be secreted by liver cell carcinomas. b-hCG is a glycoprotein that is normally synthesized by placental syncytiotrophoblasts. Markedly elevated serum levels are most often associated with choriocarcinomas, which are characterized histologically by a mixture of malignant cytotrophoblasts and syncytiotrophoblasts. Mildly elevated serum levels of b-hCG may be found in patients with other types of germ cell tumors if they contain syncytiotrophoblast-like giant cells. This is found in about 10% of classic seminomas, which are characterized histologically by large cells with distinct cell membranes and clear cytoplasm. An impoant, distinct variant of seminoma is the spermatocytic seminoma. It is characterized by being found in older individuals and by the fact that it does not metastasize. Histologically, a spermatocytic seminoma is characterized by maturation of the tumor cells, some of which histologically resemble secondary spermatocytes. To summarize: markedly elevated levels of hCG are associated with choriocarcinomas, while elevated levels of AFP are most characteristic of yolk sac tumors and embryonal carcinomas. But there are many areas of overlap between tumors, and many tumors are composed of multiple types of germ cell cancers. The only definitive statement that can be made is that elevated serum levels of AFP cannot be seen in a tumor that is a pure seminoma. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition
| 2
|
Acid phosphatase
|
a fetoprotein (AFP)
|
Alkaline phosphatase
|
b-human chorionic gonadotropin (b-hCG)
|
Pathology
|
miscellaneous
|
d075e8c3-bb4c-402a-bbc9-8b4ef7a0e914
|
single
|
In a 2-year-old child refractive error test is done with:
|
(Ref: K.D. Tripathi 8th ed. P 131)Atropine 1% ointment is preferred for refractive error test in children below 5 years. It is applied 24 hours and 2 hours before the procedure.The shorter acting agents like homatropine, tropicamide and cyclopentolate does not produce effective cycloplegia in children (ciliary muscle tone of child is high)Ointment is preferred over eye drop as there is increased risk of systemic absorption of eye drop which can cause anticholinergic side effect in child. Example: Hyperthermia, decreased secretion, tachycardia etc.Cycloplegic agent of choice is adult/elderly: Tropicamide. The protein binding of esmolol is 55%.For only fundoscopy/mydriasis, preferred agent is: Phenylephrine (Sympathomimetic)
| 1
|
1% atropine ointment
|
1% atropine eye drop
|
Tropicamide 0.5%
|
Eucatropine 5%
|
Pharmacology
|
A.N.S.
|
4c29006f-e3b9-43ec-aa27-ed568e5a3062
|
single
|
The commonest cause of metabolic alkalosis is -
| null | 2
|
Cancer stomach
|
Pyloric stenosis
|
Small-bowel obstruction
|
Diuretics
|
Surgery
| null |
dc3e6a75-bd2d-4dee-b556-718bd78cb434
|
multi
|
Inhaling the cloth soaked in drug is
|
Sniffing: Inhaling fumes from the liquid in anopen container.Bagging: Placing the chemical in a bag and thenputting it over the face.Huffing: Applying the chemical to a cloth/rag andthen inhaling it by covering nose and mouth withthe cloth/rag.
| 3
|
Bagging
|
Spraying
|
Huffing
|
Sniffing
|
Forensic Medicine
|
Drug Abuse
|
f1940d2b-ee3e-4daf-8e13-f8a0e2f6787d
|
single
|
Local anaesthetic injected directly into the tissue ?
|
Ans. is 'a' i.e., Infiltration anaesthesia o Infiltration anaesthesia is the injection of local anaesthetic directly into tissue without taking into consideration the course of cutaneous nerve.
| 1
|
Infiltration anaesthesia
|
Nerve block
|
Field block
|
Bier's block
|
Pharmacology
| null |
1177731e-9eba-40ef-ac5f-dc50d365c16d
|
single
|
Which doesnot form a part of thoracic outlet?
|
(D) Second rib# Thoracic outlet syndrome: Scalenus anticus syndrome> "This is a symptom complex resulting from compression of the neurovascular bundle (artery, vein, or nerves) at the superior thoracic outlet as it courses through the neck and shoulder.> Cervical ribs, abnormalities of the scalenus anticus muscle, proximity of the clavicle to the first rib, or abnormal insertion of the pectoralis minor muscle may compress the subclavian artery, subclavian vein (see below), and brachial plexus as these structures pass from the thorax to the arm.> Depending on the structures affected, thoracic outlet compression syndrome may be divided into arterial, venous, and neurogenic forms.> Patients with neurogenic thoracic outlet compression may develop shoulder and arm pain, weakness, and paresthesias.> Patients with arterial compression may experience claudication, Raynaud's phenomenon, and even ischemic tissue loss and gangrene.> Venous compression may cause thrombosis of the subclavian and axillary veins; this is often associated with effort and referred to as Paget-Schroetter syndrome.> Examination of the patient with thoracic outlet compression syndrome is often normal unless provocative maneuvers..."
| 4
|
Brachial plexus
|
Subclavian vein
|
Apex of lung
|
Second rib
|
Anatomy
|
Misc.
|
58813a07-d607-4bbb-9b13-70a8219eb853
|
single
|
CECT with nodular enhancement is suggestive of
|
Most common benign tumor of the liver Mainly seen in women of 45 years Small capillary hemangiomas(no clinical significance), larger cavernous hemangioma Usually single and <5 cm in diameter, occur equally in right and left liver Giant hemangioma: lesion>5cm Pathology Microscopically: Endothelium-lines, blood filled spaces that are seperated by thin, fibrous septa Enlargement of hemangiomas are by ectasia rather than neoplasia Clinical features Most commonly asymptomatic and incidentally found on imaging studies Large compressive masses may cause vague upper abdominal symptoms Kasabach-Merritt syndrome; syndrome of thrombocytopenia and consumptive coagulapathy Rarely seen LFT's and tumor markers are normal Diagnosis Diagnosis is made radiologically CT and MRI are diagnostic if a typical peripheral nodular enhancement pattern is seen Percutaneous biopsy is potentially dangerous and inaccurate not recommended Treatment Observation for asymptomatic cases Enucleation with inflow control is TOC for symptomatic cases Ref:Sabiston 20th edition Pgno :1456-1457
| 3
|
Hepatic adenoma
|
FNH
|
Hemangioma
|
Cholangiodenoma
|
Anatomy
|
G.I.T
|
d60172b9-0796-4cc9-98b0-25c9f1b4e287
|
single
|
Phospho-dephosphorylation of phosphofructokinase and fructose 1, 6, biphosphatase by fructose 2, 6,biphosphate regulation is seen in
|
Fructose 2, 6-biphosphate has unique role in regulation of glycolysis and gluconeogenesis in liver.
| 2
|
Brain
|
Liver
|
Adrenal cortex
|
RBC
|
Biochemistry
| null |
2072ec42-9613-4f33-9bd7-b5da9fed198d
|
single
|
True about OCG is – a) First done by Graham Cole in 1942b) Dye ingested at rate of 1 ml/kgc) USG has replaced itd) Dye used is telepaque
|
OCG was introduced by Graham and Cole in 1924 (not in 1942).
Two doses of 3 gm of dye is given --> first dose 14 hours, and second dose 3-4 hours prior to post-contrast examination.
OCG has largely been replaced by USG
Dye most commonly used is Na/Ca Ipanoic acid (Telepaque).
| 2
|
ab
|
cd
|
bd
|
ac
|
Radiology
| null |
f15b1abc-6619-4b1d-870e-8a107412d0bd
|
multi
|
Tom Smith arthritis involves
|
Ans. b (Hip) (Ref Maheshwari orthopedics 4th/165)TOM SMITH ARTHRITIS# Septic arthritis of hip joint in infant# Acute onset with rapid abscess formation# Head of femur is cartilaginous at this age and hence rapidly and completely destroyed by the pyogenic process.# Affected limb shorter and hip movements are increasd in all directions# Telescopy test +.# Complete absence of the head and neck of femur and normally developed round acetabulum on X-ray differentiates it from CDH.# Rx:- Arthroscopic wound lavage (minimally invasive Rx).
| 2
|
Knee
|
Hip
|
Ankle
|
Wrist
|
Orthopaedics
|
Infection of Bones & Joints
|
ecef24f3-51ab-418d-8dd6-0f60326ab766
|
single
|
Hypoglycemia caused by anti-hyperglycemic drugs like sulfonylureas can be classified as (adverse drug reaction):
|
Type A: Augmented pharmacologic effects - Dose dependent and predictable e.g. hypoglycemia caused by anti-hyperglycemic drugs like sulfonylureas.
Type B: Bizarre effects (or idiosyncratic) - Dose independent and unpredictable e.g. allergic reactions caused by penicllins.
Type C: Chronic effects e.g. peptic ulcer caused by chronic use of NSAIDs.
Type D: Delayed effects e.g. teratogenicity caused by thalidomide.
Type E: End-of-treatment effects e.g. withdrawal response to morphine.
Type F: Failure of therapy.
| 1
|
Type A
|
Type B
|
Type C
|
Type D
|
Pharmacology
| null |
6b7dca06-0169-4695-9dbb-ca4ec5ae2a0d
|
single
|
Most realistic approach in managing a difficult child in
dental clinic is
| null | 2
|
Disregard the behavior of child
|
Make child familiar with clinical atmosphere
|
Physical methods to make child accept for treatment
|
None of the above
|
Dental
| null |
7263b821-0d71-475c-8740-99da8be3c669
|
multi
|
The drug which inhibits the rate-limiting step of acetylcholine synthesis is
|
Rate limiting step is mediated by choline acetyltransferase which is blocked by hemicholinium. Ref: KD T ripathi 8th ed.
| 2
|
Vesamicol
|
Hemicholinium
|
Botulinum toxin
|
Cocaine
|
Pharmacology
|
Autonomic nervous system
|
cb386a79-982e-412d-a4c3-788e55412c25
|
multi
|
The toxic substance responsible for floppy baby syndrome is
|
It is seen in newborn babies breastfed by lithium-ingesting mothers due to disruption of afferent inputs from stretch receptors. Manifesting as hypotonicity, lethargy, and cyanosis (floppy baby syndrome).
| 1
|
Lithium
|
Cadmium
|
Antimony
|
Barium
|
Forensic Medicine
|
Toxicology - 1
|
ed0010b2-0b77-4318-b175-c472686a8287
|
single
|
WHO surveillance is done in all EXCEPT
|
(Relapsing fever) (115,204, Park 20th)SURVEILLANCE - defined as "the continuous scrutiny of all aspects of occurance and spread of disease that are pertinent to effective control"* The ultimate objective of surveillance is prevention* International surveillance: At the international level, the WHO maintains surveillance of important disease (eg. Influenza, malaria, polio etc) and gives timely warning to all national governments* Under the Intemation Health Regulations- cholera is notifiable to the WHO within 24 hours of its occurance by the National Government* Kaplan Meier estimator (Product limit estimator) method is used for survival*** "STEPS' is recommened by WHO as a method for surveillance of risk factor for non communicable disease*** Criteria suguesting casualitv in non communicable diseases (causal relationship)1. Temporal association*2. Strength of association*3. Specificity of the association *4. Consistency of the association5. Biological plausibility6. Coherence of the association* Case fatality rate is a good index of the severity of an acute disease and represents the killing power of the disease.
| 1
|
Relapsing fever
|
Malaria
|
Polio
|
Cholera
|
Social & Preventive Medicine
|
Communicable Diseases
|
bbcd7637-a220-4c69-bbca-9dd130bc0c03
|
multi
|
Convergent muscle among the following is
|
Convergent muscle is one where all the fibres converge at the insertion (Fan shaped)
Eg - Temporalis
| 3
|
Subscapularis
|
Deltoid
|
Temporalis
|
Pectoralis minor
|
Anatomy
| null |
710177ef-c2f6-428b-a34f-cd5551e23e0f
|
single
|
Choose the drug which blocks basal as well as stimulated gastric acid secretion without affecting cholinergic, histaminergic or gastrin receptors
|
Omeprazole:- It is the prototype member of substituted benzimidazoles which inhibit the final common step in gastric acid secretion. The only significant pharmacological action of omeprazole is dose dependent suppression of gastric acid secretion; without anticholinergic or H2 blocking action. It is a powerful inhibitor of gastric acid: can totally abolish HCl secretion, both resting as well as that stimulated by food or any of the secretagogues, without much effect on pepsin, intrinsic factor, juice volume and gastric motility. Omeprazole is inactive at neutral pH, but at pH < 5 it rearranges to two charged cationic forms (a sulphenic acid and a sulphenamide configurations) that react covalently with SH groups of the H+K+ATPase enzyme and inacti- vate it irreversibly. Acid secretion resumes only when new H+K+ATPase molecules are synthesized (reactivation half time 18 hours). It also inhibits gastric mucosal carbonic anhydrase. Ref:- kd tripathi; pg num:-648,651,652
| 3
|
Loxatidine
|
Pirenzepine
|
Omeprazole
|
Famotidine
|
Pharmacology
|
Gastrointestinal tract
|
92128fc6-e798-4064-9771-7e45042b7f96
|
single
|
Tinea pedis is caused by which of the following -
|
Tinea pedis ( Athlete foot ) - Infection of web space between the toes Caused by Epidermophyton floccosum
| 1
|
E. floccosum
|
M. furfur
|
M. canis
|
E. werneckii
|
Microbiology
|
Mycology
|
d6866d3e-c901-43ff-95c6-37c0ebfe6609
|
single
|
Which of the following is not seen in imaging of acute pyelonephritis?
|
Ref: Cavorsi A'. Prabhakar P, Kirby C. Acute pyelonephritis. Ultrasound Q 2010;26(2): 103-5 ami Ultrasound: A Practical Approach to Clinical Problems, Edited by Edward I. Bluth, Page 465 and Genitourinary Imaging by Shailendra Chopra, Thieme PublishersExplanation:"The affected kidney is enlarged, areas of relative ischemia develop within the kidney increased intraparenchymal pressure. Perinephric edema maybe present." Ref: Genitourinary ImagingACUTE PYELONEPHRITISDiagnosis of acute pyelonephritis is made with clinical and laboratory findings.Imaging is required only ino Atypical presentationso Complications.o Inadequate response to therapy.Ultrasound is insensitive to the changes of acute pyelonephritis, with most patients having 'normal' scan, and abnormalities only identified in 20-24% of cases, especially in severe cases.Possible Ultrasound Features include Features of Acute PyelonephritisDiffuse renal enlargement.Loss of corticomedullary differentiation.Submucosal edema of renal pelvis/ureter.Calyceal/Pelvic/ureterul dilatation.Particulate matter in the collecting system.Gas bubbles (Emphysematous pyelonephritis).Abnormal echogenicity of the renal parenchyma:o Focal/Segmental hypoechoic/hyperechotc regions.o Diffuse or focal enlargement of the kidney (Rarely 'mass' like lesion)o Wedge or round shaped.Note:Color Doppler typically shows decreased perfusion in the affected parenchyma, which is due to arteriolar vasoconstriction and interstitial edema.CECT is more accurate in detecting changes of pyelonephritis than conventional sonography.
| 4
|
Grossly enlarged kidney
|
Focal areas of hypoechogenicity
|
Perinephric edema
|
Increased vascularity
|
Radiology
|
CT and MRI of the Kidney
|
e8a4e83f-88e1-4cea-b5cd-573bec010aaf
|
single
|
The interval of time between receipt of infection by a host and maximum infectivity is known as
|
Ans. c (Generation time) (Ref. Text book of PSM by Park 22nd/96)Generation time: is the time interval between receipt of infection by host and max. infectivity1Median incubation periodTime required for 50% of cases to occur following exposure.2Incubation periodPeriod of entry of organism to appearance of first sign or symptom.3Serial intervalThe gap in onset of primary and secondary case.4Primary caseFirst case in community5Index caseFirst case detected in community (may or may not be primary case)
| 3
|
Median incubation period
|
Screening time
|
Generation time
|
Minimum incubation period
|
Social & Preventive Medicine
|
Concept of Health and Disease
|
aec922d3-7897-4037-a2bd-4e80d2383964
|
single
|
Most common cause of proptosis in adults is -
|
Ans. is 'b' i.e., Thyroid Ophthalmopathy o The most common cause of unilateral proptosis in children is orbital cellulitis.o The most common cause of unilateral proptosis in adults is thyroid ophthalmopathy.
| 2
|
Orbital cellulitis
|
Thyroid Ophthalmopathy
|
Carotico - cavernous fistula
|
Trauma
|
Ophthalmology
|
Proptosis, Enophthalmos, Developmental Anomalies
|
4b5cc976-e3f5-404d-87dc-1e68ef359c67
|
single
|
Glucogenic amino acid transported to the liver most commonly -
|
Ans. is 'a' i.e., Alanine o Transport of alanine from muscle to liver (glucose-alanine cycle) has two functions :-Providing substrate for giuconeogenesisTransport of ammonia (NH4+) to liver for urea synthesis.o During the first few days of starvation, there is a rapid breakdown of muscle protein, providing aminoacids for giuconeogenesis. The most important gluconeogenic amino acid is alanineQ (through glucose-alanine cycle). Alanine is released due to increased muscle protein breakdownQ and is transported to liver for giuconeogen-esis (glucose alanine cycle). The other important gluconeogenic amino acid in starvation is glutamine,o After some weeks of starvation, the rate of muscle breakdown decreases due to decreased need of glucose as a fuel for brain which has began using ketone bodies as a source of energy'. However, when the triacylglycerol stores are completely exhaused, muscle proteins once again enter in a stage of rapid depletion due to protein breakdown,o Alanine transport from muscle to liver has an important additional role, beside giuconeogenesis. Because muscle is incapable of synthesizing urea, most of the ammonia formed by protein catabolism is transferred to pyruvate to form alanine by transamination. Alanine is transported to liver where amino group of alanine is removed to form urea and the resulting pyruvate is converted to glucose by giuconeogenesis.o Thus, sources of alanine release from muscle are (i) Degradation of protein (ii) Transamination of pyruvate.o Besides alanine, lactate produced in muscles by anerobic use of glucose, also seves as a substrate for giuconeogenesis - cori cycle or lactic acid cycle
| 1
|
Alanine
|
Glycine
|
Lysine
|
Leucine
|
Biochemistry
|
Amino Acids Basics
|
d844ee84-474f-45f9-82bf-c4e074171e91
|
single
|
True regarding autonomic system is :
|
Ans. is 'c' is Preganglionic parasympathetic fibres are more lengthy The cell bodies of the post ganglionic parasympathetic neurons are located on or near the body of the viscera and therefore postganglionic neurons are very short.Whereas the cell bodies of the preganglionic parasympathetic neurons are located in the intermediolateral (IML) gray column of the spinal cord or the homologous motor nuclei of the cranial nerves. Therefore the preganglionic neurons have a long course.Ratio of preganglionic and post ganglionic fibres is not 20:1 but is 1:8 or 1:9.Conduction in autonomic fibres and in somatic motor fibres is not the same.Somatic motor fibres are of A. types* (Aa)Autonomic preganglionic axons are of B type*Autonomic postganglionic axons are of C type*Conduction speeds differ in all three A> B> C*Highest centre of integration is not medulla oblongata but hypothalamus.Also knowPreganglionic fibres are myelinated* whereas post ganglionic fibres are unmyelinated*Sympathetic outflow* is through - T1 to L3 & L4Parasympathetic outflow is - Cranio SacralCranial outflow* - III, VI, IX, X C.N.Sacral outflow* - S2 - 4
| 3
|
High center of integration is medulla oblongata.
|
Conduction autonomic fibers are same as in somatic motor fibers.
|
Preganglionic parasympathetic fibers are lengthier.
|
Ratio of pregnanglionic and post ganglionic fibers is 20:1.
|
Physiology
|
Autonomic Nervous System
|
180c140a-2e74-480c-80c4-84444955fd37
|
multi
|
All of the following statements are true regarding the submandibular gland except?
|
Submandibular gland Consist of large superficial pa and small deep pa Wrapped around the posterior border of Mylohyoid muscle. Lingual nerve loops around the submandibular duct Facial aery is related to superficial pa of the gland
| 4
|
Lingual nerve loops around the submandibular duct
|
Facial aery is related to superficial pa of the gland
|
The gland is wrapped around the posterior border of mylohyoid
|
Gland is made up of small superficial pa and large deep pa
|
Anatomy
|
Neck Triangles and parotid gland
|
c214e8df-96ab-4ec2-a03c-9ae1635e925c
|
multi
|
Which of the following is not evaluated using 99mm Tc- DMSA scintigraphy?
|
Ans DDMSA scan is used to study renal morphology thus out of given options only renal artery stenosis is not a renal morphological defect. Renal artery stenosis is studied by Captopril-DTPA scan
| 4
|
Renal anomalies
|
Renal pseudomass
|
Renal scarring
|
Renal artery stenosis
|
Radiology
|
Genito Urinary System
|
26c93082-d155-4d7a-8292-212ab8fba98b
|
single
|
DNA fingerprinting was first developed by?
|
DNA fingerprinting was developed by Alec JeffreyQ. Brain finger printing invented by Dr.Lawrence FarrelQ Brain Fingerprinting (Brain Mapping): Brain mapping is a group of neuroscience techniques based on the mapping the activities of the different areas of the brain. The electrical activities of the brain is measured & analysed. Is a computer-based test
| 1
|
Alec jeffreys
|
William herschelle
|
Edward hennery
|
Francis galton
|
Forensic Medicine
|
Human identification
|
f02d5b03-7dc1-4011-8742-807506ec2ff6
|
single
|
Valve of Rosenmuller is present in which pa of lacrimal system?
|
Answer- B. CanaliculiValve of Rosenmuller is a small flap of mucosa in lacrimal canaliculus at its junction with lacrimal sac.
| 2
|
Puncta
|
Canaliculi
|
Lacrimal sac
|
Nasolacrimal duct
|
Ophthalmology
| null |
a7eff991-869d-47d5-b2ee-4423876fa389
|
single
|
A 22 year old man presents to ENT OPD complaining of itching, earache and discharge from the ear. Discharge is watery in consistency and have musty odour. On examination, doctor found black headed filamentous growth which resembled wet blotting paper. Which of the following is likely diagnosis in this case?
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-Patient is suffering from otomycosis due to Aspergillus niger. Otomycosis Fungal infection of the external auditary canal C/F: Intense itching Pain in the ear (More with Aspergillus flavus) Watery discharge with a musty odour The fungal mass have wet blotting paper/newspaper appearance Causes - Aspergillus niger Aspergillus fumigatus Candida Appearance - Black headed filamentous growth Green or brown colour growth White & creamy deposit Treatment: Syringing,suctioning or mopping. Antifungals: Clotrimazole and povidine iodine
| 2
|
Acute Otitis externa
|
Otomycosis by Aspergillus niger
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Otomycosis by Aspergillus fumigatus
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Otomycosis by Candida
|
ENT
|
Diseases of External Ear
|
9dd8e20a-0f91-4796-a7d3-aad496ee33da
|
single
|
Length of LES is ?
|
Ans. is 'b' i.e., 3-4 cm The lower esophageal sphincter (LES) is a bundle of muscles at the low end of the esophagus, where it meets the stomach.When the LES is closed, it prevents acid and stomach contents from traveling backwards from the stomach.The LES muscles are not under voluntary control.Lower esophageal splincter is at diaphragmatic constriction.Normal abdominal LES length (3.1cm)The basal pressure of the LES is 10-45 mmHg.
| 2
|
1-2 cm
|
3-4 cm
|
1-2 mm
|
3-4 mm
|
Anatomy
| null |
b1dd8f8a-ab61-4c33-a902-bc777d93d4b4
|
single
|
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